Episode 169:

Show Notes 

In this episode, Dr Mary Barson and Dr Lucy Burns took listeners on a journey into the nuanced world of weight loss. They navigated the complex landscape of shedding pounds by highlighting the importance of understanding the basic framework while embracing the unique nuances of individual experiences.

Dr Lucy Burns introduced a thought-provoking analogy, likening weight loss to running a business. She emphasized the need for knowledge and strategy, explaining that just as a mechanic requires a toolkit to repair a car, individuals embarking on a weight loss journey need multiple tools to mend their metabolism and achieve lasting health.

One of the central themes of the episode was the role of calories in weight management. Calories are merely units of energy, akin to temperature measurement units like degrees. Dr Lucy Burns humorously noted the marketing trickery surrounding "high-energy" products, highlighting how different languages might affect consumer perception.

The podcast delved into the significance of protein in weight loss. Dr Mary Barson passionately advocated for the importance of protein, not only for its role in building the body but also for its ability to stave off hunger. Dr Lucy Burns echoed this sentiment, emphasizing that prioritizing protein in one's diet can make the weight loss journey smoother.

The nuances of eating habits, particularly the tendency to overeat. She underscored the idea that occasional overindulgence is not a failure but rather an acknowledgment of the body's need for more fuel at times. Listening to hunger and satiety cues emerged as a key strategy in achieving a healthier relationship with food.

Another nuanced topic explored was the consumption of fats, especially in beverages like coffee. Dr Mary Barson pointed out that while fats can be calorie-dense, they may not trigger the same feelings of fullness as whole foods. This insight sheds light on the potential pitfalls of drinking fats, particularly for individuals with weight loss goals.

As the episode drew to a close, Dr Lucy Burns shared personal anecdotes about her eating habits, revealing her tendency to eat quickly. She offered practical strategies for more mindful eating, such as using smaller bowls to prevent overindulgence and respecting hunger signals.

In summary, Dr Mary Barson and Dr Lucy Burns emphasized the importance of mastering the foundational framework while embracing the unique nuances of each individual's weight loss journey. Their informative and insightful discussion left listeners equipped with valuable insights to navigate the complexities of sustainable weight loss and overall well-being.

Episode 169: 


Dr Mary Barson (0:11) Hello, my lovely listeners. I'm Dr Mary Barson.

Dr Lucy Barson (0:15) And I'm Dr Lucy Burns. Welcome to this episode of

Both (0:20) Real Health and Weight Loss!

Dr Mary Barson (0:23) Good morning, gorgeous listeners. It's Dr Lucy here again joined this week. We're back together, the dynamic duo, gorgeous Dr Mary's here. Hello, Miss, how are you?

Dr Mary Barson  (0:34) Good, good, happy to be back podcasting with you lovely one. Excited, excited about today's topic, It comes back to this idea that we're simultaneously complicated, but simple. And we're talking about the nuance, the nuances of weight loss. I think really important and this is where people like you and I can get very excited talking about the very important tweaks and details that matter.

Dr Lucy Burns  (1:08)  Absolutely, absolutely. And I think it comes down to lots of things but we know – you need knowledge, you need strategy. It's a bit like running a business, really. You need knowledge and strategy. You need to understand facts and figures. And then you need to recognize the nuances or the little differences that apply to your situation. So I guess, you know, your uniqueness, which is not captured in a meal plan for example.

Dr Mary Barson  (1:42)  Hmm. You've said many times that weight loss is more than a meal plan. Yes, and so meal plans are not the end all be all, but people often feel that they are. They feel like they just got the right meal plan, and then it would work finally. They'd be able to do it, it's just that they haven't yet found the right one, or they need the right recipes. And then it'll work, then they'll finally be able to, you know, get the health and weight loss that they want. And although recipes can be helpful, meal plans can be helpful. They're not enough on their own.

