by Dr.Karla, ActivistMD | Dec 9, 2025 | Parenting and Teens
Lizzie is a 13-year-old with a great sense of humor.
She tells it like it is, especially to her Mom, Jackie, who admits to being a bit of an Almond Mom (parent who is stuck in weight-focused diet culture). Jackie leads a very healthy lifestyle and has never had to deal with being overweight. Jackie is different from other Moms I work with because she isn’t telling me that information because she doesn’t want to be affiliated with being overweight. She genuinely wants to help her daughter, and every action she takes to help she recognizes comes from her own experience.
Also, Lizzie is a very picky eater and Jackie blames herself because she has accommodated the pickiness. She wants her to be happy and feels like a burger and fries for dinner is better than trying to force Lizzie to eat something she’s not going to touch and then binge on whatever processed foods are in the house later.
Lizzie also has insulin resistance which hasn’t been diagnosed, and Jackie hadn’t heard of it until she found me on TikTok. She thought this made so much sense. “Obesity is hormonal. It’s not simply caloric.”
“We’ve tried everything from personal trainers, dietitians, gone low-carb, and even gone to specialists and functional medicine doctors. Lizzie’s labs showed creeping Hemoglobin A1c, cholesterol levels have always been off, and her doctor said she has fatty liver disease. I feel so ashamed, and like the pediatrician keeps saying the same thing. Portion control and more exercise. I’m constantly in her lane when she’s eating and can see that she’s also started to eat in secret in her room.”
“My Mom gives me looks all the time if I go for seconds.”
“Lizzie, are you sure you want to eat that?”
Jackie is also starting to notice that Lizzie complains about her clothes not fitting and they are getting into arguments about it. Jackie feels like it’s more than Lizzie’s health that’s at stake. If their interactions keep going like they are, their relationship is at stake too.
Lizzie has a strong genetic predisposition for insulin resistance and type 2 diabetes, metabolic syndrome, and obesity on the paternal side. I reviewed prior laboratory studies which were indicative of insulin resistance. Her starting BMI was 32.5, and her waist circumference was 45 inches. On exam, Lizzie has acanthosis nigricans, abdominal obesity, striae, and acne.
The results of the STEP TEENS phase 3 trial of once-weekly subcutaneous semaglutide 2.4mg (Wegovy) in adolescents aged 12 up to 18 years old with obesity are very promising.
Published in November of 2022 in the NEJM, the study showed that patients who received semaglutide vs. placebo had greater reductions in body weight, improvements in waist circumference, A1c, lipids (except HDL cholesterol), and ALT. Quality of Life measures were better in the semaglutide group. Adverse gastrointestinal events were greater with semaglutide compared with placebo.
GLP-1 exerts its main effect by stimulating glucose-dependent insulin release from the pancreatic islets, slows gastric emptying, inhibits post-meal glucagon release, and reduces food intake.
GLP-1 RA medications work by reducing the appetite and feelings of hunger, slowing the release of food from the stomach, and increasing feelings of fullness after eating. Some, like tirzepatide, have the added action of “quieting the mind” or stopping food noise through receptors in the brain.
Along with nutrition, behavior, and physical activity, medication options were discussed. Lizzie met the criteria for Wegovy. It was an uphill battle to get the Prior Authorization and then the appeal approved through the pharmacy plan. Then, the national shortage of Wegovy starting doses created another daunting obstacle. Jackie called around to what seemed like 100 pharmacies to find the starting dose before she finally found a pharmacy who had it.
Lizzie tolerated the medication well with minimal side effects. Over the next few months, the dose was titrated up to the maximum dose of 2.4mg. Her weight stayed the same.
First, I coached Lizzie and Jackie to manage disappointment and reset expectations.
Next, let’s reassess all causes, comorbidities and contributing factors. I did another Review of Systems.
Is Lizzie a non-responder? Or is the medication working and just not showing up on the scale? Are there metabolic health improvements that can be measured?
Is the medication bioavailable? Does Lizzie have PCOS? Is Lizzie taking other medications that are contributing? Does she need a sleep study? What about binge or loss-of-control eating?
Lab studies showed metabolic biomarkers were markedly improved. Her fasting lipid panel was normalized as were AST and ALT levels. HgbA1c had decreased. I considered other contributing factors and noted that her free testosterone level was elevated.
