Subscribe on Apple 

Subscribe on Spotify 

There are moments in our work that stay with you long after the conversation ends. My interview with Jamie Selzler was one of those moments.

At 652 pounds, Jamie's world had become frighteningly small. Short walks left him breathless. He couldn't get up from a fall without help. And the haunting reality that people his size rarely lived past 50 forced him to face where his life was heading.

What followed wasn't a quick fix or dramatic intervention. It was a complete transformation built on small promises, deep self-compassion, and the support of GLP-1 medication. Over three years, Jamie lost more than 340 pounds. But what moved me most wasn't the number on the scale. It was how he rebuilt his relationship with himself.

In this blog, I'm sharing key insights from our conversation, including Jamie's four rules for lasting change, why he keeps a notebook with hundreds of handwritten wins, and why he refuses to set a goal weight. If you've ever struggled to believe change is possible for you, Jamie's story will remind you: it's never too late to start.

Life at 652 Pounds

Jamie had been over 500 pounds for roughly 25 years. He'd tried losing weight before (Atkins in the early 2000s, a medical meal replacement program in 2015) but each time followed the same pattern: initial success, then rapid regain.

During COVID, everything intensified. Working 80-90 hours a week from home and living on food delivery, Jamie's weight climbed to at least 652 pounds. His mobility became almost nonexistent and he couldn't walk 20 feet without stopping to breathe.

Friends and family started pulling him aside, scared he wouldn't make it much longer. His mentor, a man in his seventies, delivered the wake-up call that still makes Jamie emotional: "I want you to go to my funeral. I don't want to go to yours."

Starting GLP-1 Medication

Three years ago, Jamie started with small changes on his own by eating slightly better and moving a bit more. He lost 50 pounds that first year without medication, but the constant food noise made every day a battle.

After finding an obesity specialist, he started semaglutide. The first three months brought no weight loss, which he now sees as an important part of his story because it sets realistic expectations for others starting their journey.

What was changing was subtler but more important: the constant mental battle around food was beginning to ease. Small shifts in his eating patterns emerged. And then one Sunday, a routine McDonald's run became a turning point when he stopped mid-drive and asked himself why he was even going. He wasn't even hungry. So he turned around and went home, never resuming that habit again.

After shortages forced a switch to tirzepatide, his progress continued. The medication didn't do the work for him, he still had to show up every day, but it finally made the work possible.

Jamie's Four Rules for Transformation

Throughout our conversation, Jamie kept coming back to four core principles that guided his journey. These aren't complicated strategies or restrictive protocols, they're mindset shifts that made everything else possible.

Rule 1: Keep the Promises You Make to Yourself

Jamie realized something profound early on: we're quick to keep promises to people we love, but we constantly break the ones we make to ourselves. His advice? Start small. Really small.

Instead of promising to overhaul your entire life on Monday, promise yourself you'll drink one glass of water in the next hour. Then do it. These micro-commitments build trust with yourself over time.

Rule 2: Rely on Consistency and Discipline Over Motivation

Jamie now lifts weights four days a week and walks 12,000 steps daily, but he's not always motivated to do it.

He reminds us that motivation is fleeting. Some days it's there, but most days it's not. What carries you through is consistency built on promises you know you can keep.

Rule 3: Celebrate Every Single Win

This might be my favorite part of Jamie's approach. He keeps a physical notebook where he writes down every win—and I mean every win. He estimates he's recorded about 900 so far.

Small wins he celebrates:

• Walking from his door to his car without stopping to breathe
• Hopping out of his car quickly
• Fitting comfortably in a restaurant booth
• Making a bag of spinach for breakfast

"When you start doing that, you go through life looking for these positive moments," he explained. "And on bad days, I pull out my notebook and read through my wins. It works every single time."

Rule 4: Focus on Input Goals, Not Output Goals

Jamie doesn't have a goal weight. When his doctor asked what would make this journey feel worth it, he said maybe 400 pounds, and now he's at 310.

Here's why this matters: Output goals (the number on the scale, clothing size, compliments from others) aren't within your direct control. Input goals are.

Jamie's input goals:

• What types of food is he eating?
• How much protein is he getting?
• Is he going to the gym?
• How many steps is he taking?
• How much water is he drinking?
• How much sleep is he getting?

"I cannot control the scale," he said. "But I can control what I eat, how I move, and the promises I keep to myself."

When Shame Keeps Us Stuck

The shame tied to Jamie’s weight was so overwhelming that he avoided healthcare entirely, and did not see a doctor from 2016 to 2023. 

This hit close to home for me. We know from research that people with obesity access healthcare less frequently because of shame and stigma. They don't get mammograms, preventive screenings, or the help they need.

But even before those seven years of avoidance, when Jamie did see doctors regularly, not a single one ever mentioned his weight or suggested intervention. His labs looked fine, so he was labeled "healthy", even though he knew he was a ticking time bomb.

The irony is that when help was finally offered, he still couldn't take it. In 2021, an endocrinologist sitting next to him on a plane told him about GLP-1 medications that might rival bariatric surgery. She gave him her card, but he never called.

He wasn't ready yet. The shame was still too heavy to overcome.

Finding the Right Support

When Jamie finally sought help, he found an obesity specialist (something he now urges everyone to prioritize).

His advice on building your team:

• Find a doctor who truly specializes in obesity medicine
• Consider working with a registered dietitian
• Don't go it alone—assemble people who understand this is a chronic disease
• Be open to medication as a tool, not a failure

Rethinking When Life Gets Better

Near the end of our conversation, Jamie shared something that gave me chills:

"I used to think the happier life came at the end of all this. I thought once I worked out enough, ate better, lost the weight—then I'd have the happier life. But I realized the movement, the good food, testing myself at the gym—that is the happier life. That's not the road to the end. That's the end. I'm living it right now."

This is what I want you to take away: Don't wait until you hit some arbitrary number to buy clothes that fit well. Don't postpone joy until you reach a goal weight. The transformation isn't just about your body, it's about how you treat yourself along the way.

Jamie's advice for anyone at the beginning:

1. Don't compare yourself to anyone else. Comparing the start of your journey to someone else's middle or end will only make you feel like you're failing.
2. Get help. Build a team. Talk to medical providers who specialize in obesity. Work with a registered dietitian. You don't have to do this alone.
3. Have compassion for yourself. Jamie forgives himself for all the years he didn't get help, didn't go to the doctor, didn't take care of himself the way he needed. "I just did the best I could with what I knew at the time," he said.

