109: Why Your Weight Is Creeping Up (And What To Do About It)

Ten extra calories a day. That’s it. That’s the kind of razor-thin margin that can quietly add a pound a year and it’s why so many people swear they “didn’t change anything” while the scale slowly drifted upward. We unpack the simple math behind the one pound rule, what the research shows across decades, and why the real story is rarely one dramatic habit. It’s a stack of tiny shifts: a little less walking, a little more convenience food, a little less sleep, a few more liquid calories. 

From there, we get practical. We talk through an easy “build your plate” framework that makes balanced eating feel doable in real life, not like a list of rules. We also dig into movement in a more honest way: exercise is incredible for your heart, brain, and mood, but it really shines for weight maintenance and preventing weight regain. We cover strength training to protect lean muscle and basal metabolic rate, plus NEAT, the everyday movement that adds up when the daily margin is so small. 

We also hit the sneaky stuff that sabotages progress: silent calories from sweet drinks, alcohol, oils, and butter, and the way processed foods can make it harder to notice fullness. Then we tie it together with two under-rated drivers of weight management: sleep and environment. Willpower comes and goes, but your environment is what you live in, so we share simple setups that make the healthier choice easier and help you avoid the all-or-nothing trap. 

If you take one thing from this conversation, let it be this: you don’t need a perfect plan, you need one sustainable change you can repeat. Subscribe, share with a friend, and leave a review, then tell us what small tweak you’re starting with this week.

Transcript

SPEAKER_01 0:02

Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area.

SPEAKER_00 0:16

And I'm Nicola Rufo. I'm a nurse.

SPEAKER_01 0:18

And we are so excited for you to join us here again today. So for us, it's been a little bit of a break from the podcasting. We took a little break and I went to the obesity medicine conference in San Diego.

SPEAKER_00 0:36

You learned a lot.

SPEAKER_01 0:38

And I learned so much. I learned so much to bring back for these episodes. We're going to slowly start doling them out. Today, um, before we we're going to talk about, and we're going to we're going to banter, of course. You can hear that at the end of the episode. But today we are going to be talking about um how weight gain can be so subtle over time. So you can stick around for that. So, what are we going to talk about today, Nick?

SPEAKER_00 1:05

Today we're talking about something you recently learned at the conference, which was really interesting about this one pound rule. I guess we'll talk about or call it the one pound rule. Um, and more so why these small, tiny changes in your life actually matter more than you think when it comes to weight gain, weight loss. Right?

The One Pound Rule Explained

Why Small Changes Beat Extremes

SPEAKER_01 1:28

Yeah. Yeah. And I think once you hear this, it may really completely change how you think about weight and how you think about change in general. I've whipped this out even in a few short days being back from the conference, and it has really like given a lot of patients that I've talked to that aha moment of like, oh, okay, this makes some more sense. So researchers have they tend to follow, like they have certain studies that I won't like name, like there's like the national like nurses study or health profession study or Framingham study. There are like several studies that follow tens of thousands of people over decades, and they just watch and they see what happens to these people. And so when research follows, when researchers follow people over years or decades even, they've seen something incredibly consistent. Most adults gain about half a pound to one pound per year. And what's fascinating is that this has shown up across different populations, different lifestyles, different countries, which tells us that this or weight gain isn't about one bad habit. It's about how small shifts in our daily lives add up over time. And they at the conference they were talking about this pretty matter of fact. They were just in their presentation and they were just like, oh yeah. And so we know, like, we understand that people gain weight about a pound a year, and that is how this happens, and like a pretty well-known thing. And this was it's newer to me, but it makes a lot of sense. So we've I've taken this and gone well one step further in my thinking to think about the part that really changed how we are going to look at things. So if we put it in this perspective, which is sort of a very simplistic view, but in one way it helps illustrate the point I'm trying to make. Gaining about one pound per year comes down, if you were to think that 3,500 calories is one caloric pound. That's we generally know that as a thing. Like if someone is to eat 3,500 calories, that is about a pound of energy. Or if someone loses 3,500 calories, that is a pound of energy. But if we take that 3,500 calories and stretch it out over the entire year, that is about 10 calories a day. That's how small the margin is. The margin is razor thin. So one way I like to explain this to patients is to think about weight like a bank account. If you deposit just a few extra dollars every day, you probably wouldn't notice it. But over the years, you look up and the balance is very different. The same is true even in reverse. Small, consistent withdrawals over time completely change the trajectory. And this, I feel, ends up being why people get confused. They'll say, I didn't really change anything when it comes to weight gain. It's mysterious. And honestly, I always believed them, but now I think this adds a sense of clarity because it's not usually one big change. Of course, there are the people who think otherwise, but for, and we can talk about that, but by and large, for most people, it's the small things. Maybe it's a little less movement, maybe a little bit more convenience in food, maybe a little less sleep. Each one is very tiny, but they all push in the same direction. I I distinctly remember patients when they say, like they tell me exactly like I don't snack, I don't overeat, I don't understand this. And when we looked closer, it wasn't one big thing. It was a handful of small things stacked together. And so once we started to adjust just a few of those things, things started to move. So here's the reframe that I think is really empowering. If weight gain happens from small, nearly invisible imbalances, then you might not need extreme solutions to fix it. Otherwise, you don't need to be perfect. You just might maybe need to be slightly more intentional. And most importantly, you need changes you can actually live with long term. So I'd like to like go back and forth about what we've thought about this before we dive into like how to approach some of those small changes. Um it's gonna be similar to the some of the stuff you hear, but if you're new here, we would love for you to hear these things anyway. Um, I've been bringing this up. I've been bringing this up to patients, maybe like in even in the early days since coming back. And some people have definitely contended with me where it's like, oh, that's not how it is for me. Like I gained all this weight from X to X time. Yeah, I I agree. Like, I don't think that this is one size fits all for everyone by any means. Yeah.