What changes had she made to her nutrition? She was eating 1300 calories a day, the same as before starting the medication. Her body was stuck in metabolic adaptation.
I told them about the thermogenic effects of food and they became more intentional about a balance of Protein/Fat/Fiber. Lizzie started having slow weight loss over the next few months.
Lizzie’s BMI has gone from 32.5 to 27.5 and her waist circumference has decreased by three inches. I will see Lizzie for a follow-up telehealth visit in three months with updates in the interim from Jackie.
GLP-1 RA medications as approved by the FDA may be a helpful adjunct in your adolescent patient’s treatment plan, but require a whole approach to metabolic health.
See my videos on TikTok @DrKarlaMD or @imecommunity to learn more about insulin resistance and my metabolic health approach.
https://kevinmd.com/2024/04/glp-1-medications-like-wegovy-are-effective-metabolic-health-tools-for-teens-with-insulin-resistance.html
by Dr.Karla, ActivistMD | Dec 9, 2025 | Teen Health and Wellness
Will a telehealth model effectively engage adolescents with obesity and their parents to participate in their treatment plan?
Do GLP-1 agonist medications work to improve weight status and reduce or eliminate comorbidities in adolescents?
I’ve worked for over two decades as a community pediatrician to address the childhood and adolescent obesity epidemic. I can say with full certainty, when it comes to adolescents, we aren’t getting anywhere. With the COVID-19 pandemic, the rates of adolescents with obesity, eating disorders, mental health diagnoses, and health disparities have increased. It’s imperative that we adopt a new approach.
As a medical director of a weight management program at a Children’s Hospital, I found it was difficult to engage adolescents due to high attrition, low program adherence, and low attendance rates. There were no effective treatments offered other than bariatric surgery, but it is drastic and not feasible for most adolescent patients. When I was told to refer adolescents to the bariatric pathway at their first visit, I knew my values and vision didn’t align with a corporate profit-only driven system.
Approximately 14.4 million U.S. children and adolescents have obesity.1 The TODAY2 Study showed the incidence of type 2 diabetes in youth increased in parallel with obesity.2 In 2022, the FDA approved once-weekly semaglutide for adolescents with obesity.3
In 2023, the AAP released the Clinical Practice Guidelines (CPG) for the evaluation and treatment of children and adolescents with obesity.4 Pediatricians are called to integrate: comprehensive obesity treatment; comprehensive patient history; family-based treatment; Intensive Health Behavior and Lifestyle Treatment (IHBLT); and longitudinal care.
Due to a lack of obesity training, time, and minimal reimbursement for obesity services, it is not feasible for most pediatricians to implement the AAP Clinical Practice Guidelines. Many pediatricians will not prescribe GLP-1 medications for adolescents because of a lack of experience and the time it takes to write prior authorizations and file appeals. Access issues should also include the lack of physicians who prescribe GLP-1 medications for adolescents.
When clinical obesity programs are available within communities, there are barriers that impact outcomes. Weight stigma, time out of school and work, and travel distance result in poor patient retention in clinical obesity programs.5 A telehealth model has the potential to mitigate some of the barriers to treatment and improve weight management outcomes for children and adolescents.
Methods:
To address access and to determine positive treatment outcomes, I founded metabolic telehealth for children and adolescents ages 5 to 21 years in 2022. The practice is licensed in 15 states. The model includes initial telehealth consultation, follow-up appointments, and medication checks. The initial consultation includes a comprehensive patient history and a treatment plan. The Health Yourself group coaching course supports family-centered behavior change as the IHBLT component. Program evaluation is measured using a database to evaluate demographics, accessibility, and treatment outcomes.
Results:
Demographics:
- Of the 44 patients seen for consultation, 34% are from rural areas (population less than 10,000). 77% of patients identify as female and 23% identify as male.
- Of the different classes of obesity, 43% Class I obesity (BMI 30 – 34.9), 21% Class II obesity (BMI 35-39.9), and 16% Class III or severe obesity (BMI 40 or higher).
- 7% of patients had a BMI of 27 to 30 with a comorbidity, meeting the FDA criteria for prescribing semaglutide.
- The most common comorbidities are prediabetes and dyslipidemia.
Accessibility:
- 34% had one visit; 20% had two visits; 46% had three or more visits
Treatment/outcomes:
-
- 38 (86.4%) patients were prescribed GLP-1
- 20 of the 38 (53%) Prior Authorization was denied by their insurance plan.
