Welcome to a year in review of Metabolic Health in teens!  A year in review: Teen Metabolic Health in 2023 I can’t think of a more prolific year for teen metabolic health than 2023. And, I’m not just talking about the FDA’s approval of GLP-1 medications like wegovy. In fact, did you know I created my metabolic telehealth clinic well before I even heard of the STEP teens trial showing the results of using semaglutide in teens?  Medication is one part of the puzzle. Not the whole treatment puzzle.  It’s been a frustrating year too. The most frustrating thing about what I do is that no one is focusing on health. Our culture and health systems (lots of doctors) are still attached to the Energy Balance Theory of CICO (calories in calories out). Parents are very stuck in it and then their teens are stuck in it too. Their bodies are metabolically adapted to a low number of poor quality macronutrients. That’s their biggest obstacle to getting results. They often binge on refined carbohydrates at home after restricting their intake during the day.  Some teens don’t feel safe eating in front of other people. It all makes sense to me. The UPF (ultra-processed food) system and its addictive triad of trans fats, salt and refined sugar (HFCS, high fructose corn syrup) along with their digital neuromarketing tactics are powerful drivers of the epidemic of poor nutrition and binge eating in teens. Our weight-biased society creates constant body judging and food shaming in teens.   The best study findings out in 2023, and there’s absolutely no comparison are the TODAY study findings showing that Youth Type 2 Diabetes is a more aggressive disease than seen in adults. Learn more here:  https://www.adameetingnews.org/live-updates/session-coverage/today2-study-youth-onset-type-2-diabetes-more-severe-than-adult-onset-disease/ I want my legacy to be that I helped as many children and teens as possible enter young adulthood without the burden of metabolic diseases like type 2 diabetes and non-alcoholic fatty liver disease. Sound easy? It’s not. It’s an epically difficult mission. 2023 has been a year with metabolic ups and downs and some wins.  As parents learn more about insulin resistance and metabolic health and are willing to let go of the harms of diet culture, then their teens are able to make the changes necessary to get positive health outcomes.  Medication is only one part of the puzzle. There are so many action steps to take to improve metabolic health. All health habits count. Start by downloading my What’s your health why? Printable and fill it out for 2024. It’s powerful work!  Start with your health why, Dr. Karla

Parents, Teens, Doctors, listen to a Mom of an adolescent with insulin resistance and obesity talk with Dr. Karla about her journey of how she advocates to get her daughter effective treatment with the new Anti-Obesity Medications. It's been a long road for Mom, Kailey, and her family as she has advocated since her daughter started to gain unhealthy weight in early childhood. Though she was shut down by her pediatrician and told to restrict her daughter's intake and was referred to a dietitian and a psychologist, Kailey's intuition told her there was something more going on. Kailey shares her journey navigating our weight-biased healthcare system which often blames and shames children, adolescents and their parents and tells parents to place their children on restrictive diets. She finally found a pediatric endocrinologist who would listen and did a full assessment to rule-out causes and contributing factors, diagnosed her with Insulin Resistance and started treatment. Kailey has also taken a GLP-1 medication and shares her journey on TikTok and IG @thegeriatricmillennial. Recently, she started sharing their f struggles with finding a doctor who would listen and actually help. Go to drkarlamd.com to learn more about Metabolic Telehealth for children & adolescents.  Self-love superpower, Dr. Karla #teenhealthandwellness #childobesity #pediatricians #obesitytreatment #childhealthcare #wegovy #semaglutide #saxenda #insulinresistance #pcos #type2diabetes

A Doctor’s Take on Weight Loss Medications & Teens Go to drkarlamd.com to learn more. The results of the STEP TEENS phase 3 trial of once-weekly subcutaneous semaglutide 2.4mg (Wegovy) in adolescents aged 12 up to 18 years old with obesity are very promising. Published in November of this year in the NEJM, the study showed that patients who received semaglutide vs. placebo had greater reductions in body weight, improvements in waist circumference, A1C, lipids (except HDL cholesterol) and alanine aminotransferase. Quality of Life measures were better in the semaglutide group. Adverse gastrointestinal events were greater with semaglutide compared with placebo. Many pediatricians and childhood obesity experts, like me, who have been working for decades, taking care of hundreds of adolescent patients while watching the rates of severe obesity rise, especially during the pandemic, have hope that medical treatment will finally have effective tools to help our teen patients. Up until now, the weight loss medications approved for adolescents have been Qysmia, a combination of phentermine and topiramate which curbs appetite and once-daily injectable GLP-1 agonist. There have, of course, been other medications used for weight loss in adolescents, but with minimal effect and more side effects. Teen patients have told me they don’t like how they feel taking phentermine, especially if they have anxiety disorder. A daily injection is, well, a daily injection. I’m grateful these medications are coming out now instead of four years ago when I was the medical director of a pediatric weight management program at a Children’s Hospital and before I went through my own weight loss journey. The program was stuck in CICO thinking. The old Calories In Calories Out Energy Imbalance Model of Obesity and ignoring the epidemic of Insulin Resistance and that obesity is hormonal and not simply caloric. I was stuck in it too. Now, after becoming a certified life and weight coach and Diplomate of the ABOM, as I add a virtual health component to my digital coaching platform for teens, the timing to add in GLP-1 agonists to my physician toolbox is spot on. Mostly, I’m grateful for the countless hours I have been able to spend coaching teens and parents and as a TikTokdoc learning what it’s actually like for patients who share their journey using GLP-1 agonists on the app. The biggest benefit of GLP-1 agonists is the “quiet mind” patients experience. For the first time, their mind is not constantly food seeking and craving. Patients also feel fuller faster which makes sense because GLP-1 delays gastric emptying. Weight loss medications that effectively treat the root cause is what’s exciting: Insulin Resistance and sugar cravings from ultra-processed foods. Weight gain is a byproduct of Insulin Resistance and weight loss is a byproduct of reversing insulin resistance. Of course, as appetite is suppressed, it is important to make sure patients are getting adequate intake and don’t get into a restrictive eating pattern that will rebound as binging if and when they stop their medication. If you are someone like me who has successfully and sustainably lost weight, you know a major part of the journey is making changes to transition to eating real food. You understand what it’s like to believe that sugar and ultra-processed food is addictive. The instant gratification of dopamine from ultra-processed foods is powerful. Helping teen patients create a dopamine balance so their daily life is full of true reward and gratification is imperative even with the use of GLP-1 agonists. There is so much stigma around weight in the clinic setting and the patient-doctor interaction. Attrition rates are high and attendance rates are low for teens going to weight management programs. As a doctor in a clinic, patients didn’t share with me what they share with me when I’m coaching them. Now, I get to meet them where they are. Motivational Interviewing is powerful but isn’t the same as offering access to parents and teen patients coaching through obstacles as they come up in real time. What is your plan for patients to have access to you? Obviously, there’s the issue of accessibility, insurance coverage, supply chain issues, side effects and whether the patient is interested and willing to take an injection. There’s also a belief that teens I coach often express, I'm broken or there’s something wrong with me so I need this singular fix. Stay away from perpetuating that. Frame up the use of medications as just one part of a whole approach to health. The new GLP-1 agonists potentially reduce disease risk and chronic disease burden in teens with a once-weekly injection. Let’s focus on what the GLP-1 agonists are really treating and be excited about that instead of celebrating weight loss. I want to caution all of us to stay out of singular solution quick fix thinking while treating a chronic complex disease in teens.

I'm struggling with wanting to help my daughter who is overweight.  I want her to be healthy and feel good about her body. I also know there is so much stigma about size in our society. I feel stuck. How can I help her? This is what I call dualistic thinking, black and white, two sides of a coin, where on one side Mom is stuck in wanting her daughter to be body positive and fully love and accept herself and feel healthy, but also is stuck in diet culture beliefs perpetuated by our society and in all the promises of thinness. You’re pinging back and forth and that’s creating a lot of confusion and self-doubt and fear and keeping you stuck and not taking action. What if they are not mutually exclusive? What if you could meet in the middle and believe your daughter can be both body positive and have healthy habits that help her reach her healthy weight range? Research shows that positive body image and family mealtimes are protective factors to prevent weight gain and eating disorders. Helping her create healthy habits takes action steps like more family mealtime planning. Get yourself in the middle lane taking action.  How can I help my daughter when she feels frustrated and gets upset about her body and uses food and sugary drinks to feel better? I know that external fixes are just a quick fix band-aid and seem to make the problem worse.   You have great awareness. Sounds like she is buffering her emotions with food. It’s like numbing out. Instead of allowing an urge that comes up, which is a feeling, she is avoiding the feeling by getting the false reward sugary dopamine zing. It’s a conditioned overdesire pathway in the brain. It’s a habit path in the brain.  Habits are based on environmental cues. Good news is the brain is malleable and adaptable and so is the environment. Don’t get in her lane. Stay in yours. Start by creating more openness about feelings so that she is able to respond and process instead of avoiding and going to food. How are you feeling? Talk about your feelings and get a bit descriptive by using a metaphor. Model healthy coping skills. Also, don’t assume you know what’s going on in her mind.  Don’t bring up body image issues unless she does. This can bite you in the butt. If she has urges and cravings at certain times of the day, then have some snacks readily available that have a balance and aren’t processed foods.  Ask her what she wants and plan a day ahead. You are helping her create mindfulness eating habits and awareness before choice.  I know my daughter is unhappy about her body and I desperately want to help her, but I am also terrified that if I bring it up she will feel judged or I will destroy her confidence.   You get to decide ahead of time how you want to show up in situations. That’s what you can control.  You can’t control how your daughter feels or how she responds. If she feels judged, it’s coming from her thoughts.  That being said, what you want is to be a responsive parent, to be intentional about how you will respond when SHE brings it up or there are situations that activate her negative body image thoughts.  You want to be a soft place to land.   Self-love superpower, Dr. Karla

Ready to challenge beliefs? Like, really challenge beliefs? Do you know your thoughts have power? Your current thinking creates your current reality. Your Now thinking creates your Now result. Your brain is a story making machine. Most of what goes on in your brain, the thousands of unconscious thoughts coming up on the daily are just stories. Thoughts are a rainbow that comes and goes; a sentence in your mind; a cloud going by while the real you is the quiet confidence of the blue sky. It’s a powerful thought on a loop in your brain, mostly left unchallenged. Did you know you can drop beliefs that don’t serve you like a book? When you are aware that you are not your thoughts, your thoughts are optional, same with beliefs, you can start to let go of what doesn’t serve you and create beliefs on purpose that do serve you. It’s called a belief upgrade and it’s an epically powerful life coaching tool. Once you become aware of the beliefs or thoughts creating your feelings, you’re there. Just pause. You can then shift to create a belief upgrade or thoughts to think list. 30 Current diet thinking beliefs: The only way to lose weight is to go on a diet. The only way to lose weight is to deprive myself and watch what I eat all the time. I have to count calories and be strict. If I gain weight I will feel like a failure. If I binge all of my work is gone. I’m out of control when it comes to sugar. I have to work out every day to lose weight. A calorie deficit is the only way to lose weight. Weighing myself is the only way to see if I’m successful or a failure. I have to set a weight loss goal. I can’t eat what I want and lose weight. Everyone else gets to eat what they want. I should be able to stick to eating less sugar, but I can’t. I don’t believe it’s possible for me to eat sugar in moderation. Every time I have something I need to do, I just grab my phone and put it off. I’m such a procrastinator. I hate exercising. I’m not an athlete. I’ll get bullied if I try out for a sport. I love sports, but I’m not good enough to make the team. Every time I exercise I get so out of breath. Exercising just isn’t for me. There must be something wrong with my body. I would have less worries in life if my body was smaller. I’ll feel good about myself when I reach my goal weight. I know I need to love myself, but how is the question. I wish I could just live my life but everyone is so obsessed with my weight. Truth is I don’t really care about my health. I wish I wasn’t judged by my body size. I wish people didn’t feel so entitled to make comments about my body. Now, check out my 30 belief upgrades for each day of September: I’m curious to discover a non-diet approach to reach my health goals. Deprivation never works long-term, is harmful and leads to binging. I always get to choose how to measure my success. I never make gaining weight mean anything is going wrong. When I binge eat, I use my self-compassion mantras to disrupt the binge-restriction cycle. My over-desire for sugary foods is a habit pathway in my brain. My body was created to move. Creating healthy habit sticks is the way to help my body reach a healthy weight set point range. I never have to weigh myself if I don’t want to, especially if it’s triggering for me. Setting a weight loss goal dehumanizes my body and puts all my success at the finish line. I choose to eat delicious food that serves me and my health goals. I stay out of self-judging by not judging body sizes and what others eat or don’t eat. I’m curious to learn more brain science about sugar craving pathways. I am not powerless over sugar. Going on my phone is a habit and I can easily get unstuck. I can take one action step and that’s enough. I get to try new ways to be active and move my body. I am an active person. My past experience trying out for new things doesn’t have to be in the way of my future self. I try out for the team with every intention of making it. When I’m out of breath exercising, I can take a break. I trust I will discover fun ways to be active. My body is working. Shaming my body never works. Wishing my body was smaller creates unnecessary drama in my brain. I fully love and accept myself now. Self-love is my daily intentional habit practice. I’m choosing to live my magical life. I get to create my own definition of health that works for me. I connect with people who value body diversity. I let people know my body is my business. Check off the mantras that resonate with you and write one of your own. Let’s go: Current belief:__________________________________________________ Belief upgrade:__________________________________________________ When you sign up for my Cut the Cringe parent coaching workshop (link here), you’ll get entered into a drawing for a signed copy of Pete’s book, “Thoughts: The Power of Your Mind”. Thoughts anyone? Self-love superpower, Dr. Karla

To learn more about my self-love superpower approach to create healthy habits for life for teens and parents, like and subscribe to my YouTube channel and go to imecommunity.com and check out my Cut the Cringe downloadable healthy conversation script. Self-love superpower, Dr. Karla When it comes to helping children, teens, and parents who have struggled with weight gain, health issues like pre-diabetes, fatty liver disease, PCOS, and body image, why haven't we gotten anywhere? Have we caused harm? Share in the comments below! Let's call out where we've gone wrong. What are our 3 epic fails? 1. Parents are not supported to really help children and teens make. healthy lifestyle changes within the environments we live. 2. Despite its lack of effectiveness and potential harms, healthcare has taken on diet culture's calories in/calories out fixed and limited belief and we can't seem to let it go. 3. Our approach, specifically fixation on weight and BMI (Body Mass Index) has created stigma and weight blame and shame for children and teens. Ready to learn more about flipping the script? Check out imecommunity.com and read my amazing blogs with all the latest and greatest ways to get the support you need. Self-love superpower, Dr. Karla, ActivistMD drkarlaactivistmd@imecommunity.com #bodypositiveteens#childhoodobesity#selflovematters#Bodymassindex#parentsupportcoach#prediabetes#type2diabetes#PCOS#fattyliverdisease

Do you bully your body? How to get unstuck from your body negative thoughts! IME Body Image Thoughts to Think for June! Welcome to summer! Whew! So far, it’s been a whirlwind for our family with my daughter’s graduation from High School and tomorrow I’m headed to Texas to move my oldest daughter into a new house (for her) with new roommates! I’m grateful I get to do it. IME is six months or half a year, however you slice up that summer fruit, through a year of self-love superpower mantras! This glorious month of June let’s do fun stuff and get out of self-judging and hating on our bodies. We just wrapped up Celebrate Measures of Success in May. You get to decide how to measure your success. How’d you do? If you were busy like me and didn’t get to it, no worries (I can’t stand when the Starbucks drive-thru person says, “No worries” after I place my order), you can create your measures of success this month. Since I’m on social media a lot and lately have been going all in with my cancel diet culture posts, helping everyone stop their pursuit of thin privilege and live their magical lives, I figure June would be a great month to focus on body image. Do you bully your body? Do you have a certain body part that you fixate on wanting to fix? We all do sometimes. We all have parts of us that we would choose to change. Maybe you can and that’s okay too. Maybe once you realize you can, you will decide not to. Any decisions we make about making health behavior change or taking action in life must come from a place of self-acceptance and self-love. We cannot hate ourselves to what we want. Lots of psychology and coaching research shows this. It’s called PEA or Positive Emotion Activation. It’s cool stuff. After years of being a pediatrician and taking care of so many patients, I can assure you that once you decide to focus on what you want in life and you have full love and acceptance for yourself, the healthy lifestyle changes become so easy. I’ve seen this time and time again with my patients and with myself. One of the obstacles in our way is staying stuck in negative body image thoughts or staying attached to thoughts that don’t serve us. I’m not asking you to flip a body positive switch and just love yourself all day. That’s cheesy and not realistic. When you say the letters I M E out loud, it sounds like I aM mE. The power of you as an individual with the support of a body positive community. How cool is that? Here’s a quick tip: Wear clothes right now that are comfortable that you love and feel-good in. If you have stuck thoughts that are creating negative body image feelings and actions, try my IME Community June Body Image Thoughts to Think! 6/1 I define beauty by actions. 6/2 If I want to change something about my physical appearance, I don’t make it mean that I’m sacrificing my values. 6/3 I am deciding not to decide right now. 6/4 I am never stuck. 6/5 I fully love and accept myself no matter what. 6/6 I make decisions from a healthy place of self-love and self-acceptance. 6/7 Self-acceptance is always available to me like a nice warm blanket. 6/8 I don’t let society define me or make decisions for me. 6/9 It’s okay to wish something was different about me. 6/10 Imayre-decideatanytime. 6/11 When I decide, there is no right or wrong. 6/12 Ialwayslikemyreasonsfordeciding. 6/13 Icancreateathoughtaboutmyselfthatservesme. 6/14 Itrustmyselftostopself-judging. 6/15 Therearesomanybeautifulthingsaboutme. 6/16 Iamkindtomyselfnomatterwhat. 6/17 I don’t have to be perfect. I just have to be perfectly kind to myself. 6/18 IrecognizewhenmybraingetsstuckinathoughtloopandIcreatea pause. 6/19 It’sokaytoallowsadnessaspartofmyhumanjourney. 6/20 Whensomethingishard,Isayit,“Thisfeelsreallyhardrightnow. May I be kind to myself.” 6/21 Irecognizethatlifeis50/50positive/negativerightnowandifI change my body. 6/22 Idon’tconvincemyselfifI’mnotfeelingit. 6/23 IfIdon’tfeelbodypositive,Idon’tlietomyself.Thatfeelsliketoxic positivity. 6/24 Beinghardonmyselfisnothelpful. 6/25 Fixatingonchangingmybodyisawasteoftime. 6/26 I’mlivingmylifeanddoingwhatIwant. 6/27 WhenI’minabodynegativespace,IstayoffInstagram. 6/28 Idon’tlookforhowtofixmybodyontheinternet. 6/29 AllImustdoiscreatespaceforself-kindnesswhenI’mbeinghardon my body. 6/30 Idon’tlikeanyofthecheesyloveyourbodyalwayssayings. Be okay with having an authentic human experience which means sometimes you love your body, sometimes you don’t, sometimes you are meh. I just want you to get unstuck from attachment to body negative thoughts. Let me know what self-love superpower mantra theme you want for July! Stay tuned for my upcoming Cut the Cringe Life Coaching Workshops for Parents of Teens where I will coach you to cancel diet culture and raise a body positive teen in a body negative world! Please follow IME Community on social media and share with everyone you know! Self-love superpower, Dr. Karla, ActivistMD

