Why You Keep Failing at Your Weight Loss Goal

Venus Ramos, MD

Oh, I am so excited to be here, Dr. Keesha, thank you.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

So we’re going to be talking about the frame of the body and how it holds onto its form, weight. And this has a lot to do with the energy body and we’ve talked in some other guest expert interviews about how in Ayurvedic medicine, the mind is the one that determines what’s going on in the body. So body image becomes such an important subject in how we see ourselves and what we think is going to make us happy. So, I would love to talk a little bit about how you approach weight and how our patients with autoimmune disease who are having a dysmorphic relationship with their bodies already, ’cause it’s combative, how does it figure in?

Venus Ramos, MD

Well, a lot of the way I look at weight loss and approach weight loss, I should say, was heavily influenced of course, by my history as a fitness athlete, competing on a stage where I’m being compared, my body is being compared to other bodies and being ranked. This is certainly something that can be very difficult to deal with mentally. And I’ve seen many competitors in that space really struggle with the mental aspects of getting their bodies in the ideal, perfect shape that they think the judges are looking for. And coming from that background, I realized that I had to be very, very strong in how I looked at my own body and how I was feeling so that I could be successful. I did compete for 20 years. So there was an element where I felt good about competing, where I really felt good about my body and what I was doing with it. And it was always a matter of not looking at it as if I didn’t like what I was seeing and I had to improve it so that it could be better for other people to look at, it was always a matter of, or at least it definitely grew to be what I was feeling. And I think that’s really the important aspect of weight loss and what your body image should actually be. So that is the huge factor that I think comes into the approach when I’m dealing with patients or dealing with clients who are wanting to lose weight or feeling like they need to lose weight. If weight loss is a goal, I really focus in on what the image of their body is and what their true motivations are for wanting to lose that weight.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Well, I like behind you, you have the little signs that say, “Stay fit and be happy.” So that seems like a good stepping stone for moving into what next steps would be.

Venus Ramos, MD

Absolutely, I think that there are some people who are somewhat put off by when I say stay fit, be happy, as if being fit is the only way that you could be happy. But I absolutely believe that fitness is a lot more than just physical fitness. Being fit absolutely has to do with being mentally fit, emotionally fit, spiritually fit, that is all important when you’re talking about achieving that right balance of physical, mental, emotional, and spiritual health.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

So, when we talk about body image, I mention this word dysmorphic, and a lot of times people with autoimmune disease feel betrayed by their bodies. Like here, this body was something I took for granted, I didn’t realize that I was taking it for granted until it wasn’t working the way that I want it to work. And there can be a level of not trusting the body. And then others will still be able to maintain a positive body image, but have noticed that they’ve put on weight for a variety of different reasons, maybe joint mobility issues, things like that, that have it so that they can’t be as active as they used to be. And so can you have a positive body image and still wanna lose weight?

Venus Ramos, MD

Absolutely, there is absolutely a way to have a positive body image and want to lose weight. And having a positive body image is so very important when it comes to achieving your goals, when it comes to weight loss. Because when you are looking at your body positively and you’re not feeling betrayed, you’re not feeling those negative thoughts about your body, it becomes so much easier to take the steps and have those steps actually be successful in achieving your goals. So it’s absolutely important for a positive body image to be intact when you are trying to lose weight. So it’s absolutely possible. I think right now, actually very recently in recent years, I’ve seen this push towards being body positive for, it’s almost like a hashtag, be very positive about what we think of in society as a beautiful body, what a healthy body is, to be more accepting and even just tearing down those ideal images that we have of what a healthy body or a beautiful body is supposed to be. I think that’s fantastic.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Airbrushed magazine cover grocery story.

