Episode 154:
Show Notes
Lipoedema (ly-po-dee-mah) is a disease of loose connective tissue: It is a body fat, or adipose cell disorder. It sounds very similar to the unrelated disease lipidemia (lip-id-eem-ah) which is a blood fat disorder and more widely understood within the medical community. Many medical professionals may not even be aware of lipoedema as it is not taught in medical schools, and it is often misdiagnosed as simple obesity or lymphodema, a disorder of the lymphatic system.
Lipoedema was first discussed in the USA in 1940: with a diagnostic criteria being determined in the 1950’s. This is not a newly discovered disorder.
The Foldi Clinic in Germany estimated that 11% of women have this condition. This is not a rare disorder, but awareness is low. It also may occur in males with hormonal disturbances.
Lipoedema is distinct from lymphoedema, and obesity: It can occur alongside obesity and lipoedema can progress into lipo-lymphoedema, with lymphatic fluid accumulation, as the lymphatics are impacted by the accumulation of fat over time. It may also be present in the absence of obesity. This fat does not respond to calorie restriction.
Symptoms of lipoedema:
Individuals with lipoedema have symmetrically disproportionately enlarged loose connective tissue (fatty tissue) in affected areas.
- The most commonly affected areas are the lower body and legs and the upper arms, but lipoedema can also affect the abdomen, breasts and lower arms.
- Nodules can be felt under the skin. Often, but not always, the affected areas are painful.
- A heavy feeling in the legs is common.
- Excessive weight gain can occur very quickly when lipoedema is triggered to progress, often by hormonal changes in puberty, pregnancy and menopause.
- The upper body often remains disproportionately smaller with a small waist.
- A fat pad is often present under the knee.
- As the condition progresses, larger lobules of fatty tissue develop that can overhang the knees particularly and it can affect mobility.
- Often women identify with the feeling that their legs are simply “different” to those around them.
- Women with lipoedema often have lower muscle mass than would be expected for an obese women of the same weight.
- Often with weight loss, including following bariatric surgery these individuals will lose weight from everywhere other than their lipoedema affected areas.
Eat Less Move More is unhelpful and in fact harmful: Increasing exercise can increase inflammation for women with lipoedema. They often have downregulated metabolisms from a life-time of dieting and calorie restriction, which can compromise their reproductive system, mental health and immune system. It is essential to get enough protein, as these are the building blocks of life. Long term deprivation can also trigger cravings and bingeing as the body struggles to get enough nutrition to survive.
Diet culture is incredibly harmful as it encourages an all or nothing mentality - It blames and shames women who are overweight and places an unhealthy emphasis on the number on the scale.
Lipoedema is diseased fat: It is not normal fat tissue or adipose tissue. It does not look like regular adipose tissue under the microscope, with enlarged multi-nucleated cells. It does not respond in the same way as regular adipose tissue to lowering insulin levels. There are leaky capillaries in the affected tissue, which increase the growth of fat cells and lead to an accumulation of fluid, which is bound to the fat cells by GAGs (glycosaminoglycans). There is a chronic inflammatory response in the affected tissues.
Could you have lipoedema? Take our quiz:
https://www.rlmedicine.com/lipo
Lipoedema Inflammation Buster Package:
https://www.rlmedicine.com/lipoedema
Scientific paper:
“Ketogenic diet as a potential intervention for lipedema”
Scientific paper:
“Experience of participants with chronic pain in a pilot randomized clinical trial using a ketogenic diet”
https://www.futuremedicine.com/doi/abs/10.2217/pmt-2021-0084
Real Health and Weight Loss Podcast, Episode 101: Can Diet Help with Chronic Pain?
https://www.rlmedicine.com/101
Could you have lipoedema? Take our quiz here
Episode 154:
Transcript
Dr Mary Barson: (0:11) Hello, my lovely listeners. I'm Dr Mary Barson.
Dr Lucy Burns: (0:15) And I'm Dr Lucy Burns. Welcome to this episode of
Both: (0:20) Real Health and Weight Loss!
Dr Lucy Burns: (0:23) Good morning, gorgeous listeners. How are you this morning? It's Dr Lucy here and I'm still sounding a little bit husky. But I am much, much better for those of you who know that I have had a recent non COVID bog standard cold. This morning, I don't have the fabulous Dr Mary with me. Instead, I have a guest and I am super excited to have a chat with her because I think many of you will relate and resonate with her story. Now, our gorgeous guest this morning, her name is Nikki Simpson. For those of you, you may know that she now works for us. But again, we're going to chat about how that came about in today's episode. We're going to chat all about lipoedema and we're going to chat about diet culture and actually how Nikki was able to heal her own body and mind using real food as one of the pillars, but also many of the other, I guess, pillars that we teach in Real Life Medicine. So gorgeous. Nikki, welcome to the podcast.
