In typical twenty first century fashion I am listening to 10% Happier by Dan Harris instead of actually reading it. Usually while doing dishes at the end of the night. Always multitasking. The thing that got me to pause and write in my journal after was his description in the first few chapters of constantly seeking The Next Big Thing.
The book starts off as an autobiography of the life of Dan Harris, a news anchor and reporter for ABC news who has a panic attack on public television. In getting to chapter three I can tell the introduction of mindfulness is around the corner. However, in the early chapters he seems to be laying the groundwork for why he needs mindfulness.
How does one really “need” mindfulness? For a long time in his life Dan describes a lot of mindlessness. Mindless chasing of The Next Big Thing. I see threads of myself woven in that story, echoing what I hear from many patients too. Everyone has their own Big Things as they go along. Some people, amazingly, are “type B” and not driven by the motor that seeks the peaks and valleys of life. They are content and “trucking along” like my best friend Jen who always answers “how are things with you?” With “Good”, and she means it. Here’s how the journey of The Next Big Thing has gone for me:
First big thing, my parents got divorced. I was two and a half and remember the moment they told me it was happening. I was in a pizza parlor. I had no real idea what it meant. My next memory is being at a stop light when I realized a parent was in each car and I could only be in one. That is when the crying for the one ensued.
The Next Big Thing, I moved to a town of one hundred and fifty people in the eastern Sierra outside of Lake Tahoe. I thought my mom and my step dad were trying to “ruin my life”. Turns out it was just beginning. I met friends I have to this day that became my soul sisters. Small town life was incredible. Also, boring.
The town I lived in was too small to have a high school, so we bussed to Nevada for a new school had four hundred kids in a class. With eight graduating in my eighth grade class it was a big transition. High school was both fun and painful, in the way that teenage years are hard. I graduated valedictorian of my class. The Next Big Thing.
Off to college, and UC Berkeley blew my mind. Academically I was swimming, and eating it up. I majored in a subject I had never even heard of before - medical anthropology. I could eat pizza at 2 AM (a true delight for a lifetime lactose intolerant country girl). I thought I would become a vet since I was a child until one day my chemistry teacher told me I was “smart enough to be a doctor”. Her husband was the town vet so I figured maybe she was trying to tell me to do something different. I also felt that humans needed more help than animals. I didn’t have any physicians in my family, in fact the generations before me never completed to college. After health challenges of my own that were helped by a chiropractor and acupuncturist, I started to explore the many directions the medical path could take me. Enter, The Next Big Thing. One could say I didn’t have a clue what I was getting into.
The journey to and through medical training is cultured around seeking The Next Big Thing. A classic carrot on the stick routine. First you need the MCAT (i.e. big test), then med school, then test after test after test for the first two years. Next the clinical experiences of third and fourth year. Enter Colorado, where I was selected by lottery to spend my third year. I landed in Castle Rock for my very first rotation, with a family doctor father/daughter combination. The older physician reminded me of Sherlock Holmes, twirling his glasses when thinking about hard cases. His daughter showed me that you could be a mom and be a doctor too. I was falling in love with Colorado and family medicine.
Love was the Next Big Thing. I met my husband my third year and moved back to California shortly thereafter to teach Osteopathic manipulation in a teaching fellowship. Enter a new, long distance relationship. Over the next three years, I traveled back and forth between California and Colorado (here’s looking at you loneliest highway in America) going between teaching and clinical rotations. One Big Thing to another. All the while residency loomed.
Residency is what they make doctor shows about. It’s when there are interns and “attendings” and life as you know it is pretty much all medicine all of the time. For “type A” carrot-on-the-stick folks it's the fact that you can’t control “the Match” into residency that drives you wild until it is settled. Residency determines where you live for three to seven years of your life AND what kind of medicine you will practice. For me, I was checking my palm pilot obsessively on a nice spring day eating crepes on 16th street mall when The Match results came in: Swedish Hospital, family medicine, my number one choice. The Next Big Thing.
After residency I started a clinic for a large corporation. We built it, they would own it (or did they own me?). Soon, I saw further to the medical system I did not want to be a part of. I wanted to do things differently. I had ideas brewing that solidified as I learned about direct primary care. I knew I could bring together the medicine I was passionate about practicing AND the people I loved to serve, my patients. I simply needed a different model. Direct Primary Care became my Next Big Thing.
Of course there were other great encounters along the way. I had my daughter literally the day after I finished residency. Between my two practices, I had my son. Parenting has been, quite possibly, The Biggest Thing I have done. Markedly the best. And sometimes the hardest.
