Health – identity vs hobby?

This idea has generated a lot of conversations amongst my friends and patients this past week.  I think it does a great job of summarizing why most of us struggle with weight! Let’s dive into the why

After years of counseling hundreds of patients through their weight and health journeys, I have come to the conclusion that there isn’t one universal solution to fixing excess weight and changing eating habits.  However, there are definitely trends. 

Some of my patients are pretty easy to figure out.  They just need some guidance and education as to what to eat and they’ve got it.  Some have been put on some weight-positive medications and simply changing those makes all the difference.  Most patients, however, require a lot more.  

Many of my patients are caught in this perpetual tug-of-war between what their logical brain wants forever (usually things like: to be healthy, to lose weight, to get off of their high blood pressure medication) and what their emotional brain wants right now (to eat cake at their daughter’s birthday party, to have drinks with friends on Friday nights, to snack on popcorn while watching TV at night with the family, etc.).

This tug-of-war causes a lot of emotional distress.  I see it every day in my office. I see it every time I get on to social media and scroll through the groups I belong to.  Over and over again, I hear people lamenting about how they have fallen off the wagon and gained back weight. How they are stress eating and can’t seem to stop.  Lots of cries for help. Smart people asking for advice about how to get or stay on track. Lately, it’s post after post about the COVID 19 (the 19 pounds of weight gain that people are attributing to this virus). 

I would say that being torn between the forever goal and the right now goal is the biggest hurdle that my patients have to overcome.  Many patients struggle through it and manage to achieve what most of us would call “success.”   They get the weight off and they improve their health. However, these patients feel deprived and punished the whole time.  The process is torture.  

Others, however, make the shift without as much trouble.  These patients fascinate me! Over the past few years, I have been trying to figure out what makes these people tick – what creates this “joyful determination.”  I used to think it was the patients that came in with new onset medical problems and had a burning desire to resolve them. My newly-diagnosed diabetics that wanted to get off of their medications.  My patients that just finished treatment for breast cancer and wanted to decrease their risk for recurrence. I have a lot of these patients and many of them are hugely successful with their process.  But some aren’t. Some of these patients struggle with me for a while and eventually stop coming to my office. And some of my most successful patients have no underlying health problems whatsoever – so that can’t be the can’t be the only key.

At this point in my career, I think a huge part of success lies in acceptance – acceptance that this healthier way of eating and thinking about food is now part of who they are.  The patients that are hugely successful – those I call my “rockstar patients” – typically make a decision that they need to be healthier and they just start plugging ahead.  I won’t say it’s always easy for them – they struggle from time to time – but the struggles tend to be the exception instead of the rule.

I did my residency training in OB/GYN in the early 2000’s – back when residency training was getting ripped apart publicly for being inhumane and brutal.  At the very end of my residency, the powers that be set down some rules to make the process less horrible – guidelines stating that residents could only work 80 clinical hours inside the hospital each week (not counting lectures or rounds/meetings) and various other things that were designed to make our life easier.  I don’t practice in an academic setting, so I have no idea whether or not these rules have done much for improving the mental and physical health of residents today, but I hope and pray they are.

However, back when my colleagues and I were being residents, it was awful.  Truly awful. I remember working 49 days in a row my intern year. The only reason I got that 50th day off was because I had to go take my written board exam – and I fell sound asleep in the middle of the exam (seriously, the proctor had to come shake me awake so I could finish the test!).  Some weeks were lighter than others – only 80 hours instead of 105 – but it was still awful. I had my first son my third year of residency and delivered my second one a few months after graduating. Trying to balance pregnancy and then motherhood with that life was unbelievably hard. It definitely pushed me to the limits.   In addition to the burden of the workload, the emotional exhaustion was intense – we were learning how to make big decisions that impacted people’s health. We were learning how to cut people open and sew them back up again. We were memorizing protocols and algorithms and learning how to recognize subtle signs that would help us make a diagnosis. 

The reason I bring this up is not to generate sympathy but to demonstrate something.  If I took a new job today that turned out to require that amount of time commitment and emotional exhaustion, I would quit.  Right away. There is nothing you could bribe me with at this point in my life that would justify that level of intensity. But, I didn’t quit back then.  No one was forcing me to go in every morning – I could have quit any one of those days during those four years. But I didn’t. Why? Because I knew that becoming a doctor required it of me – that it was a necessary step to get me to the place I wanted to be.  There were many days I didn’t like it – but I put my head down and slogged through it – determined to get to the end.  

I did that because becoming a doctor was who I wanted to be.  It became part of my identity. I accepted that the process was part of the journey.  

When we accept that health and healthy eating and being a healthy person is part of who we are, it makes all the difference.  We don’t have to love doing it every moment of every day, but when it is part of us, we do it without nearly as much emotional distress.  