SPEAKER_00 7:05

Well, I mean, you know, it's kind of just like like most things are on average for the general population. One pound per year.

SPEAKER_01 7:15

Yeah. Um, and weight fluctuates like day to day.

SPEAKER_00 7:20

Yeah.

SPEAKER_01 7:21

Moment to moment. And weight is more complicated than just a number. Like you could have more water one day, more water and salt one day, and like your weight might be bigger or a larger number the next day because you had water and you have more water in your body. Um, so all of that to say like it fluctuates, it goes up, but like on average, when you look at like they account for this in data when they present this information. So, like the they look at all of this to try to capture all of that. Um, any thoughts so far about this? When I told you this, what did you think initially?

SPEAKER_00 8:01

Well, I mean, one pound is like not a lot.

SPEAKER_01 8:04

No. It's not.

SPEAKER_00 8:07

But then I don't know. Is it like one pound of fat? I guess.

SPEAKER_01 8:17

Every year.

SPEAKER_00 8:19

Every year.

SPEAKER_01 8:20

So like ten years go by and then like slowly and mysteriously you're ten times more than you used to be. Yeah. Which is like a big deal. That's like what people will look at. They're like, oh, I'm like twenty years ago I used to be this and now I'm I weigh this number. Like that's sort of how it happens. I mean, I even think um, so when I when I changed jobs from like being a resident to an attending, I when I was a resident, I was in the city and I was walking to work every day, and then like to and from every day. And then as an attending, I drive. And like there was a little bit of a change. Like a lot of it happened like after we came back from vacation and blah, blah, blah. But like I've noticed that. And I was like a weight when I was a resident, and now I am await when I'm an attending. And it's very different. And I'm like trying to incorporate like a walk at lunch if I can, but that is like the type of small behavioral change that adds up over time. Like the 20 minutes I would take to walk, I am now sitting in a car.

SPEAKER_00 9:27

Yeah.

SPEAKER_01 9:27

Each way.

SPEAKER_00 9:29

You go for your walks at lunch pretty consistently, I'd say.

SPEAKER_01 9:32

I tried to. Last week it didn't happen. I want to get back into it. Yeah. But there were extendues.

SPEAKER_00 9:36

And now that it's nicer out, we can like go for a walk after dinner. Because it's like lighter out longer.

Weight Fluctuations And Real Life Examples

SPEAKER_01 9:41

Right. So we're realistic, but like this stuff happens to us too. So I like I think it's very interesting and I hope applicable if you hear it even coming from us. Yeah. Like how things happen. So now that we've explored that that's a confusing thing and mysterious that happens to people and this razor thin margin. And you know, day to day, it's not that like every single day you're 10 calories over, but maybe one day you're like a hundred calories in more than you burned. And the next day that you're like minus 90 and you feel good about it. But like on average, between those two days, two days, that is 10 calories of excess. So that's the concept is that on average, this is how this goes. Obviously, there are like complex biological mechanisms playing here that lead to this happening as well, like hormone responses and your body maintaining something called homeostasis. So I wanted to package all of this in that way as we move to the next part of the episode where we review some of the healthy lifestyle things that are simple and easy that you can incorporate to kind of fight this, because this is like happening mysteriously and invisibly throughout the day. So let's start with something practical, how you build your plate. Can you take us through some approaches to this? Like how we look at a plate for our food rather than like lists of things.