Recently I had been fantasizing about moving out of the urban Highlands area where we have a lovely house and nice yard on a busy street. I grew up in the middle of nowhere on 6 acres and I miss quietude and stars. Don’t worry I wasn’t imaging anything drastic, but Golden and Arvada were looking nice. When I started listening to Dan Harris’s book I realized the treadmill I was jumping right back on. I see so many people do the same. As adults, we jump on the treadmill of life and start running 70-100 miles per hour. At first it seems like a lot. At Berkeley I remember feeling that pace, it felt hard and exhilarating and exhausting at times. Somehow, along the way I became habituated. I stopped realizing that running at a 7-10/10 on the stress scale wasn’t normal. Seventy miles an hour started to feel like walking and only once in a while do I realize I am moving 100 miles per hour. This is where mindfulness comes in. One day I’ll tell you more about my journey with that but shockingly I have been using some form of mindfulness to balance my “type A” nature since I was seven years old.
The next step in my mindfulness journey is to take the modified Mindfulness Based Stress Reduction class with you. This is a way to learn a new practice or cultivate a deeper one. Something that can help you change the treadmill habits. We have 3 more spots, is one yours? Register today. It really is your last opportunity to join.
It is mindfulness that keeps me grounded in my moment to moment awareness. Brings me back into my body and time checks my warp speed with the world around me. It lets me breathe bigger and deeper. It helps me to remember what it feels like to get out of fight or flight, to settle into myself. To let my nervous system calm down and stop seeking The Next Big Thing. Dan Harris chased adrenaline in war time news reporting. It is no wonder his adrenal system eventually crashed and needed the rescue of mindfulness to bring him fresh air (after boosting it up on the crutches of cocaine for a while). I appreciated the reminder that I don’t need to move houses. I can recognize the desire to move is my nervous system looking for The Next Big Thing. We start jumping back on the treadmill again because we are habituated to do so. Our adrenal system becomes wired for our stressful pace and unlearning this stress becomes the next real challenge.
I look forward to hearing more in the book about how mindfulness enters the stage for Dan Harris and how it transforms him. Are you reading along? You have until April 4 before we meet, plenty of time to start reading along. Leave a comment, let me know what you think about it so far. Tell me about YOUR Next Big Thing.
Happy New Year!
Hope the holidays treated you well and you are full with family, fun, and food! I know I am. When we started our quarter, we knew it was going to be a hard one. With high stress, lots going on, colds and flus and short days to top it all, we often seek comfort in the most familiar ways: tasty food, warm drinks and cozy blankets.
This is probably why one of the top New Year’s resolutions are some variation of be healthier, eat healthier, exercise more, cut back on (insert less than good thing we are consuming to excess). Inc. reported that 5 of their top 10 resolutions were the above, with 71% wanting to diet or eat healthier.
You probably already know this, but the stats are against you achieving your resolution. Why? Well, most likely because it’s far more complicated than the simple statement that makes up the resolution. Take healthy eating and weight loss, for example: after having read my blog on the different diets, you may have chosen to pick one and start it in the New Year. Did you also know that there are other factors that contribute to your dietary needs and weight control than just which diet you are on? Read on!
This seems like a no-brainer. When we are stressed, we don’t make the best food decisions (we can even make really bad ones). We forego our plans to exercise and we indulge instead. Most people are this way. Did you also know that when we are stressed, our body releases cortisol and this makes us GAIN weight? It does! Cortisol is responsible for regulating our metabolism, helps to regulate our blood sugar, regulates salt and water balance, our heart rate, blood pressure, our sleep, and our memory. When we are stressed, these functions alter then return to normal balance afterwards.
But when we are chronically stressed, we may see things such as poor digestion, increased blood sugar (even diabetes), increased blood pressure, poor sleep and memory, poor immune function (getting sick often), hair loss, slowed metabolism, low energy. How is this going to make it any easier to eat better and lose weight?!
While sleep is not something that comes to people’s mind with nutrition or weight loss, it is so important! The average adult needs between 7-9 hours of sleep per night. If you get less once in a while, it’s what Dr. Brie likes to call NABD (not a big deal). But many people get less than 7 hours on a regular basis. When we don’t get enough sleep, our body doesn’t sense hunger/satiety normally. We tend be more hungry and crave high calorie, high fat and high carb foods. Not to mention, poor sleep also impairs our decision making and we are not able to resist cravings/temptations very well.
Poor sleep can slow your metabolism--your body is trying to conserve energy for increased waking hours. Being sleep deprived is also a condition of stress, and you know what that means? You got it, increased cortisol levels, which we just talked about. You’re also more tired and less likely to do physical activity.
While it would be easy to say,” Work out more and you’ll lose the weight,” it’s actually not that easy. Yes, physical activity will cause a deficit in calories. But often times, when you are working out, your body needs fuel to be able to sustain the activity and then repair itself afterwards. Some people eat more when they work out for this reason. It is important to eat enough calories when you are working out so your body does not become stressed (read: releases cortisol). It is important to note that exercise alone will not result in significant weight loss, but ongoing exercise can help tremendously with weight loss maintenance (see one of many studies).
Not only that, exercise helps to increase heart, bone and muscle health (your doctors will thank you), it helps manage stress and keeps you happier (bye bye, excess cortisol), and it will help you sleep better (regulate that hunger!).