Nikki Simpson: (1:24) Thank you, Dr Lucy, I can't believe I'm actually on here.
Dr Lucy Burns: (1:28) Well, we're thrilled to have you because gorgeous one, you have a very, very important story to share. And I'm just so happy to give a platform for your voice because the story that you have, so many women in particular will relate to it. And I think it's really important that people know about it. So I'm going to talk a little bit about lipoedema. But next week, Dr Mary and I have a bigger episode on lipoedema, the pathophysiology, the treatment, all of those things, but just as a quick summary, if you like lipoedema, which can be pronounced ly-po-deema, or some people pronounce it lip-o-deema. But I'm in the lypo category. And it is a disease of the adipose tissue. So adipose tissue is our fat, and it comprises of fat cells and connective tissues, so the tissue between the cells. And lipoedema is a condition that affects essentially both of those elements, but in particular, the tissue between the fat cells and causes the fat tissue, therefore, to be quite painful in many people. So tender, but also proliferate, ie. grow bigger than you would expect just standard fat storage. So that's a summary. It actually affects somewhere around about 11% of women, we think, the majority of whom are undiagnosed. So I am going to hand the story over to Nikki because Nikki, I would just love for you to share your story with our listeners
Nikki Simpson: (3:04) Okay. First of all, I'd like to say that I self diagnosed my lipoedema, I think it was about four years ago. Nobody was able to tell me what was going on, my legs just kept getting bigger and bigger. So ever since I was young, I have a beautiful, beautiful sister. And she has not got lipoedema. And I've always compared myself with her. So when I hit puberty and I noticed that my lower body was getting much bigger, I didn't know what was going on. I thought I'm just eating too much, I'm greedy, I need to exercise more. And that was the beginning of my horrible journey with diet culture. And I must say I dived in so deep into diet culture. So first of all, I thought, Well, I'm eating too much. So I'll eat less. I'll eat low fat. And I was living on a rice cake and an apple. That would be what I'd eat all day. And my parents, my lovely parents would make sure I had a proper dinner. So meat and veggies. But as I got older, and I noticed that my legs were still growing larger, I became more and more distressed, and I started trying more and more different things. So I tried diet shakes, I took the fat blaster pills, I don't know if you guys have heard of like thermogenic pills too. I’d exercise more and more, and I'd run, so I was exercising more, I was eating practically nothing. And then every now and again, it would just get too much. So I’d just throw it all in and I’d just eat all of the things again. I'm sure that's a familiar story for everyone. So what eventually happened when I was 19 was that I got very, very sick. And right now I'm sure that it's because I had not been eating proper food for ages. I'd moved out of my parents’ house and I’d decided that a bowl of porridge was a meal, basically. And I wasn't eating any protein, my immune system was just so low. And I developed what's called chronic fatigue syndrome. And nobody believed me at the time. That was devastating. But I'm sure that was because I was malnourished.
Dr Lucy Burns: (5:20) I think it's a common story from patients, that they have symptoms, they'll go to their healthcare practitioner and often feel dismissed or not believed. And it's really, really important that people, doctors in particular, believe their patients.
Nikki Simpson: (5:35) Yeah well that that's the one thing that I love about you, Lucy, and Dr Mary, too, is that if you don't know what's going on with something, you think about it, and you examine it, and everything. It's like a big experiment to see what's going on. Using science, of course, science based experimentation, which is the best type. I should have mentioned, I am actually a medical scientist, I did a degree. I got a bachelor of science, medical science. So I love all the sciency stuff and all the science speak. But so basically, with my CFS, I had double vision, I could not perceive depth. I could not think, I couldn't follow a line on a page. I could barely go upstairs, I'd have to lean on it. I couldn't lift a saucepan. If I went out anywhere. I'd have to sleep the entire next day. It was devastating.
Dr Lucy Burns: (6:31) Wow. So really debilitating.
