Changing How We See Weight And Health

Weight is often treated as a simple matter of willpower or discipline, yet for many people it carries a heavy burden of shame and judgement. Conversations about weight can feel exposing and personal, making it harder to seek support or make changes that genuinely improve health.

In this episode, Dr Lee David is joined by Dr Hussain Al-Zubaidi – GP and lifestyle medicine specialist – to explore why shame is so closely linked to weight, and why focusing only on the number on the scales often misses what really matters.

They discuss obesity as a complex, long-term health condition shaped by biology, genetics, environment, stress, sleep and social context, rather than personal failure. Hussain shares insights from his clinical work, including how stigma – sometimes within healthcare itself – can undermine confidence, motivation and access to care.

The conversation looks at why behaviour change is rarely linear, how self-criticism can derail progress, and why compassionate, realistic approaches are more likely to support long-term health. They also discuss weight-management medication – when it may be helpful, why it attracts stigma, and how informed decision-making can support wellbeing.

This is a thoughtful discussion about shifting the focus from weight to health, understanding the forces that shape our choices, and finding kinder, more sustainable ways to care for our bodies.

Key moments

00:00 Health gained versus weight lost
02:02 Personal experiences of shame and weight
03:33 Why weight is seen as a personal failing
05:30 Stigma, bias and their impact on care
07:19 Self-criticism and behaviour change
10:33 The value of shared support
12:44 Why advice alone rarely leads to change
15:40 The wider drivers of obesity and environment
22:38 Understanding weight-management medication
27:11 Making health decisions without shame
30:46 Why change is non-linear
33:18 Environments that support healthier choices
37:10 Measuring success through health, not scales 

About the Guest

Dr Hussain Al-Zubaidi is a GP with an extended role in lifestyle medicine and personalised care lead for the Leamington PCN. He is the RCGP lifestyle and physical activity champion, heads the UK’s first PCN-based fitness club, appears as a TV on This Morning and GMB and is parkrun’s Health Partnerships lead. He is also a trustee at ThinkActive, sits on the advisory board for Swim England and leads the Red Whale Lifestyle and Obesity medicine courses. Outside work, he’s is a keen triathlete who has represented his country.  

You can find Hussain on Instagram and LinkedIn

Find the Red Whale obesity medicine course 

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn.  You can find more about her books, wellbeing courses and therapy here:  https://linktr.ee/dr.lee.david 

Transcript

Hussain (00:00)
measure the success, not on weight loss, but on health gained. a lot of the behaviours you'll do, you may or may not see weight loss from it, but I'm pretty sure you'll see health gain, whether that be increased activity, improvement in diet, sleep, your relationships, et cetera. And the second one is that fierce compassion.

and trying to understand that balance between giving ourselves the space to accept those challenges and the failings, but understanding that we need to keep moving forward and keep being in how we try to things going

Lee (00:44)
Welcome to the Choice Space podcast. I'm Dr. Lee David, GP, CBT therapist and author. Today, we're talking about something many people find deeply personal and often hard to discuss. The relationship between weight, shame and our health. Weight is often framed as a matter of willpower or discipline, yet the reality is far more complex. Biology, stress, environment, mental health, all play a part. 

And shame can often sit at the center of that experience. Stigma and shame can erode our confidence, our motivation and self-worth. They make it harder to ask for support and can make even small changes difficult or overwhelming. But when we start to view weight and health with more kindness and acceptance, people can find space to make choices that genuinely support their health and wellbeing. Today I'm joined by Dr. Hussain Al-Zubaidi, GP and lifestyle medicine specialist to explore why shame shows up so strongly around weight and what really influences health and what helps people make realistic, meaningful changes in their everyday Hussain, could you start by introducing yourself and sharing what first drew you into this work?

Hussain (02:02)
Hi, my name is Hussain. I'm a GP with a keen interest in lifestyle medicine as well as weight management. I think back as to why weight management has been a particular focus of the things that I've done, it's been born out of two tracks. One is a personal journey where going through school and in particular university, I gained a lot of weight and looking back on it now, with the knowledge that I have, I can understand some of the drivers that led to that. At the time, I was very confused, very frustrated. And that word shame you mentioned before, I had great shame. I really felt as a medical student and then as a junior doctor that, how could I be struggling with my weight? How could I ever be able to have conversations with patients and are they going to take me seriously? 

