Are you struggling to see obesity as more than a number on the scale? Do you wonder why shame and stigma still dominate the conversation around bariatric surgery? 

In this episode, we explore the truth about obesity as a chronic disease and how we can shift the narrative to one of compassion, education, and long-term support. Our guest, Carah Horn, brings her clinical expertise and lived experience to the table in an eye-opening and empowering conversation. We talk about the outdated perceptions surrounding bariatric surgery, the crisis in obesity care, and why finding the right provider makes all the difference. Carah shares powerful analogies—like her “lawn care” metaphor—to help us understand why long-term maintenance and ongoing support matter. She also explains the dangers of anti-obesity medications without proper oversight and how the BariNation Community provides a unique space for education, encouragement, and behavior change. Whether you are post-op, pre-op, or still considering surgery, this episode will leave you feeling seen, supported, and more equipped for the road ahead.

IN THIS EPISODE:

• (00:00) Introduction and opening
• (01:24) Carah shares her professional background in obesity disease and bariatric surgery
• (12:19) The narrative surrounding obesity needs to change, and finding the correct doctor
• (19:14) Carah speaks to the crisis of care, anti-obesity medications and comorbid conditions
• (33:03) Each patient is different, and she encourages going back to your surgeon when health changes occur
• (39:31) Carah shares the word picture she tells her patients
• (56:12) Making your bariatric journey positive rather than negative and using the tools provided by the BariNation Community 

KEY TAKEAWAYS:

• Obesity is a complex, chronic disease affecting every aspect of a person’s life—physical, emotional, and social. It should be promoted as a legitimate medical condition that requires real treatment. Unfortunately, shame and stigma surrounding obesity prevent many people from seeking treatment. 
• Treating obesity is about improving health, not appearance. Viewing it through the lens of disease management—similar to diabetes or cancer—can help shift public perception and lead to better care. Medications and surgery are tools to treat the underlying condition, not just to achieve a certain weight.
• The lack of long-term support and education around obesity medications is dangerous. When prescribed without proper medical oversight or behavioral support, these medications can lead to serious health risks. Without a comprehensive program—including nutrition guidance, mental health care, and consistent follow-up—patients are more likely to misuse medications, relapse, or face complications, especially if access to treatment is suddenly lost.

RESOURCES:

• BariNation Website 
• Join the BariNation Membership community meetups to support you on your journey with obesity treatment. https://barination.com/pages/join-our-community
• Want to see bonus content? Head over to https://www.patreon.com/BariNationPodcast to get more and support the podcast for as low as $5 per month!    

GUEST RESOURCES:

Carah Horn - LinkedIn

BIOGRAPHY: 

MBA-HCA, BSN, RN, CBN, FASMBS-IH

Carah is a clinician who is passionate about engagement. She believes that change and best practices happen in the community. She is active at the local, state, and national levels of obesity treatment and advocacy, as well as an Integrated Health Star in Florida for the American Society of Metabolic and Bariatric Surgeons (ASMBS). She has four daughters and five grandsons and loves fitness and learning! 1 Corinthians 10:31—So whether you eat or drink, or whatever you do, do it all for the glory of God. 

ABOUT:

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April Williams: You've just tuned into a podcast that welcomes you into a community, a resource center, and a safe place that powers your [00:00:15] journey towards personal wellness.

Natalie Tierney: Our goal is you leave us today feeling hopeful, inspired, and ready to live your best bariatric life.

We want her take on this crisis of care [00:01:00] that she is seeing occurring right now in the world. And then she's going to share with us this amazing metaphor or this way of living for bariatric patients who are post-op and maybe struggling with the idea of having to do this forever. [00:01:15] So there's gonna be a lot that we cover in today's episode.

But before we get to it, I'm gonna turn the microphone over to you, Kara, to introduce yourself. All right.

