Cutting the Quiet, Episode 2: The psychology of weight management with Brian Baumal

[00:00:00] Brian Baumal You can’t hate yourself thin. Quick leads to perfectionism, leads to black and white thinking, leads to failure. Then we ask what leads to quick, and that’s shame. 

[00:00:11] Amber Mac What I’m taking away from this is people should just mind their own business. 

[00:00:15] Brian Baumal Sometimes the most helpful thing a helpful person can do is not be helpful. 

[00:00:23] Amber Mac So much about body size and health still goes unsaid. The science gets skipped, the shame gets glossed over, the lived experience gets dismissed. This is where that changes. I’m Amber Mac, and this is Cutting the Quiet, a Felix limited series where I talk with medical experts and Canadians navigating their journeys to bring you truth and insight. Body size is often talked about as a personal choice, what someone chooses to eat, how to move, and even how much willpower it takes to lose weight. But it’s far more complex than that. It’s also shaped by factors like our environment, biology, and a commonly overlooked part of the picture, our mind. Today’s guest is a registered psychotherapist who spent his career helping people make sense of how the body and mind communicate. From the psychology behind weight management, food noise, eating behaviors, and body image. Welcome to the show, Brian Baumal. Thank you so much for joining me today. 

[00:01:29] Brian Baumal It is my pleasure. Nice to be here. 

[00:01:31] Amber Mac For anyone who’s tuning in for the first time, tell us a little bit about your background and what led you to focus on weight management. 

[00:01:38] Brian Baumal I focused on weight management because I myself have struggled with weight and body image and eating disorders. The very short version of how I got here is I developed two eating disorders in my 30s and had to struggle with managing my weight. And then in my 40s, I entered general psychotherapy practice. And I remember sitting down one day and saying, okay, Brian, what are you going to do with your career? And I thought I could do anything. Like, I just had a very sort of whiteboard in front of my mind, in my mind saying, what do you really want to do? First question I asked myself was, what have you been successful at or what have you been good at? And at that time I had managed my weight and eating and eating disorders for about four or five years. I said, ah, I’m good at this. I’m good at this and I said, psychotherapist, who’s managed his weight for a while can help you do same. And it just sort of flowed right from there. 

[00:02:43] Amber Mac Let’s talk a little more about that. When you say the psychology of weight management, what exactly does that mean? 

[00:02:49] Brian Baumal I’ve boiled it down to four letters, A, B, C, and D. 

[00:02:54] Amber Mac Easy to remember.

[00:02:57] Brian Baumal Easy to remember. Acceptance, balance, complexity and depth. And so I’ll go into each of those a little bit. Acceptance means to sort of orient yourself to where you are. It doesn’t necessarily mean, at least in my view, body positivity. Another way of saying it is acceptance is a starting not an end point in your journey. And I can give you an example of that from my own journey. As I was managing my weight and as I started doing a little bit of exercise, I found myself doing bicep curls in a gym, not nothing special about the bicep curls or anything like, like that. But I get an endorphin rush from resistance training, which is common for many people, not every, not everyone. But I was doing these bicep curls and the endorphin rush comes over me. And I had an acceptance thought of this endorphin rush is what I’m after in my life. And it’s not about weight. It’s not calories in or calories out. The acceptance journey was this is really what I’m after, and everything about the scale and about eating and about macros is all secondary to me feeling good about myself. So that leads into balance, because when you begin to accept sort of other areas of the weight loss journey or the weight management journey, you still have to balance out results on the scale versus your health and your metabolic readings. You also have to balance out life as well in all of this. So balance becomes extremely important. Focusing too much on the number on the scale, for example, can lead you into a full-blown eating disorder, or can lead you into very difficult circumstances. The number on the scale may not get to where you want to be. So balancing things out becomes very important. And of course, balance leads to complexity. And I’ll say it this way. If people have tried to manage their weight before, and there are many people that I see who have tried even dozens of times to do it. If it hasn’t worked for them, then we have to begin to recognize that there’s a complexity to this that really has to sort of be looked at. And that’s where my therapy comes in in terms of exploring the complexity in depth. So A, B, C, D. 

[00:05:57] Amber Mac So you mentioned you’ve worked with a lot of people. Are there certain patterns that you see along the way in terms of their relationship with food as one example? 

