Want to Understand Macros?
We have received several emails over the past month asking for more info on calculating macros. So, I thought I would share this broad overview with you.
The Three Macronutrients
The three macronutrients are protein, carbohydrate, and fat. Generally, calculating macros requires a balanced diet with all three macronutrients. That being said, if you’re following keto or low-carb, you can still calculate your macros but you’ll be using different percentages.
The Broad Picture
We all have a Total Daily Energy Expenditure (TDEE), which includes our basal metabolic rate (the calories our body burns just by being itself), the thermic effect of food (which accounts for about 10% of our TDEE), and exercise and activity (about 15 to 30% of our TDEE). This is why exercise isn’t the number one way to create a calorie deficit.
Protein
Protein helps so many different things in our body, like the growth of muscle and skin. When you combine protein with carbohydrates and fat, you’ll be able to blunt your insulin response. That means that eating protein helps your blood sugar stay more stable than if you just eat carbohydrates. Often when we don’t get enough protein, especially if we’re engaging in lots of exercise, we’ll experience hunger and even cravings.
Carbohydrates
Carbohydrates are our body’s quick and slow energy. Many people think carbohydrates make us gain weight, but in order to make a body composition change, you’ll need to put a good amount of demand on your body. Moving and stressing your muscles is necessary for body composition change. And to have enough energy to put in the work, you’ll need fuel. Carbohydrates give us that fuel.
If you’re diabetic, pre-diabetic, or have insulin resistance, you can absolutely still include carbohydrates in your macros. It’ll require more of a low-carbohydrate diet than a no-carbohydrate diet, and you’ll still be able to get all the benefits you need from those carbohydrates. And note that strength training can actually improve our insulin sensitivity so we’re simultaneously making amazing changes while improving our health parameters.
If we eat the right carbohydrates, we’ll get lots of good stuff, like fiber and B-vitamins. It’s about looking at food as medicine and fuel rather than as “bad foods.” Processed carbohydrates aren’t as healthy for us, but many of them can do good things for us.
Fat
“Fat” is not most people’s favorite word, and it was especially the enemy in the late 80s and 90s. But fat is so necessary. Poly- and monounsaturated fats are considered good, and you want to stay away from saturated and trans fats, even if you’re doing low-carb high-fat.
Saturated fats have been shown to increase hemoglobin A1C in people who are doing low-carb dieting. It has a lot to do with genetics, but it is a phenomenon. To reverse this, it’s important to make sure your fats are coming from healthy sources.
Fat supports hormones, which control everything. Somebody who over-exercises and drops body fat may stop menstruating, and their hormone levels can be off. Often there is an issue with the amount of dietary fat they’re eating.
Fat also supports healthy tissues and lets us have nice skin and shiny hair. Fat has the lowest glycemic load of the three macronutrients, which slows the absorption of protein and carbohydrates, allowing us to blunt the insulin response when we eat a balanced meal.
Counting Macros
There is a protocol called If It Fits Your Macros that tells you anything is fair game as long as you stick to your chosen macronutrient ratios. But I like to focus on optimal health, with more of an emphasis on nutritious foods. These are what I call all-the-time foods (note: not bad foods!), which feel really good in our body and serve us really well. In contrast, “sometimes foods” are more processed but taste good - and you don’t have to stop eating them. The idea is you can fit all these foods in macros if you’re calculating them.
If you have somebody calculate your macros, they’ll usually give you percentages. One very balanced way to do it is 40% carbohydrates, 30% protein, and 30% fat (also known as the Zone diet). These percentages are calculated from your Total Daily Energy Expenditure.
Another option is to eat one gram of protein for every pound of lean body mass you have. From there, you keep fat at about 30% and carbohydrates make up the rest. It’s really just about doing the math. The important part is that after you get a jumping-off point, you observe and see what’s happening.
Macros Aren’t for Everybody
Counting macros may sound great, but it requires weighing, measuring, and food prepping your food. It can get pretty tedious, which may not make you want to do it long-term. I certainly don’t. So a couple of years ago, I invented a program called Mindful Macros which allows you to eyeball and estimate how much of each food to eat to make up a balanced meal. It’s turned out to be very effective, especially for body transformation and quality of life.
Following our intuition, knowing when we’re hungry, and stopping when we’re full, combined with Mindful Macros, is very appropriate for those of us who aren’t looking to compete on a stage. People like me, who have a family, a business - a lot going on. For me, flexibility is the most important. I rely on my intuition, hunger scale, and eyeballs. Together, these two approaches allow me to have an exciting, flexible, and free plan.
I’ve been following this for nearly eight years now, and I’ll never go back to calculating my macros every day. I love the flexibility. I’m within a healthy weight range and optimal healthy zone. I want freedom and results, so I meet myself halfway in the middle. It works for me.
I hope that this is helpful and gives you some great insight.
How To Notably Reduce Stress in Only 5 Mins. a Day
3 easy self-care tips for healthcare professionals to feel more peaceful and at ease, in the time it takes to brush your teeth!
By Ali Novitsky, M.D.
Life Coach for Women Physicians
Triple Board Certified in Neonatology, Pediatrics, and Obesity Medicine
Why “Self-Care” Is Not a Dirty Word
Does just hearing the word, “self-care,” irritate you?
I know it can be annoying, or even feel like an insult, when you are already at your max and don’t know how you could possibly have the time or energy to fit “me time” in.
But self-care for physicians is not about being selfish or taking time away from those you love, it’s about protecting your day-to-day health and the longevity of your career.
In the short term, self-care allows you to get through each day with more ease, flow, and peace.
Are you wondering . . .
What even is “self-care” anyway, and what is it really going to do for me? Is it even worth my time?
I completely understand the feeling that you are just doing your best to get through each day and that adding one more thing to your already packed to-do list seems impossible. But, if that’s how you feel, I promise that you need to practice daily self-care more than anyone.
But, “self-care” doesn’t mean expensive treatments or luxurious, blow-out spa days. It’s also not about drawing yourself a bubble bath or pouring yourself a generous glass of wine after work, although it can be!
Real self-care for healthcare professionals is about small daily habits that ease your mind and allow you to handle what comes your way while feeling grounded, centered, and calm.
In this article, I will show you just how simple it can be to release anxiety, pressure, and stress in just 5 minutes a day.
Why Don’t Doctors Take Time Out for Self-Care?
As physicians, we tend to overlook taking care of ourselves, being so focused on our care and concern for others. But, in a field where almost half of practicing doctors report physician burnout, you cannot afford NOT to make an effort to take care of yourself daily. Especially since it gives you the emotional resiliency to deal with whatever comes your way and helps you better navigate the challenging decisions and unique pressures you face as a busy female physician.
The irony is — the tougher things get and the busier we are as physicians, the more we need to make sure we take time out for small daily self-care practices.
However, it doesn’t take as long as you think to practice self-care. But, you do have to make it a priority. The question is, are you? Or do you make excuses like, “I don’t have time,” “It’s too expensive,” or “I just can’t focus on me right now, I have too much going on in my life.”
I know it feels like you don’t have the time or energy. I felt the same way before I became a physician coach myself and learned first hand how important mindset work is along with exercise in keeping ourselves healthy for the long run. But it doesn’t take as long as you think.
The benefits of mindful self-care for doctors are indisputable, as this article from everydayhealth.com states,
“When self-care is regularly practiced, the benefits are broad and have even been linked to positive health outcomes such as reduced stress, improved immune system, increased productivity, and higher self-esteem,” says Brighid Courtney, of Boston, a client leader at the wellness technology company Wellable and a faculty member at the Wellness Council of America (WELCOA).”
So here are a few self-care helpers I’ve found to take the edge off of a stressful day . . .
3 Easy Ways to De-Stress and Gain Peace in Just 5 Mins. a Day
Set a Timer on Your Phone To Focus on Your Breathing for 5 Mins. a Day
The act of focusing on your breathing, and slowing your mind down, re-regulates your nervous system and allows you to lower your stress level. It also helps you focus and concentrate so you feel less overwhelmed.
Here is a short 5-minute exercise to reduce stress that you can do anywhere, with tips for how to get the most out of it.
So, go ahead, shut the door to your office, put up an “unavailable” sign, and dedicate 5 WHOLE minutes to feeling better the rest of the day. I give you full permission.
And if you don’t think that’s enough time to make a lasting change, studies show that just 5 minutes a day of mindful breathing can lower your blood pressure and boost performance, both of which prevent physician burnout.
2. Just Walk Outside (You Don’t Even Have to Go for a Walk!)
The benefits of nature on relieving depression and overwhelm have been proven time and again. Taking five minutes to leave the building, or take a break from the hospital chaos, even if it seems insignificant, will do wonders for your mental health.
According to this research, “An initial study of 123 university students found that participants who sat in an urban park for just five minutes showed significant increases in positive emotions compared to participants who sat in a windowless laboratory room.”
Nature is so fundamental to our health that It’s now even possible to write patients a prescription for park time as a way to improve their physical and mental health. How about that!
As Time Magazine reports, this is helping people to see that getting outdoors is just as essential to their well-being as their medications are. But, it’s equally important for you as a busy female physician. Don’t forget we have to take our own advice too.
3. Identify and Change Negative Self-Talk Habits with Mindfulness
Believe it or not, positive self-talk IS a form of self-care. We all have those self-critical thoughts as physicians, second-guessing even our most educated decisions, but when we don’t keep them in check, it’s easy to stay stuck in harmful thought patterns.
Check out this short article in Forbes with other ways to stay positive, including a gratitude journal, saying positive affirmations, and surrounding yourself with positive people.
