Core Bariatrics

Episode 20: Factors of weight

Dr. Maria Iliakova & Tammie Lakose

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Join e Dr. Maria Iliakova and Tammie Lakose, as they delve into the intricate web of factors that shape our weight. From genetics to the hustle of daily life, they explore the complex influences on what we eat and how it affects our weight. Forget the age-old advice of "eat less, move more"—their discussion will lead you on a journey through the often-overlooked aspects of weight management that go far beyond calorie counting.

Strap in for a candid talk about the harsh economics of eating well, as we navigate through the paradox where processed foods often pinch our wallets less than fresh produce. The struggle is real when time and money dance in a tango of compromise, affecting not just meal choices but our collective well-being. Maria and Tammie venture further and discuss the surprising connections between obesity, nutrition, and the quality of your slumber. Ever considered how the climate you live in, or your financial literacy could play pivotal roles in your health? They dissect these factors and more, leaving no stone unturned.

Closing the loop, Maria and Tammie share their personal encounters with the real-life hurdles that complicate weight management, such as work stress, familial patterns, and the inevitable curveballs life throws their way. Whether it's navigating the challenges of sleep apnea or hormonal changes, or debunking misconceptions around conditions like COPD, they lay it all out on the table. This episode isn't just about shedding light on the issues—it's about empowering you with understanding and strategies for a healthier lifestyle, one informed choice at a time.

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Speaker 1:

Welcome to Core Bariatrics Podcast hosted by Bariatric Surgeon Dr Maria Iliapova and TMA LaCose, bariatric Coordinator and a patient herself. Our goal is building and elevating our community. The Core Bariatric Podcast does not offer medical advice, diagnosis or treatment. On this podcast, we aim to share stories, support and insight into the world beyond the clinic. Let's get into it, alright, maria. Again, it is just eat less, move more. There's nothing else that factors into weight.

Speaker 2:

Duh. What else do I think factored in?

Speaker 1:

I feel like there needs to be a little bit more, because me and you pretty much ate the exact same thing while we were in Florida together. True, and I'm not your size yet, yeah it's an overnight thing, by the way.

Speaker 2:

It's in and out and it's overnight and no matter what you do, it's the same for everyone. Yeah, exactly, okay, sorry, heavy dose of sarcasm there.

Speaker 1:

Yes, absolutely. I think people are already catching on to our I'm hoping that's the case. Absolutely.

Speaker 2:

Just in case for everyone in the back and for me. Sometimes too, if I'm, it's a slow day. Like you just said, we've had really busy weeks and I personally am in Cedar Rapids right now. I'm in a hotel room, as you can see, and my life is actually a little chaotic. I'm on call right now. Hopefully there will not be anything that disrupts us today, but there may always be.

Speaker 1:

Surgeon life.

Speaker 2:

Surgeon life.

Speaker 1:

Can I just start off by saying that your hotel room looks like a whole apartment. It is.

Speaker 2:

It has a whole kitchen and a whole. Yeah, it's a whole. They set me up pretty good.

Speaker 1:

Party at Maria's hotel room.

Speaker 2:

Exactly, party at the holiday in Anyway.

Speaker 1:

Literally All right, all right.

Speaker 2:

So anyway, yeah. So what we're going to talk about today, though, tammy, is very prescient to your question about isn't it just calories in, calories out, and we're all doing the same thing and eating the same thing. Why aren't we the same size? There's a lot of factors that go into weight, and I think we really downplay that. So I'm curious Absolutely I'm curious what do you think factors into weight for people?

Speaker 1:

I really think that, again, I still don't know the difference between genetics and epigenetics, so you'll have to get there. But family, if your parents are heavier, chances are I feel like the kids are heavier. Us going to Florida, I realized food, like where you are, has to have something to do with it because, look, we ate pretty well. Granted, we were at restaurants and stuff, but I feel like there's more options where we were. Oh yeah, then I come back to Iowa where it's cold and I had lasagna and I'm like no, I feel like poop it was. It tastes good. But also, I think we both can relate to this because even though you are a surgeon, you haven't always you have not come from money. Clearly, your mom worked very hard to give you what you had, but I think money obviously has something to do with it. Oh yeah, there's a lot, there's so much.

