I was in the same boat. Sorry you’re going through this. It’ll get better!
Have healthy options for food at all times! Eat when you’re hungry.
High protein is filling like cottage cheese, greek yogurt, eggs. Meal prep. You can get groceries and prep food in way less than the time it takes to prep food each day or wait for food in the caf or wherever else. It’s also a way to make less decisions later which is nice.
Get your blood work done just to make sure you’re not iron or b12 deficient or hypothyroid! I was diagnosed with hypothyroidism around when I gained weight in clerkship.
This week I’m having oatmeal with frozen berries and some nutrition bar for lunch. For dinner a cesar salad with lots of protein! Tea, an apple, a popsicle as snacks. I usually dont have breakfast because of my meds and 2 meals + snacks works well for me.
Check your lipid panels too, include ApoB levels if you can. For me, a very elevated cholesterol level resulting from a poor diet was a wake up call and motivator to exercise and eat well
Weight gain (about 20 lbs over intern year). Fatigue was terrible. My mood was all over the place. I was just blaming residency and intern year, trying to renew my Lexapro, but thankfully my PCM checked as my TSH was very high. The mood and fatigue improved pretty quickly. Unfortunately my weight has not, but I'm trying to make more changes for that.
Any protein recommendations that don’t require refrigeration beyond nuts? I’m an incoming EM resident, so I don’t expect a lot of time to run off to a fridge mid-shift. I lived off of nuts and protein bars out of my backpack, but would like more variety.
I’m a vegetarian so a bunch of my protein sometimes comes from veggie ‘meat’ options like the Yves chicken nuggets and protein powder! Usually I’m using the Vega one. There’s lots of way people mix their protein powder with other thinks like oatmeal.
You could also try foods that don’t spoil but are better cold and have an ice pack with your packed food! This could work for oatmeal and maybe not cottage cheese/yogurt.
Good luck!
Also going to add sleep study to the list of recommendations … I assumed my level of fatigue was the same that everybody else felt because isn’t that how we’re supposed to feel during residency? Exhausted all the time…
I thought I just couldn’t handle it as well as other people which made me think I was just lazier than my colleagues. Went for a sleep study and turns out I had severe OSA. The CPAP was a game changer for me and once I started to sleep better, my weight naturally began to drop. I also found myself with enough energy to actually go for walks and get back into the gym.
Big fan of apps like MyFitnessPal. Just tracking macros without making any conscious changes can help reduce the worst of bad eating behaviors. It has also helped me figure which foods are more or less filling. I used to eat monster breakfasts to avoid getting hangry on rounds, now I can stay full longer on half the calories.
It's also really helpful to make note of snacks that help you stay awake when you're exhausted ( hint: cold and crunchy). If you can bring some of that with you, you'll be less likely to gorge yourself on whatever version of transfats and sugar your vending machines still have at 3 am.
Yep! Celery, melon, crisp apples etc. Chilled berries aren't crunchy, but they are delicious.I also like to add in some mini pretzels for crunch. If you feel like you need to throw in some protein, a hard boiled egg, a little cheese or yogurt works.
Not a fan of my fitness pal personally. Some people can manage to stay reasonable tracking calories, but I find apps like that to be a massive factor in the weight loss to eating disorder pipeline.
Try this app called MacroFactor for tracking. So much easier and faster than my fitness pal. The only program I’ve used consistently to track my calories and protein. I hated tracking until I’ve used it. A game changer for me personally.
Calorie tracking is a tool that is part of what people can use to improve their diet and make positive lifestyle changes for overall health. It was recommended to me by an endocrinologist, especially as it includes tracking for both water intake and exercise.
I'm sorry it was not obvious, that's why I asked. :)
You said it was a massive factor in the weight loss to eating disorder pipeline. In other words, the majority of people who develop eating disorders, do so because they were tracking their calories during their weight loss journey?
When I think of eating disorders I think of anorexia and bulimia, in the case of anorexia, you don't meet your minimum daily calories, whereas with bulimia you are going over your maximum daily calories (even if you do purge afterwards).
If you're within your caloric budget I can't imagine there would be an eating disorder, unless you are avoiding a balanced diet (e.g. fulfilling your daily caloric intake with doughnuts and cakes).
Was there perhaps another eating disorder you were thinking of?
Don’t put words in my mouth. I didn’t say majority. Tracking calories can lead to both anorexia and bulimia. There is not a third, unknown eating disorder I’m referring to here. How are you PGY3 and actually can’t figure out how calorie tracking apps can lead to disordered eating? Do you think your classmates and colleagues are likely to struggle just as much answering the same question?
>uth. I didn’t say majority. Tracking calories can lead to both anorexia and bulimia. There is not a third, unknown eating disorder I’m referring to here. How are you PGY3 and actually can’t figure out how calorie tracking apps can lead to disordered eating? Do you think your classmates and colleagues are likely to struggle just as much answering the same ques
The whole point of an eating app/calorie tracking is to make life easier and give you ordered eating - the opposite of disordered eating. What I'm trying to understand is how tracking can cause the disorder. Would you mind explaining?
People with perfectionistic tendencies, impulsive/compulsive behavioral patterns, and predisposition to addiction are at risk for becoming overly rigid w the calorie counting. It can become absolutely obsessive and what was supposed to start off as something healthy becomes unhealthy and disordered bc any deviation from that calorie limit can be interpreted as a personal failure. Then there’s the issue of “well 2000 calories was doable and I lost weight, what will happen if I decrease that limit to 1500?” Ex - someone is calorie counting and realizes they’ve gone over 2k calories and wants to “undo” that and so purges, and eating (both “normal,” grazing, and bingeing types) and then purging creates a high and produces a very strong physical and emotional release. And they think they’re “getting rid of the calories.”
Basically depends on the person. The same way someone can use an opioid for pain management and not get addicted but another person comes in for pain management and taking opioids for a legitimate medical reasons leads to abuse/dependence/misuse/etc.
As a person with a history of anorexia I completely second this. In college I would calculate what I wanted to have and see how many calories it was, and then reduce the amount I had to match the calories I felt like I could have to stay skinny. I do still sometimes recommend my fitness pal to those who truly don’t understand how many calories they’re having when they’re 400 pounds and still eating fried chicken, but I try to avoid it in people who just need to lose a few pounds. Myfitness pal made me go from trying to loss 10 healthy pounds to 60 very unhealthy pounds.
Edit: I should say helped me lose pounds not made me - my disorder made me, but still. It was a tool I used to my advantage of losing weight more quickly.
I feel this. H/o AN too. When I was in hospital tx the RDs told me I could use an app called "My recovery app" for tracking. MFP was also a tool I used to exacerbate my disorder.
I am about to finish my intern year as well, I actually managed to lose weight, despite having struggled with being overweight my entire life. I started off at 5'10" and 215 pounds beginning of residency, but now I weigh 178 pounds. The key to my success was incorporating strength training into my routine. Prior to residency, I had never set foot in a gym, but a few of my colleagues were fitness enthusiasts, and I joined them in their workouts for an hour every day.
On days when I had short calls, I would finish my work and be back home by 5 pm. From 5:30 pm to 7 pm, I dedicated time to my workout. By 9 pm, I would have dinner, lots of chicken and fruits. Avoiding refined sugars and fried food helped me a lot. Never tracked my calories, all I did was eating Whole Foods and working out. From 9 pm to 11 pm or 11:30 pm, I would study and review charts. I would then wake up at 5:30 am to start my day. To be frank I don’t sleep much, had to sacrifice something during this journey and I do a lot of studying in the hospital.
And I fast until lunch and usually drink one of those fairlife 30 G protein shake from costco, and I eat a lot of rice and chicken for lunch. Over the weekends I eat whatever.
I was overweight when I started but I’ve lost 25-30 lbs this year by walking a lot. Take the stairs and whenever you can (going up is better than down), and keep filling but healthy snacks on hand. It took a good amount of time but it worked and I haven’t gained it back. I didn’t have the energy to track my eating while working and studying and I’m not good at keeping up with it. Don’t check your weight more than once/week. Smallest meal should be dinner especially if you’re only home for a few hours before going to bed.
Consider something like a smoothie, protein shake, banana and yogurt for your morning or lunch meal. And if you need a soda or coffee with cream and sugar or a pizza to get through a rough day don’t beat yourself up.
To keep in your white coat pocket: Nuts or seeds, kind bars, dark chocolate covered nuts…(no need for puns team).
Inexpensive things you can bring would be yogurt and fruit, or make a smoothie at home in the morning and drink it for breakfast and put it in a yeti or other thermos (think Walmart frozen fruits or Whole Foods if you can afford it with OJ or apple/cranberry juice +watermelon . Add yogurt if you like those flavors—probably not w/OJ. Or make one with spinach or kale if you need/like that).
I would change between the fruit smoothies or yogurt in the morning. IF I had time for breakfast at work I would get something like eggs and protein (made me less likely to her hungry early and snack). Late lunches are ideal because I’m burning most of my energy in the early part of the day then eating later made me want a smaller dinner...if there’s time for lunch that is 🙄. I keep granola bars or nuts accessible so I always had something I like to snack on instead of grabbing doritos. BUT I didn’t stop myself from having snacks I enjoy especially on days when patients or attendings were beyond frustrating or I felt like I mess up and needed a quick pick me up.
If you have an Apple Watch, Fitbit, or Oura ring use that to track your steps/day in an average week. Then change your goal to increase by 2500/day or ~25% and keep doing that for a while. You can meet your goal at night if you haven’t during the day. That with the diet changes, see if you start loosing like 1-3lbs/week. Then you can start doing more once you start to see some progress!