So it's interesting that that's, that's a real, a real thing now, that's reality. Mm-hmm. Um, I started out in labor and delivery and er, when I was at the bedside and transitioned [00:01:45] to a transplant and was a living donor coordinator. Loved what I was doing actually as a, a living kidney transplant coordinator.

Which is, I mean, that's was the [00:02:15] idea that I had. I knew nothing about it except for some bad experiences that, you know, we've all probably heard about right over time. And he said, well, think about those patients right, that are on dialysis that are, our dieticians aren't able to help by, you know, [00:02:30] just within nutrition itself to lose the weight to qualify, uh, for transplant because you had to be for kidneys, A BMI of 35 or lower to be able to be listed.

I. All the [00:03:00] systems that it attacks all of the comorbidities and other conditions that it predisposes them to. It's not just qual. I mean it's quality of life, like being able to socialize it, it hits like every aspect of a person's life. And then in addition to that, [00:03:15] the fact that I knew nothing about it and realizing that I'm part of the problem was completely mortifying.

I was life-changing for me as well. And so, and then moving [00:03:45] forward, that's been my passion. I wanna change that mindset for everyone. I wanna raise awareness. Everyone should know how much I did it know, uh, because we didn't talk about it in nursing school. I mean, maybe a paragraph here or there ish.

And I would love to see that go to go to more medical programs. Um, but until then they got me and my big mouth and I to keep talking about it and, um, and thrilled, you know, with A-S-M-B-S and that being kind of the, the [00:04:30] governing body really for metabolic and bariatric surgery and the passion that, that they're showing, that we're showing as we're coming together to spread that, that, uh, kind of terminology, flip that narrative and, uh, really advocate for care.

With all of your experience with patients really in so many different areas of medicine, is that what you see [00:05:15] as the largest barrier to care? Is it that shame and stigma that surrounds the disease or treatment?

They experience kind of what obesity is in different ways. But I do think even that in some ways ties back to that, the narrative that causes shame for other people, [00:05:45] right? Because there's a difference between living in a larger body and in what we see in the mirror and the disease of obesity. 'cause you don't see obesity in the mirror.

And so learning to understand what obesity [00:06:15] is spreading kind of that awareness and the fact that it isn't what I'm seeing in the mirror, and then on the other side, that treatment is not cosmetic is gonna be critical, I think to moving forward.

I can't stick to a diet or, you know, all of that to. Screw it. I'm gonna embrace my big body. I did that for about a year, uh, crept, uh, all the way up to my highest weight [00:07:00] before I realized what am I doing? Like why am why is this, why is body positivity? And listen, you guys know, if you're longtime listeners, I'm all about body love and, and accepting our bodies [00:07:15] for what they are.

Um, you know, there were just starting to be these conversations and so. I'm just excited to see we have a long way to go. And also we've come so far already just in the, in the 15 years that [00:08:00] I've been fighting for my own treatment.

Mm-hmm. Because what we allow shame to do and keeping us silent, keeps us in kind of that denial pattern, right? Mm-hmm. If we can't talk about it, then we try and pretend it's not there, and we, we try and make it [00:08:30] okay in different ways as opposed to taking it out, looking at it and, and treating it. But then also with that, when you do talk about it and you get that negative pushback from people that are saying, well, you just need to eat less and exercise more while you're starving yourself and hitting the gym every [00:08:45] day.

Mm-hmm. You don't, you don't know why that that boy is crying. You don't know why, you know that girl is, you know, wearing sunglasses or is, you know, more, you know, manly or, or [00:09:15] aggressive or whatever, and it's not okay to talk about that. But if someone wants to talk about seeking treatment for obesity immediately, it's, well, she doesn't have any willpower.

Yeah.

Which you have heard constantly your entire life. And that messaging absolutely just kind of shuts. You down, and [00:10:15] it can lead to this place of thinking that, well, this is just cosmetic, right? Like I, you know, I just want to lose weight. So I, I look differently. Even though we know deep down that's the least of our concerns, we are actually terrified for the longevity of our life, for [00:10:30] the quality of our life.