Parents, stop weight bullying your kid and your kid's friends! You're crossing an inappropriate boundary when you judge and comment on a child's body. Do better! Now! Here's the logic thread: If you weight bully, your kid will bully. If you are bullying, do a U-turn. You are bullying yourself. If you bully, you are stuck in diet culture and its toxic harms. All of it trickles to your kid. You are living a limited life and you're putting cinder blocks on your kid's potential growth as a human being and chance at happiness. When I started TikTok over a year ago, I was shocked at the number of videos of body positive creators getting cyber-bullied based on their body size. Absolutely horrible! So, I started making videos talking about how you know nothing about anyone else's health. Health and weight are not directly correlated and health information is private and protected. So, that was that. And, the cyber-bullying continues in full force. Then, shockingly, I started noticing videos made by young adults whose parents have weight bullied them. Totally disgusting and abusive! So, I made duets and called it out on my go-to platform, TikTok. Okay then, what will I discover next after putting on my scuba gear and diving into the clock app? I won't change the world. I'm here to learn. Listen. Listen. Listen. Just the other day, I ran across a video while scrolling, where @powerlove2855, who I follow and you should too, talked about when she was little, her friend's mom weight bullied her. Unbelievably toxic! Of course, I did a duet video with @powerlove2285 on TikTok: My text at the top: Studies show young children experience weight-based victimization from parents, friends, peers, doctors, and teachers. "On more than one occasion in elementary school I would have a friend tell me that her Mom said I was fat and I needed to lose weight. That Mom was secretly hoping that that little girl would stop being my friend. Because she wanted her little girl to have the social capital of being friends with all the pretty, tiny, little Limited 2 girls back in my time." "It is so absolutely petty. The part of this conversation of growing up fat that we don't talk about enough is that adults that are not your family, not your parents consistently comment on your body. Friends of parents, teachers, lunch ladies, school librarians, neighbors, unhinged women at the grocery store who tell your Mom to stop feeding you." "The absolutely disgusting commentary around a child's body must end. Must end." The comments on my video are rolling in and it's not looking good, folks! Grandparents weight bully, Parents, friends' parents, teachers, doctors, neighbors. It's a toxic entitlement to comment on children's bodies. As a pediatrician and mandatory reporter, these comments strike me as inappropriate on the level of verbal and emotional abuse. Let's disrupt the toxicity by calling it out! Research and studies have been out for quite a while of parental perceptions of weight-based victimization, its harms for their children and listing weight bullying as the number one health concern for parents of teens with overweight. It's unfortunately, not a surprise that children in larger bodies are ostracized and their weight is weaponized as a weakness, just as they are growing and developing. Research and studies have shown that basically everyone weight bullies children and teens, including, but not limited to, friends and peers, parents, teachers, and doctors. Parents, we can help our children and teens create bully bans or boundary setting statements, but, if you are a weight bully stuck in diet culture and your internalized biases, you've got some work to do. Commit today to not weight bully your child or teen. What are your future parent guide words. Envision you showing up as the kind of parent you want to be. Nobody's watching but you, and your kid. If you are a parent who is a weight bully, you're most likely weight bullying yourself and it's not a simple flip of a switch to cancel diet culture. It's Mental Health Awareness Month. Teens are in a Mental Health Crisis as another wave of COVID hits. We simply don't have time or tolerance for adults who weight bully children. Go too imecommunity.com and get on my email list, read and share my blogs! Follow @imecommunity on TikTok! Self-love superpower, Dr. Karla, ActivistMD

Setting Boundaries with Teens to Stop Weight Bullying   First on the playlist for the week is "We're not gonna take it" by Twisted Sister, a real get you pumped up to set some powerful boundaries with bullies 80's rock song. Video is hilarious too in case you want to transport yourself back to the 80’s.   When it comes to setting boundaries, are you an avoidant or compliant or are you an aggressive or manipulative controller? I doubt you're a controller if you are reading this blog, and most likely are an avoidant or compliant who doesn't want to deal with conflict or hasn't been taught the skill of setting a boundary. I get you. That's where I've been most of my life, especially when it comes to setting boundaries for myself.    You are worthy of setting boundaries.    Sometimes teens don’t want to share if they are being bullied, let alone set a boundary and speak up.    Boundary setting is self-love superpower.  Setting boundaries and following through creates self-trust that you have your own back.     Did you know we were created to set boundaries? Setting boundaries is a part of living a healthy life and I'm not talking about food boundaries or being strict and rigid with boundaries.    I love the book, “Boundaries” by Dr. Henry Cloud & Dr. John Townsend.  Check it out!   How do you decide when and in what situations to set boundaries? What are the different kinds of boundaries you can set? I guarantee you are setting boundaries even when you don't think you are.    Sitting in class, Jill couldn’t help but feel someone staring at her. She turned her head and he was staring right at her, the kid with his hoodie on, sitting behind and diagonally to her, just watching her.     So creepy.     Jill could literally almost feel his breathing.     Her Mom said, “Maybe he likes you.”    “Um, no.  He’s trying to make a statement about me being fat.”    “How do you know that?”    “I just know.”    “Did you talk to the teacher about it?”   “Yes, I tried anyway, but she said to ignore it and it will stop.  But, that hasn’t worked.  All I want to do is just sit in class in peace and it’s so hard to focus when someone keeps staring at me.”     Jill (not her real name) was a patient of mine and I was so sad that she was being bullied sitting in class.  How creepy and distracting! Keep reading this blog and you’ll see how the IME Community teen members suggested coaching Jill to set boundaries.     Our society and culture lack boundaries because of the entitled belief that it’s okay to openly comment on another person’s body. The reality is humans can be harsh and boundaryless at times and we all experience aggression toward us in our life as part of our common humanity.     I know if you’re reading this, you’ll agree with me that it’s not okay to weight bully anyone.   Bullies are cowards.  It’s true.     What’s also true is, you don’t have to fix or solve the bully or change yourself in any way.  You don’t cause or control all the things in life.    If you spend your time thinking that it shouldn’t be happening and hope the bully will wake up and be a decent human and stop bullying, you may be wasting your time. Also, if you’re spending time wishing it wasn’t happening when it is, that won’t help either. What you can control is how you show up to create self-trust that you will have your own back.    Another truth is you are not powerless and you can create boundaries to stop the bullying for you.     I know what you’re thinking because I was in your shoes as someone who was more passive and non-confrontational. I had never been taught to set boundaries for myself.  I thought I had to be nice all the time and then hope it would just go away.  Now, I look back on my life, at the times that I set a boundary with a bully, and there have been many, and it’s just absolutely glorious to look back on.     The level of self-trust and self-worth that I created just perpetuates itself. It has given me so much self-confidence.     Here are some more Boundary setting false beliefs that you may have: It’s mean to set a boundary. It will make things worse for me.  I can’t set a boundary. I will feel guilty if I set a boundary.    Do you know what an Upstander is?    Are you like me? You can stick up for someone else at the drop of a hat, but when it comes to yourself, that’s a different story.  Sticking up for a friend or peer who is being bullied is called being an Upstander. I will talk more about being an Upstander in an upcoming blog.     Did you know you can be your own Upstander?   What did I do with Jill’s situation? I took it to the community and let the teen IME Community members coach on it and it was epic. We had been coaching on the different kinds of boundary setting and they were able to coach on setting a physical boundary, an emotional boundary, a verbal boundary, and how Jill could advocate for herself to create a plan so the bullying will stop.     Create a Physical Boundary:  Let's take a boundary setting approach to stop bullying for ourselves too. Remember, you can always walk away and that is setting a physical boundary and is not giving up. Walking away is a powerful boundary and without words can send a powerful message.    Move to a different seat. Talk to your teacher about sitting somewhere else if there is assigned seating.  Change classes if you need to. (I know. I know. The bully should be the one to change classes.) Take a different route to class if possible. Change up the timing of your route to class.    Word Boundaries Jill might try: You’re making me feel uncomfortable.   I’m uncomfortable with you staring at me.  Stop staring at me.  I’m uncomfortable.    Setting boundaries with words:   From a Psychology Today article, memorize a simple statement is the #1 thing to do from “8 Things Kids Can Say and Do to Stop Bullying” by Signe Whitson, L.S.W. She calls them Bully Bans.  https://www.psychologytoday.com/us/blog/passive-aggressive-diaries/201801/8-things-kids-can-say-and-do-stop-bullying   Let’s practice some boundary setting words (Bully Bans):  Stop saying that to me. I heard you the first time.  Stop bullying me. You’re crossing the line. Whatever. My ears work just fine.  I heard you the first time you said it.  Way to be original.   Emotional boundaries are powerful:   Bullies project their weaknesses and insecurities onto their victims.  Bullies are not coming from a powerful place when they bully.  They are coming from a weak place of insecurity.  The bully’s insecurities and weaknesses are not ours to fix or solve.  Let’s believe them when they say who they are.       I’ve heard so many stories from teens about how they defended themselves and then ended up with the same consequence as the bully. Setting a boundary isn’t fighting back as much as it is diffusing the situation to stop the bullying for you.  In other words, don’t get in the mix with the bully.  Don’t degrade yourself to the level of the bully.  That doesn’t mean you don’t stand up for yourself and make powerful bully ban statements.    By all means, please do.  You can even do a mental rehearsal.  It’s like a play you’re writing and you’re the hero who saves the day for yourself.     Recognize you don’t cause or control what another human being says.   What you do control is how you want to show up and where to put your attentional focus.     That’s powerful.    Remember, our thoughts create our feelings and our feelings drive our actions or inactions. If you are feeling stuck and powerless in a bullying situation, try to write down your thoughts and beliefs about the situation. If you keep believing that thought without challenging it or realizing your brain is attached to it because of fear (is a human response and makes sense), then you will stay stuck with that belief, the fear and the inaction.  Why you shouldn’t ignore bullying: The problem with letting bullying go is that the bullying has to go somewhere and guess where it’s going to go? To you.  If not challenged, you may start to internalize it.  Or, you may believe if you change something about yourself, like your body size, that your bully will stop.  That’s not always true. If you believe you are the one that’s broken and not the bully, you may restrict your eating or binge eat to cope with the stress to avoid the stress of bullying.     By the way, I want you to know that I know it’s not always as easy as creating boundary statements or talking to a trusted adult to create a plan to stop the bullying.  I encourage you to talk with your doctor because bullying is a preventative health issue and also work with a therapist to heal from trauma.     Remember, you are unbroken and a perfectly incredible magic being who is meant to live your fun life.     Remember,   Bullying comes from a place of complete weakness, powerlessness, and insecurity.     Here are your action steps: Visit Stopbullying.gov Write your Bully Bans Write down some beliefs you have about setting boundaries. What would it feel like to have your own back and set a boundary for yourself? Massive self-trust and massive self-worth? Do a mental rehearsal.  Visualize and practice it using your Bully Bans. Role play and say your Bully Bans with casual confidence.    How do you want to show up for yourself? One powerful decision creates powerful clarity for your next step. Make sure you connect with a trusted adult to help create a plan so the bullying stops for you.    I've got your back. I only care about helping you and when I coach you in IME Community, we are going to stay in your lane and not in the business of the bully trying to convince or thinking they shouldn't be bullying or waste our time figuring out why they are bullying. We believe them when they have shown us who they are.    Let them be who they are and let them be wrong about you.    Self-love superpower,  Dr. Karla, ActivistMD

Hey,    Whether you are a teen, parent, physician, healthcare provider, teacher or school administrator, listen up!    I want you to know that I'm coaching you on a very sensitive topic in this first blog of my ongoing series.    In my teens and weight bullying series, I'm talking about bullying and its harmful effects, how common it is, who's at risk, the different types of bullying, but, most importantly, what you can do about it.    Did you know that any type of bullying affects your health?     Make sure you work with your pediatrician or family doctor and/or seek help from a licensed mental health provider to address your individual situation and potential mental health effects.    I would love for you to go to stopbullying.gov to check out their helpful resources.    Also, I’m not going to get into bullying and intersectionality in this first blog.  Intersectional bullying happens based on race, gender, income, sexual orientation, etc. I’ll talk more about intersectional bullying in upcoming blogs in this series.    Basically, a bully is someone who is willing to weaponize what they perceive as a weakness, with their only goal to make themselves feel powerful.    Bullies seek to control the narrative.     Maybe they were bullied?  It’s often the case.  When I coach teens who have been bullied and parents of children and teens who have been weight bullied, I try to stay out of getting in the lane of the “bully/victim”.  In other words, stay out of trying to figure out the bully’s motivation for bullying. They have shown you who they are.  Let’s focus on what you can do.     We can’t control or fix or solve the bully’s actions, but we can certainly create a plan that includes boundaries so it stops for you if you’re being bullied.     One of the main reasons to set boundaries is to make sure you don’t internalize the bully’s messaging. I don’t want you to feel powerless and believe what the bully says about you or feel like if you change yourself, the bullying will stop or you will finally “fit in”.     Another harmful consequence of weight bullying in teens is restricting yourself by dieting, which causes harm on top of harm. The bullying is harmful, let’s not create more harm for ourselves with the punishing restriction of calories.    By the way, if you cope with the stress of bullying by overeating or binging, give yourself a massive break.  It’s okay.  You’re not alone.    Check out my IME 5 Steps to say I aM mE, which are my 5 easy steps to full love and acceptance and the first step to self-love superpower.     Recognize, that self-acceptance is available to you all the time.  If you’re bullied, pull out your nice warm invisible self-acceptance blanket and say,  “I fully love and accept myself.”     Try some other mantras like,  “Bullying is unacceptable. I accept myself no matter what.”    Put your hand over your heart and give yourself a nurturing hug.   “I’m not powerless.  I am not stuck.”  “This is so hard.  I won’t be hard on myself.”  “I can set healthy boundaries for myself.”  “What they said has nothing to do with me.”   “I will set boundaries and let them be them and live my amazing life.”       Have you been bullied because of your weight?    Or, for any reason?    Studies show that it's more common than we like to think.    Unfortunately, some people still believe enduring bullying is a rite of passage into adulthood. Nothing could be further from the truth.    Bullying is a preventative health issue.    It's important to recognize and address bullying or it can cause long-term harm.    According to a 2012 Weight-Based Victimization (WBV) Study, published in Pediatrics, “WBV is prevalent in treatment-seeking youth, who report victimization from peers (92%), friends (70%), parents (37%), and teachers (27%).”    If you’re a physician, let’s start by listening and validating the stories of our patients’ experience with weight-based victimization.    Life in America is a bullying obstacle course for youth with weight struggles.    “I’m ostracized everywhere I go because of my weight. Sitting in class. Everywhere.”-Jessica, age 18    When I heard Jessica, one of my patients say this, it broke my heart.     Jessica (not her name) is absolutely wonderful and is living a very successful life.  She’s so strong and has been through and overcome so much in her life. The last thing she needs to deal with is weight-based bullying.    My initial thought was give me the names of whoever is bullying you and I’ll make some calls.  I felt so protective of Jessica. If only it were that simple.  A trusted adult makes a call and it stops.    It may not be that simple, but know that you are not alone.    You are not alone.    There are trusted adults who want to help you and will create a plan to stop the bullying. It may be as simple as making a phone call, but usually you need to put a bit more planning in place. Learning how to set healthy boundaries for yourself is a skill that you are not taught in school.  More often than not, families and society can be pretty intrusive and boundaryless.     Even if you are a victim of bullying, you are not powerless.   I coach a lot on boundaries and relationships in IME Community.   I coach on setting some boundaries for yourself so you are able to show up with clarity for yourself.    First, bullying is not acceptable and must be recognized and called out as unacceptable.    Next, let's step up as trusted adults and work with the school (teacher and/or counselor) if that's where the bullying is happening, and create a plan to stop the bullying so school is a safe place.    Here’s what's needed from parents, physicians and educators to help stop bullying:  Support Build Skills Connect to resources School Involvement Referral to mental health provider Follow-up to check in    How to support the "bully/victim" is important too. A harsh approach does not work.    Make sure you check out stopbullying.gov and make sure you Join IME Community to get even more coaching to create healthy boundaries!    IME Community is a safe space, a Body Positive Community for Teens in a Body Negative World!    Self-love superpower,  Dr. Karla, ActivistMD