And so more recently, that journey to improve my own personal health took me to try and translate into my professional life. So I completed further qualifications in lifestyle medicine and over the years built up a portfolio career in both education as well as research to understand the factors better so therefore I can try to implement it for my patients. So it's been a bit of a personal and professional journey.

Lee (03:21)
I think that really highlights there how we're all affected by shame around our weight. I don't think anybody's immune. It's such an emotive topic. Why do you think that is, Hussain?

Hussain (03:33)
Yeah, do you know what? I think it's such a visual thing that is always there.

it does feel like it's something that's within purely our control. So many view success or failure based on purely the individual's input. But it's more complicated than that. Yes, there are definitely individual factors that are at play here and there's a lot that we can do. And I'm sure we can talk about some of that.

But there's so many things that change your ability to enact those based on your environment, your genetics, stress levels, sleep, mental health. And so all these things get wrapped up and they become very confusing. And I think even still to this day, that kind of oversimplification of weight happens within healthcare professional community. 

And it will impact how patients can access care or the style of care that they receive. And it's really a shame because I think as a population, I don't think we've done enough to support people in the right way. That's not just in terms of offering them the interventions that may be effective, but also in the approach, how that's done and how that even impacts other health areas that may

Lee (04:47)
something I'm aware of is that there's a lot of what we might call stigma around weight, that people make very quick judgments about other people based on as you say, a visual, very quick analysis. And use then make an assessment of other qualities which are actually not related at all. And I think that is true for both the general public, for everybody. It happens in advertising, it also does happen in health. We know that people can be viewed more negatively or may be expected not to sometimes engage with health so readily. 

And actually that's all based around really unfair judgment simply based on visual appearance. And that's really tough, isn't it?

Hussain (05:30)
It's tough because it's often hard to understand and to see, these are unconscious biases quite often. And so you may not even think that you're doing this and it could be going on and it happens in all walks of life. Yes, within the consultation space, but even just in everyday interactions, how people are taken seriously or not, outside in social spaces. 

I remember having a long conversation with a patient where I wanted to understand what it was like live with obesity. And it was clear that they had far reaching impacts. she described how even in the supermarket, she would always get two or three glances, And so even whether that was the case or not, you then have the issue of always being concerned that the people around you are viewing you negatively. And then that changes your behaviour and the cycle gets so complex as they all interact with each other.

Lee (06:27)
I think we all have different types of biases that's just being a person. And it's our brain quick way of analyzing the world and coming up with quick answers so that we don't have to think through things all the time. But we need to be aware of that and then step back and recognize, ⁓ actually, that's not how I want to be. So I'm not going to let that affect how I behave. 

And I think we can become aware of them and then we can take steps to address them. And the other thing I think is really worth thinking about is the impact of that feeling of shame and judgment around us. It then makes it much think there's evidence showing that then people find it stick with lifestyle changes because it's very disempowering, it's very negative to feel that everyone's judging you, that everyone's a critic, that everyone's putting you down. And I also then think it leads to a self-esteem problem where we then start being hard on ourselves. And I wondered if that's something you'd seen.

Hussain (07:19)
all the time at the primary care network that I work in the NHS, we do group consultations around weight management and improving lifestyle. And it's so commonly put that, any challenges that they have new behaviour that they're trying to work on, they take full responsibility for any failings that occur, not understanding just how complicated and difficult it is for anyone to undergo a persistent and long lasting behaviour change. And I think it's so important that they try to remove, It's just part of that onward spiral upwards. as you know, never linear.

But in reality, we need to reframe it and go, do you know, that's just part of the process. What do we learn from that previous attempts that we can maybe adapt and change and slowly we will get to the desired outcome.

Lee (08:11)
I would sometimes frame it with people as - guilt - I say this a lot in lots of different scenarios, but I think guilt is a sign that we really care about something. And it doesn't mean that we've done something wrong. So we almost need to make some space for guilt as, I really want to look after my body and I care about making choices that work for me, but we need to let go of that sense of, it means that I'm not doing well enough, that I'm failing and that self judgment.

and shift to a kind of compassionate perspective of, I want to do this, I do want to make changes. Sometimes we need some fierce compassion, we need to be quite strong to make life changes because change is hard, right? You know, any change for anyone is always and we know that there are barriers to making changes around weight that are particularly hard. So we need to at the core of it be really kind to ourselves and remember
The reason we're doing this is not because we're not good enough in the first place, but because we're really worth the effort of putting in loads of energy and self-care it. So it's the same energy, but from a perspective rather than that negative one.

