Latest / Clearly Hormonal / Ep 07: Body Positivity & Metabolic Health with Dr. Matthea Rentea

Transcript

Ep 07: Body Positivity & Metabolic Health with Dr. Matthea Rentea · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to the Reset Recharge podcast with your host, Dr.
• 0:05
  Dr. Komal Patil-Sisodia: Komal Patil-Sisodia, a board certified endocrinologist, internist, and obesity medicine specialist.
• 0:11
  Dr. Komal Patil-Sisodia: This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health.
• 0:18
  Dr. Komal Patil-Sisodia: And recharge the conversations you are having with your healthcare providers.
• 0:22
  Dr. Komal Patil-Sisodia: While I am a physician, this podcast is purely for educational purposes.
• 0:26
  Dr. Komal Patil-Sisodia: No individualized medical advice is being given on this podcast.
• 0:29
  Dr. Komal Patil-Sisodia: If you do find information that is helpful, please discuss it with your healthcare provider at your next visit.
• 0:39
  Dr. Komal Patil-Sisodia: Hi, everyone.
• 0:40
  Dr. Komal Patil-Sisodia: Welcome back to Reset Recharge.
• 0:42
  Dr. Komal Patil-Sisodia: I'm excited to have Dr.
• 0:44
  Dr. Komal Patil-Sisodia: Matthea Rentea with us here today.
• 0:47
  Dr. Komal Patil-Sisodia: She is an internal medicine and obesity medicine physician who's been in practice for 10 years and she runs the Rentea Metabolic clinic, which is a metabolic health practice that is 100 percent virtual, which is such a cool model because it makes it so much easier and accessible to patients.
• 1:02
  Dr. Komal Patil-Sisodia: And you serve Indiana and Illinois, correct?
• 1:05
  Dr. Komal Patil-Sisodia: Yes.
• 1:05
  Dr. Komal Patil-Sisodia: Yes.
• 1:06
  Dr. Komal Patil-Sisodia: And you have a phenomenal podcast called the obesity guide, which I was really honored to be on last month, I think it was.
• 1:12
  Dr. Komal Patil-Sisodia: So thank you for joining us today.
• 1:15
  Dr. Matthea Rentea: Yes.
• 1:15
  Dr. Matthea Rentea: Thank you so much for having me.
• 1:17
  Dr. Matthea Rentea: I am absolutely loving your podcast and I tell everyone about it.
• 1:21
  Dr. Komal Patil-Sisodia: Thank you.
• 1:21
  Dr. Komal Patil-Sisodia: I feel the same way about yours.
• 1:23
  Dr. Komal Patil-Sisodia: We have a weight management practice in the clinic that I work in and my partners are loving your podcast and, so are the patients.
• 1:31
  Dr. Komal Patil-Sisodia: So thank you for that.
• 1:33
  Dr. Komal Patil-Sisodia: I'm excited to delve into the topic of body positivity and metabolic health.
• 1:38
  Dr. Komal Patil-Sisodia: We are in this time where Culturally there's a movement for body positivity supporting women who are in, or people in general, who are living in larger bodies.
• 1:50
  Dr. Komal Patil-Sisodia: But then there is this media push to look a certain way, right?
• 1:54
  Dr. Komal Patil-Sisodia: And we find that a lot of times people get caught in the middle between the two.
• 1:58
  Dr. Komal Patil-Sisodia: But what we forget about in this battle between being body positive or aspiring to what the media wants us to look like is What does that mean for our metabolic health?
• 2:08
  Dr. Komal Patil-Sisodia: Because I'm sure as in my practice, you've seen in yours, you can have people who are fitting the media ideal of what you should look like, but have terrible metabolic health and then vice versa.
• 2:20
  Dr. Komal Patil-Sisodia: I'd love to hear your thoughts on that, your experience with that.
• 2:24
  Dr. Komal Patil-Sisodia: And we can just go from there.
• 2:26
  Dr. Matthea Rentea: I, okay, I love this topic because media always makes things look black and white, right?
• 2:31
  Dr. Matthea Rentea: It's either this way or that way.
• 2:33
  Dr. Matthea Rentea: And what we know from clinical practice is that there, there is so much in between and it's so much more nuanced.
• 2:39
  Dr. Matthea Rentea: So I want to start first with how it's not either or I want to talk about that, but then remind me in case I forget, I literally did a podcast a few weeks ago and it was about how the BMI is wrong.
• 2:48
  Dr. Matthea Rentea: And I gave these two case studies where.
• 2:51
  Dr. Matthea Rentea: One person had a BMI 21 and they had a much higher body fat percentage and problems going on compared to the BMI 28.
• 2:58
  Dr. Matthea Rentea: And so it just tells us like size is not, it's not a good indicator of health, muscle mass, hormone balance, like it's not a good mix of any of that.
• 3:06
  Dr. Matthea Rentea: But just to start off with, I think what's, what always makes me not happy when I hear this in media, when you positivity movement, I don't understand why we can't also embrace metabolic health with that.
• 3:21
  Dr. Matthea Rentea: And one of the ways that I know I'll just tell you how it feels quite vicious at times.
• 3:25
  Dr. Matthea Rentea: So online, there's a really big creator and she has a really nice space and she really embraces a lot of the body positivity things.
• 3:32
  Dr. Matthea Rentea: And underneath one of her videos, one time.
• 3:34
  Dr. Matthea Rentea: They were talking about how hard it is to find a doctor that really embraces looking at your whole health and isn't just focused on the weight going down and things like that.
• 3:42
  Dr. Matthea Rentea: And so I made a comment, hey, maybe it's finding an obesity medicine physician because we're actually really not just caring about your weight.
• 3:48
  Dr. Matthea Rentea: We actually care about what your blood sugar is doing and your cholesterol and are you moving and active and what types of foods are you eating and how is your sleep like all the different pillars that we could look at if you're healthy.
• 4:00
  Dr. Matthea Rentea: And people attacked me in the comments because somewhere on my website it said weight management.
• 4:07
  Dr. Matthea Rentea: That there could, right?
• 4:09
  Dr. Komal Patil-Sisodia: Yeah that just breaks my heart.
• 4:11
  Dr. Komal Patil-Sisodia: It is such a touchy term.
• 4:13
  Dr. Komal Patil-Sisodia: Anytime you say obesity, anytime you say weight.
• 4:16
  Dr. Komal Patil-Sisodia: And I understand to a because that population has been so marginalized and in healthcare.
• 4:22
  Dr. Komal Patil-Sisodia: For the longest time people were hearing you need to just eat less and move more.
• 4:27
  Dr. Komal Patil-Sisodia: And we know that it's so much more than that, right?
• 4:30
  Dr. Komal Patil-Sisodia: So I can understand why there's so much medical PTSD around that.
• 4:35
  Dr. Komal Patil-Sisodia: I actually had the opportunity this last weekend to go meet with an Ehlers Danlos group here locally And they were like, That is a very underserved community as well.
• 4:44
  Dr. Komal Patil-Sisodia: And one woman actually said those words to me and I looked on their website this morning and, or their Instagram this morning, and they had this beautiful set of slides about medical PTSD.
• 4:54
  Dr. Komal Patil-Sisodia: And and I think that's what our population really struggles from.
• 4:58
  Dr. Komal Patil-Sisodia: Those who are living in bigger bodies, they have repeatedly been told and shamed.
• 5:03
  Dr. Komal Patil-Sisodia: And I can understand why you would react to a word like that, but there are truly people out there like you, your clinic.
• 5:12
  Dr. Komal Patil-Sisodia: It's such a beautiful space for patients to come and get help in a nonjudgmental way which I love.
