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 #type2diabetesSee omnystudio.com/listener for privacy information.

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.See omnystudio.com/listener for privacy information.

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 See omnystudio.com/listener for privacy information.

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. KarlaSee omnystudio.com/listener for privacy information.

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 [email protected] #bodypositiveteens #childhoodobesity #selflovematters #Bodymassindex #parentsupportcoach #prediabetes #type2diabetes #PCOS #fattyliverdiseaseSee omnystudio.com/listener for privacy information.

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, ActivistMDSee omnystudio.com/listener for privacy information.

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, ActivistMDSee omnystudio.com/listener for privacy information.

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 See omnystudio.com/listener for privacy information.

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 See omnystudio.com/listener for privacy information.

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. KarlaSee omnystudio.com/listener for privacy information.