SPEAKER_00 11:04

I can. We're gonna take it back to basics with this one. So if you have a plate, we're going to want to break it up into three different sections, with half of your plate being vegetables or fruits, and then a quarter being protein, a quarter being carbs, and then in there working some sort of healthy fat. So if it's the half of your plate of vegetables is a salad, maybe with some olive oil, or, you know, however you want to work that in there. And this works because fiber-rich foods like the fruits and vegetables are taking up space. So they are making you feel more full with fewer calories. Um, the quarter plate of protein will help you make help you stay fuller longer and stabilize your appetite. And when your meals are balanced like this, they're less likely to have those strong cravings later in the day. There's no crazy blood sugar spike, and you're not trying to constantly chase a feeling of hunger or getting any sort of crash.

SPEAKER_01 12:12

No, that was beautiful. Um, I think looking at the plate is way more practical. Like I was even, we had um, I made salmon the other night and I was looking and I like laid out the plate and I did not align my plate like this. And I'm like, oh hmm. I don't do that a lot. But like the rice, I was like, the rice is half the plate. Um when like the broccoli I made was a quarter of the plate. And I was like, oh, hmm. So we're we're also still working on these things. Not we, you're great. I'm still working on these things. Um, awesome. So I'll take exercise. Um, we've talked about these things a lot, but you know, we know that you guys don't need to know more, but maybe you need help implementing it. We know that exercise is incredible for your health, your heart, your brain, your mood, but it is not always the main driver of weight loss, per se. But where it really shines is helping prevent weight regain. And so, and meaning that like helping you keep weight off once you've lost it. So, a practical structure to think about would be that like 30 minutes of moderate intensity exercise a day or five times a week is good for your general health. If you are thinking more about weight maintenance, we start to get to more to 45 to 60 minutes a day, which is different than 30 minutes a day. And we must incorporate strength training. We've talked about this a lot. Um, two days for an average person if you're on medications to lose weight, uh, to lose weight, then, um, or help manage obesity rather, that it would be more three days a week. And when we talk about that is mainly to help keep muscle mass, keep lean muscle mass, because one, it'll keep you strong and functional as you age, but also help you maintain a basal metabolic rate. You know, the thing your body just existing burns is responsible for about 60 to 70 percent of the calories in your day that you burn. And that will drop if you lose muscle. So that's something to keep in mind. Um, you know, something people don't always realize is that your daily movement outside of exercise matters a lot. It's called neat. Um, walking more, standing more, just being a little bit more active throughout the day, this adds up significantly when we are thinking about how small the margin is. So think of exercise as building a stronger system, not just burning calories, if you will. All righty. So, and then the way, you know, in the theme of just helping you apply it a little bit more. We say two to three days of major muscle groups like your legs, your back, your core, your arms. But maybe you just start by doing one activity three times after dinner, maybe. Like, could it be three sets of 10 of air squats after dinner, or maybe when you wake up in the morning? Is that somewhere that you can start? And maybe that can translate into something greater. Maybe. Maybe. So can you take us into the third step? Um, can you help us when we're considering the razor-thin margin of 10 calories, plus or minus a day? Can you help us talk about silent calories and processed foods a little bit?

SPEAKER_00 15:39

Alrighty. Silent calories are one of the easiest ways that we can sneak calories in, and oftentimes they are liquid calories. So, like our sugar-sweetened beverages, which we love to talk about and tell you not to drink so much of. But then they can also be found um even in things that are like the healthier fats, like an olive oil. Um, if you're cooking with like a lot of butter, that also adds up into calories. So things like that. Um, your body doesn't register these liquid calories in the same way that it does in whole solid foods. So you can drink these calories, but then you will still feel hungry later. And this is a probably a big portion of where the daily surplus can come from. Yeah.

SPEAKER_01 16:29

And you know, you don't ideally probably people would like eliminate these completely, but even just being a little bit more intentional about how often you have them can make a big difference. Like when if we're talking about this razor thin margin and we're talking about the like, I don't know, like I all day I'm like, people come in and they're like, oh, I've gained all this weight. But yeah, you know, every night I'm like having like two or three beers, and on the weekends I'm having more beers. I'm like, oh, I wonder if they realize that that is that's the thing. That's it. That's the margin. That's like, even if you're having like a light one that's like 96 calories or whatever, that like that times two or three, times five, maybe more, is all the extra. That's it.

unknown 17:20

Yeah.

SPEAKER_01 17:21

And then what about um we've explored a little bit, and maybe we need to like, I don't know, we have a nice episode about processed foods, people can go back and listen to, but what about those?