Talking with Jamie reminded me why I do this work. Obesity is a chronic disease, and it deserves to be treated with the same compassion, medical intervention, and evidence-based approaches as any other condition.

But beyond the medication and the medical protocols, lasting transformation requires something deeper: learning to keep promises to yourself, celebrating your wins, and understanding that the life you're building isn't waiting at some distant finish line.

It's happening right now, in every small choice you make.

Want to hear Jamie's full story? Listen to the complete episode for more insights on his four rules for transformation, celebrating wins, and building lasting change through self-compassion.

You can follow Jamie's journey on TikTok: @JamSelz or Instagram: @jselzler.

 

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance.  

 Welcome back to another episode of the podcast. Today I am really excited because we have Jamie Selzner on, and I wanna give you a little bit of context 'cause I always say this on the podcast. I don't bring. Random people on, I bring people on where I might be following them online.

I love their message. I love their story. And Jamie is really one of these people that has been on an amazing transformational journey. And every video, Jamie, that I watch of yours, I feel inspired. And so, I just messaged you and I said, Hey, could you come on the podcast? And you've been so gracious to come on.

Can we start with people that. That have not had the privilege yet of getting to know you on your channel. Can you just introduce yourself and tell us a little bit about you? ' I don't even know that I know very much about you either. Sure. Well, first of all, huge honor to be here. Dr. Rentea, I've been listening to your podcast for a super long time, and there's only a few podcasts that are really focused on obesity, and particularly like the medical treatment of obesity.

And I like other podcasts that are just about, the fitness side, which I think is great. But, I like that, , this is a disease and . You talk about that, and I really appreciate that. , So thank you for having me on. I'm Jamie. , I guess what it brought me to this community is that, , I used to weigh 652 pounds.

That was my highest weight, , three years ago. I. And I've lost 340 pounds over the last three years using only, , GLP one. Semaglutide at first, tirzepatide, , name brand is what I use. And so I've used that over the last, , few years. But my stories, obviously, I'm not just. That. , I live in North Dakota.

I'm 46 years old. I've worked in the tech space, Amazon and Walmart, e-commerce for most of the last 25 years. And except for a brief foray into politics where I'm fairly politically active as well, and, I do some of that stuff. , And I started, , posting on TikTok and Instagram about this stuff really just a few months ago.

Yeah, it's pretty recent that I started. And , the reason I didn't talk about this for a long time, 'cause I never envisioned talking about this at all. But I realized that, , one people are asking me, Hey, what are you doing special? And I didn't feel comfortable, , not being fully honest with those around me.

And I don't judge anyone who isn't because everyone has their own story to tell. Totally. Everyone has their own medical. Yeah. . Their right to their medical privacy. I didn't wanna just say, well, I'm eating better and working out even though I was, , because there are other people in my life who also have obesity or have overweight and who could really benefit from GLP one.

And , I don't want them to feel like I did it on my own, quote unquote. And so I just started speaking out about it. And, , then a few months ago appeared on a very large, , podcast that I knew would get some attention. And so I started posting about this and I really try to focus on, , the mindset aspect and goal setting, and I have some rules for myself.

So that's really who I am , and why I'm doing what I'm doing. , This is not something I ever intended on making a major part of my life, but here I am. Thank you for having shared this. , I find this is maybe a theme in my life. The people that I like the most are those that they didn't go out like wanting to be an influencer.

Because there's something very contrived about that. And , there's something about when you've been through an experience and you are, like you said, sharing 'cause you wanna help others. It's just a different energy behind it. Yeah. And so, I really appreciate that. Can you take us back to, what did your life look like before you started this journey?

What moment did you hit where something changed? Because I'm sure in the past probably there were a bunch of things that you did. Yeah, I've been over 500 pounds for, . Since like maybe 2000, 2001. So 25 years roughly. , I've been over 500 pounds and during that time I tried to lose weight multiple times.

, Like a hundred percent of those listening probably have tried , to do. And there's a few times , I had success losing weight. I think many of us are pros at losing weight. Oh yeah. It's like keeping it off. That's the hard part. And so in the past I did, . An Atkins style diet in the early two thousands was working out a lot.

I didn't really like that. I was just eating meat all the time. I eventually hurt myself in the gym and in my head at that point, it's like, well, I can't work out right now, so I might as well not eat that well and fell off and gained all that weight back incredibly quickly. I. Yeah. And then another time around 2015, I lost a hundred pounds in like just a few months using a medical diet, with my doctor at the hospital using essentially meal replacement shakes and bars and lost a lot of weight quickly.

I. , Did not do any working out during that point. And so I think I lost a ton of muscle, which is why I'm such a huge advocate for resistance training as part of this process. Yeah, yeah. , But part of why I lost the weight during that time is I had to go in and get weighed every week, and it was a group thing where there were 15 of us in this group going through this program together.

We would all go in, we'd all get weighed in front of each other. Ooh. Yeah. Did you, why? How would you think about that? I mean, I hated it, but my ego would not let me show up and not losing weight. That, yeah, that was wonderful. So I mean, it was accountability and I appreciated the accountability aspect of it.

Yeah. It's like people go one of two ways with that. ? So you went the way of letting it positively fuel you. It certainly caused me to lose weight. I wouldn't say, I wouldn't say it was probably positive. I mean, I definitely lost weight. , I wasn't necessarily doing it for the right reasons.

I was doing it to protect myself from embarrassment, and I ended up moving. After about three months, I moved to a different state. I moved to Seattle for work and I gained all of the weight back. I lost to almost a hundred pounds. I gained all of it back in three months, I lost to the three months and gained it right back in three months.

But in the process, I'm sure I lost mostly muscle , if we can just stop here for a second. It's really interesting that you're bringing up all these different, let's just call it modalities, right? Or like ways of doing things. 'cause I've never been a fan of the meal replacement route because unless you plan long-term to keep that, it doesn't work.

So I'll give you an example. I've had patients that are truck drivers. It works well for them because they'll be able to continue their route. They just take a drink, you know? Yeah. But other people, it's not realistic, and then you're in this cycle because you'll lose the weight and then the doctor's like, well, then let's do it again in three months.