Hussain (09:16)
I love the fierce compassion that you mentioned there. Because yes, when we talk about, giving ourselves the space and trying to remove that it's not about saying that, okay, you let yourself on all previous behaviours. No, it's reframing it from that guilt to being one where it's just appreciating just how important it is to you.

because it can be really emotional space. know, when we have these group consultations, there's a lot of tears. there was one even a couple of weeks ago, where a lady had explained that she'd been struggling with her weight ever since she had children and she has three kids and is a busy mum and works part time.

And she felt like such a failure, and it was just so hard. And you could just sense everyone in the room could understand and relate to what she was going through. And the patient next to her just put her arm around her and just said, do know what? I totally what you just said. And that is me to the core.

So this isn't uncommon, this kind of deep feeling of shame and guilt. It's not an uncommon thing that people struggle with. And it goes far beyond simply those living with something that we see many long-term conditions, in many walks of life. And so we do need to think about how we take that on and you have to acknowledge it at some point.

Lee (10:33)
I totally agree. And I think one thing that you mentioned there that comes through to me really powerfully is the power of those consultations, to support people to manage shame and self criticism. And I think that is something that really can a lot around is we do become very hard on ourselves And we're very, very critical.

But one of the ways to create a sense of compassion is shared common humanity. And that means having these conversations more widely getting support from others. So having people who are supporters, people who get it, we feel able to say, do you know what? This has been a really challenging perhaps for many years, in my life. And it's something I want to work on because I care about this. I care about my health. I care about myself.

But actually, I want to open up these conversations and start talking about them because otherwise it's that sense of people doing it all very quietly by themselves and feeling completely isolated and thinking, it's just me. I'm the only one that's struggling here and everyone else is doing okay.

Hussain (11:33)
Yeah, one of the big things about the groups is that awareness that this is a shared challenge that so many of us face. And So I'm very glad that kind of peer support stepped in because it was one of those things where

you just suddenly realize just the weight that she's carrying and her self esteem was just gone. so her confidence to take on things was minimal. And we suddenly realized there's no point bringing in new behaviours at this stage, we need to work on that we need to work on her confidence and how she views herself and her actions, etc. And before we look to bring on very difficult behaviour change, which for even those with high self esteem, good factors in their life is difficult, let alone if you then have other challenges that you're having to overcome as well.

Lee (12:21)
I think often people, they want to fix it. If someone says, I feel really sad, then they come in very quickly with, have you tried this? try that. What about And we're full of solutions. And actually probably what the person needs most is to find their own, and I know Hussain, you're very expert on how to support self-management and how to coach people into taking positive choices. 

And what I understand, it's really about supporting people to find their own motivation. so actually too many suggestions, too much advice. And especially when someone's quite emotional and feeling quite vulnerable, it's a bit of a mismatch. It doesn't really help at that do you think?

Hussain (12:44)
Yeah, yeah, Lifestyle advice, in my view, is often a vice to the patient's own actions. Because, look, you know, I've got some great things that I do in my own personal life. And I know lots of great research that shows impact in various areas. But when you have someone in front of you, you will only have the tip of the iceberg as to who they are.

what is their environment like? The tip of the iceberg. And it's the tip that the patient has shown you. There may be reasons why they don't want you to know deeper in. And so if you're trying to create actions based on the tip of the iceberg, the likelihood that you're going to identify the right thing for them to approach first is pretty minimal, no matter how knowledgeable you are.

So what you want to try and do is get the patient who knows the full iceberg, not only what you can see, but the stuff deeper down. And you can support them to start to reflect and look deeper down because what can often happen is we jump to wanting to just correct and go, yeah, try this, try that, put this plan in place. When in reality, we need to firstly understand the problem. This hasn't just happened over a few weeks or months. This has been a long-term issue.

that we need to try to fully understand what are the driving forces. Now, not all individuals will know them. we need to try and help the patient to identify them. What are the key drivers? And then support them to think about what are the first steps that they may do. 

And it can be quite daunting at first move away from being the advice giver it's actually 100 % liberating because you don't have to bring the answers. Instead, you need to create an environment that the patient feels safe enough to explore those answers and you can work together to implement them, but get them to drive it. 