Nikki Simpson: (6:33) Yeah, yeah. And this went on for 13 years. And I was very lucky to be supported by my parents and my husband, who all believed me. Believing people and listening to people, that means everything. So eventually, I had two children. And what happened when I had my babies was that obviously the insulin resistance associated with pregnancy, I gained so much weight when I was pregnant. And then after I had them, my legs swelled up. I'm like, What's going on here? And they just got bigger and bigger, and I wasn't eating more. And then I started to get really curious, What is going on here? So I started hill climbing and exercise bike for 90 minutes a day on high intensity. I did Lite n’ Easy. And I did not lose any weight. And I was like, This is scientifically impossible. How is this possible? Like calories in, low, calories out, massive, and I'm not losing weight. So that's when I started to question everything. And I actually found Dr Jason Fung’s book, The Obesity Code.
Dr Lucy Burns: (7:47) That was my book, too. That was my first book that was like, Woah.
Nikki Simpson: (7:50) It exploded my brain. And because of my background in science, it made sense to me. I'm like, Oh, this is interesting. So I read that book. And then at the same time I was Googling, as we do. “Why do my shins have fat on the front of them?” And that's where I found lipoedema. And on the lipoedema groups, they recommended keto or low carb and Dr Jason Fung was recommending keto, low carb and I’m like, Ooh, I think I’ve found something here. So what I did was I just decided, look, I've tried everything else. I'd even been to an endocrinologist. And she did tests and said that everything was normal, my thyroid was fine. And we tried appetite suppressing medication. And I was eating nothing, like literally nothing.
Dr Lucy Burns: (8:43) You weren't hungry. You weren't eating a lot anyway.
Nikki Simpson: (8:45) No, but I was eating even less and I didn't lose weight. So at that point, I decided it was weight loss surgery, or it was this new keto idea. So I threw everything I had into keto. And that was the beginning of a wonderful, exciting journey that has changed my life and turned me into a keto evangelist.
Dr Lucy Burns: (9:08) Oh, that's so good to hear. It's interesting, because one of the things I'm wondering, was that when you were, you know, spending all of those times eating just you know, nibbling on rice cake for the whole day. The weakness and fatigue that you experienced, I'm imagining that you had lost quite a bit of muscle mass.
Nikki Simpson: (9:26) I'm sure I lost almost all of my muscle mass. I was so weak, but all I cared about was the number on the scale. And that was how I got it to go down initially. I got it to go down by starving myself of protein. But because I still had a healthy BMI, I was able to convince myself that it was okay. Because my BMI says I'm okay. It doesn't matter how I feel or what I'm doing. So, yeah, the reliance on numbers is very unhealthy. Very unhealthy indeed.
Dr Lucy Burns: (9:59) Oh, absolutely. And this is, as you know, at Real Life Medicine, we really abhor the concept of weight loss at any cost. And we find that part of, I guess, part of diet culture is that it's, it is all about the number on the scales. It's all about being thin. And the idea of being thin is that you will therefore be more acceptable. And I guess for you growing up and, you know, it's hard to imagine, and it's easy to see how it happened. But that comparing yourself, your body, to a sister that doesn't have lipoedema, you know, must have been hard, all those years of that.
Nikki Simpson: (10:41) Yeah. And she never made me feel bad. My sister is a gorgeous person, but just looking at her and her size 6, size 8 frame, and then my own size 12 to 14 lower body. It was just like, What's happened here? I blamed myself. And that was really hard. And I'm sure lots of people blame themselves. But there was so much more to it that I didn't realise.
Dr Lucy Burns: (11:03) Of course, and I think this is part of it, you know, comparison, comparison-itis. But I also get it because you know, our culture is obsessed with body perfection. I'm sure it was a marketing thing. But I also believed in sort of spot improvement. So if I did more butt exercises, I would have a smaller butt.
Nikki Simpson: (11:26) Isn't that funny? It's so funny, knowing what we know now. Exercise increases the size of the muscle in that area. And you can't spot reduce fat but yes, I tried that. I did the Pilates, I was doing the leg lifts. You know, was it? Is it ThighBuster?