According to this article, the National Science Foundation did research that shows that 80% of our thoughts are negative! Especially, as physicians, we tend to overthink everything — from our daily choices to patient care. It’s easy to see how that would easily spiral into an overwhelming sense of anxiety if left unchecked day in and day out.
Reducing negative self-talk can be as simple as identifying a worry-based thought and changing it to something softer. For example, the next time you hear yourself saying, “I should have done . . .” catch yourself and change it to, “I am always learning from my mistakes and I will approach it differently next time.”
These small tweaks, one thought at a time, are all it takes to start shifting to a healthier mindset that will keep you from burning out.
In my physician wellness coaching programs, I use Cognitive Behavioral Therapy (CBT) mindset coaching to help you overcome long-held negative thought patterns. Because I know that our mindset affects EVERYTHING we do and the quality of our professional and home lives. And we often don’t address it or go years without being aware of how we really feel because we are so busy.
But it’s just as important to keep our mental health strong as it is to keep our bodies healthy.
As a practicing physician and life coach for women, I understand that we don’t have a lot of extra time in the day.
That’s why I’ve created a streamlined physician wellness program tailored just for you!
G.O.A.L.S. Society, my monthly physician coaching program for women, is based on science, so you get the maximum benefit in the least amount of time.
Our coaching calls and online workouts are available online anytime, so you can work them into your schedule whenever and wherever you want.
My goal is to reduce your stress, not add to it.
Come join our community of self-acceptance and positivity and see the kind of life-changing transformation it makes in your life.
The Day I Became A Normal Eater
What is normal eating, anyway?
The best way that I can define it is: eating when we are hungry, stopping when we are satisfied, and taking the emotional component out of it. This is exactly why the first 3 letters in my G.O.A.L.S. principles are Get Hungry First, Observe for Fullness, Allow Feelings.
And, while these principles sound simple… we often have difficulty implementing them because we just don’t trust them. Doesn’t this sound silly? We would rather trust some “diet plan” before we would our own body. Now, for many, following a prescribed plan is no big deal. But, for those of us who have ever been on a diet and have struggled; following someone else’s prescribed nutrition plan just isn’t going to work. Not long-term.
Those of us who do not have “normal eating” usually do 1 of 2 things (or both). They are either constantly restricting food, or they are saying yes to food most of the time. So, wherever you may fall on this spectrum, the idea is to find yourself in the middle. If you say “No” too often, then we actually need to say “Yes” more often. If you say “Yes” more often, then we need to learn how to respectively say “No.”
But if I say “yes,” won’t I gain weight? But if I say “no,” won’t I feel deprived?
The idea is that if we can live in the middle and become “normal eaters,” then we will say “yes” and “no” appropriately. And, by default - we will become less emotional eaters.
Now, if this is a new concept for you… then I must warn you. This will not happen overnight. You will need to play around with your “yes” and “no” functions in order to get it just right. If you are a restrictive eater, then it may be easy to potentially overdo it. If you are an emotional eater who says “yes” more often, then there is a possibility that you will say “no” a bit too much and feel restricted.
You see, no one can tell us exactly how to find our own normal eating. We just have to be curious and experiment. What does it take to actually move forward with this strategy? I can tell you that it takes a whole lot of trusting the process. But, ultimately, if we are able to normalize our eating, we will be able to enjoy contentment, joy, and freedom. Food will have less control over us.
You know when you make your best friend a care package. And, you think about him/her opening it and the delight they will feel. We believe that our friend will feel cared for. Well, imagine giving yourself the ultimate care package of listening to and honoring your body. Every time you make a food decision, you get to do that.
Whether it is saying “no” to extra bites because you are already full, or saying “yes” to the birthday cake at the party… the idea is that you become empowered to be the authority on your own health. And, when we feel empowered, we will continue to take actions that will honor our health.
Enjoy. Say “Yes”... Say “No”... Find your middle.
Have You Heard of The Yips?
I wanted to share something very personal that for years I couldn’t even talk about.
See - I never had a problem throwing a softball. In fact, I could hit the catcher’s target at home plate from far center field. My senior year in high school, I remember grabbing a ball at home plate and I was unable to hit my target at first base. It was subtle at first.
Then… it hit me like a ton of bricks. My first day as a college softball player. I received a full scholarship to play at Seton Hall University. I was in right field taking fielding practice. When the ball was hit to me, I stopped it… but I was unable to throw it. It was as if my wrist turned to stone. Then the next day at practice, it happened again. To the point that I was barely able to play catch. My wrist could just lock up.
It was humiliating. It was as if I had never played a game of softball in my life. But, here I was, a full scholarship athlete and I couldn’t throw the ball. Once it was noticed, the coach did everything he could to put me on the spot thinking more inducing more pressure would help this.
I developed anxiety… depression… I didn’t know what was happening to me. I was sure that I would lose my scholarship. But, fortunately I was able to come through with my hitting ability to hold my spot. It never got better. I had a special routine I went through to be able to throw during a game of catch. And I would pray to sit on the bench; I didn’t want to play. I would do anything not to be publicly embarrassed and “found out.”
I knew that if I stopped playing, I would let everyone down. I worried that I might regret leaving. Not once did I consider that what was happening to me was actually something known in sports. Something called: the Yips.
The Yips is a form of task-specific focal dystonia that is heightened by anxiety. Focal dystonia is a condition in which certain muscles that have long been used repeatedly to perform a task, suddenly cannot perform that task anymore. It manifests itself with a loss of awareness of body position and locking of limbs. The “locking of the hand” feeling that many players report is caused by the muscles in the wrist activating at the wrong time.
This. Is. What. I. Had.
I wish it were different. I kept going despite the extreme fear and anxiety that I felt every time I walked on the softball field. I don’t believe that this was necessary. In fact, I wish I was brave enough to have asked for help. At the time, I wasn’t.
I took summer classes so that I could finish my degree early. You know, I still have nightmares about having to play one more season of softball. All because of the fear of having to throw the ball.
Why am I sharing? I am sharing because we don’t always have to push through at the expense of our mental, emotional, and physical health. As doctors… we do this often. And each time, we pay the price.
What I wish for you all:
Be extra kind and gentle to yourselves. Stop pushing so hard all the time. It’s ok to stop or say no. You are enough, just as you are… you are enough.
I choose to accept myself - yips and all - knowing that I have my own back now; I don’t have to be afraid anymore.
Thank you for letting me share. It’s something I’ve wanted to get off my chest for a while. Also, hoping to inspire you, and encourage you to do the same.
Hit Your Protein Goals
We all know how important it is to maintain our lean muscle mass. After the age 30, we start losing some each year with the aging process. Besides lifting weights, eating enough protein is another top strategy to preserve all of that metabolically active tissue.
So, let’s talk about hitting your protein goals. If you read about how much protein you require, you will get 10,000 different responses. I keep it simple. I recommend getting at least 3 full servings of protein every single day. This is going to give you about 60g of protein each day. We know that this amount is enough for most women to support their muscle mass. Obviously, if you are engaging in strenuous exercise, then you may require much more.
If you are not fasting, then I typically say to focus on including protein at breakfast, lunch, and dinner. If you are fasting, then you can decide what works best for you. Then you just build your meal around your protein.
For breakfast, think eggs, egg whites, turkey bacon, greek yogurt, cottage cheese, protein powder. I actually love making a protein shake and pouring it over my cereal or even dry oats. Adding some carbohydrates and a bit of fat will give you a complete meal. I love eggs on Ezekiel toast with avocado and tomatoes. It keeps me full for hours.
Next up… lunch.
Some great options might be lean meat, tofu, tempeh, eggs, tuna, greek yogurt, a plant protein of your choice like lentils. Then we do the same as above… combine with a complex carbohydrate, some fat, and lots of fibrous veggies. I love grilled chicken with peppers and onions on a whole grain tortilla with avocado. Also, try grilled shrimp over kale/spinach mix with fruit, nuts, and some EVOO. How about oven baked tempeh with sweet potato/almond butter and some crispy broiled broccoli. See… you just grab a protein, add a complex carb, a fat, some veggies and boom!
Then dinner!! Anything goes here.
Repeat protein as above. I love ground turkey made with cumin and chili powder over fresh greens, tomato, avocado, and crushed Quest chips!! I also like to make high-protein nachos. I use Quest chips then top with ground turkey, black beans, scallions, tomatoes, cheese, and a dollop of sour cream. Another favorite is thinly sliced sirloin with onions and peppers served in whole wheat tortillas… a Philly favorite for sure.
My best advice is to find the foods that you love…. and eat those. By balancing your meals as outlined above, it will keep your body metabolically happy and you will be doing your best to preserve your muscle mass and support your body optimally.
Did You Know Consistent Weekly Exercise Prevents These Serious Conditions?
Why even mild to moderate weekly exercise significantly lowers your risk for dementia, heart disease, and even cancer.
Read below to see why you do have the power to possibly prevent chronic health conditions before they develop, without as much time and effort as you think. (Even if you’re a busy female physician like me!)
By Ali Novitsky, M.D.
Life Coach for Women Physicians
Triple Board Certified in Neonatology, Pediatrics, and Obesity Medicine
We all have something in our family history that we secretly worry about.
Whether that is a history of high blood pressure, stroke, or a certain cancer, we fear that someday in the future we will be the next in line to get blindsided by that scary gene that seems to run in the family. It begins to feel inevitable when we watch so many people in our families struggle with the same condition.
