How starting with 5 minutes of exercise a day helped a doctor go from liver disease to competing for his country in triathlons – and what small changes you can make now that will compound to improve your long-term quality of life.
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What do you do to unwind after a long and difficult day?
Rachel:Is it a glass of wine and a takeaway or an hour scrolling Instagram?
Rachel:When we're pushed to the limit, getting quick dopamine hits.
Rachel:Seem to be the easiest thing to do.
Rachel:But we know how small improvements can compound over time.
Rachel:And my guest this week is living proof.
Rachel:So in today's episode, I'm speaking with Dr.
Rachel:Hussain Al-Zubaidi, the RCGP lifestyle and physical activity champion, who went from being diagnosed
Rachel:with nonalcoholic fatty liver disease in his twenties to losing 30 kilos, to competing as a triathlete.
Rachel:Hussain shares some really practical tips that will help you find tiny, tiny changes that will help
Rachel:you to rescue your time, help you practice that necessary care, even if you're stuck in overwhelm
Rachel:If you're in a high stress, high stakes, still blank medicine, and you're feeling stressed or overwhelmed,
Rachel:burning out or getting out are not your only options.
Rachel:I'm Dr.
Rachel:Rachel Morris, and welcome to You Are Not a Frog
Hussein:My name's Hussain Al-Zubaidi.
Hussein:I'm a GP based in Warwickshire and I have a portfolio career including the Royal College of GPs Lifestyle and Physical
Hussein:Activity Champion, as well as the Lifestyle Medicine course lead at Red Whale and Parkrun's health partnerships lead.
Hussein:I have a few other roles outside of that, but those are my core ones.
Rachel:I'm sure we'll get to those, those other roles.
Rachel:So Hussein, thank you so much for coming on the podcast today.
Rachel:I'm really interested to explore your story, so I'd love to hear how you got into all of this.
Rachel:How did you become like the Parkrun lead and the RCGP lifestyle champion?
Rachel:Have you always been into fitness, healthy living and all that, that sort of thing?
Hussein:So quite simply, I haven't always been into fitness.
Hussein:And in fact, when I think about my younger years and going through school and university, you know,
Hussein:movement, physical activity, the exercise was not only something I didn't do, but I actively hated.
Hussein:Um, you know, like I, I used to despise people running.
Hussein:Like I wouldn't even give them way when I'd be driving.
Hussein:Uh, and it was raining, just 'cause I just didn't understand why they were doing it.
Hussein:I thought it was a waste of time and energy.
Hussein:It wasn't until I was, you know, on a hospital bed essentially with an ultrasonographer who had
Hussein:just told me that I had the, the fattest liver that he had ever seen, that it sort of gave me the
Hussein:wake up call that at, you know, in my mid twenties to be already diagnosed with non-alcoholic fatty
Hussein:liver disease, I thought something wasn't right.
Hussein:And, and I started to explore and try and understand why I'd gotten myself in that situation.
Hussein:And as part of that journey, movement was a key element to help reverse the changes that were going on there.
Hussein:And, and although my first priority was correct this issue of non-alcoholic fatty liver disease,
Hussein:what I learned on that journey and that process was the benefits were far wider than that.
Hussein:And now, looking back on it, I'm glad I went on that journey.
Hussein:Not because of improving my liver's health, but just improving my life, you know?
Hussein:And the way that I enjoy life and, and I get things out of life.
Hussein:And if I'm being honest, if I didn't have something as, as dramatic as that, I don't
Hussein:know whether I would've ever made that change.
Hussein:I think I still wouldn't be letting runners across the road, even in the rain.
Rachel:What were you doing when you, when you had that scan?
Rachel:What, what role were you in at that point in your career?
Hussein:So that was junior doctor role.
Hussein:So I went straight into medicine.
Hussein:I didn't do sort of a graduate entry program and like, it really does propel you into life just so quickly.
Hussein:You know, I, I think in my mind, I, I was still a child.
Hussein:I think I was still a teenager, probably in my head because I hadn't done anything kind of serious.
Hussein:And I just found it really stressful, not, not just sort of the latter years of medical school,
Hussein:but just taking on all this extra responsibility.
Hussein:I felt quite alone and isolated, and I used a lot of the things that I know now, sort
Hussein:of certain lifestyle behaviors just to cope.
Hussein:Whether it was, um, you know, going out with friends and potentially not eating or consuming the right
Hussein:things there, or just eating takeaways or foods that gave me kind of pleasure in the short term,
Hussein:but were, were causing harm in the long term.
Hussein:And, you know, before I knew it, I, I developed certain behaviors and traits over a number of
Hussein:years, which had completely changed, you know, who I was, not just visually in that I gained
Hussein:a lot of weight, but just my behavior as well.
Hussein:You know, when, when I think back and, and a lot of the comments that my friends and families were saying, in a
Hussein:nice way, they were trying to let me know that, you know, I, I was, I was starting to head in the wrong direction.
Hussein:But it only took sort of that realization of the diagnosis for me to sort of actually reflect and realize that I'd,
Hussein:I'd come a long way and I wasn't heading in the right direction, and I needed to make a course correction.
Rachel:And in terms of your career, were you, were you sort of very, very focused on, on success or were
Rachel:you not that bothered about career at that point?
Hussein:I think that was my main priority.
Hussein:I think everything that I did at university and in my early career was I wanted to seem
Hussein:successful and I wanted to be successful.
Hussein:You know, like my, my parents were very academically focused and throughout my, um, schooling, always
Hussein:pushed me to try and achieve the best, you know, at the real neglect of anything like physical activity.
Hussein:You know, I remember once when I was in primary school, I think I was year three and I'd, I joined the local football
Hussein:club 'cause I wanted to try and play a bit of football.
Hussein:And I've never been in more trouble in my life.
Hussein:You think, so most kids get in trouble for like, you know, doing something wrong.
Hussein:You know, like I remember it was days where my parents wouldn't speak to me because they just
Hussein:thought, you know, he's neglecting his, his studies, he's neglecting his focus that, you know, all
Hussein:I wanted to do is play a bit of footie with my,
Rachel:Year
Hussein:with my friends.
Hussein:So going through uni, you know, I've really pushed myself and I, I I achieved very well.
Hussein:You know, if you looked at the results and kind of what I was doing, you know, I was achieving
Hussein:fantastically, you wouldn't think that this person physically is, you know, slowly falling apart
Hussein:because of how he's trying to get to that result.
Hussein:And in fact, going on this journey of, of reducing a lot of the pressure that I was putting on
Hussein:myself academically, reducing a lot of the key workload and, and responsibilities actually had the
Hussein:opposite effect than what I was trying to achieve.
Hussein:I thought I'd have to let go of a lot of those kind of career ambitions and
Hussein:pushing myself from an academic standpoint.
Hussein:But it's done the opposite.
Hussein:In fact, it's, it's just given me the head space to be a lot more creative.
Hussein:I find that when I'm, I'm trying to apply myself at work, I can do so far more productively and in
Hussein:far more sort of focused and, and intelligent way.
Hussein:When before I think I was just, you know, putting absolutely everything just to try to
Hussein:get that goal and it wasn't very efficient.
Hussein:Yes, it was getting results in some respects, but it was doing that at the neglect of my
Hussein:own health and the other priorities of life.
Rachel:And I know when we spoke before the podcast, you told me that as soon as you focused on, yeah, how
Rachel:do I make my life easier rather than how do I become very, very successful, that was what actually made
Rachel:you successful and that was what I'm so fascinated by.
Rachel:Because we hear, hear all this leadership stuff around, you know, how to be more productive, how to do
Rachel:this, how to have better conversations and all that.
Rachel:And, and that's all well and good and we talk about that a lot on this podcast.
Rachel:But it's something that I have realized pretty recently and pretty late in life, which is really annoying to
Rachel:myself because I'm now maximizing on the self-care.
Rachel:And I did a podcast recently about, you know, I was pretty close to burnout earlier on this year.
Rachel:And since putting the self-care in a, I feel a lot better.
Rachel:But b I'm actually getting more done and I'm, I'm more productive.