- 11 of the 20 denied (55%) opted to pay out of pocket for the GLP-1 medication.
- 20 patients with GLP-1 had 3 or more follow-up visits
- 6 (30%) patients on GLP-1 had 20% or more BMI reduction
- 4 (20%) had between 10 and 20% BMI reduction
- 9 (45%) had between 1 to 10% BMI reduction
- 1 (5%) patient increased BMI
Almost all patients are managed on semaglutide. One patient has been treated with tirzepatide. The two most common side effects are nausea and constipation. Follow-up laboratory data is currently being gathered to determine the reduction of comorbidities.
Conclusion:
There is a need to develop novel approaches to treat children and adolescents with obesity and comorbidities. A telehealth model shows that barriers to treatment are reduced, weight status is improved, and comorbidities are reduced. The limitations with telehealth are that measurement of vital signs is self-reported, and the physical examination is limited. The benefits showing improved health far outweigh the limitations.
Telehealth decreases weight stigma, a key factor when helping adolescents struggling with obesity and insulin resistance.
GLP-1 agonist medications are effective medications to treat adolescents with obesity and insulin resistance. They are not a singular fix, but should be considered an adjunct in the treatment plan, which also includes nutrition, physical activity, behavior, and other medications. The long-term risk of using these medications has not been studied in adolescents.
Future questions to study:
Are there harms that are caused by treating adolescents with GLP-1 agonist medications?
What are the obstacles to access?
What are the ethical considerations of starting a potentially lifelong medication in an adolescent?
I do not prescribe compounded GLP-1 medications for adolescent patients. I have no conflicts with the pharmaceutical industry to disclose.
References:
- Centers for Disease Control and Prevention. Prevalence of childhood obesity in the United States. 2021.
- TODAY Study Group. Long-Term Complications in Youth Onset Type 2 Diabetes. N Engl J Med 2021; 385:416-426.
- Weghuber D, Barrett T, Barrientos-Perez M, et al. Once Weekly Semaglutide in Adolescents with Obesity. N Engl J Med 2022; 387:2245-2257.
- Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. Pediatrics 2023; 151 (2): e2022060640.
- Hampl SE, Borner KB, Dean KM, et al. Patient Attendance and Outcomes in a Structured Weight Management Program. The Journal of Pediatrics 2016; Volume 176: 30-35
- https://kevinmd.com/2025/06/an-effective-treatment-using-an-effective-care-delivery-model-using-telehealth-to-treat-adolescents-with-obesity-with-glp-1-medications.html
by Dr.Karla, ActivistMD | Oct 23, 2023 | Parenting and Teens
My daughter wanted to go to Target which is nothing new. She’s 19 and is a consumer of skin care products and sunscreen, knowing much more about the latest and greatest than her pediatrician mother. She’ll be shocked at the sticker price when we finally make it to self check-out and will offer to take one of them (not the most expensive one) back, knowing I won’t want to deal with it, so will give in. We’ll get home with stuff and I’ll never know if it works or not.
It’s our first home from college summer and it’s going so well, mainly because I’ve finally learned to stay in my lane. I’ll say to my husband while patting myself on the back, “This is the best summer. I have to give Audrey all the credit. She’s really learned to let go of stuff.”
Until tonight at Target. It’s 7:30 pm on a Sunday and I never give up an opportunity to connect with Audrey. It’s always been on her terms and she knows it. Sure, I’ll take you to Target. Oh, my friend Ava may be working tonight. She saw you and Dad buying a pillow the other night at Target. Yes, Violet peed on Dad’s pillow. I know. Gross. She peed on the bed. Damn, Violet.
She said you guys didn’t say anything to her. We didn’t see her. We don’t really know her. You know how we are. We would always say something. We go overboard. Both of us. You know that, Audrey.
We were doing great in the make-up and skin care section. I was silently applauding myself for not saying anything and acting like I wasn’t judging her selections out of my “bombastic side eye” (TikTok viral trend- get with it, friend) when we made our way by the toothpaste aisle. First, I went to get my husband his 3 in 1 shampoo and Audge was still in the make-up/skin care section. Excellent.