And so you're just like constantly up and down and up and down. And , I find that stop start energy to be really hard, long term. So, it's good to hear your experience with it. It certainly changed my relationship with food or even with friends or family. I remember going out to a wing place and , I didn't order any wings or a beer, and normally I would've even had just a couple wings and a small beer, but I didn't because I had my way in the next day, and I.

, , it didn't work for me 'cause the food noise never went away. None of this made the food noise stop. It just, it made the numbers on the scale drop. , It also really taught me, and we'll talk about this a bit later, it really taught me that , any focus on the scale as. As the goal, at least for me, is not a good idea, and I learned it during that.

But anyway, so I gained the weight back and then gained weight fairly dramatically during COVID. So I went into COVID weighing maybe 550 pounds. I , previously, lived in England and moved back to the us Yeah. And I worked for Amazon at the time, and when COVID started, Amazon got very, very busy, as you would imagine.

And I worked at our corporate office and I started working 80 to 90 hours a week. And I was working from home for the most part. And literally all I did was work and order, meal delivery, food delivery. I did that for a year and gained. The highest number I ever saw on the scale was 652 pounds. I suspect I was probably 6 75 or north of there.

Yeah. But was so I didn't want to use the scale because I knew it was gonna be bad news, so I just went a year without weighing myself. Yeah. And when I eventually got to that weight, to that six, I'd say anything over 600, my life really changed. Dramatically. In lots of ways, my mobility became almost non-existent.

Yeah. I couldn't walk more than 20 feet without getting outta breath. Oh. And, , the combination of the physical aspect and the, how much working I was doing cos me to eventually quit my job. Took a few months to leave. It was called the long Goodbye. I called up but eventually was able to get outta there.

Yeah. And it was because I'd come back to North Dakota where I'm from and a number of my friends and family had seen me 650 pounds and were all pulling me aside individually to tell me that they were worried about me, that they were scared for me, that they thought I was. Not gonna be around a whole lot longer.

And I began to look around and realize I was 43. I looked around and realized that there were no one my size was in their fifties. , They had all died. All of them. Or if they hadn't died, they weren't ever in public. They were just at home and , I had a few turning moments. One was a friend of mine, a hero of mine, who I just respect the, I get emotionally even talking about this or thinking about him.

He's in his seventies and was at his place one night with a group of friends and we were all leaving. And as I'm leaving, he pulled me aside and he was, I think 74 at this point. And he pulled me aside and said, Jamie I want you to go to my funeral. I don't want to go to yours. And when someone in their seventies tells you that they think they're gonna be at your funeral.

Because of your health. It was sort of eye-opening around that same time. I mean, all this stuff happened all within about a month or two of each other. Yeah. And this was fate or the world or whatever, like telling me I needed to make a change around that same time I went to Florida for my sister's wedding.

She got married on the beach. I officiated her wedding and I had not been on the sand in decades, I knew walking on the sound was gonna be hard at my size. I did not anticipate that it would be nearly impossible. Okay. Especially in the panhandle where it's like this really soft sand.

And I get through the wedding and after the ceremony where like 20 of us were standing for a group picture and I step wrong and I fall. And so I fall on the beach with the sand. I hurt my knee. I didn't realize until later I torn, , the meniscus in my knee, but at the moment I could not get back up.

Because I was so big and there was nothing to hold onto. Yeah. And I was laughing 'cause it was sort of funny, you know, fall in the sand. It's not like I cut myself or something, but I was laughing and I couldn't get up and in my head was absolute pure terror about one thing, which is someone's gonna pull out their camera.

And record me at 650 pounds. And here I am stuck on the beach and I'm gonna become a viral superstar as the beach D whale overweight guy. And fortunately, one of the people at the wedding is this amateur powerlifter, and he got me up by some miracle. And so I never became a viral star, but if he had not been there, someone would've recorded me.

And just knowing how the internet is,, and how people get turned into memes. I know it would've happened. Got up. That was an eye-opening. And then a few weeks later I was back home and this is the, I'm just being like honest with people because I think my reality is the reality for other people.

Yeah. If not yet, it will be your reality if you're not able to get this stuff under control. , Couldn't get up off the toilet. . I couldn't get up. I was physically not strong enough to do it and was terrified that I didn't have a phone, I didn't have to call and terrified. Not that I was gonna die at that moment.

I knew worst case, I'd throw myself on the floor and crawl or something, but I began thinking like. Do I die this way? In a situation where I physically can't get help? Yeah. And it led to things like if I have, some sort of serious medical issue, cancer or a heart issue, I can't be treated 'cause I'm too big for a lot of the machines in the hospitals.

Yeah. And then I started looking at stuff like, what do you do with a body my size? Like can I be cremated? Dark stuff that you begin to look at. Yeah. Yeah. Anyway, all of these things happened over the course of a couple months and told me that I really needed to change, and this would've been three years ago, and at that point I just started, I.

Eating a little bit better, moving a little bit more, and I was able to lose 50 pounds that first year, no medication, which is great. I'd been gaining for years, so the fact I lost anything is wonderful. Yeah. But that was. An insanely hard year because I was constantly fighting a battle in my head against the desire to eat and the food noise all the time.

And after a year, I eventually got an obesity specialist. And that's why I constantly tell people, when you find a medical provider, find someone who really specializes in this work. Can I ask you, had you, up to this point you had not seen, 'cause like who was running that medical the, that program that you were doing?

That was 2015. That was my previous primary care doctor using their medical weight loss program in the city that I was, yeah. Oh wow. So can I just ask and feel free to not answer this if you wanna answer this? No, I'm open book. Had primary care not said to you, Hey, let's do a surgery. , Let's refer you to a specialist.

Had that been recommended or you weren't open to it, or no. Doctor had ever said anything to me about my weight. Wow. And I'd been 4 50, 500 plus pounds for years. And so I had broke my wrist twice in like 20 11, 20 12. I'd fallen. , And. I went and saw my doctor every year or two, , when I was younger.

The thing is at that, at least at that point, none of my labs were bad. They were all good. I've always had low cholesterol. I've never had any significant heart issues. , And so my numbers all looked pretty good. Blood sugar for many years was a little bit higher than they got higher near the end. But if you were to look at my chart, other than the number on the scale,, I was healthy.