Dr Lucy Burns  (2:16)  No, no, they're definitely not, they are a tool. But you know, if you ask a mechanic, he doesn't just have one tool to fix the car. He's got lots. And I kind of think we're a bit like the car. You know, there are lots of things that we need, lots of tools.  We're all different, so just like the cars, you know, the cars are all the same, but all different. You've got a car, one car's got a GPS system in it and the other one doesn't. So getting a GPS fixing tool is of no use to a car without a GPS.

Dr Mary Barson  (2:52)  Absolutely. I think that nuances are extremely important. Because if you take any argument and simplify it too much, you're gonna get to the point where the argument is wrong. And I think that the weight loss world in particular, even the low carb world, is really peppered with a lot of these simplified arguments that are simplified down to the point of no longer being helpful. Like the argument that calories don't matter. Not entirely true in a helpful way, the idea that you just need to count your carbs and keep your carbs low, it's not necessarily helpful. Even in modern medicine, there's a simplistic argument that has become deeply embedded that all LDL cholesterol is bad. Your LDL lipoproteins are bad, and the lower they are, the better. Whereas all of these arguments are simplified down to the point where they're actually kind of become untrue. And it's extremely noble to know the nuances, but you do need to be educated. So lovely Lucy, can we expand a little bit on this calories don't count, calories don't matter?

Dr Lucy Burns  (4:07)  Yeah, absolutely. So first thing is what is a calorie? So a calorie is just a unit of measurement. It's just, it's like, how do you measure temperature? You use degrees. In Australia, we use degrees Celsius, in America,  they use degrees Fahrenheit, it's just a measurement. So it's a unit of energy. So I always have a sneaker then because you're imagining in marketing, whenever they talk about high energy drinks, energy bars, if they swapped that word for calorie drinks or calorie bars, no one would buy them.

Dr Mary Barson  (4:40)  The big, probably less popular. Yes.

Dr Lucy Burns  (4:43)  Yeah. It's also fascinating to me that calories are an old metric and kilojoules are actually the new metric, but for whatever reason, that certainly has not been adopted very much within any community. People understand calories that aren't necessarily understood or related to, kilojoules and I think it's a little bit like, and I'm diverting amazingly here, but it's a bit like when we measure babies. Like when babies are born, They're in pounds. Yeah, they're in pounds. Everyone knows a 10-pound baby is massive but a four-kilo baby, people go- is that big?  

Dr Mary Barson  (5:24)  Totally. Yeah, it's a 24-hour time, I'm used to thinking in kilojoules and measuring babies in kilos and grams. But I appreciate that is not generally how our society works. We think about the energy in our food in calories. And we have for a long time been sold this idea that you just need to eat less calories than you consume and you will lose weight because we're simple buckets of calories. And so high-calorie food has been demonised, stay away from fat fats, calorically dense. You know, don't eat fat, low-calorie diets are what you need. And then, you know, you and I being among the more enlightened people out there. I'd like to say, it's quiet, it's quiet. But I believe we know that there's so much more to it. But then I think there has been this backlash, particularly in low-carb communities, where it's not calories. That's just such a simplistic argument. It's not about calories, it's really about metabolic hormones and metabolic health. So forget calories, calories don't count. And then people can completely perhaps even swing right the other way, where they think it doesn't matter how much energy they consume, as long as they're consuming it in a low-carb way. Discuss.

Dr Lucy Burns  (6:36)  Indeed, indeed, and this is one of the foibles I guess the issues that we see is when people, you know, we talk about it a little bit with weight loss stalls, but it's still overeating I guess food. Overeating your energy in the form of food because that's how we get our energy. Again, this is a lesson I think takes a long time to catch on to or to learn or to finesse, which is that lesson of being able to tune into your hunger and tune into your satiety signalling. And know that there are times when we do overeat. And there are times when we eat when we're not hungry. And that if we do that, it's not bad like you're not a robber, you're not it mowing people down in a car. What you are, though, is just recognising that you, it's a little bit like a bank, you've taken money out of a savings account, and but you'll probably need to put it back in. So at some stage further on, you will probably be unlikely to be hungry because your body has enough fuel. If your wood sheds open, you can access that fuel. But we need to listen to that. And just know yourself well.