We were walking together by the toothpaste aisle when she saw one of her friends and said hello and we kept walking. I walked a few feet down the toothpaste aisle, grabbed the Colgate whitening value pack (won’t work on our old yellow teeth), literally turned away for a few seconds and Audrey and our cart had vanished. Like out of thin air. I wasn’t panicked at this point at all. I calmly took my value pack and kept going on the main aisle as my strategy, looking down each aisle, but no Audrey. Maybe she went to the grocery aisle to get some LaCroix or stock up on the food she says we never have at home. How could our food be worse than the college food she’s complained about all year, giving her scurvy. According to her, just look in our home fridge.
Nope. Not there. Go back to get toilet paper and kleenexes, looking like Steve Martin out of The Jerk, “All I need is this paddle ball, and this chair and this….” All I needed was a cart. I put my stuff down in the old DVD section to get my phone which wasn’t there! I had no phone, no Audrey and NO CART!
I’ve lost my daughter. You could see the franticness on their faces, then reassurance when I said, “She’s old.”
Later recounting my side of the story, Audrey says, “Mom, I seriously doubt they took one look at you and thought you had a toddler.” Is this why Audrey is obsessed with buying all the latest anti-wrinkle age prevention creams on the market?
If you go back to the front to get a cart it will look like you’re trying to steal toilet paper and kleenexes and value pack whitening toothpaste.
Damnit, Audrey. Are you messing with me?
Then, I hope she’s okay. I went through the grocery aisles, the home goods aisles, then back to the make-up skin care area, found a Target employee who told me I had to go to customer service to page her overhead.
I decided to make one last attempt before going to the front. I stood at the multi-vitamin supplement section without going to look down the aisles (big mistake) and yelled her name, “Audrey. Audrey! AUDREY!” I found out later she heard me but was too embarrassed to answer.
I went to check out and went to customer service. They let me use their landline and I tried calling her, must have called the wrong number, then called my husband and told him to call Audrey and tell her to go to the front of the store.
“Maam, do you want me to page her overhead?” Yes, definitely. Please. When I’m in panic mode, I want all options to be utilized.
While she’s on the phone with her Dad, she hears, “Audrey to the front of the store. Audrey Lester come to the front of the store. Audrey to the front of the store.” About six times.
She and her Dad burst out laughing at the ridiculousness.
Audrey comes up pushing the cart shaking her head. I grab my items and walk back through and there’s Audrey, “Why didn’t you bring your phone?” “Why wouldn’t you bring your phone to Target?” “Who doesn’t bring their phone to Target?”
“Why did you ghost me, Audrey?”
“Why did you page me and use my last name like 6 times?”
I was super worried about you.
“Must not have been too worried if you checked out before finding me?”
I knew this first home from college summer was too good to be true.
Ava walks up because she heard Audrey’s name called overhead so met her up front.
“Hi Ava. I’m Karla. I’m Audrey’s Mom. Do you like working here at Target? What area do you work in? How long have you worked here?”
by Dr.Karla, ActivistMD | Sep 29, 2023 | Self Care, Teen Health and Wellness
What are your top 5 reasons for eating sugar?
I’m going to teach you some sugar awareness. Sugar is everywhere and it’s super powerful. To say, “Oh, just stop eating sugar,” is absurd. It doesn’t work and it will backfire, making the sugar extra delicious and create more desire. Plus, you don’t need to stop eating sugar. That would be super boring. If someone told me to stop eating ice cream, they would probably get hurt!
The thing is because our food system is a dumping ground for processed sugar, making the food what’s called “hyper-palatable”, so super yummy. That means our bodies end up being a dumping ground for added sugar, Plus, if you’re a teen, you are exposed to tons of digital marketing tactics from food companies that research shows activate four craving pathways in the brain. Awareness is powerful. Nerdy science is powerful.
What are the reasons you eat or drink sugar?
How do you use sugar in your daily life? Is it for energy? When you’re bored? Habit? It’s just there? Does it simply taste good? A reward for doing something? Tired? Pleasure? No idea? Do you eat sugar when you’re judging or shaming yourself? Peer pressure?
Usually, when we have an urge or craving, there’s a thought that comes up that’s either a judging or shaming thought or a reward thought. So, it’s like either your negative self-talk voice comes up in your brain judging you or giving you permission, like, “Go ahead, you deserve it.”
