Episode 192:
Show Notes 


In this episode, Dr Lucy and Dr Mary delve into the intricate relationship between stress, mental well-being, and metabolic health. They explore the detrimental effects of chronic stress on the body and mind, emphasising the importance of effective stress management techniques.

Managing Internal Narratives
Stress management involves controlling the stories we create in our minds about stressful situations. Reframing stressful events can mitigate their negative impact on mental and physical health.

Impact on Metabolic Health
Chronic stress adversely affects metabolic health by disrupting hormonal balance. Stress can lead to weight gain, impaired blood sugar regulation, and increased risk of obesity and diabetes.

Understanding Stress Response
Awareness of triggers and stressors is crucial for effective stress management. Recognizing how stress manifests physiologically helps individuals address it proactively.

Tools for Stress Management
Changing perspectives allows individuals to view challenges as opportunities for growth. Practices like journaling, expressing gratitude, and engaging in active relaxation techniques such as meditation aid in stress reduction.

Cognitive Reframing
Cognitive reframing involves shifting negative thought patterns towards more positive and constructive perspectives. Focusing on progress and accomplishments rather than shortcomings fosters resilience and psychological well-being.

Concept of the Gap and the Gain
People often focus on perceived shortcomings (the "gap") instead of acknowledging achievements and progress (the "gain"). Shifting focus towards recognising accomplishments promotes a healthier mindset.

Practice of Active Relaxation
Active relaxation techniques, including meditation and hypnosis, counteract the physiological stress response. These practices help individuals achieve a state of relaxation and reduce the impact of stress on both mind and body.

Dog Walking Analogy
Similar to training a dog to focus during walks, meditation trains the mind to redirect thoughts and maintain focus. Consistent practice improves the ability to manage distractions and maintain mental clarity during meditation sessions.

Episode 192: 


Dr Mary Barson (0:04) Hello, my lovely friends. I'm Dr Mary Barson.

Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.

Both (0:16) And this is the Real Health and Weight Loss podcast!

Dr Lucy Burns (0:23)  Good morning gorgeous friend. I'm here this morning with my beautiful colleague, Dr Mary, who you all know and hopefully love as much as I do for this week's podcast. Gorgeous one, how are you?

Dr Mary Barson  (0:34)  I am pretty good, I am. I've had some stressful events over the weekend regarding having to take my dog to the vet and other things and have had an opportunity to practice my distress tolerance, opportunity to practice by dealing with uncertainty and stress management. So it's been good, very happy to say my dog is fine. And she's out of the woods now. But it was a really horrible, scary, icky weekend where we weren't sure whether or not she was exposed to a poisonous fox bite. And it sucked because it was nothing to be done, except hurry up and wait. So you know, it was really stressful yucky time because I love my doggy. But we're good now. So that's a lovely, happy ending. Yay! But that was quite preoccupying all weekend, I must say. How are you, lovely Lucy? 

Dr Lucy Burns (1:32)  Yeah, I'm great. I'm great. And you know, on the story of pets, we lost our cat for five days. And the same, it's the uncertainty that we don't like, and you sort of just want time to hurry up. So you know what you're dealing with. And the humans, you know, as you know, we talk about a lot, humans do not like uncertainty. If you gave the human a choice between knowing the outcome. Even if that outcome is negative, they would prefer to do that than just be waiting, waiting, waiting.

Dr Mary Barson  (2:06)  Yeah, it is. It's really very uncomfortable for us. One way that I reframed this was that it was an opportunity to practice my dealing with discomfort given that there was nothing I could do, that was outside of my control. But we don't like it holding that our brain constantly gets pulled into this disasterisation wants to be pulled into this but what if, but what if, but what if, and we are designed psychologically, we tell stories all the time, and we love to try and predict the future. And we love to rehash and go over the past and sometimes we can do both at the same time. And often we can create a lot of secondary distress for ourselves, just by the stories that are going on in our heads. And being able to reframe the stories in our head is a fabulous skill to cultivate because it can make your life so much better. Even when you can't control the stressors in your life. 

Dr Lucy Burns (3:04)  Absolutely. Absolutely. And you're right, you know, it's our brain that does this all the time, it likes to make sense of the world. And so it will get bits and pieces of information, some of it true, some of it, not some of it, you know, past information, some of it current information, it'll hash all that together and create a scenario to help us try and manage an unknown. And this is so unhelpful because we spend so long then worrying, and trying to control an unknown, when actually it is just often just the passage of time, it unfolds and it's nothing like the scenario you had invented. 