. That's why I get concerned about this stuff. It's like, can you be healthy at any size? Sure. At that moment in time, you may be healthy at a certain size, but I was aware at my size I was a ticking time bomb that just had not exploded yet. That's what I tell people is 'cause, .

There's a lot of talk in this area, and it's, for me, I call it the off the cliff moment where it's like, you're fine, you're fine, you're fine. And then suddenly there's diabetes and heart disease and all the things that hits Yes. All at once. Yep. And I don't know that I've met anyone yet that at a certain point that does not occur because there's just certain physiologic realities within our body.

Yeah, a hundred percent. I should have to see if I can process this out loud for a second with you. I'm really shocked . , That your physician didn't ever bring it up, 'cause I feel like everyone is constantly getting traumatized with it being brought up all the time by the doctor.

And you're telling me that you had the opposite where no one even was going there with you? I. No one did. The only time it came up is when I would bring it up and I would say something like, oh, I wanna work out better. And for many of these years I had sort of slightly elevated blood pressure that had not been, , medicated.

And the reason I started the medical weight loss program is because I'd seen some advertisement for it and, , asked my doctor who was aligned with that hospital, Hey, can I do this? And then he referred me to that to that group. Yeah. If you, do you think if someone. In this time had said, oh, I would recommend bariatric surgery.

'cause I feel like GLP ones be like years ago when you were talking about were not, it was not as known to primary care and things like that. Right? Yeah. Would you have been open to that or do you think that the timing wasn't right? , . It would've depended on the message.

So I was aware of bariatric. I had friends who had had it in my head. I thought that it was the sort of the easy way out. Same thing with with glp, and I was worried about doing something that was permanent and all of that, and my numbers were okay. And at this point, , this is two thousands into the, the 20 teens I was, my mobility was still okay.

My labs were okay , if I'd had a medical provider say to me during that point, Hey, your numbers are fine. Now you're okay, another 10 years of this and you're gonna be in major trouble. Mm-hmm. And if they would've maybe scared me a little bit, rather than reassure me that how good all my numbers were, that might've got me to think about it.

Well, but you know what you bring up, it's, I dunno if it's scaring so much as. In medicine,, we see the trajectory. Like, when you were talking about how you looked around and you had that moment where you were like, there are people not 10 years from now that are my size , that are in this room.

Yeah. , When I was in, , medical, , well past medical school and residency training, I did a hospitalist month where, you admit people and you take care of 'em. I think internal medicine, inpatient. Yep. Yep. And I kept a list of those patients because, I always liked long-term taking care of people, and I wanted to see, okay, in a month or two, where were they, had they bounced back, you know, da.

, Half the patients were dead. And the reality is they were 65 or 60 or 55, they had an elevated weight set point. They were coming in with BiPAP. The point is, it's exactly what you said, and I think we see all that. And so if someone can not scare you, but say, this is what I see, and then you get to decide what you wanna do with it.

But, it's interesting that I don't know, it's just interesting, right? The interactions that we have. Yeah. If they had been honest about the reality, that would've scared me. . Not that someone would intentionally try to scare me, but it would've been scary to know the reality of my situation is what, that's what I intend.

Yeah. But actually know in 2021, I was flying back to North Dakota from Seattle is Right, like as COVID. . Right after the vaccines came out and so it started to fly again and. Flying is horrifically bad for anyone of size. We all know that. And there was a woman next to me and it was like a two seater, row.

And, I was crowding her and I felt so bad and was apologizing about it. And she, must have known. And , I. She told me that she was a doctor, an endocrinologist, and she was practicing on the east coast and west coast. She would travel back and forth between the two and, she asked me if I had ever considered bariatric and I said, no, I.

She said, there's this new class of medications , that's out now. This would've been ozempic at the time. And she said, I think that over the years these are going to rival and beat bariatric surgery in terms of weight loss. And she gave me your card and said, when you get back, let me know and reach out to me and I'll see what I can do to help you.

And I didn't, I didn't do it. Wow. I didn't think you didn't do it. I wasn't, I don't think I was ready yet. Like, yeah. I had not hit my rock bottom yet. Yeah. Yeah. I had so much shame, I had so much shame tied up in my size that even, I mean, I didn't go to the doctor from 2016 until 2023.

Can I normalize this? This? Yeah. We know this based on studies and data that. That because of shame, we do not access healthcare as much, and so we don't get diagnoses. We don't get the help that we need. Right. I'm getting chills as I say this. There's no one that comes into my clinic where that's not the case.

And so when someone comes in, I'm shocked if they've had their mammograms and preventive health things because. We just don't access healthcare because there's such resistance when you go in on some levels. Absolutely. I, I love going to the doctor. I go to my doctor every four months. I love going, I want every test.

If you have a test, give it to me. If there's a procedure, I want to use everything, which is why partially, I'm sure insurance companies don't want people to lose weight because then they start using the doctor more. I wouldn't shock me one bit, but . Part of this journey for me, and I talk about this a lot in my posts and when I go live and chat and streams forgiving yourself.

I think the only way that you can really move on and create a new healthy life for yourself is you really do have to forgive yourself. Me at my heaviest. Eventually asked for help and got it. But there were many years prior to that where I didn't ask for help or I didn't act the way that I should have.

I didn't. I didn't do the things I should have done for whatever reason. And I forgive myself for that. I love myself. I respect me at my heaviest because life at my heaviest was a thousand times harder than life. Today. I lift weights like crazy. Today. I walk 12 to 15,000 steps a day. All of that is .

A cakewalk compared to what I used to do. And so I forgiven myself for not going to the doctor and not getting the test and doing all that stuff. Yeah. Because I just did the best I could with what I knew at the time that it happened. And I encourage people to forgive themselves their past selves. 'cause that's the only way to move on.

I a hundred percent, it's beautiful. I sometimes have people write a letter and it's, I forgive myself for.dot. And you just stream a consciousness. Five minutes you write because. It's really bottled up the judgment that we have on ourselves. But you know, the other thing that I also say to people is , you were doing the best that you knew possible, right?

Yeah. I, I don't know if in those moments you were trying to volitionally do stuff negative. I mean, , same with me. I think I was surviving right at my highest and there's something that almost makes me wanna cry about that because, I think we all. What's so hard about this disease is that I think we think it's like an intentional choice, and I don't think majority of it is.