Dr Mary Barson  (7:57)  Yes, it is true that if your goal is to burn some of your body fat, simply reducing calories is not a good nor sustainable way to do that. We have talked about this at length in this podcast topic you and I are very, very passionate about if you want to be able to access your own fat stores and use that as some of the fuel that fuels your beautiful body through your beautiful life, then you need to get metabolic healing, you need to get your hormones into a better balance. Specifically, you need to get your insulin levels lower and reduce any insulin resistance that is around and you do that by changing what you eat. Not how much what you ate, the real food that's naturally lower in sugar and starches will give you that metabolic healing. But how much you eat does play a role as well? It really does. Yeah, our bodies are clever. And yeah, if we're eating a lot of extra fuel that we're eating lots of fuel, our body will just burn that fuel first. Yeah. Yeah, absolutely.

Dr Lucy Burns  (9:00)  And look again, on average, you know, people go –Oh, what do you mean calories don't matter? Let's go the average human so this is just an average human, whatever that might look like. Because in fact, is there an average human, that's a whole different topic. But let's say the average human requires about 2000 calories a day to burn to run their body. So 2000 units of energy is what we can call that. So we need 2000 units of energy. Now, some people are going to need more, some people are going to need less, let's not debate that argument. So we can get that energy from our food. And we can get it from our own body fat. Which is where I think the original concept of calorie counting came from. Again, I'm trying not to be too mean to old researchers because we didn't know stuff back in the 1900s. We didn't know about leptin, which is our satiety hormone, we didn't know about ghrelin, which is our hunger hormone, we didn't know about the peptide yy and all these other hormones and polypeptides that are involved in our hunger and satiety signalling. But what I think is fascinating, and this is interesting is, you know, protein, we, as everybody, hopefully, who listened to our podcast know how much we love protein, why it's so important. But most importantly, the thing about protein is it's so satiating, it fills you up. So, you know, recently, we had a question where somebody said, they're having trouble eating enough protein. Again, let's say you're 120 kilos, then you need about 120 grams of protein a day. Which, if we then translate that to calories, that's 480 calories. When you boil it down to that, it's actually not that much. Like it's a quarter of your body's needs come from protein, which is about right, 25% give or take. So, therefore, isn't it interesting that we've got this macronutrient, but it's hard to eat enough. Like, it's almost the opposite of dieting, where we're going, No, you can eat no more for you, you've had enough. Here people are going– I can't eat that much.

Dr Mary Barson  (11:30)  Yes, it is a high satiety. macronutrient, which is something we love about protein, apart from the fact that we are literally built of protein building blocks. And if we don't eat enough protein, we aren't able to heal and function and you know, have as well as we want. And we can't really store protein, so we need to eat it. But it literally is it fills us up. So you know, 105 100 calories of salmon, that's a lot. So it's let's say 300 calories of salmon is not going to have the same effect on our body as 300 calories of chocolate chip ice cream. Whereas the previous you know, it's all about calories, argument or point counting arguments would say that you just need to eat less doesn't matter what you eat as long as you eat less. But it is not about how much you ate, but more about the quality of what you ate. Because when you improve the quality of what you eat, you get metabolic healing, you can boost your metabolism, you can feel better, you can have great energy, and you can access your fat stores because of that normal metabolic balance and your metabolic hormones. You also naturally eat less fuel when you're feeling the body the right way. This means that your body will happily healthily make up that deficit by burning your fat stores, which is what you want. Calories do matter. But counting them isn't helpful.

Dr Lucy Burns  (13:07)  No, no, they're again, they're a small piece of the puzzle, not the whole puzzle, which is what we've been taught for such a long time. And again, I just, you know, think God, you know how many packets of bloody processed diet chocolate mousse did I buy? You know, because they were half a point, which was like 50 calories or something. And they did nothing, they just did nothing. The interesting thing, and again, this all comes back to being able to regulate, tune into that beautiful knowing of being able to really estimate when you're full. If you prioritize your protein first, then the rest becomes easy. Because you're then full. So if you're full, as in fuel full, if your fuel full, and of course, we can override our satiety, you know, we're humans, we can do that. But two things– one, why would you want to and two, it's harder to.