Now, if the patient comes back at you and says, I have no idea, I came here because I wanted some support from you. What I would try to do is like an is go, well, what have other people  told you before that you think would be helpful and what have you thought of that? Just get them to reflect on previous bits of advice and find maybe they'll say that, look, they don't understand say that I should just try this, but it's not as easy as that. Then already you're individual to start thinking and start it themselves. And then hopefully with time, you can get them to drive further actions from.

Lee (15:17)
That's so helpful. think one of the things that really strikes me about weight management is it's a very, very complex issue that, as we said at the start, is often linked with a sense of judgment. So if we let go of that, I think it can really help to understand some complex factors that are at play. it's not just as simple idea that it should be something that's very easy and quick to do.

Hussain (15:40)
Yeah, it's so complicated. And in fact, when I was updating material Red Whale Obesity Medicine course, I learned still more factors that I hadn't fully been aware of. firstly, we need to understand that as a population in the vast majority of developed nations, we are all on average gaining weight.

So I think first and foremost, we need to appreciate that this is a global issue rather than specific individuals. So one thing to understand is the environment. And when we talk about the environment, you may hear the term obesogenic environment.

What we're saying here is that there's various factors, which means that the likelihood of the population to gain weight is higher. That could be food. So when we say about the food environment, the availability of nutritious food versus food that is very calorie dense, the marketing, pricing, even portion sizes. If we compare them over the decades, that's vastly increased. Physical activity, and in particular, I'm talking about physical inactivity.

So this is the fact that movement has been engineered out of our lives. Before, people were active not because they wanted to, but because they needed to. It was a necessity for either transportation or for general life. And then we need to think about, the sociocultural elements. So I'm talking about increased stress that's prevalent in society.

the likelihood of poor sleep. There are various different biological factors. So there are up to 150 different genes that are associated with obesity. depending on the number that you have, increases the likelihood of weight. And we know that from various studies, that can be the difference from as much as 13 to 14 kilograms. And then there's other factors which the sort of early research, but it's growing things like the gut microbiome, where diversity in the diet.

And an increased use of antibiotics in the population means that we're starting to see a much narrower range of bugs in our gut. And there is an association of reduced diversity with

Lee (17:46)
So there's so much going on And so you really can't just bring it a simple matter of willpower, It really feels just missing the complexity of what we're talking about. And if you think about the power of some of those influences, I know I've seen you talking about when you're walking around, say, a town, all of the advertising is very often for highly calorie dense, often ultra processed foods, isn't it?

Hussain (18:12)
I will give you a task. Walk down your high street and I want you to count all the establishments that are selling something that if you consumed it predominantly, would it be positive or negative to health? And then tally all the ones that are selling you things or products or services that are promoting health. you know which chart is going to you find many on the positive side, I'd be impressed.

that ratio is even worse in areas of deprivation, where we see obesity is far more likely. And so we need to understand that how our environment is built is such an important factor, whether it be the restaurants and the foods that they're serving to the supermarkets and the layout to the advertising along that high street, they are designed unfortunately, not to promote health. And that's a huge shame because for so many of us, think we would put health really high up in our priority list, doesn't seem to be happening in town planning.

Lee (19:13)
a commercial element, isn't there? And wellbeing, unfortunately, doesn't necessarily sell as well as certain, less healthy there's a big profit margin. So I think one of the makes it so hard.

Lee (19:30)
This is the choice pause. A short two to three minute tool you'll hear in every episode, each time with something different to help you pause, notice and choose your next step.

Today's pause is encouragement from your future self.
planning small ways to look after yourself, especially when life feels difficult, can be an act of care, that makes healthier choices feel just a little bit more possible.

Start by taking a slow breath and a longer breath out.

Let yourself settle for a moment held by kindness and not by pressure.

Picture a future version of you who feels calmer and more supported.

Someone who knows you well and who wants the best for you.

Take a slow breath in and place a hand on your heart.

Let that future self offer kindness and reassurance.

A gentle reminder that you are worth caring for and that your health and wellbeing matter.

Now imagine what that friendly future self might suggest to make life a little easier.

one small step today, that would help a future choice feel easier or more doable later on.

it might be preparing something simple and healthy to eat in advance, planning a short walk or ways to move your body, tidying a small space that creates a sense of freedom or just giving yourself permission to pause before the next task.

choose one small step that feels manageable. A quiet act of care that supports and encourages you.

and now take one final slow breath, and carry that sense of acceptance and encouragement into the rest of your day.