There's a lot of factors driving, like, food noise and a lot of things like that. And so it's so hard that we think it's this conscious process when a lot of it I don't think is run consciously. So that's why, it's just hard. For sure., Giving grace to yourself is a powerful thing to do.

And there's just so much shame tied in having obesity. I talk now, I mean constantly I, that number 6 5 2 652 is the my highest weight and. For many of us, especially those listening, that number, the number at your highest or whatever you are today, a lot of people have so much shame tied to that number.

That is a number that I never imagined I would ever say out loud because saying that number out loud to me was gonna be admitting. A truth that I didn't want anyone to know. And I found the more I say that number, the less power that it has over me. And so, yeah, I was 6 52 pounds. Try living at 6 52 pounds, , or 500 or 300 or whatever it is for you.

I'm also very tall, so I mean, it's 6 2, 6 3, so I can handle it maybe a little more than someone else could. But I take the power away from that number. That number now is I'm, i'm probably proud of it more than anything , that I made it through and that I survived. But yeah, that's where I am.

. So two years ago I started on GLP one. I started,, semaglutide. Did that for about six months. Then there was shortages as everyone who's been on this for a long time can remember and then was forced to move to Tirzepatide., Which was a great move in hindsight, and that's what I've been on ever since. I've lost in the last two years, I've lost significant amount of weight. I got down to 600 before the medication. Yeah. But I do all sorts of other stuff. I lift weights four days a week. I walk 12,000 steps a day. , The things they tell you're supposed to do that are impossible when food noise Yeah.

Is crowning everything out. Once I got rid of that food noise, I was able to actually do this stuff. So I'm curious. Okay, so you get on the med, but then what was some of the first steps that you took, because it's like right now, like I don't want people to compare your journey right now to their beginning

yeah. So what were some of those first things where it was like, these were the first things I did that were accessible, that were reasonable? Everyone has a secret sauce in the beginning. What do you think yours was? Once I started. GLP one. I did not lose anything for three months.

I love that this happened. Can I just say that? Yeah. I love that it happened too. I love that happened too, because people see my before and after pictures and they compare themselves to me and they think they're doing so great and they come and they say, I've only lost 10 pounds the first month.

And I'm like 10 pounds. , You've won the lottery. Congratulations. You've won the GLP lottery, the G, the GP lottery. Congrats. I lost nothing the first three months. Yeah. . The food noise started to go away a little bit during that time. My eating changed a little bit. My movement didn't change a lot.

So I've developed these four rules for myself over the course of time. But the first one that was part of this is that I began to keep the promises that I make to myself. And that's the first thing I honestly changed. It is so easy for us to. Break the promises we make to ourselves. We keep promises to others, people that we love.

But we break the promises we make to ourself because we don't necessarily have to be accountable to them. And my, what I like to remind people is if you make a promise to someone that you love, you keep it because you love them. If you make a promise to yourself, you should keep it because that's how you show you love yourself.

How we demonstrate love to ourselves and others is keeping the vows and promises we make to them. . That's truly what love means. Yeah. And so I began to make promises to myself, and they were, at first they were things like water. Like how much water am I drinking? The biggest one I made right away was about movement, and it was that.

I would not take the easiest path every time. Something as small and simple as when I was going to a store, if there was a sliding door, and then off to the side was like a push old school push pull door, I go to the side door and I pull it open, or I push it. It's a few extra steps. It's a little bit of resistance, but more than that, those little things.

In your head begin to tell you you don't have to do the easy thing all the time, and it retrains your brain to not look for the easy path. And that's a huge difference that happened in my life right away. It's brilliant to be honest. Yeah. I. And so I started keeping promise to myself. And then after a few months, I, I began to, and , I always caution people about this 'cause , everyone does things differently, but I really needed to way measure and track my food, to really get a sense of what I was eating.

'cause there were things that I knew logically, but I didn't fully understand. I used to make, , I still love stir fry vegetables and I'd make all these vegetables and broccoli and peppers and be like, why am I not losing weight and not aware of a calorie density of olive oil that I put in there.

And so I had to start doing that stuff and it made a real change for me. But when I realized, this is probably about a month or two in when I realized that life had changed with GLP one is that for many years. Every Sunday morning I would go to McDonald's it was just this habit for years, I'd go to McDonald's, I'd get four sandwiches and two big orange juices and whatever, and probably, I dunno, 2,500 calories maybe.

And I did it every Sunday morning. And then there was one Sunday I, after I'd been on GLP for six-ish weeks and I was driving to McDonald's. Out of habit. I did it all the time. And halfway there I stopped. And literally it was like this flash in my head. I just said, why are you doing this? You're not even hungry, like you don't wanna do this?

And I pulled into a parking lot and had one of those little self conversation that we have with ourself that takes a minute. And I turned around and I went home. And this is the last time I ever did that. I've never had the desire to do that again. And that was the moment that I realized. Things were different, and for those of us who've lost weight in the past or trying now, it sometimes feels like a little bit like gambling or like an an election or your favorite TV show that's ending and you don't know how it's gonna go.

You have hopes, you hope your person wins the election. You hope you win that lottery, but you don't really know at that moment. Instead of my new journey being about, I hope this works for me, I realized, oh, this is going to work for me. I know, and once I was aware that this is gonna work for me and this is gonna be my life now, that gave me, I'm getting emotional.

I've I, one sec.

You know all the talk I've done about this, I've never gotten emotional about it. What have you done to me, Dr. I realize then, all the effort that I'm about to put in is gonna pay off for the first time and it changed my life. Yes. Alright. I'm better now. I better. Okay. This moment that you're talking about, I really think that everyone goes through this when it's lasting.

Where this moment where it's, I call it the crack in the foundation moment, it's like your actual identity changed and you had hope, and this wasn't just, we're gonna be trialing random things. Yeah. It's so powerful what you just shared. And you know what I also love too? It's like it was random

it wasn't this big proclamation, this big, I'm gonna set out and do whatever. It was like you were doing the normal thing you were gonna do and then you just had this moment and you listen to yourself, right? 'cause you could've been like, Nope, still gonna go do it. But yeah, God, it was a powerful thing and it made the, you know, the rules I had for myself.

It really just made them all easier to follow. Because now, rather than think all the working out, I'm gonna start going to the gym now, and I'm gonna start walking now and I'm gonna really gonna be careful. I'm gonna be mindful of what I'm eating. I realized that it was actually gonna pay off for once and it wasn't gonna be, I'm gonna do all this stuff and still be overweight at the end.