But like you said, if we're not talking about anything that we're experiencing on the inside, it's never going to change [00:11:00] and get. Fuel or the bravery that you need to say the scary thing out loud takes a lot. And after saying it to so many people for so many years, you're just like, I'm just not gonna talk about this anymore because I already know what they're gonna say.[00:11:15]

And I've done that, I do that, and it doesn't help.

I, I had an earache and I went to my primary care doctor and they said, well, you know, if you weighed less, you know, you, this wouldn't happen. So you [00:11:45] probably need to eat less. You need to exercise more. And maybe they get a drop for their ears, and at some point they just stop going like statistically.

It's, it, [00:12:15] it's not the way that I guarantee they were taught, taught to practice.

April Williams: Yeah. Right.

It's, it's not okay and we've gotta change it. And you have to be brave to talk about it. And it's gonna take a bunch of people being brave. And when that happens and we're all talking about it, [00:12:45] then the other people are gonna be ashamed. I was ashamed. Yeah. And I changed. Everybody can do it. Yeah. And I didn't think I was a problem.

A lot of people don't know it's that [00:13:15] implicit bias, right? They don't, they don't understand what it is that they're doing, what their words are doing, what deciding to talk about a person's weight is doing to the person that's sitting there. Mm-hmm. So let's, let's ask, can we have these conversations?

Natalie Tierney: I had a, a conversation in, in the Berry Nation support community, uh, with a, a [00:13:45] pre-op member. I, I host a beginner bariatrics meetup every week. Um, for, for us to just have these types of conversations, right?

Mm-hmm. Um, as a patient and the more patients right, that [00:14:30] hone in on that bravery and can just say what they need, um, the more. Hopefully providers will be more in tune with obese patients and understand how to speak, uh, to us. But [00:14:45] it's hard and it takes a lot of bravery and it's, mm-hmm. It shouldn't be us, but also it's us.

So we gotta, we gotta put on our bravery hats a little bit,

Let's find, and enough, enough physicians and physician groups start losing that number of patients, and they [00:15:15] take their family with them. They're gonna fig, they have to sit down and be like, what's going on? Like, why is this going this way? Why is their practice booming? And they, all my patients are going there.

It's not, yes. It's [00:15:45] not an adjective. It's announced. Yes. It, it's a disease state. Let's talk about it that way.

And that is the person that is truly going to partner with you to walk alongside you [00:16:15] and learn from you. And I so appreciate you saying that as patients. I think for decades when you are living in a larger body, you automatically get assigned a lower iq. Right. Like you clearly don't know how to eat, [00:16:30] right?

Well, in this modern era we see this, um, emergence of patients. Like us who are willing to say, um, this [00:17:00] isn't right. And this is a disease and I deserve better and my friends deserve better, and the community deserves better. And when we are allowed to gather in these safe places, right, like, like Berry Nation, we can have these conversations with [00:17:15] one another, and that conversation helps us grow our courageous muscle.

I practice this conversation up and [00:17:45] down so many times and, and I know what I want to say and what I need to say. And when we are able to practice that. We see shifts because we've got hundreds of members that have come to us and said, I dumped my doctor. I went in to [00:18:00] talk to 'em about this, and they told me, eat less and move more.

Mm-hmm. That it is, while outwardly people might know that we're suffering from it, what's actually [00:18:30] going on is internal and that that facet, uh, that every facet of life that, that it is, uh, impacting. We need to understand that because the more educated we are, the more we can educate others. And Yeah. Yeah, you're right.

So, Kara, where else do you see, or how do you see this crisis of care un unfolding in our nation or in the world today?

Um, people are, are feeling more comfortable saying, [00:19:30] oh, I don't, I don't like this, so I'm gonna take this medication and saying it loud, you know, uh, Kelly Clarkson, you know, came out saying that she was doing it, and Oprah and everyone at the beginning was like, oh, that's so great. We're talking about this.

