Scott Webb (Host): The holidays are often a joyous and fun time for many, but it can be challenging to stay focused on our health journey when those pumpkin pies are staring back at us. Joining me today to offer some expert suggestions for how we can survive the holidays on our health journey is Dr. Robert Catania. He's a fellowship-trained bariatric surgeon with Southern NH Health.

This is Your Wellness Solution, the podcast by Elliott Health System and Southern New Hampshire Health, members of SolutionHealth, I'm Scott Webb. Doctor, welcome to the podcast.

Robert Catania, MD: Thanks, Scott. Appreciate it.

Host: Yeah, it's good to have you here. I was mentioning there about pumpkin pies and I have sort of a love-hate thing with pumpkin pies. I love them. My scale hates them, apparently. So, it's great to have you here. Great to talk through this stuff this time of year. Just wondering, what are some of the common challenges that people face during our, you know, holiday celebrations? We're trying to stick to our weight loss goals. How do we do that? How do we overcome that?

Robert Catania, MD: Well, I think you hit the nail right on the head in the introduction when you said, you know, the pumpkin pie staring you in the face. And it really does feel like that oftentimes that, you know, that food is just calling to you. And there are lots of ways to eat healthy, maintain a healthy weight, and still really enjoy yourself. So, there's no rule that says you have to starve yourself through the holidays to maintain a healthy weight. It's just a matter of balance and making good choices when you have the opportunity to do that.

Host: Yeah, I think for me, it's having the one piece of pumpkin pie, not three, right? So, you know, I mean, I'm human, I love the holidays, I love eating maybe foods that aren't great for me, but I love them anyway. Is that really part of the struggle, if you will, of limiting yourself? Like, go ahead, be a person, enjoy yourself, but limit it to one piece of pumpkin pie, not three.

Robert Catania, MD: I'll give you a pro tip here. most of the enjoyment that we experience in our brains and in our mouths when we try something new, particularly something like pumpkin pie, occurs in the first bite. And I challenge you to try this at home before the holidays. So, you take the first bite of pumpkin pie, it's delicious, it has that great texture in your mouth. It feels really good. It makes you really happy. The second bite, same thing. By the third bite, it's sort of your mouth has accommodated to it. It doesn't feel so great. It doesn't taste so great anymore. But the piece of pie is sitting there looking at you. And so, you feel like, "Well, I took it. I got to finish it." If you take one bite of pumpkin pie and stop, you're going to be as happy as if you eat three slices. The difference is you're going to feel a heck of a lot better tomorrow when you wake up and say, "Oh boy, I don't have to now run for six hours to make up for what I did yesterday."

Host: Well, yeah, that's such a great tip. And I think that's how we balance it out. It's like, "Okay, if I eat this, then I'm going to have to walk more, I'm going to have to run more. I'm going to have to play more pickleball," or whatever it is. So, just wondering can we enjoy these traditional holiday meals, be it turkey or whatever it might be, pumpkin pie, without feeling like we're sacrificing, you know, that healthier lifestyle that we're in of?

Robert Catania, MD: Sure. Portion size is really important in the holidays. And I think we're, particularly in the holidays, we're all guilty of sort of eating until we feel like we're about to bust. And that's actually kind of an uncomfortable feeling, but we want to try a little of everything. And we, you know, we want to have all those different flavors, we want to be part of the gang, because you know everybody brings their own dish for you to sample. Eating anything you want is fine in proper portion size. And if you take your proteins first in your meal, so if you eat your turkey first, that's going to fill you up a little bit more. It's going to stay in there in the stomach a little bit longer. And so, you're not going to be able to eat quite as much of the less healthy choices. So, I generally recommend to my patients, you know, start with your proteins on the plate. Put a little bit of everything on your plate and there's no rule that says you have to finish everything you take, right? I know that was what our grandparents taught us. They all lived through the Depression and you had to finish the food that was available. But It's not the best way to eat. Take a bite of everything. Start with your proteins. You'll be very satisfied. You'll feel very full and you'll still have a chance to stay healthy. 

