For more than four decades, Dr. James Hill has studied one of the most important questions in health and human behavior: how do people create meaningful change, and perhaps even more importantly, how do they sustain it? In this episode of 1,000 Waking Minutes, we explore not simply the science of weight loss, but the far more complex and deeply human challenge of what happens after success.

Dr. Hill is one of the world's leading experts in obesity, physical activity, weight management, and behavior change. He is Professor at the University of Alabama at Birmingham, Director of the Nutrition Obesity Research Center, co-founder of the National Weight Control Registry, and co-author, with Dr. Holly Wyatt, of the new book Losing the Weight Loss Meds: A 10-Week Playbook for Stopping GLP-1 Medications Without Regaining the Weight.

Our conversation begins with a deceptively simple but profound idea: losing weight and maintaining weight are fundamentally different challenges. While GLP-1 medications have transformed obesity treatment by helping many individuals achieve weight losses that previously felt out of reach, they have also brought renewed attention to a question Dr. Hill has been asking throughout his career: what does it actually take to maintain health changes over time?

Together, we discuss why physical activity becomes increasingly important during weight maintenance, what researchers are learning about muscle loss and preservation during weight reduction, the emerging science of food noise, and why nutrient quality matters even more when energy intake decreases. We also explore the lessons learned from decades of research through the National Weight Control Registry, which has focused not on failure, but on understanding the people who succeed.

One of the most fascinating parts of our conversation centers on what Dr. Hill and Dr. Wyatt call "mindstate," including their concepts of victim, victor, and voyager orientations toward change. We discuss motivation, identity, resilience, habit formation, and why successful weight maintenance may ultimately be less about willpower and more about creating a life that becomes easier, more satisfying, and more aligned over time.

Perhaps most importantly, this conversation broadens beyond weight itself. It asks what it means to build a happier life, how we prioritize our approximately 1,000 waking minutes each day, and why the pursuit of health is ultimately inseparable from the pursuit of meaning.

If you've ever wondered why lasting change can feel so difficult, or why some people seem able to sustain it over decades, I hope you'll spend some of your waking minutes with us.

Resources Mentioned

• Losing the Weight Loss Meds: A 10-Week Playbook for Stopping GLP-1 Medications Without Regaining the Weight by Dr. Holly R. Wyatt and Dr. James O. Hill Learn More About the Book
• Weight Wisdom: science-based resources, programs, and tools from Dr. Holly Wyatt and Dr. James Hill Weight Wisdom
• Jim and Holly's podcast, Weight Loss And... Weight Loss And... Podcast

WE DISCUSS

(00:00) Meet Dr. James Hill, Author of Losing the Weight Loss Meds and Weight Loss Maintenance after GLP-1s for Lasting Change

(04:22) Why Weight Loss Maintenance Is a Different Challenge

(07:10) How GLP-1 Medications Changed the Conversation About Obesity

(11:53) Muscle Loss, Food Quality, and the New Nutrition Landscape

(18:39) What Happens When Weight Loss Medications Stop

(20:48) The Three Pillars: Food, Physical Activity, and "Mind State"

(26:58) Motivation, Identity, and Building a Happier Life

(29:26) The National Weight Control Registry and the Science of Success

(39:53) How to Spend Your 1,000 Waking Minutes Well

CONNECT WITH WENDY

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Visit my website: wendybazilian.com

Email me topics you want covered on the podcast: [email protected]

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Thank you for tuning in to 1,000 Waking Minutes and being part of this journey together. A huge thank you to our amazing collaborators including our production and marketing teams and Gabriela Escalante in particular. To the ultra-talented Beza for my theme music, my lifelong friend and artist Pearl Preis Photography and Design, to Danielle Ballantyne, Jen Nguyen, Joanna Powell, and of course, my family and everyone working tirelessly behind the scenes.

HEALTH DISCLAIMER

The information shared in this podcast is for educational purposes only and should not be considered individual medical or health advice. Always consult with your trusted healthcare provider before making any changes to your diet, exercise, or medical treatment.

Health isn't built on one moment.

It's built over time, the choices we make, the way we invest in our days, and perhaps those 1,000 waking minutes.

We experience 1,000 waking minutes on average every day.

How are you spending yours?

I'm Dr. Wendy Bazilian, and you're listening to 1,000 Waking Minutes.

I can't wait to connect with you here with practical ways to eat well, move daily, and be healthy.

To optimize every waking minute you live for a happier, healthier life.

Thank you for sharing some of your waking minutes with me today.

Let's get started.

Welcome to 1,000 Waking Minutes.

I'm Dr. Wendy Bazilian, and I'm so glad you're here with me today.

Every day, we begin with the same 1,440 minutes.

And after sleep and the essentials of life, most of us are left with roughly 1,000 waking minutes.