• 5:18
  Dr. Komal Patil-Sisodia: So I'm sorry that happened to you.
• 5:21
  Dr. Matthea Rentea: I think, the thing, the thing about it is that, I think this whole medical space is really tough to navigate.
• 5:26
  Dr. Matthea Rentea: And so I think it is beautiful that there's a place where, you know, no matter what, we're going to celebrate things.
• 5:32
  Dr. Matthea Rentea: I don't think though that when you think about health at every size or body positivity, I don't know that any of these need to be exclusive to the other.
• 5:42
  Dr. Matthea Rentea: So what I really like to work on with patients I do like to work on body acceptance, or I more I want to say body neutrality.
• 5:48
  Dr. Matthea Rentea: I'm really not trying to get people to a place where, oh, we're massively happy and we're just like over the moon.
• 5:53
  Dr. Matthea Rentea: But I do actually incorporate in my clinic, a lot of body image work.
• 5:57
  Dr. Matthea Rentea: I bring in some other people to help me with that as well, because I'm not trying to claim to be the expert on everything.
• 6:02
  Dr. Matthea Rentea: But a lot of it does go into things because I can.
• 6:06
  Dr. Matthea Rentea: Work with you on explaining to you what are the actual parameters that we can look at for health, things like that.
• 6:11
  Dr. Matthea Rentea: But if you keep getting inundated 99 percent of the other times with social media messaging on you need to look a certain way and this is the only, you keep getting compared to that.
• 6:20
  Dr. Matthea Rentea: It's really hard to hold fast to, but these are the things that actually matter.
• 6:25
  Dr. Matthea Rentea: And so I think part of the conversation has to be that.
• 6:28
  Dr. Matthea Rentea: What I like to tell my patients is maybe one person doesn't get the say over what your health is.
• 6:33
  Dr. Matthea Rentea: Maybe it's like collectively, you're going to listen to a few different people.
• 6:37
  Dr. Matthea Rentea: You're going to see what works.
• 6:38
  Dr. Matthea Rentea: You're going to drop the rest.
• 6:39
  Dr. Matthea Rentea: And that's a very different place to come from compared to thinking you're going to find this one guru or this one leader.
• 6:46
  Dr. Matthea Rentea: And it's a problem because everyone is flawed, like even me, there's going to be things at times that later I'm going to realize we're not right and so people need to realize there's not one thing that's ever going to have all the answers.
• 6:59
  Dr. Matthea Rentea: It's I know it's not fun to hear though.
• 7:01
  Dr. Komal Patil-Sisodia: Yeah, no, it's not and it's confusing right because when you're feeling miserable or you, your health is going in a direction that you don't want it to, you want that one answer, right?
• 7:11
  Dr. Komal Patil-Sisodia: As humans, I think we desperately cling to trying to find the one thing that we can fix We're problem solvers.
• 7:17
  Dr. Komal Patil-Sisodia: And when patients come into my office for endocrine issues, I see the same thing.
• 7:22
  Dr. Komal Patil-Sisodia: They want an answer.
• 7:23
  Dr. Komal Patil-Sisodia: Is it my thyroid?
• 7:24
  Dr. Komal Patil-Sisodia: Is it my adrenals?
• 7:26
  Dr. Komal Patil-Sisodia: What can you give me to fix this?
• 7:27
  Dr. Komal Patil-Sisodia: And when we do blood work and it comes back negative or normal it becomes such a devastating thing because all of a sudden I've taken the option of a fixable problem away from somebody when they were really hoping that was the case.
• 7:43
  Dr. Komal Patil-Sisodia: And that is a really hard thing to manage.
• 7:46
  Dr. Komal Patil-Sisodia: What are my expectations around what I can do for my health?
• 7:50
  Dr. Komal Patil-Sisodia: And to your point, what we know now is going to be different than what we know five years from now.
• 7:55
  Dr. Komal Patil-Sisodia: So our thought process is constantly evolving, which is why you can't get stuck on just one facet of your health, right?
• 8:04
  Dr. Matthea Rentea: Completely.
• 8:05
  Dr. Matthea Rentea: And what, okay, so what you were saying, and I want to expand on this, this sort of what is possible for you and diversity and things like that.
• 8:12
  Dr. Matthea Rentea: So the way I like to explain to patients, it's based on, I'm just going to come from a weight set point for a second, so based on where you are, people think that they can just pick a random number down on the scale and they're like, that's where we're going to end.
• 8:24
  Dr. Matthea Rentea: Like that's what it is, Dr.
• 8:25
  Dr. Matthea Rentea: Rentea, like we're, I'm here at 250 and I'm just going to decide 120 is where I'm going to be.
• 8:30
  Dr. Matthea Rentea: And I often ask, I'm like, where did this come from?
• 8:32
  Dr. Matthea Rentea: Is this where you last felt great?
• 8:34
  Dr. Matthea Rentea: Is this when you were last active?
• 8:35
  Dr. Matthea Rentea: Was this high school weight?
• 8:37
  Dr. Matthea Rentea: So part of my intake is really trying to understand.
• 8:40
  Dr. Matthea Rentea: I mean, I don't mean to laugh when I say this, but like, where is it coming from?
• 8:43
  Dr. Matthea Rentea: And oftentimes it will be like a pre child weight, it will be a prepubescent weight often, which is the saddest when you're hearing, Oh, that's what I was.
• 8:52
  Dr. Matthea Rentea: When I was like 14 years old, like you hadn't even fully matured, like life didn't happen.
• 8:57
  Dr. Matthea Rentea: And so one thing I really like to express upon people is your body is going to be able to achieve optimally what we can get it to do, but it's not, we're not going to be able to force this to for you to magically get to certain numbers.
• 9:09
  Dr. Matthea Rentea: That's where you really get into the land with disordered eating.
• 9:12
  Dr. Matthea Rentea: And.
• 9:13
  Dr. Matthea Rentea: Also like some of us don't feel good being active 24 seven.
• 9:16
  Dr. Matthea Rentea: I know that's really like the way that we're like, Oh, like you should be active all the time.
• 9:19
  Dr. Matthea Rentea: Some people don't feel nauseous and sick and dizzy when they're too active.
• 9:23
  Dr. Matthea Rentea: And so you're going to be able to get to where you can get to.
• 9:26
  Dr. Matthea Rentea: So it's like diversity of size does need to be in your thought process.
• 9:31
  Dr. Matthea Rentea: And so one practical thing I want to offer to people, if this is a struggle for you, it's like, You're thinking, no, but I want to be less.
• 9:36
  Dr. Matthea Rentea: And the media tells me I need to be less.
• 9:38
  Dr. Matthea Rentea: You need to start to, I would say on social media, if you spend time on there, diversify what you're seeing.
• 9:44
  Dr. Matthea Rentea: So I call this like you need to be looking at different body shapes and sizes.
• 9:47
  Dr. Matthea Rentea: This needs to be part of what is normalized to you because otherwise you always think that you're a problem how you are.
• 9:54
  Dr. Matthea Rentea: And I want to guarantee you that there are other people in the world that look the exact same as you that are dressing in amazing ways that are living great lives.
• 10:01
  Dr. Matthea Rentea: Yeah.
• 10:01
  Dr. Matthea Rentea: And you need to normalize that.
• 10:03
  Dr. Matthea Rentea: Otherwise, you always feel like it's a problem.
• 10:06
  Dr. Komal Patil-Sisodia: I completely agree.
• 10:07
  Dr. Komal Patil-Sisodia: I saw a patient probably six months ago now and our interaction was burned into my brain because she came in obviously very I see her for Something not related to weight, but came in, obviously an extremely fit person works out all the time was when I asked about symptoms just said I've gained weight and I'm not happy about it because I've always been this one weight and I said what did you change?