Sometimes when I eat sugar, my brain gets hijacked and I just keep eating it. It feels impossible to have just one or two. That happened to me recently at a family reunion. The stress of being around people and trying to manage my emotions, my brain was like, “Um, no. Those mini cupcakes are mine.” By the way, I just said to myself it makes sense and went on with my day and didn’t shame or judge myself. That’s the number one trick is to not judge yourself, but to be more aware of what’s going on with your brain and body. That’s a coaching trick called Write it down and move on. I will teach you more later.
How can you find a sugar balance?
Start by thinking about when you usually eat sugar and why? Write down the reasons you eat sugar. Start by writing down the top 5 reasons you eat sugar. These are mine:
- Taste
- Feels like a Reward
- Boredom
- Tired
- It’s there and I’m stuck in a habit
Next up, I will teach you how to add up how much added sugar you’re eating on the daily.
Be a curious scientist,
Dr. Karla
by Dr.Karla, ActivistMD | Sep 29, 2023 | Self Acceptance, Self Care
Is that a tongue twister? Typo? Copy and paste?
Nope.
One of the first coaching tools I teach you about is story vs. facts. Your brain is a story making machine. Your brain is a meaning-making machine. Your brain has negativity bias.
As a human, you attach meaning to the thousands of thoughts swirling around in your brain. It can be exhausting. Why does it matter? The reason it matters is because your thoughts create your feelings which drive your actions or inactions. Everything you do or don’t do is to make you feel a certain way or avoid feeling a certain way.
If you’re stuck not taking action, it’s because you have an attachment to a belief or beliefs about yourself that are creating a feeling of shame, powerless, helpless, unmotivated, or defeated, tired, sad, and on and on. It’s like you’re stuck like paint on a wall to a thought. You are choosing to stay attached to a thought that doesn’t serve you.
Get curious and start with thought awareness. Thoughts are like a rainbow. They come and go in your mind.
Beliefs are powerful thoughts on a loop in your brain. I believe that beliefs are a way to organize all the thoughts. It’s like we’ve got a big filing cabinet and self-beliefs are a whole drawer.
Self-beliefs are optional. The problem is without creating awareness of your thoughts or beliefs or the story, you will keep staying stuck.
Let me give you an example.
I was coaching a teen who feels guilty every time she eats. Her brain tells her, literally every time she eats any food, “You shouldn’t be eating this.” Her relationship with food is her punishing relationship with herself. It feels safe. Restriction is control. I know it well.
I didn’t argue with her and I didn’t convince her to believe a different story. We coached on how the rigidity comes up in her body, described it as a metaphor, and how she can recognize and take a pause. She wasn’t ready for that. The restriction feels good to her. It’s a powerful addictive obsessive pathway in her brain. It’s perfectionism. It has nothing to do with food or weight. It feels safe to her and if it leads to binging, then so be it. Binging is a powerful relief, followed by shame, doubling down on restriction and so the cycle goes. She’s stuck in the extremes, pinging back and forth, all coming from the story she keeps believing about herself.
What would it feel like to have a softer kinder approach? To feel like food is food?
“I can’t.”
When you learn to drive, you learn that you don’t have to slam on the brakes. Just let up on the gas. Let up on the self-punishing accelerator.
“I don’t know.”
I let up on the coaching accelerator. Don’t argue. Don’t convince. There’s a little crack in the darkness where a bit of light is shining through.
I know what you’re thinking. “Hey, Dr. Karla, how do you not cry when you’re coaching a teen who says this?” Let me tell you, I hold it in and then once I click the end meeting for all button on zoom, I do cry. The reason I cry is because I adore her and I send up a little prayer or positive vibes into the metaverse, “All good things for ______.”
I emailed her Mom to let her know her daughter’s thought model, and asked her Mom to be on the next coaching session. I also asked her Mom to connect with me on zoom. I’m not licensed in her state, so she couldn’t be a patient in my Metabolic Telehealth clinic (drkarlamd.com), but I decided I needed to put on my medical hat with this one. I don’t give medical advice, but education and sharing resources.
What do you want to let go of?
Most of the time it’s hard to let it go because that negative self-talk voice is so strong and has served a purpose for so long.
You are worthy of this work. You are unbroken. You are enough. Always.
Self-kindness (not self-loathing) is the key to your health goals,
Dr. Karla
by Dr.Karla, ActivistMD | Sep 29, 2023 | Self Care, Teen Health and Wellness
I was recently coaching a Mom of a teen who wanted my help with her daughter who has struggled with her weight “all her life”.
