Tell me about your weight during residency/fellowship, SDN

[Elach]

First off, I feel like in these days and age, I should start by saying you are all beautiful just as you are. No, really. Look at you! You're stunning and brave.

Now that we got that out of our way, I'm genuinely interested about what you think about this. What's your experience? Do you gain a lot of weight during residency/fellowship? Do you actuallly lose weight? Does your clothes remain the same size through it?

Is this another unrealistic thing we should add to the "Grey's Anatomy inconsistencies" list since the actors remain pretty much the same throughout the show?

Yes, I do realize getting through residency/fellowship can potentially take 10 years during your 30s, and whatever you do in life you tend to gain a bit of weight as you age, but you know that's not what I mean. C'mon, SDN!

It seems to me that the people that tell me how much weight they lost during residency/fellowship are usually older surgeons, as opposed to younger ones that tell me the total opposite. Seems legit to me as food is crappier and more available nowadays. Even when you're on-call (oh, tasty tasty chicken tikka massala from indian place near the hospital, you've been so kind to us!).

So, what do you think? What's your story? Maybe we can even rank specialties based on how easy it is to mantain actual weight, since we do like ranking stuff around here.

*totally-normal-and-not-suspicious-crew.jpeg*

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[bannie22]

lose weight because there is no eating

 

[LucidSplash]

I gained weight (general surgery). There's a lot of prophylactic eating (grab something now because I might not have time later) and unhealthy choices (whatever is quick and easy). Plus we have a generous food allowance in our cafeteria, which is not known for healthy options. Add inconsistency with working out, stress, chronic sleep deficit and it all adds up to weight gain.

 

[Light at end of tunnel]

lose weight because there is no eating

In podiatry residency?

You're killing me smalls.

 

[Light at end of tunnel]

Well, I think it is fair to expect that you probably will not have 45 minute lunches and dinners, every day. But honestly, eating is the boring part of the day during work, unless its some fancy meeting or conference.

In any event, if there was such a thing as "no eating," residents would be dropping left and right of near somalian like starvation. If anything, most folks seem to gain weight which argues in favor of there being too much food and maybe some less than stellar decision making on the part of the residents who are understandably stressed.

Like anything else, you just gotta adjust to your work flow and daily schedule and make good choices.

 

[bannie22]

In podiatry residency?

You're killing me smalls.

not all podiatry residencies are a walk in the park.

 

[bannie22]

Yeah, I don't really buy the whole "there is no eating" thing, although I hear it constantly. We do eat. Might not be actual meals or something satisfying, but there's always some sort of food around.

I think it's more like "I don't have a whole hour of lunchtime like other people, so I just grab whatever I can from cafeteria/home that I might be able to eat while working/walking/etc. be that cookies, donuts or such. Also, I don't usually have a lot spare time at home to make meals for the next day, so that doesn't help either".

That would probably translate into weight gain. At least in my case it did. It took me about 3 years to gain about 15kgs and then lose about 17kgs. NOT healthy.

I might just start grabbing an apple or something before leaving to avoid relapse.

wait till the general surgeons tell u all about their stories of no breakfast lunch or dinner and being on an iv drip while operating. 😉

 

[Light at end of tunnel]

wait till the general surgeons tell u all about their stories of no breakfast lunch or dinner and being on an iv drip while operating. 😉

While a premed, I shadowed a surgery heavy podiatrist and he was in at 5:30 am and out no earlier than 5 pm, 6 days per week.

He gained so much weight bc of poor habits that he ended up doing a gastric bypass to address the weight issue.

Miserable, but filthy rich, bloke he was. No IV fluids needed for him. Foley would have been more useful though, to help with his pre-diabetic state.

 

[bannie22]

While a premed, I shadowed a surgery heavy podiatrist and he was in at 5:30 am and out no earlier than 5 pm, 6 days per week.

He gained so much weight bc of poor habits that he ended up doing a gastric bypass to address the weight issue.