• 10:33
  Dr. Komal Patil-Sisodia: So we talked through things.
• 10:34
  Dr. Komal Patil-Sisodia: Well, she'd been eating more protein and doing more strength training.
• 10:37
  Dr. Komal Patil-Sisodia: It was all muscle mass.
• 10:38
  Dr. Komal Patil-Sisodia: She looked.
• 10:39
  Dr. Komal Patil-Sisodia: Fabulous.
• 10:40
  Dr. Komal Patil-Sisodia: But she was so tied to that one number on the scale.
• 10:45
  Dr. Komal Patil-Sisodia: And I said, if you lose muscle, we're at that age range where it's actually going to negatively impact your bones.
• 10:51
  Dr. Komal Patil-Sisodia: So don't do like everything you're doing right now, even though you don't love that number on the scale.
• 10:57
  Dr. Komal Patil-Sisodia: I promise you that you are metabolically better off than you were.
• 11:02
  Dr. Komal Patil-Sisodia: At that lower weight because you have more muscle, your bones are stronger as a result and it did not land.
• 11:10
  Dr. Matthea Rentea: It's interesting, right?
• 11:12
  Dr. Matthea Rentea: But this is another thing, too.
• 11:13
  Dr. Matthea Rentea: If someone is not willing to accept it, it does not matter what you're going to say.
• 11:17
  Dr. Matthea Rentea: This is something I've really had to learn as a physician.
• 11:19
  Dr. Matthea Rentea: I'm not here to convince you.
• 11:21
  Dr. Matthea Rentea: I'm here to share things, and are you open?
• 11:23
  Dr. Matthea Rentea: Are you ready?
• 11:24
  Dr. Matthea Rentea: Am I the right person to deliver it?
• 11:26
  Dr. Matthea Rentea: That's a very hard thing, actually, for physicians to hear, right?
• 11:30
  Dr. Matthea Rentea: What you're saying, I'm like, yeah, I'm on board, but she is not ready for that yet.
• 11:34
  Dr. Komal Patil-Sisodia: She was not ready for it.
• 11:36
  Dr. Komal Patil-Sisodia: So we kind of let it go.
• 11:37
  Dr. Komal Patil-Sisodia: And I said, I think focus on the healthy lifestyle and just how your clothes are fitting.
• 11:41
  Dr. Komal Patil-Sisodia: Yeah.
• 11:42
  Dr. Komal Patil-Sisodia: And I, I said to her, what our good friend, Dr.
• 11:44
  Dr. Komal Patil-Sisodia: Ali Novitsky always says, your weight is your gravitational pull on this earth for this moment in time.
• 11:51
  Dr. Komal Patil-Sisodia: It's a neutral number but that also probably did not land well, right?
• 11:55
  Dr. Komal Patil-Sisodia: And, speaking of things not landing well, I know you and I were talking several months ago, there's a musician who is known for being very body positive and living in a bigger body.
• 12:05
  Dr. Komal Patil-Sisodia: And when they Started to get healthy.
• 12:08
  Dr. Komal Patil-Sisodia: There were a lot of their fans who were really upset because they took that that person's health journey meant that they were no longer representing body positivity.
• 12:19
  Dr. Komal Patil-Sisodia: And that's not the case.
• 12:20
  Dr. Komal Patil-Sisodia: You can be in a bigger body.
• 12:22
  Dr. Komal Patil-Sisodia: You can be metabolically healthy.
• 12:23
  Dr. Komal Patil-Sisodia: You can be committed to your health.
• 12:25
  Dr. Komal Patil-Sisodia: All of those things do not have to be mutually exclusive, right?
• 12:28
  Dr. Komal Patil-Sisodia: To your point, if we're not diversifying our lens and looking across at all of the different body types that exist, all of the different pictures of health that exist, we're going to keep trying to put like a square peg into a round hole.
• 12:42
  Dr. Komal Patil-Sisodia: It's not going to work.
• 12:43
  Dr. Matthea Rentea: Exactly.
• 12:44
  Dr. Matthea Rentea: What's interesting is we never know people's stories, right?
• 12:47
  Dr. Matthea Rentea: Talking about that, you're talking about that celebrity there, there was, this girl's not as big, but I followed her on social since I was a teenager.
• 12:53
  Dr. Matthea Rentea: Okay.
• 12:54
  Dr. Matthea Rentea: People that's let's say it's been a few, a little while since then.
• 12:56
  Dr. Matthea Rentea: So the point is, I remember I really liked her channel because I was in a plus size girl growing up and she was, and I, she would say different plus size fashion halls.
• 13:06
  Dr. Matthea Rentea: Okay.
• 13:07
  Dr. Matthea Rentea: You know how it is when you're growing up, you're trying to look for what are the ideas for things.
• 13:11
  Dr. Matthea Rentea: And then I remember it came out that she'd had a tummy tuck and then later on she got bariatric surgery and all these things.
• 13:15
  Dr. Matthea Rentea: She was never really forthright with the things were happening.
• 13:18
  Dr. Matthea Rentea: It was always afterward.
• 13:19
  Dr. Matthea Rentea: And what I've really come to realize is we had no right to know we had no right.
• 13:24
  Dr. Matthea Rentea: It didn't matter.
• 13:25
  Dr. Matthea Rentea: So I feel it like I've gone through it too, but it's very interesting.
• 13:28
  Dr. Matthea Rentea: Now, myself being on social media, I realize It's not people's right to know every single thing.
• 13:33
  Dr. Matthea Rentea: They don't know your history.
• 13:34
  Dr. Matthea Rentea: It turned out that she couldn't get pregnant.
• 13:36
  Dr. Matthea Rentea: It was actually a blocker for fertility, right?
• 13:39
  Dr. Matthea Rentea: We didn't know all this.
• 13:40
  Dr. Matthea Rentea: We didn't need to know all this.
• 13:41
  Dr. Matthea Rentea: And so it's very interesting, the, how attached we get to the identity that people put out there.
• 13:45
  Dr. Matthea Rentea: But this is another thing I want to get out there is you can change at any moment.
• 13:49
  Dr. Matthea Rentea: You could decide, I now want to be more active.
• 13:51
  Dr. Matthea Rentea: Like I, I share this very openly that in the past, like six, seven years ago at this point, now it's been a lot of years.
• 13:57
  Dr. Matthea Rentea: I would be in clinic.
• 13:59
  Dr. Matthea Rentea: I would get up at 5 36 in the morning.
• 14:01
  Dr. Matthea Rentea: I was in the office by 6 30.
• 14:03
  Dr. Matthea Rentea: I would be there till nine when I 9 p.
• 14:06
  Dr. Matthea Rentea: m.
• 14:07
  Dr. Matthea Rentea: When I came into the clinic, I inherited an entire full panel.
• 14:10
  Dr. Matthea Rentea: Think thousands of patients all at once.
• 14:12
  Dr. Matthea Rentea: I know you're like that.
• 14:13
  Dr. Matthea Rentea: I was in primary care.
• 14:14
  Dr. Matthea Rentea: It was intense, and I didn't want to do a bad job.
• 14:17
  Dr. Matthea Rentea: I want to make sure to look everyone up thoroughly.
• 14:19
  Dr. Matthea Rentea: So even though my day would end at five, I would spend hours looking the next day of answering messages like it was overwhelming.
• 14:25
  Dr. Matthea Rentea: And that did end up getting to me from a standpoint of health and how I was taking care of myself.
• 14:30
  Dr. Matthea Rentea: And so I decided at some point, life is going to change.
• 14:34
  Dr. Matthea Rentea: I want to get more active.