Rachel:But it's this very, very weird, it, it's this paradox, isn't it?
Rachel:And the way we've been brought up and everything in us, as medics says, work harder, work harder.
Rachel:That's how you achieve more, that's how you've been more successful.
Rachel:And like there's a little boy in year three not being allowed to play football.
Rachel:No wonder that's the mindset that you had.
Rachel:Right?
Hussein:A hundred percent.
Rachel:What else do you think in our training and in the way that we work contributes to that mindset?
Hussein:You know, like, I think we always feel that if we work harder, we'll get more.
Hussein:And that's just not the case.
Hussein:You know, it wasn't the case for me.
Hussein:In fact, like if we work smarter and actually work on the tool that is going to get us the results,
Hussein:which is ourselves, then you're gonna get further.
Hussein:You know, I, I often use the analogy with colleagues and patients of a bicycle in the sense that, you
Hussein:know, I actually have two bikes in my garage.
Hussein:One is a bike that I absolutely rag, you know, it's like my commuter bike.
Hussein:I'll just go anywhere on it.
Hussein:I give it no love.
Hussein:I haven't lubricated it for God knows how long.
Hussein:I haven't changed the tires for God knows how long.
Hussein:And I have another bike, which is my, my pride and joy.
Hussein:You know, it's, it's carbon fiber, it, it gets more love than even myself or probably even anyone else.
Hussein:And if you asked me to ride a hundred kilometers on each of those bikes, same person, same fitness,
Hussein:I would be able to do it far quicker on the bike that I've given a hell of a lot of love to.
Hussein:And it's a far more effective tool to get anything done, whether it's climbing a mountain, covering
Hussein:a hundred kilometers or reaching a top speed.
Hussein:And that's the same case for ourselves.
Hussein:You know, I'm more able to complete that project, that task, that busy day.
Hussein:If I myself am the well-oiled bike rather than the bike that's been absolutely ragged.
Hussein:Done far more miles, it's done far more miles than the, uh, than the nice bike, but it's not as effective.
Hussein:And for me, when I was looking and I was making these changes, I didn't do it with that in mind,
Hussein:but I just quickly realized that the work that I was doing was just to a far higher quality.
Hussein:I wasn't doing it in two weeks because I just wanted to rush it out and get it done.
Hussein:I was taking a bit more time, but the quality was far, far better.
Hussein:And it was starting to get noticed.
Hussein:It was starting to get rewards and acknowledgements.
Hussein:And that motivates you, but it also helps with that career progression.
Hussein:And a number of the roles that I have gotten, and these are dream roles that I absolutely adore doing,
Hussein:you know, it's in things that I'm really passionate about, they've all come about because of, I've
Hussein:been noticed with some of the work that I've done.
Hussein:And if I'm being honest, if I'd done them with the previous mindset, then they just wouldn't have had
Hussein:the same effect because I just would've done that.
Hussein:Yes, to try to do my best.
Hussein:But as we always trying to squeeze it around, not giving it the, the real thought and care that we should give,
Rachel:I completely agree with that, but I have some yes buts going on in my head.
Rachel:Because I think, you know, presumably this diagnosis came when you were sort of just finishing up being a junior
Rachel:doctor and moving into GP training and stuff like that.
Rachel:There's an awful lot to get done.
Rachel:You've gotta do a lot of surgeries, you've gotta do your exams, you portfolios, and then you
Rachel:become a GP and there's a lot of work to do.
Rachel:And if you're a partner, there's all the extra partnership stuff.
Rachel:And so it's a bit of a paradox saying, well, you'll perform better if you look after yourself, but there
Rachel:is so much you're not gonna be successful unless you get that stuff done that you need to do, which
Rachel:then gives you no time to look after yourself.
Rachel:So how did you navigate that?
Hussein:If I'm being honest, it's hard, hard decisions.
Hussein:You need to start really reflecting on both the small and big decisions when they come upon you.
Hussein:You know, often we want to be helpful.
Hussein:We want to look to seem like we are being productive.
Hussein:But what you need to do is decide what is really important, what's kind of important, and what
Hussein:potentially can be left to one side regardless of how painful leaving that to one side is.
Hussein:So there may be some fantastic opportunities that you've had to accept that you're not gonna take it up right now.
Hussein:And I think it's that constant feeling that another opportunity will never come.
Hussein:But if we just focus on achieving things that are within our sphere of influence at this time, and really making tough
Hussein:decisions on potentially leaving really good opportunities that have come at this point in time, to focus on doing
Hussein:what you can do right now to the best of your ability, I promise you those opportunities will come again.
Hussein:And one of the key things I did was reduce my sessions.
Hussein:I'll be totally honest.
Hussein:I reduced the amount that I was earning quite significantly.
Hussein:In fact, I, I probably reduced about 40%.
Hussein:Um, so my paycheck reflected that.
Hussein:But at the beginning I thought that that just wasn't achievable 'cause I wasn't exactly rolling in money.
Hussein:You know, I didn't feel like, uh, I, I, I had that much finances to spare, but then as soon as I adapted
Hussein:my lifestyle to accept that I was gonna be earning less, it didn't negatively impact my quality of life.
Hussein:Yes, I was buying different things and I was spending my time doing different things.
Hussein:But just that time, that space to not feel like I have further responsibilities and, and to be able
Hussein:to focus it on myself, to do things like sleep, to, to do things like spend time with friends and
Hussein:family, that was worth every pound that I'd lost.
Hussein:And it enabled me now, whenever I think about how I undertake work, a key part of it is like,
Hussein:what's gonna be the worth to me of that work?
Hussein:Not just financially, I want it to ensure that it can allow me to work the hours
Hussein:that I want to do rather than have to do.
Hussein:And also the work that I'm doing, does it reward me outside of that financial impact?
Hussein:Does it make me feel excited?
Hussein:Does it push me in a certain way?
Hussein:So I think when it comes down to it is it's really difficult decisions.
Hussein:You know, I'll be lying to say that it's really easy, you can just reduce this and then you're
Hussein:suddenly gonna be able to get what you want.
Hussein:I had to say no to things that I really wanted to do that were financially really great.
Hussein:And it's by saying no to those things that it enabled me to be able to be on a kind of a platform that allowed me
Hussein:to feel strong, rather than constantly chasing my tail.
Hussein:'Cause it was just the worst feeling of constantly having things to do.
Hussein:Don't get me wrong, we're busy people.
Hussein:We'll always have things to do, but that list, it needs to feel manageable.
Hussein:That treadmill speed that you are walking on needs to feel like it's something you can maintain rather
Hussein:than constantly hoping that it's gonna get better.
Hussein:'Cause that was the other thing I was doing, you know, I was constantly thinking, oh, do you know what?
Hussein:It's a busy month.
Hussein:Let me just smash through this 'cause it's gonna get better.
Hussein:December's better.
Hussein:I remember my wife just admitting to me one day going Hussein, december never comes.
Hussein:It never comes.
Hussein:You keep saying this and it never comes.
Hussein:And, and, and she was totally right.
Hussein:It was, she was totally right.
Hussein:And unless I make changes right now and say no to things that I desperately wanted to do, it wouldn't change.
Hussein:And I'm grateful that that's the case.
Hussein:And it, and as time goes on, you become better at saying no.
Hussein:Um, you, you just realize that, do you know what another opportunity's gonna come if you
Hussein:keep applying yourself in the right way and doing what you can do more opportunities come.
Rachel:So what did you say No to?
Hussein:I eventually said no to a partnership that I was in.
Hussein:So a really well-working partnership at a practice, um, that I'm still at, uh, in, in a different role
Hussein:that I really enjoyed, I enjoyed that partnership.
Hussein:There were a great set of partners doing fantastic work, but at the end of the day, I just, for me, and
Hussein:with the position that I was in and the work that I needed to do on myself, I had to say no to that.
Hussein:I had to move away from that and, uh, allow myself the space.
Hussein:And it was difficult.
Hussein:And it probably took about five months of deliberating, of discussing with my closest friends and family.
Hussein:And even when I sent that email and wrote that letter, I still, a huge part of me did not want to leave.