Venus Ramos, MD

Exactly, so we see these images and I think there actually is a difference between being body positive and having this positive body image. Again, you can be a body positive person, you can have appreciation for all bodies and know that we each have our own ways of being able to contribute to our society and we shouldn’t be tearing down anyone’s body, the whole fat shaming thing. I think it’s definitely great to be body positive, but there are certainly people who feel like they are part of the body positive movement, but they don’t necessarily have a positive body image, it’s very possible for that to happen. And while you can have appreciation for all body types and know that all body types are beautiful and have contributions in this world, you may still have your own negative body image, which could be affecting how you are achieving your weight loss or weight management goals.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Interesting, because I will often be heard saying, that the body I believe is one of the most underappreciated miracles on the planet. That we put it to bed at night and we think that we’re resting it, but indeed the liver’s detoxifying, the lymphatic system’s going and doing its job of getting rid of trash and the heart is still pumping and the lungs are still oxygenating. Everything is still going on with this body, even though our minds have gone into a different state of being. And then we wake up and open eyelids that have the most miraculous thing where we can see and then we can taste and we have teeth we can brush. And we have just all these really beautiful aspects, to be able to hear and feel and touch. And yet we look in the mirror and say, “Oh, I can’t believe.” And I always think that if you were a child of a parent that did that all the time to you, you can never do anything right, it’s exhausting. And so when you think about to me, body positive or positive body image is this deep, deep unbounded appreciation for the blessing that you have to have a body that works to whatever degree it works in, not to have an expectation that it should be different than it is. And from that space of appreciation and gratitude, you’re actually sending out completely different neuro hormones and biochemicals to your body.

Venus Ramos, MD

Absolutely.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It shifts everything. So that perfectionistic drive and constant nitpicking and criticizing about what’s not right gets us what we see in front of us. And so I love this discussion about image and positivity as going beyond what you see in the mirror, but what is happening in your mind in relationship to your body.

Venus Ramos, MD

I like to think of when I wake up in the morning and oh, my hair may be a little disheveled and I look in there, I say, “Oh, wow, look what a wonderful rest I had last night.” That’s more about all the beauty that I was able to achieve by getting a really good night’s rest rather than, oh, I look like I just got up out of bed. So it’s really, truly just a matter of really appreciating everything that you are doing for your body and everything that your body can do. So that is where having a positive body image can certainly help put you on the right path and the right frame of mind so that you can achieve the goals that you set out for yourself, those health goals.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I have a lot of patients with autoimmunity that it would be great for them to just feel gratitude, to have hair, to be disheveled.

Venus Ramos, MD

There you go.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

They would look at your hair and go, “Oh, yeah, I would love to see hair like that disheveled.” So if somebody is struggling with some extra weight, which we know that fat is a storehouse for toxins of a whole variety of toxins, including hormones that can then as you lose weight, be randomly deposited back out into the bloodstream. What are some of the secrets to getting into that collaborative, seriously compassionate relationship with your body to have it achieved the weight that it’s meant to be at for optimal health?

Venus Ramos, MD

Well, I deal with so many people who sometimes feel like when I’m talking about how they’re feeling and their body image and things of that sort, they wanna deal with, I just wanna deal with the facts, give me the facts.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

What should I eat?

Venus Ramos, MD

Exactly, what should I eat?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

How much?

Venus Ramos, MD

How much of this am I supposed to do? And I tell them, okay, I understand you truly have that understanding that your body weight is basically the products of an energy balance, energy in, energy out. Are you having more energy/calories in than you have going out, as far as your exercise and your normal body processes, consuming those calories, what is the balance there? And are you out of balance so that you’re gaining weight or losing weight. That is true, there is an energy balance situation you have to look at, the calories in and the calories out. But what I think is not appreciated enough is that there’s a whole lot more than just counting the exercise calories and the food intake calories, and figuring out the balance or the non-balance. ‘Cause usually if you’re doing a weight loss, you want it not to be necessarily balanced. There is more to it than just the food and the exercise.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

In and out.

Venus Ramos, MD

There’s definitely more to it because there’s things that affect how that scale works. There’s your feelings, the hormones behind those feelings that can generate those feelings, the hormones that can come as a result of those emotions and those feelings.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I wanna highlight that for just a second for people to really hear that, that can determine what’s going on or can be a result of what’s going on.

Venus Ramos, MD

‘Cause they can definitely be a feedback on each other in terms of how hormones and your emotions react, inter-react I guess we should say, interact. I’m creating words now. So that is basically very important to understand that that affects how that balance can work. Your calories may not be consumed as well if there are specific emotions, if there are specific traumas, if there are hormones that are affecting that, that energy calorie consumption is not going to be as effective. So there are certainly things that have very important consequences on that energy balance and really looking at what you can do to keep a positive energy around so that your energy balance is working most effectively for you, is an important thing to look at.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

So you just mentioned hormones, there are toxins, there is mindset, there’s amount that you eat and how you exercise. How do you individualize all that?