Dr Mary Barson  (3:49) Yes, indeed. And if we can cultivate that skill of distress tolerance, cultivate the skill of patience, and be mindful of what's going on in our heads, our lives can be so much better. And this is extremely relevant for you and I, as lifestyle medicine doctors, as people are keenly interested in empowering people to reclaim their health and lose weight healthily, for good, that being able to manage the stories in your head being able to reframe stressful situations, being able to manage your stress is actually key to metabolic health, because stress is bad for your metabolism, and stress, the chronic stress like stress over a long period of time, it literally makes you gain weight. It literally can impair your blood sugar. It’s implicated in obesity in diabetes, as well as just poor health in general.

Dr Lucy Burns (4:53)  Indeed, indeed and I think there's like everything. There's no just one reason for that. It's a con donation of the hormones as our listeners know, we love talking about metabolic hormones. But it does, it changes your metabolic hormonal profile. It also creates a situation where you will use tools like we talked about last week in emotional eating, you will use tools to manage this state that is sometimes not that helpful for you.

Dr Mary Barson  (5:22)  It makes you more vulnerable to these tools. So if you're stressed about a situation you're worried about, anything that's causing you stress, and often we stress about things that are beyond our control. And in that situation, if you're stressed your body physically changes, and these changes, these adaptations with a stress response evolved to help us deal with immediate life-threatening situations like my child is going near a snake, there's a tiger there, I’m about to be attacked by you know, a threatened in tribes person. We've evolved these situations so that our bodies get primed to be able to navigate these situations and increase our chances of survival. And lots of physical changes happen, which literally help us survive those situations. Our blood gets thicker, it gets more clotty. So if the tiger bites our leg off, we're less likely to bleed to death, our blood pressure goes up, our heart rate goes up, we get quite vigilant, we can our eyes get wider, our pupils get wider, we’re vigilant, we're sort of looking for the threat absolutely everywhere, scanning around our environment, blood sugar goes up. All these things happen, which is great to survive the tiger attack, but not great when it's happening to stay in day out long term because of the stresses of modern life. When that happens, it really sets you up for poor health, it interrupts and having that ongoing activation of your stress hormone pathway interferes with all of your other hormonal pathways, such as our sleep pathway, you know, our melatonin and our circadian rhythms. Increased cortisol disrupts our ability to make and secrete normal amounts of melatonin second, upsets our sleep, and elevates our blood sugar. It actually literally makes us more insulin-resistant. So it increases fat gain, but also not just as increased fat gain, you know, the two types of fat we've got the subcutaneous fat, the fat under our skin, which is metabolically fairly inert, and not that dangerous. And then there's the visceral fat, the fat that sort of packs around our organs, which is really metabolically dangerous. Elevated cortisol causes us to make more visceral fat relative to subcutaneous fat. So it sets you up in a fat-gaining state, but also, you know, bad fat-gaining state, it increases our appetite, we make more hunger hormones like ghrelin, it affects the way our hunger hormones work, and also makes us crave comfort foods and hyper-palatable foods. So it's this whole unhelpful internal Millia, which can really slow down sabotage or reverse our attempts at getting healthier.

Dr Lucy Burns (8:12)  Absolutely. And I reckon, I mean, we see this a lot when people go, I'm eating well, you know, eating foods on point, everything's good. But I'm not losing weight, or my insulin levels are still higher than if they're monitoring those or if you have type two diabetes, my blood glucose is still high, but my food's good, Doc, my food's good. And I go–Okay, well, you know, check. Yeah, third seems to be fine. And then we talk about stress. And it's like, oh, yeah, yeah, I've got all this stuff going on. And I think sometimes people think, though, that they need to control their external environment, that the only way that they can feel better is to control the external environment, and therefore the internal environment will be better. But in fact, as we all know, that's often impossible.