• 14:35
  Dr. Matthea Rentea: I don't want to sit here all day.
• 14:37
  Dr. Matthea Rentea: You can make those changes, but you don't need to justify it to other people.
• 14:41
  Dr. Matthea Rentea: I'm sure my patients didn't understand when I left, they didn't know all the things that went into it.
• 14:46
  Dr. Matthea Rentea: And it's not their space to know either.
• 14:48
  Dr. Komal Patil-Sisodia: No, it exactly.
• 14:49
  Dr. Komal Patil-Sisodia: And that, that gets, that is so in parallel with this.
• 14:54
  Dr. Komal Patil-Sisodia: culture of overexposure.
• 14:55
  Dr. Komal Patil-Sisodia: We put so many pieces of our lives out there for public consumption, which is all fine and good.
• 15:02
  Dr. Komal Patil-Sisodia: But, we, at some point in that journey, you realize that to your point, you don't owe anybody any explanation or anything like that And it's this culture around social media I see this in the menopause space, What I find a little jarring is that hormones are one treatment option, right?
• 15:23
  Dr. Komal Patil-Sisodia: And they're fantastic.
• 15:24
  Dr. Komal Patil-Sisodia: If you can have them.
• 15:26
  Dr. Komal Patil-Sisodia: We should be offering hormones to all women who can have them, but it's not something that you have to do.
• 15:33
  Dr. Komal Patil-Sisodia: That decision is yours.
• 15:35
  Dr. Komal Patil-Sisodia: If it's not for you, that's okay.
• 15:37
  Dr. Komal Patil-Sisodia: There are other non hormonal prescription treatment options.
• 15:40
  Dr. Komal Patil-Sisodia: There are lifestyle things that you can do.
• 15:42
  Dr. Komal Patil-Sisodia: in our quest for creating one clear path forward, we marginalized so many people that feel like they now can't be part of this movement, right?
• 15:53
  Dr. Komal Patil-Sisodia: And it's it, I feel like body positivity and metabolic health have also taken a parallel track, right?
• 15:59
  Dr. Komal Patil-Sisodia: It's that either or mentality, but you can be both.
• 16:03
  Dr. Matthea Rentea: It's interesting, right?
• 16:04
  Dr. Matthea Rentea: Because everyone feels different in a different body or with different parameters.
• 16:09
  Dr. Matthea Rentea: I just want to take blood sugar, for example, right?
• 16:10
  Dr. Matthea Rentea: I'm sure you have to hear this in the clinic too.
• 16:13
  Dr. Matthea Rentea: Some people, when they're working with me, like even in the pre diabetic range, they're actually starting to get some neuropathy, which if you're not medical and you're listening, like they're starting to get some numbness and tingling in areas.
• 16:22
  Dr. Matthea Rentea: They're actually starting to already get some of the symptoms that maybe someone else would need to have already had diabetes for a while.
• 16:28
  Dr. Matthea Rentea: And so it's very interesting.
• 16:30
  Dr. Matthea Rentea: Like they might be more thirsty.
• 16:31
  Dr. Matthea Rentea: Like all these things are happening where you think, no, you need to have been so much further progressed, but in their body at that health, they're not feeling good with it.
• 16:39
  Dr. Matthea Rentea: And who knows if it suddenly started for them versus slowly over time.
• 16:43
  Dr. Matthea Rentea: And so it's I think the thing number two here, if I had like the diversity, I really wanted to make sure we talked about that thing.
• 16:47
  Dr. Matthea Rentea: Number two is, what is health to you?
• 16:50
  Dr. Matthea Rentea: And maybe you nerd out more on the numbers.
• 16:53
  Dr. Matthea Rentea: Maybe you're more intuitive in your body.
• 16:54
  Dr. Matthea Rentea: And you're like, I just want to I just want to feel good.
• 16:56
  Dr. Matthea Rentea: Like little check in daily.
• 16:58
  Dr. Matthea Rentea: I like how I feel, but you need to, I think you need to actually, and this is me as a physician, I think you need to have it very clearly defined what healthy is going to look like for you, because otherwise it's always a moving target that's never achieved.
• 17:10
  Dr. Matthea Rentea: If we think about that patient of yours, like sounds like she's incredibly healthy, but in her mind, no, no, no, because the scale number.
• 17:17
  Dr. Matthea Rentea: And then she's not willing probably to get a body composition test or do anything else that would look at the realities.
• 17:22
  Dr. Matthea Rentea: Is that reasonable for me to get to that?
• 17:25
  Dr. Matthea Rentea: If you know what health, what you're defining as health, then you can check in.
• 17:29
  Dr. Matthea Rentea: Is this reasonable or not?
• 17:30
  Dr. Matthea Rentea: You could talk to a doctor, you could talk to friends, but oftentimes in our mind, we sort of tell these stories that don't fully make sense.
• 17:37
  Dr. Matthea Rentea: And so I think it needs to be really concrete.
• 17:40
  Dr. Matthea Rentea: Cause I don't know.
• 17:41
  Dr. Matthea Rentea: Do you, do you do that?
• 17:42
  Dr. Matthea Rentea: Do you think to yourself, like what health means do you know in your mind?
• 17:45
  Dr. Komal Patil-Sisodia: I, I do, and I will tell you, I, but that's a very recent thing for me, right?
• 17:50
  Dr. Komal Patil-Sisodia: I've talked about this on another podcast episode, like, if you look at me and my three sisters, we're from the same gene pool, but I have never been as tiny or petite as them, and I probably never will be.
• 17:59
  Dr. Komal Patil-Sisodia: I tried at one point, I think in college, I got close.
• 18:03
  Dr. Komal Patil-Sisodia: But I felt awful and I looked awful.
• 18:05
  Dr. Komal Patil-Sisodia: I like did not like the way that I looked.
• 18:08
  Dr. Komal Patil-Sisodia: And it was not the right weight for my body type.
• 18:10
  Dr. Komal Patil-Sisodia: I am a more muscular person.
• 18:11
  Dr. Komal Patil-Sisodia: So therefore I'm going to weigh more.
• 18:13
  Dr. Komal Patil-Sisodia: But to get to that mental space of knowing that, I'm okay with that.
• 18:19
  Dr. Komal Patil-Sisodia: That was a really long journey, right?
• 18:21
  Dr. Komal Patil-Sisodia: Because you have all of these cultural, societal, the medical stuff that we tell ourselves as we go through and it can create it can create this picture in your mind that, that becomes unattainable, right?
• 18:34
  Dr. Komal Patil-Sisodia: I will say it was just, Probably just five, four or five years ago that I stopped saving the clothes that I was going to one day fit into the most cathartic thing for me to, to send everything off to thread up and get, money back that I could then go spend on clothes that actually fit me.
• 18:55
  Dr. Komal Patil-Sisodia: Instead of holding on to this preconception it was a very symbolic moment for me, right?
• 18:59
  Dr. Komal Patil-Sisodia: Cathartic, symbolic, let go of that mindset, let go of those clothes, but it took a long time to get there.
• 19:05
  Dr. Komal Patil-Sisodia: And every now and then when I'm on social media and I feel myself like slipping looking at only one sort of person.
• 19:12
  Dr. Komal Patil-Sisodia: It's something that I have to intentionally work at being aware of, which I think that that's it for most of us if you've grown up purely with social media, I think.
• 19:22
  Dr. Komal Patil-Sisodia: You and I were lucky in that we didn't have it for all of our lives, right?
• 19:27
  Dr. Komal Patil-Sisodia: And I'm older than you are.
• 19:28
  Dr. Komal Patil-Sisodia: I didn't even have a cell phone until I started medical school, right?