And so people are taking them a, not because they have the disease of obesity, but because they don't like how they look in the mirror, which is part of the narrative that needs to shift, right? To really emphasize that what we are treating. It's not the mirror. [00:20:15] We're treating a disease process. Right.

You're having nutrition education, you're [00:20:45] probably seeing a psychologist, you're probably incorporating sports medicine because we recognize that as that weight's going down. Right. That's changing the way that your body is dealing with. With nutrients. Mm-hmm. Dealing, uh, changing the way that your body is, you know, [00:21:00] processing those nutrients.

You know, people are losing all this weight. Their skin looks like it's falling off muscle, kind of [00:21:30] looks like it's sagging. Uh, I've had patients that have come in, you know, we look at body composition in my clinic and I've had patients come in that have lost a significant amount of weight. But when we look at it on the body composition side, that visceral [00:21:45] fat, which is what we know is the fat that's, you know, surrounding those internal abdominal organs leading to those additional disease processes, has either stayed the same or gotten higher and their muscle mass has gone down.

That's it. You've seen the two little bottles of Coke, right? Two liters of visceral fat had gone down. Her body fat percentage was down and her skeletal muscle mass had gone up by 10 pounds. [00:22:30] Oh my gosh. Her body That's incredible. Not just by the scale. Yeah. But measurements are changing and her health is changing.

April Williams: Yeah. So

Carah Horn: when we're treating it and treating it well, that person's getting healthier.

Natalie Tierney: Yeah. Um, I, there were a lot of moments, um, you know, with the Oprah special and everything within the Berry Nation [00:23:15] support community.

The same messaging, just in a different form. Mm-hmm. And, um, I, I'm really hopeful that we can get to that [00:24:00] place of discussing obesity as a disease and not as a co cosmetic situation. Um, we're just not there yet. Uh, so who knows? But these conversations are what propel us forward. And, and I [00:24:15] know that, and I think everyone listening knows that.

Um, but man, sometimes you watch those and you're like, but that's not what it's used for. This is,

April Williams: Mm-hmm.

Carah Horn: But we're only gonna give it to you if. Yes. You know what I mean? So that's, that's in itself its own issue as well. First, you know, they, they've exploded.

It's, it's been such a rapid expansion of understanding and research and treatment.

Carah Horn: so now what do we do once that person reaches the, the goal weight or whatever, you know what I mean? Like, they're in a healthy, healthy BMI, they're no longer treating those comorbid conditions, then what? Mm-hmm.

Yeah. And now my blood sugar's stable, so I'm gonna stop taking my insulin. Right. No, no. [00:25:15] Like, that's completely counterintuitive. That's kind of where we are, um, with medications and with insurances, wanting to cover it and choosing and being able to opt out of covering obesity. What the heck is that? Oh, I, I just, it blows my mind.

Avoidable conditions are developed because we just don't wanna say out loud that obesity's a disease when research shows that, when [00:26:00] we're what, 12 years in to the American Diabetes Association defining, or, I'm sorry, the American Medical Association defining it as a disease. 12 years. Yeah. Yeah. I just, I don't understand it.

So, no, like you said, exciting to talk about it, but Right. Yes. Like I, I feel like what, what harm are we doing? What eating disorders maybe are we, are we [00:26:30] causing, because again, we're celebrating the weight loss. Yes. And then yes, you can't have the medication anymore and I need to, I have to keep this weight loss.

We had a patient when we first started prescribing, um, I believe it was manjaro when it came out [00:27:00] that came in and was living on diet Coke. Hmm. That was it. Oh my God. And they felt great. God, oh my gosh, I feel so good. I'm losing all this weight. It was like two weeks in, or three weeks in, they've lost 17 pounds or something.

April Williams: Yeah.