But yeah,, that was a pretty life changing moment. I've not done that since. I've not had the desire to do that. I could do it. The difference now is I know I could go do that and I'd be fine. Yeah. And, but I just don't want to. Yeah. So that food noise going away in that moment made a difference and after a few months, I started adding more rules and one on another.

And next thing you know about a bing, about a boom, I've lost 340 pounds. I, okay. I wanna go back to something though. You know how you said you had to track and measure stuff, right? And I know everyone has different strategies around this. I am curious we actually didn't talk about how long you struggled with weight.

Was it your whole life? Was it in childhood history? Starting when I was about 10 years old. Okay. 'cause, everyone has a point. I got addicted to Mountain Dew when I was 10 years old and Mountain.

But I find that when people have really struggled a long time, the tracking is very triggering. Yeah. So you didn't experience that or were you starting to think differently about it No, I mean that's why I always caution people when I talk about tracking is it's very di in some cases it can cause disordered eating or bring back disordered eating for people.

And so some people, there's all sorts of different ways to do it. And in my case it was fine and, but for me it was really about the mindset of it. Yeah. I did not view the tracking as. This is a way for me to restrict what I'm eating. I really viewed it as I need to make sure that I'm nourishing my body, particularly with protein and, for me, without tracking, it's just a guesstimate.

At this point, I probably track 80% of the time I've gotten much better at, but whenever I eat at home, I measure how much spray oil I'm using, , and it takes a few minutes. It's never really been very triggering for me. But I also don't really, we will talk about the scale. I don't really care about the scale a whole lot either, but people need to be careful about that because for some that can cause them to restrict, which is not good.

It's the mindset though. It's what you're talking about. . Because I find if people have that to begin with, normally when we start to work together after a period, they're okay to track because. For example, if we have the thoughts behind tracking how fun can I make this how can I make this higher protein?

How can I make it taste better? What crunch can I add instead of, like you said, what can I take away? It becomes very different also to your point. Yeah. You sometimes go the opposite direction of malnourishing and then you just have no idea. Also, the circuitry is a little off when we first start and when we're going down this journey, and so like those loving boundaries, if that's helpful.

I think that's great. But I wanna double back to your first thing here where you. Where you were talking about, keeping promises we make to ourselves. I think that this sounds great,? And I agree. My whole philosophy with people is let's make the commitment small enough where you know a hundred percent you can do it, right?

Yep. So, but how did you do that? Because I think that a lot of people, they're in a hard place. They're struggling like intellectually, we know a lot of the things, like most people are very smart,, it's usually not a knowledge problem, but. How did you bring what you were doing down to scale enough where you could do promises and keep it to yourself?

You know what I mean? Yeah. You only make a promise that, you know, with certainty that you can do Yeah. But is not easy. I can make a promise myself that I'm going to lift up my AirPod case promise. That's a silly promise to make to yourself. Yeah. Now, if , I make a promise to myself that within the next hour I'm going to stand up and drink one glass of water.

And then sit back down. I have an hour to do that. That's the type of promise that I started making to myself at the beginning. And I think the biggest, I mean, there's so many big mistakes we all make and we've all made, and we're trying to lose weight. The biggest mistake is trying just to do everything all at once.

Like starting Monday, I'm going to eat better, I'm gonna drink my water, I'm gonna sleep right? I'm gonna go working out, I'm gonna do all this stuff. And what happens when you try to do all things at once? All it takes is failing one thing to cause you to give up on everything. So, right. Like short circuits it, right?

Yes. So make one promise of something that you have to work a little bit for, but you know, you can do and just do that. And the thing is, you don't have to do all of it. For those on GLP, that promise can simply be, I'm going to take my injection every Sunday, or whatever it is. Pick a promise that you know you can do.

And once you consistently do that where you're like, okay, now I'm gonna add a second one. And a third one and a fourth one. And that's really how you do it. And it's not as difficult , as it seems because they're small enough that you're just building. Ha I mean, it's just building habits is what you are.

Yeah. Which actually is part of the second rule I have, which is I rely on consistency and discipline over motivation. Mm-hmm. Motivation is great, but motivation runs out. I view motivation and inspiration as different things. I was inspired to lose weight because I did not want to die. That didn't motivate me to lose weight necessarily.

Yes, right. Motivation to me is like a daily thing. Yeah. And so in my case, , I work out, I lift weights four days a week. I don't really do any cardio. I'll be honest. I don't use the treadmills. I rarely sweat. I just walk and lift weights and I do it four days a week. I walk 12,000 steps a day.

I didn't start with that. I started with a thousand steps a day. But, there are some days I'm motivated to do those things and it's fantastic. I love when I'm motivated, but many days I'm not. I'm motivated often just to lay in bed or watch Netflix, like that's my motivation often, but I make a promise to myself and I'm going to be consistent with it, and in my case, GLP one actually makes that much easier.

I still have to do all the work, but it makes it easier to do. But relying on a feeling of motivation to do anything is a recipe for disaster. 'cause it runs out. 'cause we all have bad days. Yeah. So instead just say, what can I consistently do? What promise can I make myself that I can consistently do? I.

Then do that. And if you can't do that, then that means that the promise you're making maybe, it's too big of a promise at that moment. And you have to think that it's smaller until you can actually be consistent. I always say , when people are not consistent, they're like, but no, it is small. It is reasonable.

I'm like, well, it's not, because if it's not happening, that means that there's friction somewhere, there's an obstacle.? So clearly it's not as quote unquote easy as we think.. If you were to think about all the things that you did,, and obviously this is ever evolving, but do you think there are things, and some of them you've already mentioned, but some things that worked better than others or some things that really didn't work, maybe that surprised you where you were like, I, you thought that was gonna be the way and it didn't work out?

It is one another rule, but I'll give a a little hint. It's about the scale, it's about the number and the scale. I thought that having a goal weight, we always hear about having a goal weight and what's your goal? Weight. And it's still a question everyone asks me all the time. Yeah. What's your final goal?

Weight. And I realized early on in this process that if I was focused on a number on the scale, like I had been all the other times I was going to fail. And so. That initially happened when I was on GLP one and I wasn't losing anything the first three months. There was a part of me that intellectually knew, okay, weight loss isn't linear, and all those things, but it's still hard to not see the scale move.