Speaker 2:

Absolutely, absolutely. So yeah, I think we're catching onto the fact that pretty much everything in our lives affects how we eat and how our body and our weight and things like that. I think you're absolutely onto that. You're totally right. I remember when we were in Florida. Like you said, there's a lot more access to fresh fruits and vegetables. That's more accessible year round. That's a little bit more encouraged and available. Even when you go out to eat, it's always there.

Speaker 2:

And I actually have been seeing people here at the hospital this week and one of the guys actually came in and we were talking about what kinds of things contributed to what he was, what problem he was having, which is actually a colon problem, not related to weight or anything like that. And I said, good, healthy diet high in fiber can definitely help this process down the road, and having a diet low in fiber can actually make this worse. If he's in Ireland, you don't burn in Ireland. Where am I supposed to find good food? And that's not heavily processed and that's not, and so you're obviously right, the location where you are and where you spend your time, or if you travel a lot, for instance, if you're not in a regular place, that can be a huge factor in whether or not you're able to maintain your weight and eat purposefully what you want to eat.

Speaker 1:

Yeah, absolutely. And I know exactly where Mount Vernon is because my best friend lives there and he got bar food.

Speaker 2:

Bar food. Hey, there's bar food and there's bar food. Okay, some places have really amazing healthy options, and then some places you are right, yeah, yeah, really don't.

Speaker 2:

So, yeah, but you're also onto something with the family and it's actually I'm impressed that you remember genetics and epigenetics. That's already a win in my books that we when we covered that episode that's coming up. But, yeah, so there's an element to weight which definitely is inherited. We definitely see people's weight being either high or low and that seems to run in families, at least to some extent. We certainly don't know any one gene that's responsible for that. In fact, over 60 genes have been affiliated with weight management and metabolism, but that's 60. Okay, that's not like we can target one and all of them Right.

Speaker 2:

We've treated everything. No, that's not the case. So it really is complex. Only culture and how you were raised and what was normalized in your family, like, for instance I'm curious, actually in your family what was the go to meal when you came home from school?

Speaker 1:

Chicken casserole, which involved noodles, cream of chicken, soup, chicken, so I had good stuff in it, but it was still pasta. Honestly, I'm not a good person to ask, because I didn't have the sit down and eat mom cooking dinner or even dad cooking dinner type of thing. We were always on our own thing, but yeah.

Speaker 2:

Honestly, I think that's really common and I don't think we I think we idealize our families as oh, we sit down and we cook and we eat dinner and like we do all these things together. I don't think most people have that in their lives, I think.

Speaker 1:

I try to because I did not have it. I very much tried to do that with my boys for sure.

Speaker 2:

Does it work out?

Speaker 1:

No, especially this week. My flight was delayed. I got home a day late. By the time I got home I was so exhausted because I slept in an airport. We did have dinner that night, but then I've been at work the last three days and yeah, so it doesn't always work out.

Speaker 2:

But we try, and that's the thing is. People make do, and so when we are making do especially with busy lives and busy schedules and family that still needs to be fed and ourselves that still need to be fed, I do what's convenient. And if what's convenient is pre packaged, pre processed, maybe healthy, maybe not, it's whether or not you're going to have good fresh food or homemade meals or things like that.

Speaker 1:

Exactly.

Speaker 2:

So that's a big factor. And I notice the same thing, like when I travel I eat really differently than when I do at home, when it's purposeful and I can have all my all the foods that I want to have, rather than the foods that are available. It's a much. It's much easier to stay on track, I think, for everyone in that situation.