• 19:31
  Dr. Komal Patil-Sisodia: Let alone a smartphone wasn't till much later.
• 19:35
  Dr. Komal Patil-Sisodia: So I just didn't have that degree of exposure.
• 19:38
  Dr. Komal Patil-Sisodia: I think that also plays into it.
• 19:41
  Dr. Komal Patil-Sisodia: And how you try and diversify your mindset.
• 19:44
  Dr. Komal Patil-Sisodia: I feel like I got off on a tangent there.
• 19:46
  Dr. Matthea Rentea: No, completely.
• 19:46
  Dr. Matthea Rentea: You actually remind me, you said a good comment how you were saying how you and your siblings, you come from the same gene pool.
• 19:51
  Dr. Matthea Rentea: Same with me.
• 19:52
  Dr. Matthea Rentea: It's interesting, right?
• 19:53
  Dr. Matthea Rentea: Like I have some sisters that are, Lower weight set points.
• 19:56
  Dr. Matthea Rentea: Some of us that are higher weight.
• 19:57
  Dr. Matthea Rentea: What was interesting is so nerdy moment We both got on the in body scale And if those of you that are listening don't know it's a body composition scale and I have 23 more pounds of muscle Compared to my other sister.
• 20:09
  Dr. Matthea Rentea: And so do you know what I was sitting there?
• 20:10
  Dr. Matthea Rentea: I was like, I understand I'm more overweight, but it's but I'm just gonna like just like that for a moment That I have much more muscle and that it's right.
• 20:19
  Dr. Matthea Rentea: You just sit there and it's always glorified.
• 20:22
  Dr. Matthea Rentea: Oh, her weight's better.
• 20:23
  Dr. Matthea Rentea: But no, let's just stop for a second.
• 20:26
  Dr. Matthea Rentea: We, we can all work where we're at.
• 20:29
  Dr. Matthea Rentea: Yes.
• 20:30
  Dr. Matthea Rentea: That's the reality.
• 20:31
  Dr. Matthea Rentea: So it was so funny.
• 20:32
  Dr. Matthea Rentea: I thought to myself, even if we were to account for the muscle, like I would never, I would never be where she is.
• 20:38
  Dr. Matthea Rentea: That would, it would literally never happen unless I wanted to lose 23 pounds of muscle.
• 20:42
  Dr. Matthea Rentea: That's a no.
• 20:43
  Dr. Matthea Rentea: Oh, no.
• 20:44
  Dr. Komal Patil-Sisodia: Metabolically, that just sounds so bad to me.
• 20:46
  Dr. Komal Patil-Sisodia: I'm like, no, don't do it.
• 20:49
  Dr. Komal Patil-Sisodia: Don't do it.
• 20:51
  Dr. Komal Patil-Sisodia: Muscle is our friend.
• 20:52
  Dr. Komal Patil-Sisodia: So it's yeah, but I, but it is one of those things, where you have society shaping what you're trying to push yourself towards being.
• 21:00
  Dr. Komal Patil-Sisodia: So I love that.
• 21:01
  Dr. Komal Patil-Sisodia: That concept of diversity and your suggestion to look across at different types of people, different accounts that you may follow on social media to get a better idea of what you want your health journey to look like.
• 21:14
  Dr. Komal Patil-Sisodia: And then in real life, talking to different doctors and then establishing what you really want your health journey to look like for you.
• 21:21
  Dr. Komal Patil-Sisodia: Yeah.
• 21:22
  Dr. Komal Patil-Sisodia: I, and to your point earlier about the blood sugars and pre-diabetes versus diabetes, you are spot on.
• 21:28
  Dr. Komal Patil-Sisodia: I have some people who can feel their blood sugars and they feel crummy when they're getting up into the higher one hundreds.
• 21:35
  Dr. Komal Patil-Sisodia: I have some patients who don't feel it till they're like three, 400, and even then they're like, oh, fine.
• 21:40
  Dr. Komal Patil-Sisodia: I feel good.
• 21:41
  Dr. Komal Patil-Sisodia: And I'm like, really?
• 21:42
  Dr. Komal Patil-Sisodia: Because I don't think you should feel good.
• 21:44
  Dr. Komal Patil-Sisodia: They actually feel worse when I drop them.
• 21:46
  Dr. Komal Patil-Sisodia: Oh, completely.
• 21:47
  Dr. Komal Patil-Sisodia: As it rose so slowly and then hit that point and just stayed there.
• 21:51
  Dr. Komal Patil-Sisodia: Yeah.
• 21:52
  Dr. Komal Patil-Sisodia: Yeah.
• 21:53
  Dr. Komal Patil-Sisodia: It's always interesting when I work with people, I'm like we don't want to get it done too quick.
• 21:55
  Dr. Komal Patil-Sisodia: Cause then you'll actually feel even worse.
• 21:57
  Dr. Komal Patil-Sisodia: And it's they're like, really?
• 21:58
  Dr. Komal Patil-Sisodia: Yeah.
• 21:58
  Dr. Komal Patil-Sisodia: When I first started in practice, I had this patient come in to see me and she was drinking four, two liter bottles of soda a day.
• 22:10
  Dr. Matthea Rentea: Wow.
• 22:10
  Dr. Komal Patil-Sisodia: It was, yeah, and I said to her, all we have to do is get you off the soda.
• 22:15
  Dr. Komal Patil-Sisodia: And I, for the first, And last time in my career, I made a soda titration schedule where we went down by a certain number of ounces.
• 22:25
  Dr. Komal Patil-Sisodia: And we did this over like a period of months.
• 22:28
  Dr. Komal Patil-Sisodia: And she came back to see me and she was like, I hate this.
• 22:32
  Dr. Komal Patil-Sisodia: And I'm going to go back to drinking my soda, and I'm never going to come back and see you again.
• 22:36
  Dr. Komal Patil-Sisodia: And her sugars were stone cold normal when she came back to see me.
• 22:40
  Dr. Komal Patil-Sisodia: And I was like, oh no, I'm so sorry.
• 22:43
  Dr. Komal Patil-Sisodia: But she wasn't mentally ready, right?
• 22:44
  Dr. Komal Patil-Sisodia: And she said as much.
• 22:45
  Dr. Komal Patil-Sisodia: She said, in doing this, I've had a lot of other mental health stuff come up, and I just can't do this right now.
• 22:52
  Dr. Komal Patil-Sisodia: And I respect that.
• 22:54
  Dr. Matthea Rentea: Isn't this okay?
• 22:55
  Dr. Matthea Rentea: These stories.
• 22:56
  Dr. Matthea Rentea: I don't know.
• 22:56
  Dr. Matthea Rentea: I don't think you've shared these before.
• 22:58
  Dr. Matthea Rentea: I'm a super fan of yours.
• 22:59
  Dr. Matthea Rentea: Okay.
• 23:01
  Dr. Matthea Rentea: So I think these are so powerful as well, because I can tell you stories where it's so funny that these stick out in our mind.
• 23:08
  Dr. Matthea Rentea: I remember that the part of town where I practice my primary care clinic was very much so underserved.
• 23:14
  Dr. Matthea Rentea: And one of the concerns would be financial, which I can understand with food.
• 23:18
  Dr. Matthea Rentea: And I remember.
• 23:20
  Dr. Matthea Rentea: Saying, well, kind of thinking along your lines can we swap one soda?
• 23:24
  Dr. Matthea Rentea: Can we get these beans?
• 23:25
  Dr. Matthea Rentea: Can we do that?
• 23:26
  Dr. Matthea Rentea: Like I, I knew the prices at the store and I was like, we can make this work.
• 23:29
  Dr. Matthea Rentea: And the reality is it's either something that people see the value in wanting to change or like it's what did I hear the other day?