Host: See, I think, Doctor, your voice is going to be ringing in my head around the holidays, and I appreciate that. You know, because, if I have a plate of these great holiday foods, turkey, mashed potatoes, whatever it might be, I will always go for the carbs, right? If I have mashed potatoes on my plate, that's going to be my first bite. But I love that tip. Like start with the protein, get filled up a little bit first, and then maybe you'll have some room left for the other stuff, right? 

Robert Catania, MD: Exactly. 

Host: That's perfect. Let's talk about cravings and temptations. You know, this time of year, you know, like when I know that those things are in the house, when I make holiday cookies or pumpkin pies or eggnog, and I'm really getting hungry now, by the way, doctor. I probably should have eaten before this. How do we do that? How do we manage those cravings? Because it seems like around the holidays, we tend to stock the house with things that we don't buy the rest of the year, only available around the holidays. So, how do we do that? All these indulgent foods are in our home and how do we manage the cravings and the temptations?

Robert Catania, MD: Yeah. So, that's a really hard question to answer, but there are ways to do it. Probably the easiest, and you're not going to like this answer, is not having them in the house, right? It's okay if we're going out to a party to bring all those foods with us. But if you're going to be in the house, you don't really need a plate of cookies sitting there. You don't need a plate of candy sitting there. Because you're right, the temptation is overwhelming and you're going to reach for it. 

Another thing you can do, there's no rule that says you have to be starving all the time, or you have to go hungry, or you have to go without. You just have to have the right snacks available. And so, if you keep a plate of vegetables in the house that's readily available, apples go great this time of year, you can throw a little bit of cinnamon on them. It's like eating a cake, but has way, way fewer calories, has a lot more fiber, a lot better choice for you. And so, what I encourage patients to do is keep the healthy snacks available, have them somewhere where they're easily accessible so you don't have to reach for them. Because if there's something easy sitting out, that's what you're going to go for.

Host: Yeah. You use the word need there and it's like, "No, I don't need more cookies or whatever it might be, but they're there. And you also mentioned there about going to gatherings, parties, social gatherings where food and drink are being imbibed, if you will, and are really kind of central to the celebration. I feel like there's this pressure, right? I feel like I'm being judged if I'm not eating as much or, you know, someone brings a new dish, I feel like I have to try it, of course, because they're going to be disappointed if I don't. So, how do we manage that pressure to indulge at these gatherings?

Robert Catania, MD: Yeah. So, that's another tough one, but a great question because I do think that that ends up being sort of the really one of the hardest parts about the holidays to manage, right? Everybody wants you to try what they made. So, I encourage people to do a couple things. One is before you go to a party, have a very big glass of cold water. It's going to fill you up. It's going to make you take away your hunger and your edge. If you don't like a big glass of cold water, you know, maybe eat a yogurt or something with some protein, something with some density that's going to sit in your stomach. That way, you're already going to not have that really overwhelming desire to eat.

The second thing you want to do is you want to keep your hands full. So, people try to hand you things. If your hands are full, you can't take them when they hand them. So, carrying a beverage around is great. Carrying two beverages and so, it's for my, you know, my friend or my partner or whatever. In the old days, cameras were great. I mean, we all now have our cameras and our phones and you look kind of silly carrying your camera everywhere around. But having your hands full prevents you from grabbing things, and just snacking with that constant hand-to-mouth behavior. 

The last thing, and this one's a little dicey, it depends on how you feel about it. But, you know, have an excuse ready, have a plan in your mind. So, when people try to force you to eat foods that you don't necessarily want to eat or you know that you shouldn't eat, you can come off very naturally with an excuse. So, you know, some of them can be, "Oh, I have a food allergy" or, "Oh, I just ate." You know, it doesn't have to be anything elaborate. But if you tell them there's a reason why you can't, oftentimes it'll stop them from constantly badgering you about eating another bite.

Host: Of course, the only problem there, doctor, is we'll have to remember. So, if we have a bank of excuses, right? "Oh, I'm allergic to this." So, I have to remember the rest of my life, "Oh, right. I told her I'm lactose intolerant. I told him I'm allergic to corn."

Robert Catania, MD: Yeah, just pick one, just pick one. 

Host: Pick a lane, right? 