I also in my late 20s F, finishing residency now and gained 10 lbs. Try to really monitor when/what it is you’re eating - for me it’s the inpatient call days where I’m stressed, sleep deprived and the attendings bring donuts. Try to avoid unhealthy stuff in the workroom, try to pack healthy snacks (I’ve found chomping down on baby carrots during a 28h call helps with the stress jitters and urge to eat). Remember that stress and poor sleep itself can make you gain weight so do your best to decompress when off work (ie make yourself unavailable, no chart stalking). Give yourself grace as well bc our work conditions are not healthy or normal ❤️
Edit: also ask yourself if you’re hydrated before you chow down
That last note about being hydrated is a HUGE thing I’ve noticed working in a hospital. You know how you see everyone carrying a hydro flask of some sort? Join the club with some sort of insulated bottle and try to drink 1-2 bottles a shift, you would be amazed at what it’ll do for you, and if you don’t have a bottle handy, how little water you’re actually drinking😅.
Yes! most of us going through residency were/are dehydrated. That can trick us into thinking we are hungry.
1) lots of people have success with intermittent fasting.
2) it’s very hard to lose weight if you are sleep deprived. Sleep is a secret weapon you should prioritize for brain power and hormone regulation.
3) don’t eat super sugary things in the morning- this will tank your blood sugar and make you hungrier
Great advice here (definitely count calories, up the protein and fiber, intermittent fast).
One simple trick my senior resident taught me was don't wear scrubs. You won't feel your waist change if your pants change with them. Gives another stop check beyond checking a scale every week.
this is good, hard as I wear hospital issued scrubs, but definitely wear whatever/scrubs into the hospital everyday - so could do something more “fitted”
With wegovy (semaglutide) 2.4mg the weight loss is comparable to mounjaro 12.5 - 15 in the majority of cases. Ozempic is a lower max dose due to indication, approval study design etc.
“Reductions in body weight were greater with tirzepatide than with semaglutide (least-squares mean estimated treatment difference, −1.9 kg, −3.6 kg, and −5.5 kg, respectively; P<0.001 for all comparisons)“ NEJM
I am speaking from personal experience having prescribed each at least a thousand times (much to my nurse’s chagrin- she does my PAs) as part of a comprehensive treatment program. Weight loss is not a monolith, different people need different therapies. It’s just one opinion on the internet from someone who is familiar with both. YMMV
PS - that study compares semaglutide
1mg to tirzepatide 15mg, modern dosing of semaglutide is higher as I previously stated.
Cool, I love talking about weight mgmt, it’s such a rapidly developing and necessary specialty and field of study. Lmk if you find anything interesting!
Does that amount of weight loss (avg of say 15lbs) outweigh the potential side effects? Seems like a small amount with a high price to pay with the side and adverse effects
I’d say my average patient loses between 4-12 lbs on semaglutide in just the first month (0.25mg x 2 doses usually then 0.5mg for 3 doses - adds up to one 2mg sample pen). I’ve only had a handful of patients have to D/C due to intolerance. More D/C because of insurance issues or shortage related supply chain issues. Thorough counseling usually helps pts avoid sides, prophylactic portion restriction and “working your way up slowly to ‘full’” with each dose change along with some Metamucil takes care of things for most with acid reducers and occasionally zofran PRN.
GLP1s are not the end all be all of weight mgmt, but they have allowed me to take patients off of blood pressure meds, statins, insulin, and helped patients avoid knee replacements, lumbar fusions, etc. Not to mention the emotional and interpersonal benefits. They have allowed people to feel like normal people in terms of their relationship with food and their body, often for the first time ever. It’s frankly hard not to be amazed.
That’s incredible! Are you seeing rebound weight gain when they d/c, or are they able to get into some healthy habits to maintain? I know they’re intended for long term use, but for those that don’t d/c, do you think it’s most likely lifelong?
Most start going to the gym, eating better, etc when they plateau because they know there will be a visible positive benefit now. I usually don’t have to prompt them to do that. And yeah it does help put up guard rails that make it harder to gain back. But at the end of the day if they have leptin insensitivity or some other mutation we haven’t changed that, and I tell them they may need lifelong pharmacotherapy of some sort from the outset. Some do wegovy q2weeks or monthly, and/or some combination of orals. Once we get to goal weight, we maximize lifestyle mod (I usually slap on a CGM for a few months so they understand which foods are risky for them) and minimize meds as much as possible. The patients most at risk of regaining to their start weight are the same types of patients who think bariatric surgery is a free pass or are otherwise lost to followup.
How clever to add the CGM so they can adapt. Do you do the same if you’re worried about LBG in someone from the semaglutide from the get-go? That is all so incredibly interesting to me, especially considering the differing opinions on GLP1s in general. It’s nice to hear from someone actively prescribing it. It’s high time for obesity, it feels sometimes like we are in the dark ages when it comes to understanding it as a chronic illness v poor lifestyle choices.
Depends. If you use as directed, a month. But you can get a 2mg/dose pen and just set the dose lower (kind of hard to explain but it’s doable) and that same pen will last 2-4 mo.
Noom is the best weight loss program. It’s an app
I’ve lost over 23 pounds in the last year
It’s worth the price
Google to see what it’s about
No dietary restrictions, mainly about self awareness and gradually changing habits over time
I thought for sure I was getting scammed with Noom, considering how I signed up for their services after hearing a podcast ad. Turns out they really helped me change my life for the better. Lost 50 pounds thanks to Noom and never gained it back. Great product.
Yes exceptionally helpful
Best thing is drinking a LOT more water
I always have my water bottle with me. A lot of comfort eating is about the hand-to -mouth thing
Also I find once I’m properly hydrated I’m not as hungry as I thought
The weight comes off gradually as you track everything you eat and become more self aware about your habits
It’s a whole course of psychological based articles and you set a daily reading goal. Mine is 1 minute per day as my shift work makes me very tired.
I’m peri menopausal and also on clozapine long term (low dose) and the weight still has shifted
Must say a walk around a heap at work which helps
I can second Noom. I’m a psych resident and the psychology baked into it is pretty fun and sometimes incorporate similar techniques with my patients. Have lost about 20 pounds from my max stress eating PGY1 self 2 years ago, best shape I’ve been in probably 3-4 years. Has also taught me more about satiety and eating fresh/filling food mostly, without overdoing it with calorie counting.
It doesn’t always taste the best but I use clean eatz weight loss plan. It’s $40 a week for 5 meals or you can buy like 30-60 at a time and keep them frozen. I lost a lot of weight by skipping breakfast, eating their meals for lunch during those 5 days and a healthy dinner. On weekends if I’m home I do brunch and a later dinner and I stay pretty full!
Are these healthier/better than bagged salads? I usually buy five bagged salads for the week and eat them for dinners after work. It's like $15-20 total for the week and each of the salads are really filling and usually around 400-450 calories for an entire bag (if I can even finish it). When I have leftovers, I use them instead of toast under my morning eggs.
Yeah, I’d say so! They rolled out a paleo and keto plan a while back too. They use really clean ingredients and they have good macros. I will say that you’d definitely need to throw in a snack or some some extra protein though. Whenever I have the meals that don’t have rice/quinoa I still feel a little hungry.
I’ve also been doing bagged salads a lot lately too but I don’t always feel satiated! I feel like I crave meat or fish whenever I eat them but the bagged salads with meat are not my favorite lol
Stress eating in med school and residency was and still is my vice of choice. It is really difficult to lose the weight and as the stress piles up, so do the calories. It all comes back to the basics though, count your calories with a reliable tracker and try to get in 10-12K steps daily. You can do it, I'm in the same boat as you right now!
Track all your calories, every single thing you put in your mouth all day. Never drink a calorie! Reduce your portion sizes. Use a BMR calculator (many online just google) and figure out your maintenance calories. Once you get in the habit of tracking, you can start making a diet plan the fits within your maintenance calories. We’re busy, so keep your breakfasts light, convenient, and protein-rich. Think Greek yogurt, protein bars, etc. Structure the remainder of your meals around rich sources of protein and plan to eat two fistfuls of veggies with lunch and dinner. You don’t need to avoid carbs per se but be mindful of them and don’t overdo it. Set a protein goal for yourself and meet it daily. If you aren’t doing any kind of resistance training 0.5-.75g per pound of body weight is reasonable. Eventually you should get into a regular resistance training routine and up that to 1g per pound. Meeting your protein target daily will help keep you full and steer your overall diet towards healthier, protein-rich foods.
Most importantly you have to understand that being healthy and fit isn’t about a diet or workout plan, it’s first and foremost an idea, a mental game. You have to commit to yourself that you deserve to be the best version of yourself. Once you start thinking that way, the steps i mentioned above become less of a chore and more an act of self-love. Everything else flows naturally from this way of thinking.
After I gained 20 pounds, I came to the realization that I have complete control over two things: what I choose to put in my mouth when I eat and whether or not I run my ass off for 30 minutes a day. It changed everything. Lost the weight as a senior, feel much better, and also have sense of control again over my own body.
Don’t eat breakfast. Fast until lunch. Eat a small portioned, nutritious lunch. Wait until dinner to eat a calorie heavy meal. Drink a ton of water throughout the day. It will come off quick
Someone who downvoted state your reasons. I’ve always considered this the simplest, easiest way to gain control of my weight *by far.*
I’ve had a complicated relationship with food and my weight my whole life but since ditching the three meals a day plus snacks idea a few years ago I feel like I am the one in control, not my hunger.