Hussein:And looking back on it now, I'm so glad that I did, you know, not because there was anything wrong with that role.
Hussein:Because it just wasn't right for me and what I needed to do
Hussein:. Rachel: I guess it becomes a virtuous cycle, doesn't it?
Hussein:That once you say no once, and then it feels like it, it really benefited you, it gives you
Hussein:a bit more permission to say no again, and, and then it like becomes a real, a real habit.
Hussein:And it sounds like you've really nailed the criteria that you use to say yes or no.
Hussein:What, what criteria would you say you use to weigh up a decision about, should I do this?
Hussein:Should, shouldn't I do this?
Hussein:Yeah, I've definitely massively improved.
Hussein:I, I, by no means have nailed it though, if I'm being honest.
Hussein:I don't think anyone can.
Hussein:And what often happens is I go through cycles where, you know, I've done really well, made those
Hussein:tough decisions, and then things start seeping in.
Hussein:And then you start to realize, oh, wait a minute, I'm starting to carry a bit
Hussein:too much baggage as I like to call it.
Hussein:And then I then have to do another sort of mini purge.
Hussein:But I, I luckily, I haven't had to do this sort of major purge that I had, that I did back at the beginning.
Hussein:But the, the criteria is, is one, when it comes to paid work, like.
Hussein:Is it financially gonna allow me the space to not work at other times?
Hussein:Does that make sense?
Hussein:You know, like we don't often need as much financially than, than we get.
Hussein:And that was my first lesson in trying to actually lean my lifestyle to a point where I didn't have
Hussein:to earn huge amounts of money to maintain it.
Hussein:So I, I very much changed my behaviors to, to mean that, I can reduce the responsibility that financially work brings.
Hussein:So the work that I do, do I wanna make sure does, is it financially rewarding?
Hussein:The other element is what I'm taking on, does it fuel me beyond money?
Hussein:Does it fuel me to keep motivated?
Hussein:Does it fuel me to push me actually outside of my, my boundaries of, of what I feel I can do?
Hussein:And then the final, and I think most important element is will this role, will this responsibility,
Hussein:will this task that you've taken on, is this gonna make a difference in five years time?
Hussein:So once this, this is done and you've done what you needed to do, or potentially you've maintained
Hussein:it, how does it change things in five years?
Hussein:And I think that's been a really important element because as I've seen my career progress to, um, where it
Hussein:is now, often it's been because I've taken on tasks that actually were completely voluntary, i, I got no money
Hussein:for, but they've enabled me to get me where I am now.
Hussein:And I think that's the key because yes, you need to be financially safe.
Hussein:Yes.
Hussein:You need to be pushing yourself from a academic or creative standpoint.
Hussein:But there needs to be thought about where do you wanna get to because you can't make those steps.
Hussein:For example, the Parkrun role, I couldn't have just walked into that Parkrun job.
Hussein:I had to make certain steps.
Hussein:And a lot of them, you know, a hundred percent unpaid in order to get there.
Hussein:So you need to have that, that, that sort of thought ahead and build those building blocks in early.
Hussein:So therefore, when you're doing these tasks, they have meaning.
Hussein:I go, yes, look, you know, this is taking up time at the moment, but it's getting me
Hussein:to an end goal, which I want to try and do.
Hussein:And I want that role because I know the influence that it can have on what millions of people essentially.
Hussein:So I'd really think about those kind of three criteria when you are deciding on taking on responsibilities.
Rachel:Do you think people use money as an excuse?
Hussein:Often.
Hussein:Yes.
Hussein:Often yes.
Hussein:And I remember when I was leaving the partnership and I was changing kind of what I was doing, the
Hussein:work, the amount of my friends that said, you're mad.
Hussein:Like how are you going to survive off, you know, this massive reduction in your income.
Hussein:How are you going to, maintain X, Y, Z?
Hussein:And, and in reality, I think often we, we kind of always live to our means and we often create a
Hussein:lifestyle which matches the earnings and sometimes potentially even a bit more than what our earnings
Hussein:are which, which forces us to make decisions that may not be right for our happiness, may not be right,
Hussein:for our health, may not be right for those around us.
Hussein:And what I found by reducing my need for a certain set of earning, by trying to live a different lifestyle, that was a
Hussein:lot leaner from that respect, it just gave me that freedom.
Hussein:It reduced that pressure that I needed to maintain.
Hussein:And yes, it means that I moved to a smaller house.
Hussein:Yes, it means that I sold my Mercedes, uh, for a Mazda, but at the end of the day, I'm, I'm so glad I did.
Hussein:Those things were giving me short-term reward, but in reality, they weren't making me the person I wanted to be.
Hussein:They weren't giving me reasons to get up in the morning.
Hussein:So yes, they're hard decisions and yes, it can seem like you're going backwards.
Hussein:And I think even to certain members of my family who are kind of just so academic and career focused, they thought,
Hussein:oh God, Hussain really has gone backwards, you know.
Hussein:But when I see where I am now.
Hussein:I'm actually more financially secure than before.
Rachel:They do say that, um, freedom of time in good health is, is the ultimate wealth, don't they?
Rachel:And, and what you've illustrated about how you have bought, you've used finances to get freedom of time
Rachel:or you, you've not tied yourself into getting certain amount of money or you've not exchanged masses
Rachel:amounts of your time for money, and actually you could have had that free time off, not had the money.
Rachel:And, and I was listening to podcasts recently about free fun, about actually the, the fun that people
Rachel:seem to enjoy the most is stuff that comes for free anywhere, like having a laugh with your mates.
Rachel:That is free, isn't it?
Rachel:And we, yeah, I've just been on a, a lovely holiday and it was a really nice hotel and stuff, but
Rachel:I got quite used to it by the end of the week.
Rachel:You get hedonistic adaption, don't you?
Rachel:No, not he hedonic adaption.
Rachel:I think that's the phrase.
Rachel:Like your Mercedes, you probably loved it for the first month, then it just became like, it's my Mercedes.
Rachel:And yes, it's nice to have a nice car, but a Mazda does exactly the same job, you know.
Rachel:And how many extra sessions would you have to work to get the Mercedes versus the other thing?
Rachel:So I think this, this thing about money, we use it as an excuse and then we can
Rachel:get ourselves trapped into the lifestyle.
Hussein:And it's a taboo topic as well.
Hussein:It is a taboo topic to talk about.
Hussein:And often, like I'll see friends, uh, and other colleagues and other GPs that, they're making
Hussein:financial decisions that I just know is gonna tie them into a lot of responsibility and a lot of stress.
Hussein:But I feel unable to really be able to talk to 'em about it in a, in a just an open and, and, and kind
Hussein:of honest way and just discuss things, you know.
Hussein:These things, it just, it's very taboo to talk about and I think that we should speak about it more because
Hussein:we get no training really on how to finance our life.
Hussein:Such an important thing.
Hussein:And, and it is important not just for us, but for those around us and the people that we're responsible for.
Rachel:And most of us have no idea what we need to live and we have no idea what we spend.
Rachel:And it's just like the end of the moment.
Rachel:This is sort of this finger in the air thing.
Rachel:And Tommy and Ed from Medics Money, they are absolutely brilliant on this.
Rachel:So we've, I've done some podcasts, so then they've, Tommy's done, some for, for us just about thinking about what's
Rachel:the value of your time and actually having a budget.
Rachel:And when you think about it, you actually do need a lot less often than you spend.
Rachel:And I, I, my one advice for, for sort of, I guess, younger doctors is I, I remember a, a younger doctor talking to
Rachel:me about, um, deciding what school to send her kids to.
Rachel:And they had some really good options, like locally, really good state, state school options.
Rachel:And she thought, well, we might as well 'cause things we've got into the private, might as well do it.
Rachel:And I'm like, you've got three kids and your other half wasn't in a really high paying job.
Rachel:Think about what you are now tying yourself into for the next 15 years.
Rachel:So there are those, there are those things that we, we can, and there's no judgment around this, no judgment
Rachel:whatsoever, whatever you choose to spend your money on.
Rachel:But I always come back to freedom of time in good health.