I. And so I really made a very conscious decision that I was not going to allow the scale to hold any sort of negative emotion over me. And so I was initially weighing once a week and I started weighing daily. Now again, this is one of those things where people have to make sure they are in the right head space and mindset for something like this.

Yeah. Because for some people weighing themselves daily. Weighing measuring tracking food can cause some real harm. So if this is you, then maybe this isn't a good idea for you, or I would certainly encourage you to, maybe seek some therapy to see that if there are things that you can work through that would help do this stuff.

But I started weighing myself every day. I. And I said, no goal weight to my doctor. , My doctor's like, , what's your goal weight? And I said, I don't have one. At this point, I was just over 600. , Then he asked the question differently. He's like, what weight would you be where you would feel like this was worth doing?

Oh, and my doctor's fantastic by the way. And I said, I guess if I got to like, I. 400 or four 50, that'd be pretty good because when you're 650 pounds, 400 is fricking skinny. That's skinny, you know? Yeah. And so I said four, I'd be okay at 400. I think that would be like awesome. And now,, I'm like three 10 today.

Yeah. And so I realized, the thing that surprised me, I guess, is not having a goal weight and focusing on other things ended up being way more successful for me than otherwise expected. I. Yeah. Yeah. I'm glad people hear that. I do talk about that on the podcast. I am personally not a fan of goal weight.

'cause I think, things declare themselves. Some people, the things they're doing, take them so far. , It's just not predictable is the problem. You know, we have on average numbers, but we're not a textbook. No, absolutely. Totally. Right. And so to focus more on the things that are in our control.

Like at some point we can't do more than we're doing, right? There is a ceiling, like people think it's endless what you're gonna be able to do. No, there are physical realities to this world, and I find that what you're talking about when you focus on the behaviors, that goes a lot further. So with motivation, I agree that if you have it. Phenomenal on that day. But yeah, we can't rely on it., A lot of days it's not gonna be there. Yeah., And the consistency carries you, but on a hard day.

Are there any tips of what you draw on or how you get yourself to still do those things? Yes. It's my rule. It's my third rule, which is I celebrate every success. Yeah. Every win I celebrate, and when I say every, I mean every, I don't have my notebook, but it's behind me. I have a notebook, I think of eight or 900 lines that I've written there. Every time something good happens, I do two things, and by good, it could be like a big one, like the first time I fit in a booth at a restaurant.

Okay? Even now, if I like hop outta my car pretty quick. I'm like, Ooh. Oh, look at me hopping outta the car like that. I have so many wins in the car. 'cause we, when you're really big, you have so many bad things about the car. Yeah. But anyway, , whenever I have a good thing, I speak it out loud and I say, this positive thing just happened to me, but I then write it down, not in a notes app, old school, pen and paper.

I write it down. And when you write when you start doing that, and when I say every small one, it doesn't matter. The first time I walked from my. Door to the car where I didn't have to stop to like breathe for a second. That's a win. And I write it down. Yeah. It imprints in your brain like you are looking for these moments to celebrate 'cause you wanna write them down, right?

Right. And so you go through your life looking for these positive things Anyway, to answer your question on days that are really bad. All I have to do is pull out my notebook and I read through the list of wins going back a couple years, including some of the first wins. And I realize the first wins now are things that I take for granted.

Those ones who are, who have obesity often look at other people like, you just take all this stuff for granted that you can do this, or walk here, or whatever, right? And looking at that list reminds me of, the things that I should not take for granted and appreciate. And honestly, that's worked on my bad days every single time.

By looking at my list of wins. I love that you shared this. I wanna call this your philo. Fabulous. Because you Oh, I love that out, right? That I heard this term in the past, and I actually do this when someone says something nice about me as a physician, like working with me, because there was a period when I first started where you have some imposter syndrome, right?

Where you like, I don't know enough, and then patients were saying really nice things. I was like, I'm gonna write this down because this is truth. They're telling me this, but I'm thinking differently in my mind. . But what you are talking about where then you get to look back at the beginning.

'cause I tell all my patients, I need you now to take inventory and write down, like physically in a journal I. What life looks like right now. I said, because you're gonna forget in two seconds. Yeah. We're gonna have achieved the 20% weight loss, whatever it is, and you are gonna still want more. You're gonna still be unhappy, nothing's gonna change.

And you have no perspective moment. No, but I love this and I'm gonna adopt this, , for me, for patients that this keeping the list of things because that's so good. We habituate, we think, oh, it's all. Easy coming to us and then we forget how all of that was hard. And if we could look back and see how we lived then and how we live now, we would be crying.

Tears of joy, yet we're sitting there sometimes. Absolutely. Yeah. Me, two years ago, if I were to look at an average day today, I would feel like. Well, I do feel like the luckiest person alive. I legitimately feel that way, and I feel that way because I was over the cliff. You talk about coming to a cliff moment, I fell over the cliff.

I somehow survived and crawled back up. I. Using the help of medication, but also mindset. And this is what my rules are about. And if you have the right mindset, and then you have the tools and the right team behind you to take care of you medically, emotionally, physically, you can really do anything. But , going through your life looking for wins, just fills you with a joyful, grateful heart and a joyful, grateful heart.

Doesn't need. As much external motivation because your life is the motivation. The fact that you're even here becomes a motivation. You're so right. So like the writing down the wind, I think it increases gratitude. Like this morning I made a big ass bag of spinach, you know, like condenses down to nothing.

Do a little bit of some stuff. I was sitting there, I was like, look at you making this for breakfast as part of it. And you're so right. If we're just like, eh, I'm having a veggie. We don't get to harness that. Yeah, and writing it down, you gotta write it down 'cause that's where one, 'cause you can look in the future, but two, it really does change how your brain works.

I really think it works on the subconscious, to be honest, because it's like we only have access to that, 10% of thoughts and there's all this other sort of like unexamined thought. And when you write it down, I think it locks it in deeper. And I know there's good research behind writing stuff down.

It's , a different process. Like we can't write as fast as we can think. So it's always interesting when we like do a journal post what's actually coming out because we have so many other thoughts in our mind. But what was important enough to make it on the page. ? Yeah. But tell me if you think someone's listening and.