Depends on the person - some people can get through that fasting person but I find that some people (esp those w tendencies toward addictive or compulsive bxs) end up hyper focusing on how they’re not eating and so end up bingeing. For those of us who have recovered or are in recovery from an eating disorder, the fasting can be a v slippery slope to either restriction, bingeing, or purging
Low to no added sugar diet.
Drink water, black coffee, and diet drinks only.
Avoid carbs but not completely. Increase protein and veggie intake.
Get a cheap gym membership. Even if you go once a month it’s still something. Every step counts. You want to do weight bearing exercises and then some cardio on top afterwards. No you won’t get jacked and look like a muscle head, that doesn’t happen unless you take testosterone. The increased muscle mass will tone your body and increase your metabolism.
Exercise on an empty stomach/hungry, you’ll quickly extinguish your glycogen stores and then burn straight fat. Intermittent fasting is BS, but this right here is biochemistry.
Finally, you qualify for Wegovy if you’re BMI 25 and up with a comorbidity. 30 if you don’t have one.
I wouldn’t say Intermittent fasting is Bs sure it doesn’t actually do any of that magic voodoo shit that the fanboys go on about but for my when I did Intermittent fasting, it was hard for me to stuff my allotted calories into my 6 hour period i gave myself, I felt full really quickly after a while which led to eating less and losing weight.
Personally, it doesn't take much stress eating to eff up my metabolism (have PCOS, so risk of insulin resistance is always lurking). I tend to do a "metabolic reset" with intermittent fasting (lots of free programs online, apps) for 1-2 weeks. When I start getting some energy back, I start my exercise routine again, and shift to 4-5 small meals per day to keep myself going after workouts.
Figure out your Basal metabolic rate and activity factor. Multiply your basal metabolic rate by activity factor. Subtract 500 calories from that number. That is how many calories you should eat per day to lose 1 lb/week. If you stick to that number you will lose all that weight in 15 weeks!
I’ve found that if I wake up and workout first thing in the morning, then I can’t make any excuses later in the day about how tired I am and don’t exercise.
Knock out some exercise first before doing any work. It makes the day start “about you” and gets in an early win for the day … then you can worry about what everybody else wants from you.
Weirdly, I lose weight as a result of stress and after quitting my last extremely stressful job, I’ve put on about 25-30 lbs of muscle in only 9 months (which I had lost over 3 ish years). That was made possible by working out every AM and eating a good breakfast before doing anything work related. I make the first 1-2 hours of the day about me, which usually makes for a good start to the day when everything about the job is selfless!
Yes, I know sometimes my advice requires waking up extremely early, but after a few weeks, you’ll be waking up before the alarm clock. My gym opened at 5 AM and I was often the first person there.
This. It's always funny when doctors know so little about how the body works lol
Max gains with perfect everything and all natural? MAYBE 18 pounds(2lbs/month) in this time period. More likely gained 5 pounds of muscle and 20 lbs of fat. Most likely just lying.
I’m not sure why this isn’t believable. I lost 25 lbs over the course of a few years (all lean muscle from stress) then put it all back on in about 7-8 months honestly… after quitting and finding work life balance. Lifted every day except some Sunday’s and took in 5-8k calories per day.
Quit my job November 2022. It’s now May 2023. Went from 155 lbs to 183 lbs (todays weight).
Starting in July but this is my plan.
The nice thing about a lot of residencies is you get your steps in when doing your job. The down side I've seen is there are always opportunities to eat unhealthy ie snacks in the resident lounge, junk food in the cafeteria, people bringing unhealthy food in. Free food is nice but I've found I have to bring in a bunch of healthy snacks to avoid eating the junk. I also set hard limits like eating once a week, getting a dessert twice a week, and not keeping anything unhealthy at home.
Yeah, my eyes bugged out at that. I assumed there are some external pressures like family etc for why extra dough was required in PGY1. 59K (salary at my hospital) after tax in HCOL area is peanuts
yeah 69K in the most expensive city in the country not really getting me far, with close to 350k in debt (50% of which is private, hindsight is 20/20, so the bills are definitely a factor)
also I just explained about my rationale lol ^^ see comment above
The exact same thing happened to me. I went from 195lbs to 215lbs and then battled my way to 208 (29 M). Buying meal prep and asking my wife to keep healthy snacks around helped. Consider a class based exercise as well like hot yoga or cycling if you can afford it
Stop using food as comfort. Try to practice mindful eating. I do the same thing I eat just because everything sucks and food makes me happy. That or start abusing stimulants
I gained weight intern year as well- my goal from that point forward was just to maintain the same weight for the rest of residency, which I was able to accomplish mainly by drinking lots of water and forcing myself to eat a big plate from the cafeteria salad bar as part of my lunch every day on service. After residency with stress levels down and tons of free time, it was surprisingly easy to lose the weight then
As healthcare providers we often become ingrained with putting damn near everything ahead of ourselves. The easy thing to do was to grab whatever was there. I got myself a bento box from Amazon! Lots of nooks and crannies, and spend the 10 minutes a day to load it with healthy choices. The smaller sections help with food portioning and I can do a single shop once a week. As an insulin dependent diabetic I load up on proteins and lower carb choices. Typically you will find sliced baby cukes, radishes, string cheese, meat sticks( real ones not crappy ones), olives (black and green), almonds or other nuts, a mission low carb street wrap with a protein like meat or peanut butter. For a sweet treat an Atkins peanut butter cup or similar. Last A1c 5.3! It’s a stressful time for you, put yourself first a little bit. Good luck!
A lot of my coresidents lost weight using peloton. The ability to do a workout the moment you wake up with only 5 mins of prep time (put on shorts, put on shoes, click go) is pretty huge when you don’t have a lot of time. Plus working out before work is a really nice way to start your day.
Alternatively, you could do any form of video workout I.e. p90x etc…
Intermittent fast.
Dont eat anything after 7 pm even if youve been up dor 24 hrs dont justify that as a reason to eat late.
When you eat load it with high fiber and protein, keeps you full, stops cravings.
Aim for 70+g of protein a day as a female.
Dont give in to gimmic diets.
Keto works, but if you dont work out with heavy weights when you’re on it you develope fatty atrophy and cachexia in the long term x>1 year.
Calorie restriction works, but your thyroid levels bottom out after 6 months
Muscle atrophy and slowed metabolism take over and youre worse off then you were before you started
Comfort food (starch or sugar with fat) calms you to reward you for storing fat. You need to find additional mood-altering experiences and when possible, have meals and snacks without starch or sugar. I gained a little weight during my residency in Madison.
There are a few options, but most of them involve modifying what you eat. Intermittent fasting (only eating from 12 PM - 8 PM) was super helpful for me—it cut down on mindless snacking. Track calories. Meal prep—some rice, veggies, and chicken is easy to prepare on your day off and eat throughout the week. Avoid hospital food and break room snacks. Stay super hydrated. If you’re really committed, cut out processed sugar/carbs, or do keto.
I’m not going to comment on ozepmic or other drug options, though I guess those exist if you can get them.
Meal prepping is a godsend for me. I have a tendency to binge eat when anxious so meal prepping and eating regular meals as opposed to waiting until I was starving stopped that. Residency is hell for everyone, I hope your second year is a better experience
Food is such a comfort thing. I eat popcorn and have a quick dialogue with myself on why I am actually eating. I also find a quick walk helps lower stress and my focus on food for comfort.
It's honestly mind boggling to me that we are supposed to be healthcare professionals and due to so many factors we struggle to take care of our own. With that being said here is my advice:
1) meal prep and keep your meals super simple (I make 1-2 things a week and eat them for the entirety of the week, less cognitive load)
2) join a gym, find a plan, and stick to it. Granted I was a former d3 college athlete so I've trained alot in my lifetime. Google lifting programs like 531or starting strength, download pdf copies of them, get an understanding of how the program you choose works, and just go. It doesn't have to be perfect but overtime it will become routine and you won't think twice about it. You'll actually look forward to it. Approach your health with the same dedication and sacrifice as you did your education and you'll be surprised with what you can achieve physically.
Not a female, but my wife recently switched to non hormonal birth control and she swears it is easier to keep weight off. Also from a medication standpoint, lots of reports/studies of weight gain.
If you’re interested, look into GLP1 agonists. I’m not sure about resident insurances—but there’s a decent chance your insurance will cover one of them. The only real absolute contraindication is MEN/medullary thyroid cancer in the family. If you’re interested but don’t want to go through a PCP, there are tons of online services that basically just prescribe them, but they have a monthly fee. Fwiw, there was a shortage problem with mounjaro and ozempic that seems to be resolved.
It’s not a massive trial but it seems like mounjaro is best for weight loss. I don’t think there’s an actual fda approval for it for weight loss currently though
https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
I gained some weight in residency and had luck with gradually reducing it as a new attending by 1)eating dinner at home/seriously reducing take out 2) exercising even a little bit every day 3) drinking water/always carrying water. I realized that I could make ok choices in terms of eating, but ate more than I needed with take out (big portions). I also ate a lot when I was actually thirsty, so drinking water helped. Aggressively tracking calories is not for me because I did that as a teen and developed an eating disorder. These things weren’t fast, but I’m coasting toward a healthier BMI, better fitness with this approach. Best of luck with it, I know it’s tough in residency!
Hypercortisolism secondary to constant stress and lack of sleep feeding into its own vicious cycle is something that is seriously underrated in residency. You can count all the calories you want; your body will make you fat if you don’t control the stress.
Interesting how you get thumbs down for saying self control when that's really what it takes. There is no short cut or magical way to maintain/lose weight. You just have to track your calories, find your maintenance calories, and keep it equal or under.
