This weekend, our provider Julianne had the honor of being a key speaker at the Downtown Oxford Spring Fling. This event has been something called Mums Morning Out in the past and this year was revamped to be more inclusive and varied in its presentation. Here are some excerpts from the speech that also give a look into who our provider is and where her passion comes from:
"When I was asked to speak today, I’ll admit, I was quite nervous and taken aback. In my position as a medical provider, I talk to people day in and day out–but large group settings are not something I’ve always been comfortable embracing. Sheepishly, I accepted. (Easy to be cool when you’re texting :-)) And then, that’s when the thoughts started racing through my head—What do I have to share? What can I say that many of these women haven’t already heard? What did others see about what I have to say is important? I shared my nervous excitement with a few close to me and they each had nothing but encouraging things to say–”Julianne, you’ll do great!” “Women need your type of encouragement”. “Talk to them like you would any of your patients…your patients love you–they all feel seen and accepted by you”. Of course, hearing this feedback was great, but also helped to ground me in sharing what I have come to learn as a nurse practitioner working in the weight loss field in addition to other focus areas since 2014.
Besides not wanting to see others struggle with their wellness, appearance, and health, I am passionate about what I do because of my own beautiful daughter. Norah is 16 months old and an absolute joy in our house full of what was all boys prior to her arrival! I never want her to think more or less of herself solely because of her appearance, weight, or size. I also want the generations that follow to recognize that worth is based on way more than superficial things and overall wellness is achievable. Of course we all want to look our best and FEEL our best, but it doesn’t simply boil down to how much we weigh or what size our pants are.
Weight, size, and feeling comfortable in my skin has been a lifelong struggle for me. I remember seeing one of my grandmothers endlessly “dieting”, my mother always being thin and a high value placed on weight and size, and my 3 beautiful older sisters never seeming to struggle with weight. Unfortunately, what I learned through these examples of “health” was an unhealthy view of self and self-worth. I was very heavy at the end of elementary and middle school and remember how badly I just wanted to fit in and feel “normal”. I know, I am not alone in the struggle of understanding wellness from skewed examples of “health”. As women, our lives are inundated with what it means to be “beautiful”. What I see on a daily basis is women (& men) who are discouraged by unattainable goals, visions of beauty, and not being able to fully appreciate the amazing beings they are for many reasons. There are many pressures on us to achieve and “be this thing or that thing” or to fill “this role or that role”. The expectation to give and do while also maintaining an image is very high and simply not realistic. We are spread thin by obligations, expectations, and influences both personal, professional, and public.
Besides not wanting to see others struggle with their wellness, appearance, and health, I am passionate about what I do because of my own beautiful daughter. Norah is 16 months old and an absolute joy in our house full of what was all boys prior to her arrival! I never want her to think more or less of herself solely because of her appearance, weight, or size. I also want the generations that follow to recognize that worth is based on way more than superficial things and overall wellness is achievable. Of course we all want to look our best and FEEL our best, but it doesn’t simply boil down to how much we weigh or what size our pants are.
Throughout my near decade long nurse practitioner career, I have worked in different types of population and specialty focuses. From acute care to addiction and mental health, flight medicine to urgent care, family practice to weight loss, I have seen a lot. As a child of a Welsh born father and a military spouse, I have had the privilege to live in many different locations (including multiple countries outside the United States). What rings universal is that our appearance as women is something we all struggle with at one time or another or on a daily basis for some. There is a drive for “perfection”, “achieving this look or that look”, “weighing this weight or that weight”. We will hear advice from people who are insensitive or simply not knowledgeable, that in order to get where we want to be, we should simply exercise more, eat less. We should try this diet or that diet and then, we’ll finally get where we want to be. Unfortunately, what is not shared is that these pieces of advice, expectations, diets, and ways of life are designed to fail. Why? Because what these things don’t do is get to the root of the issues that so many of us who struggle with weight deal with OR show us how to regain a positive body image. They don’t set us up for success because there is no simple, one size fits all solution.
While acknowledging goals and motivation for a desired outcome/change are essential in the journey to wellness, so too are understanding that the medications (ie Wegovy, Mounjaro, phentermine, contrave and the list goes on) are TOOLS and not THE ANSWER. I truly believe that medications like Wegovy and Mounjaro are fabulous options for many as they are well tolerated medications, offer cardiovascular, kidney, and liver protection while stabilizing blood sugar which helps with aspects of weight with which many struggle. When your blood sugar is up and down over and over, you have moodiness (hello feeling HANGRY), cravings (for sugar, chips & salsa), binging, and overall increased calorie intake. These medications slow the stomach emptying process which gives many a sensation of longer lasting fullness. Another benefit these medications offer is a quieting of what I term as “food noise”. It’s the voice that so many of us have when we struggle with our weight that is near constant focused on food, snacking, next meals, etc.
In order to achieve and maintain weight and wellness goals, having your labs (ie vitamins, minerals, hormones, etc) optimized is essential which is why it is another area I focus on in conjunction with other tools with my patients. Certainly it is ideal to get vitamins and nutrients from our dietary intake, but at times supplementation is essential. Many of us lead lives where consuming organic, unprocessed nutrition is challenging, expensive, and simply quite difficult. Orally consumed vitamins and minerals have relatively poor absorption (10-40%) compared to nearly 100% of those delivered intravenously or intramuscularly.
When patients come to our practice, paperwork is completed to include their history, lab work, and past diagnoses. I will hear a lot of times “I’ve been feeling fatigued” “like something just isn’t right” but “they checked my labs and told me they were normal”. “I know it’s not all in my head, but I’m discouraged and not sure what to do”. At this point, I explain that wellness also encompasses optimizing nutrients, minerals, and hormones within our bodies. What I mean by this is that just because something is “normal” doesn’t mean it is optimal.
Drawing and reviewing lab work on patients and comparing it to optimal levels often validates what patients have known to be true, but simply couldn’t articulate in the past. Once vitamins, minerals, and hormones are optimized, many other aspects of health will also improve for our patients.
Wellness is not something that is single-dimensional. It is multifactorial. Our genetics, our environment, our upbringing, our friends, our employment, and our education all play into what that means to us and how we achieve it. One of the MOST IMPORTANT things I ask any of my (weight loss) patients is “what is your goal?” I then go on to explain what I mean by goal is not necessarily a certain BMI (a very antiquated measure of “health”), a size (which can vary so greatly on what brand you wear), or what they feel I think they should be or do. It is where they want to be. So I turn this to each of you….Where do YOU want to be?
Is it having more energy at the end of your work day so you can truly enjoy your spouse, children, significant others, friends, or hobbies?
Is it wearing a bikini and feeling comfortable in your own skin?
Is it fitting into that favorite pair of jeans you haven’t been able to slide into in 5 or 10 years?
Is it a certain arbitrary number on the scale?
Is it simply not being plagued with the illnesses you see other members of your families or friends deal with due to being unwell?
Is it simply feeling “better”?
Once we can acknowledge our goals and motivation for getting well, it is less overwhelming to make sustainable change. Together, we can work to use the tools we have (be it medication, various eating habits, or exercise changes) to get to your goal. We can form a community of support, of cancellation of “fad diet culture”, of acceptance. Whether it is with me or another trusted provider, I encourage any of you who can relate to what I have shared, to find a provider who will come alongside and support you in your journey to wellness. THIS is how we practice shared decision making and support one another WHERE WE ARE".