Lee (21:34)
Can we talk a little bit about medication for weight management? So I've...
seen a whole range of different responses to this. So for example, sometimes people are seeking out medication because they feel shame about their body shape, and they just feel it's the only answer. what we really want is for people to be able to make informed decisions about when medication is appropriate and choosing it in healthy ways. I've also seen it where people don't want to take it, again, the shame of needing it and that it sometimes means something bad about them as a person. And perhaps people who don't want to tell others because they feel they're going to be judged that they're taking weight management medication or others where families are giving them a hard time about taking it.

Lee (22:16)
Sometimes when there's really good reason, there may be some risk factors that mean that actually that person really benefit from taking a medication. And yet their friends and family are telling them, you shouldn't be on this, it's really bad for you. So could you start briefly us a little bit about medication, how it works, and when you'd advise it? And then maybe we'll think about that informed decision-making.

Hussain (22:38)
Yeah, so weight management includes a number of different medications. one that's been around the longest and is still licensed is Orlistat, which is aimed at trying to reduce total energy absorption by blocking a certain proportion of the you consume in the diet, so the dietary fat.

Now, the newer class of medication, is the GLP-1 based medication. So you have things like Wigovie and Suxenda, and then more recently, Mounjaro which is a GLP-1 medication but has another receptor that it works on. And these are very much only the beginning. There are... up to 120 other agents that are currently trials explore further tools. And they do result in significant weight the sort of one year to a year and a half period. So if we think about Mounjaro specifically, that's over 20 % body weight loss at 72 weeks. 

So this can be a really life-changing weight loss because if we look at the impact that weight has on long-term conditions, we know that ten to fifteen % body weight loss, that can reverse type two diabetes in many patients, that can improve osteoarthritis pains, can lower blood pressure, improve mental health. And so there is really an opportunity to support people to long lasting change. Now, the key element with these medications is that once people stop the medication, we do need to ensure that enough lifestyle modifications have been made along that journey because weight regain is very common.

So I think what's really important, is that it's not medication or lifestyle. It has to be a combination of both and these medications can really help to catalyze those changes and can be done positively. Now, what's really interesting is when you look at all the various medications we use across health, there's huge stigma around these. Both from the individuals themselves, I sometimes have patients they go, yeah, I cheated, I used the injection.

They're using that terminology themselves. They view it as cheating. many will go, oh, no, I want to do it the proper using the So already the kind of terminology that's being used the worrying

And that increased weight and obesity as a chronic condition is something that's really important. this is a long-term condition that has complications across many different areas of health and so if we can reframe that, that's really important.

Lee (25:17)
So it's something about seeing it as a health decision that supports our health in positive ways, again, choosing our wellbeing. So for many people, if they have a long-term condition, if they have arthritis, if they have type two diabetes and many other long-term conditions, then there may well be a role. And it sounds like weight loss is more significant with medication than without.

Hussain (25:43)
if we look at data on lifestyle interventions for weight loss, there is not much that you can prove that it has more than 3 % to 5 % weight loss. And its durability over the years is not great. So I think it seems tough to explain that people have to do it properly when properly doesn't seem to result in long lasting changes for these individuals. And I think it comes down to the fact that

For each person, their ability to maintain healthy weight is different. as we said, genetic factors, environmental factors, financial factors, stress factors, et cetera. And so I think for the right individual, these medications are life-changing as long as they are prescribed in the right way and understanding that in addition to the medication, we need to have real intensive lifestyle support to ensure that you get these benefits longer term. And what I find really interesting is I speak to my colleagues, there's a lot of negativity around these treatments And I don't get that around, diabetic medication. I don't get that with antihypertensives when you could say that, well, many of those conditions are lifestyle driven,

I think it's a real lack of understanding And even though you may find that you're able to manage your weight, I don't think you can talk for other people that are living in very different situations, have very different genetic makeups. So I always find it quite baffling that there's this very specific stigma from professionals even around these injections, let alone the general public.

Lee (27:11)
Yeah, so for me, I think really it's about stepping away from some of the emotionality. You know, I'm a great believer addressing you know, Hussain, but I think sometimes actually it's letting go of the emotional side sort if we're feeling triggered sense of shame or guilt and we might need to settle those emotions down, and not allow those to make the decision for us. 