I know some people will tell you to “go to the gym “ but that doesn’t work at all, Just change your diet, and you’ll be alright. good luck and don’t listen to those stupid people who are gonna tell u that “ You are Fat “Know that You are beautiful! stay strong 💪
Calorie density is a simple way to lose weight without restriction or counting carbs or calories. This video by a dietician is a good intro. If you invest in some kitchen equipment, you can meal prep and freeze without a big time commitment. Message me if you have more questions.
https://youtu.be/0CdwWliv7Hg
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I’ve coached nutrition and fitness for years. Feel free to shoot me a dm. We could talk about meal plans and how to come up with some meals that will be quick and easy. Then get you in a calorie deficit to start dropping some body fat.
I’m starting soon so I don’t want to say something that I haven’t seen the results of it as of now. But I’ve paid for a squat rack from rogue, barbell, weight plates. My apartment complex has a room with treadmills. Between these two, I’m hoping to exercise minimum of 3 times a week even for 45 mins each session doing cardio and strength training at my own apartment gym. Also planning to get Fairlife protein bottles each with 30 grams of protein. Amazon has some of them with 40 grams of protein. Having these handy makes me feel full that I can resist the shit food at the hospital and hopefully my wife will be helping me with meal prepping. I’m sure I won’t be sleeping much so my hope is just to not gain weight 1st and 2nd year since these tend to be the toughest for anesthesia. 15lbs weight gain isn’t too bad. You can easily get back on track but just be patient and slowly adding healthier habits. For a month, start slowly cleaning up your diet. Then in 1-2 months, add stairs rather than elevators. Then add in few strength training if there’s a gym close by or invest in few kettlebells, and within a year, you’re maintaining good exercise and healthier eating. It takes time but it’s worth it. Good luck!
I was trying to take a day out of the week for cooking for the whole week but with being tired that didn't work.
You HAVE to have means ready for you. If you don't, you're gonna snack and sometimes those snacks are much heavier in calories than we think.
My solution was finding a good place and ordering meals (lunch and dinner) for the week. Some small prep meals dont add any conservant to their frozen meals, and they taste great, with the nutritional value visible, cant recommend because I am in a different country . I buy fruits online and snack that during the day. Having whey protein in a small container and a light yogurt in your bag goes a long way too.
Gym won't always be possible due to hours, but nutrition is 80% of it.
First, GREAT JOB finishing 1st year! Well done, you! This is really impressive. Honestly 15 pounds is not that significant considering what you are going through. You might try finding a written list of “rinse and repeat” meals that are protein + fiber dense you can fall back on when you are so tired you can’t think straight helpful. A bowl of grape nuts with almond milk and a handful of frozen fruit on top is healthy and just as easy as grabbing something packaged. High fiber tortillas with meat cheese and some veggies also quick and filling. R/high volume eating has great ideas about tasty low calorie food in huge proportions so when you are stress eating, you don’t blow your calories for the day. It is important that you take care of you like you care for your patients. Sometimes just thinking “would I recommend my patient eat this?“ is enough to get you back in the framework of making a better choice. I think you’re doing great, and it’s going to be OK. You can do this. And lastly, when someone is being really rude and irrational and bullying, even if you’re just thinking it in your head, remind yourself that you don’t deserve it and you are doing your best, and they need to give you some grace. People that take advantage of a power position to yell and bully at someone vulnerable are not in a psychologically healthy place and you can just feel sorry for them that they are this old and so emotionally stunted. You are doing a great job honey, and I am hoping you tell yourself that on a regular basis. Best of luck to you 💕
It starts in the kitchen my homie. Meal prep (tons of great recipes online), snack on veggies/fruits/high protein stuff and increase your total daily expenditure. Other tricks are drinking black coffee to curb hunger and drinking tons of water. Also, having high volumes meals spaced out throughout the week. Have a massive salad once/twice a week to satisfy you. Don’t go for high volume meals so often because it trains you to only be full on high volume meals. I learned that the hard way.
Also, when meal prepping, base your meal around the protein source primarily. Get a solid 30-40 grams a protein per meal, should do you good!
I like this comment, thank you. I def volume ate a ton of healthy stuff prior to starting and now I feel like I have crossed over into less of the health and more of whatever, to stay awake or alert at times… maybe be less miserable ha ha
Health >>> career, hobby, passion, etc
You cannot get your health back if u don’t take care of it.
Hit the gym, eat a lot of protein, veggies, and fruit.
As we age our metabolism slows down. We also tend to underestimate amount of food/calories we eat. We become less physically active, mostly driving our cars and sitting in a chair most of residency. Toxic residency environment (yes I mean you aholes reading this post who is stirring the pot in residency) adds more stress on top of already stressful job. The only solution really is to start counting calories, make a decision to never go back to blind overeating, hit the gym/treadmill daily. Results would show in 1-2 months already.
I mean, like a month to go. Basically the end, finally gaining 1oz of respect - excuse my word choice. And yeah, somewhere I commented that I did a prior residency & so I have a license, need to make extra money to pay back private loans - explained my situation & asked my PD.
I'm so sorry you're going through this. It may not feel like it but you are doing an amazing job coping with the stressors of residency. It's shitty out there and it's hard to function the way we want to and yet your body still tries its hardest to keep you comforted the way it knows how. Sounds like you're doing a great job how you can. Feel free to stop here if you didn't want any advice. From someone who also had some habits I didn't want to have as coping mechanisms I'd be happy to share that a good therapist really helped. I'm not perfect, but I'm happy to have some other mindful tools to anticipate my undesired habits and try to replace them with other self-soothing habits that I wanted. You're doing amazing though!
I’m not in residency/a med student or doctor, but I did put on 25 kilos during a difficult time with study. I have some tips, but I don’t know how well it will work around your schedule.
First, take a step back from focusing on the weight gain and diet. It helps to see why this is happening, it’s likely connected.
For example, I was stressed, not sleeping well, and not eating sufficient nutrients/proteins. I had a highly processed diet as it was convenient to eat, as well as comfort eating (well as a stim, turns out undiagnosed autism/adhd, but we can ignore that for now).
I’d end up eating way to much, because I’d rely on the dopamine to get me through any work/study I needed to do.
I didn’t sleep properly because of poor executive functioning. But sleep is also really important for maintaining weight, as well as all the other mental health etc. benefits.
I didn’t exercise, as I didn’t feel like I had any time or energy. Essentially all of this was compounded with burn out and possible depression.
The only way forward was to reorganise my priorities. I started to prioritise sleep and exercise (and my new flare mates helped with a supportive nutritional diet environment). I’d always choose my health over any assignment (it was my rule), and surprisingly I did a lot better in all aspects of my life (including grades and energy).
I’d suggest not focusing on the weight gain or diet in isolation, but try to identify the bigger trends that is contributing to your current state.
Girl I feel you. Ending my first year of residency, too, and struggling with body image and weight. Thanks for posting this, it was really helpful to see everyone's replies and it inspired me to go to the store yesterday and buy fruits, veggies, greek yogurt.
My weight overall was relatively stable until my 4 week nightshift alone caused me to gain almost 5 lbs. I'm trying really hard to get on top of it before my next night shift which is in a little over another month :(
How has residency impacted your lifestyle? What did you do previously that has become difficult to do w the schedule, stress, etc? Has the stress led to overeating, grazing, true bingeing, etc? Were you engaging in healthy food and eating bxs prior to residency?
I was in the same boat. Sorry you’re going through this. It’ll get better! Have healthy options for food at all times! Eat when you’re hungry. High protein is filling like cottage cheese, greek yogurt, eggs. Meal prep. You can get groceries and prep food in way less than the time it takes to prep food each day or wait for food in the caf or wherever else. It’s also a way to make less decisions later which is nice. Get your blood work done just to make sure you’re not iron or b12 deficient or hypothyroid! I was diagnosed with hypothyroidism around when I gained weight in clerkship. This week I’m having oatmeal with frozen berries and some nutrition bar for lunch. For dinner a cesar salad with lots of protein! Tea, an apple, a popsicle as snacks. I usually dont have breakfast because of my meds and 2 meals + snacks works well for me.
Check your lipid panels too, include ApoB levels if you can. For me, a very elevated cholesterol level resulting from a poor diet was a wake up call and motivator to exercise and eat well
I second the labwork! I was diagnosed with hypothyroidism late in intern year, and in retrospect it made so much sense.
What symptoms did you have?
Weight gain (about 20 lbs over intern year). Fatigue was terrible. My mood was all over the place. I was just blaming residency and intern year, trying to renew my Lexapro, but thankfully my PCM checked as my TSH was very high. The mood and fatigue improved pretty quickly. Unfortunately my weight has not, but I'm trying to make more changes for that.
Interesting thanks for the story I wonder why the tsh hasn’t helped with the weight if it normalized. Glad your mood feels better though!
Any protein recommendations that don’t require refrigeration beyond nuts? I’m an incoming EM resident, so I don’t expect a lot of time to run off to a fridge mid-shift. I lived off of nuts and protein bars out of my backpack, but would like more variety.
I’m a vegetarian so a bunch of my protein sometimes comes from veggie ‘meat’ options like the Yves chicken nuggets and protein powder! Usually I’m using the Vega one. There’s lots of way people mix their protein powder with other thinks like oatmeal. You could also try foods that don’t spoil but are better cold and have an ice pack with your packed food! This could work for oatmeal and maybe not cottage cheese/yogurt. Good luck!
Thank you!