So what, what harm are we causing, um, by it? What kind of relapse are we causing and some, some thinking [00:27:45] processes for people that are actually reaching out and trying to treat their obesity.

April Williams: Yeah. I have a sneaking suspicion that 10 years from now we're gonna see massive health issues, complications, right?

But we don't wanna, we don't wanna go there, we don't wanna look at that because it's too, that's a, I dunno, right. Extreme right. It's dangerous. It's, it's all of these things that are unequivocally, factually not true at all. But that [00:29:00] is, that is. No, but I'm gonna do the this, which is actually more dangerous, more extreme, all, all won't actually lead to health.

Carah Horn: I think it's important though to, to point out that there are benefits to these medications, right? Mm-hmm. Uh, the FDA approved medications that have gone through the trials, that [00:29:45] have done the testing, that there are uses for that, even sometimes for patients who have had bariatric surgery, you know, uh, in the long term, right?

April Williams: we're

Carah Horn: saying they're treating diabetes.

Yeah. So that's where, that's where I get really concerned with the obesity management medications and the way that they're being used and distributed at this point in time is that it's all gonna get lumped in when those [00:30:45] complications come out, when those concerns that you're mentioning, which I'm sure are gonna happen, happen, and come out, it's all gonna kind of get thrown away with bath water, baby bath, water, all of it together.

April Williams: things like that. Yeah. So, yep. It, it is, it is a yes and right. I had, I had iatric [00:31:15] surgery five and a half years ago. Uh, lost a hundred pounds, experienced a little bit of weight recurrence with the return of comorbidities.

I had the education because I have [00:31:45] variation. Um, so I, I knew that background stuff, but with that adjunct treatment, I was able to reverse my comorbidity. And a happy side effect of that was I also lost some of my excess weight again, but then [00:32:00] lost access, gained excess. I, I've been doing this, this yo-yo forever.

Mm-hmm.

Carah Horn: And

And I can always, I can always tap into this. And [00:32:30] without my bariatric surgery, had I been on medication and lost access to it, I would've absolutely regained all of my weight and, and then some. So to know that I've onboarded this tool that I always have it at my disposal makes me [00:32:45] feel not as hopeless as I think I would have if I was just on the medication and, and not had that, that care team.

Carah Horn: It is, but also as you're looking at it, you know, metabolic, a adaptation is a real thing, right? Yeah. You, you're treating a disease process for which there is not a cure.

Mm-hmm. And it adjusts those hormones. It adjusts that metabolism, and it tries to figure out a way around those changes that happen when intrinsically, right, when you have that bariatric surgery. And so for some people, that's gonna happen [00:33:45] faster. It's gonna happen slower, it's gonna happen different.

Even then when you go to bariatric surgery, right? And then if you've had the bariatric surgery and you've done great, and you know, we're all required to make good choices, right? Every single one of [00:34:15] us is gonna have the, you know, consequence to the choices that we make. But that's, that's me, that's you.

Right. And because that's what everybody else is saying too, it's easy to believe and then it's difficult. A [00:34:45] lot of times I, I'm very glad and proud that you stepped up and you said, I need something else. 'cause a lot of patients, because of that, shame, blame. Mm-hmm. Fear. Sense of failure, don't. Right. They just, they let it come back and they say, [00:35:00] it's my fault.

Something else that didn't happen.

April Williams: Mm-hmm. And

Carah Horn: you know, I tell my patients all the time, if you're on blood pressure medication and it's working and then it stops working, you don't say, oh, well I guess blood pressure medicine's not for me. You know, you go back to your doctor and you're like, Hey, this isn't working anymore.

Right. That we can treat your disease in a way that your body and your metabolism and your metabolic kind of system understands. [00:35:45] And, and we can treat it right, but we can't do that if you're sitting at home. And the general public is saying, well, it's your fault. You should stay at home. Even more people aren't coming, which emphasizes that need.

April Williams: Yes. Uh, Nat and I are just, we are so thrilled to hear you say this. We say this every day. We say this [00:36:15] every day in Bury Nation.