SPEAKER_00 17:31

Yeah, so our processed foods, um, these are foods that are designed to be eaten quickly and they make it harder for our body to recognize when they're full. Um, a lot of times they are more calories in a smaller portion, and then you still feel hungry, even though you just had a lot of calories.

SPEAKER_01 17:53

Yeah. Sick.

SPEAKER_00 17:55

Yeah.

SPEAKER_01 17:56

And so, you know, maybe the like an ultimate goal is to probably limit these as much as possible. But even if you can re-examine in your day, thanks, typhoid Mary, if you can re-examine in your day where these are sneaking into your life and try to make one adjustment. Add one thing instead. Can you replace it with? I mean, one could argue that yogurt's processed, but can you a healthier processed thing, like a yogurt, or could you replace it with a fruit? Could you replace it with a vegetable? Um, if you're looking for a little bit of that salty thing, I feel like a cucumber or celery and some hummus is a nice way to go for a snack instead of something very processed. Like, can you look at one thing, find it, and then replace it with something like a healthier option? That's how I would try to apply it in your day-to-day. Oh, the other one. This is good. Um now we are having fruits for dessert most consistently.

SPEAKER_00 19:09

Yeah, we like our little grape dessert.

SPEAKER_01 19:11

Yeah, that's something like we as a even you, the listener, like that's what we're moving towards now. Like your little sweet treaty.

SPEAKER_00 19:17

Except it's Sunday, so I got us ice cream for a little sweet treat tonight.

SPEAKER_01 19:21

You gotta live. You gotta live.

SPEAKER_00 19:23

But tomorrow, Monday night, we're having grapes for dessert.

SPEAKER_01 19:26

After our healthy burgers. Um, so fruit for dessert. Try to think of it and incorporate it and let us know in a voicemail how it's going. No one did that yet. I'm looking at you guys.

SPEAKER_00 19:37

You know, it's actually really good. Like a little cool whip and like strawberries or blueberries.

SPEAKER_01 19:42

There we go. Delicious. See, we're gonna do it.

SPEAKER_00 19:46

Do you want it to be a little more sweeter?

Build A Balanced Plate

SPEAKER_01 19:47

A little sweeter. I'll take sleep. Sleep tends to be one of the most underappreciated parts of weight management. When you don't get enough sleep, seven to nine hours for you adults, your hunger hormones increase. I'm looking at you, ghrelin. Ghrelin is the primary hunger hormone, and it communicates with the brain. It comes from the stomach. And when you don't get enough sleep, it's increased. And so when ghrelin is higher, your brain tends to look for quick energy, usually higher calorie foods. Plus, let's say you're someone who's only sleeping five hours a night and you're supposed to be sleeping at least seven. That's two extra hours that you're awake that you could be consuming calories. And so when sleep is off, everything else gets harder. So try to try to find some ways to do to get some better sleep. You can also recent to one of listen, excuse me, listen to one of our most recent episodes about being tired. So I want to explore this, like in that it's all about your environment. It's way more about environment than it is about willpower. We cover this in our motivation checkup quite a bit. Um, it's a mini-series that we did about how to start to incorporate lifestyle changes that people say that you should do. But this might be the most important thing in this entire episode. Willpower is something you have temporarily, but your environment is something you live in constantly. And here are some this may seem a little nebulous, but here are some practical examples that we want to share with you. Keep healthier foods visible. Move less helpful foods out of sight. And sometimes you can even look to prepare meals ahead of time. The practical example I love to give about myself is if I'm coming back from work on a Wednesday night and it's been a very long day, like 12 hours at the office, commuting time, not included. And I come back and it's been a few hours since I've eaten, and I'm very if I'm hungry and I see that there are tortilla chips around, I will probably eat the vacuum. Majority of the bag of tortilla chips. And that's an example from me that like that's something I deal with.

SPEAKER_00 22:05

And you're so brave.

SPEAKER_01 22:07

Thank you for sharing my story. And so we either try not to keep them in the house or I we try to put them away somewhere. You've portion controlled it for me like I'm a puppy. You did you put out his little bowl? A bowl. Um but you know, if I move those tortilla chips to a place where I can't see them, I am less inclined to have them. Is there any are there any foods like that for you, Miss Perfect?

SPEAKER_00 22:34

Um yeah, I do like jelly beans a lot.

SPEAKER_01 22:39

It's just like snacky, like a gummy candy.

SPEAKER_00 22:43

I really thought about asking if you wanted to go to the candy store yesterday. But I had self-control and I didn't replenish our gummy candy in the house.