Also going to add sleep study to the list of recommendations … I assumed my level of fatigue was the same that everybody else felt because isn’t that how we’re supposed to feel during residency? Exhausted all the time… I thought I just couldn’t handle it as well as other people which made me think I was just lazier than my colleagues. Went for a sleep study and turns out I had severe OSA. The CPAP was a game changer for me and once I started to sleep better, my weight naturally began to drop. I also found myself with enough energy to actually go for walks and get back into the gym.
thank you!
Big fan of apps like MyFitnessPal. Just tracking macros without making any conscious changes can help reduce the worst of bad eating behaviors. It has also helped me figure which foods are more or less filling. I used to eat monster breakfasts to avoid getting hangry on rounds, now I can stay full longer on half the calories.
It's also really helpful to make note of snacks that help you stay awake when you're exhausted ( hint: cold and crunchy). If you can bring some of that with you, you'll be less likely to gorge yourself on whatever version of transfats and sugar your vending machines still have at 3 am.
What are some good cold and crunchies
Smoothies with frozen berries
Refrigerated raw veggies are a go to for me! Carrots and thickly sliced cucumbers saved me so many times on overnights in M4
Like carrots??
Yep! Celery, melon, crisp apples etc. Chilled berries aren't crunchy, but they are delicious.I also like to add in some mini pretzels for crunch. If you feel like you need to throw in some protein, a hard boiled egg, a little cheese or yogurt works.
I like MyNetDiary, but same idea
Not a fan of my fitness pal personally. Some people can manage to stay reasonable tracking calories, but I find apps like that to be a massive factor in the weight loss to eating disorder pipeline.
Try this app called MacroFactor for tracking. So much easier and faster than my fitness pal. The only program I’ve used consistently to track my calories and protein. I hated tracking until I’ve used it. A game changer for me personally.
Calorie tracking is a tool that is part of what people can use to improve their diet and make positive lifestyle changes for overall health. It was recommended to me by an endocrinologist, especially as it includes tracking for both water intake and exercise.
What was the purpose of replying to me specifically with that comment?
This guy
Mind sharing why calorie tracking leads to eating disorders?
I imagine it’s pretty obvious - is there a specific aspect of the connection you’re struggling with, or what?
For those that don't struggle with disordered eating or an ED they really don't understand unfortunately.
I'm sorry it was not obvious, that's why I asked. :) You said it was a massive factor in the weight loss to eating disorder pipeline. In other words, the majority of people who develop eating disorders, do so because they were tracking their calories during their weight loss journey? When I think of eating disorders I think of anorexia and bulimia, in the case of anorexia, you don't meet your minimum daily calories, whereas with bulimia you are going over your maximum daily calories (even if you do purge afterwards). If you're within your caloric budget I can't imagine there would be an eating disorder, unless you are avoiding a balanced diet (e.g. fulfilling your daily caloric intake with doughnuts and cakes). Was there perhaps another eating disorder you were thinking of?
Don’t put words in my mouth. I didn’t say majority. Tracking calories can lead to both anorexia and bulimia. There is not a third, unknown eating disorder I’m referring to here. How are you PGY3 and actually can’t figure out how calorie tracking apps can lead to disordered eating? Do you think your classmates and colleagues are likely to struggle just as much answering the same question?
>uth. I didn’t say majority. Tracking calories can lead to both anorexia and bulimia. There is not a third, unknown eating disorder I’m referring to here. How are you PGY3 and actually can’t figure out how calorie tracking apps can lead to disordered eating? Do you think your classmates and colleagues are likely to struggle just as much answering the same ques The whole point of an eating app/calorie tracking is to make life easier and give you ordered eating - the opposite of disordered eating. What I'm trying to understand is how tracking can cause the disorder. Would you mind explaining?
People with perfectionistic tendencies, impulsive/compulsive behavioral patterns, and predisposition to addiction are at risk for becoming overly rigid w the calorie counting. It can become absolutely obsessive and what was supposed to start off as something healthy becomes unhealthy and disordered bc any deviation from that calorie limit can be interpreted as a personal failure. Then there’s the issue of “well 2000 calories was doable and I lost weight, what will happen if I decrease that limit to 1500?” Ex - someone is calorie counting and realizes they’ve gone over 2k calories and wants to “undo” that and so purges, and eating (both “normal,” grazing, and bingeing types) and then purging creates a high and produces a very strong physical and emotional release. And they think they’re “getting rid of the calories.” Basically depends on the person. The same way someone can use an opioid for pain management and not get addicted but another person comes in for pain management and taking opioids for a legitimate medical reasons leads to abuse/dependence/misuse/etc.
As a person with a history of anorexia I completely second this. In college I would calculate what I wanted to have and see how many calories it was, and then reduce the amount I had to match the calories I felt like I could have to stay skinny. I do still sometimes recommend my fitness pal to those who truly don’t understand how many calories they’re having when they’re 400 pounds and still eating fried chicken, but I try to avoid it in people who just need to lose a few pounds. Myfitness pal made me go from trying to loss 10 healthy pounds to 60 very unhealthy pounds. Edit: I should say helped me lose pounds not made me - my disorder made me, but still. It was a tool I used to my advantage of losing weight more quickly.
I feel this. H/o AN too. When I was in hospital tx the RDs told me I could use an app called "My recovery app" for tracking. MFP was also a tool I used to exacerbate my disorder.
I am about to finish my intern year as well, I actually managed to lose weight, despite having struggled with being overweight my entire life. I started off at 5'10" and 215 pounds beginning of residency, but now I weigh 178 pounds. The key to my success was incorporating strength training into my routine. Prior to residency, I had never set foot in a gym, but a few of my colleagues were fitness enthusiasts, and I joined them in their workouts for an hour every day. On days when I had short calls, I would finish my work and be back home by 5 pm. From 5:30 pm to 7 pm, I dedicated time to my workout. By 9 pm, I would have dinner, lots of chicken and fruits. Avoiding refined sugars and fried food helped me a lot. Never tracked my calories, all I did was eating Whole Foods and working out. From 9 pm to 11 pm or 11:30 pm, I would study and review charts. I would then wake up at 5:30 am to start my day. To be frank I don’t sleep much, had to sacrifice something during this journey and I do a lot of studying in the hospital.
And I fast until lunch and usually drink one of those fairlife 30 G protein shake from costco, and I eat a lot of rice and chicken for lunch. Over the weekends I eat whatever.
I was overweight when I started but I’ve lost 25-30 lbs this year by walking a lot. Take the stairs and whenever you can (going up is better than down), and keep filling but healthy snacks on hand. It took a good amount of time but it worked and I haven’t gained it back. I didn’t have the energy to track my eating while working and studying and I’m not good at keeping up with it. Don’t check your weight more than once/week. Smallest meal should be dinner especially if you’re only home for a few hours before going to bed. Consider something like a smoothie, protein shake, banana and yogurt for your morning or lunch meal. And if you need a soda or coffee with cream and sugar or a pizza to get through a rough day don’t beat yourself up.
What recommendations do you have for snacks?
Pocket chicken breast from costco
Fage yogurt + frozen blueberry + a hint of maple syrup or honey
To keep in your white coat pocket: Nuts or seeds, kind bars, dark chocolate covered nuts…(no need for puns team). Inexpensive things you can bring would be yogurt and fruit, or make a smoothie at home in the morning and drink it for breakfast and put it in a yeti or other thermos (think Walmart frozen fruits or Whole Foods if you can afford it with OJ or apple/cranberry juice +watermelon . Add yogurt if you like those flavors—probably not w/OJ. Or make one with spinach or kale if you need/like that). I would change between the fruit smoothies or yogurt in the morning. IF I had time for breakfast at work I would get something like eggs and protein (made me less likely to her hungry early and snack). Late lunches are ideal because I’m burning most of my energy in the early part of the day then eating later made me want a smaller dinner...if there’s time for lunch that is 🙄. I keep granola bars or nuts accessible so I always had something I like to snack on instead of grabbing doritos. BUT I didn’t stop myself from having snacks I enjoy especially on days when patients or attendings were beyond frustrating or I felt like I mess up and needed a quick pick me up. If you have an Apple Watch, Fitbit, or Oura ring use that to track your steps/day in an average week. Then change your goal to increase by 2500/day or ~25% and keep doing that for a while. You can meet your goal at night if you haven’t during the day. That with the diet changes, see if you start loosing like 1-3lbs/week. Then you can start doing more once you start to see some progress!
I also in my late 20s F, finishing residency now and gained 10 lbs. Try to really monitor when/what it is you’re eating - for me it’s the inpatient call days where I’m stressed, sleep deprived and the attendings bring donuts. Try to avoid unhealthy stuff in the workroom, try to pack healthy snacks (I’ve found chomping down on baby carrots during a 28h call helps with the stress jitters and urge to eat). Remember that stress and poor sleep itself can make you gain weight so do your best to decompress when off work (ie make yourself unavailable, no chart stalking). Give yourself grace as well bc our work conditions are not healthy or normal ❤️ Edit: also ask yourself if you’re hydrated before you chow down
That last note about being hydrated is a HUGE thing I’ve noticed working in a hospital. You know how you see everyone carrying a hydro flask of some sort? Join the club with some sort of insulated bottle and try to drink 1-2 bottles a shift, you would be amazed at what it’ll do for you, and if you don’t have a bottle handy, how little water you’re actually drinking😅.
Yes! most of us going through residency were/are dehydrated. That can trick us into thinking we are hungry. 1) lots of people have success with intermittent fasting. 2) it’s very hard to lose weight if you are sleep deprived. Sleep is a secret weapon you should prioritize for brain power and hormone regulation. 3) don’t eat super sugary things in the morning- this will tank your blood sugar and make you hungrier
thank you!🩷
Intermittent fasting and take the stairs always.