How do parents get it wrong when it comes to helping their teens struggling with weight and body image? Are parents helping or harming? I’m learning so much coaching teens and parents and learning on TikTok all the ways parents are getting it wrong. But, don’t worry. You are most likely working with good intentions and surely are getting a lot of parenting right. Let’s work together to set our teens on a healthier and more loving and fun path. I promise you can make it fun to get it done! Hey Parents! I know it’s never easy to admit you’ve been doing things wrong. But it’s ok! You are here, which means you love your child and want to help them right? Why not try? I get you. I got you. You’ve got this. I love coaching parents to support your teen’s health independence and I’m ready to get going! First, we have to rip this band-aid off and learn what we are doing that is the opposite of helpful. I’m here with you. Yikes! Let’s go! We do hard things! Tomorrow I’ll show you 25 ways to help you flip the script Click the link in my bio for more information about the IME community —————————- 1. Stay stuck in believing the diet culture lie we grew up with. Reality check: Thin does not mean happy. 2. Give up on your teen and yourself as a parent. 3. Perpetuate weight stigma and bias in their home. 4. Make their teen’s weight mean anything about them as a parent. 5. Focusing on their teen’s weight and not focusing on their teen’s strength. 6. Teach their teens to be self-critical, not process or allow all human emotions, 7. Think there is something going wrong when your teen is at a different stage of change than you are. 8. Make it mean their teen is unmotivated. 9. Don’t focus on their teen’s strengths and nurture their gifts. 10. Fixate on fixing and solving their teen or believe there is something broken. 11. Create shame triggers by getting in your teen’s business and judging the amount of food their teen is eating. This doesn’t allow your teen to create self-trust or intuitive eating. 12. Make it about them as a parent and blame the teen and their weight for how they feel about themselves as a parent. 13. Be your teen’s food police. 14. Create anti-trust eating and the opposite of intuitive eating skills by getting in your teen’s lane when eating. 15. Not recognizing or ignoring the signs of disordered eating and not getting the help they need. 16. Being self-critical and judging of their parenting and shift the blame to the teen. 17. Not taking a holistic approach to their teen’s health. 18. Not listening and having fun with their teen. 19. Believe their teen’s success has anything to do with their weight. 20. Role modeling negative self-talk as the way to motivate instead of self-compassion. 21. Thinking you have to be a role model for perfect eating and fitness. 22. Believing you need to be perfect. 23. Not recognizing when you are triggered to over-function and think you need to fix and solve your teen’s weight. 24. Having scarcity of opportunity mindset to help your teen. 25. Making your teen’s health all about you. Believing your health journey and your teen’s will be the same. Now, get ready to switch things up and I will coach you, Parents, to flip the script! Make sure you Join IME Community! Self-love superpower, Dr. Karla

What a great theme for the February IME Community Self-Love superpower daily mantras. February was a powerful month of mantras! We canceled diet culture, let go of the negative self-talk and learned the power of showing up for yourself! Pick out the daily mantras that are a good fit for you, write them down, change them up if you want and post them on your bulletin board or write them in a journal. Follow IME Community on TikTok to get my Dr. Karla daily self-love superpower mantras and make sure you Join IME Community membership if you’re a teen, 12 to 18, or parent of a teen, and I’ll coach you to fill up your self-love superpower toolkit! The theme of March mantras goes along with March Madness (Rock Chalk Jayhawk!): Self-Worth is an inside game! Here’s your IME Community February Self-Love Superpower Daily Mantras: 2/1 - I no longer let diet culture set food rules for my body. 2/2- Giving up diet thinking is letting go of self-harm. 2/3 I will take time to heal from diet culture trauma. 2/4- I’m not wasting any more time imagining being thinner. 2/5 - I am entitled to rage at the diet industry machine. 2/6- I’m done with fighting and shaming my body. Like right now! 2/7- I can befriend the mean girl in my head. 2/8- My pursuit of thinness is really a pursuit for society’s thin privilege and is a big waste of my magical life! 2/9- I’m ready to show up for myself when no one is looking. 2/10- The truth of my own body’s story is beautiful. 2/11- The truth is I love taking risk. I eat risk for breakfast! 2/12- I believe I can be kind and compassionate with myself and achieve my goals! 2/13- I am ready to block anyone who weight bullies me! 2/14- When I compare my body to someone else’s body, it’s a micro-aggression against myself. 2/15- Time is too precious to waste beating myself up and wishing I was different. 2/16- I can’t hate myself and reach any goal! 2/17- My habits are 100% based on cues in my environment. 2/18- I don’t waste my time rationalizing the behavior of weight bullies! 2/19- I can write a letter to break up with diet culture and create my own weight neutral definition of health. 2/20- My body, my face, my soul is my beauty standard! 2/21- I recognize when I’m judging and shaming others, I’m judging and shaming myself. 2/22- I can drop my pursuit of thin privilege like a book and live my fun life! 2/23- When I give up diet thinking and fully love and accept myself now, I am well on my way to my health goals. 2/24- I can navigate weight bias at the doctor. I am not powerless. 2/25- Instead of “what I eat in a day”, I’m going to focus on “what music I listen to in a day”. 2/26- When someone thinks they can silence me, I get louder. 2/27- I always speak my truth. 2/28- No matter what’s happening in the world, it’s okay if I feel happy. See you in IME Community! Self-love superpower, Dr. Karla, ActivistMD

Dr. Karla Life Coaching GenX Parents of Teens  

Eating Disorders Thrive in Secrecy, so Let's Talk About It! If you are struggling with an eating disorder or believe you may be, Go to the National Eating Disorders Association (https://www.nationaleatingdisorders.o...) for their Free online chat, call their Help Line at 1-800-931-2237 or contact their Crisis Line by Texting "NEDA" to 741741. Dr. Karla talks with Dr. Jillian Rigert (DMD and MD) about what teens, parents, doctors, and teachers can do to help teens recognize, get treatment and heal from eating disorders, starting with self-worth and self-compassion. You get to live your magical and FUN life! Dr. Rigert wrote an incredibly helpful blog for IME Community, titled, "Lessons from a recovering perfectionist". I found Dr. Rigert's blog and my interview with her to be so helpful and healing. We're talking about Eating Disorders in this video, so just know that if you are not feeling it, go ahead and stop listening. Also, the video is super helpful and healing, but doesn't take the place of going to your doctor and working with a therapist who specializes in eating disorder treatment. The earlier you are diagnosed and receive treatment, the better your outcome. First, if you are experiencing disordered eating, know that you are not alone, that it's never your fault, you are worthy of help and treatment and healing no matter where you are with your diagnosis. Recognize, you are not broken and you can heal and live your beautiful life. You don't cause and you don't control all the things in life. Eating disorders are a mental health diagnosis. They are a medical condition. You are not a diagnosis. I simply love you and want you to know that you are deserving of a self-love superpower life. Eating disorders are unfortunately common, cross gender lines, and do not have anything to do with weight. What do I mean by that? You cannot determine if someone has an eating disorder based on their weight and external appearance. In our society and culture, we feel entitled to comment on bodies and sizeism is a thing and so is weight bullying, weight stigma and bias, and the false association between weight and health. It's all 100% harmful. Dr. Jillian and I talk a lot about social media in this helpful discussion. It's very very helpful. Welcome to National Eating Disorders Awareness Week. I mean, I guess it's a good thing to have an awareness week? What do you think? I spent some time figuring out how to be helpful and not just share the typical talking points that are out there on eating disorders. How IME Community is addressing eating disorders starts with sharing the story of Dr. Jillian Rigert and her experience with an eating disorder, but most importantly, how Dr. Jillian is intentionally healing through her journey of self-worth and self-compassion. Sound familiar? It's self-love superpower! Eating disorders are "suffering", a word Dr. Jillian used many times in this discussion. Parents, note that your teen's weight has absolutely nothing to do with their internal mental state. If you believe your teen's thinness means they should be happy, you're wrong. If you believe your teen who exists in a larger body, needs to shrink their body and their emotional and mental health and well-being will be fixed, wrong. I'm not saying that improving health habits won't improve well-being. Our focus on weight being equated to health and emotional health is just wrong. Stop believing the pursuit of thin privilege gets to happiness. Silence is fuel for an eating disorder. Not talking about it, not knowing how to talk about it, staying stuck in diet culture, focusing too much on weight and not on mental health are all ways that parents and doctors contribute to the perpetuation of eating disorders and potentially create continued harm. Just like many issues in healthcare, eating disorder screening and treatment is another thing we've not been that helpful in addressing. Dr. Jillian and I talk about how we can start by having discussions with physicians and get rid of the focus on BMI (Body Mass Index) and weight-based diagnostic criteria. When she talks about how harmful BMI at the doctor's office was for her, I was overcome with emotion. Her story is very powerful. Here's a link to one of the many helpful Dr. Jillian Rigert articles on eating disorders, published in KevinMD.com. https://www.kevinmd.com/blog/2022/01/... Next up, I will discuss the different types of eating disorders. Parents, please let me know what needs you have for coaching on this important health issue. Reach out to me at drkarlaactivistmd@imecommunity.com. Teens, 12 to 18, and parents of teens, go to imecommunity.com and Join IME Community to get my coaching to create a Body Positive Community for Teens in a Body Negative World! Self- love superpower, Dr. Karla, ActivistMD

Self-Kindness is the Key to Your Health Goals! Self-kindness is the key to Your Health Goals! I talk about self-love superpower all the time, but where should you start to get there? Self-love superpower starts with self-kindness. Happy Valentine's Day, by the way! I'm coaching you to be your own Valentine every day. Self-kindness leads to self-trust that you will have your own back as you take action. Then, when you trust yourself to be kind to yourself no matter what, you can do anything! Self-kindness and self-trust go together like PB&J. Do you believe you can be kind and compassionate with yourself and reach your goals and get whatever you want in life? I'm sure you're saying, duh, of course. Whatever. Hold up. I'm onto you. I coach teens and know from being a human myself that it's easy to believe this in theory, but, when it comes to taking action, especially on a goal you set for yourself, the negative self-talk, inner critic voice starts yapping away! Instead of listening to your inner critic, start being your inner hype person. Start by recognizing when you're being hard on yourself and create a pause. You may feel tired, not getting the results you want, or coping with overeating food. Thoughts create feelings which drive our action and inaction. You are not your inner critic voice. You are not your thoughts. When you feel that negative self-talk coming up, create a pause and then an opportunity to soften up and be kind to yourself. Try this daily mantra: "I am kind to myself no matter what!" Make sure you check out imecommunity.com and Join the IME membership community if you are a teen, 12 to 18, ready to permanently cancel diet culture, health yourself, and co-create a Body Positive community in a body negative world! Self-love superpower, Dr. Karla, ActivistMD

It's IME Community's One Year Anniversary! Guess what I'm doing to celebrate a year of IME Community building? Making this YouTube video! What else would I be doing? I'm sharing with you all my wins, losses, fails, all the things. I've been a founder of many things and, let me tell you, it's been a year. It's been incredible and so tough in many ways. Coaching teens has been the absolute best part of everything and my biggest joy over the last year. I also wasn't planning on the TikTok growth of the IME Community platform or becoming the Doctor on TikTok who is disrupting weight stigma and bias in healthcare! If you're a teen, looking for motivation to take on your health goals and permanently cancel diet culture from your life, then Join IME Community, to get Dr. Karla coaching! Go to imecommunity.com! It's been quite the year of community building, of co-creating a teen health and wellness community, life and weight coaching, lots and lots of social media, content creation, writing, YouTube, podcasts, blog writing, all the things. It's been an epic year of wins, epic fails, taking epic risks, epic powerful decision making which brings on epic clarity, and lots of life in between. I embrace epic failure because I never make it mean I'm a failure! If you're a teen, you're your own Founder, CEO of your life! You will need to take epic risk to create epic wins and learn to learn from epic fails. It's all okay! I've got your back along the way. I'm accessible and an expert who's been through all of this myself! So, like and subscribe to IME Community YouTube and go to imecommunity.com to Join IME Community if you're a teen, 12 to 18 who wants to co-create a Body Positive Community for Teens in a Body Negative World! Self-love superpower, Dr. Karla, ActivistMD (funny/unapologetic/fire-starter)

Are you ready to have self-trust when it comes to eating? What if you could create a healthy relationship with food? What if you could accept yourself no matter what and also accept that you are worthy of your healthy life? You will be successful when your why will be to build self-trust by committing to loving yourself no matter what. That’s it. I bet you trust yourself in many areas of your life, but when it comes to food and eating it’s a different story. There are many reasons for this. One of the reasons is all of the marketing, of unhealthy foods, but also the myth that diets work even though we know they don’t. Our society tells us the opposite everyday. Food companies, health systems, all of the diet companies, supplements, are all telling you not to trust yourself to listen to your mind and body and to trust yourself. Building self-trust eating starts with building your relationship with yourself. Step 1: Reject the diet mentality – As of 2018, the weight loss market is worth an estimated $70 billion. This staggering figure is staffed by the 45 million people that take up at least one new diet per year. When everything is taken into account the average adult will try about 126 different diets in their lifetime. Step 2: Recognize your hunger. Often we aren’t used to listening to our body’s hunger cues. Our hunger and appetite are fueled by many different physiologic processes. When we eat when we aren’t hungry, overeat past fullness, or don’t honor our hunger when we are, we are not connecting our minds and bodies. Instead of self-trust, we are creating distrust and putting the power outside of ourselves. How tuned in to your physical hunger do you think you are? Step 3: Make peace with food – One thing I’ve noticed a lot, especially with teens I’ve worked with is the thought of making changes with food creates a lot of anxiety. That’s most likely because food has been the go to comfort in our lives and many of you have gone through and are still going through some really hard times. Creating a healthy relationship with food isn’t restrictive and when you own your choice to eat foods that serve your body, you will be on your way. Step 4: Challenge the food police. Food is food, but not all calories are created equal. While it doesn’t serve us to think of foods as good or bad foods, not all calories are created equal. Sugary and ultra-processed foods often mess with our hunger and appetite cues. So, while it’s not helpful at all to think of good or bad foods, it may be helpful to think of honoring yourself and building self-trust by eating foods that serve and fuel your body. Step 5: Feel your fullness. When you’ve started to build self-trust with your eating, you will notice that you get full faster than before. It does get uncomfortable to eat past fullness. Don’t beat yourself up. You and your body and mind are learning to work together. There will be times you will keep overeating past fullness. We are always practicing and learning, but I can definitely assure you it gets easier. Step 6: Discover the satisfaction factor. Eating real food creates a sense of satiety, also known as fullness. Foods that are healthy fats like cheese, nuts, avocado, especially create a sense of satisfaction and satiety, so you want to make sure you have healthy fats and some protein with each meal and snacks. Step 7: Practice coping with your feelings without using food. Recognize when you have an urge or craving is most likely because you are having a feeling or emotion that you sense is negative and your brain is telling you to eat the sugary food to get the dopamine feel-good zing instead of feeling your "negative" emotion. Just recognize when an urge comes up and create a pause. That's it and will get you far. Step 8: Respect your body. Weight is not health. There’s the body positivity movement. There’s the body neutrality movement. There’s the health at every size movement. In what ways does your body serve you? In what ways do you serve your body? How are you honoring your body? Step 9: Exercise and feel the difference. What are your thoughts and feelings when you think of exercise or achieving a fitness goal? Your body was made to move. Another way to respect your body and create a positive body image is to move your body. All movement counts. Step 10: Honor your health by thinking of your health holistically and practice self-compassion when things don’t go like you want. Fueling our bodies with food is one aspect of our health. Great job! Practice self-compassion as you are making changes and learning to build self-trust eating habits.

How do you really feel about Food?   Do you have a crush on Food? Is Food like an ex that won’t go away?   Maybe you are grateful to Food for helping you get through tough times in life?   Want to create a healthy relationship with Food in 2022?   Start by writing a Dear Food letter.    Food is such a weird word!   Here’s my Dear Food letter:   Dear Food, I hope you are doing well. Happy New Year, by the way.    I have no doubt that 2022 will be an amazing year for you, full of variety, new adventures, trying new things, deliciousness and satisfaction.    You will continue to be the star of shows like the “Great British Baking Show” and “Chopped”.   I have a feeling, Food, that your quality efforts will be sustainable.    I wanted to write to thank you for your service.  You have been a true friend to me through the dark times, the sunny times, basically, all the time.   I do have to tell you, Food, sometimes I feel like you are my only friend and Food, you have been what I look forward to. It helps that you seem to be everywhere.  You are always accessible and there when I have needed you.    For that, I am truly grateful.   Food, you have always been there to nourish me through whatever I am going through in life. Food, I wouldn’t be where I am without you.  Sometimes, I can’t figure out if that’s a good or bad thing.    Food, sometimes you make me so mad with all your sweetness, I feel powerless.    Food, sometimes you are just too much.  You’re so extra, Food.    You can be mind-numbing, Food.  Did you know that about yourself?   Sometimes, I wish you would just chill out, Food.   It’s been real, Food.  I don’t want to spoil this for you.    Food, you are enough.    Food, you don’t have to keep trying to fix and solve my problems.    I am grateful for you, Food.  My unconditional love for you is never-ending.    Food, I’m focusing on your strengths, your enduring qualities and seeking a more balanced relationship with you in 2022.    Don’t cry over spilled milk, Food.  Boundaries are healthy and relationships change!    Our relationship has been pretty one-sided for quite a while now.  Even you can admit that?   I’m okay.  You’re okay, Food.   Food, let’s raise our 8th glass of water of the day and cheers to our whole-new, fresh, quality, healthy relationship in 2022!   With gratitude, Dr. Karla   Are you ready to write your own Dear Food letter?   If you’re a teen, 12 to 18, who wants to Level Up and create a healthy relationship with Food, then Join IME Community to get my coaching to create any result you want!   Self-love superpower, Dr. Karla, ActivistMD        

Happy 2022! Driving in a blizzard is something you shouldn’t willingly do, but sometimes cannot avoid.  Do you want to get home so much that you are willing to be stuck in an adrenaline surge for 12 straight hours?   We recently drove through a Colorado winter snowstorm in our family van (aka the family truckster).    Our kids are 21, 18 and 15 and I don’t know what to call them.  Kids? Children? Young adults? Offspring?  Nothing really fits.  Sometimes I wish I could go back in time and spend a day with each of them.  I want to pick the day.  It wouldn’t be a road trip day.    We’ve taken a lot of road trips with our kids. It’s always a ton of work that we never take into consideration.  I suppose we believe we will be fueled by the excitement of it all.   Family road trips are for the heartiest among us.   There are three phases: the preparation and getting there; the actual vacation; the packing up and getting home.   If you want a successful road trip, you have to take an aerial (should have taken an airplane) view and consider all three parts of the family road trip.  My husband and I are slow on the uptake.  We never give enough credit to parts 1 and 3.    What’s it worth to get home?  We’ll get there eventually.  Should we just wait out the rest of winter?   “Didn’t you check the weather conditions?”    “I always check the weather.”   “Exactly my point.”   “Why can’t you check the weather for once?”   “There’s no service.  Oh wait, I have one bar.”   “Mom, you always blame Dad for the weather!”   “I’m feeling motion sick. I shouldn’t have ridden in the back in the mountains.”   “Here, take this Dramamine.  Oh, I only have one left.  I’ve had these for years.”   “Wait, is this expired?  Is this old pill going to poison me?  Do you have water? I need water.”   “Of course, we have water. Oh wait, it’s frozen!”   The wind is blowing the snow in horizontal rivers perpendicular to our minivan.    “Why didn’t we get a SUV?  This van is crap in the snow.”   “I’m hungry! What do we have to eat?”   “Let’s turn around here.”   “No, let’s keep going through to Laramie.”   It’s only 42 more miles going 10mph, covered wagon speed, to get there.  Seems reasonable. “Kids, we’ve got a math problem for ya!”  Never pass up on a learning opportunity while on a family road trip!   “There are no cars coming from that direction. That’s a bad sign.” “Why is Wyoming so bad with their roads? Do we have enough gas? We’ve run out before, remember?”   We let the white-out snowstorm make the decision for us.  Turned around and drove back to Walden, Colorado, gas station to reassess.   “Everyone get out and go to the bathroom.”   “I don’t have to go.”   “GO TO THE BATHROOM!!!!  THIS MAY BE YOUR LAST CHANCE!” Headline for the Walden newspaper decorated with a gruesome picture of the remains: Wolves Attack Heifer Calf!   “Oh God, is this what’s going to happen to us? “   We may end up another small mountain town newspaper headline: Wolves Attack Stranded Family with Questionable IQ and Zero Problem-Solving Abilities! Family, friends and neighbors back home only surprised it’s taken this long.   The cashier at the gas station I tried to make small talk with wasn’t having it.  She looked like someone who is never interested in small talk and never sweats the small stuff.  I got the sense that our family is definitely small stuff to her.   When I said, “We’re going to head through the Cameron Pass,” she responded, “It’s snowing there too.” Our safety was clearly not her concern. Seeking any sort of re-assurance we were making the right decision, I instantly regretted it and walked away in silence with my gas station coffee, bag of corn nuts and an impending sense of doom.     “I’ve got one bar of service!”   “Good, check the weather.”   “No way. I’m trying to get YouTube! Can you turn on Skyfall when we’re driving through the canyon? That will be cool.”   “I think I’m gonna puke!”   Here’s to a 2022 full of family experiences, honing our planning skills and recognizing we don’t cause or control all the things!   If you’re a teen, 12 to 18 or parent of a teen, don’t forget to Join IME Community and co-create community with compassionate connection!   Self-love superpower, Dr. Karla, ActivistMD            