Speaker 1:

I don't know. See, I'm a little backwards because when we were out I had the options and I had the options up the tip of my finger and I did not have to cook them ever since having surgery, I actually dislike cooking more because obviously cooking takes time and then I can eat half my plate or whatever. My portion is obviously much smaller. So it sounds enjoyable to eat or to cook, because you don't really sit down and enjoy very much, I should say.

Speaker 2:

I actually I hear you because I think when we sometimes it's like the pink elephant in the room or something, don't think about the pink elephant, don't think about it. And when we're overthinking what we're going to cook and how we're going to cook it and all the stuff that goes into that, and especially if it's if you are on a diet that's different than the rest of the population or maybe then your family or your kids or something are, it becomes a chore or it can.

Speaker 1:

Yeah, Absolutely so.

Speaker 2:

I'm curious how do you deal with that on a daily basis?

Speaker 1:

Again, I do struggle a lot. So we may sit down and eat, but we don't always eat the same thing. Because my kids are obsessed with, of course, chicken, niddies and fries. Mine just looks a little different. Sometimes our dishes just look a little different. Right, and I can. Especially my six year old does not want to supply him with the chicken, so it's easier for me just to grab string cheese or yogurt and whatnot. So my kids are still, unfortunately, eating a lot of convenient things for the most part, especially the three days that I work a week, sometimes more. Yeah, convenience is so hard.

Speaker 2:

Do you? If you had convenient let's say you had a fruit and vegetable stand in your neighborhood or something Do you think you would be? Would that be convenient enough? That would be included more in the food, especially that the kids were eating, because I know it's tough to not only do something that's not necessarily convenient but then to convince someone else to eat it.

Speaker 1:

So luckily, my kids actually love fruits, obviously, and somehow my six year old. All the things he dislikes he loves, like green beans, so I'll take that as a win. But I always say that we always ask ourselves if you could pick one thing, would you want to never worry about money? Would you never want to do laundry again? Would you never want to? Whatever Mine would be, if I could get a chef, I would eat perfect constantly. Honestly, because as long as it's there available for me just to grab and eat, I'll be perfect, so perfect, like I'm. We had those options even in a hotel room. I could get a string cheese, I could get you grab some, some nuts. So just as long as it's there and easily grabbable, eating better is easier. But it's, yeah, it's the convenience aspect of it.

Speaker 2:

Honestly, it makes me think and I know we've talked about this before but that there need to be convenient things almost home delivered, or just boxes, or something available for people who have had bariatric surgery. Just so that it's not a guessing game, because I know a lot of people like a lot of the phone calls that we get, or even a lot of the questions that we got from people was can I eat this, can I eat this, can I eat this? And that is a constant, from what I understand, for like years ahead. You're constantly questioning like what about this thing? What about that thing? Is it good, is it not?

Speaker 1:

Is it going to?

Speaker 2:

make me hurt? Is it going to give me bad gas or diarrhea or other problems? Does that sound relatable to you?

Speaker 1:

Absolutely, and we have tried things like Hello Fresh and it is great, because then my husband can make it, doesn't even have to think, right, it's all there, it tells you what to do, it don't have to measure anything out and all of that.

Speaker 2:

That's not sponsored by Hello Fresh, but we are certainly open.

Speaker 1:

No, yeah, oh yeah, no, no sponsors yeah, sorry, but that's something we utilize for a little bit. But it did get pricey because obviously they have to make money while also giving good, fresh produce and someone has to package up or measure it up and put it in a package and so it's definitely out there. It's just still it's not affordable. It yeah. So there's options and even in the airport I realized that they had those fresh vending machines. I was actually shocked at the salads in the jar and pastas that you can go and warm up and stuff like that. So I was impressed there. I didn't try it because I don't even know why, but because it was probably expensive. Honestly, that little thing of salad was probably 15 bucks. I can almost guarantee it.

Speaker 2:

So we're getting there.

Speaker 1:

I think I spent $10 on a big bottle of water. Yeah, what is that?

Speaker 2:

easily.

Speaker 1:

And my Stanley was in my luggage, so I couldn't fill up a water bottle.