So we don't want the part that feels ashamed of our weight to be making decisions about how to go about changing it because us to very changes that can't be sustained avoid it altogether. neither of those are likely to be particularly helpful. know, from a therapy point of view, I sometimes talk about 
being very caring, being compassionate to that part who feels vulnerable, who feels that sense of shame, giving them a big hug, but then also putting boundaries around their influence because we don't really want that part who might be quite young, For many people, this is a really lifelong issue. And so for many people,

that emotion will be linked to things that happened right in their childhood. So they've young part of themselves who feels very vulnerable, feels very ashamed. And that part needs to be held and hugged but not allowed to make the life decisions. And then once we feel a bit settled and soothed and, we've maybe connected with others and we feel a bit more validated and heard, then we need to come back to, okay, let's look at what outcomes am I looking for 
what's going to be the most helpful for me at this point and what are my options and come away from some of that emotive ideas and just think pragmatically about what steps can I take and are my choices?

Hussain (28:47)
I think you can tell when those behaviours are overridden because of that programming from earlier patients often describe it doing very well and then a certain event occurs and have a reaction which they just didn't brings back past emotions.

I love that concept of, giving it love, but not giving it the steering wheel. And I think that's really important because too often it jumps straight into the steering wheel and it starts doing things rather than trying to, create that boundary. I love that. I'm going to, I'm going to use that going forward.

Lee (29:20)
Yeah, and if that part's a child and it's like giving them the wheel of the car and they're like driving like, you know, all over the shop, and they just don't have...

Hussain (29:26)
Making really negative, decisions that in the long term are going to cause harm. And, you see it time and time again, when people, for example, maybe let's fail on the particular behavioUR that they're trying to implement. And their reaction is to do the exact opposite to what it is.

Lee (29:43)
that's why shame isn't a great motivator for any kind of lifestyle

change because it leads to us feeling triggered at times because it often gets overwhelming. And then we're much more likely to make a choice that really is counterproductive. thinking about the driving actually And I think for me, it's something like we need to set our sat nav to where we want to go. So we put in our destination and that destination is health and wellbeing and looking after my body and also being kind to myself.

So it might not be the fastest route because actually  we want the kind route. We want the realistic route. We want the we're likely to be able to keep going And so it might be a slightly more winding route than just jumping on the motorway and driving at 90. But actually, it's much more helpful do that. And then there is a roadblock, if there's a traffic jam, then what we need to not do is then

suddenly do a u-turn and drive really fast in the opposite direction and then we end up 20 miles back in the opposite direction going I don't know why I did that actually.

Hussain (30:46)
Yeah, 100%. When we make the error, we allow the sat nav to readjust. It's probably going to add a few minutes onto the journey, but we don't suddenly go, well, that's added three, four minutes to the journey. I'm just going to, turn in the opposite direction. And I think that's so important. our groups, we often talk about it like the artwork. If you're working on a bit of artwork and you make a mistake,

You're not suddenly just going destroy your piece of artwork. No, you're going to look about how you can work through it, see what you can do to amend it, and work around it, try and incorporate it in. And so at the end, it'll be part of the piece of artwork, and it'll be a memory of an experience that you had. And you'll go, oh, I had to change. And it maybe wasn't the flower that I was hoping to be there, but we made it into a book. And that helps. 

And so I think understanding what you've planned and the outcome that you're aiming for, it will look different. It will look different. And so while we try to recommend people when they're creating their goals, that they're not kind of things that are outside of control. So like a goal where you say, I'm going to lose 10 kilograms over, let's say, three months. There are so many factors that are going to influence whether that is an outcome. That isn't a behaviour.

Instead, you know, break down that particular aspiration and go one of the various different behaviours I can do that will positively increase the chance of a outcome which is increased weight loss. And that's the aim. And so what will happen is if you focus on specific goals like 10 kilos, if you don't hit that, then it's just going to drive that guilt and shame that we talked about before.

And so we have to have a constantly adapting goal and instead focus on an approach to living rather than an end result.

And what's the greater picture? I think that's the key. Rather that black and white thinking, which I find can sometimes lead to worse outcomes. two thirds of people that go to lose weight via lifestyle means gain more weight than they lost over the long term. so we do need to think about an approach rather than a quick solution.

Lee (32:45)
So I love that idea and that really positive focus on what's in my control. So it's not in my control how much weight I lose. What's in my control is how I choose to live over the next week, month, year. We do have to have some flexibility, but we also need to avoid falling into that trap of permissiveness finding that fierce compassion where we're finding strength to say, you know, actually, am I hungry right now? am I tired? Am I stressed? Was my boss mean to me today? worried about my kids. And and actually, is that what's going on here?