Dr Lucy Burns: (11:39) Oh, yeah. Yeah, yeah, Thighmaster
Nikki Simpson: (11:43) Oh maybe ThighMaster, that's the one. I had a ThighMaster. I’d sit there doing it, like all day, trying to shrink my legs. But over time, it became less of a body shape issue, that was still a big thing, but I started to develop horrible, horrible pain. I was limping around, I had hip pain, I had knee pain, I had foot pain. Basically, everything in my lower body hurts all the time. And then here I am trying to bust myself running up hills. And then I'd be limping around with a walking stick at home because I was in so much pain afterwards. And I still couldn't understand why my legs weren't shrinking. And um, that's where it's very important to understand what lipoedema is. And that the normal approach does not work, it does not work. In fact, it makes it worse. It lowers your metabolism. So this is what happened to me. I started out eating normal-ish amounts, cut them down. And I lost a little bit of weight at some point. And then when I couldn't sustain it anymore, because I was starving, and I went back to the normal amount of food. I just packed weight on really, really quickly. And it was so confusing. I didn't know what was going on. And I think a lot of it was in pregnancy too, that I wasn't starving myself anymore, because I was thinking of the baby. So I think this might happen to a lot of women. But I packed the weight on very quickly. I think I packed on 20 kilos, and I wasn't over eating, I was eating like rice and veggies and small amounts of chicken and all those things, lots of healthy grains, you know?
Dr Lucy Burns: (13:28) And certainly we know in lipoedema that pregnancy will increase lipoedema tissue often, not always, but often. And that combination of physiological insulin resistance, which I also have, which Dr Mary has, which means that you will, your body stores fat way more easily than it would if you're not pregnant, which in itself is not a terrible thing. Again, the body is clever, trying to work out, it's trying to imagine that, you know, after the baby's born, you need to have fat reserves to make breast milk blah, blah, blah. But the problem is that you know, we're not living on in the wild plains of Africa anymore. We live in a hyper palatable, obesogenic environment where there's food at every stop. So it's really interesting, but what I want to know, I guess now Nikki, what I'd love you to share, is what happened next. So you found Jason Fung, you'd read about lipoedema, people are going, Yep, let's do low carb, you thought, Oh, I'll give it a crack, got nothing to lose.
Nikki Simpson: (14:26) Okay, so I was feeling very weak, very tired. And I had nothing to lose. So I threw myself into this. And I committed myself to stick with it, even if it didn't seem to work at first because nothing else was working. And I think that really worked in my favour. Because I was willing to let the scale do what it did. And just keep going. And I think that's key. Just keep going. So I actually started out very badly. I didn't understand about electrolytes so I thought that Powerade Zero was an electrolyte.
Dr Lucy Burns: (15:03) Not unsurprisingly, because that's what the ad tells you it is. So you know.
Nikki Simpson: (15:08) It does, it does. So I was confused. Like, Why isn't this working? I had the worst keto flu, like transition period, ever, I was so weak and so sick because I was eating like Quest Protein Bars. And I was taking Powerade Zeros as my electrolyte. And I felt sick. But I was continuing to read ‘The Obesity Code.’ And in ‘The Obesity Code’, I learned about real food being better than fake food. So I was quickly able to tweak it, so that I was eating vegetables, meat, fish, back then I ate egg, dairy, nuts, all of those things. And I noticed that my legs stopped hurting. And I was like, What is going on here? Also, I had swelling in my feet. And it just went away. I was like, What is this? This is really, really good. So I got excited. And I started reading more and more. I joined all of the keto groups I could find. And I started sharing what was going on. Because I think by about six months in, I'd lost 30 kilos. And I hadn't been able to lose anything by starving myself. I started feeling really healthy. I had sinus infections all the time. And they went away. I'd had migraines constantly every month, they were gone too. And I just thought, What magic is this? I must tell the whole world about this. So I still have lipoedema. My legs, actually, as I lost weight, it became more obvious. You could see the nodules, and you could feel the nodules, they're like kidney beans maybe under my skin. And they still hurt if they have pressure on them. But all of my hip pain was gone, all of my knee pain was gone. All of my leg pain was gone. My skin that had felt stretched out and horrible, like it felt like it was going to split, like the tissue started feeling soft. And it's just the best thing ever. I can't rave enough about how much better I felt. And I just thought this is a revelation, I have to help all of the people. So I volunteered to moderate a keto group. And I got to share information with people and support people. And that made me feel so happy. And then one day while I was in the group, this wonderful doctor popped in to teach us about real food and low carb. And we were selling like gluten wraps and
Dr Lucy Burns: (17:50) Processed foods yes.