Did you grow up hungry?  I did. The first time I shared my story of child hunger was when I was asked to do a write-up for the Food Bank of Lincoln's newsletter.  I was a new Board member and had my non-profit and as a community pediatrician, there were many intersections and common visions.  But, I had not shared the real reason why I wanted to serve on the Board of the Food Bank of Lincoln.   If you look at me now, you would never think I grew up with food insecurity and hunger.  It was a shameful secret that we never gave a name to and I rarely speak about.  Growing up hungry is one of the reasons I served on the Board of the Food Bank of Lincoln and continue to be a Hunger Advocate in my community, supporting on many levels.   There is power in the courage of being vulnerable and sharing your story.  Maybe, someone will look at me and see my life and feel like they aren't stuck and things can truly get better.  Hunger is a symptom of an underlying cause.  It's not the thing.  In my case, my Mom struggled with depression which made it really difficult for her and for us.   What are your biases when it comes to people experiencing hunger in your community?  You may believe you know what someone who's hungry looks like or what their life is like.  You know nothing.  You know absolutely nothing. Listen to this podcast to be challenged and learn how you can support hunger efforts in your community!  You may be shocked that the face of hunger isn't who you think.  Especially, during COVID, many families have needed to access the resources of the Food Bank to meet their family's needs.  Many families continue to struggle.   Welcome to the second in the IME Community Solutions for Children's Health podcast series where I interview community visionary champions who are driving impact and sharing what it takes to stay the course during COVID.  Today's podcast guest is Alynn Sampson, MSW, VP Operations and Impact at the Food Bank of Lincoln.  I've known Alynn for over ten years and have had the opportunity to work with her and watch her incredible work building the child hunger programs and programs that address the root causes of hunger like Bridges Out of Poverty.   Listen in on how Alynn and the Food Bank team have risen to the occasion to meet the needs of the  community during COVID.  There are many ongoing challenges.   There is power in connection through sharing stories and aligning vision and showing up for every individual in the community to say, "You matter and I want to be here with you." Grab your coffee or tea and listen up to this incredible visionary and social justice warrior who gives us a call to action to get uncomfortable with anyone being hungry in our community.   Self-love superpower, Dr. Karla, ActivistMD

Welcome to the December IME Parent Coaching Coffee Talk where I coach parents on all the happenings in IME Community. This is jam-packed with helpful goodness. I just know, since I’m a mom of three amazing humans, that we have good intentions as parents. The problem is, even though we have good intentions, it doesn’t always translate to showing up as a loving and supportive parent. So, what gets in the way? Why do we show up as emotionally reactive instead of with compassion for our teen? First, hand over heart and with lots of grace and compassion for ourselves as parents, we live in a society and culture that puts a lot of pressure on us as parents. TBH (to be honest, in case you’re not as cool as I am), we go about parenting with a lot of fear and lack. It’s really unfun or what I call a “nufnu” (unfun backwards). From a place of fear and lack, we get into our teen’s lane and try to fix and solve. It’s called over-functioning and I’m the absolute Queen of it. Ugh! It’s seriously embarrassing. I know what you’re thinking, “If I don’t get in my teen’s lane and stay on top of it, he/she/they will do nothing, and will stay on their screen all day.” Believe me, I get it. I’m not talking about having standards and expectations for your teen and supporting with boundaries and consequences. It’s just when we are trying to catch our teen and come from a judging and shaming place, we just continue the pattern that builds more friction, we feel crappy, and our teens never get the opportunity to create self-trust which is what allows them to create their big magic life. I’m seeing a trend in our teens, the ones I coach, on social media and my own, and that is that the same fear and lack is spilling over into their lives. Can you start to recognize when you are coming from a place of fear and lack and have an urge to fix and solve your teen? Next, create a pause and then, what if you show up with self-love superpower for yourself as a parent? Put your self-love superpower oxygen mask on first. Your teen doesn’t need you to put their oxygen mask on for them, like when they were little. Believe me, they need you to show them by putting it on yourself first. Then, your teen will start to show up with self-love superpower and create the results of their dreams! Check out imecommunity.com and Join IME Community, if you’re a teen, 12 to 18, or parent of a teen to get my awesome coaching! Self-love superpower, Dr. Karla, ActivistMD

Hello, I’m so excited to launch the IME Community Solutions for Children’s Health Podcast and YouTube series focusing on local solutions, highlighting the impactful work of visionary champions like my first guest, Jessie Coffey, MS, RDN! Want to hear about the time Jessie was working in the School Nutrition Department and one of the middle schools boycotted school lunch? Then, when she worked with the students to ask for their input, specifically, what they wanted for lunch, they demanded, “Lobster, ice cream, and soda!” By the way, I’m dedicating this series to my former non-profit, Teach a Kid to Fish, and the many community partners who aligned with the mission and vision to create community solutions for children’s health. IME Community (imecommunity.com) is the new Teach a Kid to Fish with my updated vision to create community with compassionate connection! If you’ve listened to any of my IME Community podcasts or watched any of my YouTube videos (get on it if you haven’t and remember to like and subscribe), you know that I fully believe in the power of community. With the ongoing COVID pandemic, I can’t think of anything more important than connecting on a community level with compassion. Before we get into it, make sure, after you listen, check out imecommunity.com, Join IME Community if you’re a teen, 12 to 18, or parent of a teen, or email me at drkarlaactivistmd@imecommunity.com with any questions! For my first IME Community Solutions for Children’s Health visionary champion interview, I asked Jessie Coffey, MS, RDN, to share her work over two decades working on every level in the community. I have worked with Jessie for nearly 15 years and I can’t think of anyone who is more of a massive action-taker and impactful community visionary than Jessie. Jessie Coffey, MS, RDN has 20 years of experience in public health and is a registered dietitian by training and has a master's degree in Family Services Administration and is currently pursuing her PhD in Health Communication studies. Jessie has worked in multiple sectors, including state & federal nutrition programs, K-12 education and with non-profits to co-create wellbeing opportunities that support the equitable promotion of health for ALL Nebraskans. Jessie works to be a human connector, a life -long learner and strives to embrace the messiness of life that is at the heart of public health work. Key Takeaways (Absolute Gems for your stack of Post-It Notes): • “Co-construct solutions with the community.” • “I became a R.D. because I loved finding everyday solutions to help people with their complex medical problems.” • “If you’re going to do community work, be prepared for the messiness.” • “Focus on relationships and systems change to drive impact.” • “Let your participants, the end user, share their story to learn about the challenges and successes.” • “Talk less. Listen more.” • “Schools know their students best. Parents know their children and teens best.” • “Let’s get rid of the judgment and shame put on parents and move forward together as a team.” • “Always be willing to shift.” • “Don’t be afraid to take action. Go out and do that thing. You will learn more from what goes wrong than from what goes right.” • “Just think of all the knowledge and skills the child, teen and family takes with them when they participate in a community program.” Abbreviations, Resources and Links: LPS- Lincoln Public Schools NDE- Nebraska Department of Education R.D.- Registered Dietitian ACES (Adverse Childhood Experiences)- Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years)(https://www.cdc.gov/violenceprevention/aces/fastfact.html) Alliance for a Healthier Generation- (www.healthiergeneration.org) BodyWorks- A Toolkit for Healthy Teens & Strong Families. Office on Women’s Health, U.S. Department of Health & Human Services (no longer available) FFVP- Funding for the Fresh Fruit and Vegetable Program, USDA Food and Nutrition, is available for the 2021-2022 school year through the Food, Conservation and Energy Act of 2008. FFVP is designed to help create healthier school environments and combat childhood obesity. (https://www.fns.usda.gov/ffvp/fresh-fruit-and-vegetable-program) Full-Service Community Schools Program (FSCS) encourages coordination of academic, social and health services through partnerships among public elementary and secondary schools; the schools’ local educational agencies; and community-based organizations to improve educational outcomes in children. (www2.ed.gov/programs/communityschools) WIC – Special Supplemental Nutrition Program for Women, Infants, and Children (www.fns.usda.gov/wic) Next up is my interview with Alynn Sampson, MSW, VP Operations, Food Bank of Lincoln! This will be another powerful interview! Self-love superpower, Dr. Karla, ActivistMD

Welcome to another hot mess TikTok Live Coaching session! I have fun coaching wherever I have the opportunity. Unedited rapid question coaching is the best coaching. Are you stuck in fear of failure and lack of self-worth? Maybe you don’t even know you’re stuck in fear and lack with your parenting. It’s super tough to find a balance with our teens. It’s tough to know when to push and when to stay back. It’s really hard to let them fail and not feel like a neglectful parent. If you start doing some thought work to unveil some of your beliefs about your teen or you as a parent, that will create powerful awareness of where your actions are coming from. Fear and lack come from our thoughts and not from our teens or their actions. When you start to recognize when you’re triggered to get into your teen’s lane, you can acknowledge and then create a pause and shift to more helpful thoughts like: “I don’t cause and I don’t control.” ___(say teen’s name)__________ is ___(say teen’s name)____________ i.e., Katherine is Katherine. Audrey is Audrey. Andrew is Andrew. “I don’t want my teen to suffer. I can’t prevent suffering for myself or my teen. It’s part of being a human.” “I trust my teen to figure it out and I will be here to support with unconditional love.” “I fully love and accept my teen no matter what.” “My teen’s actions don’t mean anything about me as a parent.” “I don’t have to make anything my teen says or does mean anything about me as a parent.” “There’s no such thing as a perfect parent or a perfect teen.” “My only job is to listen with compassion to my teen.” “My goal is to create trust by showing up as a loving and compassionate parent.” “My teen isn’t broken. I don’t need to fix or solve my teen.” “I will seek the support and help my teen needs.” “It’s healthy to set boundaries with my teen and to follow through.” Write these down on a post-it note and keep them handy. Choose the mantras that resonate the most with you. Create your own and add to them. You are creating powerful self-awareness and moving toward becoming the authentic compassionate parent your teen needs. Don’t forget to check out imecommunity.com and Join IME Community to get my amazing coaching on zoom. It’s time to Level Up! Self-love superpower, Dr. Karla, ActivistMD

TikTok Trolls are gonna hate, I guess. We can't control that or the first comment they post on our videos. Oh wait. Yes, we can. Report. Delete. Block and then Lather. Rinse. Repeat. That's my strategy. I was coached by the IME Community member teens to only reply and to do so with a video to the outright misinformation that trolls try to spread. Otherwise, ignore. I'm lucky, I suppose, that I usually only have a few haters respond to my videos. They're basement dwelling keyboard screamers, if you will. Cyberbullies looking for a quick power and control hit as they hide behind their screen and eat a steady diet of hot pockets. But, enough about the hot pockets of all varieties eating hate spewers, let's talk about us for a minute. As a teen or parent of a teen, how do you find balance with social media? First of all, you don't have to show up on social media at all and if you do, there is no right way to show up. See above for the wrong way to show up. I know that anyone who reads my blogs is the kind of human who is a kind human. So, if you're reading this, you're good. If you decide to show up on social media, do so with intentionality. What does that mean? It's just like with food, school, friends, stuff we have to do, simply make a decision ahead of time. We don't have power over other people. Remember, I've coached you on this like a thousand times. I've already coached myself on this about a thousand times already today. It sure is a hard human concept for us humans. I'm so glad we are powerless over others because, "Powerless over others means powerless over me!" That's a Dr. Karla original quote to be used however is helpful. I was calling out celebrity thin privilege I saw in People Magazine on TikTok the other day and caught some hate from a keyboard screamer who said, "Celebrities are devil you should know that from the get go. You're a sucker for buying it. And stop using the word privilege." I created a quick reply video where I said the word "privilege" about 20 times, even sang the word, which is hard to say over and over, and then ended with, "today is sponsored by the word privilege". That was kind of petty, or a lot petty. Every once in a while I got to speak up and if I am feeling sarcastic, watch out. My vision is to show up to create community with compassionate connection and be helpful. So far, IME Community has almost 58k TikTok followers. Our message is getting out and it's making a big difference in people's lives who are transforming their health and sharing their real life health wins of reversing their diabetes trend and have normalized their blood sugars and are losing weight. It's thrilling, actually. If you want to contribute to fun, to inform, or connect on social media, you should do it. Just remember to be intentional and decide how you want to show up and where you put your attentional focus. Recognize you don't cause or control much, but can always: Report. Delete. Block. Then, Lather. Rinse. Repeat. Don't forget to check out imecommunity.com and if you are a teen, 12 to 18 or parent of a teen struggling with weight and body image and want to create a fun and healthy way forward that is devoid of deprivation and hot pockets, Join IME Community today! Self-love superpower, Dr. Karla, ActivistMD

Parents, Don't be Stupid! In other words, stop sweating the small stuff with your teen. As a teen life and healthy weight coach and parent coach, but most importantly as a parent of three, who are 20, 18 and 15, believe me I have been stupid a lot and on many occasions. It's okay. We're creating a more helpful approach moving forward. First, does your teen struggle with their weight or body image or have you noticed increased anxiety in your teen? We are still in the COVID pandemic and data shows that not only are our teens struggling with pandemic weight gain, they're struggling with increased anxiety. Teens with Anxiety need a compassionate approach. Anxiety in teens is common, especially with the pressures from us Gen X hyper competitive, people pleasing, overachiever parents, and what has been our non-compassionate approach to ourselves and our teens. Anxiety in teens will be increased if we continue our rigid, fix and solve approach to the small things that come up in life. The reality is the stakes aren't that high among the everyday things in life. This morning, my daughter, Audrey who is 18, has a car and a job, asked me right before she needed to leave for school, while I'm still in my pajamas and hadn't had any coffee, to take her to school because her car is out of gas. My old reactive self who hadn't worked on self-love superpower or on any life coaching, would have reacted and said something like, "Audrey, why would your car be out of gas? You had tons of time over the weekend to fill up the car with gas. We could have filled up the car with gas for you. If you would just let us know then we can avoid these last minute crises." But, it's really no big deal. Of course, I recognized that I was triggered and these thoughts came up, but I'm intentionally a more responsive compassionate parent these days and got dressed, took her to school and it was zero problem. Because, it isn't! With so many teens experiencing anxiety these days, the last thing we want to do is create more anxiety for our teens over small things. So, on the way there we heard "Don't be Stupid" by Shania Twain, who I'm a huge fan of. Talk about the gift of a song. Lyrics are a gift in the world. I laughed because my old parenting self would have used that opportunity to say, "Hey, don't be stupid. Put gas in the car." But, instead, of increasing anxiety in my teen and creating more of a divide between us, I chose to turn those "Don't be Stupid" lyrics back on myself and I did a U-turn, and said, not out loud, for God's sake, "Hey, don't sweat the small stuff. Don't be stupid!" I said, "Have a great day. Liebe dich." She said, "Love you", and she was off. Remember, Parents of teens, to get my amazing coaching, check out imecommunity.com and Join IME Community. I will coach you to not sweat the small stuff and create a compassionate and fun relationship with your teen. When you change, your teen changes. Liebe dich! Self-love superpower, Dr. Karla, ActivistMD  

