Jen Schwartz V2

Dr. Jen Schwartz talks about her weight loss journey, which started with her struggle with weight due to a genetic predisposition. She also discusses her health issues like hypertension and diabetes, which motivated her to seek help. She joined Lifestyle Health and used methods like medication, planning meals, and convenient foods to achieve sustainable weight loss. She emphasizes the importance of protein intake and mentions the challenges of staying hydrated. Overall, her approach has been successful and she has been able to maintain her weight loss. Hi, so I'm sitting here with Dr. Jen Schwartz and we wanted to tap into her knowledge and experience and her recent weight loss journey. Jen, do you mind introducing yourself and giving us some background about who you are and let's start there. Hi, I'm Jennifer Schwartz and I am a member of our Lifestyle Health team. I have been part of the Lifestyle Health team for a little over four years now. I came to the team originally as a patient and have had such a positive and life-changing experience that I was invited to join the team as a physician. Can you, do you mind sharing some of the background of your sort of weight history and what led you to come to the clinic? I have a lifelong struggle with weight. I think I have a strong genetic predisposition to weight. My father struggled with his weight his whole life. My mother never really struggled but it was certainly a focus of hers her entire life so I truly grew up thinking about my weight, thinking about the influence of my weight. I have an incredibly strong family history of cardiovascular disease and so I've always connected the two together and how important that has been. I have spent, I spent my teen years conversing with my best friend over which diet was available and what exercise programs we would do. I did challenges in my 20s. I joined a spin class in medical school. I joke that there is no diet book or diet program that I haven't tried at some point and then most recently my focus was on my overall metabolic health. And why don't you give us some details about that? I a few years ago was diagnosed with both hypertension and diabetes. Hypertension first. I was very focused on the fact that if I exercised a little bit more I could bring my blood pressure down but eventually just needed to go on blood pressure medicine and when I was pregnant had gestational diabetes and so I was well aware that my risk of becoming a diabetic, so I was very well aware that my risk of getting diabetes was on the order of 30% after having had gestational diabetes. When I got my new primary care doctor several years ago my first question to her was please give me something to help me lose weight. I'm a physician, I'm a cardiologist, I am well aware of healthy eating, exercise, how that all plays together and yet I still struggled with my weight, high blood pressure, and diabetes. And a very strong family history of elevated cholesterol levels. In fact, many years ago before even having my daughter I was seen by a lipid specialist in Los Angeles and my cholesterol was high a decade ago. We knew that this was a genetic predisposition. I have a most likely familial heterozygous hypercholesterolemia where my LDL or my bad cholesterol is elevated and my triglycerides are elevated. And then how did you get to Lifestyle Health? So when I met with my primary care, my new primary care, and I demanded something to help me with my weight loss and that this was a concern of mine and a struggle, a lifelong struggle of mine, she referred me as a patient to Lifestyle Health. Was your pure motivation to just get healthier or just to lose the weight? What really was the motivation? I'll be honest in that the weight loss part of it was the primary driver but having the background of high cholesterol, high blood pressure and diabetes clearly put me at risk for multiple, you know, my biggest fear was a cardiovascular event. But I'll be honest, the weight loss, the self-perception, the way clothes fit, the ability to shop and buy things was probably my primary motivator. Can you speak a little bit about the methods and strategies you use to help you lose weight? So this has by far been my most successful attempt at weight loss. It's been the most sustainable. It has now lasted years. I've been able to maintain my weight, keep it off and find it not difficult to do so. In the past, it was all about fad diets, I'll admit. As a medical student or actually as a resident, I actually tried centramine prescribed to me by my senior residents, believe it or not. And at the time, I also focused on a fad diet called the Zone and I did both of those together. I was successful for a couple of years and then regained the weight. So this has been my most successful approach. And we started with putting me on Sexenda several years ago because of the diabetes, the benefit of cardiovascular risk reduction and the weight loss associated with it. So, you know, you are a working mother, working full-time. Can you speak a little bit about how you manage your lunch at work, what type of planning goes into that and share some of those ideas. And I tell my patients all the time, I cook once a week. It's that. I am all about convenient foods. I'm all about having