Miserable, but filthy rich, bloke he was. No IV fluids needed for him. Foley would have been more useful though, to help with his pre-diabetic state.

howd ya know he was miserable?

 

[Light at end of tunnel]

howd ya know he was miserable?

He would tell me that he never saw his wife, that he was under constant pressure from both insurance companies and patients.

Worked at 3 different areas, which meant he had to travel from place to place in order to keep the volume up. In the same day, he could drive 75-100 miles.

Very money hungry, so he was loving correcting those bunyons, one leg at a time of course although he could do both feet at the same time. He would just re book same patient so as to bill insurance two different times for two separate procedures I guess. I did not understand it back then, but it seems like a sleazy but technically legal way to double bill.

In retrospect, it was all about money. Miserable, but lots of money.

After seeing that, real surgery becomes much more attractive.

 

[Jolie South]

It depends on your year. I was at a fairly malignant place for intern year, never ate anything other than snacks in my pocket at work, and drank wine while sad at home at night. I was skinny and looked good.

Flash forward to my second year at a much more positive program where we actually had time to eat lunch as a team, and I definitely gained weight. I never worked out because I felt mentally stressed from ICU and learning to operate, blah, blah and was with a significant other who wanted to spend every minute outside of work together.

My 4th and 5th years, my now husband and I worked out together and I try to make healthier food choices. However, i still feel like I am digging out from irreparable damage done in my 2nd and 3rd years. Imma blame my crazy ex. I think I look ok and am more fit but heavier.

Incidentally, I keep up with people from my intern year on Facebook and 50-60% look straight obese from average sized interns/med students so YMMV.

 

[TraumaLlamaMD]

He would tell me that he never saw his wife, that he was under constant pressure from both insurance companies and patients.

Worked at 3 different areas, which meant he had to travel from place to place in order to keep the volume up. In the same day, he could drive 75-100 miles.

Very money hungry, so he was loving correcting those bunyons, one leg at a time of course although he could do both feet at the same time. He would just re book same patient so as to bill insurance two different times for two separate procedures I guess. I did not understand it back then, but it seems like a sleazy but technically legal way to double bill.

In retrospect, it was all about money. Miserable, but lots of money.

After seeing that, real surgery becomes much more attractive.

Not to derail, but my understanding is that recovery from bunion surgery can be extremely painful, with limited use of the foot for several weeks, and there are patients who would prefer to have only one limb down at a time.

 

[Light at end of tunnel]

Not to derail, but my understanding is that recovery from bunion surgery can be extremely painful, with limited use of the foot for several weeks, and there are patients who would prefer to have only one limb down at a time.

Agreed, but it did not seem like a choice to be made by them.

 

[PennDippody]

With few exceptions, everyone I've talked to gains weight. I think it's a factor of all the points above (stress, unhealthy eating, lack of good sleep hygiene/exercise) and also just that time in life where your body just starts to more easily succumb to all those things. As you transition through that 30y mark, that belly and love handle combo just become ever resilient.

 

[TypeADissection]

I gained weight (general surgery). There's a lot of prophylactic eating (grab something now because I might not have time later) and unhealthy choices (whatever is quick and easy). Plus we have a generous food allowance in our cafeteria, which is not known for healthy options. Add inconsistency with working out, stress, chronic sleep deficit and it all adds up to weight gain.

This sums up my experience and my wife's. I always lose weight during night float months because I only eat 1 or 2 meals a day tops, but usually just dinner. Working out becomes almost impossible during that time. Then when back on a normal rotation, with a generous food allowance, I'm usually chowing 3 square meals a day even if they are quick. You learn the art of eating while walking just so you can pound out a consult in between cases to stay efficient (almost always pizza because they're so portable and delicious). Also the art of sitting down quickly and inhaling your food before you're up and gone. Now my scrubs fit tighter and make my ass pop, and not because I've been doing squats...