So, how do we break the legacy of disease that seems to get passed down from one generation to the next when it seems unavoidable?
As physicians, we know that even when you’re genetically predisposed to a certain condition, there is a lot that can be done to prevent it from developing and/or worsening through healthy habits.
The shocking thing is, most major conditions from diabetes to strokes, and even dementia can be thwarted by one simple thing — weekly mild to moderate aerobic exercise.
Sounds easy, right?
The problem is you don’t feel you have the time, energy, or motivation to follow through with weekly workout routines when you’re an over-achieving, hard-working physician. But this is also what creates physician burnout.
The truth is getting healthy and preventing major diseases you may be predisposed to doesn’t require as much effort as you think.
In my group coaching programs for physicians, I've helped hundreds of women fit regular exercise into their hectic lifestyles.
You don’t have to exercise every day or do a strenuous, high-intensity workout to get results and protect your health.
Read below to see some of the surprising ways moderate, bi-weekly exercise helps prevent the hereditary disease patterns in your family from becoming an ongoing curse.
Moderate Weekly Workouts Block Potential Strokes and Diabetes
According to the American Diabetes Association, 10.5% of Americans had diabetes as of 2018. However, many conditions like diabetes, stroke, and high blood pressure can be prevented or controlled simply by maintaining a regular exercise routine. As stated in this article from John Muir Health,
“The National Institutes of Health conducted a breakthrough study to show that diet and exercise can delay diabetes. The clinical trial proved that a half hour of walking or other low-intensity exercise daily, combined with a low-fat diet, reduced the risk of developing type 2 diabetes by 58 percent.”
58%! And, as physicians, we know that diabetes and high blood pressure also put us at risk for more serious medical conditions like stroke and heart disease.
Sounds like a good reason to take a short walk after work, besides the obvious mental health benefits of getting outside, clearing your head after a long day, and getting some fresh air and Vitamin D.
Even Walking 2 Mins. a Day Improves Memory and Prevents Dementia
In his book, Keep Sharp: Building a Better Brain at Any Age, neurosurgeon, Sunjay Gupta, states, “When people ask me what’s the single most important thing they can do to enhance their brain’s function and resiliency to disease, I answer with one word: exercise.”
This article goes on to state that Gupta says exercise is even more important than mind-sharpening tools like crossword puzzles in warding off dementia and cognitive decline, contrary to popular belief.
He says even two minutes a day of walking helps with preventing dementia and memory loss, and that’s something even the busiest women physicians can commit to doing. No excuses!
Staying active and avoiding a sedentary lifestyle promotes healthy cell growth and discourages inflammation, both of which keep major diseases like cancer at bay.
Exercise Helps You Sleep Better & Stops Major Disease from Developing
When you incorporate moderate exercise into your weekly routine you’ll find you fall asleep faster, have a better quality of sleep, and stay asleep longer according to the Sleep Foundation. And, as you know, regular sleep helps you fight everything from chronic fatigue that makes you feel grouchy and irritable, to major medical conditions like cancer and heart disease.
According to the Mayo Clinic, “ . . . infection-fighting antibodies and cells are reduced during periods when you don't get enough sleep. So, your body needs sleep to fight infectious diseases. Long-term lack of sleep also increases your risk of obesity, diabetes, and heart and blood vessel (cardiovascular) disease.”
Not sleeping enough is a risk you can’t afford to take as an on-the-go physician.
In a profession where you give so much, you must focus on the importance of your own self-care as a doctor, to maintain longevity in your career and balance in your personal life. You have to give your body the downtime it needs to keep you alert and focused during the day.
Getting enough sleep also allows you to be fully present with your kids, friends, and partners, thanks to being rested and refreshed, instead of drained and dragging. If you find yourself being snappy and on edge during the day, it might be time to look at your sleeping schedule to see how you can get more shut-eye each night.
When you get solid, restful sleep, you give your body a chance to fight off disease in the important early stages, before it has a chance to become a full-blown condition.
Staying Active Reduces Anxiety and Depression as Much as Medication
We all know exercise is important for our physical fitness, but our mental health needs it just as much. Our mood is greatly improved by regular workouts and anxiety has been shown to reduce by as much as 20% when you add exercise. In this article, they note that even walking or weight lifting significantly reduces anxiety.
Exercise also has a proven positive impact on depression. Depression is so pervasive that 1 in 10 adults are currently suffering from it in the U.S. and of those 13.2% are using antidepressants to treat it. However, according to Harvard Health,
“‘In people who are depressed, neuroscientists have noticed that the hippocampus in the brain—the region that helps regulate mood—is smaller. Exercise supports nerve cell growth in the hippocampus, improving nerve cell connections, which helps relieve depression,’ explains Dr. Miller.”
In the above article, they also note that the short-term “feel-good” endorphins produced during intensive exercise don’t do as much to curb depression as sustained, consistent activity. This can be as simple as walking or a “regular activity you enjoy,” they state.
This is proof we don’t have to do as much as we think to feel happier and more hopeful in our daily lives.
Exercise has also been proven just as effective as antidepressants in treating depression. Plus, it’s all-natural. According to this study, exercise had the same positive effect on treating depression as medication did!
How Much Time Do You Have to Exercise Daily to Protect Your Health?
According to this study, it only takes 30 minutes of “modest activity,” including walking, swimming, or even doing yard work, to keep your heart and body healthy.
The point is you don’t have to do intensive, Crossfit sessions to get stronger, healthier, and prevent disease. You just have to do something. But that motivation is often lacking in overworked physicians, and I get it. I was once there too.
That’s why my programs put a big emphasis on doing things in a physician’s group of your peers, so you stay motivated and don’t lose sight of how important your own health is.
One thing that motivates me is knowing it doesn't take massive effort to get results. The bonus is knowing that I am also preventing what could be a life-threatening or lifestyle-compromising illness from taking root and gaining momentum.
Still not sure you can make time to work out?
What if I told you a sedentary lifestyle is one of the 5 biggest risk factors for cardiovascular disease?
How I Help You Find Time to Work Out, Even as a Busy Female Physician
As physicians we all know how important regular exercise is to our overall health, but how do we fit working out into our insanely busy lives when we are already overwhelmed and exhausted?
And then there’s the energy it takes, which, let’s face it, most women physicians just don’t feel they have after standing on their feet all day at work, then coming home to more chores, tasks, and homework.
As a mom and physician myself, I know that it’s hard to find time to prioritize your own health and fitness.
But, as a life coach for women physicians, I’ve learned it doesn’t take as much time or effort as you think to see the results you want. In fact, the Mayo Clinic says you only need to strength train about 2x per week for 75-150 minutes each to stay healthy and it doesn’t even have to be an overly strenuous workout!
That’s why I designed a physician coaching program that is customized to fit into your busy schedule, without demanding more effort or time from you than you have to give.
This is exactly what we do in G.O.A.L.S. Society, my monthly coaching program for busy women physicians. I combine live weekly strength training workouts in a group of your peers, with my signature Mindful Macro Nutrition Plan that requires no meal prep or laborious planning, for the ultimate health and fitness plan.
I use an evidence-based scientific approach to fitness, along with Cognitive Behavioral Therapy mindset coaching to get you through those mindset blocks and fitness plateaus.
With a small minimum weekly time commitment from you and expert guidance from your fellow women physicians, you’ll feel better in your body and wow colleagues when you radiate from the inside out, plus protect your health and longevity for the long-term.
In coaching physicians, I’ve learned that:
Small changes = Big progress
Check Out My 10-Week Progress Pics
Today’s post is short and sweet. I want to give you 4 things to think about when you are determining whether or not you are making progress toward your goals.
Take a look at this picture. My goal is to gain lean muscle mass. These pictures are 10 weeks apart.
This is what I want you to know.
1) We need more than 1 way to measure progress… the scale is exactly the same 10 weeks later, but inches are down and pics are changed. Imagine if I stopped because the scale didn’t change and I believed I wasn’t making progress?
2) Adding lean muscle mass at age 41 means… it’s never too late, in fact - we are just getting started!
3) Embracing your body means that if it is meant to grow muscles, help it out by feeding it and exercising it.
4) Carbs are necessary to make this shift in 10 short weeks. In fact, carbs are increased by 50% from pink shorts to black shorts.
And - what I tell my crew…
Transformation is embracing who you are. Do that, and some strategic nutrition/exercise programming, and the rest will follow.
What I am proud to celebrate as I turn 41 today
From the age of 6 through the age of 22, I did not have a great relationship with my body.
I was not the same as my friends, so I thought that there was something wrong with me.
I saw 2 ways to have a body: thin and not thin. But, our society taught me that there might be just one acceptable way to have a body - and that was thin. I was not thin.
At the age of 12, I had reached my adult height and weight. I was the “big” friend. I didn’t know any better… I didn’t have the tools to believe that I was uniquely beautiful.
Thankfully, I excelled at sports, so I was able to salvage some body confidence by focusing on what my body could do.
Then, my senior year of high school, I decided to over-exercise and under-eat. At the same time, I was being recruited to play college softball. My “experiment” worked in that I lost 20 pounds - but I also lost muscle and power. My softball game suffered. And, because I didn’t know any better… for every pound 1 lost, about 25% was lean mass. Which means that my basal metabolic rate went down. So, when I gained the weight back, I didn’t gain my lean mass back; I just gained extra body fat.
I entered college with an extra 10 pounds. For the next 4 years, I yo-yo dieted. I would gain and lose 30 pounds at least 4 times. I have to say, with the amount of training I was doing for softball, I was strong… I had a lot of muscle mass.