SPEAKER_01 22:54

Well we differ in that way. I can't with a gummy candy. It makes my I feel like my teeth are gonna fall out. Maybe that's a personal problem. So, you know, when it comes to this, you don't, and we're thinking about the environment. You don't, if you don't rise to your goals, you fall into your environment. And so, like we have to try to think about all of these things in the background. I'd like to then take our way into a trap, if you will. It's an all or nothing trap. So far in this episode, we've been exploring that the margin is razor thin. And one of the biggest traps I see is an all or nothing mindset. People feel like if they can't do everything perfectly, then they shouldn't do anything at all. But when it comes to weight and managing the chronic disease of obesity, partial effort still counts. And this is one area of health where a little better is actually very powerful. And so here's something I think pay people need to deserve to hear more often. It's much easier to prevent weight gain than it is to lose weight later. And that's not about willpower, that's about biology. Your body actively defends a weight once it's there through complicated mechanisms, which is why these small early changes matter so much. So if you're listening and you're thinking, like, okay, great, this all makes sense, but where do I start? The simple rule that we would have is to start with one thing, just one. Find a time to pick a walk in your day, and an additional walk if you're doing that already. Look at your plate, make an adjustment to what goes on your plate or cut back on liquid calories, like we talked about, like with all or nothing. You don't need the perfect plan, you just need literally something to start with. So let's bring this back to where we all started. A one pound per year weight gain comes from a very small daily imbalance. But that also means that small, consistent changes can shift that in your favor. So the choices you make this week may not show up tomorrow, but they will show up over time. With weight, it's not about doing everything, it's about doing something consistently. So if you take one thing from today, it's this your health is shaped by what you do consistently, not occasionally. You don't need to overhaul your life, you need to move the margin slightly in your favor. I've been moving the banter to the end so that someone who's interested in the topic can listen all the way through. Um but we've also had some great dinners recently. I can't help but let's talk about a few of them. Um just because it happened a little bit more distantly in the past, we have enjoyed I can't stop thinking about this fish, a hamachi. And maybe it wasn't just the fish in general, but I can't help think about the cilantro and jalapeno dressing that the white fish was in.

SPEAKER_00 26:38

It was yeah, yeah. We were just like eating the sauce.

SPEAKER_01 26:45

It was a sauce. Yeah, it was a sauce they had knots, not knots, rolls, rolls that were also so delicious. This restaurant was able to take Mediterranean food and just I I I just can't stop thinking about this Hamachi dish. I, you know, I think the style that we like, we like to ask, maybe I do, we ask the person who works at the restaurant what they think.

SPEAKER_00 27:12

Yeah. I feared you were gonna do that yesterday, which we'll get into.

SPEAKER_01 27:19

No, there was no way that I was gonna be the one allowed to speak yesterday. So I really enjoyed that one. We also went to a recent uh we also went to a recent Mexican restaurant. And can you tell us about the Mexican restaurant experience that we had?

SPEAKER_00 27:37

Well, I made a reservation at this place which will remain unnamed. I mean, it wasn't bad. It was good, but like it was low-key a club.

SPEAKER_01 27:51

Not what we were expecting.

Exercise For Maintenance And Muscle

SPEAKER_00 27:53

Not what we were expecting. And like we had kind of an earlier dinner reservation, it was like seven. And I feel like places, if they kind of like turn into that later, that happens after like 10 p.m. or so. Sure. So we walk in, it's really loud, and like music, the music is really loud, and I'm like, oh no, I've made a giant mistake. But we stay there and we like order our drinks, and the drinks are really good. I thought the food was good, but then there's like a whole DJ 10 feet behind Eddie. The speakers are loud, there's like lights every like the moving lights everywhere, and then intermittently, like, I don't know what they're called when they like come out with like when it's like bottle service and they have like the sign and like people are cheering and they would like the flares come over to like come over to a table and like do that and then recede back into the back. And it was an experience.

SPEAKER_01 28:56

I you know, we were celebrating our six months of being married. That happened since well.

SPEAKER_00 29:02

I was afraid when our waitress like asked, like, are like are you here celebrating anything, whatever? And then you told them, Yeah, it's like our six-month anniversary. I was like, Oh my god, these people better not come out to our table with a sign.

SPEAKER_01 29:15

I was worried, I was worried they were gonna come out, and then we were like that was an experience. Yeah, we were getting ready to wrap up, and I was like, Did we make it out unscathed? And then thankfully we were able to. Tacos were great. I I like making so I make jambalaya. I've always made this. Um, I have the same recipe. It's like this crock pot recipe, and now I just have like slight variations of it that I try to make, and it tastes fine. And like growing up, it turned out well. But we also had jambalaya from a like Louisiana focused, Louisiana-inspired place. And I also similarly can't stop thinking about this like Cajun style jambalaya that we enjoy.