 

[310prolene]

Pretty health-minded -- eat well and exercise as much as I can. Throughout internship, I've lost a few pounds. Still eat healthy, still work out. Just don't have time to eat as much. Don't listen to people who try to tell you that being in a surgical residency means you won't have time to take care of yourself. It takes some creativity and a whole lot of will power. You will not have as much time to focus on yourself as you did during medical school. However, signing up for a surgical residency does not resign you to becoming overweight and sedentary. If health, wellness, and maintaining fitness are priorities for you, it can be done.

 

[LucidSplash]

Pretty health-minded -- eat well and exercise as much as I can. Throughout internship, I've lost a few pounds. Still eat healthy, still work out. Just don't have time to eat as much. Don't listen to people who try to tell you that being in a surgical residency means you won't have time to take care of yourself. It takes some creativity and a whole lot of will power. You will not have as much time to focus on yourself as you did during medical school. However, signing up for a surgical residency does not resign you to becoming overweight and sedentary. If health, wellness, and maintaining fitness are priorities for you, it can be done.

I actually did pretty well while I was an intern, made it to the gym regularly etc. all that went out the window when I became a senior resident. I even had a trainer that I met with twice a week as a junior resident. I'm not saying it can't be done, just that it's usually more than most people manage.

 

[LucidSplash]

Agreed. Senior residency kicked my ass health wise.

PGY1-3 I did pretty well. Lab years obviously had plenty of time to take care of health.

Last two years it's gone off the rails way more than I expected, especially chief year. Night float, long OR days...they not only mess with my eating they also sap any reserve for physical activity

One particular challenge is that I always feel like I need to eat a substantial breakfast before a long OR day. But then with our meager cafeteria options breakfast is usually a carb laden calorie bomb.

Sigh...big plans for a post-residency diet plan to get back in shape.

Exactly. I've been on elective the last couple months and been doing better again, feeling fitter and losing some weight. But I know that's short-lived because I'll be starting fellowship. I'm moving back to the northeast and the cold weather is psychologically draining and then there's the service that averages 40-50 patients in-house...

 

[neusu]

I tend to yo-yo. As a junior I never had time for food, or exercise and my stress level was higher than I could even imagine it would ever have gotten. As such, I tended to make poor decisions with respect to eating. Even when I would eat well, it didn't matter, so I put on weight. When I was off service, I ate better, slept better, exercised, and my stress was far lower, so I lost weight. Chief year was stressful again, kept the diet in check, but still put on weight.

I think for me stress is and/or lack of sleep/exercise tends to be the biggest factors in weight. When I am overworked, and overstressed, I tend to not sleep as well and have less time to exercise. Even if I can, somehow, keep exercise going, my body just ads on weight as a coping mechanism.

In some ways, this whole process has taught me to mentally relax and be less stressed. Life is rarely as intense as it seems in the moment. Stepping back emotionally, and taking a breath, can change the entire outlook on things.

 

[MediCane2006]

Currently climbing out of the 60 pound weight gain hole I dug myself in fellowship. Stress + homesickness + the Midwest were not a good combo.

In gen surg residency, my weight probably swung about 15 pounds up and down depending on how stressful the rotation was. I was skinny and hot as the trauma PGY-2 for sure....

 

[mimelim]

Agreed. Senior residency kicked my ass health wise.

PGY1-3 I did pretty well. Lab years obviously had plenty of time to take care of health.

Last two years it's gone off the rails way more than I expected, especially chief year. Night float, long OR days...they not only mess with my eating they also sap any reserve for physical activity

One particular challenge is that I always feel like I need to eat a substantial breakfast before a long OR day. But then with our meager cafeteria options breakfast is usually a carb laden calorie bomb.

Sigh...big plans for a post-residency diet plan to get back in shape.

One of my better ideas...

First I got rid of my parking spot ($80/month), then I got rid of my car entirely. Forcing me to run to and from the hospital every day. On paper and from an outsider's perspective, it sounds like stupidity, getting out at 9pm and having to run home, but I think it actually helps, a lot. Can always borrow my wife's car in a pinch to get in really quickly (or even Uber since it is infrequent enough), but for day to day? Works for me.

 

[mimelim]

You must either live real close or run real far...that heat tho...