Venus Ramos, MD

Again, as far as individualizing things, it’s certainly something that takes a lot of individual introspection, really taking a look at each thing and really determining what it is that you can focus on. I think a lot of weight loss, weight management, a lot of it has to do with balancing what you are able to achieve and focus on. I think oftentimes my patients or my clients may feel very overwhelmed by the nutritional aspects, taking a look at their food and knowing what they’re eating and knowing that they’re eating the right things and the right amounts of things. And then they have to take a look at, oh, what’s my physical activity. Am I doing the right kind? Am I doing the right amount? Am I doing it at the right time of day? There’s all of these things that they’re thinking about. And then you say, oh, now you’re telling me there’s this other stuff I need to look at. I need to look at my environment, the toxins that might be affecting how this is all working out. And now I have to also look at my emotions and how I’m feeling about that. And I think one of the big things to make sure that is addressed because it has such an overall effect on everything is absolutely looking at the more emotional and mental aspects because of the stress that it can put on your body. So I believe that oftentimes that’s where I wanna start with many of my patients or most of them, because if that is not addressed and protected and made sure that it is moving in a very positive direction, then it basically tears down everything else that you’re trying to achieve in all the other aspects.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It’s like a hole in the bottom of the bucket. You’re trying to fill in the bucket, it’s just pouring out the bottom.

Venus Ramos, MD

Absolutely, you need to make sure that that’s plugged up really well and you have a plan for when things might come in and try to tear that hole down even more. So making sure that you have ways to manage any stresses or making sure that you are starting from a very good emotional place when you start on all of these things is very, very important because even if you just point at one hormone, cortisol, that one hormone, if that one hormone is out of balance, goes unchecked, it can absolutely tear into your mental state, it can tear into other hormonal states, insulin, which we know can play a big factor in terms of your fat loss. It can affect your sleep, it can affect your sex life, it can affect so many different things.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It causes leaky gut, kind of sensitive to foods and your environment.

Venus Ramos, MD

Absolutely, it can affect your cardiovascular system. It basically affects every system in your body, head to toe that–

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Immune system.

Venus Ramos, MD

That one hormone has such overreaching effects on your entire body that you definitely need to make sure that that is in place before you move on to all of the other steps.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C​

But Dr. Venus, I’m positive it’s my thyroid. I hear that all the time. And you know, thyroid, yes. But it’s so interesting.

Venus Ramos, MD

And so, do you know about thyroid and cortisol?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Exactly, I always tell my patients, thyroid and adrenals are the flip side of the same coin and the thyroid will get dragged because the adrenals are out of whack and the adrenals are only out of whack because of the way you’re perceiving yourself in your world. It really has everything to do, it starts here.

Venus Ramos, MD

Yes, absolutely, and that’s one of the biggest things, most challenging things I have to deal with is making people understand or helping them understand that it’s not bad for it to all be in their head. A lot of, even my pain management patients, “It’s not in my head.” I’m like, “It’s actually in your head “and that’s not a bad thing.”

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It doesn’t mean you are crazy.

Venus Ramos, MD

It doesn’t mean you’re crazy, it doesn’t mean I don’t believe you. The fact that it’s in your head means that there are things

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It can be changed.

Venus Ramos, MD

that you control there.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It’s a good thing.

Venus Ramos, MD

It’s a good thing, and it’s scientifically based, it absolutely is.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And it’s true, there’s not just an easy pill you can take for that, it takes some work. But the other thing is a lot of press is being given now rightly so and beautifully though, to insulin resistance. And a lot of people are starting to wear things like 24 hour glucose monitors. And I had a patient the other day who was telling me that she was waking up in spite of doing intermittent fasting, where she fasted for 16 hours and ate at lunchtime, did not eat past five or 6:00 pm and rested her digestive system and everything, really great, but she was waking up with a very high blood sugar. And when I started talking to her, I did adrenal and hormone DUTCH test with her and her cortisol was crazy. Her hormones were completely, the buckets were empty. 

And I said, this intermittent fasting regimen that you’re on is on paper, perfect. It’s the one I follow, it’s really good, but not for you right now, because what’s happening is you’re stressing your body too much. It’s not getting the food that it wants at the time that it wants and so you’re waking up with this intensely high blood sugar, not because of what you’ve been eating, but because of the stress. And I don’t think people realize that actually stress increases your need for insulin. And so, this is the base, sure eating a Snickers bar, but she wasn’t, she was eating a very good diet. And so I find a lot of my very sophisticated, intelligent patients that know a lot about this and are trying these different protocols in isolation of their own blue are not having good success and even making things worse because they’re not listening to the feedback of the body.