One day in the cafeteria when I was ordering food, I was mistaken for a man. The chef only looked up as far as my shoulders and just assumed I was not a woman. How embarrassing. There were so many external signals that were saying, “Ali, you are not ok… you are not enough.”
Then one day, I got sick of it all. I said no more! Maybe I needed to actually take a look, dig deep, and consider getting to know my body. Appreciate my body. Optimize its unique potential.
So I did. And 21 years later - I’m still doing it.
Going on the journey of self-love… discovering who I am… and not being afraid to show the world has been the bravest thing I’ve done. So, as I was reviewing the pictures my husband took yesterday, it reminded me of how far I’ve come.
This is me.
Today I turn 41, and I am just getting started.
Strength is knowing who you are and not being afraid to show the world.
Is Being a Perfectionist Harmful or Helpful for Women Physicians?
6 Small Steps to Overcome Perfectionism & Bring More Peace and Satisfaction Into Your Life
By Ali Novitsky, M.D.
Triple Board Certified in Neonatology, Pediatrics, and Obesity Medicine
Does this cycle of perfectionism sound familiar to you?
You set unrealistically high expectations for yourself, get overwhelmed by what it will take to achieve them, and then FREEZE . . . Now you’re beating yourself up for not getting to where you wanted to be fast enough and then you start doubting yourself and feeling down.
If this sounds like you, just know that you’re not alone, many of the women physicians I work with in my life coaching programs are experiencing the same vicious, self-defeating cycle in their lives. My goal is to help them release the fear of failure that is holding them back and start living lives of freedom and bliss again.
If you find yourself procrastinating and then feeling lazy, don’t beat yourself up! You may just be suffering from a toxic level of perfectionism, which is very common for all physicians, especially women. This causes intense feelings of shame, self-doubt, and fear that immobilize even the best of us.
If you’ve ever set impossibly high goals for yourselves only to be left disillusioned and disappointed, this article will help you find a better balance between achieving your dreams and keeping your mental health balanced.
1. Become More Mindful of Perfectionist Traits & All or Nothing Thinking
Take this quick, 10-question perfectionist test, or read this blog with 10 signs you may be a perfectionist to see if you relate.
Most women physicians are self-reported perfectionists.
We all feel that constant pressure to be "perfect" when there is so much at stake with our patients.
Of course a level of perfectionism is expected in the medical profession, but when this expectation spills over into every other aspect of your life it's easy to see how it quickly causes overwhelm.
So, how do we know when perfectionism is becoming harmful instead of helpful?
One key difference between high achievers and perfectionists is “all or nothing thinking.”
Whereas high achievers can find satisfaction in achieving smaller goals, perfectionists are rarely fulfilled unless they hit the ultimate goal, feeling like a failure if they fall short.
As mentioned in this article, we sometimes forget that we are all human, and we all make mistakes.
Have you always had high standards for yourself?
If you can’t remember a time when you haven’t been highly critical of yourself, you may just be a perfectionist! it’s also the reason you may have been driven to such an exacting profession in the first place.
Perfectionists tend to set unusually high standards for themselves, then procrastinate when they get overwhelmed by them.
Then, when you fall short of those super-high goals, goals that were probably too big of a leap in the first place, you become immobilized by fear. This is called “perfection paralysis” and we’ll discuss that more in the next section.
2. Let Go of the Fear of Failure
If you’re already identifying as a perfectionist, you’re likely motivated by an intense fear of failure. This becomes unhealthy when you’re constantly stressed or disappointed by goals that aren’t easily achievable.
This fear of failure reinforces feelings of unworthiness or low self-esteem that are pushing you to overachieve in the first place.
In my life coaching programs, I've noticed a common theme — that women physicians tend to beat themselves up for not getting something right the first time. And this is even when learning something new, such as a different way to approach fitness and nutrition.
The precision that being a doctor requires means that most of us struggle with this need to “be perfect,” which keeps us from trying new things that may benefit us.
In our personal lives, this may translate into feeling down and a deep dissatisfaction with our lives when we put constant pressure on ourselves to get everything perfect the first time around. So we avoid the very things that would help us grow.
Then things start to feel out of control and we feel stuck.
This has a name and it’s called “perfection paralysis.” Instead, we should get used to taking the next best step and try not to project too far out into the future, which causes most perfectionists to stop before they even start.
3. Know When Perfectionism is Becoming Unhealthy
So, is perfectionism a good thing or a bad thing? According to this article, by Dr. Melissa Welby, M.D., the high expectations that perfectionists put on themselves creates a slippery slope that quickly becomes harmful to your mental health if unchecked. And it starts even before we become doctors . . .
In this study of med students, “More females (41% - 52%) experienced clinical levels of impostor phenomenon compared to males.” Many of those med students that felt imposter syndrome reported “shame, embarrassment, or inadequacy” according to this article, which states that they also reported higher levels of depression and anxiety.
And this is while we’re still in med school, so it’s easy to imagine what the increased pressure of becoming a full-time physician does to our mental health when we have been practicing perfectionism for years before!
Imposter syndrome is like the evil stepsister of perfectionism.
Major signs of imposter syndrome include feeling like you’ll never be good enough, or like you will be “found out” for not knowing what you’re doing. This creates an underlying anxiety and stress you aren’t even aware that you’re dealing with on a day-to-day basis.
It’s easy to see then how perfectionism paralysis becomes a key component of physician burnout.
When related to your fitness and wellness, perfectionism translates to not having realistic body goals and not accepting the limitations of your natural body type.
This sets you up for failure when you feel like you’ll never reach your goals, which are often unrealistic in the first place. One huge component of my life coaching programs for women is accepting your true body type and learning how to work with it to maximize your genetic potential.
4. Set Small Goals and Boundaries to Keep Perfectionist Paralysis at Bay
Having patience with yourself and allowing yourself to celebrate the small victories is the first step in changing your perfectionist habits.
Take small steps towards reaching your goals to prevent the overwhelm and procrastination that perfectionism brings.
Try SMART goal setting that helps you focus on the next best step rather than planning too far ahead and losing sight of your short-term wins.
So often we forget to celebrate all of our accomplishments along the way to the BIG GOALS.
As a life coach for women, I often see this in our fitness and mental health journeys too. Take a moment to pat yourself on the back for all the ways you’ve stayed strong and healthy despite a grueling schedule and ever-changing world climate.
As women physicians, we also need to learn to set boundaries and say “no” more often, so we don’t spread ourselves too thin.
Boundary setting is often a challenge for my life coaching clients, but this often spills over into our personal lives when we overcommit and run ourselves ragged. This is exhausting and zaps our energy, so we have to learn how to let the need to “do it all” go.
5. Give Yourself Permission to Fail Up & Try Something New
This goes along with the black and white, “all or nothing” thinking.
Without giving yourself a chance to learn as you go and make mistakes, you’ll never reach the top.
What happens is you avoid growth and stay stuck in a safer, more comfortable place where true expansion is limited. Allow yourself a chance to fail, and accept that it’s OK, this is how we adapt and grow.
As Thomas Edison said, “I have not failed, I’ve just found 10,000 ways that won’t work.”
You have to give yourself room to process what you’ve gained from every perceived mishap without the pressure of feeling like you have to get everything just right out of the gate.
Read a biography of someone you look up to and I bet you’ll see it probably took them years of trial and error to get to where they are now
If you allow yourself to be human, not a robot, you’ll stop beating yourself up for every little faux pas and start seeing any hiccups along the way as necessary lessons to get you to where you’re going.
So, give yourself a break and take up a new hobby or program to relearn that adaptable beginner mindset. When you adapt the open mindset of a student again, the growth potential is unlimited, and you’ll soon realize how silly it is to expect immediate perfection.
Free yourself from the mental trap of perfectionist habits and try something new today.
6. Surround Yourself With Support from Other Women Physicians Who Get It
The benefits of surrounding yourself with other women who understand the unique demands and pressures of being a physician can’t be understated.
That’s why I created a monthly wellness program for women physicians, called G.O.A.L.S Society, where you get live workouts with your peers, plus mindful nutrition and mindset guidance from women physicians just like you! See more here . . .
Live On-Demand Workouts,
My Signature Mindful Macro® Nutrition Program, and
Intuitive Mindset Coaching
to start releasing perfectionism today!
Become Independent of Your Limiting Beliefs
Happy 4th of July!!!
July is my favorite month… and happens to be my birthday month which makes it extra fun. Just wanted to stop in and give you a pearl or two on motivation.
Motivation is such an interesting thing, right? Today I want to take a different spin on it. I often have women come to me and say, “I was doing so well… and then I ate an entire cake.” Or, “I was doing so well, and then I skipped a workout - and it went all downhill from there.”
Let’s just get all-or-none thinking out of the way. When we have this mentality and thought process, we will feel that we failed if we miss a workout or eat off our plan; feeling like we have “failed” will encourage us not to workout the rest of the week.
So remember, we only have to do the next best thing. When women tell me that they missed a workout, my response is usually, ”So What?”
See, it isn’t the missed workout that matters... it is the motivation or reason behind the missed workout. It is the motivation or reason behind eating until overfull.
Let me give you an example.
I like to get a minimum of 10K steps per day. Yesterday, I did not. The reason I didn’t push to 10K steps was because I made the decision that I was going to physically rest. I loved my reason, so I was at peace with it. But, let’s say that yesterday I had planned to lift weights and get 10K steps. And I didn’t. And my reason why was: I just kept procrastinating until it was too late.