Your social life
Humans are social beings and Coloradans especially love to celebrate everything that makes this state so fun to live in: the grand outdoors and our craft beer, all booze, really. (Anyone read this article in 5280?) Even if you don’t ski, mountain bike, rock climb, etc, social gatherings are yet another time where your healthy eating plans can fall by the wayside. Call it peer pressure, call it indulging, call it what you want. It’s harder to resist the beer or bar food when you’re with a group of friends. Seeing, smelling and being able to reach out to the french fries or wings or whatever is temptation waiting to win. Alcohol also can impair judgement, make you hungrier and adds calories!
Besides work adding the obvious stress, your work situation may make it difficult for you to stay on your bandwagon. On the go all the time? This makes it easier to want to pick up fast food or skip a meal. No lunch hour? You may be more prone to snacking throughout the day or bingeing when you do eat. Traveling? Less chance for a home cooked meal or meal planning. We won’t even talk about catered lunches/lunches out and office snacks or candy/cookie jars that park themselves at the end of everyone’s desk for convenience.
Your gut bacteria
Say what?! Yep, if you didn’t know it already, your gut bacteria may be playing a part in keeping your weight the way that it is. This Scientific American article is one of many that summarize current research on this association specifically. We know that the bacteria in our gut help digest things we can’t, making more calories available to us. They also can affect hormone production, altering the signals that tell us we are full or hungry. The bacteria can affect inflammation in our gut, calming it or increasing it by releasing certain chemicals based on our diets, thereby causing us to gain weight. No, there isn’t a probiotic for weight loss yet, but having a good diversity of bacteria and eating a variety of prebiotics (foods that feed our gut bacteria, usually high-fiber foods) is a good place to start.
Your medications and your health conditions
Yet another example of why it may be more elusive than you think to maintain a healthy diet and/or weight. Certain health conditions limit what you can eat and you may only be able to choose what you can eat rather than what you should eat. Take those who are doing a FODMAP elimination diet, for example, foods like asparagus, apples and some seafood are considered healthy, but are high in FODMAPs and thus need to be limited.
Certain medications can cause weight gain too, like medications for seizures and insulin, and it would not be easy to “avoid” these medications in some individuals.
It is important to remember that while it may seem easy to modify one or several of these factors, the reality is that eating healthy and maintaining a healthy weight are not easy things to do. Because, as I always like to say, “If they were, I’d be out of a job!” This doesn’t mean you don’t try to modify one or several of the factors mentioned above, it means that you modify what you can and don’t beat yourself up over the rest of it. Just keep at it, one step at a time. Healthy eating and maintaining a healthy weight should be lifelong goals, not just a resolution for this year. And really, if getting better sleep, having less stress, being more active and having a healthy social life are things you can fold into your lifestyle and actually enjoy (who wouldn’t??), you’ll get full bragging rights on those successes, whether or not you lose weight—I promise.
By Michelle Levine, OMS IV
Rocky Vista University College of Osteopathic Medicine, Colorado, Class of 2019
If you’ve struggled with your weight, as so many of us have either intermittently or continuously in our lives, I hope you already know that you’re not alone. That your self worth does not rest in your physical appearance. You also probably know many or all of the various types of diets suggested in our culture to lose weight and be healthier, and have likely tried many of these diets in hopes of more energy, fewer necessitated medications, and maybe even a bit of the prestige that accompanies a slim physique in our modern society. In struggling with obesity, it is not only our bodies that are affected but disproportionately our minds and our spirits as well.
The Obesity Code by Dr. Jason Fung translates his experiences as a physician treating obesity into terms that are easily understood, relatable, and backed by various scientific studies. His perspective on obesity will offer validation of your prior dieting efforts as well as explanations for why diets fail despite continued compliance. He explores how we arrived at such overwhelming rates of obesity as a culture as well as the role of each of the macronutrients in our diet. He also offers steps that you can take to reduce your weight and improve your overall health, focusing mainly on the type and timing of food consumption but also acknowledging the roles of exercise, sleep, and meditation in creating a balanced picture of health.
Dr. Fung presents a hormonal theory of obesity that integrates our bodies’ tendency to self-regulate with the effect that eating has on insulin levels. He suggests a diet that minimizes blood insulin levels and fights insulin resistance with short periods of fasting. The diet he recommends reflects a healthy balance of whole unprocessed foods. His theories about obesity are well supported in scientific literature, although his interventions have not yet been accepted as superior to other diets and further research in this area is needed.
In my own personal experience since reading the book, I have done a fast of about 30 hours and found it to be achievable with the right mindset and not disruptive to my normal activities. I have done more frequent and shorter fasting intervals of ~16 hours and found this to help decrease cravings and allow me to make healthier food choices. Although I will need much more time to fully evaluate the effects of these practices on my own body, the relationship between insulin and the body’s homeostatic mechanisms to control weight fits well into my greater understanding of physiology.
Join the Conversation!
What are your thoughts on The Obesity Code? Leave a comment below, and join us in January 10th 2019 for a live book group discussion at our office in Denver. Click for more details.