Dr Mary Barson  (9:05)  There's certainly a lot you can do, you can look at your external environment and you know, let go of the things that aren't serving you if you can let go of them. Yeah, yeah, do an audit. Totally, totally. You know, is that toxic friendship really worth hanging on to you know, can I let go of the perfectionism, does my throw rugs always have to be perfectly creased all the time? You know, don't have throw rugs. But, you know, you can let go of things. But we cannot. We cannot live some utopian stress-free life where there's nothing out there that's going to tax us or worry us, because things happen, you know, a dog gets exposed to poisonous baits and your kids get sick and the weather is bad and things are always going to happen that we can't control outside of ourselves. But we do have more control than we realise on our internal environment. Because we get to decide how we process our external environment, our external stressors, we have quite a lot of control on how much we let them cause us that metabolically damaging physiological stress. 

Dr Lucy Burns (10:20)  Absolutely. And I think one of the things we said this last week is, you know, it's not willpower that you need, it's skills. So, mindset skills for managing emotional eating and stress management is a skill. People, they think are, you know if you talk about stress management, they go– well, I can't, you know, I've got this terribly busy job and my husband's away a lot. And I've got four kids, and I have to ferry them around everywhere. And it's like, it's not that that's not what we're talking about, what we're talking about is the skills in which you have to manage your mind, your internal state, so that you can do all those things that you need to do.

Dr Mary Barson  (11:06)  Yeah, it does get better with practice, one of the most helpful things that you can do is have awareness. So have awareness to what your triggers and stressors are. So I can be very good at managing my stress in like a work environment. And I can be good at, you know, understanding that I hate letting people down. And if I have any sort of perceived that I've dropped a ball that I, you know, I might be really quick to get down on myself. And I can have grounding strategies to sort of manage that stress. But I'm not as good at it with parenting. So if I feel like I've dropped some parenting ball, my inner critic jumps on me really hard, really fast. And that's much more difficult for me to manage my stress in that, that sort of situation, that scenario, I still can, and having awareness to the fact that my stories in my head are going to be stronger, and my inner critic is going to be a bit more vicious in that setting, helps me regulate my internal environment. Awareness is not the only thing you need, but it is a really essential first step.

Dr Lucy Burns (12:21)  Yes, you can't change what you're not aware of. And I love that idea that you've recognised that there are different lenses through which we look at ourselves through. And the lens, as you said, the work lens, you know, that's, that's probably reasonably balanced by the sounds of things, the parenting lens, you tend to lean towards more of that self-criticism. And there's the thing about us as humans is, that there are so many different facets to our roles the way we think, and the way we interact with other people. It's not just a blanket rule like it's not just a blanket, you need more self-compassion in all areas of your life, or you need to improve this bit in the area of your life, what you'll notice is that in some areas of your life, you've got that nailed. And in other areas, there's a shortfall. 

Dr Mary Barson  (13:15)   Yes. And creating your toolkit, and having that variety of tools is really important. You know, one tool that is really helpful is changing your perspective, you can get better at this with practice, if you can imagine two people that got in the same car crash, for example, and it's just it was a bingo, you know, and I was hurt, they were in a car crash, and both cars have been good, super annoying cause delay, one person could interpret this as an absolute disaster, it's ruined their day, it's gonna cost so much money, since this is you know, and be their internal environment could be very, very, very unbalanced and stressed. Whereas another person, exactly the same situation, could be interpreting this as like– Wow, isn't it lucky, no one was hurt, oh, my goodness, isn't this great, and could just be changing their perspective. And they're both in exactly the same situation, but they have an entirely different perspective. One example we can cultivate that more helpful perspective so that we can live our lives more healthily. 

Dr Lucy Burns (14:21)  Absolutely and I mean, you know, the psychological frame, our term for this is cognitive reframing. One of the things we both spend a lot of time doing in our personal lives, but also for our beautiful, you know, clients and members is the concept of the gap and the gain. And as humans, we spend a lot of time. So the gap in the game concept is that you're in a position you want to get to somewhere else, and there's, you know, a path you have to kind of go along to get there. And we're constantly striving to get to that place. And so we focus on how close we or how far away we are. And what we will do in that situation is often just look at our shortfall, rather than looking at how far we've come. And it's so interesting that we do this for lots of things. It's, and I guess some people have a, maybe genetic predisposition to be the pessimist and other people are the optimists. So the optimists tend to look at the game more than the pessimists who automatically will look at the the gap. But again, that's just a learnable skill, just like some people are naturally good at gymnastics, other people might have to cultivate that skill. Some people are naturally good singers, other people can learn it, you might naturally be an optimist and spend time in the game and your life seems to be a little less stressful. And other people have to cultivate that. But it's learnable. 