Nikki Simpson: (17:52) And I just connected with everything Dr Lucy had to say. It was so exciting. So I immediately started following Real Life Medicine. And I noticed that I had a problem with sugar. So even through all of this, I didn't realise I had a sugar addiction and a sweet craving that had driven my behaviour in the past, when I wasn't being perfect. So I've noticed some amazing things like that I actually am addicted to processed food, not just sugar, which I didn't even realise was possible. I thought that it's just sugar. But no, it was all processed food. And I worked out that I was unable to regulate processed food, which means that if I'd start eating like a protein bar, so it's a keto protein bar, good ingredients, nice and clean, but sweet. I’d buy a box of them, and they'd be sitting there whispering to me from the cupboard. And I'd end up eating three or four of them and then being disgusted with myself thinking, What's going on here? What am I doing? I think it's important to note that if you can't regulate these foods, they will make you gain weight, potentially and feel less than perfect as well.
Dr Lucy Burns: (19:16) Yeah, and this is I mean, as you know, listeners, we talk about this a lot. There are certain foods for certain people and they're all different. So there's no particular prescription here. This is about you working out for yourself, what are the foods that you find difficult to regulate? What are the ones that when you have some, they then call your name in the cupboard? And they're not necessarily things that you would expect. I know you all know this that nuts and it's not all nuts for me, it's just salted cashews, salted macadamia nuts. If I have those, even though they're, particularly the macadamia is a green list, I can wolf down a whole packet of those, 200 grams of them, which is probably unhelpful. Plain macadamia is way less so. And same with almonds. I can eat a few almonds and I don't care about them. They don't call my name. So I agree with you, Nikki, I think it's really important that people do recognise and this is where I guess that self reflection comes in, where you can reflect on what's happening for you. And the question is always asking yourself, in really gentle kind terms, what's going on for me here? What's happening?
Nikki Simpson: (20:25) Yeah, really, really exciting thing that happened for me when I quit processed food, processed keto foods, so I quit the wraps, I quit the bread. I've had gut health issues for as long as I can remember. And cutting out the processed keto food was like a miracle on top of all the other miracles. And my gut health just improved out of sight to the point where I was now asymptomatic, after suffering for years and years and years. For me, also, quitting processed food made me lose more weight as well. So the processed keto food, was keeping me out of plateau. And when I cut that out, plateau busted. It just went steadily downhill from there until I found my perfect spot where I settled and stayed ever since, for four years. So that was really good. I must mention, though, that I did have terrible, terrible iron stores. I'm sure this is a story common to many women. My ferritin was, I think it was 14. I've had lots of iron injections in the past, lots and lots of iron supplements. Iron injections hurt when you have lipoedema. They put them in your thigh and it inflames everything. It was the most awful, awful experience ever. And it didn't hardly raise my iron. But eating more meat for me has been important because it's got my iron up, stopped my hair from falling out. And it's just been another factor in feeling energetic. I used to be very pale and very weak. I don't recognise myself most of the time now.
Dr Lucy Burns: (22:07) I know because now you are a strong woman.
Nikki Simpson: (22:11) Yeah, strong woman. Isn't it wonderful to celebrate that? I can't wait to get stronger and stronger too.
Dr Lucy Burns: (22:19) Yeah, and again, part of you know, we often talk about identity. So your, you know, again, your identity in the past was, was that you were probably again, inadequate. That you're not bodily perfect. So you identify all around, you know, fat, ugly thighs, or you know, fat ugly arse. That was my one, big arse. One day I was walking to the beach, and it was just me and I lived near the beach at one stage. And this bunch of boys hung out the window and they yelled out fat arse. And I look around and I realise I'm the only one in the street. They’re clearly talking to me. I thought, Oh my god.
Nikki Simpson: (22:57) It’s devastating, isn't it? So hurtful. And they don't realise. Or maybe they do and they don't care.
Dr Lucy Burns: (23:03) Yeah, they do it to get a rise. But the interesting thing is that, you know what? This doesn't actually matter. We've all got different arses, just like dogs, all different shapes, all different sizes. And I think that we just need to again recognise that we don't all need to look like Elle MacPherson. Interestingly, of course, that was back in the 80s or 90s or early 90s. And these days, of course, everyone wants a bigger booty. I probably had the best arse ever. So anyway, who knows?
Nikki Simpson: (23:33) Can I talk a little bit about how, for me, the conservative management for lipoedema has been everything. For me, with lipoedema, I see a lot in the chat groups that basically everyone thinks that surgery is the answer. And I just want to share my journey for those people who are considering surgery, and I know surgery has helped some of my friends. For me with lipoedema and conservative management, I was able to lose 30 kilos, I was able to manage my pain, eliminate my pain. I was able to remove the lymphoedema components from my lipoedema. Which was huge. So no more swelling in my feet. I was able to improve my gait, so I was able to walk easily and stop the thigh chafing.