Those minutes become your choices, your habits, your relationships, your work, your health, and your purpose.

They become, in many ways, the story of our lives.

I want to remind our audience of that, and thank you for following along if you've been an active listener, because today's guest has spent more than four decades studying one of the most important questions in health and human behavior.

The question being, how do people create meaningful change, and perhaps even more importantly, how do they sustain it?

So Dr. James Hill is one of the world's foremost experts in obesity, weight management, physical activity, and behavior change.

He is professor at the University of Alabama at Birmingham, director of the Nutrition Obesity Research Center, co-founder of the National Weight Control Registry, and author of multiple books, including his newest release, Losing the Weight Loss Meds, a 10-week playbook for stopping GLP-1 medications without regaining the weight.

Jim, welcome to 1,000 Waking Minutes.

I'm so excited to talk to you about your new book, but even more than that, sort of how we spend our 1,000 Waking Minutes every day and dig into some of your professional expertise as well as your history in this space.

Love it.

Thanks for having me.

I'm looking forward to our conversation, Wendy.

Well, and I should say that we are friends from way back, professional friends.

From way back.

Absolutely.

We crossed paths for a long time, including I've referenced his research many, many decades ago.

Well, many, many.

A couple decades ago, let's put it that way.

And then we run into each other at various conferences and different kinds of events.

I'm old, Wendy.

I've been around for a while, so I'm much longer than you.

Well, our expertise shows with the turning of time.

Yeah, exactly.

Yeah, exactly.

Well, when I think of your career, Jim, I don't just think about weight loss.

I know that sometimes that comes up because you talk about weight management, weight loss, and you followed that.

But I think of someone who has spent decades trying to understand what allows people to keep promises to themselves, basically.

And that's sort of what I'd love to explore with you today.

Yeah, yeah.

Yeah, and after these four decades or so of studying this field of obesity, weight management, and all of this, starting with the book, why was Losing the Weight Loss Meds the book that needed to be written now?

Where did that come about?

Because reading the book isn't just about the medication.

In fact, that's a great hook into it.

It's really what happens after the success with the medication, which I think is a more interesting conversation.

So I'd love to hear about the book and how it came to be.

Yeah, Wendy, you nailed it.

It's not just about the medication.

But for decades, I've been interested in weight loss maintenance.

And we were the first, or among the first, to talk about how weight loss maintenance is different from weight loss.

But here's the problem.

Nobody wanted to hear about weight loss maintenance because they couldn't get to the weight they were happy with.

So so many of our people, Wendy, we would start talking about weight loss maintenance and they would say, yeah, when I lose another 5 or 10 or 15 pounds, I'll think about maintenance.

This is why the timing is so good for this, because the medications now are helping people reach or nearly reach their goal.

So for the first time, people are saying, oh wait, I might be at a weight that I would be happy maintaining.

So this is really a book about weight loss maintenance.

And you're right.

We hooked it into the medication.

And another reason that I think it's timely, you know, the medications are fantastic.

And I'm a big fan of the medications.

But they only work when you take them.

And what we're learning is less than half the people that take them continue.

And when they stop, the medications stop working and most people regain that.

And so it's so sad to see someone lose 20, 25, 30% of their weight and they gain it back.

So for those reasons, my coauthor Holly White and I decided this was the perfect time to write the book about weight loss maintenance that we've always wanted to write, but the timing wasn't right.

I think now it is.

I mean, that's so key to everything, right?

The timing.

I mean, you probably felt like the timing.

Well, it's all led up to this, but the timing was right many times to talk about it.

But to your point, I've heard you mention before that, you know, through lifestyle and behavior change and all the doing all the things that we can get into a little bit in the maintenance phase, but that, you know, people can lose weight.

But I think what I heard you just say is that the weight loss medications is sort of pushing beyond or getting people a little bit further for while they're on it so that maybe their minds are opening to the maintenance equation and maybe have to, I would guess.

So, Wendy, we did some work many years ago with Tom Wyden and Gary Foster, who you know well, and they started this whole thing of simply asking people who started a weight loss program what their goal was.

And the long and short of it is people would be happy with about 25% weight loss.

Well, with behavioral programs, we can produce 10, 12, maybe 15.

So we weren't reaching that goal.

With the medications and especially the new ones that are coming along, people are losing 20, 25, even 30% of their body weight.

So people are reaching their goals, and we couldn't do that with lifestyle.

So that's why I welcome the medications.

But also, and I know we're going to talk about this, I don't think the medications alone is the answer.

It's medication plus lifestyle.

Well, it seems like one of the ideas that stood out, and again, probably the big reveal is not anything new to you, but the ability to think about how losing weight and maintaining weight are sort of fundamentally different challenges.