Mm-hmm. It has nothing to do with you. You are doing everything right. You are rocket. You are [00:36:45] focusing on movement, mindset, metabolic wellness. The disease is progressing and you need to onboard new treatment. That's all this is, that's all this is. And to be able to go to a safe place and just say those things and to be met, [00:37:00] not with what the public is saying, but to be met with unconditional understanding and love, that's where people know there is something different.

Carah Horn: Right.

Carah Horn: And it's what every one of us expects. Yeah. When we're seeking treatment for whatever it is that we're seeking treatment. Yeah. Why is it different for obesity? Why? It just, it blows my mind that I can sit back here, you know, in [00:37:30] all of my, my pride and self-righteousness and say, well, I have x, y, Z disease process, so I'm gonna treat that.

It doesn't make any sense to me whatsoever. [00:38:00] And not that it has to, but it should make sense to everybody, like mm-hmm. Step, step back, look in the mirror. Like, if I had a disease process, would I wanna treat it? Yeah. Oh yeah, yeah, yeah. I would, right? Mm-hmm. So everybody should have [00:38:15] that, right? Nobody should feel ashamed

April Williams: for that.

You have this awesome way [00:38:45] of describing to your patients why, why sometimes it feels easier, right? And it kind of should, the whole goal of treatment is you make treating the disease a little bit easier, right? So it makes sense that right after surgery, your first year, right, it's, it's often [00:39:00] referred to as the honeymoon.

Why is this happening? You have an awesome way of talking about this to your patients, and I'm so excited for you to share with us, uh, your, your metaphor for [00:39:30] it.

Carah Horn: Okay. Um, never really thought I'd be talking about it to a general public, but I do talk about it with my patients all the time. Um, I was sitting at home actually, uh, one day.

And I'm like, you know what, obesity's kind of the same way, right? I'm like, because I'm always thinking like, how can I make it a word picture that's gonna make sense to my patients because I'm, I. Simple that way. I think if I can tie it to something, [00:40:15] um, then I'm gonna remember it and it makes sense. If it makes sense, I'm gonna do it.

You get a fixer upper, you know, you've gotta work on it, right? Or you step in and you've got, for however long this beautiful lawn, you know, it looks good. You, you, you buy it, [00:40:45] you're good. But at some point, because you have this lawn and because a lawn's gonna do what a lawn's gonna do, you've gotta treat the lawn right?

I said, but when you get bariatric surgery, like we're, we're teaching you how to use that tool. We're teaching you how to, how and when to use the fertilizer to, you know, to use the weeder that you know, all the things that you need to do. Um, and, and you learn and you know, and then you come and you [00:41:30] have bariatric surgery.

And, and he's using those tools for you. The lawn is no less yours. The tools are still yours. You still know how to use them, but you're not having to work really [00:42:00] hard to get the effects that you want, and all of a sudden you've got a yard of the one side in your yard, right? You're taking selfies with it.

He's no longer using the tools on your lawn. Still your tools, you still own them. You still know how to use them. [00:42:30] You still have that chronic disease. You still have that lawn, and the lawn's gonna do what the lawn's gonna do. It doesn't matter how much happened in that previous year, if those tools are in the shed getting dusty, if it rained the weekend before and you're not, you didn't get to [00:42:45] use 'em.

You have control over some things. You don't have control over some things, but at the end of the day, you have a lawn and a lawn's gonna do what a lawn's gonna do. You have [00:43:15] tools if you're not using them, they can't treat whatever that is. So we talk about, you know, am I using my tools? They're mine. Am I doing everything that I need to be doing with those tools to treat the lawn?

Right. Have I laid any of those down? I haven't. I'm using all of my tools, but there's something that's still, like I said, blown it on the wind or whatever, that that was not maybe affecting it [00:44:00] before. That's affecting it. Now, do you just say, well, I tried and like sit down? No, you're gonna fight for that lawn.