Rachel:That is, that is the real wealth.
Hussein:Yeah, I think that's so important.
Hussein:'Cause like every decision in this, there's no right or wrong.
Hussein:You know, everyone will have different set of circumstances will mean that a different decision is right for them.
Hussein:But what they need to also think about is not just the outcome of spending that
Hussein:money, but what's the outcome of not.
Hussein:What are the benefits for potential?
Hussein:For example, let's just use that example of that family of having more time to spend with each other and the growth
Hussein:and the development that that will have on the child, compared to the child goes to a great school, fantastic.
Hussein:But do they see their parents or are their parents constantly working?
Hussein:And when they see their parents, are their parents stressed?
Hussein:Are they able to give them the time and, and the energy?
Hussein:So all these kind of things, it's so important.
Hussein:I remember when I looked at my own finances and I was making cutbacks, I couldn't believe
Hussein:the stuff that I was paying for, something I didn't even realize I was still paying for it.
Hussein:And it wasn't until I just brought an Excel sheet, it was like, okay, what are the things that I have to pay for
Hussein:unless someone's coming to the door to, to sort myself out?
Hussein:And, and I actually found out that a good chunk of what I was spending were things that I no longer was really using.
Hussein:And if I was using, I wasn't really getting much from it.
Hussein:And it's, it's now that whenever I look to spend again, I always go back to this Excel sheet and
Hussein:just go, okay, look, what am I gonna get out of it?
Hussein:What do, how do I maximize, if I do spend my money on it, how do I really maximize the outcome from that?
Hussein:And it's about having that thought process always going through, because I know that it's not just
Hussein:about spending money, but it's the impact that that does on the time and space in your life.
Hussein:That is also a commodity that you should measure rather than just the bank account.
Rachel:The problem is, and I'm gonna challenge you back here, is that it sounds like you
Rachel:had this wake up call in your late twenties.
Rachel:And while obviously nobody would, would, would wish health problems on anybody, you say it actually was
Rachel:good for you in terms of it made you change your life.
Rachel:What advice would you give to people like me?
Rachel:I'm about to turn 50 next year.
Rachel:I can't quite believe that's happening.
Hussein:can I.
Rachel:I know.
Rachel:I'm so young looking.
Rachel:Okay.
Rachel:But I've got, you know, three kids and my kids are at, you know, school, university, you know, we've got mortgage.
Rachel:Um, lots of people my age are in partnerships, maybe leading partnerships.
Rachel:PCN directors, clinical directors in hospitals.
Rachel:So, a lot of financial responsibilities.
Rachel:But even if they got their finances totally sorted out, which I believe that people, that people can do
Rachel:that with a bit of, a bit of, you know, let's just cut out that skiing holiday, let's not do this, you know.
Rachel:You can make it work.
Rachel:So if you've got that sorted out, there are other things stopping you, like the responsibility you
Rachel:feel to your, to your practice, to your colleagues and just feeling that you, you've got to do it all.
Rachel:And I guess when you did your change, you were just coming up through that and yet made a decision not
Rachel:to, not to be the partner, but what can people do who are in that position and who thinks, well, I
Rachel:would love to do any of that, I'd love to have that mindset, but I just can't 'cause I've got so many
Rachel:responsibilities to employing all these people, perhaps?
Hussein:I think first message is that, you know, it doesn't matter what point or what stage you are, I think
Hussein:focusing and, and refocusing potentially on, on not just your health, but the health of those around you.
Hussein:It's something you should do at, at, at any age, regardless.
Hussein:'Cause there are, it's not just the long-term benefits here, there, there are short-term benefits and kind of
Hussein:relief that you can get by just reducing that burden.
Hussein:Now, the ability for, from person to person of how much weight you can essentially shed.
Hussein:I'm not talking about weight on the weighing scales, I'm talking about weight of responsibility.
Hussein:That varies and I think we have to be totally open and honest with ourselves that for some
Hussein:of us it can be really challenging to, to, to shed significant bits of responsibility and,
Hussein:and for others, maybe potentially a bit easier.
Hussein:I think I was lucky.
Hussein:I think I was, because I was, I was, I was far younger and I had other options.
Hussein:It was easier to shed that, but still felt very difficult at the time.
Hussein:Now if you do feel like you're in that camp where those kind of key responsibilities are very difficult to share
Hussein:and maybe you don't want to, maybe you want to, uh, stay in, in those kind of high pressure, high stress
Hussein:roles, then really consider even the small things.
Hussein:Because it can be even tiny little decisions if stacked up upon each other over time, that can make a difference.
Hussein:And for many of us, it's about trying to go below a threshold point.
Hussein:You know, for me, I know that there's a certain threshold that when I go over things start to present
Hussein:themselves when maybe I'm a bit more irritable, maybe I'm, uh, less compassionate, et cetera.
Hussein:And so it's about being aware of that fresher point.
Hussein:So it may be for you that you just need to make lots of little decisions that may seem insignificant, but they help.
Hussein:And if I could just use an example, I had a friend of mine who has two kids in fact, but one of them's
Hussein:four, and has joined the football club, unlike me.
Hussein:But, um, he was asked by his, uh, kids' football team if he would be up for coaching and, and, and, and supporting
Hussein:them., 'cause he was a pretty decent footballer himself.
Hussein:And he said yes, and he didn't even think about it.
Hussein:And he told me later, he goes I'm really annoyed that I'm, I said yes because I have no time.
Hussein:You know, like I'm, I'm, I'm working eight sessions, I'm doing out of hours.
Hussein:I'm, you know, doing X, Y, Z and, and I don't have time to do this coaching.
Hussein:But then, you know, he asked and I wanted to be helpful and it's my kid's club.
Hussein:And, and I didn't wanna say no.
Hussein:And so now he, he's doing something that, don't get me wrong, he enjoys, he likes coaching and he
Hussein:loves obviously doing it where his kid does it.
Hussein:But actually that was the wrong decision for him.
Hussein:And it was a discussion that I had with him a few times, and eventually he made the realization that
Hussein:he had to say no and, and, and give that role back.
Hussein:And it was the right decision for him because now he's got that space and that bit of time
Hussein:and, and that just put him over the edge.
Hussein:So it's little things like that.
Hussein:And, and it may be that it's about taking decisions going forward rather than cutting things that you've currently
Hussein:got, if you're finding that really difficult to do.
Hussein:But where possible, even good decisions, even decisions that seem like it's the thing you wanna do, just
Hussein:stop for a second and think, how is this going to interact with everything else that I've got going on?
Hussein:Will this enable me to get my goals and my outcomes?
Hussein:Because I think we often don't make those priority decisions at the right time, and we're
Hussein:just thinking about that specific decision.
Hussein:And at the time it seemed like the right thing.
Hussein:He loves football, he loves his kid, he loves coaching.
Hussein:So it seemed like this is a no brainer.
Hussein:But when you then put it in the context of his life, it was the worst decision.
Rachel:That's a really interesting example because it's something he really wanted to do.
Rachel:And I think, you know, when, when we talk about saying no to stuff and, and, and leaving decisions, I'm often
Rachel:talking about the guilt and the shame of saying no to stuff.
Rachel:But often that's stuff you don't wanna do.
Rachel:it, it, it is much, much harder saying no to the stuff that you do want to do, or,
Rachel:or you do, you do partially want to do.
Rachel:Uh, and I think one of the problems that a lot of us have is that we're generally pretty competent.
Rachel:I think medics, people work in healthcare are pretty good at everything.
Rachel:And, and there are skills that you, you have built up.
Rachel:So you're quite good at doing this, you're quite good at doing that.
Rachel:And that, that quite good or that even pretty good is really dangerous because that, that zone of excellence
Rachel:just detracts from your zone of absolute genius, 'cause you'll just end up doing it and end up doing it.
Rachel:And the problem is as you go further on and you reach the, my age, you've picked up this role and then that role
Rachel:and then this role and you're pretty good at doing it.
Rachel:And then it becomes really, really hard to say no.
Rachel:So I love that thing about, about going forwards, you know, think about what you're saying yes to going forward.