a stocked freezer and preparing for the week as a whole, but not preparing the actual foods. I will come in on Monday morning with a shopping bag filled with cottage cheese and yogurts and fruit and bad salad and turkey in the package and a package of low-carb wraps. Nothing that has actually been assembled. Oh, interesting. That sounds like a great idea. Has it worked well for you? And this has been very successful. I don't have to think about what I need to prepare every morning. I am always running out the door last minute. I have a child that needs to get off to school and the way I think about it is I've never let her go off to school without having some kind of plan for lunch. So, I do the same for myself. Excellent. Excellent. And maybe let's take it a step further. So, now you're getting home at the end of the day, how do you manage your dinners for your daughter and your family? I think there are two things. One is that a colleague once said to me the most important thing that I could do was to have a snack on my way home from work. And so, I do make that a habit of either having it still at the office or while I'm walking or to the car or in the car while I'm on my way home. And this fills me up so that when I get home, I'm just much more calm and controlled about what it is I'm going to do about dinner. Can you give me an example of what that might be? It could be a yogurt. It could be string cheese. It could be the sandwich that I didn't make earlier in the day. As much as that. And honestly, the larger my snack is, the better job I do with dinner. Excellent. Okay. And what's your approach to dinner? Dinner, like I said, is usually prepared once a week. If I'm going to cook something, this is just, I like to think about this as just life. Life gets in the way. Life is busy. We have kids. We have families. There are dogs. There is cleaning to do and laundry to do. And I just, honestly, I think about it as doing the best I can. So usually on the weekend, I will do my food shopping and make sure that I have one large meal to cook that will have several leftovers. So that'll usually last up to sometimes even three days. It could be salmon. It could be hamburgers. It could be meat. It could be shrimp. Anything like vegetables. But something, soup is a big one right now. So I like to prepare a soup that we can have for several meals during the week. But I try to make that one thing. And then I am all about having convenient foods in the fridge. So I do utilize a lot of Trader Joe's prepared foods. Even my 12 year old will know that she can go to the refrigerator and take something and put it on a plate and stick it in the microwave, but it still meets kind of healthy expectations. And then I try to make a meal that doesn't require me to do something separate for myself. So if I for one of my one of our easy go to meals is frozen shrimp and frozen stir fried vegetables. Easy in the microwave with the stir fried vegetables, I do add lots of fresh vegetables to it. So I'm doing kind of a combination of frozen and fresh. I see my fresh vegetables in the microwave. I take the shrimp and it goes into a pot of boiling water that takes four minutes. And then my family can put it on individual portions of rice or individual portions of noodles if they want. And then I won't have the noodles or the rice, but yet I didn't prepare an entirely separate meal for myself. I really like those ideas. Can you tell me how you think through about making sure you're getting enough protein? I think this is the biggest challenge for everyone. For us, for our patients, but it's so important. There's so much social media right now about weight loss and the loss of muscle mass. I tell patients all the time that protein serves multiple roles and one of them is maintaining your muscle mass. There is nothing that we can do. We do lose fat and muscle when we're losing weight, but I want to preferentially keep muscle mass. So again, for me, it's about convenient foods. It's about having yogurts around and string cheese and baby bell cheese and sliced turkey already or turkey pepperoni. Even my child knows that when it's time for a snack, the first thing you grab is a yogurt from the refrigerator. Since you've been doing this so long, are you actively counting your proteins or have you figured it out and what would you estimate you're getting? I think on a good day, I get between 80, at least 80 grams of protein. I think it's an ongoing struggle to make sure. I do a lot of calculating in my head. I'm used to the way certain meals calculate out, so I have my go-to meals that I don't have to recalculate. What I do notice is if for a week or two I am struggling, if you see changes, I'm not feeling as energetic, I am doing more exercise or you see changes on the scale, those are the times that I take a moment to sit back and say, am I truly getting all my protein in? Where am I falling short? Do you have any strategies about your hydration for the day? So I am the worst with drinking water. I tell people all the time that I probably consume five ounces of water a day, but thanks to one of my dietician colleagues, we were talking about other alternative ways to get some hydration in and I adapted this about six months ago and it has made a huge difference