Dr Mary Barson  (15:56)  It is learnable. And we're not talking about toxic positivity here of just like putting your hand over your ears and going–no, everything's fine, everything's fine. It's so great. It's so great. This is all great, everything's great. It's not that at all, it's accepting reality as the reality. But still looking at it through this lens of looking at all the good things I've got, look at how far I've come, look at how much I've learned. And then looking back with that lens and saying, well, because I've already come so far and already learned so much. Of course, I can keep going and achieve those goals, of course I can, you know, bridge that gap between where I am and where I want to be. And gratitude is helpful here. But it's even more than gratitude. It's looking back at all the evidence of how fabulous you are and all the things you've done well, all the things that you have, and knowing that you can just keep moving forward. 

Dr Lucy Burns (16:48)  Yeah. And again, for some people, that's harder than other people. I know that that some people, you know, you go, you know, I'm sure job interviews, people go–Oh, tell us, you know, your strengths and some people can just rattle off a list of five things they're good at, and other people find that really hard. And, again, we can look at why do we do that? Why do we find it hard? And for lots of us, there were stories where you didn't want to, again, it Australians in particular, and probably Brits are similar. You don't want to be too big for your boots. You don't want to have the tall poppy, you don't want to look like you're better than everyone else. You don't want to step out of your station, you don't have tickets on yourself. Like there's a million phrases to tell you. Don't get ahead of yourself. Don't get too big for your boots.

Dr Mary Barson  (17:36)  I was always told as a kid, don't Scott don't Scott, you know, it's guiding with feisty, yes, yeah,

Dr Lucy Burns (17:42)  Yes, yes. Yes. Be humble, don't brag. And in fact, you know, as far as a human, it's important to acknowledge that we do have skills, we are valuable. We're on this planet for a reason. People, you know, need us, love us. want us for multiple reasons. And that's not only, okay, it's imperative for you to acknowledge that.

Dr Mary Barson  (18:08)  Yeah, self-effacing humor, like, it may be funny, but if you really internalise those stories, it's not going to be helpful for you. Not not helpful in the long term.

Dr Lucy Burns (18:17)  Yeah. And, you know, humility is helpful. I think, you know if I think about somebody who I reckon has, who doesn't really well, would be Ash Barty. So, you know, most people will know Ash Barty is an Australian woman who's won, you know, tennis glory, winning Wimbledon, not that long ago. And I think acknowledges where she's come from. She's had certainly, you know, there's things that she's had to overcome. She's an indigenous woman, we know that indigenous people have many barriers placed in front of them. But always in all of her successes, she acknowledged her team that people around her, rather than just going–Ah, you know, I was just lucky or I just, you know, just flipped it, which is the other thing was sometimes do actually acknowledging that no, what she's done was incredible. And she did it with the support of other people.

Dr Mary Barson  (19:12)  Yes, she's awesome. It does come back to that. Another point with our human brains is that being our negativity bias, we are very keen to hang on to all of the negative experiences, the negative thoughts, and the criticisms that we get, the bad experiences, we hang on to those and we tend to brush off the positive experiences, you know, those compliments, or our accomplishments, we do tend to brush them off and focus on the negative. And again, that's how our brain has evolved to help us survive our wild past. And now, it is potentially unhelpful if left, unchecked.

Dr Lucy Burns (19:59)  Indeed, indeed. And contributes, I think, to making us feel bad in a world where we can feel better, you know, at the drop of a hat. And if we think about health in general, like what you know, healthy is, and we talk a lot about metabolic health, obviously, we want to be metabolically well, but psychological health, mental health, whichever phrase you want to use it is so critical to how we feel and how we feel. When we feel good about ourselves. When we feel that we deserve good health, we then more likely to prioritise our needs, rather than just putting them at the bottom of the ground, at the bottom of the pile, looking after everyone else first, making sure everyone else is okay and you know, we'll give ourselves that dregs of the low-carb coffee.