Rachel:In the back of my mind though, I'm thinking, what a shame that your friend had to say no to
Rachel:something that potentially was probably more life affirming than doing an out of hours shift.
Rachel:And wouldn't that been nice if he'd had the, the head space and the time in his week to be able to do that?
Rachel:Because like, I think doctors should be able to, to coach a football team, they should be able to, you
Rachel:know, I mean, don't coach 10 football teams, be a member of the local choir, orchestra and run this
Rachel:charity as well as being a full-time partner, no.
Rachel:But you know, we should be able to have a life and do stuff like that.
Rachel:So, sounds like his life was just at capacity with work, and we actually want to be working a little
Rachel:bit below capacity, so we've got the time and space is, is that something you'd be advising people to do?
Hussein:Precisely.
Hussein:And, and that's what we talked about, in fact.
Hussein:We said that, look, this was the right decision at the wrong time, and why it's so important that if you're
Hussein:going to add something, you make sure there's space.
Hussein:And so hopefully this is gonna trigger him to consider what can he reduce within his capacity
Hussein:at the moment to take on things like that.
Hussein:So therefore, when the next opportunity arises for something that he's passionate about, that as you say
Hussein:is, is is life affirming, that he's able to pop it on.
Hussein:'Cause at the moment, too often I see people just adding, they'll just add this on, they'll
Hussein:make it work, they'll make it work, you know, we'll find the time, but you don't find time.
Hussein:You know, like time is just there.
Hussein:And so it's really important that when you are thinking about taking on something new,
Hussein:consider what, where is it gonna replace?
Hussein:Rather than constantly adding it in.
Hussein:And so it can be really useful to constantly reflect.
Hussein:And often I do it like on a six monthly basis.
Hussein:Every six months I'll just take a moment and I'll look at my kind of calendar and I'll think,
Hussein:where am I currently spending all my time?
Hussein:Is it where I want it to be?
Hussein:Are there things that I can cut back?
Hussein:And I'm always looking at things where I can cut it back.
Hussein:Because I know that if I create that bit of capacity, it enables me that when I get that
Hussein:email, that message, or someone gives me a ring with an opportunity that is fantastic, I've got
Hussein:the space to go, okay, yeah, let's give that a go.
Hussein:But if you don't constantly consider and refine and tidy up your time, then it will
Hussein:always just be added on, added on, added on.
Hussein:And before you know it, it'll be bursting from the seams.
Hussein:And then you won't be able to do the things that you really want to do, spend time with your kid teaching the local club
Hussein:football instead, as you say, you're doing an out of hour shift, which you know, I doubt most people would rather do.
Rachel:Getting sort of back to practical and reality of people that probably do have too many roles and
Rachel:they probably can't change it overnight, and as a lifestyle medicine guru yourself, I wanna ask you,
Rachel:right, if, if I'm that overwhelmed doctor working all hours, and yes, I'm gonna start to say no to
Rachel:stuff, I'm gonna do a bit of a, a tidy up of my time.
Rachel:I'm gonna start looking at where I'm spending my time, but what's the low hanging fruit in terms of
Rachel:making myself feel better and practicing some, well, I don't call it self-care anymore, I call it necessary.
Rachel:Necessary care.
Rachel:What would you start with?
Rachel:When I'm thinking about I need to focus on oiling oiling my bike, making my bike a high
Rachel:performance bike, where would you start then?
Hussein:I'm gonna stick to cycling on this one because the best cycling teams in the world, they
Hussein:use a philosophy called marginal gains, which is the fact that even small, absolutely tiny changes
Hussein:when stacked up over time, make a big difference.
Hussein:And when I think about my initial journey, one of the key reasons why I had failed in the past to make
Hussein:changes was I'd always try to make big sweeping moves, which invariably never got me very far for very long.
Hussein:And in fact, when I just changed my mindset to going, okay, let me make some tiny changes, little
Hussein:things that on their own they're gonna do nothing, really, nothing on the grand scale of things.
Hussein:But when you combine them and, and, and you, you allow yourself to increase with confidence as
Hussein:you move from goal to goal, they get you far.
Hussein:And I remember one of the first things I did was I gave myself 15 minutes more time to sleep, 15 minutes.
Hussein:And it sounds crazy, but what was happening was something that's called rev revenge, revenge procrastinating.
Rachel:bedtime, revenge, procrastination.
Hussein:Oh man, I was the best at it.
Hussein:I was absolutely the best at it.
Hussein:'cause I was just constantly working, constantly stressing, constantly doing stuff that when it came to it, even when I
Hussein:could have gone to bed, I was just like, do you know what?
Hussein:I've had no time to myself.
Hussein:And I'm now just going to not do actually something that's gonna be useful and feed me.
Hussein:It was generally just scrolling through Instagram or watching something on Netflix
Hussein:or whatever and I just decided that okay.
Hussein:I'm gonna give myself 15 minutes more sleep, and that's where I started.
Hussein:And I can tell you that just getting better sleep enables you to do that a little bit better
Hussein:the next day, make little bit better decisions and feel a little bit more like you're coping.
Hussein:And then I moved from 15 minutes of extra sleep and I said, okay, now I want to spend 10 minutes in my
Hussein:day doing something I actually really want to do.
Hussein:And so in fact, those 10 minutes was spending time in my garden.
Hussein:And at that time reflecting on how terrible it was because I didn't have any time to look after it or prune it.
Hussein:So then what ended up happening was those 10 minutes was, okay, I'm gonna spend five minutes just sitting in the
Hussein:garden and five minutes doing something in the garden.
Hussein:No matter how small it was, 'cause hell, it took more than five minutes.
Hussein:It would probably take days to sort out that garden at that time.
Hussein:But just five minutes, I just felt like I could just fix that little bit that's there.
Hussein:Let me just weed it out, and then I felt like I was accomplishing something in that day.
Hussein:So at least I've tidied up maybe a half square meter of the vegetable patch.
Hussein:And so it just, it just, it just snowballed from there.
Hussein:And then I'll just move on to something else.
Hussein:And I kept stacking on little things and I kept a little Excel sheet of all the things because, you
Hussein:know, we're doctors, we like to tick things off.
Rachel:I would love to see your Excel sheet.
Hussein:Oh, it is amazing.
Hussein:And red had various shades of orange as sort of, I felt increased confidence, uh, to eventually green.
Hussein:And, and I, I just kept stacking them up.
Hussein:And then when you look back at it, now, what, 10, 12 years later, like those little
Hussein:things have made a massive difference.
Hussein:And in fact, there came a point where I had enough small little changes and I got
Hussein:more confidence to make bigger changes.
Hussein:And I said, do you know what?
Hussein:I've, I've created and carved out a bit more energy, a bit more motivation, a bit more time.
Hussein:I can now take this on.
Hussein:And then it just slowly, slowly, eventually snowballed.
Hussein:And it's can seem a bit demoralizing to take on such small things to start off with that on their own, that
Hussein:15 minutes, it didn't do that much, but it was the start.
Hussein:And I think that's what's really important is that you make those little changes, not
Hussein:thinking that they're gonna sort out the world.
Hussein:But thinking that what will 50 little changes do in six months time if I take on a new thing every, let's say
Hussein:week or whatever time you wanna have interval between it?
Hussein:'Cause I promise you, you put them together by God, it makes a massive difference.
Rachel:and you start getting the rewards quite soon.
Rachel:I remember coaching a, a GP who, um, was yeah, his senior partner had had no time in the day whatsoever.
Rachel:And, um, I think at the, the end of one of the coaching sessions, he'd come to the conclusion that he was
Rachel:so stressed in the afternoon and staying so late and not get anything done, he just said he needed
Rachel:to get out in a, a lunchtime into the local park.
Rachel:So we left.
Rachel:He was gonna go for a walk at lunchtime.
Rachel:And, and so six months later I got an email from him saying that every day he goes to the park for 45 minutes,
Rachel:started off 10 minutes, 45 minutes, eats his lunch under a tree, and he was in the afternoon, getting home sooner,
Rachel:getting more done, and the practice income had gone up.
Rachel:Amazing.