Why did I procrastinate? It was my action driven by my feeling of “entitled” because I was thinking, “I work out every day, can’t I just skip one?” You see, this thought is an automatic negative thought!!! It is an old thought. It is not one that I currently believe. We call this a limiting belief.
You see where this is going? If we don’t identify our limiting beliefs and think that we can get long-term results by forcing ourselves into the workout or forcing ourselves into eating the salad… this will not work. This may get you short-term results, not long-term.
To get sustainable results, our time is best spent in creating a new belief system. Sounds challenging, huh? This process can’t be rushed; it is a journey. We evaluate and recreate thoughts 1 by 1.
Sending you lots of love and fireworks!
Vacation Food Plan Strategy
Awhile back, I had posted my vacation food plan strategy and we received several emails asking us to revisit it. So let’s do that today.
Vacation!!! Time to relax… unwind. We should be so excited, right??? What if I tell you that one of the most common things I hear is, “I am worried about vacation because I can never stick to my food plan.”
Does this sound familiar? Stick with me here… there is a lot to unpack. But, read until the end. I am going to give you my vacation strategy that will allow you to have freedom and also feel amazing while you travel.
Let’s break down the mindset piece first.
When we think of vacation, we believe that it is time to relax, unwind, let loose, let go. Our brain suggests that this should be true for the food that we eat and the exercise that we don’t do on vacation. Vacation allows us to vacate from the normal everyday routine.
The next question is very important. So don’t skip answering. When on vacation, why do you want to vacate the eating style that makes you feel amazing? Often, it is because we have an automatic thought that we deserve to eat nonstop treats - we earned it. Or, we may have a thought that our everyday nutrition is not something that we want to do, but it is something that we have to do.
You see, nutrition on vacation will be super easy when we are in love with our food plan outside of vacation. We are in love with how we feel eating foods that fuel us. We are in love with having a stable mood and great energy.
So… what if we could combine being carefree on vacation AND eating the foods that make us feel amazing? For us to buy in, we have to gather evidence.
Here is a great example. I am on vacation with my family this week. We are at the shore. The idea of sipping some cocktails on the porch sounds divine. So, last night this is what we did. The idea was so amazing. BUT I SLEPT LIKE ABSOLUTE CRAP.
I know that my brain will offer something that will provide immediate pleasure. But, what I am really choosing between is immediate pleasure or long-term pleasure. See, I woke up this morning and was tired. Felt hungover, thirsty, a bit bloated. The immediate pleasure was really not worth it. Now, this is not to say that I won’t choose cocktails again - but I know that I am willing to accept the consequences. It will take me about a day to recover. And, I chose this.
A powerful question that you can ask yourself is: ‘Will the result of the action I take be something that I am willing to accept?’ Am I willing to accept the discomfort of not giving in to an urge now, so I can enjoy feeling amazing later? Or would I rather reject the discomfort now and feel uncomfortable later? We always have the choice: discomfort now or later.
Ok. If you are still with me: I am going to share with you my vacation strategy. Let’s be honest… vacation is time to vacate our everyday and be in the moment. This is the strategy that I use with my clients.
Step 1: Get super pumped up and hype for your vacation!!!! You do deserve it.
Step 2: Throw food rules out the window and commit to following your hunger scale. What this means is: ONLY EAT WHEN YOU ARE HUNGRY and STOP WHEN YOU ARE SATISFIED, NOT FULL. If you do this, you will not have to worry about your actual food choices. You are practicing intuitive eating, which makes so much sense for vacation because you will actually be honoring what your body needs on all accounts. Nachos look tasty poolside? Have them using your hunger scale.
Step 3: If you drink alcohol: Make a drink plan and stick to it. I don’t care what you pick. But plan it and do it. Make sure you are drinking water between drinks. Maybe your plan is to have 2-3 drinks with dinner each night. Maybe your plan is to have drinks every other day. Maybe your plan is to have 7 drinks for the whole trip. Make a reasonable plan and honor it.
Step 4: Aim for 10,000 steps per day. You do not need a formal workout routine - just move.
My clients who utilize this strategy will maintain their weight and/or lose. It works. It’s for real.
What if it were this simple for you?? It can be.
Enjoy, my friends.
An Overachiever’s Dream
We had some awesome things drop in my coaching program this week, and I want to share with you all because the evolution was quite unique.
If you remember, last week I talked about my 10% increased effort on the treadmill and what that meant for my results. So, then I got thinking… what if we could focus on our health with a 10% strategy and achieve our best results?
When I thought of this plan, I got so excited that I actually made a powerpoint, a video, and a workbook so that I could launch it to my program that day.
Today, I would like to share it with you.
I have identified 10 components that I think are super important when it comes to achieving optimal health.
Steps per day, strength training, nutrition, intuitive hunger awareness, water consumption, sleep, mindset work, coaching or self-coaching, accountability, and progress tracking.
So, here is the deal. If you try to focus on all 10 at once, then this could become your full-time job. We have to acclimate ourselves to healthy habits that over time, will take little effort.
We do this by implementing just one at a time. And, each component equals 10% effort.
Now, what we have to realize is that we aren’t trying to be perfect in all of these categories, we just want to have heightened awareness as we move through the components. And, I always recommend starting with the component that we are least aware of.
For example, I wouldn’t start with strength training or nutrition because those are fairly autopilot. Instead, I would start with water or sleep.
The idea is that you plan to work through this process over 10 weeks. Each week, you add a new component. Let’s say that I focus on my sleep week 1, that is 10% optimal health effort. Week 2, I add water, that is 20% optimal health effort. By week 10, we will arrive at 100% effort, but this may be too much. What we are looking for is your sweet spot.
Here is my sweet spot example.
Right now, I am operating at 70%. The 30% that are not on autopilot for me are the areas that I will add. Potentially in three weeks, I could be at 100%. It is not my goal to live at 100%, just to be aware of what that feels like.
What categories do most struggle with?
I will tell you that many avoid the accountability and progress tracking category. Why??? Let’s say you are using the scale to measure your progress. If the scale doesn’t change, then we may get disappointed and not trust the effort that we are making. So it is easier for us to just avoid. Accountability? What if we commit to something out loud and then don’t follow through? Do we then feel failure?
I always say that wherever the discomfort is - go after that.
So here are my official recs:
Track your daily steps and try to achieve 3k more each day
Start a strength training program and gradually work up to 3/week
Eat 3 servings of protein each day
Learn your hunger signals: eat when hungry, stop when satisfied
Drink at least 64 ounces of water each day
Try to get 7-9 hours of sleep each night (or just do your best)
Journal your thoughts for 5 minutes each day
Self-Coach or Be Coached
Track your progress (don’t skip this step and don’t just use the scale)
Enlist an accountability partner or group
Where do you think you will start???
Remember, a little goes a long way.
How to Go From Chaos to Calm at the Family Table
Teach Your Kids How to Develop a Healthy Relationship with Food & Regain Control of Your Kitchen
By, Ali Novitsky, M.D., Physician Life Coach for Women
Triple Board Certified in Neonatology, Pediatrics & Obesity Medicine
As a busy woman physician who juggles homeschooling my kids while running a full-time business, I know how much stress meal and snack time causes for overworked parents. It’s hard enough just to get everyone TO the table, let alone trying to figure out what to make for dinner each night that will please everyone. Sometimes it’s just easier to give in when your kids are demanding that extra snack and you’re just too exhausted to uphold your boundaries for the millionth time.
I noticed when I’m tired from a long day, I start letting things slide because I’m just too worn out to fight over it. And, let’s be honest, it gives me a moment of much-needed peace when the kids are buried in the latest app or show online.
But, when I noticed the kids were on their electronics more than usual at the table and wanting snacks constantly throughout the day, I knew it was time for a dinner table revolution and to change the way our family behaved towards food. I was letting things go because I was just too overwhelmed to make the changes I needed to make to bring order back to eating time.
As soon as we implemented the simple guidelines I will outline below, I felt more peaceful and less stressed around food choices and meals in our home. My kids also became more aware of how what they ate made them feel and, with fewer distractions, started developing a healthier relationship with their food.
Setting up healthy eating patterns early on teaches your kids how to eat intuitively for a lifetime AND it saves your sanity now!
Even better, we started enjoying our meals as a family again after we started these simple changes to our table habits. I want to share with you what worked for us so you can bring more peace to your home life too.
In this blog, I help you minimize the kitchen chaos and bring order back to your meals with a few tips that made a huge difference with our kids at home.
Teach Your Children to Have a Healthy Relationship with Food
How many times have you set a plate down in front of your children, a meal you slaved over, just to hear the dreaded, “I don’t want that,” or “I’m not hungry”? And then you run through a list of other replacement foods you can make and end up cooking all over again just to please your kids.
Yeah, I’ve been there, we all have!
This is exhausting, especially for busy women physicians, and it’s time we put a stop to letting the kids run the show.
One of the main things I noticed that had to be corrected right away was my own lack of boundaries around food at home. It’s often easier just to let the kids have what they want, rather than policing a snack policy, especially when you’re already drained from a long day in your practice. I SO get it. Now we do snacks once a day and I set the timing for that.
When we start letting our kids have those sugary treats whenever they want, or an iPad at dinner to keep the peace, we jeopardize their healthy relationships with food in the future. It’s important we keep our boundaries in check so they learn how to eat for confidence and well-being, as these early habits will continue to affect their feelings about food throughout their lives.