• 23:36
  Dr. Matthea Rentea: They're matching your urgency.
• 23:38
  Dr. Matthea Rentea: Like they're actually taking it as urgent.
• 23:40
  Dr. Matthea Rentea: But the reality is we're all human.
• 23:42
  Dr. Matthea Rentea: And I get it because I've been on the other side of things as well.
• 23:44
  Dr. Matthea Rentea: And I think, honestly, this is the kind of doctor, this is probably why people see us because we understand you're going to be where you're going to be.
• 23:52
  Dr. Matthea Rentea: And you're only going to make changes when you're ready.
• 23:54
  Dr. Matthea Rentea: And it's not all a straight line.
• 23:56
  Dr. Matthea Rentea: And I just think it's so powerful to hear that.
• 23:58
  Dr. Matthea Rentea: I thought you were going to tell me she was just so happy.
• 24:01
  Dr. Komal Patil-Sisodia: No, that's what I was hoping for.
• 24:02
  Dr. Komal Patil-Sisodia: And she came in and I was shocked, but it was a good learning lesson early in my career that You know, even though you're teaching somebody to do the right thing, they, again, may not be in a place where that they, where they can receive it.
• 24:15
  Dr. Komal Patil-Sisodia: And she clearly wasn't And it was, I hope she's okay now.
• 24:20
  Dr. Komal Patil-Sisodia: I hope she's found a situation that that has helped her get her health back on track.
• 24:25
  Dr. Komal Patil-Sisodia: But that's the other thing.
• 24:26
  Dr. Komal Patil-Sisodia: We don't talk about the interplay of mental health with physical health.
• 24:31
  Dr. Komal Patil-Sisodia: And whether, and this brings up a really good point as to whether you are in a place where you can receive that type of information or that type of help.
• 24:41
  Dr. Matthea Rentea: I was listening to there's another obesity medicine doctor online that I really like, and she said, she made a reel the other day, and she was talking about how basically, at least in my space with, as far as weight management, it's about 50 percent endocrine and 50 percent mental health.
• 24:55
  Dr. Matthea Rentea: And she was saying, look, we got to get a lot better at these psychiatry meds and what we're thinking and how people are feeling because that's about 50 percent of it.
• 25:01
  Dr. Matthea Rentea: And I agree.
• 25:02
  Dr. Matthea Rentea: I could imagine maybe getting rid of all that sugar, made depression worse, made anxiety worse.
• 25:06
  Dr. Matthea Rentea: I don't know.
• 25:06
  Dr. Komal Patil-Sisodia: Because it lights up dopamine receptors, right?
• 25:08
  Dr. Matthea Rentea: Totally.
• 25:09
  Dr. Matthea Rentea: It's definitely a tool.
• 25:10
  Dr. Matthea Rentea: And yeah, it's just fascinating.
• 25:12
  Dr. Matthea Rentea: And I think to your point, so when people are looking at when people are looking at what their health means, keeping an individual to you.
• 25:19
  Dr. Matthea Rentea: Do not be comparing to others because your body, your capability, your genetics, your potential, it might look a lot different.
• 25:25
  Dr. Matthea Rentea: And it's very much so a compare and despair thing.
• 25:27
  Dr. Matthea Rentea: And like you said, you have to constantly refocus yourself.
• 25:30
  Dr. Matthea Rentea: I have to do the same thing because we get into groups.
• 25:33
  Dr. Matthea Rentea: Like I'll give you an example of the one we're in right now where it's okay, everyone's working on health and fitness.
• 25:38
  Dr. Matthea Rentea: And then I'll sit there and be like they've lost more or they're doing this or they're doing that.
• 25:41
  Dr. Matthea Rentea: And I'm like, Hold on.
• 25:43
  Dr. Matthea Rentea: You had a move.
• 25:44
  Dr. Matthea Rentea: You still walked.
• 25:46
  Dr. Matthea Rentea: I have to just re qualify the positives for myself.
• 25:49
  Dr. Matthea Rentea: And then I get happy instantly.
• 25:51
  Dr. Matthea Rentea: But if you sit there and compare to others, it's a really long road.
• 25:55
  Dr. Matthea Rentea: So I always say, You stay in your own lane.
• 25:58
  Dr. Matthea Rentea: You are in your own car.
• 26:00
  Dr. Matthea Rentea: You're not going to involve others in this unless you invite them in.
• 26:05
  Dr. Matthea Rentea: And it's helpful.
• 26:05
  Dr. Matthea Rentea: Otherwise, you're going to stay in your own lane.
• 26:07
  Dr. Komal Patil-Sisodia: Yeah, I love that.
• 26:09
  Dr. Komal Patil-Sisodia: My dad used to tell us that when we were growing up in terms of like how you set a bar for yourself.
• 26:16
  Dr. Komal Patil-Sisodia: You should be the only one you're measuring yourself against because there will always be people doing quote unquote better or what you perceive to be better, right?
• 26:25
  Dr. Komal Patil-Sisodia: So you should be competing with yourself.
• 26:27
  Dr. Komal Patil-Sisodia: And when you reach a certain point, you get to decide whether you move that finish line forward or be okay with where you're at.
• 26:36
  Dr. Komal Patil-Sisodia: And I thought that was really good advice.
• 26:38
  Dr. Komal Patil-Sisodia: And I feel like that has stuck with me for many years.
• 26:40
  Dr. Matthea Rentea: Yeah.
• 26:41
  Dr. Matthea Rentea: Yeah.
• 26:41
  Dr. Matthea Rentea: That's so good.
• 26:43
  Dr. Komal Patil-Sisodia: I would love to hear more about the body image work that you do in your practice and how you get people to a point where they can, be okay with what their body image is, but still be working simultaneously on health goals.
• 26:58
  Dr. Komal Patil-Sisodia: Yeah.
• 26:58
  Dr. Komal Patil-Sisodia: And people go through so many.
• 27:00
  Dr. Komal Patil-Sisodia: Women especially go through so many different changes between puberty, pregnancies, if you have them, menopause.
• 27:08
  Dr. Komal Patil-Sisodia: Bodies are shifting constantly.
• 27:09
  Dr. Komal Patil-Sisodia: So it is lifelong work for women because we're never going to look the same at any given stage in our life.
• 27:15
  Dr. Matthea Rentea: Yeah.
• 27:16
  Dr. Matthea Rentea: Yeah, awesome.
• 27:17
  Dr. Matthea Rentea: Such a good question.
• 27:17
  Dr. Matthea Rentea: So everything's always shifting, right?
• 27:19
  Dr. Matthea Rentea: So people need to hear that you're not alone.
• 27:20
  Dr. Matthea Rentea: If you're suddenly looking in the mirror and you're saying, wait, it never looked this way before.
• 27:24
  Dr. Matthea Rentea: Maybe even your weight's the same, but the distribution's different.
• 27:27
  Dr. Matthea Rentea: So these are all, this is all a big mind game.
• 27:30
  Dr. Matthea Rentea: Or maybe you've even lost weight and you look in the mirror.
• 27:33
  Dr. Matthea Rentea: I know I have gone through this recently where it's almost like a body dysmorphia moment where you're looking in the mirror and you feel like you look three times as big as you've ever looked, but you tell yourself in your mind that can't intellectually be true because you've lost 50, 60 or whatever it is.
• 27:45
  Dr. Matthea Rentea: And so these are just interesting moments.
• 27:47
  Dr. Matthea Rentea: So I really liked the work of Judith Gatton.
• 27:49
  Dr. Matthea Rentea: She does a lot with body image.