Rachel:So you, you think, oh, I haven't got time to do that.
Rachel:Actually you get that time back.
Rachel:It's almost like you haven't got time not to do it and I can imagine, yeah, the benefits of the
Rachel:tiny benefits from a tiny amount extra of sleep actually that probably, that probably balanced.
Rachel:That's like exercise, isn't it?
Rachel:We know that the productivity you gain from doing that exercise is, is huge.
Rachel:I mean, would you be looking to go across all of the, well, five ways away, wellbeing?
Rachel:I think there's eight ways to wellbeing, but uh, you know, or do you, would you like try and maximize movement
Rachel:or maximize ice or what would you be focusing on?
Hussein:I would encourage the person just to consider what they want to do most.
Hussein:Whether it be they want a bit more sleep and energy, whether it be that they wanna try and focus on their diet,
Hussein:let their motivation be the trigger to that first goal.
Hussein:It's so important that we consider all the pillars, absolutely.
Hussein:But when it comes to those first small goals, just go bare bare where you wanted to go.
Hussein:For me, I just wanted to wake up in the morning and not feel like I'd been run over by a bus every day.
Hussein:And so for me, I wanted to start off with that bit more sleep.
Hussein:And then, you know, my next goal, I wanted to just sometimes feel like my head wasn't constantly going
Hussein:to explode with thinking and decisions, so that's where the 10 minutes of doing nothing came from.
Hussein:And so just be guided based on what do you want to try to work on right now?
Hussein:Create a goal based on that.
Hussein:And then as time goes on, consider where else you need to move into.
Hussein:And so I actually got to my nutrition and diet.
Hussein:Quite late, even though it was probably the biggest problem.
Hussein:I, you know, my diet was hideous and it was probably, if you were looking at it from an root cause analysis, you'd say
Hussein:that's where you need to put in most of your effort or work.
Hussein:But I actually got to it much later on because I knew that I had such a, like a emotive connection with food
Hussein:and such an unhealthy relationship with it, it needs time.
Hussein:And I needed to improve my confidence.
Hussein:I needed to have a bit more energy and head space through the sleep.
Hussein:I needed to reduce my stress before I even think about tackling on it.
Hussein:Because in the past I would always just focus on diet and I'd be like, okay, that's it.
Hussein:Mediterranean diet tomorrow.
Hussein:Like here we go, you know, no more takeaways.
Hussein:And I would maintain it for like four weeks and then it would just go, it would just vanish.
Hussein:And so I knew that I couldn't just keep doing that.
Hussein:I had to build the space and the time and strengthen all lots of other elements in my lifestyle and resilience, so
Hussein:therefore when I did approach nutrition, I felt stronger.
Hussein:And again, I was still still making small changes in nutrition, but I knew that I couldn't make even
Hussein:small changes in nutrition until I did lots of the other stuff, lots of the accompanying work around it.
Hussein:Because I'm telling you now, sleep stress, they have huge, huge drivers on the
Hussein:reasons that we eat the food that we eat.
Hussein:And it was just creating this sort of cycle of guilt for me, because I would eat something and feel hideous about
Hussein:myself for doing that and think that I'm useless and, and why am I not doing what I said I was going to do?
Hussein:But then you realize that there's other strings at play.
Hussein:You know, the reason I I, I clicked that takeaway was because, you know, work was really stressful and I
Hussein:didn't have much time and, and my sleep was just awful.
Hussein:I had no energy.
Hussein:I just wanted something quick and easy.
Hussein:I didn't have time to prepare.
Hussein:So really think about what you can do around a difficult area before you just dive into it.
Hussein:We often really think about how, let's say if you want to lose weight, people just focus on, okay,
Hussein:you know, how am I gonna change my diet, how I'm gonna increase my activity, et cetera, et cetera.
Hussein:But they don't think about why am I here?
Hussein:And I think that's, it's, once I realized that, look, I gained nearly what, 30 kilos
Hussein:because, not because of just what I was eating.
Hussein:Because you have to think about why was I eating that?
Hussein:You know, why was I not moving my body?
Hussein:Why was I not getting restorative sleep?
Hussein:And once I started to focus all my little goals on trying to correct those underlying drivers, the weight came off.
Hussein:You know, the weight came off not, not quickly, it wasn't like six weeks.
Hussein:And I was better.
Hussein:Over six years, just consistently, just slowly lowering the weight to a point where I stopped
Hussein:weighing myself and instead measured where I was going based on the, that Excel sheet, the outcomes
Hussein:that I was trying to create, those little goals.
Hussein:I just said, look, if I focus on that, rather than looking at the weighing scales,
Hussein:that's where I'm gonna get my reward.
Hussein:Because not everything we need to do in life needs to be focused on having an external outcome like weight loss.
Hussein:You know, it could, there's so much more to that.
Hussein:And so really do consider those kind of surrounding environment that you are putting your body in.
Hussein:Rather than just what you can do.
Hussein:Because we always want to do more.
Hussein:I'm now going to eat more fruit and vegetable, I'm now going to exercise more.
Hussein:And those are great, but they're also difficult.
Hussein:So think about what could I do less?
Hussein:What could I potentially have less of that's going to drive less stress?
Hussein:And I remember be back 10 years ago, if you left like an entire, let's say 24 multi-pack of crisps,
Hussein:I'm telling you now, I would eat all of them.
Hussein:Now, if I go to, let's say, a function, there's crisps out, I don't even touch it.
Hussein:And it's not because I'm saying, look, you can't have a crisp, oh my God, have one, no, knock yourself out.
Hussein:But that craving that was so strong before where I would literally be killing myself trying not
Hussein:to eat them yet, still doing so, now, like it when I look at them, there is no emotion anymore.
Hussein:And that didn't come through sort of a short term psychological intervention that came through actually
Hussein:reducing the stress and the pressure, that, that valve just letting it release to a point now where I'm in
Hussein:better control, you know, I pick the things that I want to eat and don't get me wrong, I eat some crap
Hussein:sometimes, but I do that now in much better control.
Hussein:I don't do it because I have to have it because I've been craving for it for days and months.
Hussein:And so therefore I'm now better able to make those changes on nutrition.
Hussein:And I just realized I had to just change that environment before I make those changes.
Rachel:And what I'm realizing, and I think what you're talking about a lot with the goals as well, is
Rachel:it's, it's much more about process goals, isn't it?
Rachel:Than outcome goals.
Rachel:So, you know, I signed up for, I think I've done a podcast or this is, well, I signed up for Cambridge half marathon,
Rachel:which I hate running, so that wasn't gonna happen.
Rachel:And, you know, two months before I'm like, mm, this isn't gonna happen.
Rachel:Whereas if I'd have set the process goal of three times a week, I'm gonna go put my trainers on for 10 minutes,
Rachel:well, that would've, that would've happened that I'd been more likely to hit the, the outcome goal anyway.
Rachel:But I think we are quite driven by results and achievement and success, aren't we?
Rachel:So we just always make that mistake of going for the outcome as opposed to the routine and the process and the habit.
Hussein:Precisely.
Hussein:And my top tip is gamifying that process, so therefore it feels like a reward.
Hussein:So for me, changing those colors, I know it sounds silly, but it was lovely, and I
Hussein:could see an Excel sheet and I'd look back.
Hussein:I'd be like, look at all the things that I've managed to do and maintain.
Hussein:And that is the reward.
Hussein:And you are absolutely right.
Hussein:The, the outcomes, they will come as a result of hitting those kind of goals.
Hussein:And so, you know, when I think about where I started, my first physical activity goal I remember
Hussein:was just, you know, going for a walk for five minutes after food in the evening with my wife.
Hussein:Now, that's now stretched to, we probably go for about 30 to 40 minutes.
Hussein:That sort of happened over time.
Hussein:'Cause initially I thought I had no more than five minutes.
Hussein:And it's amazing how, you know, your, um, person that you were coaching, how he's now walking 45 minutes
Hussein:when initially it was just 10 minutes in the park.
Hussein:It's amazing how time opens itself up if you change your direction of priorities.
Hussein:But, you know, that initial goal, that's where it started.