In our house, and with the women physicians I train in my life coaching programs, I teach mindful, intuitive eating as a way to build a healthy relationship with food. A few guiding principles of intuitive eating I teach my kids and women life coaching clients are:
No food restriction — No food is “off-limits” but that doesn’t mean we should let our kids have all the treats they want either. Finding food freedom through moderation is the way to go. You can have those high-calorie meals you love as long as you find a balance where it’s not EVERY meal.
Pay attention to your emotions before and after you eat — We tend to eat when we are seeking comfort or feeling emotional. Being more consciously aware of how you feel before and after you eat helps you be more in control so you don’t overeat feel-good foods as a solution for your mood. Kids do this too!
Being mindful of how full or hungry you really are — When you do overeat it is usually because you aren’t bringing enough awareness to how you feel in the moment. Asking your kids questions like — “Are you full?” “Are you still hungry?” and, either way, “How does that feel?” can go a long way in setting healthy habits that will last a lifetime.
Focus on how your meal tastes and feels — If you’ve been used to dieting in the past, meal planning may be stressful, or you may have some guilt around eating certain types of food. Instead, focus on the color, texture, and flavor of what’s on your plate and encourage your kids to do the same. Even if they don’t like something, have them describe to you what it feels like to them, it may help you learn other foods to avoid based on their preferences.
There are no “good” or “bad” foods — This is something that’s often hard-wired into our brains from childhood. It also comes from a punishment/reward system where treats are put on a pedestal and have to be “earned.” The danger of this is that you are creating positive/negative relationships with food that can be harmful later on. Instead, allow yourself and your kids to have treats but show them that other foods like veggies and fruit can be equally delicious and rewarding.
Intuitive eating is when you listen to your body, pay attention to if you're full or not, and give your body what it needs. There are no “good” or “bad” foods but there can be too much of something.
Many of us grew up in the “clean plate club” as mentioned in this article, where we weren’t allowed to leave the table until we polished off our entire plate.
Rules like this cause overeating and a feeling of guilt and remorse, which starts a chain reaction of negative feelings towards food that are hard to overcome.
If you want to learn more, this blog has some great intuitive eating tips as well.
Table Rules To Set Good Food Boundaries & Save Your Sanity
My stress level went way down when my husband and I started enforcing the following easy changes to our eating habits in our family. I encourage you to try them, both for your children’s benefit and your own!
Dr. Ali’s Family Table Rules:
No electronics are allowed when eating. Period. This is non-negotiable!
Check-in before/after meals and ask kids: Are you hungry? What does that feel like? Are you full? What does that feel like?
There are no restricted foods.
A daily treat is encouraged, however boundaries must be set for when the treat happens.
As parents, we are allowed to say, “No,” and ask for support from others.
I promise your kids will engage with you more just by implementing these 5 simple things that create more positive food habits. Give it a try today and you’ll see the difference it makes in your children’s behavior and your peace of mind right away!
Make Dinner Time a Chance to Bond with Your Family Again
Just because there is no restriction on what type of foods you can eat, doesn’t mean you shouldn’t still try to eat healthy meals, especially when keeping our immune systems strong is more important than ever. As Dr. Tiffany Lowe-Payne, a Board-Certified Osteopath says in this article,
“Nourishing meals create an environment where loved ones feel healthy and safe.”
The point of mealtime is to come together as a family and to nourish our bodies. Not to sit there on our individual devices ignoring each other and totally unaware of what we’re eating. This is how we get into patterns that don’t serve us later on, by being unconscious of our food choices.
When we eliminate distractions, such as electronics, and keep healthy boundaries around treat times that tend to get out of control, we maintain order and peace in our homes.
This also allows our home to be what it should be — a sanctuary where we get a break from our busy careers as women physicians. Instead of another place where we feel stressed and anxious all the time.
By making these small changes you will see big results in your family’s sense of connectedness that will take the stress and tediousness out of daily meal and food decisions too.
Conclusion
I hope this article gave you some ideas for how to regain control of mealtimes at home to bring more peace into your life. If you need more help with meal planning in a mindful, doable way, I encourage you to try my monthly group coaching membership program, G.O.A.L.S Society, exclusively for women physicians.
Learn how to eat for your body type with no food restriction or laborious meal prepping and take the guesswork out of planning meals for your family.
Join My Health & Fitness Coaching Program for Women Physicians!
We use mindset training combined with strategic nutrition and exercise programming to help you optimize your genetic potential.
Chasing Chase Tucker
I couldn’t wait to write to you this week because I had a pretty big AHA moment. I am a big believer in small and steady changes. I love helping perfectionists overcome all-or-none thinking. After all, I am a perfectionist who would live in this thought distortion.
Lately, I have been testing myself. My latest test was on my treadmill taking a class with Chase Tucker from Peloton. I love Chase Tucker’s class… and I proudly identify as a member of his wolf pack. He always promotes a beginner mindset, so this is what I explored on my latest run.
I got on the tread and planned to do a 20 minute HIIT run. If you followed my Instagram this week, I talked all about EPOC and the Afterburn effect. So - I was getting in my HITT to optimize the afterburn effect of my workout. During the workout, I pushed myself on this HIIT run… but not as much as I could have. And that was ok.
But I was curious. I am working on developing more lean muscle mass and getting stronger, so I have been making an effort to challenge myself.
When the run was complete, I had ranked 2,500 out of 5,000 runners. Right smack dab in the middle of the bell shaped curve. I then had a moment in thought. What does it take to excel? How could I come out of the average and move ahead? I could feel my competitive energy coming on strong. How much extra effort would it take?
So - I decided that I would repeat the 20 minute HIIT. And I would increase all speeds by 10%. So if I were at 6.0, my new speed would be 6.6. If I were at 9.0, my next speed would be 9.9. I was starting to wonder what results I would get by just increasing my effort by 10?
Now, in this scenario, I am using my rank as the result. What would my rank be if I increased my effort by 10%?
I got back on the treadmill and performed the workout. Many observations during this one. The most exciting one was that an increase in 10% did not feel that different!!! It was not more difficult. So interesting. I completed the workout. I felt great. Strong. When the ranks came up, I had improved my position to 1,800 out of 5,000 runners. I had moved my position to the 36th percentile from the 50th percentile. All with just a 10% increase in 10% effort.
What if our efforts didn’t have to be that much more? Perhaps a 10 minute walk on a day that you were going to not walk. Or 10 pushups added to your week when you otherwise wouldn’t do strength training. A small effort (just 10% even) can give huge results. Small efforts are easier to sustain because we will feel accomplished doing something very achievable.
I want to give you a little push today. Where do you want to put an extra 10%? Excited to see what you come up with.
Lizard Brain or Wizard Brain
I often coach my clients on topics such as: willpower, emotional eating, and small steady changes. Really, at the core of this coaching is Cognitive Behavioral Therapy (CBT). And, it is something that we can implement right away. Today, I want to talk a bit about CBT and how we can start sharing it with our families, even kids.
The CBT triad says that thoughts create feelings create behaviors. Asking children about how they are feeling will empower them to trust themselves and their feelings. A huge skill that many adults do not have mastered.
When they can identify their feelings and you ask why they are feeling this way, they will tell you their thoughts. In order for us to create a different feeling, we have to think a different thought. When we ask, “What makes you feel better?” We are actually asking for new thoughts. This is an easy way to start implementing CBT on your own. This can become a typical conversation that you have with kids.
Why is this important?
When we are talking about overeating behaviors, they are most often emotionally-driven. If we can process our emotion, first by identifying what we are feeling… we can eliminate eating because we are sad, stressed, bored - insert your feeling.
Now, this won’t happen overnight. When we learn to eat emotionally, then we create a type of neuroplasticity that looks like this. Let’s say that Little Johnny was sad because he had no one to play with. So, his mom and dad felt bad and said, “Let’s go for ice cream.” Ice cream will typically release feel good hormones, so next time Johnny is sad, he will remember that ice cream made him feel better and he may ask for it.
This is probably a good time to talk about the wizard and the lizard brain.
The wizard part of our brain makes logical, practical decisions. The lizard part of our brain just wants immediate pleasure. When we repeatedly listen to our lizard brain, this is when we will form bad habits. Our wizard brain knows better, but the lizard brain can overpower it if we leave it unsupervised… if this goes on too long, this is when we start to believe that we do not have willpower.
But, we don’t ever actually have to use willpower if we can understand and implement the CBT triad. The CBT triad says that we can create beliefs with our thoughts that will drive a healthy behavior, rather than having nagging thoughts that will trigger our lizard brain to want a quick fix. When our wizard brain and our lizard brain are fighting, this is when we are using willpower. Willpower is not a long-term solution. Imagine if we can help ourselves and our families with this now.
So… how about some homework?
I want you to notice your thoughts this week. Particularly, notice your urge to do something. When we are using our wizard brain, we have typically planned ahead of time to make a good decision. When we use our lizard brain, we are talking about the primitive thought pathway that wants pleasure ASAP. Notice what you use more of - wizard or lizard.
When we shift more towards wizard-driven actions, we will be creating good habits that will serve us. Realize that fatigue, stress, and alcohol will shift us more towards using our lizard brain. Use this time to just be aware.
Awareness is powerful.
Don’t Fix What Isn’t Broken
There is a common theme that comes up in my life quite a bit. On a bell-shaped curve, right in the middle is where most people live.
Let me give you an example. On my high school softball team, the coach was trying to teach everyone to swing the bat the same way. We went through countless drills. But, it just didn’t work for me.
I had a long baseball swing that I learned from my dad and brothers. The concern is that my bat speed would not be quick enough. But, we had evidence that my bat speed was as quick as can be.