Her daughter is 17 and is begging her Mom to let her take the new GLP-1 medications (saxenda, wegovy, ozempic, mounjaro) and Mom is full of questions and concerns. Mom also has hope that the new medications may help her daughter.
“What are they and how do they work?
“What are the side effects?”
“Are there studies on long-term effects?”
“Are they forever medications?”
“Do they work?”
“Will they cause an eating disorder?”
“How do you get them?”
“Are they covered by insurance?”
“Is there more than one to try if the first one doesn’t work?”
“What are the other things we need to work on?”
GLP-1 receptor agonists work by reducing the appetite and feelings of hunger, slowing the release of food from the stomach, and increasing feelings of fullness after eating. Some, like mounjaro, have the added action of “quieting the mind” through acting on the G1P receptors in the brain.
- Wegovy is semaglutide, a GLP-1 receptor agonist and is given as a weekly injection. It’s approved by the FDA as an Anti-Obesity Medication for 12 years and up.
- Ozempic is lower dose semaglutide, approved by the FDA for treating type 2 diabetes for 18 years and up.
- Liraglutide, also known as Saxenda, is approved for 12 years and up and is a daily injection, and is more easily covered by insurance.
This is just information and is not a recommendation for use of these medications. There are many considerations to take into account before prescribing the medications. Also, you should know I have zero ties to the pharmaceutical industry and zero conflicts of interest.
It’s a nuanced, individual, medical, ethical, and family decision to determine if a teen patient should try a medication like wegovy. If you’re ready to start the conversation, check out Metabolic Telehealth for children & adolescents at drkarlamd.com.
Science is the best,
Karla Lester, M.D., Pediatrician & Certified Diplomate of the ABOM
by Dr.Karla, ActivistMD | Sep 29, 2023 | Parenting and Teens, Self Care, Teen Health and Wellness
You just heard St. Elmo’s Fire by John Parr and I started your 80’s Mixtape with You spin me round by Dead or Alive. Playlist for the day is almost all top hits from August of 1985, so 38 years ago. It’s got an industrial feel, so I thought we’d talk about the top benefitters or profiters of America’s poor health. That’s what it’s all about, right? Toxic profits and for just a few.
The very concentrated few. You’ve heard of the Military Industrial Complex. Well, I’m here to tell you about the Industrial Complexes that have created and profit from the epidemic of obesity, type 2 diabetes and on and on. Especially in children and teens and now for generations.
These are not in any order of their toxicity. First is Big Food or the Food Industrial Complex. Next is Big Pharma or the Pharmaceutical Industrial Complex. Not to be outdone, Big Healthcare or Corporate Healthcare, which is what all of healthcare is, comes in as the Healthcare Industrial Complex. Let’s not forget Big Diet or the Diet Industrial Complex profiting off of promotion and glorification of eating disorders.
I’ll tell you more during the next break about the most powerful industrial complex and it’s subterranean and has all the control and reaps all the profits and has tons of feeders.
Here’s We don’t need another hero by Tina Turner. When it comes to your health, you need to be your own hero.
It can happen by Yes. That’s from 1984.
Spanish Eddie by Laura Branigan from 1985.
Lay it down by Ratt. That’s Ratt with two T’s for everyone in the back.
Now, let’s go with Wham Rap by Wham.
Invincible by Pat Benatar
Would I lie to you by Eurythmics. Of course, they would. That brings me to the next Industrial complex which I believe is super powerful and has tons of feeders and perpetuates our poor health and is a major influence on children and teens. Any guesses? It’s what I call the Media Industrial complex. Social media, Influencer culture, toxic wellness industry, digital marketing. Let’s call it Big MIC. Teens have high exposure to: digital advertising, peer-group influence, and they have developing brains with cognitive and emotional vulnerabilities. Food marketers are stealth and use three main promotional platforms:
Broadcast/mass media food packaging, TV, billboards, magazines
Digital marketing
Settings-based like schools, movie theaters, restaurants, stores, clubs, and transit systems.
In honor of us disrupting the toxicity of the Big Media Industrial Complex, BIg MIC, This is Hey Mickey by Toni Basil.
Thank you to my daughter, Audrey for her research on marketing tactics and children and teens.
If you’re ready to help your teen be their own health hero, connect with me for a coaching consultation.
If you’re ready for a metabolic telehealth consultation, go to drkarlamd.com and schedule a consultation today. No referrals needed!