Dr Mary Barson  (14:10)  Yes. With that beautiful metabolic healing, you also get less of those physiological cravings for sugar as well. So you're having a beautiful meal that's delicious, it's yummy, really enjoy it. You're prioritising your protein, you feel nice and full, so that— I'm hungry, I'm hungry, I'm hungry, I'm hungry– so the chatter in your brain isn't there. But also, those carbohydrate cravings are much lower. And so that little chatter of like I need the cookies, I need the cookies, only the ice cream and the ice cream is much lower as well. So it's just a much more peaceful way to be in the world. And this is what I love about a higher protein, lower carbohydrate, real food diet. It's so yummy, and you just ate your meals. And you don't have to think about food or worry about food until it's time to have another meal. It is much calmer.

Dr Lucy Burns  (14:57)  Indeed. And, you know, again, this is the nuances because I think a lot of people are wanting to lose weight there. The other sentence I hear a lot apart from I just need to count my calories is I need to reduce my portion sizes. And it's interesting. And again, we've been told that– oh, you know, you eat too much. Okay, so, you know, look and think, right, you eat too much? Well, again, do we need to reduce portion sizes? Now I was thinking about this the other day, my two foibles around eating– one, I'm a fast eater, a wolfer of food, which doesn't serve me well.

Dr Mary Barson  (15:38)  I don't know about you, but that's a throwback to my medical training. You either eat fast, or you don't at all, as a junior doctor. Yep. Every doctor is the same. 

Dr Lucy Burns  (15:47)  Yeah, mine was actually the brothers. You know, if you wanted more, you had to quickly gobble up what you had, so that you could get in for more, right? So yeah, fast eater and a picker. So if there is food in front of me, even if I don't really want it, my brain, my brain eats it. So the two things that have helped me with that, are to try and eat more slowly, which again, is a work in progress, because I often default to Wolfing. And just not to have food in front of me. So when I wolf, and when I pick, I override that beautiful satiety, knowing that intuitive eating that you know, I really love that idea. And again, I know there's an intuitive eating brand. It's slightly different to ours, when we talk about intuitive eating, we believe it is incredibly hard to intuitively eat a processed food product that is designed for overeating.

Dr Mary Barson  (16:47)  But when you eat natural real food, you almost automatically intuitively eat it just because it's natural, real food, the food we're designed to eat.

Dr Lucy Burns  (16:55)  Yeah. So as part of my wolfing and picking things, I've also recognised that if I have a bowl of food, particularly if it's yummy, like you know, my favourite would be something like chicken satay, if it's yummy. I find it hard to go— Oh, I'm halfway through the bowl, I'm full. I'll just put it in the fridge. But brangus will tea now males will eat it. So there are two consequences of that. One is that I'm actually filled in for very long because I've got fuel, it's all available, my woodshed is open, and I don't need to eat so I can naturally fast longer without forcing it. But what I've learned is that when I do this, I also am a bit uncomfortable, like I'll go sit down on the couch later and go— Oh my God, I've eaten too much, or a lion bender, I'm still full, this is uncomfortable. So it is better for me to use small bowls. Take a serving. And the deal with myself is if I'm still hungry, I can go back and get some more. As opposed to the idea of well, you do have a small bowl because then you're going to have a small portion and then you're going to not overeat, even if you're hungry.

Dr Mary Barson  (18:10) And you have to just have your small portion. And if you want more, you're still not allowed to have it because you just have to work knuckle your way through and be hungry because it's all about calories. Yes, that's much, much less helpful. That's just understanding the way that your beautiful body and your beautiful mind work.