Just to give you an idea, when we clocked my bat speed, I would consistently register at 100mph. And - I never had any problems facing the fastest pitchers. In fact, in my high school career, I never struck out. Not once.
Ok, back to my point. Nothing was broken with my swing. But, that didn’t protect me from believing that maybe I should change it. This is so easy to do when we forget to just trust ourselves… when we realize that we can (and have to) do things our own way.
When I went to college to play softball and also study Pre med, some of my teammates and even coach said, “You won’t last a year.” But - I did. In fact - I finished my degree almost a year early.
And then in the marketing world… so many mentors telling me to do this, not do this. And none of it worked anyway.
But… you know what did?
Being me. Little ole authentic me. Which means that I get to not only make the rules, but also trust my rules.
I have to believe that I am not supposed to do it the same as others.
Heck, as an obesity medicine specialist and weight loss coach… my main focus isn’t even on scale weight loss.
The trend that I see is that I was meant to do things differently in certain areas of my life. Which means, I can stop shopping around for the thing that is going to help me the most. Maybe I can stop listening to the opinions of others who think that they can do it better. Maybe this is where I trust that I have everything that I need, and I can do it my way.
I am writing to you because: You are Simply Extraordinary.
You are Unique. You do not fit the bell-shaped curve on all things. Find the things that don’t fit the bell shaped curve; those are your gifts and weaknesses. Both of which deserve celebration.
Our weaknesses give us insight and help us build strength while our strengths just need to be unleashed. I like to call this growth and explosion.
I invite you take a moment and carve out some space today - and commit to the ever-complex process of trusting yourself.
Trust the process. Trust yourself. You are amazing.
It's a Trap! How to Avoid the 5 Most Common Physician Mindset Pitfalls
By, Ali Novitsky, M.D., Physician Life Coach
Triple Board Certified in Neonatology, Pediatrics & Obesity Medicine
Read below to see if you’ve unintentionally fallen prey to any of these wellness wreckers . . .
1. Perfectionism
In med school, we are taught to get things exact. We worry about every move we make and how it could negatively impact our patients if we don’t get it right. This becomes harmful in our personal lives when we become used to putting pressure on ourselves to get everything just right the first time. This perfectionist tendency causes a cycle of self-shame that we have to unlearn to bring more peace and balance to our lives.
We have to remember — we are humans, not machines.
As a life coach for women physicians, I’ve noticed that women put an even higher level of pressure and stress on themselves in juggling the delicate balance of work and family life. This causes us to feel like we’re failing on one or all fronts much of the time. We have labor-intensive jobs and soon being stressed becomes the norm and an acceptable part of the job.
According to this article, more than a third of women in corporate jobs scored high as perfectionists, whereas only 21% of men did. Women were also more self-critical.
So how do we stop the cycle of perfectionism from ruining our lives?
We have to give ourselves enough grace to make mistakes and learn from them. This is key to prevent physician burnout and to have wellness and longevity in our careers.
The need to be flawless often continues in our personal lives, which can cause a lack of self-acceptance and a need to strive for perfection with our bodies.
In my monthly group coaching program for physicians, we don’t focus on hitting a “perfect” goal weight or dress size. I teach you how to accept your unique body type and help you set realistic results that are based on how you want to feel.
Read more about the science behind why my coaching philosophy works here.
2. Fear of Failure
Closely tied to perfectionism, the fear of failure is intense for physicians whose careers demand close attention to detail. We avoid trying new things that may benefit us because we’re afraid it won’t work out again. When we are already overloaded we worry that investing more time and money will be a waste we can’t afford.
Many women physicians fear failure in many areas besides career, including in your relationships, friendships, jobs, and even in your health and fitness.
Having a supportive atmosphere to learn and grow in is important to feel safe enough to try something new. The women I work with in my life coaching programs are surprised to learn how easy it is to start seeing changes in their physical and mental well-being when they are surrounded by a support system of sympathetic peers.
You need a soft landing spot to feel comfortable to explore a lifestyle you love. This is why it’s important to me that my coaching programs are accessible to all levels of fitness and experience. We need safe, nurturing environments to be allowed to grow without worrying about feeling defeated, especially since one third of Americans struggle with the fear of failure.
3. All-or-Nothing Thinking
Do you avoid exercising altogether because you don’t think you have enough time to make a difference?
Or eat one guilty pleasure food and then give up on being healthy for the rest of the day because it’s already “ruined”?
These are normal worries the women physicians I’ve helped struggle with before they join my life coaching groups.
In reality, exercising once a week is very effective if you pair it with healthy eating.
Many women physicians I work with aren’t sure what they should be eating but don’t have time to figure it out on their own either.
In G.O.A.L.S. Society, I show you how to easily incorporate these changes into your busy lifestyle with a comprehensive Mindful Macro Nutrition Plan and live weekly workouts, as well as a library of on demand workouts. These include cognitive behavioral therapy mindset coaching so you get everything you need in one convenient online portal.
This way you maximize the short amount of time you spend with us and still get results.
As physicians with high standards for ourselves, we tend to have black and white thinking that harms our overall health. For example, you may believe it’s not worth working out if you can’t do it for an hour when you would be better served by doing a 30-minute walk than nothing at all.
And I know sometimes working out just seems like more work to add to your already demanding schedule.
By committing to regular exercise, you are improving not only your physical health, but your mental health too.
I know that after a long, tedious day at work in the medical field it’s hard to muster the energy to put in an intensive workout at home.
The good news is — you don’t have to do time-intensive, gut-wrenching workout routines to get results.
Strategic strength training workouts along with a solid nutrition plan, like you get in G.O.A.L.S, is effective enough that you will see the difference right away. You’ll be better able to withstand those long, demanding days on your feet with less frustration and fatigue.
What makes my coaching style unique is that it’s built specifically for busy women physicians who want a complete, quick, and effective workout that is based on research-based principles.
4. No Time for Self-Care
When you don’t feel like you have enough time for your own needs, that’s exactly when you need self-care the most!
The women who join my group coaching programs are shocked at how easy it is to fit a workout into their busy schedules and how much better they feel after even one session. We meet multiple times a month to work on our fitness and self-care together, but without putting too many demands on your time.
As this study shows, “although 80 percent of physicians say practicing self-care is "very important" to them personally, only 57 percent practice it "often" and about one-third (36%) do so only "sometimes."
I designed my programs to maximize time for busy physicians like you who know they need to do more to take care of themselves but don’t know how to fit it in.
If you worry about making time for self-care, I have a treasure trove of pre-recorded calls and workouts available to you 24/7 online. I strive to provide multiple options to make it as easy for you as possible to take care of yourself.
5. Trying to Figure Everything Out on Your Own
As women physicians, we are used to a high level of autonomy and self-mastery in our field. This can be a hindrance though when it comes to asking for help or trusting others to know what’s best for you. I mean, you’re the one usually running the show, right?
What I love about G.O.A.L.S is that it’s a community of women with the same shared experiences and challenges as physicians. We get what it’s like to have a long day and just want to zone out rather than work out, but we hold you accountable for taking care of yourself in a loving way.
This is often a missing component in a physician’s life — the inability to let go and get guidance from others because you’re so used to being in control all of the time.
Letting someone else take the reins for a minute, not only gives you a much-needed break from having to feel “on” all the time and it relieves stress too. One hour of true “it’s all about me right now” time can take loads of overwhelm from the workweek off your mind.
The thoroughly researched methods I use in my physician coaching programs give you the most bang for your buck in the shortest amount of time. As a triple board-certified physician, I know exactly what it’s like to feel like you’re worn thin and like there’s no time to take care of yourself.
Through my research, I learned how to work with our body chemistry to achieve the optimal health and fitness results we all desperately need to sustain our mental well-being and careers for the long-term.
Our mind and body are intrinsically linked, there is no point in addressing one without the other. This is why I combine mindset coaching into my weekly workout routines.
This maximizes your low time investment, while giving you an outside perspective that is often overlooked by physicians trying to go it alone.
Our complex careers are hard enough, don’t put so much pressure on yourself to find out how to get fit and healthy on your own.
My Yearly Date With the Scale
I couldn’t wait to write to you this week. You see - once a year, I weigh myself. I have had such a negative relationship with the scale based on childhood experiences that I have a tendency to avoid.
Yes, I have done the thought work that I preach. Make it neutral. It is data. But, those thoughts never seemed to work for me. And then my client helped me. Yes - I learn tons from my clients, too. I recently worked with a fabulous doc who weighed herself to find that she lost 2 lbs. Guess what she said, “Oh, I hope I didn’t lose muscle.” My coach brain was very happy.
We are conditioned to believe that our weight has power.
Weight is simply gravitational pull on the earth. But, to break it down further… most of us have fixated on a number that we think we should weigh. And if we don’t weigh that number, we often think we have failed. Or, our body has failed.
Let’s just try something on. What if a higher number on the scale was a great thing?? I can think of many reasons why it may be. More muscle, dense bones, proper hydration, adequate nutrition to name a few.
Ok… getting back to weighing myself this week.
In my mind, I have a high number: the number that I weighed in college while playing softball, eating junk, overtraining, not sleeping, and being under a lot of stress. Then I have my low number, the number I weighed a year after my first baby where I was high on life, sleeping, eating well, walking in nature, and enjoying my daughter and husband.
How interesting!!!!!
I weighed my highest when I was stressed and unhappy and my lowest weight when I was happy and content.
Now - I wasn’t stressed because I weighed more in college; feeling stressed caused me to take actions that pushed me higher on the scale. I wasn’t happy because I was a lower weight on the scale… my happiness and contentment allowed me to take actions that promoted a lower weight on the scale. You see - it is not about the weight.