So I think there's something about recognising what our triggers are and then focusing power. And it's not about the outcome as much as how do I look after myself as I navigate life, which is complex, isn't it?

Hussain (33:18)
Totally, totally. And we need to understand that in any given day, our decision making will vary on all those factors. Like I'm telling you now, let's say if we turned up to work and there were lots of treats out, if I had a bad night's sleep, if I had just had an argument with my wife, if work was piling up, I would have a very different approach

Compared to if I'd gone for a run in the morning, I had a great night's sleep, I felt I felt positive and in control, And I see that happen to myself week in, week out, and that happens to all of us.

So just trying to be as aware as possible. try to create an environment which is as safe and as positive to make those good choices. But

Lee (34:13)
That is so important. this is the Choice Space I think what makes it easier to make choices is when we put structures in place in our life that encourage us and support us to make are following our sat NAV. So if we've set it up already so that it's easy to read, that we've got the information that we need, We fill the car up with petrol before we leave.

then all of those things just make that journey more straightforward and they make us less likely to be pulled off by things that are outside our control. thinking about your future self, you look back and think, what would help me? What could I put in place today that will help my future self to make a healthy choice? Because actually, it is really difficult to maintain things all the time. So we do need to be really thoughtful about how we can make it easier.

Life is hard enough without making our lives harder it needs to be.

Hussain (35:04)
Definitely, definitely. some of the first things that we try to support our patients to do is before you enact any new behaviours, what environmental changes can you do to make it as positive as possible? We talk about like a new behavioUR being a plant that you're gonna put out into the garden. Now, if your garden is a mess, if the soil hasn't been prepared, if you've got lots of trees blocking it so you're not getting sunlight in,

then you're gonna find it hard, but no matter how good quality the plant is that you're trying to bring in, for it to actually take and for it to grow. So first work on trying to create that space. And so that may look like, for example, reducing exposure to the foods in your house. It could look like making sure that you prioritize more time for sleep. It could look like trying to gather support from your family and friends and make them aware of the change that you're trying to do so they're gonna be less likely.

to say, let's go for a dominoes, for example, when you're trying to make those changes. Look at what you can do in the environment first, get everything prepared, and then start to implement these new plants, these new behaviours, they're much more likely to take hold. Like for me, it was just so easy to access the foods that I didn't want to eat all the time. In my desk at work, I had treats in the desk. It was literally within 30 centimeters away from me.

At home, the cupboard, you had lots of those things in. I had to change all of those things if I was going to make positive choices so really consider that and consider those environmental shifts and changes not just doing it alone. Think about those that share your environment and your spaces. How can you get them to support you on this, whether it's something that they want to do personally or not?

Hopefully they can understand the importance it is for you if you've shared that with

Lee (36:52)
Thank you so much, Hussain. It's been such a fascinating conversation and Just to finish, we always end with a choice space takeaway. So if someone wanted to or two small changes to support their relationship with weight and their wellbeing, what would be one small step that they could take today?

Hussain (37:10)
First step is measure the success, not on weight loss, but on health gained. Okay? So what I mean by that is a lot of the behaviours you'll do, you may or may not see weight loss from it, but I'm pretty sure you'll see health gain, whether that be increased activity, improvement in diet, sleep, your relationships, et cetera. And the second one is I'm gonna steal something that you said today, which is that fierce compassion.

and trying to understand that balance between giving ourselves the space to accept those challenges and the failings, but understanding that we need to keep moving forward and keep being positive in how we try to tackle things going forward.

Lee (37:52)
Brilliant. think I'd add connect with others and try to reduce that sense of isolation - seek support, because I think that gives us strength to have these conversations. And actually that reduces shame and actually opens up people's opportunities to create more choices. And then I think I'm going to use one of yours, which is to put things in place that make life just that bit easier to make more healthy choices. So just think about one or two things that you could put in your environment that would mean it would be just easier for you to make a healthy choice and look after yourself.

Thanks for listening to the Choice Space podcast. I hope this conversation has offered a little more room to pause, breathe and find your own way forward. We've linked to all the ways you can connect with Hussain in the show notes. And if today's episode has been helpful, please download, follow and share with someone who might value the space as well. I'd love to have you with me for the next episode. Until then, take care and keep making space for what matters most.