Dr Lucy Burns: (24:27) Yeah, that sort of waddle, waddle that sometimes women with lipoedema get.
Nikki Simpson: (24:31) Yes, I was able to change almost everything except for the little nodules that are remaining in my legs. But I felt great. And I was able to fit into most of my old clothes. They say that you can't reduce lipoedema with diet, maybe normal diet, but for me low carb real food, it did reduce. It reduced a lot. The swelling was much, much less, the pockets on the front of my shins went from being like, quite large to almost gone. It was very effective. When I learned about conservative measures like the compression tights. First, I hated them. But then I got used to wearing them. And the swelling went down even more, I felt better and better, the tissue, the inflammation was gone. And eventually, I had very little pain. So I did go ahead and have surgery. And I thought that if I had surgery, that I would have a normal body shape. And I want to say that for me it, it really hasn't made much of a difference. Honestly, it hasn't.
Dr Lucy Burns: (25:50) Yeah, absolutely. And I think it's like lots of things, we have levers or tools, you get to pull the levers. So one of the levers is getting rid of processed food. And this actually goes whether you have lipoedema or not, this is for everybody. Another lever is managing stress. Another lever is, you know, trying to prioritise your sleep. I guess then there's the sort of the fourth or fifth or whatever lever we're up to, and that for some people, and depending on what condition you've got, might be surgery, it might be medication. So again, whether you've got lipoedema, whether you've got type two diabetes, whether you've got severe insulin resistance, they're all just levers to pull. You know, and again, you experiment with them, but the more levers that you can pull, then the better your outcome is, rather than just relying on one particular lever. And I think that's really important. You're right. I mean, I know, again, in the lipoedema community, there is a lot on surgery, and it certainly has its place. And there are many women who's who have a very advanced lipoedema who who really, their mobility is grossly impaired, and they regain mobility, which of course, you know, mobility is part of your quality of life. So it's certainly no judgement. But the thing that I think that a lot of people miss is to get the foundations first, because they're important for everything.
Nikki Simpson: (27:14) Yeah, I didn't realise how well I was doing until it made very little difference to me, basically. So the lifestyles, everything, like sleep. You pointed out sleep. I progressed my lipoedema a lot when I had very little sleep, because I have two children who have special needs. And my first child slept about three hours a day, which meant that I slept even less. So that was when I think I advanced from stage one to stage two.
Dr Lucy Burns: (27:52) Yeah. So lovely listeners, I guess this is, you know, again, this is an example of a story. And it's for a particular condition. The reason we were talking a bit about lipoedema in June is that it is Lipoedema Awareness Month. But this story, this could be the story for somebody who has fibromyalgia, this could be the story for someone who has type two diabetes, it's the same story, just insert different condition. Because most of us have gone down that path of trying to lose weight to improve your condition, we're finding out that actually, what we've done is weight loss at any cost, which doesn't therefore, take into account the needs of the human, ie you, what you actually need. And instead of focusing on nourishing, we focus on punishing. So lovely listeners, we are going to link in the show notes, a couple of papers that are around low carb or ketogenic approach for lipoedema and also a ketogenic approach for chronic pain. So both of those are scientific evidence. So you know, I'm not just sort of using a bit of woo, these are scientific evidence that these approaches can be helpful. And also just a link to our Lipoedema Inflammation Buster Package, which is really an approach on low carb real food, along with hypnotherapy and a stress management program. All of those together, will absolutely pull one, two or three of your levers in improving your lipoedema. Or, in fact, really, any inflammatory process. Gorgeous Nikki, it has been a delight talking to you. I'm so thrilled to be part of your flourishing journey. And I look forward to many many years of flourishment.
Nikki Simpson: (29:39) I can't wait to see what's going to happen next. It's just been the most exciting time of my life.
Dr Lucy Burns: (29:45) Excellent. Lovely listeners, we will see you next week. I'll be back with Dr Mary. Take gorgeous care of yourselves. Bye for now.
Dr Lucy Burns: (29:58) So my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr Lucy Burns…
Dr Mary Barson: (30:05) and I'm Dr Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com
Dr Lucy Burns: (30:16) And until next time…
Both: (30:18) Thanks for listening!
Dr Lucy Burns: (30:20) The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide, individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