Listen up, Parents, Teens and Doctors! Sometimes, I crack myself up. Do you do that? I hope so. Take your work seriously, but not yourself is my philosophy. Life is meant to be fun. Is easeful a word? It should be if it isn’t. I'm helping you take something that is very difficult, meaning having a conversation with your teen about weight, and create a more easeful approach. It will never be easy, but you can start to reject diet culture and thinking and getting out trying to fix or solve your teen and making your teen's weight mean anything about their success or happiness or anything about you as a parent. I'm coaching you to go from the "how" or compliance coaching to the "why" or compassion coaching. Believe me, I have intentionally, worked on my relationship with my teens, as a massive action goal in my life. I've created a softer, kinder, and more compassionate relational approach by pausing before I go down the well-trodded, fix and solve, control, transactional approach I was stuck in. Once my life and well-being coach, helped me realize I don't cause and I don't control much, and how to set boundaries, I started to change. When you change, your teen changes. It's very cool, is completely imperfect, takes daily intentional practice and habit building, and is more worth it than any goal I have ever achieved. Weight loss, schmeight loss. Who cares if I got to my weight loss goal, if my daughter didn't trust me to show up as a loving supportive Mom who stayed out of emotional reactivity and control? I know. I know. You have really good intentions and just want what's best for your teen. Me too. It's just that we don't always know what's best for our teen and when we stay in fix and control mode, our teens don't build the necessary skills to create self-trust and figure it out on their own. We really believe we can prevent our teens from suffering in life and that when things are going well for our teen, that's because of us and our parenting. Again, not true. It's almost laughable. I decided instead of being one of those doctors and I’ve been this doctor in the past, who just doles out bullet point recommendations focused on the how, I will actually be super helpful. Things have changed with the pandemic and by changing, I mean things have gotten worse, our health, and all areas of our health is what I’m talking about. So, let’s have a conversation with our teens about healthy weight. I recently had a parent commenter on my TikTok post where I was super vulnerable about how doctors have gotten much of this wrong when it comes to addressing the childhood obesity epidemic. Mom said she feels stuck and worried about her 12 year-old daughter who is really struggling with her weight and body image. “I’m worried if I bring it up I will cause harm and if I don’t do anything to help her, it will get worse and she will suffer in silence.” To me, this sounds like she is thinking in two extremes and the answer for how to be helpful is my whole philosophy “Let’s meet in the middle”. It is possible to reject diet culture, cultivate body positivity and help our teens find self-love superpower to reach their health and life goals. Mom, you are never stuck. Our first task, is to recognize our teens are unbroken. There is nothing to fix or solve. Their weight is not a problem and is not a reflection on us as parents. Breathe. It’s okay. Next, let’s reject diet culture’s big fat lie that happiness is outside of us, that happiness, success or superiority is a measure on a scale. I was just coaching one of the IME Community teen members on this. Andrea said, she watches TikTok’s of young women who have lost a lot of weight and they show the before and they are happy with friends and having fun and now, after losing weight, have a lot of loose skin, and feel duped by diet culture because they don’t feel different. I coached on why this is happening and why IME Community is so important, now more than ever. The problem is not the TikToker. The problem is diet culture’s big fat lie that conditions us to put our happiness on the external, that a measure on the scale will make us feel a certain way. This is where my trifecta for transformation comes in and why and how I created IME Community. I coach teens to fully reject diet culture, starting with recognizing its harms and how it’s a failure. Sure, diets work in the short term. We believe that once we get to that point or weight, then our pain is relieved. That’s not true. So, listen up to this, sometimes cringey acting I'm doing in this video and podcast. I hope it's helpful. If you're a teen or parent of a teen, age 12 to 18, don't forget to go to imecommunity.com and Join the IME member Community where self-love is your superpower to achieve your life and weight goals and make your mark in the world! Self-love superpower, Dr. Karla, ActivistMD  

Dr. Karla Parent Coaching Coffee Talk Teens and Weight Bullying First, playlist for the week is "We're not gonna take it" by Twisted Sister, a real get you pumped up to set some powerful boundaries 80's rock song. Video is hilarious too in case you want to transport yourself back to my teen era.   Good morning or whatever time of day it is for you. I've been talking about teens and bullying this week and thought I would share the coffee talk parent coaching. Hey, this is truly unedited.   By the way, if you are a teen who is ready to Level Up your health and achieve your weight and life goals starting with me coaching you to create self-love superpower, then go to imecommunity.com and Join IME Community. You'll get Dr. Karla coaching on zoom and I love being a teen life coach and creating IME Community, but I also love coaching parents to help support your teen's health independence.   This YouTube video and IME Community podcast is a very important topic. We're talking about weight-based victimization, teens and bullying and what we can do as parents to help stop the bullying for our teens. I use a coaching approach, and I always coach with compassion, to build skills like boundary setting and connecting with a trusted adult, to address bullying.   When it comes to setting boundaries, are you an avoidant or compliant or are you an aggressive or manipulative controller? I doubt you're a controller if you are watching this YouTube video, and most likely are an avoidant or compliant who doesn't want to deal with conflict or hasn't been the taught the skill of setting a boundary. I get you. That's where I've been most of my life, especially when it comes to setting boundaries for myself.   You are worthy of setting boundaries. Did you know we were created to set boundaries?   Setting boundaries is a part of living a healthy life and I'm not talking about food boundaries or being strict and rigid with boundaries. How do you decide when and in what situations to set boundaries? What are the different kinds of boundaries you can set?   I guarantee you are setting boundaries even when you don't think you are. Let's take a boundary setting approach to stop bullying for ourselves.   Remember, you can always walk away and that is setting a physical boundary and is not giving up. Walking away is a powerful boundary and without words can send a powerful message.   Remember, our thoughts create our feelings and our feelings drive our actions or inactions. If you are feeling stuck and powerless in a bullying situation, try to write down your thoughts and beliefs about the situation. If you keep believing that thought without challenging it or realizing your brain is attached to it because of fear (is a human response and makes sense), then you will stay stuck with that belief, the fear and the inaction.   How do you want to show up for yourself? One powerful decision creates powerful clarity for your next step. Make sure you connect with a trusted adult to help create a plan so the bullying stops for you.   I've got your back. I only care about helping you and we are going to stay in your lane and not in the business of the bully trying to convince or thinking they shouldn't be bullying or why they are bullying. We believe them when they have shown us who they are. Let them be who they are and let them be wrong about you.   Self-love superpower, Dr. Karla, ActivistMD  

Hey, First, I want you to know that I'm talking about a sensitive topic in this YouTube video. I'm talking about bullying and its harmful effects, how common it is, who's at risk, the different types of bullying, but, most importantly, what you can do about it. Make sure you work with your pediatrician or family doctor and/or seek help from a licensed medical health provider to address your individual situation and potential mental health effects. You are not alone. There are trusted adults who want to help you and will create a plan to stop the bullying. I also coach on setting some boundaries for yourself so you are able to show up with clarity for yourself. We were just talking about boundaries and relationships last week, so that is coming in handy in our everyday lives. In this video I talk about some amazing teen life coaching I got from my amazing IME Community members on a bullying situation one of my former patients had. Whether you are a teen, parent, physician, healthcare provider, teacher or school administrator, listen up! I would love for you to go to stopbullying.gov to check out the resources to help you. First, bullying is not acceptable and must be recognized and called out as unacceptable. Next, let's step up as trusted adults and work with the school (teacher and/or counselor) if that's where the bullying is happening, and create a plan to stop the bullying so school is a safe place. Have you been bullied based on your weight? Or, for any reason? Studies show that it's more common than we like to think. Unfortunately, some people still believe enduring bullying is a rite of passage into adulthood. Nothing could be further from the truth. Bullying is a preventative health issue. It's important to recognize and address or it can cause long-term harm. In this YouTube video and IME Community podcast I talk about what's needed to help stop bullying: Support/Build Skills/Connect to resources/School Involvement/Referral to mental health provider/Follow-up to check in. How to support the "bully/victim" is important too. A harsh approach does not work. For pediatricians, our role is: Identification/Gather more information/Intervention/Advocacy, education, and research. Make sure you check out stop bullying.gov and make sure you Join IME Community to get even more support!   Self-love superpower, Dr. Karla, ActivistMD  

• IME/UBU MONDAY o We are talking Relationships and boundaries for Week 12 of the IME Reverse Your Insulin Resistance Challenge o What do relationships and boundaries have to do with reversing your insulin resistance, reaching your health goals and losing weight? I’ve told you before and I’m gonna tell you again this week that taking action on a goal you are setting for yourself is all about your relationship with yourself. You know putting on your oxygen mask first? We have to learn to do that and when we believe or stay attached to fixed and limited beliefs that it’s selfish to put our oxygen mask on first, then we aren’t helpful to anyone. o Your relationship with food is your relationship with yourself. That’s the most important thing I can coach you on is that self-worth is not related to achieving your goal or producing or anything external. You are worthy and 100% lovable now and always. We’ve coached on fully loving and accepting ourselves and how self-acceptance is like a warm self-acceptance blanket that is always readily available to you. No action needed ever. Then, we talked about self-love superpower and now we are digging deeper and talking about our relationship with ourselves and others. o What is a relationship? How we feel about another person is created by our thoughts about them and same with ourselves. Our relationship with ourselves is based on our thoughts and beliefs about ourselves. It also has to do with our expectations we have for other people and ourselves too and if other people meet our expectations we have for them or we have for ourselves. Sounds like lots of judging doesn’t it? Remember, when we are judging others we are often judging ourselves. o Here’s your playlist for the week “Shake It Off” by Taylor Swift “Brave” by Sara Bareilles “New Rules” by Dua Lipa “Stronger” by Kelly Clarkson “Feeling Myself” by Nicki Minaj feat. Beyonce You are 100% lovable, always and forever. Self-love superpower, Dr. Karla

Stress Less Sleep More: It’s Week 11 of the IME Reverse Your Insulin Resistance Challenge! • Welcome to Week 11 of the IME Reverse Your Insulin Resistance Challenge on TikTok, IG, YouTube and the IME Community podcast on Apple and Spotify. Check them all out and share with your friends! • Learning how to Stress Less Sleep More is a very important part of your overall health and health transformation and life goals. In fact, diet culture keeps us fixated on just one area and that’s focusing on the number of calories, but, what is really effective is focusing on all of our health, including Stress Less Sleep More. Plus, these two go together, so let’s get started! This week we are talking about stress reduction and sleep hygiene, which I will talk more about later. • Cortisol is our body’s stress hormone and the problem is our bodies are not meant to constantly be exposed to stress hormones, like in the case of chronic toxic stress that we will talk about on Thursday of the week as it relates to ACES or the Adverse Childhood Experiences Study. • Cortisol raises insulin levels and we are now week 11 of the Reverse Your Insulin Resistance Challenge, so we know that constantly elevated levels of insulin usually translates to weight gain and poor health consequences. Remember, you are worthy of your healthy life! I’ve coached you on taking massive action and starting with one goal at a time. Starting with taking action on a goal to Stress Less Sleep More means you are taking massive action on your health goals! You have the power to choose where to start. • There is a healthy amount of stress, but when we are continually exposed to cortisol, studies show that we become at risk to suffer from chronic diseases. • Remember, you are never stuck. I always believe in your unlimited potential to live your magical healthy life! Make sure if you are a teen, 12 to 18, or parent of a teen, that you go to imecommunity.com, sign up for my email list and get my Make It Fun to Get It Done 3 day email challenge! Make sure you Join IME Community where you will find it easy and fun to start creating results right away and get me coaching you on zoom! Get ready for the week! self-love superpower, Dr. Karla, ActivistMD

Do you fully love and accept yourself no matter what? Did you know that self-acceptance is always available to you like a nice warm blanket? Did you know that self-acceptance has nothing to do with your weight? Self-love superpower is why I created IME Community. Welcome to Self-love Superpower, Week 10 or the IME Reverse Your Insulin Resistance Challenge! We just wrapped up Week 9: Diffusing LowCarb Confusion. It was awesome! Make sure if you're a teen, 12 to 18 or parent of a teen who wants to LevelUp and get my expert coaching on zoom starting with teaching my 5 Easy Steps to say I aM mE, Join the IME member Community. It's easy, fun and you create results right away! I would love to coach you to create any result you want! Self-love superpower, Dr. Karla, ActivistMD

LowCarb is not zero carbs! Carbs are not bad. Eating LowCarb is not restriction. You don’t have to count carbs to eat low-carb. The low-calorie and low-fat diet craze that we’ve been attached to for decades has been an epic failure and has driven the epidemic of obesity, insulin resistance, metabolic syndrome, and all of the other psychosocial and economic costs that have come along with this epidemic.  Let’s drop it and our diet culture and thinking like a book.    We get to move forward with curiosity and the power of choosing for ourselves.  When I started my weight loss, health transformation and life coaching journey in September, 2017, I had no clue that it was going to include a LowCarb lifestyle.  I was literally “Clueless”, which is a great movie if you haven’t seen it.  By the way, Paul Rudd was at KU when I was there and Alicia Silverstone is on TikTok a lot these days.  Paul Rudd going to KU at the same time as me and that one time I saw Jack Black in the Orlando Airport Hotel at the elevator at 1am are my only claims to fame.    Cutting your processed carbs is not a cure all.  It’s not one size fits all.  You get to take an individualized approach.  If you are taking medications, you will want to consult with your physician.  Remember, I am not giving medical advice and I am not your doctor.    Monday Macros: What is Essential nutrition?  In other words what macros do our bodies need to function? Essential Macronutrients: Our bodies require us to consume protein and fat to function.  Protein and fat are essential nutrition for us to live.  Essential nutrition means that our bodies can’t make them on their own.  Studies have shown our bodies can produce glucose (energy source from carbohyrdrates) for energy even when we are not consuming carbohydrates. That doesn’t mean that foods that have   A well-formulated carbohydrate-restricted diet includes adequate energy, protein, fat, vitamins, and minerals. With adequate protein and fat, the dietary requirement for carbohydrate is zero (Institute of Medicine [U.S.], 2005; Westman, 2002).   Even when no dietary carbohydrate is consumed, glucose-dependent tissues are able to utilize glucose produced through gluconeogenesis and glycogenolysis (Westman et al., 2007). Because dietary carbohydrate is not essential, it need not be a primary focus for certain therapeutic nutritional interventions. Tuesday LowCarb LevelUp: Different levels of carbohydrate reduction Dietary carbohydrate restriction can take many forms. The term “low-carbohydrate diet” lacks specificity and has been used to refer to carbohydrate intake levels that are low only in relation to population averages and/or measured as a percentage of kcals, but do not reach the therapeutic levels of restriction referred to here. Therapeutic carbohydrate reduction refers to dietary interventions measured in absolute amounts (grams/day) that fall below 130g of dietary carbohydrate per day, which is the U.S. Dietary Reference Intake (DRI) for carbohydrate (see Institute of Medicine [U.S.], 2005). The following definitions for levels of carbohydrate restriction are based on protocols currently in use or on definitions found in the literature: ●  VLCK (very low-carbohydrate ketogenic) diets recommend 30g or less of dietary carbohydrate per day (Hallberg et al., 2018). ●  LCK (low-carbohydrate ketogenic) diets recommend 30-50g of dietary carbohydrate per day (Saslow et al., 2017). ●  RC (reduced-carbohydrate) diets recommend 50-130g of dietary carbohydrate per day, a level that is higher than levels listed above and lower than the U.S. DRI for carbohydrate. ●  MC-CR (moderate-carbohydrate, calorie-restricted) diets recommend more than 130g of dietary carbohydrate per day with a range of 45-65% of daily kcals coming from carbohydrate (“Carbohydrate Counting & Diabetes | NIDDK,” n.d.). In most cases, kcals are also restricted to maintain energy balance or to achieve a deficit for weight loss. This dietary intervention reflects the amount of dietary carbohydrate typically found in “carbohydrate counting” interventions given to many people with type 2 diabetes. What are Net carbs Wednesday: Definitions of carbohydrate intake levels may refer to either total carbohydrate content or to non-fiber grams of carbohydrate, as fiber is not typically metabolized to glucose. Using food labels or nutrition data, the calculation of total carbohydrate minus fiber is referred to as “net carbohydrate.” As no comparative studies of “total” vs. “net” carbohydrate have been done, clinical experience may inform which approach is best for patients. Protein Power Thursday: In contrast to carbohydrate, protein is an essential macronutrient because essential amino acids are unable to be made by the body and need to be provided by ingested protein. Patients may choose an omnivorous or plant-based approach in order to acquire adequate protein intake. The Recommended Dietary Allowance (RDA) intake for adults is 0.8g protein per kilogram of ideal body weight per day; however, this may be an underestimate of actual protein needs for many individuals (Layman et al., 2015; Phillips, Chevalier, & Leidy, 2016). When carbohydrate is restricted, dietary sources of protein and fat provide kcal in addition to providing the structural components of cells and tissue, therefore additional protein intake may be necessary, up to 2.0g protein per kilogram of ideal body weight. Even at levels above the RDA, protein intake on a low-carbohydrate diets typically remains within the acceptable macronutrient distribution range (AMDR) of 10-35% of kcals.   Yummy Healthy Fats Friday:   Therapeutic carbohydrate restriction creates a metabolic milieu in which the body can use fat as a primary source of energy (see also 3.1). Dietary fat provides essential fatty acids and is needed for the absorption of certain micronutrients (fat-soluble vitamins A,D, E and K). Foods that contain a combination of fatty acids—including monounsaturated, polyunsaturated and saturated fats—are recommended. As it has not been clearly determined that saturated fats in foods contribute to adverse health outcomes (Forouhi, Krauss, Taubes, & Willett, 2018), foods considered to be significant sources of dietary saturated fat are not usually restricted for this intervention. However, trans fats should be avoided. Trans fats are thought to contribute to disease through a number of potential mechanisms (Remig et al., 2010)     Saturday LowCarb take-out guide: The cool thing about eating lowcarb or trending lowcarb or whatever you decide to do is that you are adding in more protein and fat and will then feel more full.  Your blood sugars are stable when eating lowcarb and you don’t feel deprived.  So, don’t worry if you are going out to eat.  Many restaurants have lots of options that are actually LowCarb.  Check out the menu ahead of time and remember ABC Awareness Before Choice.  You’re going out for the experience and you can be assured you will eat well and feel satiated or satisfied.    Sunday keep it super simpleLowCarb planning – do you want to meal prep, plan one day ahead of time? No problem. You get to choose.  What works best for you and your life?  Just create some constraints around the planning and don’t overconsume recipes and get overwhelmed.  You don’t want to change everything up.  That’s not necessary.  Can you take the processed carbs and sugar out of what you usually eat for family meals and snacks?  Try a LowCarb Swap like a lettuce wrap or cheese wrap and make sure you are planning for protein, fat every time you eat.   Self-love superpower, Dr. Karla, ActivistMD

Life Coaching Teens on All or Nothing Thinking! Hey, Teens and Parents and Doctors and everyone, it's time to get out of all or nothing thinking. In this awesome YouTube video and IME Community podcast, I'll teach you about dualistic, black and white, on again and off again thinking, and the harms of staying stuck. When I am life coaching teens on health and weight goals, I teach them, step by step, all about how I created my own results. We can recognize when we think of other people as all good or all bad, or how we eat as all good or all bad, or our weight or ourselves as all good or all bad. It sounds like diet culture and thinking, doesn't it? As a pediatrician, life and weight coach for teens and parents, and board certified obesity medicine doctor, I can tell you that all of us get caught in all or nothing thinking and it keeps us stuck with our current results. If you're a teen who is ready to slay some life and health goals and want to get to your body's natural weight set point, then I'm ready to be your teen life and weight coach! Listen in and learn my step by step strategy to get you unstuck from all or nothing thinking and how to rewire your brain to have a self-love superpower pathway as you slay any goal you want! Make sure you go to imecommunity.com and click on Join IME Community to get access to me, Dr. Karla, and my step by step support as your teen life and weight coach, along with the fun of co-creating IME Community with other teens who are going through exactly what you are going through! You get to be body positive and achieve your health and weight goals! Let's start with kicking all or nothing thinking to the curb! Let's rewire our brains to create a self-love superpower pathway! How cool is that? Remember, as your teen life and weight coach, I'm accessible and always have your back. What could be better than connecting with me, Dr. Karla, as your teen life and weight coach on zoom from your phone or your room? IME Community is easy, fun and you create results right away! If you have questions, then reach out to me at drkarlaactivistmd@imecommunity.com. I can't wait to be your teen life and weight coach and co-create IME Community with you! Self-love superpower, Dr. Karla, ActivistMD