• 27:51
  Dr. Matthea Rentea: She she has come into my clinic and taught something called the 3A framework, which again, I can write out the basic steps so we can put underneath in the show notes, but just to give the most briefest of brief, and I'm not going to teach everything because it's her method.
• 28:03
  Dr. Matthea Rentea: But basically the point is you need awareness, number one.
• 28:06
  Dr. Matthea Rentea: So a lot of, I'm just going to speak to women for a second here, but this applies to men as well.
• 28:11
  Dr. Matthea Rentea: We are sort of a surprise to ourselves.
• 28:13
  Dr. Matthea Rentea: We don't look at ourselves in a mirror.
• 28:14
  Dr. Matthea Rentea: We're kind of shocked when we go clothes shopping or when we walk by something that has a mirror reflecting.
• 28:19
  Dr. Matthea Rentea: I was at a conference here recently and I did a walk in the morning and the only place I could find a walk with the little atrium front thing, and there were all these like reflective mirror things around it.
• 28:29
  Dr. Matthea Rentea: And I was like, Oh, it's like a very not fun experience.
• 28:32
  Dr. Matthea Rentea: Cause there's all these, you know, like a walking around and around it's like, Matthea Matthea Matthea, right?
• 28:36
  Dr. Matthea Rentea: But the point is, number one, let's not be a shock to ourselves.
• 28:39
  Dr. Matthea Rentea: If you can look at yourself in the mirror daily, you know what you look like when you're tired.
• 28:42
  Dr. Matthea Rentea: You know what you look like when you're rested.
• 28:44
  Dr. Matthea Rentea: Really getting familiar with yourself.
• 28:46
  Dr. Matthea Rentea: And then, thing number two, now by the way, all this applies to people that do not have body dysmorphia.
• 28:51
  Dr. Matthea Rentea: If you have it as a diagnosis, please, that's working with a therapist.
• 28:54
  Dr. Matthea Rentea: That's really another land.
• 28:55
  Dr. Matthea Rentea: Because that can actually make it worse, what I'm talking about.
• 28:58
  Dr. Matthea Rentea: So this is for people where it's really when we talk body image, it means just a little bit more awareness of how we view ourselves, how we want to perceive ourselves, things like that.
• 29:07
  Dr. Matthea Rentea: So the awareness, number one of checking in with yourself, having some awareness, like maybe you take one exercise that I did when working with her, we would take a picture daily just to know what we were wearing that week.
• 29:18
  Dr. Matthea Rentea: How did we feel in it?
• 29:19
  Dr. Matthea Rentea: How did we think we looked like it was, Oh my gosh, was that helpful?
• 29:22
  Dr. Matthea Rentea: Because I always had what I thought I looked like or what I was telling myself.
• 29:26
  Dr. Matthea Rentea: But then when you saw it, you could actually see what you wanted to take action on or what you wanted to do.
• 29:30
  Dr. Matthea Rentea: So the awareness part, I think, is just getting familiar with yourself and like actually looking in the mirror for a second because we're often so busy in the morning.
• 29:38
  Dr. Matthea Rentea: I don't know about you, but I don't even remember what I look like when I brush my teeth.
• 29:41
  Dr. Matthea Rentea: I'm not even looking, you're just, you're in your zone.
• 29:43
  Dr. Komal Patil-Sisodia: So I'm looking up thinking like going through my mental calendar, like for what I need to do that day.
• 29:49
  Dr. Matthea Rentea: Exactly.
• 29:49
  Dr. Matthea Rentea: I'm not looking at what do you look like?
• 29:51
  Dr. Matthea Rentea: So that's one thing you could do.
• 29:52
  Dr. Matthea Rentea: And then the second thing when you're doing that, it's really zooming out.
• 29:56
  Dr. Matthea Rentea: And I will tell you, and I'm always just going to take myself as the case study because I don't need to sit here and out other patients stories, but for me, it's always the stomach.
• 30:03
  Dr. Matthea Rentea: I'm always like, oh my gosh, the stomach.
• 30:04
  Dr. Matthea Rentea: We might use the word panus in medicine, if there's like lower abdominal weight that kind of hangs down, I will always focus on that.
• 30:09
  Dr. Matthea Rentea: And I've really had to retrain myself over time.
• 30:12
  Dr. Matthea Rentea: Zoom out.
• 30:13
  Dr. Matthea Rentea: You had a baby, you had lost weight.
• 30:16
  Dr. Matthea Rentea: I'm so glad your digestion works.
• 30:18
  Dr. Matthea Rentea: Zooming out, what are other things that, that you like about yourself?
• 30:21
  Dr. Matthea Rentea: Can I pick one thing that I like?
• 30:23
  Dr. Matthea Rentea: And so this isn't actually about getting to the place of but love is all the way at one end, hatred is at the other end.
• 30:29
  Dr. Matthea Rentea: What we're trying to do is just move you a little bit more toward neutrality.
• 30:33
  Dr. Matthea Rentea: Could we get you to a like place and acceptance place?
• 30:36
  Dr. Matthea Rentea: There's different phases to this, but number one, knowing where you're at, acceptance.
• 30:39
  Dr. Matthea Rentea: It's okay if at the moment, everything you're not okay with.
• 30:42
  Dr. Matthea Rentea: Can we zoom out and have some perspective?
• 30:44
  Dr. Matthea Rentea: And I'll give you an example with zooming out.
• 30:46
  Dr. Matthea Rentea: Zooming out can look like this when you're coming to a neutrality statement.
• 30:50
  Dr. Matthea Rentea: I have a body.
• 30:51
  Dr. Matthea Rentea: Is that a fact?
• 30:52
  Dr. Matthea Rentea: Can you accept that?
• 30:53
  Dr. Matthea Rentea: Okay, I have a body.
• 30:55
  Dr. Matthea Rentea: You could say anatomic parts.
• 30:56
  Dr. Matthea Rentea: My legs move me.
• 30:58
  Dr. Matthea Rentea: Those are the kind of steps that you could take with zooming out on things, right?
• 31:01
  Dr. Matthea Rentea: And even when I say that, I get chills because it brings me more to neutrality.
• 31:04
  Dr. Matthea Rentea: I'm not heat mistled in on my stomach.
• 31:06
  Dr. Matthea Rentea: So the zooming out part, can we come to some anatomically neutral terms or things that are not activating for you?
• 31:13
  Dr. Matthea Rentea: I think that's the first part when I talk about getting to neutrality.
• 31:16
  Dr. Matthea Rentea: And then we have to practice some of this.
• 31:18
  Dr. Matthea Rentea: Because it's not, we maybe have always been in a self critical zone where we're always, maybe we actually learn that from others.
• 31:25
  Dr. Matthea Rentea: Like maybe our mother actually was critical about their body or we learned, if you read all the teen magazines growing up are always like how to make this or that look better.
• 31:34
  Dr. Matthea Rentea: You actually got trained and socialized with this stuff.
• 31:36
  Dr. Matthea Rentea: So what you're doing is actually really radical work.
• 31:39
  Dr. Matthea Rentea: So this is not simple what I'm suggesting, right?
• 31:41
  Dr. Matthea Rentea: Oh, we're going to look in a mirror, we're going to zoom out, we're going to, so your neutral comment, this is actually work, honestly, that should go hand in hand with any other metabolic work you're doing, because it's actually an identity shift that's occurring.
• 31:52
  Dr. Matthea Rentea: And so if you don't do that work on the way down, people end up getting to the end.
• 31:56
  Dr. Matthea Rentea: And what are they unhappy with the loose skin that I look different?
• 31:59
  Dr. Matthea Rentea: I look like I've aged, there's all these things.
• 32:01
  Dr. Matthea Rentea: And while there are cosmetic answers.