I think you even talk about that a little bit, and I'm wondering.

Yes, that's the key.

If there's one thing for people to take away with this, the knowledge and skills necessary to keep weight off are different than those to lose weight.

Let me give you some examples.

You know this, and the data is showing right now that you can lose weight on any diet you want.

You can go out in a bookstore and pick a diet, and if you follow it, you will lose weight because the diet is geared to have you eat less.

Don't eat carbs, don't eat fat, whatever.

The end result is you eat less, and food restriction is the key to weight loss.

Let's face it.

It is the key.

The problem is that you cannot food restrict forever.

So people lose weight, they food restrict, they eat less.

You get hungry, and you can't maintain that food restriction.

And so that's why all of the diets that help you lose weight, almost none of them will help you maintain it because on maintaining weight, now you have to reach this right balance of being able to eat enough that satisfies you, but matching intake with expenditure.

And so while food restriction is the key in losing weight, physical activity actually becomes more of a key in keeping weight off because engaging in physical activity now allows you to eat enough to sort of be happy with it and maintain energy balance.

It does a lot of other things as well.

And the other difference is with weight loss, it's almost like a timeout.

You can avoid parties, you can go out and buy the stuff that you're going to...

Weight loss maintenance is forever.

You have to live your life, and you don't have 24-7 to devote to it.

You've got to figure out how to get new patterns and routines to maintain weight.

So those two things are very different, and I'm excited now because the medications can help people reach the weight loss goal, and I think we can do a much better job of using lifestyle to help them keep it off.

I mean, I think that's an incredible observation because you're right.

When someone sets, like, a goal or a defined date or something, you know, all focus goes on that, and people see it as not temporary, but effectively it becomes a temporary.

Like, while I'm on this strictly, you can say no or not navigate, you know, your day-to-day.

It's easier to do that.

But to sort of build those behaviors at the same time probably should be part and parcel with the medication, but I know that in the early stages, just sort of getting on the medication and feeling the results, you know.

But I'm curious, as you move toward that, what have you seen?

And I know a few of these and some of the statistics are a little shocking, so maybe you can level set on that.

Like, when weight loss happens naturally, you know, lifestyle medication, however, what exactly happens to our fat and muscle mass and what are the things we're contending with?

Because what I heard is physical activity later, I mean now, always great, but later becomes more important to sort of allow us to navigate the calories in our day and our food intake.

But what exactly is happening when people are on the medications that is sort of allowing this success to happen?

So what happens is the way the medications work, put simply is they make you satisfied on far less food.

So we can do a lifestyle program and say, Wendy, reduce your food intake by 25%.

You can do it, but you're hungry.

With these medications, you naturally reduce your food intake by that much and you're not hungry.

People say, I forget to eat.

I'm not hungry.

I don't desire food anymore.

And so with that degree of food restriction, what happens is you lose a lot of weight.

Now, when you lose weight, most of that will come from fat, but not all of it.

Some comes from a tissue that's nonfat, which we call fat-free mass, and a big part of fat-free mass is muscle.

So one of the big questions with the medications is, are you losing more muscle than you would expect?

So when we do a lifestyle program, for example, people will lose roughly 70% of their loss will be fat, 30% from lean.

It varies a little bit.

And so they're looking at with the medications, there were some early indications that maybe you're losing more muscle than you would have thought.

And there's a huge amount of research going on with that right now.

The question isn't answered, but more and more of the research is actually suggesting it's not as big a problem as we thought.

Yes, you're losing muscle, but it may not be the most functional part of muscle.

And, you know, what I would say is, I don't think that losing muscle is going to be a big problem for most people.

Now, saying that, there's a group that I worry about.

It's a group I'm in, Wendy.

It's older adults.

And I don't worry so much about losing it.

But when you regain it, several studies have shown that when older adults lose weight and then regain it, they don't regain as much muscle as they lose.

So we still have a lot of research to do in this area.

But for most people, the medications work.

They work by reducing your food intake.

You lose weight.

Most of it is fat.

Some of it is muscle where physical activity can help, particularly resistance exercise.

It may be able to limit that loss of muscle.

You're still going to lose some, but physical activity combined with a sufficient protein intake is probably the single best thing you can do to minimize loss of muscle.

So I'm hearing the importance of sort of both nutrition, nutrient quality during the restriction or when on medication, as well as sort of targeted or more specific type of exercise and getting a routine that will support muscle maintenance.

If not muscle gain, muscle maintenance, certainly.

Absolutely.

And you're an RD.

So you've studied nutrition a lot, and I think nutrition's playing a different role now than before.

For decades, we focused on nutrition for weight loss.

Now the meds are doing the weight loss.

So nutrition, I think, plays a different function.