Dr Lucy Burns  (18:27)  And nuance. This is exactly the nuance that we're talking about. You know, these are the things that people learn about themselves. If they listen and experiment and recognise what's going on. Then, again, you get to write your own playbook, your own weight loss book, if you like. It is specifically to you, which you know, we'll have the frameworks that we like to teach. Absolutely, and then the nuances that apply to you. But don't apply necessarily to Sam or Dave or Ben or Rachel, they're your nuances.

Dr Mary Barson  (19:07)  Yes. I think another important nuance that I would like to throw in there because I say it a lot is having extra fats, especially in the form of oil and butter and coffee and tea or having a lot of cream in your coffee or tea. This is something that's quite common out there and there are little pockets in the low-carb world that believe you need to have lots of extra fat. I think a little nuance with that is that if that is that kind of cream or butter when you drink it, I suspect it really doesn't. My suspicion is that it doesn't really signal our normal hunger feelings. So it's probably quite easy to have butter or oil or lots of cream in your coffee without feeling full. And that if you're having those extra servings of that with your drinks, it's not filling you up. It's not necessarily a bad thing at all. However, it's still and your body will burn that fuel because it sees the fuel that we eat before it bid goes into our own fat stores and burns those. And so it's possible that if you've got a weight loss goal, you know, a nuance to look at would be that drinking your fat is not necessarily helpful.

Dr Lucy Burns  (20:22)  Yeah, absolutely. And I think, it's the myth-busting world back when, you know, keto and bulletproof coffees were very popular. And people were drinking them like crazy. Which is again, you're the boss's view, you can do whatever you want. Yeah, totally. And I guess this is this is a nuance. So I remember hearing about, you know, again, you go into Facebook groups where there are people with just opinions, and people go– no, no, you need to have plenty of fat, don't feel fat, have plenty of fat. Other people go– Oh, my God, you better chugger, what's wrong with you, and it was, like really aggressive. But the nuance that we would teach people is that at the start, particularly when your woodshed is shut, you will need some fuel, and the fuel will be some extra fat. And then comes a point where you dial it back. And that's where the nuance comes in, dialling it back. When your body, when your woodshed is open, your body is fat adapted, you're running, you've got all access to your fuel. And that takes time. That doesn't happen in the first week.

Dr Mary Barson  (21:35)  It's a beautiful thing when it does happen, though. 

Dr Lucy Burns  (21:38)  Oh God, it is good. It is. It's so good. Knowing that you're, you know, you're not a slave to food. If your meal is later, you don't have access to some food that you want. You have access to your stores, it's available to you. You can just power on and then eat when it suits you. Not the other way around.

Dr Mary Barson  (22:01)  Yes, yes. It's a much calmer and happier way to be. Absolutely.

Dr Lucy Burns  (22:08)  All right, gorgeous people. So I guess that is our summary on this week's podcast is really about the nuance of weight loss. Yes, you need a broad framework. Absolutely you do. You need that. But then, after a little while, the nuances are very important.

Dr Mary Barson  (22:25)  That's what we love empowering people to be able to learn and claim their own nuance.

Dr Lucy Burns  (22:31)  Indeed, indeed. So gorgeous ones. If you're looking for some more information on the framework, the basic framework that we talk about, we have a book. It's called the Doctors Guide to Weight Loss. It's not a very inventive name, but it's very clear on what it provides. It's an ebook and you can download it. The link is in the show notes. Or you can go to our website, all the www.rlmedicine.com. Alright, gorgeous ones. Have a beautiful, beautiful week and we will catch you next week.

Dr Mary Barson  (23:03)  See ya.

Dr Lucy Burns  (23:10)  So, my lovely listeners, that ends this episode of real health and weight loss. I'm Dr Lucy Burns,

Dr Mary Burns  (23:17)  and I'm Dr Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com

Dr Lucy Burns  (23:29)  And until next time…

Both (23:30) Thanks for listening!

Dr Lucy Barson (23:31) The information shared on the real health and weight loss podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualized medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

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