Speaker 2:

You could become homeless very quickly me too, actually, and going to, I agree but actually you bring up a good point, which is money. And I think money is a huge part of the equation for what's accessible to people, because basically, with enough money, anything becomes convenient, anything becomes accessible, whether it's personal trainer, nice, or schedule at work, or the ability to not work necessarily or to do work you want to do rather than work you have to do to make money.

Speaker 2:

The ability to eat where you want to, how you want to have a Chef, have hello fresh or whatever else is it? Money is really a really big part of this equation. It actually even came up, really in a way that made it super obvious to me when we had some patients who relied on food Pantries and to think about how on earth you eat Healthily or in any way that you intend to eat, if you're relying on what's in a food pantry.

Speaker 1:

Yeah, yeah, absolutely, because I've been there, done that and most of it. Sure, you probably get one or two Protein options like chicken or something, but most of it is. Here's some macaroni here some, because you need the food to keep yourself alive and that's unfortunately what you get.

Speaker 2:

Yeah, it's pretty and I would say honestly, it's not very different from how a lot of people eat, period, because, again, it's the most convenient and readily accessible and certainly the most affordable to a lot of people, which to me is crazy. Because, if you think about it I'm not trying to start conspiracy theories or anything but shouldn't a vegetable be cheaper than a processed food? In theory, like that thing grows out of the ground, yeah, you would think, essentially pre-packaged already and is shipped and things like that. I understand things are. Obviously you can't eat fruits and vegetables as they don't stay as fresh for long, for as long, but it just drives me crazy that it's more expensive to eat something that is fresh rather than something that is pre-processed and pre-packaged. That may actually put.

Speaker 1:

At the same time, it takes more maintenance. I know like organic stuff you can't use, like the chemicals and stuff, but you there's people out there that have to Make sure things are watered, make sure things are weeded, make sure, but whatever. And then, yeah, there is a lot of. You need to hurry up and quick, get those strawberries from Florida or wherever to Iowa, because we're not getting strawberries very much in Iowa.

Speaker 2:

No, at least not right now, not in the winter time.

Speaker 2:

They do it a little bit sad right now, that's true.

Speaker 2:

And then another thing too is we've talked a little bit about schedule and things like that, and I think it's really tough if people have a busy schedule and they don't have other resources like either a lot of help around them, a lot of cultural background or other support that really makes it possible for people to sit down and eat together and cook and things like that it's essentially impossible to work out and to not drive to work.

Speaker 2:

That's another big thing too, like we're constantly in our cars from things, whether it's picking kids up from school or going to and from work, and If you don't, if you have a busy schedule, you have to do the thing that makes it, that enables you to be busy and to not miss things. And, yeah, I, it really impacts how we like when we were in Florida, for instance, we were walking Right a lot of places that we went. We even, I think, went to like down a mile or so to a restaurant and then came back, and that's never something almost getting hit by a car yeah right, I would never do that at home, because at home I'm always go.

Speaker 1:

Now, does that? Does location not only just obviously a fresh foods are available, but does location when it comes to you, what am I? Oh my goodness, I lost my train of thought.

Speaker 2:

Do you mean, like in different locations, wait, weights of obesity, or there's different rates of?

Speaker 1:

there we go. See you just know my brain.

Speaker 2:

I know your brain by now, tammy, we've heard. No, actually it's a good question and there's some interesting data on that. Obviously, obesity is considered a sort of modern Problem more than it is an older problem. In part, that's because of a lot of things like we we drive instead of walk, our food is processed instead of fresh, we have really busy schedules that lead to a lot of stress where we used to live lives that were a lot less stressful and it's a bit dense, in a way, like we're over. We overdo everything, including our own schedules and our minds and things like that. In terms of the variability in Weather and things like that. It's tough to say because actually Colorado, like one of the colder states in the country, has the lowest rate of obesity in the country and they don't probably because everybody has to work so hard to breathe.