"Time after Time" by Cindy Lauper is the theme song of the day and everyday for those of us visionary pediatricians who keep speaking up and advocating for children and teens! I wasn't planning on doing a YouTube video today or IME Community podcast, but was made aware of a new study by Dr. Brynn Marks and her team at Children's National Hospital in Washington D.C. that showed that Type 2 Diabetes in pediatrics increased by 182% during the first year of the COVID pandemic based on their hospital data. Most concerning is the fact that black youth are disproportionately affected and that an increased number of patients presented with DKA or hyperosmolar DKA, which is very severe complication of diabetes. Boys were also more affected compared to their pre-pandemic data. Based on their data, there is not a direct correlation to positive COVID infection. Lack of preventative care and screening during the pandemic may have contributed as well as environmental and social factors, such as increased sedentary time, lack of structure and routine, more screens. What we know at IME Community is that our food system with processed carbs and refined sugars and the marketing and advertising to children and teens that conditions our brains to desire these foods, is a major contributing factor. The lack of access to healthy foods, including school meals, and how that increased during the COVID. With increased stress and emotional and mental health stressors and family stresses, increased marketing, it's easy to see how the intake of processed carbs and refined sugars is a contributing factor to the development of Type 2 diabetes. The most alarming data from this important study is more evidence of health inequities. We know where to start and where to put resources from a public health standpoint. "Time after Time" it's the same story. Us visionary pediatricians are going to keep speaking up and we will keep advocating. We are loud! Type 2 diabetes which used to be termed adult onset diabetes is related to Insulin Resistance. Where to start? First, more studies from other hospitals reviewing their data will be helpful. Share this important study. If you are a parent or a teen, make sure you get vaccinated for COVID if you can and also make sure you get to your pediatrician or family medicine doctor for your well child visit and preventative care and get the screening you need. Follow IME Community on social media and follow the 12 week Reverse Your Insulin Resistance Challenge. It's free and for everyone! Like and Subscribe to the IME Community YouTube Channel and the IME Community podcast on Apple or Spotify. Share IME Community with everyone you know! It's time for an innovative approach, so check out IME Community and if you are a teen or parent of a teen, ages 12 to 18, Join IME Community where self-love is your superpower to achieve your life and weight goals and make your mark in the world! Email me at drkarlaactivistmd@imecommunity.com if you have questions, a study to share, and don't forget if you are a teen with weight loss and health transformation goals, Join IME Community! Self-love superpower, Dr. Karla, ActivistMD  

CoachU Monday: Welcome to what I believe is the most important and foundational principle you will learn when it comes to life coaching, reaching goals, and chasing your dreams. First, what I’m going to teach you isn’t anything new? Psychologists, philosophers, scientists, religious leaders, have known and taught this through the ages and that is, drumroll please, your thoughts create your feelings and your feelings create your actions or behaviors. There you go! We’re done. No. It’s not as simple as just knowing that your thoughts create your reality or that your thoughts create your feelings and your feelings or emotions are what move you to action or inaction to either make yourself feel or not feel a certain way. Thoughts Anyone Tuesday: So, what are thoughts? A Rainbow that comes and goes, a sentence in your mind, a cloud going by. They’re really like vapor. Our brains offer up thousands and thousands of thoughts a day. Some thoughts are interesting. Some thoughts are wacky. Some are sad. Some are neutral. We are not our thoughts. I think that’s a huge relief because sometimes I’m like, that’s just nonsense. Good thing I know I’m not my thoughts. Thoughts create your feelings. Thoughts can be triggered by circumstances. Your current thinking creates your current results. Your current thoughts create your current reality! Beliefs are powerful thoughts Wednesday: So, where do we start? First, let’s start with a problem. Maybe you have a problem with a relationship in your life, or something going on at school, or your weight isn’t where you want it to be, or you’re stuck in procrastination or get overwhelmed with self-doubt and perfectionism. Maybe, you just want to start feeling better? Maybe you have a seemingly impossible goal you really want to achieve that feels like a mountain and you don’t think you have the equipment or what it takes to get you to the top. What I’m going to teach you is that the only thing in your way is your thoughts. And, it’s not really your thoughts as much as it is lack of awareness of the thoughts that create whatever feeling you are having or the problem is you are so attached to the thought that it’s almost like a belief coming up for you. All together now Thursday: Let’s talk about circumstances, thoughts and feelings. It’s a helpful way to organize our mind and to create self-awareness so that you can see how It’s so cool to become a powerful observer of your mind. Just be curious. Don’t worry if this sounds like we’re thinking about thinking. That is pretty much what we’re doing. Just having awareness of thoughts and not judging them, but being a curious observer of your amazing mind is so powerful. How do you want to feel Friday: So, what about feelings? This is so important! Feelings and emotions are everything. It’s our human experience. Thoughts create our feelings, which are just a vibration in our body. You can decide how you want to feel and then choose a thought on purpose that creates that feeling! How cool is that? Believing on purpose Saturday: We are not our thoughts. Like I said, most of our thoughts are just programmed or unconscious. You can also create deliberate thoughts, that are choices. It’s not like a quick switch. We have to program that thought in our brain and into our life with repetition. You are creating a new neural pathway. It’s called mental rehearsal, practicing believing a new thought on purpose. What’s a belief? It’s a powerful thought, that is on a loop that we choose to be true. Maybe, your beliefs serve you and you are going to hold onto them. Put it on the Result line Sunday: Notice what you’re thinking. We don’t have awareness of our thoughts usually. We are attached to the thoughts, and not questioning them. We don’t realize that we are not our thoughts. Again, thoughts are a rainbow that come and go. We are not our thoughts. Thoughts are optional. You can’t just start a new thought, but having awareness of the thoughts or thought that is coming up creating your feeling, actions, and your results, helps you to start shifting to on purpose creating thoughts that create the result you want. Learning to be aware and then let go takes practice and starts with just recognizing, then pausing, allowing any feelings or emotions that are coming up for you. Notice how that thinking creates your feelings, actions, and results. Once you truly understand that it’s your thinking causing all the rest, decide to change. Decide what you want your new result to be. What will you need to do, feel, and think to create the result? Try this on as a new thought to create your new results: I create a positive body image with my thoughts. A positive body image is always available to me. Self-love superpower, Dr. Karla, ActivistMD

Do you know the ABC's of Food Choice? IME Community Radio Blast! Welcome to another IME Community Radio Blast! Are you a teen, 12 to 18, who is overweight or struggling with pre-diabetes, high blood pressure, PCOS, fatty liver disease, body image? Are you a parent of a teen and you want a different and more empowering way forward to help support your teen's health independence? Join IME Community by going to imecommunity.com. It's incredible. I'm Dr. Karla, pediatrician, life and weight coach, and obesity medicine doctor and founder and coach for IME Community, the only web-based life and weight coaching platform for teens. Feel free to email me at drkarlaactivistmd@imecommunity.com if you have any questions. I love coaching and helping parents too. To get started with making changes to improve your metabolic health, reverse what's gone wrong and create the power of choice, all you have to remember is the ABC's of food choice. ABC stands for Awareness Before Choice. That's it. Take a pause before making your choice. No drama. Have your own back. Watch this YouTube video and like and subscribe to the channel and I will coach you on the ABC's and choice power. LevelUp and Join IME Community to really create transformation and get access to me, Dr. Karla, ActivistMD. I will always have your back and will help you make it fun to get it done! Today, I was listening to the radio and came across a song, "Born to be Alive" by Patrick Hernandez. It's from the 70's and should definitely stay there. Check it out if you want. The lyrics kind of fit what we do in IME Community. Let's live our big magic amazing lives and eat food that serves us. You'll want to listen to Janet Jackson's Escapade from the 90's. When the first beat really drops, you will thank me! Self-love superpower, Dr. Karla, ActivistMD

Let's Trust Our Teens to Make Their Own Choices! I'm jammin' out to Miley Cyrus' cover of Blondie's Heart of Glass. I could listen to that intro over and over and I do! What's on your playlist for today? Here's the deal, if you are a parent of a teen, we have to start letting them figure out their health and that includes what food they want to eat Your teen's weight has nothing to do with you as a parent. Have grace and compassion for yourself. You are coming from a loving place with good intentions and want what's best for your teen and their health. But, for your teen to develop self-trust and learn self-love superpower, you have to start trusting them to figure it out. That's why I'm so excited about co-creating IME Community with teens because I coach with compassion and meet each teen member where they are and support them along the way. Plus, they get the support of other teens from all over who are going through the same thing and making their own choices. It's called choice power. The skills to make their own choice power and make decisions that they want and decide on their measures of success is so powerful and is the skill that will lead teens to slay their goals, chase their dreams and live their big magic life. Join IME Community today by going to imecommunity.com. If you are a parent of a teen, 12 to 18, and you have questions about IME Community, please feel free to reach out to me via email at drkarlaactivistmd@imecommunity.com! Self-love superpower, Dr. Karla, ActivistMDLet's Trust Our Teens to Make Their Own Choices! I'm jammin' out to Miley Cyrus' cover of Blondie's Heart of Glass. I could listen to that intro over and over and I do! What's on your playlist for today? Here's the deal, if you are a parent of a teen, we have to start letting them figure out their health and that includes what food they want to eat Your teen's weight has nothing to do with you as a parent. Have grace and compassion for yourself. You are coming from a loving place with good intentions and want what's best for your teen and their health. But, for your teen to develop self-trust and learn self-love superpower, you have to start trusting them to figure it out. That's why I'm so excited about co-creating IME Community with teens because I coach with compassion and meet each teen member where they are and support them along the way. Plus, they get the support of other teens from all over who are going through the same thing and making their own choices. It's called choice power. The skills to make their own choice power and make decisions that they want and decide on their measures of success is so powerful and is the skill that will lead teens to slay their goals, chase their dreams and live their big magic life. Join IME Community today by going to imecommunity.com. If you are a parent of a teen, 12 to 18, and you have questions about IME Community, please feel free to reach out to me via email at drkarlaactivistmd@imecommunity.com! Self-love superpower, Dr. Karla, ActivistMD

Monday Mythbusters:  Calories are not the key to improving your metabolic health. It’s not that simple. Unfortunately, even though we can look around and see that simple calories in calories out thinking, just Eat Less Move More thinking, remains the standard of care in medicine.  It often doesn’t work.  It keeps us stuck in diet culture.  That’s been beat in our heads for ages -- to look at the back of a box and the nutritional information, the fat, the sodium, etc.. We are used to eating our food like this, in processed fashion where its value is determined by calories. Another false notion beat into our heads is that we need to count calories and burn as much as we eat through exercise to be a healthy weight.   Here’s the good news: simply eating less does not make you lose weight. “The low-fat, low-calorie diet has already been proven to fail,” said Dr. Jason Fung in his book The Obesity Code. You don’t have to eat less fat or calories to lose weight, but you do need to look at the quality and composition of your food and one way to improve the quality of your food is to cut down on processed carbs.   Let’s Learn more about Insulin Resistance Tuesday: Our bodies are so incredible and interesting.  Don’t fight with your body.  Our bodies are built to conserve energy.  Our bodies were not meant to be exposed to the added sugars in our food system.  Our brains are conditioned to crave sugar because of the added sugars in processed foods.  Obesity is hormonal and not simply caloric. When we eat carbohydrates or sugars, insulin is released to bring the glucose into the cells. Insulin binds to a receptor, like a lock and key, and then glucose can be transported into the cells. Nutrients like carbohydrates raise insulin the most, whereas fats release the least amount of insulin. Every time you eat or snack, you are raising your insulin levels. Excess sugar is stored as fat. Your body can become resistant to insulin. Insulin is linked to other diseases and comorbidities. For example, if your body builds resistance to insulin, you may become diabetic.   What is metabolic syndrome Wednesday? Metabolic syndrome is a constellation of findings and includes high blood pressure, high blood sugar or glucose, increased body fat around the waist, and abnormal cholesterol levels (HDL and Triglycerides) and is linked to increased risk for type 2 diabetes and heart disease.  About 1/3 of U.S. adults have metabolic syndrome.  Metabolic Syndrome is related to Insulin Resistance.  I’ve taken care of many teens with metabolic syndrome.    “We are the champions” by Queen   The risk factors for metabolic syndrome are: age, ethnicity, obesity, family history of diabetes, and if you’ve ever had nonalcoholic fatty liver disease, polycystic ovary syndrome or sleep apnea.  If you have one risk factor, you should be assessed for the others.   Gathering your metabolic health data Thursday:  What’s your risk for metabolic syndrome?  Metabolic syndrome is a complex condition.  These are important measures to assess your metabolic health. There are four main components of metabolic syndrome and four measurements: Blood Pressure, Waist Circumference, Blood glucose (sugar), and Fasting lipid panel (cholesterol)   “Rock the Casbah” by The Clash   How to think differently Friday?  You can always improve your metabolic health.  First, you have to reject diet culture and get out of restriction, on again and off again thinking.  You can’t look for answers outside of yourself.  So, this amazing information helps you get unstuck. Also, know your risks.  You are gathering data and getting information.  How important is this?  What’s my level of confidence?  What’s my readiness for change?  Remember, small consistent changes are what you need.  If you are a teen or parent of a teen, you’ll want to Join the IME member Community.  I’ll coach you to create the results YOU want and I will meet you where you are and always have your back along the way.  Also, remember, I never coach on anything I haven’t already gone through.    “Cars” by Gary Numan   Small changes create big metabolic health rewards Saturday? What you decide on is what works.  It’s that simple.  But, small changes are very important and over time can create long-lasting improvements in your metabolic health.   How consistent should I be Sunday? Remember when we talked about slaying your goals in week 6? If not, you may want to go back and review.  To take massive action doesn’t mean you are changing everything up all at once.  To transform or improve your metabolic health, what you need to be intentional about is showing up every day for yourself, create self-trust by keeping promises you make to yourself, having your back by being kind to yourself, and doing the thought work when you’re stuck.   “Party in the U.S.A.” by Miley Cyrus   Get ready for week 8 where I’m going to coach you to coach yourself! Now, this is the most powerful work! self-love superpower, Dr. Karla, ActivistMD

Diet Culture, "Don't Bring Me Down!" Welcome to another IME Community Radio Blast. My song of the day is from 1979. It's ELO's "Don't Bring Me Down". Hey, fixed and limited diet culture, I'm so very tired and done with you. It's one thing to say reject diet culture, but, how takes a bit more work. I talk about why diets have built into business model failure and shame, why they don't work for permanent weight loss or behavior changes, and how diet companies and food companies keep us coming back for more. Yuck! Don't bring me down, diet culture. Let's start questioning what we know doesn't work and start to fully reject diet culture and thinking. You can reach your health and weight goals and life and dream goals by joining IME Community as a member and get all the support you need from me and other teens who support you along the way! Go to imecommunity.com and join the community. Email me at drkarlaactivistmd@imecommunity.com with any questions! By the way, check out Electric Light Orchestra's "Don't Bring Me Down". It's an amazing song, especially when you are wanting to reject diet culture and all of the unfunny ways our society and culture have taught us we "should" be eating and losing weight. Self-love superpower, Dr. Karla, ActivistMD

Here we go! Arguing with fatdoctoruk on TikTok! I wasn't planning on this mini podcast, but here goes! I usually agree with about 50% of fatdoctoruk's content and same goes with this recent back and forth. Health and weight are not the same thing. I agree. Healthy weight loss is possible if that's what you want. If you reject diet culture and create your powerful why, learn self-love superpower, and make small simple changes that you are consistent with and never put your success or self-worth on a number on a scale, you will be able to move your body to your natural weight set point. Social determinants of health are very important in determining our health. Those are things like race, ethnicity, income, access to safe play spaces, affordable housing, healthcare including mental healthcare access, education, and healthy food access. We see the profound effects of ACES (Adverse Childhood Experiences) and chronic toxic stress and trauma on our health with the development of chronic diseases, including obesity. I'm going to tell you that you are not stuck. There are aspects of your health and life that you can optimize. I believe in your unlimited potential to create any result you want. That's why I created IME Community so that I can help as many teens as possible create their big powerful magic healthy life and follow their dreams. You are worthy of your health goals and you are never stuck! self-love superpower, Dr. Karla, ActivistMD