• 32:04
  Dr. Matthea Rentea: That is only physical.
• 32:05
  Dr. Matthea Rentea: The internal work is what I'm talking about.
• 32:07
  Dr. Matthea Rentea: That's really where this body image work comes from.
• 32:09
  Dr. Matthea Rentea: Did that kind of answer how I start to work with people on that?
• 32:13
  Dr. Komal Patil-Sisodia: And I love that because that ties so well into our diversity conversation before It's not just one thing that you're working on.
• 32:20
  Dr. Komal Patil-Sisodia: It's not just one image you're working towards.
• 32:23
  Dr. Komal Patil-Sisodia: This is physical work.
• 32:26
  Dr. Komal Patil-Sisodia: It's metabolic work.
• 32:27
  Dr. Komal Patil-Sisodia: It's mental work.
• 32:28
  Dr. Komal Patil-Sisodia: There are so many different pieces to it.
• 32:31
  Dr. Komal Patil-Sisodia: And so there can't just always be one answer.
• 32:33
  Dr. Komal Patil-Sisodia: And that's what I want people to get from this episode is there is not just one way to be.
• 32:39
  Dr. Komal Patil-Sisodia: There is not just one answer and it looks different for everybody.
• 32:43
  Dr. Komal Patil-Sisodia: And that is okay.
• 32:45
  Dr. Matthea Rentea: Yes, like you're, I always say hating yourself a little bit less that day could actually be part of the win.
• 32:52
  Dr. Matthea Rentea: I know it sounds sad when we say it, but that's actually can be part of the win.
• 32:54
  Dr. Matthea Rentea: You didn't beat yourself up today.
• 32:56
  Dr. Matthea Rentea: Congratulations.
• 32:57
  Dr. Matthea Rentea: I don't care about your weight.
• 32:58
  Dr. Matthea Rentea: I don't care about that you had sour patch kids.
• 33:00
  Dr. Matthea Rentea: I don't care.
• 33:01
  Dr. Matthea Rentea: You did not beat yourself up.
• 33:02
  Dr. Matthea Rentea: That is a step toward self acceptance, a step toward, honestly, less cortisol and getting healthier as well.
• 33:08
  Dr. Komal Patil-Sisodia: It brings your stress down.
• 33:09
  Dr. Komal Patil-Sisodia: It's better for you, health wise.
• 33:11
  Dr. Matthea Rentea: Exactly.
• 33:12
  Dr. Matthea Rentea: So it's so different to your point.
• 33:13
  Dr. Matthea Rentea: The other thing I really work with people on, if you want to, if people here want ideas for other steps for health that are not just what my number is doing, because I'm a really big fan of that, right?
• 33:21
  Dr. Matthea Rentea: So there's labs, there's activity tolerance, all that kind of stuff.
• 33:24
  Dr. Matthea Rentea: The other thing is how food is feeling in your body.
• 33:26
  Dr. Matthea Rentea: So maybe you're eating slower.
• 33:28
  Dr. Matthea Rentea: Maybe you're acknowledging, Oh, I actually like, feel, I'm tasting the food.
• 33:32
  Dr. Matthea Rentea: I feel the food going down.
• 33:34
  Dr. Matthea Rentea: I feel the difference between liquids in my body versus when I eat different foods.
• 33:37
  Dr. Matthea Rentea: How I feel two hours after a meal.
• 33:39
  Dr. Matthea Rentea: Maybe I'm not as gaseous because I'm eating slower and I'm not like trapping as much air.
• 33:44
  Dr. Matthea Rentea: These are all things, they sound silly, but they mean so much when people are like, I just felt good after a meal.
• 33:49
  Dr. Matthea Rentea: That's a health goal.
• 33:51
  Dr. Matthea Rentea: Feel good with food.
• 33:52
  Dr. Matthea Rentea: Yeah, that is a huge win, right?
• 33:54
  Dr. Komal Patil-Sisodia: And I agree with you.
• 33:55
  Dr. Komal Patil-Sisodia: In my patients who have diabetes, I will always tell them, there are certain foods that are, we know are going to numerically raise your blood sugars.
• 34:02
  Dr. Komal Patil-Sisodia: Pay attention to how you feel when that happens If you're not feeling good in your body when that's happening, That's another sign that you can take to make different choices You can get yourself back on track into a place where you feel like you're winning.
• 34:15
  Dr. Komal Patil-Sisodia: And it's not just this uphill climb where that seems never ending.
• 34:21
  Dr. Matthea Rentea: Yeah, and it helps shape health as well because I'll give you an example.
• 34:26
  Dr. Matthea Rentea: I have I feel like I have a lot of insulin resistance and When I eat only carbohydrates or lots of sweets, I get really tired.
• 34:33
  Dr. Matthea Rentea: Like I feel super lethargic after the meal I want to go to bed at 8 o'clock instead of 10 like it has real like instant implications for me and so it's been very interesting because in my mind I was always like I really want to eat these things and I want to Do this stuff and I had to just like very lovingly slowly be like, you know You don't feel good when you only have that stuff.
• 34:51
  Dr. Matthea Rentea: That's just the reality moment here.
• 34:53
  Dr. Matthea Rentea: Here's what actually happens when you do it.
• 34:54
  Dr. Matthea Rentea: And every so often I do it, I'm like, we're just going to do the carbs and I feel horrible.
• 34:58
  Dr. Matthea Rentea: And then it's made it really easier for me to release that as being what I think is fun.
• 35:02
  Dr. Matthea Rentea: And the only way forward.
• 35:04
  Dr. Komal Patil-Sisodia: Yeah, you hear a lot of people struggle in that same way with alcohol It's a social activity.
• 35:09
  Dr. Komal Patil-Sisodia: It's a fun activity.
• 35:10
  Dr. Komal Patil-Sisodia: I've seen some patients who say that going out to a bar is their primary way of, connecting socially, and then they start something like Ozempic or Munjaro, and they don't want to drink anymore.
• 35:22
  Dr. Komal Patil-Sisodia: And they don't know what to do with their social lives.
• 35:24
  Dr. Komal Patil-Sisodia: Some of that mental work is around acceptance of these changes that you're making and how that's going to change what your life looks like on a different level, not even just the health.
• 35:34
  Dr. Komal Patil-Sisodia: Yeah.
• 35:35
  Dr. Komal Patil-Sisodia: Thank you so much for this conversation.
• 35:38
  Dr. Komal Patil-Sisodia: I feel like we, we unpacked a lot today.
• 35:42
  Dr. Matthea Rentea: A lot to think about, right?
• 35:44
  Dr. Matthea Rentea: And if people are starting this work, it's, this is long term work, meaning this is the next decade of your life that you work on.
• 35:50
  Dr. Matthea Rentea: You don't conquer this in a day.
• 35:52
  Dr. Komal Patil-Sisodia: No, I just want to thank you so much for putting that message out there to your patients, to our listeners.
• 35:58
  Dr. Komal Patil-Sisodia: The more people hear that, the more I'm hoping that they will understand how diversity of thought matters when they are looking at what is good for their health and good for their bodies and that they're opening their lens to be able to do that.
• 36:12
  Dr. Komal Patil-Sisodia: Thank you so much for doing that work for everyone and for sharing your wealth of knowledge with us today.
• 36:17
  Dr. Komal Patil-Sisodia: I really appreciate it.
• 36:19
  Dr. Matthea Rentea: Thank you so much for having me on today.
• 36:21
  Dr. Komal Patil-Sisodia: Oh, my pleasure.
• 36:22
  Dr. Komal Patil-Sisodia: We'll do this again.
• 36:22
  Dr. Komal Patil-Sisodia: Hopefully soon.