1.5 miles, so far I've had the energy/mind to extend it out to 3-4 miles in the morning if I have time a couple times a week. And yes, the fatal flaw in the plan... Started in the fall/winter, now approaching the real summer and 80 F with 80% humidity at 5am -.-. We'll see if it is worth it, honestly though, if I could pick what I spend my spare couple of hours here and there, I'd like to spend them running, so it really does kill two birds with one stone.

 

[LucidSplash]

1.5 miles, so far I've had the energy/mind to extend it out to 3-4 miles in the morning if I have time a couple times a week. And yes, the fatal flaw in the plan... Started in the fall/winter, now approaching the real summer and 80 F with 80% humidity at 5am -.-. We'll see if it is worth it, honestly though, if I could pick what I spend my spare couple of hours here and there, I'd like to spend them running, so it really does kill two birds with one stone.

In medical school I rode my bike to the hospital as much as possible; it was actually faster (city driving vs riding) and cheaper (because student parking was $6/day and 3 blocks from the hospital). It was about 1.75 miles one-way. I tried that exactly once for residency. It was about 2.5 miles and the hills of Tennessee were not at all comparable to the flatness of Baltimore. I arrived at the hospital a soaking sweaty mess and it took way too long. Plus parking is free for us...

I've gotten back into T25 while on elective the last couple months and have noticed a difference. Of course that could be all the meaningful sleep talking. Going to try to keep that up going into fellowship.

That being said I'm sitting in the waiting room of my doctor's office now and will probably be getting started on an antihypertensive. I gave up caffeine 2 years ago and despite lifestyle modifications with regular exercise and getting down to high normal BMI, I'm still running 160-170s/110-120.

Stupid genetics.

 

[dr zaius]

Intern year I lived off of coffee and had one meal a day when working (dinner). I ate pretty much whatever I wanted for dinner, though the vast majority of the time it was something reasonably healthy. Lost 40 lbs as an intern and have kept it off almost 3 years now. I don't think it's a healthy diet, but I certainly feel better than I did in medical school. Also I think not being able to go to pub trivia and drinking beer/eating wings multiple times a week like I did as a 4th year also helps. To any of the rising 4th year med students out there: don't squander this time. Enjoy it.

Most people here tend to gain weight, though a few lose weight. I don't know of anyone that stayed the same. Residency gets you one way or another.

 

[LucidSplash]

There's a gym in the building I'll be living in next month, but I was actually interested in these "T25" or "Insanity" programs. Are they really worth it? The description certainly is convenient.

I like T25. I think maybe for someone more hardcore doing just one T25 workout a day wouldn't be enough and you might want to do insanity/P90x. One of my female friends (not in medicine) did P90x for the whole program and looked amazing at the end. For me T25 is something I can commit to psychologically (though it still takes discipline). I burn around 250-300 cals (by Garmin fitness tracker) per workout. Which is more than zero I burn laying on my couch but less than I burned when I was going to an hour-long bootcamp class 4x/week that was a 15-20 min drive from my place. Something is better than nothing and I didn't have the discipline to go to the bootcamp at 715pm at night after a long OR day.

 

[Jolie South]

I have found the only way for me to go to the gym and actually stick with it is Crossfit. I pack my stuff in a bag and go straight from work. Because it is a group class and also just by nature more intense than anything I would do on my own, I work harder. I don't want to be the worst one or the slowest so that is motivating. I also supplement with treadmill runs on days I can't make it or the gym isn't open. When I go consistently, I definitely see results. I will admit that I sandbag a little on stuff that I think may injure my hands.

I also signed up for a gym between my house and work.

 

[VincentAdultman]

I did P90x in residency after two years of poor food choices and no exercise. Definitely paid off but you need to make it a priority. That means getting up extra early or doing 45 minutes of leg workout + 15 minutes of abs after 10-12 hr OR days.