Send me your 80’s requests,
Dr. Karla
by Dr.Karla, ActivistMD | Sep 21, 2023 | Parenting and Teens
Every parent, especially Moms worry about being an Almond Mom stuck in diet culture, potentially causing an eating disorder or doing absolutely nothing to help their teen who has health issues like insulin resistance and mental health issues associated with internalized weight bias.
The healthier the relationship between parent and teen, the healthier the teen. When I say healthier I don’t mean weight. Health is not a number on a scale. I’m talking about relational health.
Megan and her Mom are the best example of a parent and teen relationship being the foundation for reaching health goals.
I’ve been coaching Megan, who just started her Junior year. We’ve been working together over the summer. She’s doing great with her health goals she set for herself. Her Mom reached out to me several months ago about her amazing daughter who has struggled with her weight since she was little. Megan is a leader in her school, has great friends, makes all A’s, has been active in sports, and has an amazing supportive family. Megan’s full of dreams for her life.
Megan feels like her life is 90% great, but the 10% is holding her back. It’s like the 10% is taking over the 90%. Megan has almost a freeze response when she’s bullied. Even though she’s a leader Megan isn’t able to stick up for herself when she’s weight bullied.
My first step was a 30 minute coaching consultation with Mom to go over what’s going on. Mom was on board with my four pillars and my Let’s meet in the middle philosophy. See my viral TikTok video. Read the comments on my post to see how important it is to take a compassionate and not a compliance-based approach.
Mom felt like Megan would be a good candidate for the newly FDA approved GLP-1 medications, but her pediatrician wasn’t comfortable writing a prescription. This is a common scenario. Mom didn’t know where to start. I did. It’s like a flow diagram. We do this in medicine for patient care.
My telehealth practice isn’t licensed in her state, but that didn’t stop me from helping to navigate the process of getting a prescription and supporting Megan’s health goals.
Speaking of flow diagrams, stop here to see if you live in one of the ten states I’m licensed in and go to drkarlamd.com to schedule a specialty consultation. No referrals needed!
Define the problem. Diagnose the issue.
Back to Megan. It’s not the weight. The problem is not having answers, not knowing what’s going on, feeling stuck in self-judging, thinking if it was different then everything would be good, staying stuck in overdesire food cravings and binging.
Don’t push your solution. If you make it all about the “how”, then that’s diet culture and you will get ghosted. It’s like being a transactional parent compared to a transformational parent. I’m writing more on this in my book………..
Spoiler alert: Megan is slaying her health and life goals!
Stay tuned for the next IME-mail where I’ll share how I coached Megan and her Mom to slay her health goals!
Here to help with compassion,
Dr. Karla
by Dr.Karla, ActivistMD | Dec 7, 2022 | Body Positivity, General, Self Acceptance, Self Care, Teen Health and Wellness
We made it!
A year of self-love superpower mantras!
I’m excited to share that I’ve put the whole year of self-love mantras into a 12 month journal!
Available soon! Just email me if you would like one to gift to someone you radically love!
Let’s wrap this year up with radical self-love superpower!
Here are your December mantras:
- 12/1: Choosing food that serves my body is a gift I give to myself.
- 12/2: I am blessed to have the friends I have.
- 12/3: Picking out gifts isn’t about the gift.
- 12/4: I love thinking about the person when I pick out a gift.
- 12/5: Self-love is created over time.
- 12/6: I commit to showing up with self-love even when I hear my inner critic.
- 12/7: Self-love spills over to the people I care about.
- 12/8: I finally learned that self-love is demonstrated by actions.
- 12/9: A big part of self-love is creating boundaries.12/10: I listen to myself and it feels good to say no sometimes.
- 12/11: Beautiful food is a part of our holiday traditions.
- 12/12: Self-love is about connecting with myself and others.
- 12/13: When I feel self-love I show up as my authentic self.
- 12/14: A part of self-love is being okay with not being everyone’s cup of tea.
- 12/15: I show myself self-love when I carve out some alone time during the holidays.
- 12/16: Self-love is taking a break for myself during the holiday season.
- 12/17: Self-love is not having a checklist of expectations for myself.
- 12/18: Self-love is being in the present moment.
- 12/19: When the holidays don’t go exactly as I planned, I have grace for myself.
- 12/20: Self-love is staying out of perfectionism.
- 12/21: Self-love is a gift I intentionally give myself every day.