I can’t believe we are almost half-way through the amazingness of the 12 week Reverse Your Insulin Challenge! I’m having a lot of fun showing up on YouTube, IME Community podcast and every day on TikTok doing videos and coaching on TikTok Live.    If you have been participating, let me know how it’s going.  You can email me at drkarlaactivistmd@imecommunity.com.    Are you a teen or parent of a teen who wants to LevelUp and Join IME member Community to have access to my coaching on zoom?    By the way, I’m thinking about all of you as you are headed back to school.  This morning was my son’s first day of High School and also his 15th birthday.  He’s so hilarious.  I have three very funny kids.  It’s weird to call them kids since they are 20, 17 and 15.  I hope your school year gets off to a great start.  I’m sending lots of positive vibes out into the world to you.    Also, I’m thinking about everyone and COVID as we are in another very serious wave of the pandemic.  Health systems are completely stressed, ICU’s are full across the country, and it’s very serious.  I want to encourage you to get the vaccine if you are able to. My thoughts and prayers are with everyone. This is so very tough.   Last week was Week 5, “I Gotta Feeling” where I taught you to give yourself permission to feel your emotions instead of buffering with food.  What an important skill.  I love “More than a feeling” by Boston.  Each week builds on the next, but you can start this week and get going on slaying your goals and learning the truth about your body’s natural weight set point.    I wasn’t planning on addressing this, but there’s so much confusion, especially on TikTok, where creators are saying you are stuck at your current weight.  Nope. Nope. Nope.  Now, there’s absolutely nothing wrong with staying at your current weight.  Let’s drown out our society’s ridiculous noise that perpetuates diet culture and isn’t healthy mentally or physically for any of us.  So, if you don’t want to make changes.  No problem.  You get to decide.  If you do want to create a healthier life, you can start wherever you want.  Fueling our bodies with healthful balanced  food that serves us is possible and there’s some great data about that.   I recently saw an article in the NYT about a recent study out that looked at metabolism and is disrupting what we thought about metabolism as we age.  So cool!  There are four stages of metabolism in our lifetimes.  This study is definitely disrupting the status quo thinking about metabolism.   There’s only a handful of us doctors across the country and actually, globally, who are disrupting what doesn’t work.  We don’t take sponsorships or ad money.  There’s some amazing data.  There’s so much frickin’ confusion out there, it makes me want to pull my hair out.  Listen to experts, especially those of us physicians who are willing to speak out, say where healthcare has gone wrong, and are helping as many as people as possible to create a healthier path.  What’s also powerful, is that there are some of us physicians who have also gone through our own weight loss journey.  The importance is the focus on metabolic health and reversing insulin resistance.  You can check out the Society of Metabolic Health Practitioners website at smhp.org.  I’m a founding member and proud of it.   Our bodies are status quo homeostasis machines.  Our bodies adapt to what we are fed.  Sure, it’s more complex than that.  Making the change to cut back on processed carbs and then being consistent over time is going to show some major improvements in your metabolic health and help you to reverse insulin resistance. Let’s get to goal slaying.   So, I’m a major goal slayer.  My top strength is Activator and I can grind out a goal with diligence and persistence like nobody’s business.  I can also make it pretty grueling on myself.  I’ve learned the tools of self compassion and I created Make it fun to get it done and learned that goal slaying can be fun and also it’s not being hard on ourselves that works.  It’s self-love superpower. When you learn to be kind to yourself no matter what and have your own back, it’s so powerful.  You can do anything.  All of this is practice.   I’ll tell you the secret to any goal I’ve slayed. The key to any goal slaying is staying with your vision.  It’s an elevated approach.  It’s not about the how.  It’s like looking up and taking a 40,000 foot view.  You are the butterfly and not the caterpillar.    Expect to feel self-doubt, confusion and overwhelm, fear of failure, victim and lots of discomfort along the way.  There’s nothing going wrong.  Discomfort is the currency of our dreams.   Let’s get going with the week!   Monday Goal Slaying Motivation:  Choose the goal that commands your attention! What’s your biggest pain point? What’s the biggest obstacle in your way?  What’s the trade off?  Experience temporary discomfort now while achieving your goals and dreams or the long-term discomfort of not achieving your dream?      Choose Your Goal Tuesday :  Pick a 30-day goal.  Choose one goal at a time.  I’m sure you’re really excited, but choosing one goal at a time is very important.  Otherwise, you will most likely indulge in overwhelm and that will keep you from taking action on any of your goals.   Choose a goal that motivates you, so how important is achieving this goal and is there value in achieving this goal?  How does this goal fit into the bigger picture of my life?  Am I interested in the outcome?  Drink more water? Cut back on processed carbs?  Crush your sugar cravings?  Work on self-trust eating?  Get more organized?  Increase your fitness?  Get better sleep?  What’s your goal and why do you want to achieve it?  Why will I do it no matter what and who has your back as you are reaching your goal?    SMART Goals Wednesday:  What’s a measurable goal?  You get to decide how you measure your success. What’s SMART stand for when it comes to setting goals? SMART is an acronym used for any type of goal setting.  SMART goals help set you up for major goal slaying success! SMART stands for Specific (make your goal clear and figure out exactly where you will end up when you have achieved your goal) /Measurable (It’s important to figure out how you will measure your success so that you know when and can celebrate when you’ve achieved your goal.  By this time, I will have completed and created (insert goal).  I will know I’m done because of _______ You can also create your own measures of success.  Did I show up as my authentic self?  Did I coach with compassion?  Did I learn something new?  Did I hold space? Did I have fun? How? .    /Attainable (make sure your goal is possible, If you set a goal that is outside of your realm of possibility, your brain will use that as evidence to criticize and that will cut down on your confidence.  /Relevant means that the goal matters in the bigger picture of your life /Time Bound   Take Massive Action Thursday:  Now that you have your goal and your SMART goals, it’s time to get going.  Self-trust is created by taking action.  You are learning to show up for a goal you set for yourself.  That’s super powerful.  Write down everything you need to do to in the next 30 days to get to your goal.  Break it down into steps.    Make it Fun to Get it Done Friday: Since this is IME Community, I’m going to teach you my entire philosophy which is to Make it Fun to Get it Done.  Start by owning your goal, then get yourself all amped up to take action like Dwight from The Office before a sales call when he was jamming out on air guitar in the backseat while Jim waited patiently outside the car for Dwight to do his thing.    Superhero Saturday: Self-love is your superpower to achieve your goals and dreams.  Some of you may not have even heard of Superman.  You should watch the movie, “Superman” with Christopher Reeves, best Superman ever.  Some of the special effects in that movie are hilarious.  Clark Kent was Superman’s version of a nerdy base level human.  When the world needed saving Clark Kent would go into a phone booth and come out as hottie Superman.  Well, you are your own superhero.  You are able to go into a phone booth and put on your self-love superpower cape and go save the world.  No pressure!     Sunday Strategizing:  What are the obstacles in your way? What’s in between you and your goal?  What’s hard about your goal?  What do you need help with?  Now, turn your list of obstacles into strategies.  You can turn your obstacles into strategies which clears your path to achieve your goals.  A strategy could be a skill you need to develop.  Here’s an example: If your goal is to eat sugar in moderation, one obstacle may be “I have lots of urges and cravings to eat sugar.” Strategy examples are: “Even though my sugar cravings are conditioned, my brain can be conditioned to create a healthier pathway.” “ I will create a pause when I have an urge or craving to eat sugar.” “ I will keep an urge jar and only count my wins.”     Now, get it all on the calendar and mark off your wins! You’ve got this! Self-love s;uperpower, Dr. Karla, ActivistMD  

Hey, Are you a teen struggling with your weight or body image like so many of us, especially with the COVID pandemic? The epidemic of childhood and teen obesity has gotten worse during COVID. IME Community is the first and only web-based life and weight coaching community for teens. Do you want to be both body positive now and also reach your health and weight goals? Have you gained weight during COVID? Has your doctor told you that you are pre-diabetic, have PCOS, Non-Alcoholic Fatty Liver Disease, High Blood Pressure, Obstructive Sleep Apnea? Do you feel stuck and overwhelmed? Are you stuck in a sugar urges and cravings cycle? I'm here to tell you that you are not stuck! Want to reject diet culture and create a healthy way forward that is full of self-love and fun? I'll teach you all the tools I had to get healthy and transform my life. Welcome to IME Community Radio Blast "Every Rose Has Its Thorn". I love that song from start to finish. I heard it today after I dropped my son off for his second day of High School. That song made me think of going to High School in the 80's. It was a pretty wacky time to go to High School. Also, very fun. I want you to have fun now too. I want you to give yourself a lot of grace as you head back to school. Parents, if you are concerned about your teen's physical, emotional and mental health, you'll want to check out IME Community too. Join IME Community today! It's easy, fun and you'll start creating results right away! Let's get going on your healthy weight loss path! Go to imecommunity.com and check it out! You can also email me with questions at drkarlaactivistmd@imecommunity.com. Self-love superpower, Dr. Karla, ActivistMD  

Here’s your latest IME Community News Headline: Social Media Friend Drama Causes Teen to Buffer Emotions with Food   Coach:  How did you feel when she blocked you on IG?    Teen: “I don’t know.”    Coach: Can you describe it?  Where is it in your body?  What color is it?    Teen: “I don’t know really.  I just felt upset.”   Coach: Why did you feel upset?   Teen: “Because I just did. I have no idea why she blocked me. I didn’t do anything.  I can’t think of any reason why she blocked me.”   Coach:  What do you do when you feel upset?   Teen: “I was doing so great before she blocked me and then had so many more cravings for food and ate so much and felt out of control again.”   In IME Community, teens are learning the skill to allow emotions instead of numbing out with food, how to show up as a friend to themselves first, and how to show up and where to put their attentional focus on social media.   I love helping teens to stop self-judging, to have the self-confidence to achieve their health goals and create a big magic dream for their future.   So, what is an emotion or feeling?  It’s a vibration in your body created by your thoughts.  Your thoughts create your feelings.    I can’t believe it’s already Week 5: “I Gotta Feeling” of the Reverse Your Insulin Resistance Challenge!   This week is for all of us, social media friend drama or life drama.    This week, I’m coaching you to give yourself permission to allow all your human feelings and emotions.   If you are an adult, don’t you wish you had learned these skills when you were a teen?   Are you ready? Let’s go!   Mood Ring Monday! Do you remember mood rings?  I had several that turned my fingers green.  I was obsessed with checking in on the current color of my many mood rings to find out what my mood was at any given moment and if my many mood rings were in sync.    Mood rings are a perfect metaphor for how our culture externalizes our emotions.  It’s just like our society to teach us to watch the changing color of a mood ring instead of giving us permission and teaching the skills to allow us to get internal, check in with ourselves throughout the day and create emotional awareness.    What’s your mood this Monday?   Try on a metaphor Tuesday!   As someone who has had to learn the skill of allowing my emotions, and as a pediatrician for 25 years, and a Mom of 20, 17, and 14 year-old humans, and mostly from what I’ve learned through the amazingness of coaching teens, I know it’s super tough for all of us to describe how we are feeling.    One tool I use when I coach teens who are stuck is to create a metaphor for their feelings and emotions.   What’s a metaphor that works for you to describe how you are feeling?  Calm like in a swimming pool, sad like a weighted blanket is on you, excited like it’s your birthday?   I’m sure with school starting no one feels excited. Well, I always did.  Nerd alert.   Welcome all emotions Wednesday! In our society and culture, we are not taught the skills or even given permission to feel our human emotions.  That leads us to think there’s something wrong when we perceive a negative emotion, so we end up reacting, resisting, or avoiding, instead of allowing all emotions to pass through us, so we can be present in the moments of our lives.    Whether you are resisting, avoiding or reacting, your emotions are there under the surface or buried deep.    When you learn to allow and even welcome all your human emotions, you find a freedom you never had.  You find freedom from buffering with food.    Ask yourself, “What would it feel like if I welcomed all my human emotions?”   Don’t ride the Thought Train Thursday! Thoughts create your feelings, but that doesn’t mean you have to do anything other than recognize feelings and how emotions come up in your body. Don’t overthink your feelings.  Don’t spend a lot of time chasing down the thought train of what’s creating your feelings.  Later, you will be able to do more thought awareness, but recognition of feelings is key at the beginning.   How are you feeling Friday? When was the last time someone asked you, “How are you feeling?” Did they truly listen and care about your answer? You can listen to yourself and care about your answer.  “I care.”- This is a super cheesy line Luke Skywalker says in Star Wars.  It’s Mark Hamill’s super cheesy delivery that gets me every time.   So, I will ask you on this fine Friday, How are you feeling?   Permission to Feel Saturday! Do you get critical and judge yourself for feeling sad, anxious, tired, disappointed?    Recently, I’ve been feeling disappointment, but instead of allowing the feeling of disappointment, I was depleting my energy stores by resisting it.  I was making feeling disappointment mean that I was disappointed in myself and that didn’t feel believable.    So, through coaching, I created a space, took some breaths and decided to say to myself, “I feel disappointed.” Then, I left it at that.  It felt empty and gray and hollow to me.  I just accepted I felt the human emotion of disappointment and didn’t make it mean anything else.    Ask yourself, “How can I give myself permission to feel all of my emotions and not judge myself for having a human emotion?”   Sunday Mindfulness I coach teens to recognize what they cause and control, which is mainly deciding how they want to show up and where they put their attentional focus, and that all feelings are part of the human journey and there’s nothing going wrong when they perceive a negative emotion.    What would it feel like to respond to your emotions instead of reacting, avoiding or resisting? What mindfulness practices help you calm your mind so you can respond instead of reacting, avoiding or resisting?    

Hey Teens and Parents of Teens!  I'm excited to be doing more IME Community Radio Blasts and coach you on the daily on what's coming up for teens.  Are you struggling with pandemic weight gain?  More social anxiety, especially as you are headed back to school?  I know.  I know. Don't mention it.  First, I want to ask you what are you proud of this summer?  It doesn't have to be a major deal or accomplishment, but what are you proud of?  Did you show up?  Were you a good friend?  Honor what you are proud of.  Then, as you are getting ready to go back to school, decide how you are going to show up as a friend.  Since so many teens and all of us have more social anxiety with the pandemic, I'm going to suggest that you decide ahead of time how you're going to show up to stay out of friend drama.  You don't have to convince people to like you.  School is a fresh start.  Reflect on what you're proud of this summer and move into the year with intention to show up how you want to show up.  You get to choose to be friends with people who see the humanity in you and show up as the same kind of friend you are.  Start by being a good friend to yourself.  A song I'm listening to this week is by Concrete Blonde called, "Joey I'm not angry anymore."  Such a cool song. What are you listening to this week? self-love superpower, Dr. Karla, ActivistMD

Movement Monday: Your body was made to move!  7- day FITTE challenge.  What’s your why?  Don’t make it about calories in calories out.  Stay out of all or nothing thinking.  Stay out of waiting for motivation to come to you.  All movement counts. You are an exerciser.      Physical Activity History (remember your past self is only your thoughts about your past self): Success and/or failure (it’s all learning) of previous physical activity/exercise efforts If no longer doing routine physical activity/exercise regimen: When? Date of change What? Cause of change Why? Identify barriers to re-engagement   Current physical activity? Current fitness level, endurance capacity, and mobility?   Access to locations for increased physical activity/exercise (e.g. gym, workplace, exercise facilities, bike paths and walkways or trails, urban or rural home setting)?   Actual and perceived barriers to increased physical activity?   Tracking Tuesday:  Know yourself.  Accountability partner needed?  Don’t count calories burned unless you are already doing this or if you have managed your mind.  Are you working towards a goal like walking a marathon a week?  Getting your steps in on the daily? Create self-trust by documenting the evidence that you are moving! Tracking Progress: Daily activity logs (written or electronic) Pedometer/accelerometer logs Dynamic training metrics (miles run, laps swum, etc.) Resistance training metrics (i.e., muscle-circumference measurements, reps, sets, etc.) Percent body fat measurements   Wednesday Wisdom:  Let’s nerd out.  What’s your target heart rate?  Check your resting heart rate which is the number of times your heart beats per minute when you’re at rest.  A good time to check is in the morning.  Your maximum HR is about 220 minus your age.  AHA (American Heart Association) has a table that shows Target HR zone during moderate intensity activities is around 50-70% of your maximum HR.  So, for a 20 year-old your Target Heart Rate is 100-170.  If you are just starting out, aim for the lower range of your target heart zone (50 percent) and gradually build up.      Thursday Thoughts:  Time for a Thursday belief upgrade? There’s nothing going wrong if you are uncomfortable when you are exercising.  You can take a break when you need to. Practice self-compassion.  Don’t make it mean anything about you or start believing what your brain will be offering up, thoughts like, “See, you are not meant for this!” I put this in quotes because this is an actual quote from my inner critic.      A belief is a powerful thought on a loop in your brain that you most likely haven’t challenged.  Remember, thoughts are optional and you are not your thoughts.  Same with beliefs.  My beliefs about myself and fitness? Now, do a belief upgrade.  Here’s an example of a belief upgrade I worked on with my fitness coach.  1.) I’m not an athlete.  Upgrade: My body was created to move.  I am an active person.    Friday Fitness Fun:  Try something new and challenge yourself. You won’t know unless you try.  You may love it.  You get to choose what is fun for you.  Find a friend and try new things.  You can keep it simple like a new walking route, going to a new park, trying Zumba or boxing.    Saturday Success:  Increase your NEAT! Let’s focus on activities around your house and yard and running errands.  Make sure you are moving throughout the day.  What’s NEAT? It’s Non-Exercise Activity Thermogenesis. Not all physical activity is exercise.  NEAT is energy expenditure not typically considered physical exercise (standing, walking, stair climbing, fidgeting, cleaning, singing, and other activities or daily living).  Increase your NEAT: Take stairs instead of elevators; park further from a destination, monitor number of steps per day with a pedometer.     Sunday Strategy:  Write your own FITTE Exercise Prescription:   IME Community Exercise Rx:   Aerobic Activity   Type:   Walk    Jog       Swim   Bike     Elliptical   Frequency (days/week):   1    2          3          4          5          6          7   Intensity:        Light    Moderate        Vigorous   Time (minutes/day):   10        20        30        45        60   Make It Fun:  Music              Buddy              Dance              Class_______   Strength Training:   Do muscle strengthening exercises of moderate intensity at least two days per week Not all activities require going to a gym. You can use resistance bands or do body-weight exercises (e.g., push-ups, lunges, planks, squats, jumping jacks as you are able).    NEAT (Non-Exercise Activity Time): Park farther away from entrances. Take the stairs instead of the elevator/escalator. Stand instead of sit. Set a steps/day goal:___________ Other: ______________________________________________   Signature of Commitment: Dr. Karla/­­­­­­­______________________________   Get ready to Feel your emotions for Week 5 of the Reverse Your Insulin Resistance Challenge!

Ready for Week 3 of the Reverse Your Insulin Resistance Challenge?  Let’s go! We're talking urges, cravings and buffers this week.  This is powerful work.   Monday Motivation:  What are the ways you buffer?  Food, social media, shopping, sleeping, procrastination?  All of the above? What are the negative consequences of buffering in your life? Poor health, weight gain, not achieving your goals, not getting the grade you want, feeling a lot of negativity?   How will you manage your urges to give in to buffering? Start recognizing when you have an urge and think about stimulus control and contingency management that I talked about last week.  You can create an environment and a plan to help decrease your urges and cravings that lead you to buffering.    Tuesday Tracking:  What times of day do you have urges and cravings and tend to buffer with food?  Write it down.  What are some of the trigger foods for you that once you start eating them you get in kind of a fog?  It’s okay.  You can learn to eat those in moderation.   Get foods on your plan that serve you if you are hungry and have an urge, craving or desire to buffer.   Wednesday Wisdom:  After you allow about 100 urges, the urges will start to dissipate. Allowing an urge means feeling your emotions that are coming up instead of looking to an external source like food to fix your feelings.  Since buffering with food is what you do to avoid pain, when you stop buffering, you will feel pain.  The emotion is still there even when you buffer with food.  You can handle it.  You can learn the skill to allow your human emotions.    I really like the book, “LiveWired” by David Eagleman a neuroscientist, researcher and writer at Stanford.  It’s so interesting.  His research shows that our brains are malleable and adaptable if we challenge our brains.  What we focus on we create more of.  Keep giving all your power away to urges, you will keep buffering and stay stuck!  Start challenging your brain and start allowing your emotions and you will be well on your way to break the cycle! You can unstuck (is this a word) your brain! So cool and nerdy!   Thursday Thoughts: What emotions are you attempting to avoid when you buffer? What are your thoughts that cause your emotions you are trying to avoid when you buffer? Take some time and get curious. You are creating self-awareness.  You are not your thoughts and thoughts are optional.    Friday Fun: Can you shift to other thoughts that serve you?  How can you enjoy food, keep it simple, and have an exciting life?  What are you doing for fun this weekend?  Focus on what’s fun instead of what is a short-term pleasure like a sugary dopamine zing.   Saturday Success:  Get an urge jar that creates evidence for yourself that you are figuring this out.  Only count the positives.  Put a bead or marble or $1 in every time you allow an urge instead of buffering.  Now, how will you celebrate your wins?  Of course, I’m going to suggest not using food as your main way to celebrate.   Sunday Strategy:    What are the ways that you showed up as your Future Self this week?  What did you learn about yourself? Spend some time asking yourself these important questions: What are your true pleasures in life?  What’s meaningful?  If you’re a teen, maybe you don’t know yet, so you get to figure this out.  So fun!  