If you're going to be eating 25% to 30% fewer calories, the quality of your calories play a role.

And we're seeing people with nutrient deficiencies.

Vitamins and minerals, hydration issues.

So I think it's sort of caused us to rethink the value of nutrition.

And clearly, I've always been an advocate of physical activity.

And I think even with the medications, you don't have to exercise to lose weight.

But exercise does so much more physically and mentally that I think we have to find ways to promote both quality nutrition and physical activity.

So like more nutrition per bite, I'm hearing.

That's exactly right.

You've got it.

It's like if you're eating 30% less, you don't have a lot of room for calories that aren't bringing in adequate nutrition.

Yeah.

And I imagine that's a little bit of a hurdle for those who have tried all kinds of diets and may not yet realize that just eating less and getting weight loss can lead to some other potential detrimental effects down the road if they don't focus on the nutrition piece here.

Yeah.

And I think we're seeing repercussions here.

I think the whole food industry is looking at this.

If people are eating 25% fewer calories, you're selling less food.

So you need to give people food that is higher quality.

So the medications have really been a disruption.

And I use that in a positive way, a disruption for our field that is welcome.

Yes.

I agree with you.

And I won't name them, but I have seen some really smart either brands or innovators really looking specifically to that with the right idea in mind, like not just about supplementation, but really like how can we get more there that's also satisfying for, you know, more modest calories to fill that gap.

And I think disruption is the right word in a positive.

Yeah.

And I think we need that both on the nutrition and the physical activity side.

Where's the innovation?

Yes.

What are the new innovative food products?

How can we change the way we're promoting activity?

And how can we be innovative in finding ways to help people become active?

Yes.

Well, it pops to mind, and I'm just going to mention this, throw this out there for now.

One of my mentors is 103 years young and counting, and still vibrant and vital.

One of the things that she said to me years and years ago, and she's very involved in the wellness and health and wellness industry, she said, you know what we want guests to do?

Because I used to work at a destination spa for more than a decade.

She said, and I thought what she was going to say, you know, it's always good not to predict the words of your mentors, but I sat quietly, but I thought I knew what she was going to say.

And I thought about physical activity was you help people find the exercise they love.

And she said almost the opposite.

She says, you help people find the exercise they're least allergic to so that they'll do it.

The minimum that's effective.

Yeah, that's a good way of looking at it.

So I want to look at sort of long game because, I mean, coming up to this point in history, you have been in the maintenance world, you know, researching it, co-founding major registries, showing us what does work when people succeed for a long time.

But before we jump into that, like what happens, you know, in simple or sophisticated terms when the medication is discontinued, you know, why does weight regain happen so frequently?

You know, because I think people hear it, but maybe they don't quite understand exactly what reenters at that point.

And that's a big topic we cover in the book, what to expect when the medication stops.

Now, one thing about the medication is when you stop it, because this medication hangs around the receptors for a long time, it isn't going to stop immediately.

You're going to have a little bit of a runway.

What the medication does is to make you feel full on less food.

The other thing it does, and this seems to be maybe playing a more important role than we thought, it eliminates or reduce what we call food noise.

Food noise is that people have this constant thoughts about food, what's in my cupboard, what's the next meal?

And the medication for many people makes that go away.

So on the food side, when you stop the medications, you're gradually going to be hungrier and you're going to want to increase your food intake.

The food noise is going to come back, which probably contributes to your eating more.

Then at the same time, you know, Wendy, as you lose weight, your energy expenditure goes down.

So if you've lost weight and hadn't exercised, you're going to have an increase in appetite, an increase in food noise at the time when your energy expenditure has decreased.

That's the perfect storm for regaining weight very quickly.

But here's the problem.

You know, we've talked to a lot of people.

While they're on the medications, they say, Oh, I've got it.

I don't think I need these anymore because I'm managing my food intake and so forth.

And then the medication goes away and the effects goes away and people aren't prepared for how all that is going to come back.

The medications only work if you take them.

That's a great period on that sentence to really understand and why your book right now is so important because it almost, it tracks, I mean, it's a lifetime, but, you know, it's sort of a 10 week.

So it's like the next chunk, you know.

It's a transition is what we call it.

A 10 week transition.

We're actually working.

We're going to have some stuff going even beyond the 10 weeks.

But the book is 10 weeks and it really is built around what we call three pillars.

Two won't be very surprising to people.

On the food side, what we tell people, when you stop the meds, you're going to eat more.

What we want to do is to help you have a diet that allows your intake to be higher than it was on the meds, but lower than it was beforehand.

So we talk about resetting your appetite to a place between where it was on and off the drugs.

And so it's eating for satiety.

And there's so many things we know from the literature.

Energy density and portion size.

All these things work.

So we put them together in what we call plays to help people find ways to do that.