- 12/22: Self-love is knowing I am always enough.
- 12/23: When I recognize I’m in overfunction mode, self-love tells me to take a pause.
- 12/24: Being present despite the hustle and bustle of the holidays is self-love.
- 12/25: Today I celebrate the gifts of my life.
- 12/26: Self-love tells me to take a rest when I need to.
- 12/27: Taking some time to get outside and enjoy nature is self-love.
- 12/28: Today feels like a good day to catch up with myself.
- 12/29: I’m reflecting on all the ways I’ve shown up with self-love this year.
- 12/30: Self-love is my superpower!
- 12/31: I am launching into the New Year with radical self-love!
Cheers,
Dr. Karla
by Dr.Karla, ActivistMD | Nov 8, 2022 | Body Positivity, General, Self Acceptance, Self Care, Teen Health and Wellness
November is for Cultivating Daily Gratitude
If someone asks you if you are a grateful person, you will likely say, “Of course.”
But, do you have a daily gratitude practice? One where you show up with gratitude for even the smallest of things?
Most of the time we don’t look up in life. We spend our days looking down, grinding out external achievements with the promise that at the finish line we will feel a certain way about ourselves or avoid feeling a certain way.
We’re taught that what are perceived as negative emotions, just your everyday human brand of emotions need to be submerged like a beach ball underwater. It’s draining and keeps us depleted of the energy we need to show up as our true selves in life.
Do you believe it’s possible to create a more joyous life on purpose?
Dr. Brene’ Brown’s research on joy and gratitude is life-changing. She found that actively practicing gratitude creates a more joyous life.
How do you cultivate gratitude in your life with daily intentional habit practice?
As I’m writing this, I’m grateful to look out my dining room window onto a view of my glorious white pine tree. My dog, Violet, is quiet for now and is sitting right next to me on the rug as I type. She follows me everywhere I go. Though her bark and separation anxiety is annoying a lot of the time, I’m grateful there is a being in this world who is still interested in hanging out with me during all the moments of my life, no matter how mundane. I’m grateful for the delicious food I just ate for lunch.
What are three things you are grateful for? Be specific and in the moment. Write them down.
Try my November Daily Gratitude Practice mantras to create a more joyful life:
- 11/1- My life is full of amazing moments.
- 11/2- I love to pause during the day and just breathe in the goodness.
- 11/3- I feel so blessed to get outside and enjoy the sun.
- 11/4- I can get out of a funk by saying three things I’m grateful for.
- 11/5- I am amazed at how focusing on the goodness in others gives me peace.
- 11/6- Sweating the small stuff makes life harder than it needs to be.
- 11/7- I can’t control the weather, but I can control how I will show up during the storms.
- 11/8- I am grateful I don’t depend on others to make me happy.
- 11/9- I’m grateful for true friends.
- 11/10- I am grateful for learning self-kindness is the key to my health goals.
- 11/11- I’m grateful for food that satisfies my hunger.
- 11/12- I am grateful to let go of beliefs that don’t serve me.
- 11/13- I’m grateful that I committed to show up for myself.
- 11/14- I am blessed to have self-trust that I will have my own back.
- 11/15- I’m grateful to be done with listening to negative self-talk.
- 11/16- I am grateful for the time I have with those I love.
- 11/17- I am filled with gratitude when I think of my family and friends.
- 11/18- All the little things in life I find meaningful.
- 11/19- I am grateful for creating self-awareness.
- 11/20- I am finally showing up with self-worth and gratitude.
- 11/21- I am grateful for my body.
- 11/22- I feel gratitude for all my body does for me.
- 11/23- I am grateful when I choose to move my body doing what I enjoy.
- 11/24- I feel grateful for my family’s food traditions.
- 11/25- I feel grateful for the variety of foods I eat.
- 11/26- I wake up feeling grateful for a good night’s sleep.
- 11/27- Taking time for myself to get centered always makes me feel grateful.
- 11/28- When I feel stressed out I am grateful for mindfulness.
- 11/29- When I say no to something I don’t want or have time to do, I am grateful.
- 11/30- I am most grateful for ____________.
If you want to connect with me to cultivate healthy habits and self-confidence for your teen, then go to drkarlamd.com and join me for a 30 minute 1:1 coaching session!
Stay tuned for December Self-Love is the Gift that Keeps on Giving!
Gratefully,
Dr. Karla