[00:06:08] Brian Baumal Yes. In some ways people don’t want to accept, there’s the A, accept the fact that food can be enjoyable for them. And here’s the balance. Food is both fun and fuel for people. So there’s a balance between the two of those. And oftentimes people say to me, I only want food to be fuel. I want to fuel myself with the perfect diet and eating plan. Given the society we live in, that is not possible. So there is a fun component to food. You have to balance that out and you have to recognize we live in a very difficult food environment, and how you balance that is critical, and for that matter, the complexity in that is realizing you may not have total control over the food that you are served at an event. You don’t have control necessarily over how your brain reacts to certain food. Our food environment is such that private corporations spend probably billions and billions of dollars on food scientists doing their best to make sure that their food sets off stuff in your brain. It’s where we live. And it’s not to say we can’t resist it or we can do something about it, but to recognize that it’s complex and the odds of you having the eating plan that you want to have in our society, the odds of having that are pretty slim. 

[00:07:57] Amber Mac You’ve talked about a lot so far, but one of the things I wanted to dig into a little bit is the complexity piece. Because I think it’s fair to say for a lot of people, there is also shame around this topic. And that adds that additional layer of complexity. When you think about that, what type of impact does shame have? 

[00:08:18] Brian Baumal So a lot of people will come to me and they will recognize the following problem. Brian, I’m a perfectionist when it comes to eating. Brian, I have black and white thinking when it comes to eating, and they say they want to change that, because what they realize is perfection, leads to black and white thinking, leads to failure. And they say, they want change that. And I say, okay. What leads to perfectionism? Sometimes I can talk to them for a number of sessions about that, but basically the answer is quick. I want quick results. So what we have is quick leads to perfectionism, leads to black and white thinking, leads to failure. Then we ask what leads to quick? And that’s shame. 

[00:09:05] Amber Mac As you’re talking about perfectionism, I’m thinking of the quote, perfectionism is really the enemy of the good. And I think that applies in so many areas of our life, but especially when we talk about weight management, because I think even for people who feel they have some of these things under control, you’re not always gonna have those perfect days. 

[00:09:24] Brian Baumal Right, and people sort of recognize that, and they understand it, but the difficulty comes in accepting that they will have imperfect days. What shame does in this equation is that when somebody has an imperfect day, shame basically says to people, I am a bad person. So shame has emotive characteristics. It has behavioral characteristics, and it has thought characteristics. And the thought that shame places in our head is I am bad for failing at this, even if you were sick, even if you had to do childcare or parental care, or even if your work got in the way. So shame, has that thought of I’m a bad person. And then people are derailed from their weight loss attempts. 

[00:10:23] Amber Mac Another phrase we often hear is the phrase, food noise. I see this all over social media. Can you help us unpack what that means and the effect that it has on people’s lives? 

[00:10:37] Brian Baumal First of all, biologically, we need food, okay? So sometimes, or not sometimes, we will get hungry many times throughout the day. So sometimes food noise is simple hunger, but when people are trying to manage their weight, they often think hunger is a bad thing. Oh, calories in, calories out, I need to manage my food intake, so they will interpret hunger as food noise. And what we have to recognize at that point is, no, that’s hunger, and you need to eat, you need to do something about that. The other food noise would be, I think, the food noise that comes to us from hyper palatable foods in our environment when somebody eats sugar. That’s where the food noise will come in, or somebody eats just a hyper-palatable food. Our brains are going to sort of want us to eat more of it. And then that is sort of a subset of emotional eating. Oh, I don’t feel good. I know that this food will make me feel good. So those are really the two kinds of food noise. There’s a hunger and then there’s probably a hyper-palatable component going on in their head. 

[00:12:05] Amber Mac Just sticking with the topic of food noise, some friends I know who are going through treatment now will say that this is helping to quiet the food noise. 

[00:12:14] Brian Baumal Yes. 

[00:12:15] Amber Mac But what else is happening on the mental front in terms of some of the things that we’ve talked about so far, like shame as one example, and how do you manage all of that? 