Second pillar is physical activity.

If you're going to maintain weight without the medications, physical activity isn't a happy add-on.

It's an essential part of it.

We learned that with the National Weight Control Registry.

Increasing physical activity is absolutely necessary to keep weight off.

And again, we give people lots of different plays for doing that.

It's like you said.

We try to help people find things.

Maybe they like it.

Maybe it's tolerable.

But things that they will do.

Just like the medications don't work if you don't take it, physical activity doesn't work if you don't do it.

But the third pillar, and this is one that I have really changed a lot.

Maybe the most important of all.

And we've created a word, 'Mindstate'.

It's a little different than mindset.

But it's using your mind for all this.

And my gosh, when we look at people, Wendy, we've been doing weight loss for a long, long time.

And people will come in and they say, okay, I'm signing up for your program, but I know it isn't going to work because I've tried this before, da, da, da.

I'm going to go and exercise, but I'm going to hate it.

And what we've found is how you use your mind is so important, and you can actually do it better.

We talk about, in our experience, we've seen sort of three different kinds of mindset.

One you'll be very familiar with is the victim mindset.

These are people that go into weight loss, the first thing that goes wrong, oh, I got fired, so I'm going off my diet.

It's not my fault.

It's due to some external circumstance.

I'm the victim.

And so we worked with a lot of people to have them deal with resiliency and problem solving.

And so there's a second mindset that we call the victor mindset.

And this is when people have the skills to deal with that.

Okay, you are going to have challenges in weight maintenance.

It's not if you have challenges.

It's when you're going to have challenges.

You get sick.

The in-laws come to visit.

Who knows?

Stress after stress.

So are you going to get through those?

And the victor mindset, people, it's like, okay, I don't know what the challenge is, but I feel like I have the skills to get through it.

And then in our programs, we saw a few people that were a little different, and so we coined this the voyager mindset.

And these are the people, they don't just think they can get through challenges.

They see challenges as a growth opportunity.

It's like, I'm going to come out better.

I'm going to get through.

I'm going to learn from it.

I can come out better.

But the other thing we're finding, and we can talk about this more, these are the people that seem to appreciate success more.

They recognize it's not the number on the scale.

That's not what you want.

You want a happier life.

And these people with this voyager mindset are able to do that and use other aspects of their life change to create, really, a happier life.

Different markers of what constitutes a more well-lived and quality life through their health.

The more I study this, you cannot separate your weight from your life.

It's so intertwined that if you're going to help someone change their weight, you're going to help them change their life.

It's incredible.

I mean, it's part of our personal identity system, as we're seeing.

What I love, really, about the Mindstate is the dynamic feel of it, because mindset really felt like it almost predisposes you to victim.

I mean, I know that people are naturally probably predisposed to one or the other.

Right.

You come in with that.

Yeah, and we talk about mindset.

It's a great term.

I love it.

But it didn't quite capture everything we wanted to capture.

How you think about things, your relationship with other people.

My colleague Holly White talks about living large.

Don't be on the sidelines.

This is all encompassed in Mindstate, and you can change your Mindstate.

Absolutely.

Health is dynamic.

It's not static.

I think that also, sometimes the mindset or even the focus and the goals, like when I reach that place, I'll just be there.

But of course, it's the new game, which is the maintenance or the next phase or the next chapter.

I wonder about, in this context, in the Mindstate, about understanding of motivation or how much success is determination or so-called willpower, which I've never really played into.

This is a great topic.

I love it.

You're bringing up some really good stuff.

Again, let's look at how this differs between weight loss and weight loss maintenance.

Wendy, you're a very slim person, but imagine you're overweight, and you go on the GLP-1s, and you go in to work or your friends.

They say, Wendy, my gosh, what have you done?

You look fantastic.

That is such a good motivation.

Now you're in weight loss maintenance, and they say, Wendy, you look exactly like you did yesterday.

The external motivation goes away.

For weight loss maintenance, what we talk about is you have to know where your deep internal motivation is.

We're a big believer in why, and we do a lot of exercises to say, what's your real reason?

It's so funny because a lot of people will say, I want to lose weight for health reasons.

I don't buy it.

When you dig deeper, it's usually more emotional, which is okay.

There's no wrong answer.

But the motivation is so critical because during weight loss, it's easy to get it from external places.

During weight loss maintenance, it's got to be internal.

You've got to know why you're doing this.

When you run into challenges, you've got to be able to have the motivation to stick with it.

Critical difference between weight loss and weight loss maintenance.

That's where you create maybe architecture around your life to support it also so it doesn't have to feel like every step is a step uphill.

This is one where my colleague, Holly Wyatt, really took me to task.

I would always say, weight loss maintenance, it's really hard.

She said, okay, look.