Hussein:And if I look now this year I've, I've, I've competed in two world championships at long distance triathlon.
Hussein:And that started with five minutes of walking with my wife after dinner.
Hussein:Now, if I set the goal of I'm gonna do a marathon, or I'm gonna do a half marathon, then there would've
Hussein:been so many things that could have stopped me from achieving it, because it's really difficult.
Hussein:It's another thing that I'm adding rather than thinking about how I can support and remove.
Hussein:And so don't think always about the reward.
Hussein:Think about the process.
Hussein:Think about doing those elements, because I promise you, the rewards will naturally come.
Hussein:And they will be amazing when they do come.
Hussein:And you will always be rewarded for work that you do in yourself.
Hussein:And, and sometimes they'll be in areas that you hadn't even imagined in, in, in subjects that are not even related
Hussein:to that initial goal that you haven't quite connected.
Rachel:Oh my goodness.
Rachel:I just think it's so amazing that you've gone from like this person on that, you know, ultrasound
Rachel:couch to competing for your country in triathlon.
Rachel:I mean, that, that's just such an amazing story and I think it's very useful for people to
Rachel:know you didn't start off like this, did you?
Rachel:You've, you've, you've had that journey and you've obviously got amazing natural capacity for it.
Rachel:But it is amazing
Rachel:'Cause I think when you first start, it just does seem impossible.
Rachel:And particularly when you are in overwhelm, it seems really difficult.
Rachel:And I guess this is the same with patients as well.
Rachel:They, you know, busy lives, working two, three jobs, haven't got much money.
Rachel:And that's the whole thing about lifestyle medicine, isn't it?
Rachel:That, we know what a, a big change is for, for people.
Rachel:But actually I'm thinking, you know, when we are trying to tell patients about it and we are not doing it
Rachel:ourselves, that's really, that's really hard, isn't it?
Rachel:What else do you think is stopping us from, from doing this necessary care, from making
Rachel:these changes from, from working on ourselves?
Rachel:Is there anything else that you've come across with doctors?
Hussein:Yeah, the, there's so many reasons why it's really difficult to, to do this and, and
Hussein:one thing that's the case for not just doctors, but everyone is just the environment we live in.
Hussein:You know, like whether it be the fact that movement's been engineered out, that we now need to somehow bring it back
Hussein:in intentionally, that's, that makes it really challenging.
Hussein:You know, when we think about some of the healthiest places on, in the world, they're active, not because they've
Hussein:gone to a gym or they've signed up for half marathon.
Hussein:They're active because it's just, you have to be active to get to the next town.
Hussein:You have to cycle or walk or to wash your clothes.
Hussein:It's manual.
Hussein:And, and don't get me wrong, I'm not going back to manually washing my clothes.
Hussein:However, we need to realize that look, movement's been engineered out.
Hussein:And before you take on a new task, like a hit session or you're going spinning or you're gonna go for a run, consider
Hussein:how can you just engineer movement back into your day?
Hussein:Maybe it's that walk to work as you described.
Hussein:Yes, it's 20 minutes extra, but that was 20 minutes that you potentially were gonna need to
Hussein:do exercising and now you've done two things.
Hussein:You've got to your destination and walked.
Hussein:Um, maybe it's around deciding that you are not gonna take a lift or an elevator again.
Hussein:And that's a rule that I stick to unless you are in New York and you've got like 22 flights
Hussein:of, of stairs to do that, that I'll allow.
Hussein:And then think about the things that are advertised.
Hussein:You know, when, when I'm on my phone in the evening after stressful day of work, what's being pushed to me?
Hussein:Well, it's, it's takeaways.
Hussein:It's, you know, fast food.
Hussein:It's all the things that I crave but don't really need for my health.
Hussein:And so all these factors is why we're living in, you know, what's called an obesogenic environment.
Hussein:And we have to be compassionate to ourselves that we are essentially living in a casino.
Hussein:We're living in a world which wants us to make decisions that are not gonna be helpful for our
Hussein:long-term health, or even our short-term feeling.
Hussein:And they're trying to offer us a reward that unfortunately.
Hussein:Is, is, is lined with a lot of baggage.
Hussein:And so I think we have to be compassionate to that.
Hussein:And, and when you look at physical activity levels, when we look at weight levels, we look at nutrition
Hussein:over the decades, you can see that there's been a huge change in what we eat and how we move.
Hussein:And that's not be because we've suddenly become lazy and greedy.
Hussein:Um, we're still the same people, we're just living in a different environment.
Hussein:And that is the hardest thing to crack because there's no point creating a preventative medicine, um,
Hussein:revolution that Labour wants to do, which is fantastic.
Hussein:Not until you've corrected the environment, there's no point doing that unless you look to fix the root causes.
Hussein:And so what I always tell to patients and to colleagues is be compassionate to that reality that you are not
Hussein:making bad decisions for the sake of making bad decisions.
Hussein:You're making it because they are being advertised to you, encouraged to you, you adding
Hussein:in stress, then you've got a terrible cocktail.
Rachel:And whatever barriers there are that will just just stop you very, very quickly when you, you know,
Rachel:our local hospital, there was only a Burger King for years and years, and now there is an M&S Food so you can
Rachel:get your salad, but it's like hungry doctors on call.
Rachel:What are they gonna get?
Rachel:You know, they're not, if they're, if that's all there is, you know, you, you're
Hussein:Precisely and just, and, and, and, and that's the issue.
Hussein:And you think about then our people in population that are in our lowest socioeconomic groups,
Hussein:and you think, what do they have on offer?
Hussein:Because you know, they can't afford M&S Food for that salad.
Hussein:And what alternative options do they have to really access that kind of high nutritious food that's affordable?
Hussein:And I remember, um, so Michael Marmot, uh, had one of his research projects which sort of
Hussein:outlined the amount that you'd need to spend of your income in order to live a healthy lifestyle.
Hussein:And for the bottom 20% from an income category, it was nearly 70% of all the
Hussein:earnings would need to be spent on that.
Hussein:And you just think this is not an environment, you should not have to be wealthy and affluent to be healthy.
Hussein:And I, I feel really passionately that as clinicians, we should be advocates for them.
Hussein:And we have a role, don't get me wrong, like whether it be speaking to your counselor, speaking to your MP,
Hussein:promoting that because we're not just there to serve appointments, we're there for the health of our communities.
Hussein:And we need to start really raising our voice and our message that we gotta do better.
Hussein:We gotta do better for everyone in our society because it's actually a failing to need an appointment.
Hussein:Don't get me wrong, we always need appointments, but every extra appointment that we need to put on, that's a failing.
Hussein:And so we need to consider, rather than just constantly going, reduce wait times, increase appointment
Hussein:numbers, we need to think about how can we actually help our health, our health from the root causes.
Rachel:And, and it strikes me as well, you know, there is something about leadership as well, because
Rachel:doctors, yes, they have, they have money to spend on stuff or, or more money maybe than other people.
Rachel:They don't have the time.
Rachel:And we do have the time.
Rachel:It's just we make time for what, for what matters.
Rachel:You've given me some practical tips, um, before the, the session.
Rachel:Can you just talk about those three before, just before we wrap up?
Rachel:'Cause I'm quite interested in, in your top three tips for, you know, making some of these changes.
Hussein:my first tip would be to speak to those closest to you.
Hussein:'Cause often they will pick up on signs and on changes that you may have not understood.
Hussein:And they may also help to identify where you want to focus your initial goals, because you want them
Hussein:to be as meaningful, as impactful, as possible.
Hussein:Um, my wife was really helpful in actually, you know, informing me things that I just didn't fully appreciate
Hussein:and I didn't realize I was doing or not doing.
Hussein:And so my first tip is speak to those that you trust that are close to you and find out, you
Hussein:know from them, you know, what's their opinion.
Hussein:You may not, you may not follow it, you may not agree with it, but you definitely not
Hussein:gonna lose out in getting that perspective.
Hussein:My second tip is, I, I, I highlighted a bit before, but is gamifying things, you know, like
Hussein:gamifying anything just makes it more engaging.
Hussein:If we think about what has been the most impactful tool to increase physical activity in the world.