[00:12:24] Brian Baumal I have been managing my weight and eating for 14 years. And it’s a pain. I don’t know if that’s a good message to be saying or not, but we have to eat three to six times a day. We are surrounded by food. If we have children or people we care for, we have to prepare food for people. So we are thinking about food dozens of times a day. If we have an exercise component to that as well, we have to fit in exercise. So at some point in time, there has to be an acceptance of the fact that managing your weight becomes a chore, day in, day out, day in, day out. We don’t have to make the right decisions a hundred percent of the time. But I can tell you for me personally, I’m very busy with a growing practice. Scheduling time for the gym takes effort. Yeah, I have to go into my calendar now and I have to put in there, I have to block off gym time, gym time, and gym time. Or if I have an appointment change, I am like, oh, I got an hour. Can I run to the gym? It becomes a task that has to be managed over time. And that takes effort. And I think that people expect any kind of weight loss treatment, even a psychological one, to reduce the burden or to reduce the effort involved in it. And I know that treatment with me is not about reducing the effort involved. It’s about accepting the fact that it takes hard work, no matter what you’re doing. 

[00:14:19] Amber Mac It’s so sort of therapeutic for me to hear you talk about this, because I don’t hear a lot of men talk about these issues. But as a woman, I will say from the time women are little girls, the topic of weight and that pressure is very real. And it comes up time and time again. And it’s like, we are never the right size for the society that we are living in. And that is that additional pressure as well, from just the people in the world around us. 

[00:14:47] Brian Baumal Well, that is huge, and I will say that I think women do have it more difficult than men do. I think I had that ingrained into me as well, so I can understand what women go through. I myself was a relatively thin child, and people may think, oh, well, you were lucky. And in a sense, I was. But what happened at a very early age, at around the age of five or six for me, was people would look at me and they’d say, oh my god, he’s so thin. And at the age six, I didn’t understand that, but what I learned was adults like that, thin is good, which is I think the message that a lot of women get. And then for me, as my metabolism changed in my late teens and early twenties, when that was no longer a part of my life, I’m like, okay, if I’m not thin, then I’m good. That must mean I’m bad. And that is really difficult to deal with. 

[00:15:56] Amber Mac It’s a lot, really. I mean, you know, in your adult life, you have so much going on and then you have this added pressure and that intensity as well. And I think, again, you what I’ve seen, certainly with my circle of friends is that everybody has setbacks, right? Like they’re doing really well. They’re going in the gym, they’re eating well, treatment’s going well. But then they’ll have a point where they view that as a failure. Like, oh my goodness, I had a week where I was sick and I just ate everything in the fridge and I can’t start over. How do people deal with those setbacks and what they see as failure along the way? 

[00:16:30] Brian Baumal What we have to do is when somebody has a bad week is to nullify the shame thoughts that I’m a bad person around all of this. And that means to take the focus off of weight and the scale. It means to accept the fact that we are in a difficult food environment. It means, to understand that sometimes what we need is ice cream, let’s say, after a hard day. It’s to remove the quick from that process in all of this. So just nullifying the grip that shame has on us is extremely important in rebounding. Rebounding isn’t even the right word, but just managing how we eat because we’re all going to have days or weeks or even months where we slip up. And I will say that I’ve slipped up a lot of times, a lot, my weight since I’ve been managing it has gone up and gone down, but here I sit 14 years later. 

[00:17:37] Amber Mac I think that’s true for all of us, right? I mean, it all goes through those different periods in our lives. I’m thinking back, I’m originally from Prince Edward Island and in the book, Anne of Green Gables, there’s a quote that I absolutely love where the writer says, “Tomorrow is a new day with no mistakes in it yet.” And that just, I think, is so important for people to remember that you can always start fresh tomorrow and get back on track. 

[00:17:59] Brian Baumal That’s it exactly, yes. 

[00:18:01] Amber Mac What about the words that we use, the phrases, the terminology around this topic of weight loss and what do you even think of the phrase weight loss? What does that mean? Should we be using it? I can’t wait to hear this answer. 

[00:18:15] Brian Baumal I will be completely honest with you, I have been sitting here in our interview and in the back of my mind, I’ve been wondering, am I even using, like I’ve wondering about my own terminology and my own language in this, because it really is very complex. Again, there’s the C in my A, B, C and D in everything. I don’t necessarily like to call this weight loss or weight management. We could call it a lifestyle change, but what ends up happening is that people, at least when they see me, they say, I recognize I need to change my lifestyle. But there’s an expectation that the lifestyle change is easy, which is again, the complexity in all of this. But I don’t like the term weight loss, weight management, or even the focus on weight or even a focus on eating. I really like the notion of just getting rid of the mental preoccupation around all of this. 