Venus Ramos, MD

Absolutely and it is so key to really listen to what your body is trying to tell you, to really understand what you are feeling. Because I think when you approach weight loss through how you’re feeling, and you really try to make that your goal, as opposed to really what you’re seeing on the scale or what you’re seeing even in the mirror, if your goals are more towards what you are feeling, then you’re going to have so much more success in achieving those goals and you’ll actually have some side benefits of those other things that we don’t want you to have, necessarily as your goal. You’ll see the pounds drop on the scale, you’ll start seeing the shape taking form. Those will just be little side benefits, but how you’re feeling and moving towards making you feel better, more energetic, happier. If you’re moving towards those goals, you’re always constantly tuning in to how your body’s feeling and that means you’re actually listening to those messages and you are becoming yourself, part of that feedback loop that’s happening with things like cortisol and thyroid and insulin and things that are all interconnected, you’re actually putting your own mind and what you are putting your efforts out towards, into that whole system of feedback and working in a way that it is positive for you.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I’d love to share our daily routines because I’m sure they’re very different. And just so that people get an idea that this isn’t the same for every single person. So, what’s your daily routine like?

Venus Ramos, MD

Well, my daily routine, it actually tends to be a little bit different every day. There are certainly some elements that are always the same because my business.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Do a week, do a week.

Venus Ramos, MD

My business takes me online, it takes me into a nursing home, it takes me to various places, but I do always wake up in the morning. I’m at the point where I’m not using an alarm at all, I just wake up in the morning that usually ends up being in the range of 6:30 to 7:00 am, that’s when my body tends to wake up. And I get up in the morning and one of the first things I do is I drink a glass of water, which happens to be there. I always think it’s great to be able to have water right there next to me as I wake up in the morning, so that I have water to make myself feel so much better when I start in the morning, because I’ve gone a whole night without any water. So that’s the first thing that I’ll do. But as far as activity wise, I always start my morning off with a morning walk with my mom. It’s pretty much a very much a routine thing that I do. I moved in with my mom after my father passed, and it’s been wonderful. And I love being able to share that morning walk with my mom. And I also get to have great talks with her, as well as making sure that she maintains an active lifestyle as well. So I definitely always start my morning with that. Usually, I love having a hot beverage in the morning, it’s usually a hot coffee or a green tea, those are two of my favorites. And for myself, I actually try to change it up a little bit in terms of whether I have a caffeinated or a naturally decaffeinated version of those only because I don’t want to become caffeine dependent. So I usually vary that up on a regular basis to not necessarily become dependent on caffeine. But that’s pretty much how I start my morning every morning. And then the rest of the day kind of moves into different areas of work.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Depending on the calendar.

Venus Ramos, MD

Exactly.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

How do you wind your day down?

Venus Ramos, MD

Oh, winding my day down. More recently, it’s been just a little bit different recently, but that has a little bit to do with the fact that I’ve decided after taking an extended break to return to fitness competition. But that’s another story. I don’t want anyone to take on the fitness competitor lifestyle right now, but it generally involves me actually being able to turn my computer off. A lot of my work during the day and messages I get regarding patients come to me from my secretary and at the end of the day, usually right after dinner is when I use to just go to my computer, my phone, I take care of any of the messages that came through, emails that came through, things that need to be taken care of by the next morning, medication refills, things of that sort. So just tying things up right after dinner. And then after that, I pretty much relax for the rest of the day. Yes, I do enjoy some television. I do enjoy television in the evening. And I usually like to get a little bit of extra cardio in, I now do that an hour, an hour and a half, that’s pretty much my cutoff. I don’t do any kind of exercise after that period before my bedtime, but usually I will sit on my recumbent bike just to get a little extra cardio in while I’m watching television. That’s kind of how I do this little dual, making sure that I’m burning some calories while I’m quote, sitting on the couch and just doing a regular TV watching.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Nice, nice. Well, they’re actually kind of similar, I am surprised. Sort of, I get up in the morning between usually 5:30 and six and I have three dogs. And so I do their food and all that, and then make a drink with a couple of scoops of our collagen and then some dandy blend and monk fruit and I drink that while I’m getting them all set to go and take my morning supplements and then I take them for a walk. I live in a very hilly area, we do a hike for at least an hour and a half, sometimes two hours every morning, and then come back and I do a meditation spiritual practice for another bit and start my work day around 10. So that gives me this really nice period of time that I get to do my self-care and then start my, mine’s always on computer, time in front of the computer. And then I will, to wind down my day, so I eat, I do do intermittent fasting. I’ll break my fast at lunch and eat a really nice, very robust lunch, very robust dinner. And then at the end of the day will, if I’ll review my day and laughter is really important to me. So if I have not had a good belly laugh that has made me cry a little bit in my day, then I will either call one of my kids because that will happen in that period of time. Or I will sit down and watch a old TV show called “Psych,” makes me belly laugh, and I’ll do an episode of that. And so it’s like a prescription for me, I wanna laugh every single day,