They're at the beginning or maybe they're in the middle and they're just having these hopeless moments where, things aren't working out. They're really feeling discouraged. Would you have any words for them? I do. It's rule four, goal setting. You often feel like you're failing if you are not achieving your goals.

And often those goals are gonna be what I, what output goals. Output goals are things like a number on the scale, the size of your close, whether or not people are noticing and saying something to you. And some people love it. Some people hate it. Personally,, I'm a Leo, so I thrive off of compliments on my size at this point in my life.

But I encourage people to. Think about input goals versus output goals, and. It's a little bit like the promises, but input goals are things that you have direct control over. An output goal or an output metric are things that you can't control. I cannot control the scale, meaning I'm not a robot that gets to go in there and type out the little number.

I can't control how, the size of the shirt that I buy. I mean, I buy clothes are too big. I'm learning that. But anyway instead think about what are the things I have direct control over and set your goals. About those things, again, make the goals achievable. So in my case, my goals are all about things like, what am I eating?

Like the T type of food that I'm eating. How much am I eating? How much am I moving? Am I going to the gym or not? How many steps am I getting? How much water am I drinking? How much sleep am I getting? All my goals are about those things, and I set the goals to be achievable. Not easy, but achievable. And.

My advice to you,, for me, all my four rules that I follow from my mindset. This is the hardest one. The hardest one is setting a achievable goals. 'cause we want such great things for ourselves and we set the goals often too high. Yeah. And it's okay to have your big why, what you want at the end.

It's, but your day-to-day goals have to be things that you have direct control over. I love that so if someone's in a hard moment, what do you have control over? What is a realistic goal for you? I think that's really powerful. It's the zoom out moment. Yeah., Ooh, really good stuff.

Yeah. Do you think that there's anything today that we did not cover that you think the listeners need to hear? We sort of covered it, but I kind of wanna reiterate the fact that people really should have empathy and compassion and respect and love for themselves. Other people, of course, they should have that for, but you should have it for yourself, and that includes giving yourself grace and forgiveness for wherever you are today.

I sincerely mean this. The fact that I am still alive. Is a small miracle to me of medicine. It's also a miracle that beyond medicine of mindset, and for those who are listening who are just getting started on this. Process. I use the word journey. We all use the word journey. I don't like the word, but I use it a hundred times a day.

Sorry. I was, I said the word. Yeah. No, I say it all the time. Partially because some of these online social media places, they don't let you actually talk about weight loss. You have to talk coded words, but yeah. If you were at the start of this. I always give people three pieces of advice, especially if you're starting a GLP one , or trying to lose weight.

Number one, don't compare yourself to anybody else. Please do not compare yourself to me. I am aware that , I'm a work in progress. I'm a success story. I understand that, but I am nearing the end of my journey here. I still have a lot to do. I have to skin removal, surgery and all that stuff, but if you compare the start of your journey to the end of, or near end of someone else's, you will.

Automatically feel like a failure. Yeah. So do not compare yourself to anybody else ever. And that includes don't find out, like people ask, say how many calories you're eating or What are you eating? It's like, well, this is for me. I'm not a doctor. I'm not a dietician. I can't tell you what or how to eat.

You should talk to a medical provider. You should talk to a registered dietician. You should talk to these folks to put a team together for yourself. But please. Respect, love, have compassion for yourself, get a help, get a team. And then, probably the last thing I wanna mention is the most powerful mindset change that I've made Dr.

Rania is I used to think . That a happier life came at the end of all this. I thought that the happier life was okay, I'm gonna have to work out, I'm gonna have to eat better and all of this stuff. At the end of this, I'll have the happier life. And I really kind of came to a realization just a few months ago that , all the movement I'm doing and the mobility that I have, the finding good, healthy, nourishing, good tasting food, .

Going to the gym and testing myself with my muscle. That stuff, that's the happier life. Yeah. That's not the road to the end. That's the end. I'm living the happier life. And the sooner that you out there understand that the happier life. That's the way you're going through this process, that's happier.

Don't put your happiness off to the end till once you get, a certain clothing size, or once you get a certain number, your happiness can be today and your happiness can come from walking and from testing yourself and enjoying good food and drinking your water and being around people that you love.

That's what happiness is. Yes to that. 'cause I always tell people, what is this? You're gonna wait till the end, quote unquote, to buy new clothes. Why would you not? , I love this a term, adore the vessel. Casey Ian, she's gonna be on the podcast coming up here. You need to honor where you are at this moment.

This is not, we wait till the end and then we're worthy enough to spend a few dollars on ourself it, if anything. Frankly, it makes it harder. So I love that the. , Being in it. Yeah. And I always say, if you're hating every moment of it, I kind of think we're doing something wrong, because if you're hating every moment, you're not gonna be able to keep doing that.

It just pure brilliance, everything that you said. No, I appreciate that. I would speak endlessly to you, but I wanna respect your time. Can you tell our listeners where do you hang out? How can they follow you? How can they get into your world Yeah, follow you more. So I've been on TikTok a lot lately, so I'd love if you'd follow me on social media.

I don't do this as a profession, this is just sort of something I do, but I've really focused on mindset. Talk to a doctor about GLP. You can talk to me about my rules. I'm fine doing that. So you can find me on TikTok. You can search for my name. I have my name everywhere or on TikTok. TikTok, I'm Jam cells, JAM.

SELZ, or search my name and then Instagram as well., You'll find me there. My name or j Sz, J-S-E-L-Z-L-E-R. Happy to talk with people, and would love to connect with people on social media. I love that. We're gonna make sure to everybody who's listening. Look in the show notes, meaning either under the episode or to the right or left, however it is on the app that you're listening.

And then if you go to tia clinic.com, you click on podcast, which is forward slash blog. We're gonna have with your episode, all of your social links there. So if you didn't write it down, you don't have a pen, do not worry. We'll have that all linked. And then obviously when this comes out, I'm gonna be. , Referring to 24 7.

So, but that's great. Just thanks again for coming on this a true pleasure. And I have learned so many great things from you today, and I know that everybody, they're gonna benefit so much from hearing this. Thanks for having me. And thank you for the work you do. I love your podcast. You do great work. I love that you are both a provider and a patient, and it gives you an incredible, unique perspective.

So from all of us in the community whose lives are changed by you, thank you, Dr. Andia, and keep doing what you're doing. Thank you.