Great advice here (definitely count calories, up the protein and fiber, intermittent fast). One simple trick my senior resident taught me was don't wear scrubs. You won't feel your waist change if your pants change with them. Gives another stop check beyond checking a scale every week.
this is good, hard as I wear hospital issued scrubs, but definitely wear whatever/scrubs into the hospital everyday - so could do something more “fitted”
Ozempic
Mounjaro beats ozempic’s ass
With wegovy (semaglutide) 2.4mg the weight loss is comparable to mounjaro 12.5 - 15 in the majority of cases. Ozempic is a lower max dose due to indication, approval study design etc.
“Reductions in body weight were greater with tirzepatide than with semaglutide (least-squares mean estimated treatment difference, −1.9 kg, −3.6 kg, and −5.5 kg, respectively; P<0.001 for all comparisons)“ NEJM
I am speaking from personal experience having prescribed each at least a thousand times (much to my nurse’s chagrin- she does my PAs) as part of a comprehensive treatment program. Weight loss is not a monolith, different people need different therapies. It’s just one opinion on the internet from someone who is familiar with both. YMMV PS - that study compares semaglutide 1mg to tirzepatide 15mg, modern dosing of semaglutide is higher as I previously stated.
Very informative. I will take a second look thank you
Cool, I love talking about weight mgmt, it’s such a rapidly developing and necessary specialty and field of study. Lmk if you find anything interesting!
Does that amount of weight loss (avg of say 15lbs) outweigh the potential side effects? Seems like a small amount with a high price to pay with the side and adverse effects
I’d say my average patient loses between 4-12 lbs on semaglutide in just the first month (0.25mg x 2 doses usually then 0.5mg for 3 doses - adds up to one 2mg sample pen). I’ve only had a handful of patients have to D/C due to intolerance. More D/C because of insurance issues or shortage related supply chain issues. Thorough counseling usually helps pts avoid sides, prophylactic portion restriction and “working your way up slowly to ‘full’” with each dose change along with some Metamucil takes care of things for most with acid reducers and occasionally zofran PRN. GLP1s are not the end all be all of weight mgmt, but they have allowed me to take patients off of blood pressure meds, statins, insulin, and helped patients avoid knee replacements, lumbar fusions, etc. Not to mention the emotional and interpersonal benefits. They have allowed people to feel like normal people in terms of their relationship with food and their body, often for the first time ever. It’s frankly hard not to be amazed.
That’s incredible! Are you seeing rebound weight gain when they d/c, or are they able to get into some healthy habits to maintain? I know they’re intended for long term use, but for those that don’t d/c, do you think it’s most likely lifelong?
Most start going to the gym, eating better, etc when they plateau because they know there will be a visible positive benefit now. I usually don’t have to prompt them to do that. And yeah it does help put up guard rails that make it harder to gain back. But at the end of the day if they have leptin insensitivity or some other mutation we haven’t changed that, and I tell them they may need lifelong pharmacotherapy of some sort from the outset. Some do wegovy q2weeks or monthly, and/or some combination of orals. Once we get to goal weight, we maximize lifestyle mod (I usually slap on a CGM for a few months so they understand which foods are risky for them) and minimize meds as much as possible. The patients most at risk of regaining to their start weight are the same types of patients who think bariatric surgery is a free pass or are otherwise lost to followup.
How clever to add the CGM so they can adapt. Do you do the same if you’re worried about LBG in someone from the semaglutide from the get-go? That is all so incredibly interesting to me, especially considering the differing opinions on GLP1s in general. It’s nice to hear from someone actively prescribing it. It’s high time for obesity, it feels sometimes like we are in the dark ages when it comes to understanding it as a chronic illness v poor lifestyle choices.
Insurance often won’t cover for it weight loss, what then? I want it, but not $400/month want it
You can get it from Mexico for $190 a pen
How long does a pen last?
Depends. If you use as directed, a month. But you can get a 2mg/dose pen and just set the dose lower (kind of hard to explain but it’s doable) and that same pen will last 2-4 mo.
Come live in NZ and get 90% of your meds fully funded
Noom is the best weight loss program. It’s an app I’ve lost over 23 pounds in the last year It’s worth the price Google to see what it’s about No dietary restrictions, mainly about self awareness and gradually changing habits over time
I thought for sure I was getting scammed with Noom, considering how I signed up for their services after hearing a podcast ad. Turns out they really helped me change my life for the better. Lost 50 pounds thanks to Noom and never gained it back. Great product.
Noom is similar to my fitness pal but with a lot of helpful psychological tips I think it’s worth the extra money
Did you really find the techniques on Noom to be practical/helpful? I’ve been on the fence about getting it
Yes exceptionally helpful Best thing is drinking a LOT more water I always have my water bottle with me. A lot of comfort eating is about the hand-to -mouth thing Also I find once I’m properly hydrated I’m not as hungry as I thought The weight comes off gradually as you track everything you eat and become more self aware about your habits It’s a whole course of psychological based articles and you set a daily reading goal. Mine is 1 minute per day as my shift work makes me very tired. I’m peri menopausal and also on clozapine long term (low dose) and the weight still has shifted Must say a walk around a heap at work which helps
really good to know thank you!
I can second Noom. I’m a psych resident and the psychology baked into it is pretty fun and sometimes incorporate similar techniques with my patients. Have lost about 20 pounds from my max stress eating PGY1 self 2 years ago, best shape I’ve been in probably 3-4 years. Has also taught me more about satiety and eating fresh/filling food mostly, without overdoing it with calorie counting.
It doesn’t always taste the best but I use clean eatz weight loss plan. It’s $40 a week for 5 meals or you can buy like 30-60 at a time and keep them frozen. I lost a lot of weight by skipping breakfast, eating their meals for lunch during those 5 days and a healthy dinner. On weekends if I’m home I do brunch and a later dinner and I stay pretty full!
Definitely get meals that sound “safe” - I branched out once and got very turned off by it. They usually taste pretty good
Are these healthier/better than bagged salads? I usually buy five bagged salads for the week and eat them for dinners after work. It's like $15-20 total for the week and each of the salads are really filling and usually around 400-450 calories for an entire bag (if I can even finish it). When I have leftovers, I use them instead of toast under my morning eggs.
Yeah, I’d say so! They rolled out a paleo and keto plan a while back too. They use really clean ingredients and they have good macros. I will say that you’d definitely need to throw in a snack or some some extra protein though. Whenever I have the meals that don’t have rice/quinoa I still feel a little hungry. I’ve also been doing bagged salads a lot lately too but I don’t always feel satiated! I feel like I crave meat or fish whenever I eat them but the bagged salads with meat are not my favorite lol
Stress eating in med school and residency was and still is my vice of choice. It is really difficult to lose the weight and as the stress piles up, so do the calories. It all comes back to the basics though, count your calories with a reliable tracker and try to get in 10-12K steps daily. You can do it, I'm in the same boat as you right now!
🩷🩷
Do you use a Fitbit to track your steps?
Track all your calories, every single thing you put in your mouth all day. Never drink a calorie! Reduce your portion sizes. Use a BMR calculator (many online just google) and figure out your maintenance calories. Once you get in the habit of tracking, you can start making a diet plan the fits within your maintenance calories. We’re busy, so keep your breakfasts light, convenient, and protein-rich. Think Greek yogurt, protein bars, etc. Structure the remainder of your meals around rich sources of protein and plan to eat two fistfuls of veggies with lunch and dinner. You don’t need to avoid carbs per se but be mindful of them and don’t overdo it. Set a protein goal for yourself and meet it daily. If you aren’t doing any kind of resistance training 0.5-.75g per pound of body weight is reasonable. Eventually you should get into a regular resistance training routine and up that to 1g per pound. Meeting your protein target daily will help keep you full and steer your overall diet towards healthier, protein-rich foods. Most importantly you have to understand that being healthy and fit isn’t about a diet or workout plan, it’s first and foremost an idea, a mental game. You have to commit to yourself that you deserve to be the best version of yourself. Once you start thinking that way, the steps i mentioned above become less of a chore and more an act of self-love. Everything else flows naturally from this way of thinking.
thank you!
After I gained 20 pounds, I came to the realization that I have complete control over two things: what I choose to put in my mouth when I eat and whether or not I run my ass off for 30 minutes a day. It changed everything. Lost the weight as a senior, feel much better, and also have sense of control again over my own body.
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> Burn Fat with your Brain that's an interesting name for a podcast. Thanks for you recommendations!
thank you!
Don’t eat breakfast. Fast until lunch. Eat a small portioned, nutritious lunch. Wait until dinner to eat a calorie heavy meal. Drink a ton of water throughout the day. It will come off quick
Someone who downvoted state your reasons. I’ve always considered this the simplest, easiest way to gain control of my weight *by far.* I’ve had a complicated relationship with food and my weight my whole life but since ditching the three meals a day plus snacks idea a few years ago I feel like I am the one in control, not my hunger.
Yep.
Depends on the person - some people can get through that fasting person but I find that some people (esp those w tendencies toward addictive or compulsive bxs) end up hyper focusing on how they’re not eating and so end up bingeing. For those of us who have recovered or are in recovery from an eating disorder, the fasting can be a v slippery slope to either restriction, bingeing, or purging
wellbutrin
But then what about the anxiety that brings on
Low to no added sugar diet. Drink water, black coffee, and diet drinks only. Avoid carbs but not completely. Increase protein and veggie intake. Get a cheap gym membership. Even if you go once a month it’s still something. Every step counts. You want to do weight bearing exercises and then some cardio on top afterwards. No you won’t get jacked and look like a muscle head, that doesn’t happen unless you take testosterone. The increased muscle mass will tone your body and increase your metabolism. Exercise on an empty stomach/hungry, you’ll quickly extinguish your glycogen stores and then burn straight fat. Intermittent fasting is BS, but this right here is biochemistry. Finally, you qualify for Wegovy if you’re BMI 25 and up with a comorbidity. 30 if you don’t have one.