Mm-hmm. Um, that I can use to treat this condition here? And if you use it and you do all the things you're supposed to do, again, you're treating that [00:44:30] chronic disease with a chronic treatment because there's no cure for that. You can't, you can't fix your lawn enough that you don't ever have to do it again.

Mm-hmm. And that's what everyone I feel like needs to really grasp is that I'm beholden to my choices as well, [00:45:00] right? Every single one that's looking at someone with obesity saying, well, you need to eat less. That's eating a candy bar for. That's, that's kind of, we're all on there, right? Um, but we don't look at it that way because we don't visually see the outcome, [00:45:15] um, of a disease because we don't have that same disease with the lawn.

But it's a constant process and that's kind of how we talk about it in our program. What have I laid down? What have I been consistent with? Intentional behavior change is imperative to your long-term success. [00:45:45] Continuing to use your team. That's us. We wanna be a part of that process as part of your overall success.

And you're gonna go and you're gonna demand something different so you can fix it and then you're gonna use it. Mm-hmm. And then you're gonna be proud. You're like, Ugh. Figured it out. Mm-hmm. But [00:46:15] our bodies, we tend to look at it a little different sometimes. So for me, that word picture is helpful. Some of my patients say it is, and that's what we use

Natalie Tierney: in our program.

And we, we had a big conversation. Then she goes, you know, and I still have [00:47:00] my tool. And I was like, you absolutely still have your tool. Like, how can I support you? So this analogy, I'm gonna, as soon as we're done recording, I'm gonna be like, okay. So it's, it's like a lawn. And [00:47:15] because it does, it makes total sense when you, as you were talking, I just put all the, all the things together.

Then when you get to that second season, you're out of practice and it's, it's really kind of deceitful to yourself to think [00:47:45] I've lived. You know, 15, 30, 60 years behaving in a, you know, engaging my environment in a certain way. And because I got this tool, now I know how to use it and I'm gonna be great at it.

You don't feel like you're doing anything really different, but suddenly the results are a little [00:48:15] different. Oh, I still have the tool. I still know how to use it, but it's getting dusty in the shed.

April Williams: Yep.

Everything in our culture revolves around food. We talk about that too. Like were we eating before? Are we eating after? What are we eating there? Yeah. Do I like that restaurant? If I don't like that restaurant, should I bring something with me? [00:48:45] Right. It's Tuesday, we should have tacos. It's Friday. We're having a get together, grandma's making pie.

Yep. Um, we all have to make choices. So yes.

And this metaphor was just like mind blowing. So I was so excited to share it [00:49:45] with, with Jason, and not because I knew, especially you Now you're like, oh yes. Right? But when you think about it, right, when you think about it from this perspective. It just clicks. And, and the thing that I think is so powerful about [00:50:00] this, and, and I can speak to this and I know not everybody can speak to this, we have all done something in our life that we were so excited about and it worked.

Sure. There is absolutely nothing wrong with that. And that joy just makes everything else feel like it just falls to the wayside. Right. Because [00:50:45] that's what it's supposed to feel like. That's what it's supposed to do. Mm-hmm. And in that first year after surgery, now I know you remember this, you're just like, oh my God, I'm, I'm doing nothing.

Na, you know, Matt remembers she visited me when I just moved in and it was like, this place is pristine. And you're like, I know it's the best. And it doesn't require a lot of maintenance because it's brand new, it's brand new, and [00:51:30] it's just getting rooted and it's kind of taking care of itself and it doesn't require a lot of maintenance.

Natalie Tierney: Well, I'm glad it resonated.