SPEAKER_00 30:05

That was really good. I have to figure out nothing is as good as jambalaya made from someone from Louisiana, which I have been spoiled in my life to be able to have, and everything else is good, but it's just not as good.

SPEAKER_01 30:25

Yeah, we've been running into that problem a little bit. Um recently. I don't know if we talked about I think we talked about our Boromini experience on here. We definitely did.

SPEAKER_00 30:35

We did. Yeah, we don't need to bore them.

SPEAKER_01 30:37

We don't need yeah, all right, cool. So that's been great.

SPEAKER_00 30:40

But then Unexpectedly. We had ourselves a day yesterday. A nice little Philadelphia day.

SPEAKER_01 30:48

We did.

SPEAKER_00 30:49

Took a W and then we went to the gym, and then you know, for some balance in our life, we decided to walk from the gym down to Angelo's to get cheese steaks.

SPEAKER_01 31:02

Which I think we like there are a lot of people outside, and a lot of people in our neighborhood that we've seen. So we had the opportunity to explain this plan to like two or three people, like three, three different people that we just like saw on our street, three neighbors, and we're like, we're gonna go to Angelo's, we're gonna go to Angelo's, and I had never been before, you hadn't been before. Unexpectedly, on a previous episode, we had discussed that this is like a Michelin recommended bib gourmand place, and we had spent multiple episodes, we brought different people on to talk about the Michelin thing with this, and I did not wake up yesterday thinking I was going to have a superlative sandwich.

SPEAKER_00 31:46

Oh my god, it was so good. Well, I've been wanting a cheesesteak for a while, and then I was really just Jones in for one yesterday. So we worked out so that we could go get cheesesteaks. We had to walk a little bit, you know. Yeah. We did.

SPEAKER_01 32:01

We like we walked for the side.

SPEAKER_00 32:03

But then when we and then exercised and when we ordered, so like you get in line to order, and then you have to go back outside. They text you when it's ready, and then you get in line to go get your thing. So, like it is, I would say, akin to TSA in the Philadelphia airport. There are lines, people are yelling what to do, and they got a whole operation. And it's it all works out. So then we get up there, and I just knew that in the back of Eddie's mind, he was gonna get up there to this like sassy South Phillip Philly Italian lady and be like, Well, there's like a hundred people there. There, it's like chaos in the back. These kids are like working hard getting everyone's food ready, and he was gonna be like, hey, so what are you guys like known for? What are you most proud of? To which I was gonna have to dig myself a hole and crawl into it. So I just ever so subtly went up before him.

SPEAKER_01 33:12

Is that why that happened?

SPEAKER_00 33:13

You like type, you like type your info in, and then they're like, all right, Nicole, what do you want? And then rattle off what we want. We got a cheesesteak with onions and Cooper Sharp and an Italian hoagie, everything on it.

SPEAKER_01 33:25

It was efficient to say the least, but I didn't realize that's what happened.

SPEAKER_00 33:31

I cannot have him like making small talk, asking about the history of the restaurant while there's a line of 80 people behind us. And these people, again, akin to the TSA at the Philadelphia airport, they don't have time for small talk. Although the girl did give me a little bit of a compliment. So there was a little bit of small talk in there, but that's incredible.

SPEAKER_01 33:53

Yeah, I that definitely that absolutely would have happened. Look, can you blame me? I want to know from their perspective, like that's it led us to the Himachi, and now I can't stop thinking about it. I wanted to know. I think we found ourselves on the like signature sandwiches, and uh now we need to definitely go back. Um yeah, it was cute.

SPEAKER_00 34:16

And then we like went to the park that's across the street. We like had ourselves a little picnic.

SPEAKER_01 34:21

We did, it was cute. There were people sitting on the like the concrete siding with the fence with like six inches of place to sit.

SPEAKER_02 34:28

Yeah.

SPEAKER_01 34:29

And there were benches open. I yeah, we just went to a bench, it was great. Um, the I did not expect waking up yesterday to have a superlative cheesesteak, let alone a superlative Italian. Um I say that knowing that like on this show we endorse like limiting these things all the time.

SPEAKER_00 34:49

So I'm like Yeah, we do limit our processed meat, but sometimes you just need an Italian hoagie, you know?

SPEAKER_01 34:55

Right. And growing up everything in moderation. Like I was a regular at Subway, so much so that the local franchise and Jackson knew my order. Oh god. And they knew like that I wanted extra mayo, extra oil, extra vinegar. I have since changed my ways a little bit.

SPEAKER_00 35:11

Mayo on an Australian hoagie.

