A Nurse Was a Hamburger Shy of a Heart Attack. What She Did Next

Episode 02. One hour, unscripted. Watch on YouTube · listen on the podcast feed.

Julie Hittleman has been a nurse for 25 years. She has spent a career keeping other people alive, and for most of it she could not fix her own health. She described herself, in her own words, as the fat friend with the funny sense of humor.

In April of 2020 she was 265 pounds. Fatty liver. Pre-diabetes. High blood pressure. High cholesterol. Plantar fasciitis. Knees that hurt. She was an essential worker in an N95 mask during the shutdown, and she could not climb a flight of stairs.

She booked a telehealth visit to ask for Lasix, a water pill, because she figured she was just retaining water. The doctor on the other end of that screen had worked beside her in primary care for 10 years.

He told her he was not writing that prescription. He was sending her to cardiology, because he thought she was in congestive heart failure.

She is clear that he only said it because he knew her. Most doctors will not talk to a patient that way. She thinks they should.

How does a nurse end up unable to help herself?

Her answer is not an excuse, it is an indictment of how clinicians are trained. Doctors and nurses get very little education in nutrition. They get book knowledge and they get practical care. Julie knew how to diet, because dieting is what she had been taught her entire life, and dieting is a skill in restriction, not a skill in health.

She had failed every diet under the sun. A friend kept offering her what was working, and Julie told her to kick rocks. It took the doctor to move her, and even then she gave it 30 days as an experiment.

What actually changed, if it was not the diet?

She released 120 pounds in 11 months. That is the number people latch onto, and she moves past it fast, because the physical weight came off before the mental weight did.

About five months in, her coach handed her a book on mindset and habits, and she started doing what she calls mental push-ups. That is when the thing underneath the food finally surfaced.

What she was managing with food was a dysregulated nervous system. Grief she had never processed. Losing her mother at 59, when Julie herself was 49 and had just been told she was going to die. She could not say yes to a diet for her own sake. She could say yes for her kids, so they would not lose their mother the way she lost hers.

That reframe is the whole episode. It was the first time in her adult life she was trying to create something instead of fix something.

Why does she refuse to say cheat meal?

She asks her clients a question that makes them sit up. How many days a week do you cheat on your husband?

They react exactly the way you just did. Then she asks why not, and they say because I made a commitment. Her point lands on its own: you made a commitment to yourself too, so who are you actually cheating?

She compares a cheat meal to a person 90 days clean deciding to use once. The framing itself keeps you inside the identity you are trying to leave.

What is the dopamine trap?

This is where the nurse shows up in the conversation. When you are stressed, tired, or upset, your body goes looking for comfort. Food, especially sugar, gives you a dopamine hit, and dopamine is fast and short. What people actually want is serotonin, which lasts.

So you get the calm for a moment, the dopamine drops, and now you are beating yourself up about the argument and the chocolate. Then the discomfort sends you back for another hit. That is the loop, and it is chemical, not moral.

Her tool for breaking it is unglamorous. A pause. One deep breath, shoulders down, and three questions. Why am I doing this? What am I going to get from it? Is that what I want long term? She calls the pause the difference between responding and reacting.

Her point about the weather is that no feeling lasts. Think about the greatest joy you have ever felt and how long the feeling itself actually held. Uncomfortable feelings work the same way. Let the weather pass, drink some water, choose differently, and the new choice becomes the new pattern. She says it is easier to build a new habit than to break an old one.

What is the difference between an ex-smoker and a non-smoker?

Julie quit smoking eight times. The eighth one held, on her birthday in 2008, and she has never gone back.

The difference on the last attempt was not willpower. Every previous time she wanted to drop the habit but was not willing to live the life of a non-smoker. She kept going to the same places and standing in the same doorways. She still saw herself as a smoker who was not smoking.

An ex-smoker is still a smoker in the mind. A non-smoker is a different person. She did the same thing with her health: she stopped being a dieter and became someone who is healthy, and she says she genuinely cannot get back into the head of the woman she was six years ago, because she is not her.

What is the difference between symptom free and healthy?

This is the part of the conversation that should bother people, and it is the reason her practice exists.

She watched the system she worked inside manage symptoms rather than restore health. She watched disease get treated as normal. Her framing is that a person can be on medications that hold every number in range and still not be healthy, because the underlying metabolic dysfunction never got addressed.

Her own reversal is the proof she leads with. She came off medications. She reversed conditions she had been told she would simply live with. Her site puts the mission in five words: stop managing symptoms, start restoring health.

Who is Julie Hittleman and what is Hittleman Health?

Julie is a registered nurse of 25 years turned metabolic health coach, with advanced certifications in metabolic health and nutrition science. Her practice is Hittleman Health. By the numbers on her own site: 120+ pounds released personally, 500+ lives transformed, 20+ years in healthcare.

Her results wall is worth reading in full. Her husband Scott released 103 pounds, which puts the two of them at 223 together, an entire person. Stephanie, who was Julie's patient back when Julie was a nurse at UCLA, released 165 pounds, came off three diabetic medications and a walker, and is now a coach herself. Lanney started right after his 80th birthday and beat his goal. Richard was 71 and certain nothing would work, and released 65. Ian released 60 in 90 days.

Where do you start?

She offers a free metabolic health scan. It takes three to five minutes, costs nothing, needs no credit card, and she reviews every single one personally and follows up with next steps.

She also writes a blog called Dear Her, letters to the woman she used to be. Her own Day One was May 25, 2020, the morning she took a photo in harsh bathroom light and wrote that she was not just unhealthy, she was disappearing. She kept the picture she wanted to destroy.

How to reach Julie Hittleman

Practice: hittlemanhealth.com. Free metabolic scan: take it here. Her writing: the Hittleman Health blog. Her show: Substack. For anyone who wants to do what she does: the coach opportunity. On Facebook and Instagram she is Julie Stern Hittleman.

This episode is a conversation, not medical advice. Julie's results and her clients' results are their own and are not a promise of yours. Nothing here diagnoses or treats anything. Talk to your own physician before you change your medications, your nutrition, or your exercise.