If you're doing something that's terribly hard and you're simply hanging on by your fingertips, you aren't going to do it.

There are hard parts of it, but the successful weight loss maintenance isn't hard.

It's creating a lifestyle that's actually easy.

The way you do that is with the architecture, the new habits and routines.

Most of what we do is automatic behavior.

What we have to do is go from the automatic behavior that's keeping us overweight to an automatic behavior that's keeping us at a lower weight.

This is actually verified in the National Weight Control Registry.

These aren't miserable people that are keeping the weight off.

They're happy people.

They work at it.

They're not saying, oh, it's a piece of cake, but they aren't saying, I'm miserable every day.

I'm just trying to get through another day.

That doesn't work.

The way I see it now, I think it's hard in the short run until you develop these new habits and routines.

Then I think it becomes easier.

Yeah, and I'm so glad you brought up, that's a thread running throughout your career, is the weight maintenance piece.

I think one reason that I've always been fascinated by the National Weight Control Registry is, and I wonder how many of these things is just re-upping and reconfirming some of the things that you have so much quality data about over time, but the registry always studied success instead of failure, like why did people fail?

It's always looked at what makes a successful, well, I remember the term successful loser, which I don't know if that moniker still holds in today's society, but what makes someone successful with the maintenance?

Most research really asks, why doesn't this work?

You've asked, what can we learn from people for whom it does work?

You say that they're happy people that this works.

Are you thinking about the National Weight Control differently now?

Absolutely.

I don't think these people, the people in the National Weight Control that succeeded, I don't think they're genetically different or physiologically different.

I think for some reason they were able to stick to the behavior changes that we know work.

I think we can help more and more people do that.

I totally believe that it's possible for people to lose weight and keep it off.

I think people in the National Weight Control registry aren't different from anybody else except, as you said before, the stick-to-it-ness.

They have been able to stick with it and develop these new habits and routines.

I think other people can do that as well.

This would be a generalization, so I know the risks of that.

Would more of them perhaps be that Voyager state?

Absolutely.

When we were examining the National Weight Control registry, we didn't have the tools to do that, but we're doing that in other research.

I think that's exactly right.

With the National Weight Control registry, what we're doing is taking people who succeeded and trying to reverse-engineer it.

Now, those people, if you ask them, I don't think they know exactly why they were successful.

You almost have to be a detective and ask the right questions to understand, but I will bet you, I don't have any data, but I will bet you they're enriched with Voyager Mindstate.

Fascinating.

Fascinating.

I think that it's so incredible to think of, well, that's like the elite athlete of weight maintenance, which I also, we study the athlete, not so that we all become one, but to sort of learn what makes that change.

Great analogy.

We've talked several decades studying this field.

I'm just curious what drew you first to this work, someone with a psychology background, you built a career in this space, obesity, behavior change.

You've had a total front row seat to all the changes, all the, might I say, nonsense along the way, as well as the amazing things that have come out in the research that supports various styles and types and eras of eating and dieting and whatnot.

What brought you into this work?

Yeah, you know what?

I don't have a compelling reason to do this.

I was in psychology, and what I was interested in at the time, this was the early, late 70s, early 80s.

I was interested in how the body kept weight so constant over a lifetime.

Because at that point, most people, most adults, stayed at a constant weight over their life.

So I was looking at this regulatory system to say, how's the brain managing all this?

So people, despite changes in intake and expenditure, they stay at a constant weight.

And it was really in the late 80s that we began to see that, in fact, people weren't staying at a constant rate.

They were gaining weight.

And so, you know, being an astute PhD, I said, aha, I'm studying obesity now.

And it's just such a fascinating problem.

At that point, Wendy, very few people studied obesity.

It was a small group.

Now it's become much, much wider.

And for me, it was following a thread.

I thought I was going to identify the physiological defect that caused obesity.

And the more I looked, the more everything was fine.

There was no defect.

So it led me to behavior and to the environment.

So it was following a thread.

But it's been a fascinating thread because there are so many interesting questions.

You really are.

You're a scientific detective, for sure.

I can see that.

Absolutely.

I follow the leads.

When you're looking at this, understanding what humans do, why they do what they do, which is such a big question, what question are you still trying to answer?

Or what continues to surprise you about people that you want to know more about?

Yeah, again, what I'm really interested in, one of the things I'm interested in is sort of from a population basis.

Okay, these GLP-1 medications are fabulous.

Do we put everybody on a GLP-1 medication?

Do we wait when people are the first bit overweight as kids and give them the medication?

How is this going to work on prevention?

With the medications out there, are people more or less interested in changing the environment and prevention?

I think these are terribly important societal questions that we need to answer.

Are the meds the solution?

There are some people that think that.