Speaker 1:

This is coming from respiratory therapists that knows that, like my COPD patients going out to Colorado really Struggle, and so I think another thing is just education too is yeah, people don't know how. I didn't know how to eat until I taught myself.

Speaker 2:

Yep I.

Speaker 1:

Like and people don't. I even talked to a man today who was really struggling to breathe. I did a breathing test on him and he does have a large belly. But I told him. I said look, I'm not telling you to eat protein just to lose weight or anything. I'm telling you to use protein because it stays in your body longer, it satisfies you longer and with your lung disease you need something that's sustained. And so the light bulb went off for him. Yes, I know protein is good, but why?

Speaker 2:

And I think a lot of people really need to understand the why and when we do. I mean, if you even had a nutrition class in school I'm not sure I did in my grade school or high school or anything no, I didn't.

Speaker 1:

I learned how to make cookies and decorate a cake.

Speaker 2:

Yeah, and I went to a bougie high school and I don't remember having a sugar, whatever. I was the kid on my scholarship, so don't judge me.

Speaker 1:

Right.

Speaker 2:

And even in med school. This is the crazy thing, but in med school, on average, it's less than a few hours of any kind of education on nutrition out of thousands of hours that we get on education in terms of how the body works anatomy, physiology, microbiology, all kinds of things, pharmacology but in terms of nutrition it's less than a few hours, which is bonkers to me again, because that underpins a lot of how the body works or why it works well, why it doesn't work well. And then it's no shocker to me that people get all this not so great advice from their healthcare providers, because their healthcare providers don't know much more, on average at least, than the average patient about nutrition, that's not to say that.

Speaker 1:

And so, just like nutrition, super important. Just like bunny, how much money classes did you get? I learned how to balance a checkbook which is not even relevant anymore. I feel sitting sketching out your why put. I wrote this check whatever. I feel like even money wise. If we were taught how to utilize our money and whatnot, maybe less people would be bankrupt go bankrupt. And yeah, it's just. I feel like our education is backwards.

Speaker 2:

I know I agree, and we don't seem to focus on life skills so much as we do on. It almost seems like we're being educated for a world that exists 30 or 40 years ago, rather than the one that's frustrating in a number of reasons. Yeah, because I think if we had better financial education, if we had better like here's how to live in a household, here's how to have relationships, here's how to deal with work or a schedule, or functional things.

Speaker 2:

I bet I would bet a million bucks, maybe more that our weight management would also be easier as a country and we'd probably have less of a problem overall, because we would all be. We would all have less stress, we would all be able to live our lives a little easier and we'd be able to be more mindful about what we did with our bodies on a regular basis.

Speaker 1:

Yeah, absolutely, and so I just want to. I am like sleep deprived. I feel like, and I can tell it's killing my mood and I can kill. I can tell it is like killing my want to eat anything healthy. I want the cupcakes I want. So I just want to touch base on A.

Speaker 1:

I come from a sleep clinic as well, with a pulmonary, so I was with a sleep doctor who I hope we can get on here soon. But I just want to talk about how sleep is really important, not just get your eight hours of sleep, blah, blah, blah. But if you're not getting good enough sleep, you are tired, your body is tired, and when your body is tired, your body doesn't. You don't want to go work out, you don't want to cook dinner. Honestly, how many of us after work are just like I don't want to cook dinner? Me. That's me today. And then my mood and my mental health is just trash, trash. Those go hand in hand. And then again, if I'm not feeling happy and whatnot, I don't want to. I just want to binge watch some TV while eating some ice cream.

Speaker 2:

Honestly, oh yeah, yeah, I agree. Sleep, mood, mental health, all those things really go together if we're not getting. And the funny, there are actually some interesting studies around sleep. Not everybody needs the same amount of sleep. Some people correct.

Speaker 1:

That is very correct, right.

Speaker 2:

And then there are things that affect how well we sleep, even if we're sleeping for a certain amount of time, if it's the wrong temperature or if it's not a restful and like, for instance, I sleep when I'm on call, but that sleep is interrupted. It's not the same as good sleep when I'm not on call.