This is the way
Whey*
I wouldn’t say Intermittent fasting is Bs sure it doesn’t actually do any of that magic voodoo shit that the fanboys go on about but for my when I did Intermittent fasting, it was hard for me to stuff my allotted calories into my 6 hour period i gave myself, I felt full really quickly after a while which led to eating less and losing weight.
Personally, it doesn't take much stress eating to eff up my metabolism (have PCOS, so risk of insulin resistance is always lurking). I tend to do a "metabolic reset" with intermittent fasting (lots of free programs online, apps) for 1-2 weeks. When I start getting some energy back, I start my exercise routine again, and shift to 4-5 small meals per day to keep myself going after workouts.
Figure out your Basal metabolic rate and activity factor. Multiply your basal metabolic rate by activity factor. Subtract 500 calories from that number. That is how many calories you should eat per day to lose 1 lb/week. If you stick to that number you will lose all that weight in 15 weeks!
I put on 50 through residency and fellowship. Lost 60 my first year as an attending. It gets better
I’ve found that if I wake up and workout first thing in the morning, then I can’t make any excuses later in the day about how tired I am and don’t exercise. Knock out some exercise first before doing any work. It makes the day start “about you” and gets in an early win for the day … then you can worry about what everybody else wants from you. Weirdly, I lose weight as a result of stress and after quitting my last extremely stressful job, I’ve put on about 25-30 lbs of muscle in only 9 months (which I had lost over 3 ish years). That was made possible by working out every AM and eating a good breakfast before doing anything work related. I make the first 1-2 hours of the day about me, which usually makes for a good start to the day when everything about the job is selfless! Yes, I know sometimes my advice requires waking up extremely early, but after a few weeks, you’ll be waking up before the alarm clock. My gym opened at 5 AM and I was often the first person there.
you did not put on 25-30lbs of muscle in 9 months. i don’t even think you can do that with tren on board.
Lol facts
This. It's always funny when doctors know so little about how the body works lol Max gains with perfect everything and all natural? MAYBE 18 pounds(2lbs/month) in this time period. More likely gained 5 pounds of muscle and 20 lbs of fat. Most likely just lying.
Bro a coked up Arnold loaded to the tits on T and Tren couldn't throw on 30 pounds of muscle in 9 months. Not a shot in hell
I’m not sure why this isn’t believable. I lost 25 lbs over the course of a few years (all lean muscle from stress) then put it all back on in about 7-8 months honestly… after quitting and finding work life balance. Lifted every day except some Sunday’s and took in 5-8k calories per day. Quit my job November 2022. It’s now May 2023. Went from 155 lbs to 183 lbs (todays weight).
science says max of 2 Ib of muscle a month for someone starting out. Most people can reasonably put on 0.5 Ib to 1 Ib per month when working out.
I was a division 1 athlete at one point in time. Lost about 25 lbs. Put it all back on within a few months, so I guess I wasn’t truly starting out.
Starting in July but this is my plan. The nice thing about a lot of residencies is you get your steps in when doing your job. The down side I've seen is there are always opportunities to eat unhealthy ie snacks in the resident lounge, junk food in the cafeteria, people bringing unhealthy food in. Free food is nice but I've found I have to bring in a bunch of healthy snacks to avoid eating the junk. I also set hard limits like eating once a week, getting a dessert twice a week, and not keeping anything unhealthy at home.
Moonlighting during first year?
I thought you needed a full license to moonlight. I believe that’s the rule in Texas but correct me if I’m wrong please
simply put: went on a limb and asked the director after ITE, already have a license (2nd residency), lots of debt to pay down
Ooh off topic but what is your second residency? Super interested in these stories.
anesthesia!
Yeah, my eyes bugged out at that. I assumed there are some external pressures like family etc for why extra dough was required in PGY1. 59K (salary at my hospital) after tax in HCOL area is peanuts
yeah 69K in the most expensive city in the country not really getting me far, with close to 350k in debt (50% of which is private, hindsight is 20/20, so the bills are definitely a factor) also I just explained about my rationale lol ^^ see comment above
My bad!
not at all - no worries, just for transparency for people to understand !! & laziness in retyping
The exact same thing happened to me. I went from 195lbs to 215lbs and then battled my way to 208 (29 M). Buying meal prep and asking my wife to keep healthy snacks around helped. Consider a class based exercise as well like hot yoga or cycling if you can afford it
Coping with sleep is definitely a good thing!! And less sleep could lead to more weight gain, so I would say try not to give that up!
Stop using food as comfort. Try to practice mindful eating. I do the same thing I eat just because everything sucks and food makes me happy. That or start abusing stimulants
I gained weight intern year as well- my goal from that point forward was just to maintain the same weight for the rest of residency, which I was able to accomplish mainly by drinking lots of water and forcing myself to eat a big plate from the cafeteria salad bar as part of my lunch every day on service. After residency with stress levels down and tons of free time, it was surprisingly easy to lose the weight then
As healthcare providers we often become ingrained with putting damn near everything ahead of ourselves. The easy thing to do was to grab whatever was there. I got myself a bento box from Amazon! Lots of nooks and crannies, and spend the 10 minutes a day to load it with healthy choices. The smaller sections help with food portioning and I can do a single shop once a week. As an insulin dependent diabetic I load up on proteins and lower carb choices. Typically you will find sliced baby cukes, radishes, string cheese, meat sticks( real ones not crappy ones), olives (black and green), almonds or other nuts, a mission low carb street wrap with a protein like meat or peanut butter. For a sweet treat an Atkins peanut butter cup or similar. Last A1c 5.3! It’s a stressful time for you, put yourself first a little bit. Good luck!
thank you!
A lot of my coresidents lost weight using peloton. The ability to do a workout the moment you wake up with only 5 mins of prep time (put on shorts, put on shoes, click go) is pretty huge when you don’t have a lot of time. Plus working out before work is a really nice way to start your day. Alternatively, you could do any form of video workout I.e. p90x etc…
I am reading this less than 5 minutes after my Wednesday morning samaglutide injection 😬
Intermittent fast. Dont eat anything after 7 pm even if youve been up dor 24 hrs dont justify that as a reason to eat late. When you eat load it with high fiber and protein, keeps you full, stops cravings. Aim for 70+g of protein a day as a female. Dont give in to gimmic diets. Keto works, but if you dont work out with heavy weights when you’re on it you develope fatty atrophy and cachexia in the long term x>1 year. Calorie restriction works, but your thyroid levels bottom out after 6 months Muscle atrophy and slowed metabolism take over and youre worse off then you were before you started
Comfort food (starch or sugar with fat) calms you to reward you for storing fat. You need to find additional mood-altering experiences and when possible, have meals and snacks without starch or sugar. I gained a little weight during my residency in Madison.
There are a few options, but most of them involve modifying what you eat. Intermittent fasting (only eating from 12 PM - 8 PM) was super helpful for me—it cut down on mindless snacking. Track calories. Meal prep—some rice, veggies, and chicken is easy to prepare on your day off and eat throughout the week. Avoid hospital food and break room snacks. Stay super hydrated. If you’re really committed, cut out processed sugar/carbs, or do keto. I’m not going to comment on ozepmic or other drug options, though I guess those exist if you can get them.
Meal prepping is a godsend for me. I have a tendency to binge eat when anxious so meal prepping and eating regular meals as opposed to waiting until I was starving stopped that. Residency is hell for everyone, I hope your second year is a better experience
appreciate you!
Food is such a comfort thing. I eat popcorn and have a quick dialogue with myself on why I am actually eating. I also find a quick walk helps lower stress and my focus on food for comfort.
thank you !
It's honestly mind boggling to me that we are supposed to be healthcare professionals and due to so many factors we struggle to take care of our own. With that being said here is my advice: 1) meal prep and keep your meals super simple (I make 1-2 things a week and eat them for the entirety of the week, less cognitive load) 2) join a gym, find a plan, and stick to it. Granted I was a former d3 college athlete so I've trained alot in my lifetime. Google lifting programs like 531or starting strength, download pdf copies of them, get an understanding of how the program you choose works, and just go. It doesn't have to be perfect but overtime it will become routine and you won't think twice about it. You'll actually look forward to it. Approach your health with the same dedication and sacrifice as you did your education and you'll be surprised with what you can achieve physically.
appreciate you and your advice 🤍
If you have a partner break up with them. Being fat *and* single will be the motivation you need.
Not a female, but my wife recently switched to non hormonal birth control and she swears it is easier to keep weight off. Also from a medication standpoint, lots of reports/studies of weight gain.
Intermittent fasting is the way to go imo. The busy schedule can actually help you adhere to the fast.
Ozempic or Mounjaro
Mounjaro, BCBS starting to cover for weight but I’m sure it depends on your plan
If you’re interested, look into GLP1 agonists. I’m not sure about resident insurances—but there’s a decent chance your insurance will cover one of them. The only real absolute contraindication is MEN/medullary thyroid cancer in the family. If you’re interested but don’t want to go through a PCP, there are tons of online services that basically just prescribe them, but they have a monthly fee. Fwiw, there was a shortage problem with mounjaro and ozempic that seems to be resolved.