 

[SLUser11]

I was a bit of a meathead through med school and most of residency. I even continued to compete in and win lift contests (rarely) as a fellow. I've been out of fellowship for 5 years and I definitely feel out of shape. I rarely lift weights and the only cardio I get is from sports (men's league soccer or the occasional basketball pickup game).

The work will always be there, but for me the hard part was when I started a family. Any choice to go to the gym was a choice to not spend my very limited free time with my children. So, the children won pretty much every time. I have friends who work out before work, but I got up at 4:30ish for 8+ years and now I get up at 6am, and I'm never going back. My short-lived attempts at morning exercise were miserable: I felt tired and achy and lacked all satisfaction that I got with afternoon/evening exercise.

I also spent some money to have a relatively elaborate home gym setup, but it is DUSTY. I literally had to wipe cobwebs off of it the other day. My wife has stacked boxes on my fancy treadmill.....for me, if I get home at 8-9pm, I immediately try to spend time with my kids before they go to bed, then I'm starving and I want to eat, then after eating there's no exercise, I'm exhausted and I want to go to bed.

My current plan is to join the gym at my work so I can exercise for 30 minutes before heading home, but honestly I've had my gym bag in my trunk for over a month, haven't joined yet.

I'm not complaining, as I'm happy overall and I love both my family life and my professional life...although @Winged Scapula can tell you that my phenotype has changed in recent years. The reason I go into so much detail is that I believe some of this could have been avoided if I set limits earlier on in practice and made exercise/personal time a priority. Once you get into an unhealthy routine, it's hard to break out. All the problems @LucidSplash mentioned also become a real concern, as even 10 pounds in the wrong direction can have a significant impact on your blood pressure when coupled with your other unhealthy choices.

 

[Winged Scapula]

@SLUser11 I can honestly say I haven't noticed any change other than you post more pictures of your adorable kids than of yourself.

My story is similar to everyone else's. Intern year I lost weight with a combination of hours, no time to eat and a new boyfriend. Weight went up during senior residency with poor eating choices and wanting to be home with the SO rather than at the gym but down as a Chief with work and some significant personal stress. I lost more during fellowship and actually became underweight in my first few years out in practice as I went overboard with the Bikram yoga. I can only recall a couple of my co-residents who didn't gain weight; they were the types who truly found exercise stress relieving rather than a chore.

I hate to exercise and like SLUSer, I cannot work out in am (not only because I am lazy) because I feel tired, weak and have much more difficulty in reaching the same goals as I do later in the day.

So..you guys are motivating me...my weight is ok but I'm much less toned than I was and want to be. We're doing a new website photo in the fall (which I've know about since January but here I am 6 months later still not having done something).

 

[dienekes88]

Slightly less typical experience I guess. I was a competitive cyclist through most of medical school, so I was very thin. I only put on about 6-8 pounds but lost a ton of muscle: my pants fit better in the thigh but are tighter in the waist.

Lab time hasn't given me as much time as I had hoped to recover my fitness, but I started running and log about 25 to 35 miles a week. Having a good time racing local 5k races. Main thing is that I'm being a bit more conscious about food choices. I love fried food and sweets, but I stay away from that stuff now. I also try not to snack. Honestly, if I miss a meal, it's not the end of the world. There are worse things in the world than being a little hungry. I'm still about 6-8 pounds above my racing weight, but I've regained a lot of the muscle.

 

[vhawk]

My weight fluctuated up and down pretty significantly throughout both residency and fellowship, with my max weight being about 35 lbs heavier than my min weight. Really the only consistent predictive factor I had for these weight swings was control/consistency in my routine. On rotations like night float, though they were disruptive to normal rhythms, I had a very specific routine and could control my exercise and my diet very well, and since we would usually do 2 months straight, I would tend to lose a significant amount of weight (obviously, for me losing weight was the goal, gaining it was bad). On rotations that were hard but consistent I would tend to still lose or at the very least stay steady. It was the rotations that were wildly inconsistent from day to day, where I was routinely being called back into the hospital, when I never knew what to expect or when I'd grab a meal, where I would rapidly gain weight. I came into residency weighing about 210 (I'm 5'10" so....certainly already overweight from med school) and maxxed out at around 227 near the end of PGY2. Then I had several "good" months in a row and got down to my minimum of 189, by end of PGY3. As others have mentioned, chief year killed me and between that and first year of fellowship I was back up to 220, but second year of fellowship, especially after signing a contract and starting my final "Senior slide" I'm back down to just under 200 with plans to try to lose 20 more.