Robert Catania, MD: And whatever it is, run with it. And it's really effective. For some reason, people will badger you forever until you tell them why you can't. And then, all of a sudden, they'll leave you alone. 

Host: Right. That's perfect. You know, I know, doctor, around the holidays, it can be an emotional time and we do some emotional eating, if you will, triggered by stress, excitement. For me, if I put on a particular holiday movie, it's a wonderful life or something, that's a time where I feel like I have to have a glass of eggnog in my hand. It just feels like, you know, that they go together. So, how do we do that? How can we sort of avoid that emotional eating as best we can?

Robert Catania, MD: Yeah. So, emotional eating is rooted in biology, right? We don't do it by accident. We do it because eating releases certain pleasant chemicals in our brain, like serotonin and dopamine. And so, you know, your body can look for that in certain situations. There are a lot of other things that can also release those positive chemicals in your brain. So, simple things like, you know, doing a puzzle, doing a little painting or drawing, playing a game like Sudoku or a crossword, they all release the same chemicals in the brain, and they sort of take that pressure off to have to eat. 

Going for a walk is actually a great solution. Exercise releases those same chemicals as well. So, if you're feeling that desire, like I really need to have some snacking, take a walk around the block, that'll eliminate that desire. And then, you know, having healthy options available. Having a big glass of water, you can put a little bit of flavoring in it, whether it's like one of the flavor packets or some fresh fruit that you crush up and put in there will make you happy. Warm tea is a great option for people who like tea with a little bit of honey in it. That will kind of satisfy that need with very low calories. And then, you know, sometimes you just got to say, I'm having that glass of eggnog and it's not the end of the world, right? If you want that glass of eggnog, have it. Just make sure that before or after it, you have something that's going to help satisfy you, so you don't go for that second and third, because that does carry a lot of calories.

Host: Yeah, for sure. Eggnog is just so fattening and so rich and so amazing. But as you say, you know, I didn't realize as we were getting in here, you're not only a bariatric surgeon, but you're also a bit of a psychologist. You have given us a lot of suggestions and tips today of how we can sort of trick our brains, trick our bodies. I love it. I just want to finish up here and talk about, for those of us, unfortunately, who do overindulge during the holidays, how do we get back on track? How do we not get discouraged or feel guilty? You know, many of us set those resolution goals for ourselves. And then, very shortly after, we realize, well, that's out the window, how do we maybe just not feel bad? How do we not feel guilty?

Robert Catania, MD: Sure. First off, to go back to your earlier point, so obesity is a neurobehavioral disease. And so, treating patients with obesity, you really have to cover all bases, right? We have to cover the biochemistry. We have to cover the neurological implications. So yeah, we often talk about eating behaviors as a way to modify the way you're eating, but we're also all human, right? We have friends, we have family, we like to enjoy ourselves. So, we're going to make some bad choices at the holiday. So, just accept that it's going to happen. Don't get upset with yourself about it. Obesity and weight management is not a one day problem, right? It's a lifelong problem. 

If you have a bad day or a bad week or a bad month, it's okay. Just get back on the horse as soon as you can. Eating one bad thing does not mean you have to spend the rest of the day eating bad things, right? So, you can make one bad choice and then get right back and make better choices. But most important thing is to forgive yourself, to not be too upset with yourself for making those decisions, because it is a temporary thing. It's a holiday. It's a time that we come together to enjoy ourselves, and you really should have fun when you're with your family and friends. 

Host: Yeah, that's perfect. And I love that approach, doctor, that yes, you are a surgeon, of course, and you're performing surgery on people, on the physical part of their bodies, but you're really treating the whole self. And it is mental, it is physical, it is all of those things. It's been great to speak with you and have some fun today and learn from you. Thank you so much.

Robert Catania, MD: My pleasure. It was great being here. Thank you for having me. 

Host: Yeah. Happy holidays. Thank you so much. For more information, go to snhhealth.org/weightmanagement. And if you enjoyed this podcast, please be sure to tell a friend and share on social media. This is Your Wellness Solution, the podcast by Elliott Health System and Southern New Hampshire Health, members of SolutionHealth, I'm Scott Webb. Stay well. We'll talk again next time.