I define myself as a healthy person.  Because of this, having a healthy meal day after day is my normal.   Occasionally I do something that isn’t perfectly healthy – one of my kids turned sixteen last week and we celebrated with homemade french apple pie – and of course I had a piece of that!  But aside from those types of “champagne moments”, I eat well. Over and over again. It doesn’t cause me distress to do this – it’s who I am.  

Similarly I define myself as someone that wears a seatbelt.  Putting on my seatbelt every time I get in the car seems natural.  Yes, it takes an extra few seconds every time to buckle up. But, I would feel uncomfortable driving around without it on.  Yet, I could make the choice to do it. It’s ultimately up to me whether or not I wear a seatbelt.  

When you truly want to be a healthy person and you begin to define yourself as someone that is a healthy person (and believe it – not just say it), it makes the healthy eating part of the journey much easier to deal with.   Yes, your brain will remind you that you really like twizzlers, but your brain will also tell you that you are a healthy person and that you don’t need twizzlers today simply because they are sitting on your coworker’s desk.  Walking away from the twizzlers won’t feel like punishment because you have a reason to do it.  

When sitting down to a meal of grilled chicken and broccoli feels like a punishment, it probably doesn’t align with what you really want to be – which is someone that is eating pizza instead.  When you feel deprived because everyone else around you is going out to Sonic for burgers and ice cream, your underlying desire to be like everyone else is stronger than your want to be healthy.  You might be able to fight it for a while but ultimately, you will cave.  

I’m probably not putting it into words as well as I should – I will keep working on my ability to express the concept, but so much of what most of us need is a redefinition of who we are and how we define ourselves.  Until we make “healthy” an integral part of the way we define ourselves, we are constantly going to struggle with the day-to-day healthy behaviors.  

Let’s circle back to the quote (it’s been a big loop – so thanks for bearing with me!). When we view healthy eating or exercise as a hobby, rather than as part of who we are, we are going to give ourselves an out when something better or more stressful comes along.  Hobbies are great – we should all have several of them. But hobbies are something we consider elective. Not essential.

One of my hobbies is gardening.  Several years ago, I bought 6 acres in western Shawnee and moved us out to this little farm house.  There were a lot of factors that played into my decision (not just my desire to expand my gardening hobby!), but it provided me with loads of opportunities to dig in the dirt.  And I love it. I have been cutting down fresh asparagus this spring. We had buckets and buckets of apples and peaches last summer. However, it is not my livelihood – it’s my hobby.  

My little urban farm came with this great (somewhat broken-down) greenhouse.  The first few years that I lived here, I couldn’t attack it – it was just too big of a project.  This winter I committed. I worked hard to get it ready for spring. I emptied all of the junk out, pulled the weeds, got the tables and heat lamps set up and early in February, I planted loads of seeds.  I watered them often and checked the temperature of the greenhouse regularly. I was on my way to having a whole host of seedlings to plant in March – rows upon rows of spinach and arugula and carrots and onions.  However, my exterior water line broke in February and my boys and I spent 10 days without water. We had to leave our home to shower and had to use bottled water for everything – you can only imagine the hassle! It was at this point that my gardening hobby got discarded.  Hauling bottled water down to the greenhouse in the freezing weather to water seedlings became less important than staying warm inside the house and conserving water. Had my family been relying on that food to avoid starvation, my motivation would have been different – but thankfully, we have lots of local grocery stores where I can buy food if I fail to grow it on my land!

Because gardening is my hobby, I was able to let it go during times of chaos and stress.  Unfortunately, when I talk to people, I hear too many people say the same thing about healthy eating and exercising.  Health is a hobby. They do it during times in their life when things are going well – but when things fall apart (like a huge shift in working from home and/or having to home-school the kids – or some other unexpected chaos), they revert back to unhealthy habits and routines.  Their health hobby gets discarded.  

I think most of the decision to make healthy the new normal has to come from deep inside.  Sometimes just looking at the problem differently does it (which is why I spend my time writing these things!) but other times it’s something that I just can’t put my finger on.  I think we all should spend time reflecting on what we consider our core values versus our hobbies – and then spend some time trying to try and align our core values with what we want long-term.  If being a healthy human being is super important to you (more important than fitting in when those around you work are eating donuts), then avoiding the donuts won’t feel like punishment – it will feel like something that aligns with the way you view yourself.  

I’m going to keep circling back to this concept – because it’s a really important one – but I’m going to stop writing and dive into the part of my identity that says I’m not a workaholic and that I spend some quality time with my kids each day!

Hope everyone is staying sane and healthy and adjusted!

Courtney Younglove, M.D.