 

[LucidSplash]

In medical school I rode my bike to the hospital as much as possible; it was actually faster (city driving vs riding) and cheaper (because student parking was $6/day and 3 blocks from the hospital). It was about 1.75 miles one-way. I tried that exactly once for residency. It was about 2.5 miles and the hills of Tennessee were not at all comparable to the flatness of Baltimore. I arrived at the hospital a soaking sweaty mess and it took way too long. Plus parking is free for us...

I've gotten back into T25 while on elective the last couple months and have noticed a difference. Of course that could be all the meaningful sleep talking. Going to try to keep that up going into fellowship.

That being said I'm sitting in the waiting room of my doctor's office now and will probably be getting started on an antihypertensive. I gave up caffeine 2 years ago and despite lifestyle modifications with regular exercise and getting down to high normal BMI, I'm still running 160-170s/110-120.

Stupid genetics.

I guess I will update here to say be careful not to dismiss all health-related changes as being due to weight/stress/caffeine/sleep deficit. Turns out new onset hypertension in an otherwise healthy 35-year-old female can be a few other things. Like intrinsic kidney disease.

This is very suboptimal timing for all this. Sigh.

 

[armybound]

Lost a few pounds as an intern. Didn't always have time to eat and I ran around a lot.

Once I got on the urology service I had more time and opportunity to eat. We snack a lot. I ate a lot. I gained a few pounds. Then I got really stressed out at work and started on an antidepressant and quickly gained ~30 pounds.

 

[SouthernSurgeon]

Relevant:

http://www.journalacs.org/article/S1072-7515(16)31728-8/abstract

 

[Buzz Me]

I lost a fair amount of weight on the busier rotations/months, gained a little back on the "easier" rotations when I'd actually have time to eat breakfast or lunch (never both). Things got way busier as a chief (home call 24/7/365) and as a fellow and more so now as an attending. So the weight's back down.

 

[Nikj]

Have any of you considered protein shakes? If you mix them with fruit/vegetables/eggs they can be pretty nutritious, easy to make, and can be consumed pretty much anywhere, relatively quickly.

 

[MediCane2006]

I guess I will update here to say be careful not to dismiss all health-related changes as being due to weight/stress/caffeine/sleep deficit. Turns out new onset hypertension in an otherwise healthy 35-year-old female can be a few other things. Like intrinsic kidney disease.

This is very suboptimal timing for all this. Sigh.

🙁

 

[Winged Scapula]

Have any of you considered protein shakes? If you mix them with fruit/vegetables/eggs they can be pretty nutritious, easy to make, and can be consumed pretty much anywhere, relatively quickly.

The issue is 1) finding the time to make them; 2) find a place to store them (the refrigerator in our call room was disgusting and if I put a drink in the hospital refrigerator now, it is likely to be consumed by someone else).

Its not that we don't recognize that there are healthy options out there, its just...well, you'll see.

 

[Buzz Me]

The issue is 1) finding the time to make them; 2) find a place to store them (the refrigerator in our call room was disgusting and if I put a drink in the hospital refrigerator now, it is likely to be consumed by someone else).

Its not that we don't recognize that there are healthy options out there, its just...well, you'll see.

Exactly. No time or means to make a protein shake. Or store it. Some days I would literally never even get the chance to sit down.

 

[Jolie South]

The issue is 1) finding the time to make them; 2) find a place to store them (the refrigerator in our call room was disgusting and if I put a drink in the hospital refrigerator now, it is likely to be consumed by someone else).

Its not that we don't recognize that there are healthy options out there, its just...well, you'll see.