Dr Mary Barson  (20:57) That’s right. Self-prioritisation is also a helpful skill to cultivate. Another thing that is really helpful is the practice of active relaxation, where you spend a bit of time each day, purposely activating your relaxation response. And this is really important in modern society where we've got a whole lot of things that will activate our stress response, we want to counteract that by also activating our neurological and hormonal relaxation response. The best way to do this is through some active relaxation, like mindfulness, meditation, listen to one of our fabulous hypnosis, that's great as well. And Lucy got a beautiful analogy here. Because we often hear people say, I can't meditate, I can't fish my brain off, can't do it. Try it, it didn't work. It's not for me. But what do we mean by you know, cultivating this practice?

Dr Lucy Burns (21:54)  Yeah, so we talk about a lot of, you know, tools, you've mentioned, the toolbox. So the tools that we've mentioned, to help you manage your internal stress, so manage your response, if you like, to these external stressors we've mentioned, you know, journaling, gratitude, active relaxation, and meditation is one of those tools. And it's a really simple process. But it's actually a bit hard for our brains initially, because our brains are very stimulated in that, particularly in this modern world, there is rarely a time when you've got nothing to do. Because even when you do have nothing to do, you'll go to your phone, you might go to your to-do list, you might do online shopping, you might play a game on it, you might check your Facebook, you might look at Instagram, you might answer an email, like it's like, we don't just ever sit there. And so when we start meditating, basically, we're just sitting there and our brain goes, Oh, no, this is no fun. And it wants to run off and do things. The way I often describe your brain as being like a new puppy, we have a new puppy, so I'm currently very familiar with him. And when you are training your dog, it wants to just so let's say you're training your dog to walk on the lead, it wants to run off and sniff everything, it's sniffing bushes all over the place. So your job as the trainer of said dog is to bring it back. And you just bring it back gently, don't growl at it, because that's not going to be helpful. You don't tell the dog it's hopeless, because it's still not walking, you just go, you know, heal or come back or whatever you phrase. And as we're walking along over time, the dog, you know, soon stops sniffing bushes and just walks with you. But what a lot of people think is the only way they can meditate is to have no bushes in the first place. That's the only way they can train their brain. It's the only thing they can do when in actual fact, the process of meditation is to bring your brain back to the present moment to notice that it's wondering off and then go, oh, I noticed I'm wandering off, I'll just bring it back to an anchor, which again, in the dog walking analogy is the person, you bring your anchor your dog back to you. In meditation, the anchor can be your breath, it might be a mantra that you're or sound you know that it's the arm one it might be something you're looking at, it might be a candle. There are all sorts of ways to do it. This, whatever suits you. But the thing is that you don't need to wait until there are no bushes.

Dr Mary Barson  (24:35)  Because that will never happen.

Dr Lucy Burns (24:37)  We'll never have a no and we want to be able to navigate all the bushes. We just want to be able to walk through and manage our minds and our bodies. Because life is never like it's never going to be without some sort of external stress and if you're waiting for that day, it'll never come. Yeah.

Dr Mary Barson  (24:58)  That analogy, same also works for those, that as mindset skills that you're practising, you know, with the reframing, with the game thinking, with the gratitude, your brain will flow off back into the– oh, this is terrible, I'm terrible, you know if only I could win Tattslotto that's the only way everything will ever be okay, your brain will go back into those unhelpful stories again. And with awareness, you can just notice it, and reframe and bring it back, a little fly off again, you notice that you reframe it, you bring it back, and it gets better with practice. And the beautiful thing is, as you get better and better at this, your whole quality of life improves, even when life is still stressful. 

Dr Lucy Burns (25:43)  Indeed, absolutely. One of the phrases in our favourite sayings is that you become less reactive when you create some time between the stimulus and your response. You've got time to make a decision that you're happy with. And again, I think one of the markers of good health is going to bed, you know, with that sort of satisfaction that you've had a good day and that it was a job well done, rather than going to bed with regrets and guilt and shame and all of that stuff that's unhelpful. 

Dr Mary Barson  (26:15)  You're in charge of it. You are in everything inside your internal environment. It's all yours. It's no one else's. And you can assign whatever meaning you want to your day because it belongs to you. 

Dr Lucy Burns (26:27)  Absolutely, absolutely. And again, it's a skill. It's learnable. And that's, that's what we want for you. So lovelies, keep practising your skills, sharpen your tools, and you know, you too will be able to navigate the seas of stress.

Dr Mary Barson  (26:43)  Bye gorgeous one.

Dr Lucy Burns (26:44)  See you later. 

Dr Lucy Burns: (26:49) 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 individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

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