Let's put them in the water, and as soon as anybody has any metabolic abnormality, let's put them on the meds.

I don't know.

For me, I think we're missing something when we look at a medication-only approach.

And then I worry that, don't get me wrong, these are fantastic for treating obesity.

I would love it if we could keep obesity from starting in the first place.

And I don't know if the meds are going to make it easier or harder, but fascinating stuff going on at sort of a societal level.

Wow, yeah, that is, you know, yeah, can we get to the place where it's not about the treatment but the prevention in the first place?

At the personal level, what Holly and I are thinking about more, everybody has a piece of this.

So if you want to lose weight, boom, you go out here.

When you're done, you go somewhere else.

We want to create a place where you can go throughout your entire journey, someplace that supports you soup to nuts.

And it's a forever journey.

If you're going to lose weight and maintain it, you're always going to be in weight loss maintenance.

And so I want to see something that helps people throughout their journey, no matter what phase they're in.

I see that it would be multi-pronged, and it would have to be environmental as well as intrinsic, I guess, to sort of support all those pieces.

Yeah, and people come in and out.

We find that in our programs.

People get excited.

They get really engaged and do well.

Then life gets in the way, and they check out a little bit.

That's okay.

We have to deal with that.

And rather right now when they check out, they drop out in their failures.

Somehow we have to recognize that's a part of the journey.

How do you help people get through it?

So anyway, that's kind of what I'm thinking about these days.

Yeah, I not only agree with that, but I like how you put that.

That's sort of the evolution of life.

It's not a failure.

It's part of the long game.

It's having people know it's not a failure.

Yeah, it's pieces of the process.

Yeah, absolutely.

It's part of the process.

In the National Weight Control Registry, most of those people have failed multiple times before.

Rarely was this the first time they tried it and it worked.

They tried five, six, seven other times, lost and regained, yet in the end they succeeded.

Yeah, thank you for reminding me of that.

I remember that now from reading over the years and quoting you and various things that I've written as well, that there are some behaviors that march along that are inserted.

But that being one of them, that is one of the indicators across is that most people have so-called failed.

This wasn't their first time and they got it right the first time.

So again, if you think of that as you learn something, it's not failure, but you've learned something about yourself and external and continue on and you can succeed.

Yes, yes.

Well, as you know, I talk about in the podcast our 1,000 waking minutes.

I love that, actually.

Well, I came to that.

There's a longer backstory to it, but I'm very math-minded, science-minded.

It was just the idea that time is life's currency.

If we do, and because all that great sleep research has been coming along, but for several decades already, if we get health-supporting sleep hours, we're left with about 1,000 waking minutes to engage our day.

And some of it's obligation and not fun, and some of it's within our own personal agency.

And so I think in sort of putting it in context, I'd love to know, maybe I'll ask a little personal, but also what you've seen in your career.

If health is ultimately lived, we get the same stash every day.

You can't save up your minutes.

But if we're living sort of minute to minute, hour to hour, how are these minutes organized might be an important question.

What gives, in your opinion, or your professional knowledge base, the greatest return on investment for our waking minutes towards a well-lived life?

Not necessarily weight, but all the pieces.

I love how you frame that, and I think it's very consistent with what we're thinking.

Let's take exercise, for example.

The number one excuse why people don't exercise is they don't have time.

They have 1,000 minutes.

So it's not that they don't have time, it's they haven't prioritized it.

And the other thing with Mindstate, we talk about, gosh, take 10 minutes in the morning for yourself and just think about your day and your life, and people don't do it because they're too busy.

They've got to get up and get going.

So I love the idea that you have these 1,000 minutes.

How are you going to prioritize things?

So what I would say, back to physical activity, if you're saying, I want to prioritize physical activity, now let's help you get into some routines and rituals where you do that without thinking about it.

But you have to prioritize it enough to even give it a shot there.

Right, so you've got to prioritize it.

And maybe if someone gets interested more in the progress of it than being perfect all the time.

It is.

It's the journey, not necessarily reaching it.

And you're not going to be perfect.

But the good news is you don't have to be perfect.

I mean, literally, the more I look at this, what we're really after here is a happier life.

And weight's a big part of that.

I get it.

I'm not saying you shouldn't think about your weight, but the number on the scale isn't going to make your spouse kinder or your boss better.

It's part of that, but you've got to work on other aspects of your life too.

And it's a process.

And you're going to do well, and you're going to do poor, and you've got to stick with it.

You've got to look at where you're going.

But again, I absolutely love this thousand-minute thing.

So I think you use that and think about what you're going to prioritize in there.

And, you know, there's enough time.

I mean, what do we watch, five hours of TV a day or so?

There's plenty of time to play with once you get your priorities.

You can still have some fun.

I'm a big believer in having fun.