Welcome to Week 2 of the Reverse Your Insulin Resistance Challenge (RYIR challenge).    The focus for Week 2 is stop overeating and power of choice.  It’s all about individual autonomy.  Sounds redundant!   Everyone asks me and I get a lot of emails and requests for coaching for adults.  I get to help everyone with reversing insulin resistance and reaching health goals on TikTok and IG, but coaching teens is my favorite.  It’s why I started IME Community and it’s my dream and vision.  So, if you’re a teen 12 to 18 or parent of a teen, check out IME Community and Join the Community to get life and weight coaching on zoom with me!  It’s only $24.95 per month.    I also coach parents to help support your teen’s health independence.    If you’ve done week 1 of the RYIR challenge, awesome, and if you are getting started now, then, great.  You can catch up easily.  I would encourage you to get do Week 1 of the challenge because it sets the stage for a lot of the important goal slaying!   I’m giving away a Free one on one life and weight coaching session with me every week to participants who post on TikTok or IG.  So, post and get in the giveaway drawing.  I’ll also be giving IME Community merch and my children’s book, “the magical everywhere”.    For week 1, the most powerful why was from Anne who shared about her 16 year-old twins who are on the autism spectrum and are dependent on her and she said, “I want to feel like ME again.” So awesome!  Anne, get ready for your life coaching session!   Here’s how you can participate in the challenge!   Get on IG for daily posts, follow IME Community on TikTok watch the daily videos and participate on TikTok Lives.  Next week, I’ll start doing IG Lives.    Follow on YouTube, Like and Subscribe to YouTube channel and IME Community Podcast.    Get an accountability partner or group.  It’s fun!   Ready for week 2?   I’ve got your back this week.  We are going to learn why we overeat, how to stop overeating and Level Up with food with the power of choice.   We all come in different shapes and sizes.  Let’s celebrate that.  What a boring world we would be living in if we bought into our society’s messed up external standards. For many of us, we want to create a healthier and more fun life for ourselves.    We have to take a look at the root causes of overeating. One of the simplest ways I’ve heard we are overweight is because we overeat.    That sounds so simple and we’re talking reversing insulin resistance which is more complex.  To say we are overweight because we overeat is kind of like the old calories in calories out mentality that I keep encouraging us to stay away from.   There so much cool science behind hunger and appetite and the hormones and neurotransmitters that keep our bodies at our current weight set point.  That doesn’t mean we’re stuck.  Genetics, including what we’re learning about epigenetics, our environment, and behavior all contribute to our health.    But, the reality is we do overeat and overeating is one of the contributors to weight gain.  Everyone overeats sometimes.  There’s no shame in it.  I’ve really had so much desire to overeat in my life.  I still have it at times.    There are many factors that contribute to why we are overweight.  We are not cause and effect machines.  I’m going to talk about how to get to the root cause of our overeating and ask that you create some self-discovery and self-awareness which is the most powerful thing ever we could do.     So why do we overeat?  We overeat because we have over-desire.  I did a few tiktok videos on this and specifically on what I think are the top three reasons we over-desire food.  I want you to spend some time on this because I had many more than three reasons, but I picked out what I believe are all of our top three reasons.    Why do we over-desire food? We are conditioned to over-desire and overeat food because of the added sugars in our foods and beverages and all of the marketing. This is brain science.  Please have grace and compassion for yourself.  We haven’t been taught the skill or given permission to allow or feel our emotions. Instead, we are taught there is something wrong and we fix or numb out with food. We are stuck in fixed and limited diet culture and thinking which drives a restriction and indulgence cycle and creates over-desire for foods our society tells us are “bad”.   One of the ways to get out of our over-desire for food which causes us to overeat is to recognize that you always have the power of choice.  You get to own your power to make choices that serve you and your health goals. Individual autonomy means you are deciding for yourself and that means you are owning your choice.    Week 2, I’m going to help you Level Up with food choices and you always get to decide! Let’s go!   Monday Motivation: I would love for you to enjoy food and eat food that serves your body and your health goals.  This all starts with self-love, which I believe is the only superpower you need.  Self-love starts with full or unconditional self-acceptance. I would love for you to check out the IME 5 steps to full self-acceptance.  Self-acceptance is always available to you.  It doesn’t even take action.  Just take your warm self-acceptance blanket and wrap it around yourself whenever you need it.  Say to yourself, I fully love and accept myself.  I accept that I am worthy of my healthy life.  I accept I have the power to choose what I want!   What are the reasons I overeat?  What relationship do I want with food?  On a scale of 0 to 10, how important is it for me to make changes in how I am eating? On a scale of 0 to 10, how confident am I that I can make changes in how I am eating? What’s in my way?     Tuesday Tracking:  Today is when you Level Up (Gamer talk) with the power of choice!  Woot! Woot! All levels are taking massive action.  Where are you on your stage of change and what makes sense to you?  Level Up with Mindful Eating- hunger scale pre and post meals, plan one day ahead of time, gather data, simple eating guidelines; Level Up to crush your sugary beverage habit and drink more water- replace with the positive and create SMART goals; Level Up to healthful balanced meals where you keep it simple-transition to eating complex carbohydrates (like vegetables and whole grains) instead of simple sugary carbs that keep us in craving mode and increase IR.  Make sure you are eating protein and healthy fat whenever you eat.  Want to Level Up to trend low-carb?  At this level, you are ready to remove flour and sugar and create a low-carb lifestyle.  Keep it really simple and take out flour and sugar from what you usually eat for meals.  Don’t overconsume recipes.  Instead, just think of low-carb substitutions.    Wednesday Wisdom: What to expect?  Your brain is going to tell you to eat sugary foods.  That’s what happens when we are conditioned or habituated to eating sugary foods.  There’s nothing wrong.  It’s okay.  It’s transitional.  You may feel more emotional or irritable because your body and brain are used to numbing out and getting dopamine zings.  This is an opportunity to create self-awareness.  Go at your own pace.  No timeline or urgency.  It’s all learning. Research shows practicing stimulus control and contingency management is helpful to keep you on track. That may mean removing sugary drinks at home, driving a different route home instead of by the fast food restaurant you go through after work, or recognizing the time of day when urges and cravings come up for you, and creating a pause and practicing self- compassion instead of resisting the urge and white knuckling through it.  Create plans A through G for your eating.  You are making decisions ahead of time that will keep you on track.    Thursday Thoughts: Keep up with your daily thought downloads where you do a brain dump.  Start noticing your three top feelings of the day.  It’s our thoughts that create our feelings.  What are your thoughts that are creating the top three feelings of the day?  You may be judging yourself.  Start creating awareness of self-judging and shaming.  We have to bring this into the light to disrupt it.    Friday Fun: Do you have an active gratitude practice?  Everyday write down three things you are grateful for in the morning and three amazing things that happened today before you go to bed.  Cultivating an active gratitude practice creates a joyfully abundant life.  We have to be intentional with the practice.   Saturday Success: You are worthy of your health goals.  Some people I coach want to create a cheat day on the weekends.  They spend a lot of the week creating more over-desire for the sugary foods they eat on the weekend and then end up binging.  I would encourage you not to do this.  When you make a decision and like your reasons and love your choice and it fits into your why and your Future Self, you can love your decision, have self-integrity and create evidence that you can trust yourself to keep promises you make for yourself.   Sunday Strategy:  Rest, relaxation, self-care, connect with nature.  To set yourself up for success for week 3, I want you to calendarize (yes, this is a verb) self-care.  My husband asked me if I wanted to get a massage and I said, “No, I’m really not into those.” Self-care for me is getting outside, writing, getting some time alone, eating yummy food, taking a shower.  What does self-care mean to you?  Get it on the calendar for week three. 

Welcome to the IME Reverse Your Insulin Resistance Challenge (RYIR)! It’s the Kick Yourself in the RYIR Challenge! Yes, my children who are 20, 17, and 14 are making fun of the name.  That’s their job to make fun of their Mom!   I’m so excited! I’m having a blast with this.  IME Community is up to nearly 30k TikTok Followers from all over the world, so let’s really move the needle and create a healthier path!   I’m sharing with you all of the details of the RYIR Challenge starting with this email, and then suggest you check out the IME Community podcast and YouTube video, which I will be doing weekly, so make sure you like and subscribe to the IME Community YouTube channel and podcast on Apple or Spotify.  Make sure you follow @imecommunity on TikTok and/or ime_community on IG.    The RYIR Challenge is on TikTok, and I will share on the other IME platforms.  It’s 12 weeks, starting this Monday, so get excited! It’s 12 weeks because that’s what it takes to create a habit stick.  All you need is a notebook, journal or binder and I also suggest an accountability partner (s) if that works for you.  No problem, if not.   Here’s what I focus on: self-love superpower or the tools of self-compassion; the science behind how to reverse your insulin resistance; and the coaching tools you need to achieve your goal.    Starting Monday, I will be posting a daily video and do TikTok Lives daily.  Teens, 12 to 18, and parents of teens, you can have me as your life coach, so go ahead and Level Up and join the IME Member Community.  I created accessibility for the membership, which is only $24.95/month.  I coach parents of teens to support their teen’s health independence, in the member community, so awesome deal for the whole family!   Week 1: Let’s get this party started! The theme of this week is take action! Action is how we learn and discover ourselves, grow and evolve, but only if we are creating awareness and putting in the thought work along the way.  Action will not be served up or delivered in a nice little package.  It doesn’t matter what action you decide to take.  Just take action and commit to loving your decision.  If self-doubt, fear of failure, imposter syndrome, beliefs about your past self are coming up, there’s nothing going wrong.  That’s just what our brains do when we decide to take action.    The first week, we are focused on taking action and then starting to plan one day ahead of time, but won’t be focusing on food changes, more like getting an assessment of where you are.  Don’t send me your food.  I don’t care what you eat.  This is you figuring this out.  You own this.  You can ask me questions, but I don’t give grocery lists.   Be a curious observer of your mind! You are creating self-awareness.    Here’s the breakdown of Week 1: Monday Motivation:  What do you want? What’s your desired outcome? What’s your why? What’s your commitment? What do you have to lose if you don’t take action? What will you gain if you take action?  What’s in your way?   Tuesday Tracking: Let’s learn to make decisions ahead of time.  Making decisions from your higher brain, executive functioning or pre-frontal cortex means you won’t be making impulsive in the moment decisions about food.  Plan one day ahead what you will eat and just write down what you are eating on a typical day.  We are only learning to plan one day ahead and show up for a plan we created for ourselves. If you want to write your food down at the end of the day, that’s fine too.  It’s data.    Wednesday Wisdom:  Are you owning your health power? Have you seen your doctor, had your labs, and know your risk factors for insulin resistance?  You’re not stuck, even if you have a strong family history or have had insulin resistance for a long time.  You can optimize your health.  It’s good to have a baseline and embed goals in reality.   Thursday Thoughts: Start daily thought downloads or brain dumps for a few minutes.  What are your beliefs about your past self?  What about your health now? Your weight now? What are your beliefs about your past weight loss?  What are you making it mean about you and achieving your health goals now?   Friday Fun: Here’s my favorite work.  Visualize your Future Self who has arrived at your goal! How do you feel as your Future Self?  That feeling is what drives the actions to create your results.  Our thoughts create our feelings, so, what is a thought that creates that feeling?  Think of three Future Self guidewords that motivate you.  Mine are Funny, Unapologetic, Firestarter.  What are yours? Put them on a post-it note and stick them everywhere and look at them every day.   Saturday Success: How do you measure success?  You get to decide.  How do you celebrate in ways that don’t involve food?  We are learning to lead an exciting life and be in the moment and eat food that fuels our exciting life.   Sunday Strategy: Spend some time reflecting on the past week.  What was hard?  What was easy?  What are you proud of? Remember, to practice self-compassion.  Now, put week 2 on your calendar!     You will learn a lot.  This is a fun challenge.  I will not be giving you medical advice.  I encourage you to go to your doctor, to address diagnoses related to weight first, and to go to your therapist, have your own coach, all the things.  This will be a fun add-on.    What about fitness?  Keep doing what you are doing.  I believe in all movement counts fitness.  Sometimes, at least I know I was, stuck in thinking about exercise the same way I thought about food.  So, movement counts. You are an exerciser no matter how much you are moving.    Let’s get this party started!  Stay tuned for week 2! Teens and Parents, don’t forget to Join the IME Community by clicking  below!   Self-love superpower, Dr. Karla, ActivistMD

DO NOT TELL ME WHAT TO EAT! I have this edge to me. You do too.  No doubt.  It’s what it takes to achieve goals.    “Don’t say good job, say bad job.”  My daughter, Katherine, used to say that to us when she was a toddler whenever we would praise her. She didn’t like syrupy praise.  She’s 20 and a junior in college and she still can’t stand syrupy praise. She finds it patronizing and condescending.  She also doesn’t like to be told what to do.  Who does?   Who’s telling you what to eat?    Food companies, soda companies, society, culture, medical establishment, the government, some doctors who refuse to challenge what isn’t working, some dietitians, have all been telling you what to eat. I’m not saying there isn’t some helpful advice or education out there, but there’s a difference between education and telling someone what to do.   Telling someone what to do in any area of their life brings up NEA (Negative Emotion Attraction) and will not move anyone toward their desired outcome or sustainable change transformation.    I’m reading or listening on Audible (it’s never a shameless plug to promote audio books) a book called, “Helping People Change” by expert coaches and professors at Case Western Reserve. I heard one of the authors speak on the Institute of Coaching Webinar which is a group I am a member of that takes a scientific approach to coaching.  There are many research articles that show the positive benefits of coaching.  I love the positive psychology movement and taking a strengths-based approach to behavior change.    So, one of the key teachings in the book I was listening to, and if you’ve ever listened to a book on Audible, it is really dependent on the narrator’s voice whether you stay awake or not.  And, if you’re like me and you space off after a while, like I have always done in church around minute 8 or so, no offense to all the ministers out there, you miss out on whole chunks of the audio book and have to rewind.  Or not.    Anyway, I’m really interested in the response to different kinds of coaching.  If a coach coaches with compliance, meaning giving a directive or basically telling someone what to do, it is much less likely to be effective, meaning it is less likely to help you reach your desired outcome and you will struggle with sustaining that outcome.    It’s kind of dumb luck for those of us coaches who are just decently nice people and care about other human beings.  That’s just kind of a nice thing in life.  We can always be more intentional and on purpose compassionate with our coaching. Which is not babying you.  It’s believing in your unlimited potential and loving you no matter what.  It’s not trying to fix you.  It’s knowing in our hearts that there could never be anything to fix because you are never broken.  It’s not coaching you and pushing what I think is best.  It’s helping you discover what you believe is best and works for you.  So, that’s coaching with compassion.   Coaching with compassion taps into your ideal self, is self-directed, and visionary.  You make decisions based on your higher brain.  It’s like my vision to create community through compassionate connection.  I see it and I own that vision.  Remember, IME Community, it’s like building a city and the essential functions are laid out and we are just populating it.    It’s creating your own beautiful personal vision word-cloud.  It’s your dream-speak.  No one takes it away.  You get to take your vision alongside of you.  You and your vision get to choose your own adventure!  I want your personal health to be a part of your vision because you are worthy and deserve your healthy life and I believe in your unlimited potential to create any result you want.   Instead of NEA, restrict and indulgence mindset, coaching with compassion brings up PEA (Positive Emotion Activation) and gets you where you want to go.    There’s a reason why I’m teaching you all about self-love superpower in the beginning because you will learn to self-coach.  In fact, I can coach you with compassion until the end of time, but if you are in your head giving power away to the negative self-talk, coaching yourself with compliance, telling yourself what you should be doing, buying into society’s and our culture’s beliefs about what to eat, singular solutions, fixated on the how and the what and not your why, you will be self-sabotaging.    So, what do you have to lose by trying a new more compassionate and positive approach?  You will lose a lot of negative emotions and pain and probably some weight and will gain positive emotions, your desired outcomes, and your vision for yourself and your health.  Sounds pretty good to me! Do not tell me what to eat! You’ve got this! Self-love Superpower, Dr. Karla, ActivistMD

IME Community Radio Blast How to feel better (Playlist- “Walking on Sunshine” by Katrina and the Waves) Do you want to feel more positive? I’m not talking about the toxic positivity sugary layer of fakeness slapped on tough situations.  Don’t you just feel like telling toxic positive people to shut their mouths? Positivity has to be believable. You create positivity with your thoughts and with intention. You can’t always change up the circumstances or people or situations in our lives, but you can change your thoughts to create more positivity in your life. First, if you feel stuck in a funk, start taking some action that will support creating positivity in your life.  I challenge you to go outside for at least a few minutes every day.  You will connect to the world outside of yourself.  Make an observation.  Positivity is all about connection. Every day, start creating positivity by writing down three things you are grateful for and before you go to bed, write down three amazing things that happened today.  Literally, can be the smallest things ever.  Start connecting on purpose and with daily intention and over time, you will create more positive thoughts, which generate more positive feelings, which create more positive actions and results in your life!  Check out my daily mini podcast episodes IME Community Radio Blasts to get your day started with self-love! Let’s connect and co-create IME Community! self-love superpower, Dr. Karla