Living and eating sugar in the real world

Living and eating sugar in the real world

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:


  1. Taste
  2. Feels like a Reward
  3. Boredom
  4. Tired
  5. 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

Living and eating sugar in the real world

“Should my daughter take wegovy?”

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 

Science is the best,

Karla Lester, M.D., Pediatrician & Certified Diplomate of the ABOM

80’s Mixtape: Big Industrial Complexes

80’s Mixtape: Big Industrial Complexes

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 and schedule a consultation today. No referrals needed!


Send me your 80’s requests,

Dr. Karla

Self-Love is the Gift that Keeps on Giving – December 2022 Mantras

Self-Love is the Gift that Keeps on Giving – December 2022 Mantras

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!


Dr. Karla

Living and eating sugar in the real world

Cultivating Daily Gratitude – November 2022 Mantras

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.

House surrounded by fall foliage - November 2022 mantras - IME Community

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 and join me for a 30 minute 1:1 coaching session! 

Stay tuned for December Self-Love is the Gift that Keeps on Giving! 

Dr. Karla

80’s Mixtape: Big Industrial Complexes

Obesity Is Hormonal – October 2022 Mantras

Obesity is hormonal. Don’t be a Diet Culture Zombie!!!

TikTok testimonial from one of my followers (adult) who I coach on my TikTok lives:

“I have great news!! A1C was 6.1 in March.  Made changes to diet and did Intermittent fasting.  Lost 30 lbs and as of June A1C is 5.5. Smiley face emoji! Thank you!”

Her labs show a reversal of pre-diabetes.  She said I was the one who connected her to a new way of thinking by introducing her to “The Obesity Code” and coached her to make changes and show up as a curious compassionate scientist for her health.  Her doctor told her to diet and exercise and that’s it. So, the same old eat less and move more. She didn’t let that get in her way. She went to her doc, got her labs drawn, did some research on her own, and showed up for my TikTok coaching and videos. 

My Own Weight Loss Journey

My own weight loss journey started five years ago. It was very shocking for someone like me, who’s been a pediatrician working to address the childhood obesity epidemic for nearly two decades, to learn that the old calories in minus calories out is too simplistic and leaves out the role of hormones.  

It made total sense after I learned about it and because that’s what I was seeing in my pediatric weight management clinic. Insulin Resistance and what are called comorbidities, like type 2 diabetes and metabolic syndrome. The number of children and teens with NAFLD (non-alcoholic fatty liver disease), which I call the silent epidemic, was and is, worse after the pandemic, truly frightening! 

I love disrupting the status quo.  How about you? 

I also loved getting chocolate when I was a young one, trick or treating. Anything chocolate, except for Mars Bar or Almond Joy. Yuck! In my neighborhood growing up, we always knew which houses handed out full size Snickers and which ones gave out apples or dimes.  Steer clear of those buzzkills, for sure. That’s enough about candy, candy, candy. My mouth is watering. 

Stay Out of the Scarcity Mindset

By the way, stay out of restriction and scarcity when it comes to Halloween candy.  Don’t think, “This is the only time I get to eat candy.” 

Pace yourself, people! I know. I know. I get it. You’re going for all the m&m’s first. Which color is your favorite? Brown, for sure, for me. Those taste the most like chocolate.  Did you get that I love chocolate?

Let’s switch gears, like completely. 

October is all about metabolic health! I’m launching IME Health and disrupting the status quo that is not working, is unhelpful and seriously unfun. My only point with my Obesity is hormonal mantras is to get you thinking in a different way about unfun and unfunny zombie diet culture. 

Sure, I get my share of TikTok trolls, but I also get my share of metabolic health coaching wins. 

Let’s start getting you some results too.

October 2022 Mantras: Obesity Is Hormonal

So, let’s dress up as nerdy scientists this Halloween and dive right into my October mantras: 

Obesity is hormonal and not simply caloric.  What does that even mean? 

You’re probably thinking, “It’s the month of candy, candy, candy, so give me a break!” 

What does it mean when I say that obesity is hormonal?

The 4 Major Hormones Associated with Weight Gain or Loss

I’m talking four major hormones: Insulin, Cortisol, Leptin and Ghrelin

The way our society is so stuck in the Energy Imbalance Model of Obesity, or weight is only a result of overeating and lack of physical activity and both of those are blamed on lack of willpower.  Makes me almost puke like I did after eating too much Halloween candy one year.  JK. 

It’s just not scientifically true that weight gain is simply due to total calories eaten minus calories burned with exercise! I’m not saying what we eat and how much we move aren’t important, it’s just that this model doesn’t include the most important part of a human that controls our hunger, appetite, and energy expenditure- the BRAIN! Think about it! 

Our ultra-processed food system (yes, that includes Halloween candy but don’t get your undies in a double bubble wad) along with a bag full of bad diet culture advice has created an epidemic of Insulin Resistance and diseases like pre-diabetes, type 2 diabetes, PCOS, and fatty liver disease. 

I know it’s not as fun as eating loads of candy, but let’s try my October ghostly mantras out: 

  • 10/1 Insulin is a hormone that keeps my blood sugar stable. 
  • 10/2 Cortisol is a stress hormone that helps me focus, stay awake and helps me when I’m stressed. 
  • 10/3  Leptin is a hormone that lets me know when I feel full and satisfied.
  • 10/4 Ghrelin is a powerful hunger hormone that lets me know when I need to eat. 
  • 10/5 Obesity is hormonal. It’s not just simple calories in minus calories out. 
  • 10/6  It’s okay to challenge societal beliefs that are clearly not helpful.
  • 10/7  Diet thinking restricts me and my health goals.
  • 10/8  My body is always working. 
  • 10/9  My body is not a machine.
  • 10/10 Not all calories are created equal or are used the same in my body.
  • 10/11 A balance of real food is good for my health.
  • 10/12 I don’t control my body with willpower.
  • 10/13 I don’t cause weight gain or health issues. 
  • 10/14 There are many causes for weight gain.
  • 10/15 I’m kind to myself and stay out of self-judgment.
  • 10/16 Insulin Resistance is a way the body adapts to sugar intake.
  • 10/17 My body is able to adapt and change.
  • 10/18 My body and brain work together. 
  • 10/19 I understand when I don’t sleep well, I go to food for energy the next day. 
  • 10/20 Sugary foods create dopamine zings in my brain. 
  • 10/21 Stress creates cortisol release and cortisol raises my blood sugar.
  • 10/22  My body wasn’t meant to be stressed all the time. 
  • 10/23 Better sleep is one of the most important ways I can improve my health. 
  • 10/24  Circadian rhythm is my body and brain’s natural sleep and wake cycle. 
  • 10/25 All health behaviors are equally important. 
  • 10/26 Sometimes I have a hard time knowing when I feel full and that’s okay.
  • 10/27 I’m a curious and compassionate scientist for my health.
  • 10/28 Every body is totally different.
  • 10/29 I focus on all of my health, not my body size.
  • 10/30 I don’t have scarcity thinking when it comes to sugary treats. 
  • 10/31 Boo! It’s okay to eat candy. Just choose my favorite and make it a true treat. 

Have a fun Halloween however you do or don’t celebrate!

Self-love superpower,
Dr. Karla