for me. I drink a lot of herbal tea. As long as it doesn't have caffeine in it, it counts as hydration. I avoid the caffeine throughout the day. I always have caffeine in the morning, but I avoid it throughout the day because it's dehydrating and not hydrating. But with a little bit of flavor in my hot tea, especially in the cold weather, I seem to get, you know, upwards of eight or ten cups of herbal tea in a day and that's made a big difference. Yes, I have noticed that you always seem to be carrying around a cup of tea when we're at work together. Now that you've been on this journey for several years, is there any advice that you'd like to give to the people who are listening to this podcast? I think the first thing I would say to people is that you are more capable than you're giving yourself credit for. Small changes make huge impacts and although weight loss in and of itself is a great goal, overall metabolic health in that setting is probably what we should all be striving for. So I know that as physicians we talk to our patients all the time that a simple 5% body weight loss, so if you're 200 pounds and you simply lose 10 pounds, that seems much less insurmountable if we take it in small little bits and that 5% body weight loss actually has a mortality benefit. And so every little step that we take changes our metabolic health, changes our mortality, changes our outcomes and certainly makes it a little bit easier for us to stick with it. I wanted to circle back, Jen, can you speak a little bit about your motivation to lose weight? I think like most people, my motivation was to live longer, to be there for your family. It's an interesting thing when you are an obesity medicine doctor. We probably see our patients more than any other doctor in their lives. We know about their lives, their families, their ups, their downs and I say to people all the time, the healthier you are, the better you will be to be there for others. It's that caregiver mentality but in the caregiver mentality you tend to let your own health go by the wayside. I am happy to be that person to remind people that we need to be the healthiest version of ourselves so that we can be there for the rest of our family and friends. And if you reflect back, do you remember points in your weight loss journey where you started to say, oh my gosh I feel so much better? I think that the biggest one is related to exercise. I still struggle with the motivation to continue my exercise and I, every time I commit to it, I say now why don't I do that all the time? You feel so much better. So for me it's been a lot about maintaining my regular physical activity. Once you hit that five to ten percent for your weight loss journey, did you feel better? I felt like a different person and once I met that, I think it just gives you that positive reinforcement that you're capable of doing big things too, not just little things. We all have ups and downs. It's not an easy weight loss journey. What works for your first five or ten percent is different than what works for your second five or ten percent and so we constantly have to change, constantly have to readdress. I think that's where lifestyle health comes into play because we're the ones there reminding patients that it's not a right or a wrong, it's simply a change. The last question I wanted to have you speak about is maintenance. It's been amazing to watch how successful you've been in maintaining your weight loss. What's your thoughts about your success in this? I will be honest in that the fact that I do this every day absolutely contributes to my maintenance. The fact that I have to talk about it, that I have to do what I recommend to people and that I share the frustrations and the successes, that is definitely the major motivation in maintaining or major ability to maintain my weight loss but at the same time I have this family history and I have a child who probably has my genes and I'm demonstrating how we can be healthier so that hopefully she doesn't struggle. I often tell people that the weight loss journey is a decades-long weight loss journey and maybe more attention needs to go to the maintenance than the actual weight loss phase. Do you think that that rings true for you? Absolutely. I tell people all the time that maintaining takes effort. I wish that wasn't true. I wish we met a goal and then it was easy from that point on but I think maintaining your weight loss takes focus. Well this has been really interesting to me so thank you so much for your time and let's call it a day. Thank you. Hi my name is Joan Lebo and I'm an obesity medicine physician and this is the inaugural podcast that is intended to share patients weight loss journeys both the good and the not so good aspects because I'm a firm believer that everyone who embarks on a weight loss journey comes in with very unique circumstances but we can all learn from hearing personal stories. It is my pleasure to introduce our first interviewee. This is a woman who started her weight loss journey in her 40s. She presented to the clinic with type 2 diabetes, high blood pressure, hypercholesterolemia and does have a history of gestational diabetes. This person is our very own obesity medicine physician and my esteemed colleague Dr. Jen Schwartz.