This week right before I got on the scale, I took a guess at my weight. And then I decided how I wanted to feel before I hopped on. I also said, "So what if I am my heaviest weight… is that a problem?" I now know better. And, it is just data - data that will allow me to change things if I want.
I jumped on the scale after not having weighed in a year to find that I am exactly the same weight as I was last year. And, 3 lbs less than I guessed. I had so many powerful thoughts. Including, "Well, Ali, you do practice what you preach for sustainable results. You have a good piece of data that you can do what you want with. Carbs are serving you well. You can still have wine. Getting 10K steps per day is a big deal."
This might have been my most positive experience that I ever had with a scale.
Now… I am not telling you exact numbers for a reason. They just don’t matter. But what I can tell you is that I am not my highest, and I am not my lowest. In fact, I am right at my set-point. So, what do I want you to know? If you are going to use the scale, know your set-point. It is super important when you are considering weight loss. Studies show that we can only lose and maintain about 10-15% from our set-point without surgery and/or medication.
Now to the finale. What will I do with the info from my yearly weigh in???
I am going to keep doing exactly what I have been. I am going to love myself even more knowing that I have the ability to accept myself as-is. I also can change anything I want. I think this year, I am going to optimize my genetic potential and fuel my body the way I need to in order to gain some muscle. I am not afraid of the numbers anymore. I will not let them hold me back.
I invite you on this journey with me. What if you could let go of all the scale drama? What would your life look like?
How to Stop Feeling Overwhelmed By Life
Read below to see if you are coping with any of these comfort-seeking habits that lead to long-term dissatisfaction . . .
By Dr. Ali Novitsky, M.D.
Triple Board Certified in Neonatology, Pediatrics & Obesity Medicine
We’ve all felt it at some point — that feeling of “why try.” In this article, they call it, “languishing,” which is described as a feeling of “meh,” or ambivalence about making decisions brought on by social isolation and a general feeling of discontent.
Cue the comfy pants, the Netflix binge-watching, and the guilty pleasure foods in an attempt to simply FEEL BETTER. We’ve all done it (guilty!) but how do we break the cycle?
If you feel you’ve let your healthy habits slip, or just aren’t feeling like yourself lately, don’t beat yourself up! The general dis-ease and sense of “what’s going to happen next?” is causing all of us to feel out of control and helpless. Understandably, the unsettling feeling and fear of what’s around the corner causes us to turn to what is comforting and familiar.
In this blog, I share some useful life hacks for mental well-being and tips for healthy habits from my life coaching programs for women. Focusing on wellness as physicians is so important as we juggle the increased stress we’ve all been under.
Below are a few physician wellness tips to ease you through the feelings of ambivalence and overwhelm during this turbulent time.
Give Yourself a Break for Taking Breaks to Prevent Physician Burnout
We can’t just GO, GO, GO all the time without expecting anxiety, stress, and total physician burnout. So how do we balance all of our priorities when we have too much on our plate and it just keeps coming?
First, listen to your body, what is it trying to tell you? Do you need a break? Do you need to get more energy and make more time for exercise? Or do you need to go to sleep earlier because you’re irritable, cranky, and unable to focus? All of this makes a difference in our physical and mental well-being and we shouldn’t feel bad for taking a night, or even a whole weekend off when our body is telling us to SLOW DOWN.
As a physician turned life coach, I know that the behaviors you are feeling guilty, or even shameful about, are just coping mechanisms for the constant change and instability we are all enduring.
Reaching for your favorite comfort food more than usual?
Working non-stop and feel you don’t have time to get exercise in?
Exhausted from your busy schedule and don’t have the energy to work out?
If you’re feeling sluggish or more tired than usual, just understand you’re still adjusting to this new normal. This is expected given the increased pressure of homeschooling our kids, managing a global health crisis from the frontlines, and the constant worry about our vulnerable family members.
You are doing so much and I know how frustrating it can be when you feel you don’t have the time or energy to work out. In my life coaching programs, I’ve taken this into account and have streamlined a system for maximum efficiency and convenience. Feel better quickly without ever leaving home, with a fitness and nutrition program that comes to you.
As a life coach for women, I help physicians find more peace and satisfaction in their lives by showing you how to master your mindset and strengthen your body to withstand the demands you face.
Now more than ever, it’s vital that we focus on the importance of self-care for doctors.
Why Evidence-Based Fitness Training Gets You Out of the “Blahs”
As women physicians, we know that exercise increases our energy and metabolism, but it also increases our serotonin levels which boosts happy hormones and lowers stress. By exercising regularly, and prioritizing our self-care as busy women physicians, we boost our mental health and physical endurance so we can enjoy our careers for the long haul.
This article explains that serotonin levels not only affect our mood and energy, but they affect our ability to digest and process foods too. Low serotonin levels negatively impact our sex life, our ability to stay focused and concentrate, our emotional stability, and our mood. Meditating, going outdoors in the sun, and regular exercise, all contribute to healthy serotonin levels, which keep you feeling happy and healthy.
If you feel constantly anxious or stressed, weekly strength-training workouts combined with mindset coaching help reduce the overwhelm. This is what we do in G.O.A.L.S Society, my life coaching program for women physicians.
We help you get back into action with our evidence-based workout routines that are designed to boost your metabolism and get rid of that blasé feeling.
I know it’s hard to stay motivated alone, which is exactly why I created this peer-based life coaching program. Get support and inspiration from other women physicians going through the same thing. We help you get off the couch and get back into a healthy, evidence-based workout routine to beat that blase feeling.
We Need to Surround Ourselves with Support, Not Isolate & Withdraw
This importance of connection and social support can’t be understated. In this article we see that after attending one women’s networking conference, “78% percent of them reported feeling ‘more optimistic about the future after attending.”
This is the power of my monthly group coaching program, where you join other health-conscious women physicians for weekly life and fitness coaching that you can do online from anywhere. We help you reframe your mindset for positivity and success so you look and feel better than you have in year.
Cure Physician Burnout with G.O.A.L.S Society,
a monthly group life and fitness coaching program for women physicians.
Get emotional support and accountability from your peers and nurturing guidance from a physician turned life coach who cares. Transform your body composition and rid your mind of those worrisome quarantine troubles — one weekly workout at a time!
If you are struggling with motivation, sluggishness, or just don’t know where to start to feel better again, try my peer-based group life coaching program and see results in as little as a few sessions!
“But I don’t have time to work out,” you say?
What if I told you that you only had to work out once a week to see results in your energy, body and mental well-being? In my group life coaching program, G.O.A.L.S Society, most of my clients see powerful transformations in less than 2 months working out only once a week!
We meet every Sunday for an hour to work out and reset for the week ahead plus you get live mindset coaching calls per week. This schedule is doable even for busy women physicians who don’t have a lot of free time, but still effective enough to see lasting change.
You will be shocked at the transformation you see in your body and your confidence!
This isn’t just a fitness plan or workout, it’s cognitive behavioral therapy-based mindset work, a comprehensive nutrition plan, and a life coaching program that heals what ails you from the inside out.
My Dog May Be My Greatest Teacher
Well… this is our first week back from Florida.
I wish I could tell you that I carried all of the space and calm back home with me… but, not so much.
From the minute I walked in the house, I could feel the whirlwind of emotion take over my body. To-do lists started forming in my head. Multitasking began. I felt stressed. I wanted to run around the house and scream quite honestly.
The day after we arrived home, I went and picked up our puppy from puppy training. We hired the best dog trainer. Our trainer, Tina, went above and beyond for us. All through the training she pointed out key things about our dog, Lilly. And here is what we learned. Lilly is just like most members of our family. She is busy and full of energy. She buzzes around the room and her biggest challenge is settling.
What??? We adopted a restless dog, just like me???
Suddenly, I understood Lilly better. And - it also became clear that Tina’s strategy to help Lilly is very similar to what I would tell a client. My mind was kind of blown here. Lilly has to practice doggy meditation for 90 minutes, twice per day. Essentially she arrives in this zen space and is completely relaxed and calm. Hmmmmm… perhaps the meditation space is something that I have been ignoring a bit too long.
In one month’s time, Lilly has transformed. She used to bark continuously to the point that we had to keep her in our pool house because otherwise, we couldn’t work. Never in a million years did I think she could come into the gym with me, sit nicely in meditation, and watch me workout. She is a more confident dog and knows what to expect. We know what to expect, too.
Putting this all together… the space that the dog is creating for herself is the same space that I need for myself. In Florida, I gave myself that space. At home, my neuroplasticity set in and I started zooming all over the place.
Often it is harder for us “restless” souls to meditate or be still or create space. Which is exactly why we need to do it.
While this post may seem fun and light, I want you to use it to evaluate if you feel a significant amount of restlessness in your day. If so, the time has come to implement some slow-down strategies. Whether it be meditation, or long walks in nature, etc., our minds can be even more brilliant if we give them the space to rest and recover.
Obstacles? Thoughts like, “I have so much to do.” “I can’t slow down.” “I will slow down when I retire.” “If I slow down, I won’t start back up.”
Remember, these are just thoughts. We can just as easily think, “I am committed to taking care of myself.” “A slower pace will allow me to process my emotions better.” Creating space for rest in each day is just as important as our nutrition and exercise.
This week, I want you to focus on creating space for yourself for 1 hour. Just 1 hour. No electronics. No expectations. Just you. See what comes up for you… and if you feel up to it, send us a note and let us know.
Ok. Back to dog training…