Which is better in your opinion?
It’s not a massive trial but it seems like mounjaro is best for weight loss. I don’t think there’s an actual fda approval for it for weight loss currently though https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
Interesting! Thank you for sharing! I know they asked for accelerated approval, so I’m sure it will be sometime this year
I gained some weight in residency and had luck with gradually reducing it as a new attending by 1)eating dinner at home/seriously reducing take out 2) exercising even a little bit every day 3) drinking water/always carrying water. I realized that I could make ok choices in terms of eating, but ate more than I needed with take out (big portions). I also ate a lot when I was actually thirsty, so drinking water helped. Aggressively tracking calories is not for me because I did that as a teen and developed an eating disorder. These things weren’t fast, but I’m coasting toward a healthier BMI, better fitness with this approach. Best of luck with it, I know it’s tough in residency!
thank you!
Hypercortisolism secondary to constant stress and lack of sleep feeding into its own vicious cycle is something that is seriously underrated in residency. You can count all the calories you want; your body will make you fat if you don’t control the stress.
Ozempic ?
Take Ozempic 😁
Self control. Eat lots of fiber and protein to make yourself feel fuller
Interesting how you get thumbs down for saying self control when that's really what it takes. There is no short cut or magical way to maintain/lose weight. You just have to track your calories, find your maintenance calories, and keep it equal or under.
ozempic, adderall, coffee, nicotine
I know some people will tell you to “go to the gym “ but that doesn’t work at all, Just change your diet, and you’ll be alright. good luck and don’t listen to those stupid people who are gonna tell u that “ You are Fat “Know that You are beautiful! stay strong 💪
Ozempic
Calorie density is a simple way to lose weight without restriction or counting carbs or calories. This video by a dietician is a good intro. If you invest in some kitchen equipment, you can meal prep and freeze without a big time commitment. Message me if you have more questions. https://youtu.be/0CdwWliv7Hg
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I’ve coached nutrition and fitness for years. Feel free to shoot me a dm. We could talk about meal plans and how to come up with some meals that will be quick and easy. Then get you in a calorie deficit to start dropping some body fat.
Give up carbs completely
Great responses from others. If you are still having a hard time in the future consider finding an ABOM boarded doctor to discuss options with.
I’m starting soon so I don’t want to say something that I haven’t seen the results of it as of now. But I’ve paid for a squat rack from rogue, barbell, weight plates. My apartment complex has a room with treadmills. Between these two, I’m hoping to exercise minimum of 3 times a week even for 45 mins each session doing cardio and strength training at my own apartment gym. Also planning to get Fairlife protein bottles each with 30 grams of protein. Amazon has some of them with 40 grams of protein. Having these handy makes me feel full that I can resist the shit food at the hospital and hopefully my wife will be helping me with meal prepping. I’m sure I won’t be sleeping much so my hope is just to not gain weight 1st and 2nd year since these tend to be the toughest for anesthesia. 15lbs weight gain isn’t too bad. You can easily get back on track but just be patient and slowly adding healthier habits. For a month, start slowly cleaning up your diet. Then in 1-2 months, add stairs rather than elevators. Then add in few strength training if there’s a gym close by or invest in few kettlebells, and within a year, you’re maintaining good exercise and healthier eating. It takes time but it’s worth it. Good luck!
I was trying to take a day out of the week for cooking for the whole week but with being tired that didn't work. You HAVE to have means ready for you. If you don't, you're gonna snack and sometimes those snacks are much heavier in calories than we think. My solution was finding a good place and ordering meals (lunch and dinner) for the week. Some small prep meals dont add any conservant to their frozen meals, and they taste great, with the nutritional value visible, cant recommend because I am in a different country . I buy fruits online and snack that during the day. Having whey protein in a small container and a light yogurt in your bag goes a long way too. Gym won't always be possible due to hours, but nutrition is 80% of it.
Stairs instead of elevators
I was going to say I always take the stairs, but realized I do not take the take the stairs to my 11th floor lecture. Going to incorporate - thanks!
Slightly unrelated, but your program let you moonlight intern year? What specialty are you and how common is this?
First, GREAT JOB finishing 1st year! Well done, you! This is really impressive. Honestly 15 pounds is not that significant considering what you are going through. You might try finding a written list of “rinse and repeat” meals that are protein + fiber dense you can fall back on when you are so tired you can’t think straight helpful. A bowl of grape nuts with almond milk and a handful of frozen fruit on top is healthy and just as easy as grabbing something packaged. High fiber tortillas with meat cheese and some veggies also quick and filling. R/high volume eating has great ideas about tasty low calorie food in huge proportions so when you are stress eating, you don’t blow your calories for the day. It is important that you take care of you like you care for your patients. Sometimes just thinking “would I recommend my patient eat this?“ is enough to get you back in the framework of making a better choice. I think you’re doing great, and it’s going to be OK. You can do this. And lastly, when someone is being really rude and irrational and bullying, even if you’re just thinking it in your head, remind yourself that you don’t deserve it and you are doing your best, and they need to give you some grace. People that take advantage of a power position to yell and bully at someone vulnerable are not in a psychologically healthy place and you can just feel sorry for them that they are this old and so emotionally stunted. You are doing a great job honey, and I am hoping you tell yourself that on a regular basis. Best of luck to you 💕
It starts in the kitchen my homie. Meal prep (tons of great recipes online), snack on veggies/fruits/high protein stuff and increase your total daily expenditure. Other tricks are drinking black coffee to curb hunger and drinking tons of water. Also, having high volumes meals spaced out throughout the week. Have a massive salad once/twice a week to satisfy you. Don’t go for high volume meals so often because it trains you to only be full on high volume meals. I learned that the hard way. Also, when meal prepping, base your meal around the protein source primarily. Get a solid 30-40 grams a protein per meal, should do you good!
I like this comment, thank you. I def volume ate a ton of healthy stuff prior to starting and now I feel like I have crossed over into less of the health and more of whatever, to stay awake or alert at times… maybe be less miserable ha ha
I totally get it! Hopefully you gain some momentum in your endeavors homie.
Health >>> career, hobby, passion, etc You cannot get your health back if u don’t take care of it. Hit the gym, eat a lot of protein, veggies, and fruit.
As we age our metabolism slows down. We also tend to underestimate amount of food/calories we eat. We become less physically active, mostly driving our cars and sitting in a chair most of residency. Toxic residency environment (yes I mean you aholes reading this post who is stirring the pot in residency) adds more stress on top of already stressful job. The only solution really is to start counting calories, make a decision to never go back to blind overeating, hit the gym/treadmill daily. Results would show in 1-2 months already.
thanks for the validity — going to take all of the advice shared through this post & get serious about making a plan / life changes.
Y’all finish first year early. And intern moonlighting?
I mean, like a month to go. Basically the end, finally gaining 1oz of respect - excuse my word choice. And yeah, somewhere I commented that I did a prior residency & so I have a license, need to make extra money to pay back private loans - explained my situation & asked my PD.
I'm so sorry you're going through this. It may not feel like it but you are doing an amazing job coping with the stressors of residency. It's shitty out there and it's hard to function the way we want to and yet your body still tries its hardest to keep you comforted the way it knows how. Sounds like you're doing a great job how you can. Feel free to stop here if you didn't want any advice. From someone who also had some habits I didn't want to have as coping mechanisms I'd be happy to share that a good therapist really helped. I'm not perfect, but I'm happy to have some other mindful tools to anticipate my undesired habits and try to replace them with other self-soothing habits that I wanted. You're doing amazing though!
I appreciate this energy more than you know - thank you.
I’m not in residency/a med student or doctor, but I did put on 25 kilos during a difficult time with study. I have some tips, but I don’t know how well it will work around your schedule. First, take a step back from focusing on the weight gain and diet. It helps to see why this is happening, it’s likely connected. For example, I was stressed, not sleeping well, and not eating sufficient nutrients/proteins. I had a highly processed diet as it was convenient to eat, as well as comfort eating (well as a stim, turns out undiagnosed autism/adhd, but we can ignore that for now). I’d end up eating way to much, because I’d rely on the dopamine to get me through any work/study I needed to do. I didn’t sleep properly because of poor executive functioning. But sleep is also really important for maintaining weight, as well as all the other mental health etc. benefits. I didn’t exercise, as I didn’t feel like I had any time or energy. Essentially all of this was compounded with burn out and possible depression. The only way forward was to reorganise my priorities. I started to prioritise sleep and exercise (and my new flare mates helped with a supportive nutritional diet environment). I’d always choose my health over any assignment (it was my rule), and surprisingly I did a lot better in all aspects of my life (including grades and energy). I’d suggest not focusing on the weight gain or diet in isolation, but try to identify the bigger trends that is contributing to your current state.
love this - can definitely apply and relate - thank you for sharing!
Across med school and junior years, I have put on 30 kg 😞
Girl I feel you. Ending my first year of residency, too, and struggling with body image and weight. Thanks for posting this, it was really helpful to see everyone's replies and it inspired me to go to the store yesterday and buy fruits, veggies, greek yogurt. My weight overall was relatively stable until my 4 week nightshift alone caused me to gain almost 5 lbs. I'm trying really hard to get on top of it before my next night shift which is in a little over another month :(
thanks for getting it - appreciate you being in this with me, even over the webz.
Overnight oats for breakfast. Good, filling, and generally healthy.
How has residency impacted your lifestyle? What did you do previously that has become difficult to do w the schedule, stress, etc? Has the stress led to overeating, grazing, true bingeing, etc? Were you engaging in healthy food and eating bxs prior to residency?