Even if I had all the time in the world and made protein shakes everyday, my body and mind don't consider them food. I don't feel satisfied with "sweet" tasting foods, so I end up eating more calories as a result.

We have premade shakes in our caf that are easy to grab if you really have a ****ty day and can't eat.

 

[Apollyon]

Things got way busier as a chief (home call 24/7/365)

So you couldn't have a beer the entire year? Or am I reading that wrong? To my dumb EM self, that looks like Q1 home call. Or, was it service chief was 24/7 for that block?

 

[Winged Scapula]

So you couldn't have a beer the entire year? Or am I reading that wrong? To my dumb EM self, that looks like Q1 home call. Or, was it service chief was 24/7 for that block?

Its pretty much 24/7 throughout the year - at least when @Buzz Me and I were residents, when you were Chef (final year) resident, you were Chief on the service and back up for the residents 24/7 on all blocks/all services except when you were on vacation.

 

[dpmd]

Its pretty much 24/7 throughout the year - at least when @Buzz Me and I were residents, when you were Chef (final year) resident, you were Chief on the service and back up for the residents 24/7 on all blocks/all services except when you were on vacation.

We were better because it was only half the year, but that was because the other chief would cover the other nights (we did every other day Monday through Thursday and every other weekend).

I gained because there was always food available (floor nurses would have potluck almost every night so while on call or night float they would feed me delicious multicultural foods, ICU had lots of potlucks during the day plus we would have cookie time most afternoons around 3pm, cafeteria was free unlimited food while they were open with lots of unhealthy choices, most times we would run the list during the day at a table in the caf at lunch, lots of times we would order in dinner for whoever was staying overnight-resident buys and student retrieves, journal club at restaurants with food and liquor). It was the usual poor choices and lack of motivation to exercise more so than any true impossibility because of schedule. I also prioritized sleep and time with a spouse over exercise. But it would have been possible to make better choices and not gain. You can't just blame residency and absolve yourself of any guilt.

 

[SLUser11]

I've been thinking about this thread a lot over the last couple weeks. There's a much bigger weight that you carry after graduation that I didn't mention, and that's the weight of your complications, your deaths, your failures....even if your success:failure ratio is excellent, your failures will still be quite heavy, and your success will be "rewarded" with more responsibilities and obligations ("opportunities"). Outside of the hospital, as you age and mature you also carry the weight of your family, your health, finances, aging, illness, etc. Many of us felt this prior to graduation, but it really starts to get heavy as you get farther along. When in training, you are allowed to focus almost entirely on work. You can submerge yourself in training, and essentially defer most other responsibilities. Many (but not all) residents are young, and have few obligations outside the hospital. Residents often benefit from the "lightness" of having a surgeon upstream to consult when they need help, and blame when things go bad.

Depending on your grit and your previous failures, you may be able to carry on, or you might crushed under this increasing weight. Retrospectively, I'm shocked that we become experts in such complex medical situations, but we remain novices in how to run a business, how to manage money, how to support a lonely spouse, how to be supportive to your children, how to remain active and healthy, how to avoid drinking too much booze, etc. It's really no surprise to me now that the burnout rates are so high among surgeons.

Anyway, you should all be thinking now about how you're going to handle this weight, as it is a necessary component of being in the big leagues. Honestly, I welcome it. I feel like it's a reward. Still, the legs tire from time to time.

 

[Buzz Me]

So you couldn't have a beer the entire year? Or am I reading that wrong? To my dumb EM self, that looks like Q1 home call. Or, was it service chief was 24/7 for that block?

Yes, it was home call every day for an entire year (except for the three weeks of vacation). I would still occasionally have a drink. Just couldn't get wasted.

 

[Buzz Me]

Anyway, you should all be thinking now about how you're going to handle this weight, as it is a necessary component of being in the big leagues. Honestly, I welcome it. I feel like it's a reward. Still, the legs tire from time to time.

Man, that's a great post. Sobering, but so very true.

 

[orthogenes]

My program leaves us pretty much broke and doesn’t feed us, so I’ve been losing weight.