[00:19:26] Amber Mac What should people do who want to support people who are going through this? 

[00:19:32] Brian Baumal First of all, no comment is a good comment. So even if someone around you appears to be doing well, the best thing that somebody wants to support that journey can do is say nothing. And I’ll give a message to the people who want to support that. If you are seeing someone close to you succeeding at something, it is natural to want to go to them and say, hey, good for you. This is great. I really support you. You’re doing well. But oftentimes, that just puts the focus again on the body and on appearance. In my own weight struggles up and down and up and down, and people would come to me and say Brian, you look great. And my thought was, my god, what did you think of my appearance beforehand? Number one, and I’ve heard this in many, many sessions, so it’s not just me. Number one, number two, it means I’m being observed. So I just wanna say that the best way to support people is probably not to say anything either way. I don’t think I need to go into the opposite, which is when somebody is putting on weight or appears to be struggling, that is definitely not a good time to say anything to anyone because that just is gonna bring the shame right into the people. So that is one thing. I would encourage people around those who are trying to manage all this to do. The other thing I would also recommend for supporters of those on a weight management journey, don’t offer them food. Please, or don’t make comments like, you’re doing great. Please have a second piece of cake or the opposite. My God, you look fantastic and you’re having a piece of cake. That’s bad for you. Just don’t comment on the food. Don’t offer food. Those are the two things I would say. 

[00:21:46] Amber Mac What I’m taking away from this is people should just mind their own business. 

[00:21:50] Brian Baumal Yes. It’s difficult. I developed the saying, sometimes the most helpful thing a helpful person can do is not be helpful. So you’ve got that coming into play, but specifically with eating, I would just say no comment is the better comment. 

[00:22:07] Amber Mac As we wrap up this conversation, is there one thing that you would like our listeners to take away? 

[00:22:12] Brian Baumal I would say, I would go back to my A, B, C’s and D’s and I can just start with the acceptance piece because a lot of people think that accepting where they are is some sort of failure or it’s an end point and it really is a starting point on a weight management journey. There’s a saying, you can’t hate yourself thin, and I mean, that’s not a great saying at all, but what it means is that when you want to make a change, it is better to come from a place of acceptance and knowledge and reality than a place of I’ve got to get out of here. I got to change, I got to change. Because that will set you up for failure in the end. 

[00:23:06] Amber Mac Well, listen, thank you so much for joining me today. 

[00:23:08] Brian Baumal It is my pleasure Amber. 

[00:23:11] Amber Mac Before this episode ends, we have our Facts with Felix segment with Dr. Andrea Rowe. Andrea is a board-certified emergency medicine and obesity medicine physician and assistant medical director for Felix. She’s on the line with us now to answer a question from someone on their own weight journey that we’d love to get her take on. Hi, Andrea. Today’s question is this, I feel embarrassed to even bring up weight treatment with my doctor. Why do so many people feel this way? 

[00:23:37] Dr. Andrea Rowe That’s such a great question, Amber, and I think that it’s important to discuss and address that for so many reasons. But before we do, I just want to give a quick reminder that I’m speaking generally here and not about anyone’s individual situation, and so this is not medical advice. Also, I am the assistant medical director of Felix, who produces this series and have been on the advisory board of Eli Lilly, but I am absolutely not endorsing any product, program, company or medication. So let’s get back to the actual question though that you asked, which is why do people feel embarrassed about weight treatment and asking their healthcare practitioner about that? And I want people to understand that they are not alone and so many people feel like that and it’s understandable why. For many years, people have spent being told that their weight, their health, their body size is their fault. And that raising that with their health care practitioner may feel like a failure and admitting to a failure. And so people may feel judged or even worried that they will be judged. And so weight stigma is common. And research does show that it has significant health complications associated with it because can delay people in seeking care. And so I would encourage you to make an appointment with your health care practitioner in order to discuss if your body size, if your health conditions, if you have significant risk factors, or anything, to have that conversation with your health care practitioners. So that together you can decide on if a treatment plan is needed or appropriate and what that may entail. 

[00:25:37] Amber Mac To everyone listening, thank you for tuning in and being part of Cutting the Quiet. I hope this episode shifted your thinking or made you feel more validated in your experience. And if so, share it with someone who could also benefit. That’s a wrap on this episode and we’ll see you next time.