Venus Ramos, MD

That’s amazing, fabulous.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And then I will read, and then oftentimes do Asana or a hot detox bath with salts and do candles, be off the screen and Sesame oil massage, and then go to bed. And I usually am in bed by about nine. I really like to power down and read a book and then go to sleep and start it all again. So, yeah, so they’re kind of, I mean, I don’t do cardio at night except sometimes. So sometimes I’ll do the same thing if I’m watching “Psych,” then I’ll do some hand weights and things like that. And I usually encourage my patients to do the same, be active while you’re, do minute for minute. Do a little trampoline, or like you said, a recumbent bike or some hand weights or some yoga stretching, something to kind of like get back into an embodied space.

Venus Ramos, MD

Absolutely.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Thanks for sharing that. I wanted people to really see that there’s so many different ways of living a life, of being human, and there’s not a one size fits all, and it really does come from that emotional space. And I appreciate you pointing out like your feelings as a nice space to move from ’cause nothing else works if you’re not there. So is there anything else that you want to share with our audience before we go?

Venus Ramos, MD

Oh my goodness, there’s always so much. But the one thing that I always like to tell everyone when they’re taking on a new program or weight loss program, just no matter what’s happening, no matter how stressed out you feel, whether you’re worried about how many calories you’re supposed to be eating that day or you’re fretting about how many hours you were supposed to have spent on the treadmill this week, just remember to take a breath. That’s the answer to everything, just take a breath ’cause you can start from a good place. First off when you’re taking deep breaths, that in itself can do a lot to just get you into the right frame of mind, bring down any cortisol levels that might be going a little unchecked. So, I always say, remember to come back to your breath, just take a breath and you can start again and start feeling good about where you’re at.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Beautiful, that’s great advice. So you are providing the 15-Minute Better Body Blueprint for our audience, thank you so much, as a free gift for joining the summit. Do you want to talk a little bit about that?

Venus Ramos, MD

Absolutely, the 15-Minute Better Body Blueprint is actually something that I designed because I really felt the struggle that my patients and clients were having with fitting in all of this advice that everybody’s giving, just being able to fit it in because we’re all so busy. So I came up with five hacks. I don’t wanna say little hacks because they can actually have big, big impact on your life, but five simple things that you can do in your life that will actually fit in because all I’m asking is for 15 minutes out of your day. If you can just give me 15 extra minutes out of your day, you can put these hacks into your life, these five hacks, that can really do a lot to help you achieve that better body in mind, spirit.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Nice, and then for those of you that have listened to these talks and said, oh my gosh, I really want to have this forever that I can go back to and reference again and again and again, the All Access VIP Pass. Dr. Venus has actually provided a bonus for you too, a gift for that inner circle, the E-guide and workshop to improve productivity. So would you like to talk about that?

Venus Ramos, MD

I actually have an eight module workshop that you can take through as well as an E-guide that is going to help you achieve on a weekly basis. You’ll be able to go through each of these steps and modules that will take you through improving your energy, improving your body so that it can actually achieve what you wanted to achieve over the process or over the course of these eight modules. And I’m going to basically be able to take you through and show you how easy it is to achieve a more productive life.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Thank you so much, I really appreciate your generosity, your generosity of time and your wisdom. Thanks for all that you do in the world, Dr. Venus.

Venus Ramos, MD

Absolutely, and thank you, Dr. Keesha, I was so thrilled to be here today.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

All right, everybody, until next time, be well.