 

[kitsunepixie]

Neurosurgery

Residency (junior years): Actually lost weight to the point my PCP expressed concern, despite eating every chance I got, and having an reputation for having a voracious appetite. Had TSH checked many times. I was also used as a unit of measurement -- ie, "this patient weighs exactly 5 kitsunepixies" and also as a taunt/motivator "I see you're struggling...want me to get kitsunepixie in here to break this rod for you?"

Residency (senior/chief years): Gained weight to a normal BMI thanks to a Starbucks opening in the trauma hospital and trialing a new latte there that they only had in like 3 SB in the entire country at the time. I did some kickboxing on my bag at home to try and keep somewhat toned.

Final chief year/peds fellowship/junior attending: I gained 65 lbs to make a 5 lb baby. A true umbilical knot may have contributed to my body trying to pass nutrients to my daughter (my theory, anyway). The first 25 lbs came off right away. The remainder has been stubborn, so I read the Obesity Code and followed that and lost 20 lbs in about 6 mos. I also swim almost every day at home but still have 10 lbs to go to my goal of 5lbs over my pre-pregnancy weight and just got a Peloton last week. My BMI is in the normal range but I am vain and want to have a 6 pack again.

 

[DoctwoB]

My weight has been pretty stable (in good shape but not jacked) since starting residency, and before having a child managed to find time to exercise most days, whether that was a quick set of intervals between cases in the OR or cardio before or after work. I have gotten a few comments from OR staff when I show up to cysto still pouring sweat, but i'll take that. That is despite the fact that I rarely missed eating at work, maybe I was more efficient then most but even on busy rotations seemed to find time for a quick lunch despite my co-residents telling me they never had time to eat.

Since having a child, its been tougher, as SLUser alluded to, time spent exercising is time away from family. That's a tough sell given I'm already doing less then my share of the child rearing. Fortunately my kid loves going for runs in the jogger, so for now I've found a way to kill two birds with one stone if the weather allows.

The other thing I've found to be helpful is intermittent fasting (AKA time restricted eating), where I don't eat between 8pm and noon at least, usually more like 7pm and 1pm. There are some studies that this aids in weight loss and has some metabolic benefits while being more sustainable then traditional calorie restriction. Anecdotally I find this much easier then other forms of dieting, as even if I make some unhealthy choices it's harder to over-consume calories in a short window. It fits my body's schedule, as I'm not hungry in the morning when I wake up and as long as I keep busy working or operating I find I don't get too hungry before lunchtime. I'm also not religious about it, meaning I'm not going to skip brunch with my family or grabbing a drink with friends in the evening, but as a day to day it works well.

I've thought about trying a ketogenic diet, but so far that seems a step too far in the meal planning required for now.

 

[Psai]

Neurosurgery

Residency (junior years): Actually lost weight to the point my PCP expressed concern, despite eating every chance I got, and having an reputation for having a voracious appetite. Had TSH checked many times. I was also used as a unit of measurement -- ie, "this patient weighs exactly 5 kitsunepixies" and also as a taunt/motivator "I see you're struggling...want me to get kitsunepixie in here to break this rod for you?"

Residency (senior/chief years): Gained weight to a normal BMI thanks to a Starbucks opening in the trauma hospital and trialing a new latte there that they only had in like 3 SB in the entire country at the time. I did some kickboxing on my bag at home to try and keep somewhat toned.

Final chief year/peds fellowship/junior attending: I gained 65 lbs to make a 5 lb baby. A true umbilical knot may have contributed to my body trying to pass nutrients to my daughter (my theory, anyway). The first 25 lbs came off right away. The remainder has been stubborn, so I read the Obesity Code and followed that and lost 20 lbs in about 6 mos. I also swim almost every day at home but still have 10 lbs to go to my goal of 5lbs over my pre-pregnancy weight and just got a Peloton last week. My BMI is in the normal range but I am vain and want to have a 6 pack again.

I am trying and failing to imagine one of our neurosurgeons saying "kitsunepixie"