SPEAKER_01 35:13

Well, then I would like go to like other places with my dad later in my life, not realizing that this was a thing. This was not a thing. Um, and they clowned me. Like, God, you should be clowned. It's like a Primo Hoagie in Glassboro. And we went in there and I was like, Yeah, I would like an an Italian. I I know it's Italian, I know, but um, I'm saying it for the bit. I would like an Italian, and they're like, All right, would you like on that oil vinegar? And can I get some mayo? And they're like, What are you what are you doing?

SPEAKER_00 35:40

They're like, leave my establishment, please.

SPEAKER_01 35:43

They're like, What are you doing? And then seemingly my dad like has always known that's a weird thing, because then he like did not say anything, and then we talked about it in the car. And I'm like mid-20s at this point, and he's like, I'm like, Why did why did that happen? Like, why did he clown me so much? And he's like, Listen, um, it's a weird thing that you do, and I was like, Oh, great, thanks. It's like my squatting form, and it's like I'm just realizing that's giving me knee pain. So, yeah, Angelos. Um, that was awesome. We gotta try that other place too. Apparently, there's a buffalo chicken cleaver.

SPEAKER_00 36:19

Oh, cleavers, no chicken Caesar. You have to get a chicken Caesar, they have like sandwiches, but you can get them on a wrap. And the good people of TikTok say that their chicken Caesar wrap is really good.

SPEAKER_01 36:31

I thought you said buffalo chicken too.

SPEAKER_00 36:33

I didn't, but I'm sure if they have that, it's good. Angela's has a buffalo chicken cheesesteak. That might be good.

SPEAKER_01 36:40

Yeah, that place is great. Um, I like the experience too. Seemingly they used to be a um like cash-only and like low-tech operation, so you'd like to stand there and listen for your name.

SPEAKER_00 36:50

I mean And you can't like order ahead. You just have to go there and you wait in line. That's cool.

SPEAKER_01 36:59

Well, it's like the lines are always so long that the the people who live next door to it have chalk written on their like pavement that says like, do not lean on this. This is private property. Do not sit on our stoop. Like, that must be a little annoying, but like, look, you live next to like a famous restaurant. Famous pizzeria. It's called a pizzeria. We still I guess we would have to try their pizza too. Um we've got this whole thing now. Yeah. I'm excited. That was great. We watched lots of TV. Um maybe too much to explain here, but Yeah, we got a lot going on right now.

SPEAKER_00 37:39

Well, we've been watching your friends and neighbors. That's been fun. Because we just realized well, I just became aware that we've had an Apple TV subscription for quite a while now. Oh well that you did not make me aware of. Thanks for that.

SPEAKER_01 37:56

You can think that I didn't make you aware.

SPEAKER_00 37:58

We absolutely watched a show that had Well, I didn't know that's what it was on. Anyway, lots of Bravo. New show.

SPEAKER_02 38:09

Oh.

SPEAKER_00 38:11

Which isn't really new news anymore because we took a break, but that's going on. That's all I got.

SPEAKER_01 38:23

You know, I go hunting for like what people do in their day and what they like. And on occasion I get the person who's like, oh yeah, I like reality TV, and now I have so much to contribute like to that conversation.

SPEAKER_00 38:34

You're welcome.

SPEAKER_01 38:35

Thank you. It makes me seem much more cultured. Uh the I don't know, I like Real Housewives of Rhode Island.

SPEAKER_00 38:43

Oh my god. Oh yeah, that's oh my god, it's so good.

SPEAKER_01 38:47

It's nice placement in the week, too. It comes in.

SPEAKER_00 38:49

I feel like it's if like early days of Beverly Hills and New Jersey made a show, it would be Rhode Island. It's so good. I love Jo Ellen.

SPEAKER_01 39:00

That's she's so problematic.

SPEAKER_00 39:02

Did I tell you?

SPEAKER_01 39:03

Her one-liners are great.

SPEAKER_00 39:04

Um, the part when I forget who was talking, but she's like, Oh, you like you said, I forget what it was. You said something about this, and then Joel, Jo Ellen was like, Well, I don't think I said that, but I definitely think that Lauren was texting me that Eric, her husband, like thought that was so funny. And I was like, Oh, yeah, when we watched that, Eddie thought it was funny and then said it sounds like something I would say. She's like, Yeah, I could see that.

SPEAKER_01 39:32

It definitely is, yeah. Well, I have typhoid Mary on the plane, on the train plane gave me um she gave me this cough after I just finished having one from January and February. Um, do you that's absolutely something you would say. I haven't said that, but I think that. Oh my goodness. Yeah, that is like right on the right on the order of your Yeah.

SPEAKER_00 40:01

Like someone asking if I'm pregnant on a public platform. And then what's my response?