Hussein:It's been Pokemon Go.
Hussein:There's a really interesting study that was published and it just demonstrated, if you look at the US
Hussein:population and what they did in that study, there has been no campaign, there has been no intervention, no
Hussein:matter how well funded, that has been more impactful than Pokemon Go at increasing physical activity levels.
Hussein:It just shows you the power that gamification has.
Hussein:You know, it increased, I think it was somewhere between two to 3000 steps a day
Hussein:compared to what the user was doing before.
Hussein:That is huge.
Hussein:And so gamifying things, whether it be your goals in that Excel sheet with the different colors or whether you are
Hussein:gonna build in certain rewards based on achieving certain of those goals or whatever that may be, there's lots of apps
Hussein:out there that can help you to gamify movement or nutrition.
Hussein:Just do that.
Hussein:Don't consider it being silly.
Hussein:Actually, you'll, you'll get engaged with it and you'll find it funny and you'll find it much more rewarding.
Hussein:And then the third and final tip is accept that you are going to fail at a number of the goals that you set.
Hussein:My Excel sheet is not full of green.
Hussein:There are a number of, of dead goals on there that I've tried over and over again to do, and I still can't do them.
Hussein:And you just have to accept that.
Hussein:There are some things that we will be able to do, some things that we'll partially manage
Hussein:and some things that we'll be successful in.
Hussein:And that's, that's just life.
Hussein:And it doesn't mean that you're just gonna leave it.
Hussein:You may return like I have and try it again.
Hussein:And some of the things that I've returned to, I've managed.
Hussein:Some I've still not managed to do, but it's appreciating that it's not a straight line.
Hussein:It's this sort of constant spiral and fall down and spiral and fall down.
Hussein:And eventually you will get forward progress over time.
Hussein:And what it can often do is when you fail at things, it can help you maybe reshape
Hussein:your future goals to be more achievable.
Hussein:But don't be hard on yourself.
Hussein:And even actually now when I think about my, um, sporting career, it's the races that I have failed at that,
Hussein:that have truly enabled me to progress and to grow.
Hussein:And in fact, the races, which I've absolutely nailed, when I think about what have I
Hussein:learned from them, not really that much.
Hussein:So, you know, those failures, cherish them.
Hussein:Don't think of them negatively and use them positively.
Rachel:Oh, such, such brilliant tips.
Rachel:Thank you.
Rachel:The one thing that's made the difference to me is actually planning.
Rachel:So, you know, actually sitting down at the beginning of the week and going, right, when am I gonna do my self-care?
Rachel:When am I gonna do my exercise?
Rachel:What am I gonna eat?
Rachel:That's probably made the biggest difference.
Rachel:'Cause then, then it's in, and I've thought about it rather than just being reactive when I'm, when I'm
Rachel:hungry, or when I'm tired and then not doing anything.
Rachel:So that's really
Hussein:And plan, like for me, like includes actually popping it in my calendar.
Hussein:So in the days that I have blocks where I've popped in, I still do my 10 minute garden.
Hussein:So for example, that's actually in the calendar and it stops me from putting a Teams call or
Hussein:putting in a meeting or whatever over it because it's there and I find it difficult to replace it.
Hussein:I don't like deleting it.
Hussein:'cause then it feels like actually I'm not prioritizing that.
Hussein:I'm not giving it the time.
Hussein:I'll move it around sometimes 'cause I'll be like, well, okay, I need to move around.
Hussein:But it always needs to be in there between nine to five at some point.
Hussein:Whether it be walking outside of, of the practice or whether it be, uh, when I'm working from home,
Hussein:you know, going out into the garden, whatever that may be, think and prioritize in the same way.
Hussein:So whether it be a calendar, whether it be a diary, whether it be you write it down, you know, be intentional,
Rachel:Now I know you obviously the RCGP lead for lifestyle medicine.
Rachel:You do the course for Read, well, you run the course for, for, for healthcare professionals
Rachel:who, who deliver lifestyle medicine for patients.
Rachel:And presumably it's, it's this sort of advice that you've been giving us now, is
Rachel:it, is there anything that extra in that.
Hussein:Yeah.
Hussein:yeah.
Hussein:Because I think what's beautiful about Lifestyle medicine is that when you train in that you
Hussein:develop so many skills for your patient, but these skills are 100% transferable for yourself.
Hussein:And I'd really, really recommend anyone working in healthcare to consider doing the lifestyle medicine
Hussein:course because it just, it enables you to get a better understanding on topics that are so fundamental and
Hussein:so core for health, but when you think back on it, how much time have you had to train yourself up on it?
Hussein:And in fact, one survey asked patients, where did they get the lifestyle advice from?
Hussein:Would they get it from their GP or from another healthcare professional?
Hussein:80% put Instagram.
Hussein:And come on.
Hussein:You know when the World Health Organization says that 7% of the content on there is actually accurate?
Rachel:Seven.
Rachel:Oh, I thought you was gonna say 7% is inaccurate.
Rachel:7%
Hussein:7% is accurate, okay.
Hussein:You know, we, we can't accept that.
Hussein:And, and can you blame them for accessing it there?
Hussein:Because we don't have the knowledge, the confidence, or the skills.
Hussein:So it's really important that we consider doing it.
Hussein:And in particular for GPs, um, in April this year, I co co-authored the role for
Hussein:an extended role in lifestyle medicine.
Hussein:And I really recommend going on the college website, having a look at that framework.
Hussein:It details really kind of what the role involves, what training's required, et cetera.
Hussein:And.
Hussein:I really feel passionately that all GPS should have that lifestyle bow in their hat.
Hussein:And the more we can get, the more we can show within healthcare and within primary care
Hussein:that we care about it, that it's important.
Hussein:And that can be such a important message when it comes to policy makers and decisions.
Hussein:If healthcare is taking lifestyle seriously, then hopefully we can have the policies that impacts our
Hussein:environment, and not only for ourselves, but our patients.
Rachel:And I can imagine, um, for doctors and nurses and other healthcare professionals that train in lifestyle
Rachel:medicine, it's a, it's a really rewarding field to be in.
Rachel:You probably get a bit more time with the patients.
Rachel:Actually, it's something that you probably could say hell yes to in your day.
Hussein:Really enjoyable, and it just feels.
Hussein:Like it feels like compound interest often.
Hussein:Because when you make lifestyle changes with patients, often it's to try and remedy something specific.
Hussein:But what the patient and both the clinician realizes is that you get compound benefits.
Hussein:So for example, when you support a patient to join a community walking group because they wanna improve their
Hussein:fitness, for example, yes the fitness will improve, but they'll also improve the connection with community.
Hussein:They'll also have a space to improve their mental health.
Hussein:They'll also be able to sleep better because they're being active regularly through the day.
Hussein:It just compounds.
Hussein:So instead, unlike with medication where you have negative side effects that compound the benefit that you're treating,
Hussein:the side effects in lifestyle interventions are positive.
Hussein:They're often things that the, the clinician or the patient hadn't really focused on, but come about.
Rachel:Yeah.
Rachel:And we are right back to where we started this podcast with you saying you make the lifestyle change, actually, you
Rachel:find yourself more successful, more productive, happier.
Rachel:You are not just thinner and fitter and more relaxed, but there's all that other stuff there.
Rachel:So, thank you so much.
Rachel:That has been so, so inspiring to me.
Rachel:There's loads of stuff I'm gonna do.
Rachel:Um, we'll have to have you back another time if that's okay.
Rachel:There's loads more to talk about.
Rachel:How can we find out more about you and your work and all that sort of stuff.
Hussein:I have a kind of, uh, an Instagram account which is focused on trying to promote healthy lifestyles, give
Hussein:factual and important information, try to boost up that 7%, and the account is Iron Doctor HAZ, which is my initials.
Hussein:And on LinkedIn is where I share a lot of the kind of professional developments in terms of
Hussein:what the college is doing, and so just search that through my name, Hussain Al-Zubaidi,
Rachel:Thank you so much and hopefully we'll speak again soon.
Hussein:Take care.
Rachel:Thanks for listening.
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