But prioritize some of the things that are going to be most important, not just for your health but for your happiness.

Yes.

And fun is part of health too, right?

Absolutely.

And, Jim, I'm really big on, like, aligning our behaviors.

So if you're watching TV, and I know this doesn't have to happen all the time, but you can do stuff.

You can move.

You can be doing other while we're consuming.

Absolutely.

If someone comes to you and says, Hey, Jim, I get it.

I hear you intellectually.

I'm connected.

What's one shift?

You know, what one thing will help me get some momentum going?

Do you have a response to that?

Is it, you know, absolutely it has to be individual.

But what would you say to someone?

I would say it's complicated.

It's more than one thing.

But in the spirit of trying to answer that, what I would suggest to people, start walking.

Start walking.

Start moving your body.

When you move your body, good things happen, both to your body and your mind, your mental health.

You know, one of the other things we know, physical activity helps improve sleep.

It helps improve diet.

So it is individual, and there are more things you need to do than one.

But one of the easy ways is start walking, and oftentimes good things follow from that.

Wonderful.

Yeah, lace up those shoes and just start moving.

Yeah, the body is built to move.

How about for you?

What is a moment or a little pocket of your day where it feels especially meaningful and alive for you in your wellness journey?

So I try to do all three pillars.

You may or may not know, I married a dietician, so I've sort of outsourced my nutrition.

Just kidding.

I do pay attention.

Big exercisers.

I have to exercise every day, and that's a big deal for me.

Exercise, I can let my mind wander.

I can be creative.

I love that.

I've struggled a little bit more with the mindset.

So I've started this time for meditation and reflection.

And I'll have to say, that wasn't easy for me, but I think it's important, and I'm working on it.

I'm a work in progress.

Work in progress.

I love it.

I love it.

Well, you've been studying, you know, spent decades studying how people create lasting change in their lives.

That's no small task.

And as you look across your career and your research, and now you're losing the weight loss meds book, you know, the 10-week transition, which I love that, because I think people can really anchor in and hook into that and stick with it so that they learn those behaviors.

What continues to be true in your estimation, no matter how much science may evolve and what we learn, like what's the truth of life, the truth of, you know, where we're headed for weight maintenance and thinking the happiness part of the goal.

Yeah, Wendy, you're asking tough questions here, and that is a tough one.

But again, what I've learned from working with so many people is everybody does have this deep why, this deep sense of what they want to be and how to achieve it.

Oftentimes, you know, we did the TV show Extreme Weight Loss, and we worked with them, and people would lose half their body weight.

And in talking to them about what they loved with the experience, rarely was weight loss the first thing they said.

But one of the things that more than one of them said to me that I think is very important, they said, I'm finally the person on the outside that I've always been on the inside.

So I think it's this desire to hook who you are or who you want to be on the inside with how you're living your life.

And I think when people do that and achieve that so they feel like those two are aligned, I think it's magic.

Yeah, I got chills when you said that.

You know, I mean, that's an incredible insight coming from the experience, too, because that wouldn't have happened if they didn't go through that journey to finally feel on the outside like you feel on the inside.

Oh, that's incredible.

Well, on that note, I have many more things I could ask you, maybe for another day, another interview.

But Jim, I want to thank you so much for joining me today.

It's been a fascinating conversation, a real pleasure.

I'm grateful to you.

One of the themes that stayed with me throughout our discussion is that health isn't built on one moment.

I heard progress a lot.

It's built over time, the choices we make, the way we invest in our days, and perhaps those 1,000 waking minutes, I'm glad that resonated and connected with you also.

For those of you who are listening who would like to learn more about Jim's work and his and Holly Wyatt's new book, Losing the Weight Loss Meds, it's available wherever books are sold.

I encourage you to get it because that transition is really built for anyone.

I think there's a lot that we can take from those three pillars and how to live a more healthful, well-lived life.

And you can also find additional resources, tools, and information on his website, weightwisdom.com.

So I encourage you to go there.

I will include links to Jim's work and today's conversation in the show notes, of course.

And I want to thank you, Jim, for spending a few of your waking minutes with me today.

I want to appreciate you for doing that with me.

Wendy, it's been an absolute pleasure.

I love talking about these things, and the time flies when you're discussing things like that.

I guess I am so convinced that people can do this and succeed, and there's never been a better time for anyone who wants to manage their weight.

We have more tools than we've ever had.

Oh, you heard it.

There's never been a better time, so that's something to be said.

On that note, I'm Dr. Wendy Bazilian.

I'm your host of 1,000 Waking Minutes.

And remember, it's our small choices that we do consistently with the minutes and hours of our every day that help shape a healthier, more meaningful, and well-lived life.

And until next time, be well.

Thank you for tuning in to 1,000 Waking Minutes.

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