SPEAKER_01 40:07

That definitely did happen. Yeah. Related to the podcast too, so it's appropriate to talk about on here. My goodness. That was a that was a hoot. Um that I think I was laughing for like 45 minutes after that. Um and obviously, if anyone related to this is listening, like there's clearly no hard feelings, but gosh, that was funny.

SPEAKER_00 40:28

I I like the rate it was at which it escalated was what was funny.

SPEAKER_01 40:34

Yes. It did. I think it took three minutes. It was an incredibly fast thing to take off. I that was oh my god. Oh wow. All right, we're having a grand old time here. Um, what do you say? Do you want to jump in or do you have more to say?

SPEAKER_00 40:55

Oh, did you want to talk about how you heard the sonic boom?

SPEAKER_01 40:58

Oh, yeah. So I so I'm sitting in the conference and I we're like at one of the big lectures, everyone's really excited about it. Good speaker, exciting things to think about. And all of a sudden I hear it like it's a sound as if like a mic drops, and then everyone starts clapping. And I just I'm sitting in the back and I'm like, what is going on? I can't, like, I don't why is everyone clapping? And turned out it was the sonic boom from Artemis entering the atmosphere, and that was a really cool thing. Subsequently, everyone ran outside and looked, and I was I'm looking, I'm seeing, and I can't help but think that I see a dot, one dot that appears from behind a cloud and then disappears behind the cloud again. And so, in my head, in later in life, if people were to ask me, did I see the landing of Artemis in San Diego serendipitously while I was there for an obesity medicine conference completely unrelated to the landing, I'll say yes.

SPEAKER_00 42:03

Oh, you want to know something cool?

SPEAKER_01 42:05

What's that?

SPEAKER_00 42:05

The um woman, now I forget her name. Um, turns out her husband is an Eagles fan, so therefore she's an Eagles fan, and they were at a Super Bowl. I don't know which one, but when they won and she had confetti from that and she brought it up to the moon.

SPEAKER_01 42:25

Did she really?

SPEAKER_00 42:25

Yeah.

SPEAKER_01 42:26

Wow.

SPEAKER_00 42:27

I saw it on our TikTok.

SPEAKER_01 42:28

Oh my gosh. Yeah, Eagles everywhere these days. No kidding.

SPEAKER_00 42:32

Yeah.

SPEAKER_01 42:33

That's fun for you, Eagles fans. Us Giants fans, it's our favorite time of year, the draft.

SPEAKER_00 42:41

It's when you remain hopeful that maybe they lost correctly during the season, so we can have a first round pick and get the best person.

SPEAKER_01 42:49

But they didn't. They can't even do that.

SPEAKER_00 42:50

But they did make the Mets are stinking it up.

SPEAKER_01 42:53

Oh gosh.

SPEAKER_00 42:53

The Mets have it's been baseball season for approximately 27 minutes. And your sweet, sweet Mets have a record-breaking losing streak already in such little time.

SPEAKER_01 43:07

Yeah. It's actually really bad. Um, they're in a very expensive team that is losing in the most fantastic ways. 10 games in a row as the time of the recording. And who knows when you guys hear this, if it's 11 or if they've broken that and squeak one out. Um, it was a nice time to go to a conference and then have to settle back into work and be like kind of busy doing that to not hang on every pitch. I turned the game on yesterday and watched it for like maybe 20 minutes while you were taking a nap and just turned it on to see a Cubs three run home run to put them down. And I was like, oh, all right, this is where we're at. They can't score a single run. And anytime that the team, the other team scores runs, that's it. That's it. That's it. So hopefully we get Juan Soto back soon and um can. Make it a competitive look. They in 2024 also were similarly like really bad and then turned it around. Time will tell. A blind squirrel finds a nut sometimes. A broken clock is right twice a day. I don't know. We'll see. We'll see. I don't know. Those were good things. Is there anything I'm forgetting? I mean, there's some good stuff here.

SPEAKER_00 44:24

I don't think so.

SPEAKER_01 44:25

Alright. So thank you for coming back to another episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or a neighbor. You can send us voice memo fan mail. Please, we are looking for the first person. I'm seeing you, Temecula, and hoping to hear from you. You show up every week and we haven't yet to hear from you. Um, and Helsinki. There are also several other people in our worldwide listenership that we are so lucky that you pop in every week to listen to us. And hopefully you continue to learn things. You can share us with your loved ones and your neighbors. But most importantly, stay healthy, my friends. Until next time, I'm Ed Delesky.

SPEAKER_00 45:09

I'm Nicole Rufo.

SPEAKER_01 45:10

Thank you and goodbye.

SPEAKER_00 45:11

Bye.

SPEAKER_01 45:18

This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.