Speaker 1:

Yeah, you subconsciously know that your phone can go off at any time and you know you need to be awake and ready to go. Yeah, I'll be dealing with that soon too.

Speaker 2:

And like how many people have kids, for instance, young kids, for whom, also, if they get woken up in the middle of the night, it's not like you can just ignore that. You do have to deal with that. Yeah, exactly, yeah, you're right. Or even having sleep, medical conditions that affect their sleep, like sleep apnea, or even COPD, can affect your sleep. There's lots of different things that can. Or getting too much narcolepsy, things like that. There's a lot of impacts on our overall ability to manage our weight. And the thing is, I know we're going through a laundry list here of family issues and work issues and stress and sleep and mental health and all of these things. I don't mean that to be overwhelming. Hopefully I mean it to be. Oh my gosh, there's a lot of factors here and it's not simple. So, one, we can't judge people so easily. And then, two, there's actually a lot of ways that we can start to address this problem and even small changes can have a big impact if they're made to any of these things.

Speaker 1:

And I feel like we I want to normalize some of the things that other people struggle with. So, like some of these things, just us talking about it and it coming from, if there is a person out there that hasn't had such a supportive bariatric surgeon that it's coming from a bariatric surgeon's thing Look, let's be honest, everybody in the medical field is exhausted and just we're all hot messes, pray for us all, but coming from a surgeon that's caring and just sometimes that's all a person needs to just be okay with what's going on in their life and how they are struggling and being like I'm normal, this is normal.

Speaker 2:

Oh yeah, oh yeah. And, like I personally have struggled with all of these things, not a single one of them has not been a struggle for me. So I can very much relate and, to be honest, this is also what we discuss when people come in, when they come in the first time they come in. We talk about all of these different things that impact their current state, where we are now and where we want to be, and how that's different and what kinds of things we can change potentially, because some things you can't. It's not like you can change the number of kids you have or like the job you have very easily necessarily right.

Speaker 1:

You're so right some days I'm with.

Speaker 2:

But oh, they know, they know this, and sometimes you can't change your mood or your mental health very easily. These this is not to say that any of these things, even if they are changeable in some way, are easy to change, but there are some. Definitely it makes a big impact and even some other things that we've talked about like smoking, alcohol, other medications that people may be taking or other medical conditions that they may have certainly humongous hormonal changes like pregnancy or menopause, or even for men. Men don't go through menopause technically, but they go through what's called hormonal senescence, which is just a really fancy term, for their hormones also get downregulated and also get affected, and that does have an impact on men too. I think we have this idea of the older man with the kind of pop belly, skinny legs in our heads.

Speaker 1:

We've all heard that that's honestly, that's what I was just thinking and I was thinking does that tend to happen? I feel like I don't know exactly and you can help me. One menopause happens for women, but I feel like the manopause that you're talking about because I'm not gonna be able to say that word is that later on in life for men. Do you think?

Speaker 2:

yeah, so it seems like we we go actually. So there's a misconception around. Even menopause, there are changes in our hormone levels that happen gradually and happen more than in one period in our lives. Definitely, menopause is considered to be when we no longer, when we transition from being fertile to not fertile anymore, like not being able to have babies at all. For men, it's also spread out event, and may actually be happening more than once in their life, that their hormone levels are changing considerably.

Speaker 2:

There are definitely things that you can do to improve it. This is not to say I don't recommend everybody running out and getting testosterone injections or anything like that. That's not safe, but don't do that. Some people need it for certain reasons, but for the majority of people it's not a great idea. But, yeah, so there's a lot more to it than just, oh, this is something you can easily fix, and there's one one reason that someone is having issues. It's probably a good idea actually to talk to someone who is experienced in weight management, like you or me or anyone else in our community, because you start to see all of this web of different things that are relating to each other and how to address it, rather than just saying, oh, this is because of one, one specific thing, like my long commute or my poor sleep or something along those lines yeah, it just made me think that people think that clpd patients, so chronic obstructive lung disease patients, are usually smokers.