April Williams: Oh

Like even if you're feeling that on top of the world, I'm good kind of feeling because these tools that you're going to acquire and learn throughout, it's, it's [00:52:30] exactly as you said, Kara, you're watching the lawn guy taking care of the lawn. Mm-hmm. So that you can do it later on. And that's, you know, hopefully what we can instill, and I think we have instilled in the variation support.[00:52:45]

April Williams: Yep. And, and I really think about, I, I think about variation and I think about the things that we can learn from our surgical centers, from our surgeons, right, from practitioners. [00:53:15] Like, like you, it is, how do I use the tool? So, so now I got the tool. Great. I have no idea how to actually use this. I don't know in what scenario, and I don't know what it really does for, and I think I'm using it, but maybe I'm not using it in the [00:53:30] most efficient way.

But really it goes this way. If you don't have that, you are missing out. You, you don't actually have what you need. You might have the tool, but you don't know how to use that tool. And if you are not connected with your care team, if [00:54:00] you're not connected in community, you're not learning how to use it in the most efficient way that you could.

Like you think you don't, you think, you think it's, it's not for me. I don't need this. That's why we do require it [00:54:30] beforehand so that they can see, I can tell you all day long, but I'm not walking that journey. Right. I study it, I look at the research, but there's something about that lived experience that is just completely different.

April Williams: It's just amazing.

I was, I, I made the decision. I'm gonna start tracking. And then the next day I was going [00:55:15] out for a fun night out with friends and I knew we were going to get pizza for dinner. Like that was gonna be our dinner. And I frantically text her April and I said, how the heck am I supposed to track pizza if I don't know what's in [00:55:30] it?

Um, but it helps us. We talk about lowering the temperature. It helps us lower the temperature, lower the stress. On utilizing those tools. Mm-hmm. And that's, that's what's important.

And, you know, this isn't a journey of, I can't, we talk about that as well because if you tell yourself, I'm gonna do this now 'cause I can't later, you're setting yourself up. Right. For, for defeat and for [00:56:30] frustration and for hurdles. So we talk about, you know, changing that mindset. I'm choosing something different, right.

Sustained weight loss When you're track people who track even just a couple of times a month [00:57:00] to people who don't at all, to people who engage in support groups versus people who don't engage in support groups. Um, we're talking scholarly articles, peer reviewed, current, all the things. Um, people who stay on their vitamins versus [00:57:15] people who don't like, it's all out there.

We're your team forever. Let us be like, we wanna walk this journey with you. We wanna celebrate that you were able to put on a tennis shoe. I had one patient, I'll never forget, she. She hadn't been able to wear tennis [00:57:45] shoes. She was wearing fights for a decade. Wow. And she bought a pair of tennis shoes, and then she bought a pair of jeans.

She hadn't been able to wear jeans. People that aren't in that community, they don't get it.

April Williams: Mm-hmm.

I'm excited for you. We're gonna cheer it. Rah rah. So, yes. All the things.

Mm-hmm. When we step back and we ask what is within our control? How we choose to maintain our lawn that is within our control and [00:58:45] how we choose to celebrate that is absolutely wi within our control. Thank you for joining us for this amazing conversation. Thanks for having me. It's been fun. Oh, right. I told you, we told you.

Carah Horn: Sure. Um, I'm on LinkedIn. I can share my email address. Uh, I give all of my patients my cell phone number. Whatever you guys feel comfortable with sharing, reach out.

April Williams: It's gonna happen. And friends, we will make sure that we link her contact information in the description of this episode. So if you open up those show notes, you're gonna see her contact information and we will absolutely get those research studies that she referenced. And we will also link them [00:59:45] in our show notes, because that's one of our key missions here at BariNation.

As as we are. Kara, thank you again for joining us. This was an amazing conversation.

April Williams: That wraps up another empowering episode of the Berry Nation Podcast. If you enjoyed today's episode, keep the conversation going by joining the BariNation membership community where you can attend live support events, access OnDemand resources, and find a [01:00:30] caring community.

Natalie Tierney: Join us@barination.mn.co.

If you found this podcast valuable, help us produce it by becoming a $5 monthly supporter@barinationpodcast.com.