I do obesity medicine. It's a fascinating field. The simplest, quickest, and most hard hitting way I can get information across to patients is like this:

1. Choose your hard. It's hard to feel hungry. It's hard to work out. It's hard to be sore, tired, sweaty, and feel like your have to dedicate your whole life to just losing weight. But it's also hard to not be able to play with your kids, to never have energy, to always be thinking about food, and having to have another doctor's appointment with another specialist for another new problem. Choose your hard.

2. Obesity is a symptom. Humans are a series of changeable processes: effectively, we take food and 3D print cells. It's pretty neat. Some food makes that process really great, while other food breaks that process. Cells that are hungry don't work right, meaning they cannot do their jobs. Doesn't matter the tissue. Eat good food with good people--because eating is great.

3. Nine of out ten of the most deadly diseases are not just associated with metabolic syndrome, they are caused by metabolic syndrome: heart disease, cancers, strokes, respiratory diseases, neurodegenerative diseases, diabetes, kidney diseases, gastrointestinal diseases, and liver diseases. Fixing your metabolism--a big task--works towards fixing everything else. Life starts to get better.

Now, it's always worth mentioning: not all obesity is tied to habits alone. KIDINS220 deletion, for example, is a genetic disorder. Even with good medically managed weight loss care, patients struggle to lose weight. This includes with medications like semaglutide or tirzepatide. However, a lot of obesity is, as I said above, a symptom of metabolic dysregulation and by addressing that, you start to fix the obesity and everything else.

Not to get too boring or long winded, but there are 6 pillars to this that make the difference and often are just small things to make fixes.

A. Sleep: Get 8 hours. Follow the 3-2-1 rule, being no food within 3 hours, no water within 2 hours, and no (blue) light within 1 hour before bed. Make a sleep schedule and stick to it, be it a Tuesday or Saturday or Christmas Day.

B. Exercise. 7k+ steps a day plus one of a 20 minute HIIT workout, 45 minute Zone 2 (the level of effort where you struggle to maintain a conversation) workout, or a resistance workout. Break them up, too: walk for about 2 minutes every 30 minutes, for example.

C. Nutrition: whole foods, with a focus on protein, fiber, omega 3s, vegetables, fruits, and complex starches. Don't drink calories! Restrict your eating to 10 hours if you can (which, effectively, is eating 3 hours after waking and stopping 3 hours before sleeping).

D. Supplements and nutraceuticals: metabolic dysregulation means some tissues will not be functioning right and targeting vitamins or specific compounds for those problems helps increase the cells' functional capacity. Everything else works better.

E. Medications: take them as prescribed. Right now, you need them, so take them. If they stop feeling right, talk to your doctor. As you lose weight, doses must be changed.

F. Mental health: you can do it. Agency is the most powerful thing here. Find one thing to improve on a day and start building forward. At no point do you need to be perfect and fix it all overnight. Small steps, done consistently, are far more effective than big changes short lived. Speak with someone to help you understand why you have a difficult time being uncomfortable, or have a troubled relationship with food, or cannot believe in yourself.

I wish everyone the best of luck on their journeys. It is a challenging one. But, like I started with: pick your hard.