Speaker 1:

So actually just a pulmonary function test on myself and I have mild COPD. Never smoked a day in my life, but I grew up in a house that windows were closed. Smoking was around me, so you know. But people don't realize like COPD patients actually tend. Sometimes our factory workers, our housekeepers around the chemicals are especially farmers because of that, all that dust and all that.

Speaker 2:

So this is the same exact thing that there's so much more to weight than just eating, just like there's so much more to lung disease than just smoking and so when you put it all together, it's there's drips from a faucet, but ultimately, if you have enough drips from a faucet, it'll still fill a sink, the idea being like it doesn't take a massive one source. It doesn't take a massive change or a massive reason for someone to have difficulty with weight management. It takes small things and small things over time really add up right and then at some point it becomes really difficult to lose weight, even if you're eating right and exercising and doing all the quote unquote right things. Our bodies do not like to lose weight and keep it off. That is not how human metabolism and human bodies are structured to, to exist, into function. That just isn't how it works.

Speaker 1:

Ain't that the truth? And in our one episode with Dr Jessica Smith, she just stated how women tend to be on all these diets and actually it gets harder and harder to lose weight. I've explained this to some people and their mind was blown as much as mine was, and so, yeah, this is educating me so much and that I tell other people and I'm glad that I have the opportunity to do that because it's mind-blowing to them for the exact reason of them knowing it's not just you, it's not, you're doing something wrong right yeah, yeah yeah, and it is helpful to reach out and start to have these conversations and, like you said, just start to normalize that.

Speaker 2:

maybe there's more to it than blaming a person and maybe there's things that we can do as a community to help people and maybe there's ways that we can Band together to make it easier for families to get together and eat and to have easier access to food that we want. We want people to eat, or better sleep, or better mental health access, or Absolutely yeah, the ability to actually treat smoking addictions.

Speaker 2:

People even support people during hormonal changes in their life like menopause. I don't think I've ever as an adult, had a single conversation with somebody out about menopause outside of my mom, outside of a medical setting with one of my patients, woman in her 30s. I have never, with a friend or with a with any like person outside of a patient of mine, had a conversation about menopause. I think it's a point. Yeah, I think it's. Yeah, I think it's.

Speaker 2:

Maybe what we're doing is radical in a way, because we're asking people to talk about subjects that are taboo. We're like told, basically, or we're made to believe, that we're not supposed to talk about these things, but if we don't talk about them, it makes it so much harder to deal with and so much harder to know where to go to for advice and support and legitimate information about it. So, again, education, and we all deal with this. It's not just people who have a certain BMI, it's not just people who come into a medical office seeking help or people who treat them, or people in our distinct community, as we define it. It's literally everybody who is affected by these, these factors.

Speaker 2:

Yep absolutely no. Alright, friend, I think we are both needing a little nap or something else to catch up for the rest of our day. In fact, I'm actually heading to the or here shortly.

Speaker 1:

I was about to say a little nap, you're going to the war, I'll take it a little nap.

Speaker 2:

no, I'm kidding, but so I'm gonna leave you with some food for thought, maybe, and so think about and one of our coming episodes we're going to talk a lot more about sleep and how it works better, because I think a lot of people are really curious about the link between sleep and weight and overall health.

Speaker 1:

Yes, absolutely so, everybody. Thank you for listening. Don't forget to follow if your platform allows you to rate or comment or anything like that, please do. We appreciate it so much. I also can head over to Instagram. That's my, our, main platform right now, until I'm still learning the tech stuff and, and so we just appreciate if you want to reach out to us corbariatrics on Instagram. Let us know if you want to talk about something or if you want to come on with us. So well, maria, enjoy your surgery, because I know that is your who's up place.

Speaker 2:

Who's so? Let's go bye to me. See you soon, bye, bye.