Tag Archives: mental-health

Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

Obesity.jpg
Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight.  We’ll also set the table for losing weight by discussing why weight gain occurs.  It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?
obesity1
As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss?  What’s the balance between family predisposition and the foods I eat?

diet-goals

No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?

weight gaim while active

The most simple way to answer this is that weight gain occurs from an energy imbalance.  You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both.  I mentioned in a previous post on caloric counts that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound.  It takes work.  This is the simple answer as to why fad diets don’t work long-term.  You can’t cheat the equation.  The moment you stop being diligent, you’re headed in the wrong direction.  Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask any questions or submit any comments you have.
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Straight No Chaser: Examining Obesity – Is It Really a Choice Between Health and Happiness

obesity4

Obesity in the United States places many at a crossroad between self-esteem and health.  Often, larger frames are celebrated as more desirable.  Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise.  Of course, our culture embraces and contributes to obesity.  Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport.  I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.obesity_trends_20092
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health.  If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed.  As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:

Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.

Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.

‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
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Straight, No Chaser: Sexual Deviances and Perversions (Paraphilias)

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This is a serious conversation that I won’t sensationalize or joke about. The mental health disorders known as paraphilias (commonly referred to as sexual deviancies or perversions) represent a disturbing level of dysfunction that has devastating consequences for victims. This Straight, No Chaser will provide an overview of these disorders as categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM).
First, here’s a working definition from the DSM: paraphilias involving recurrent fantasies, urges or behaviors of a sexual nature that center on children, non-humans (animals, objects or materials), or harming others or one’s self. That definition isn’t especially difficult to understand, but what is more difficult to appreciate is these deviants (and often predators) suffer from mental illness and aren’t just “bad people.” What’s especially difficult for society to reconcile is when and if treatment is more appropriate than punishment.
Here’s a list of recognized sexual deviancy disorders, which will be individually discussed in future posts. It is important to note that some of these behaviors occur in the general population in certain circumstances (e.g., between consenting adults) and only are defined as mental disorders when the activity becomes a compulsion, interfering with normal function and/or behavior.

 paraphilia exhibitionism

Exhibitionism: the compulsion to display one’s sexual organs to strangers. This compulsion increases until relieved by the act of exposure.

paraphilia shoe fetish

Fetishism: the habit of having sexual energies fixated on an object. Typical objects include garments such as shoes or underwear or may involve materials such as leather or rubber. The objects of fetishes often are required to achieve orgasm.

paraphiliaFrotteurism

Frotteurism: the compulsion to rub ones self against strangers others in a sexual manner. This compulsion increases until relieved by the act.

Paraphilia Pedophiles

Pedophilia: the act of a sexually mature adult fantasizing about or engaging in sexual behavior with children who haven’t achieved puberty.

paraphilia sadomasochism

Sadism and Masochism: the habit of engaging in sexual encounters where the focus is on causing (sadism) or receiving (masochism) physical and emotional pain, embarrassment and humiliation.

paraphilia transvestism

Transvestism: (aka cross-dressing) the habit of an otherwise “normal” heterosexual male having fantasies about and/or dressing in woman’s clothing, which is usually sexually arousing.

paraphilia voyeurism

Voyeurism: the compulsion to fantasize about and/or actually spy on an unsuspecting person in the act of undressing (aka being a “peeping tom”) as part of a person’s sexual routine.
The DSM also includes a Not-Otherwise-Specified category of paraphilias, including such actions as a chronic preoccupation with making obscene telephone calls, relating sexually to only a part of another’s body, dead people, animals, feces and urine.
Sexual perversions generate many different emotions in victims and the general public. Perhaps Job One is to be conscious of your surroundings and the situations in which you place yourself. Although in most instances you can’t control the inclinations or prevent the actions of others, you can control the choices you make that increase or decrease your risk of becoming a victim of a sexual deviant.
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Straight, No Chaser: Personality Disorder Screening Quiz – Now It's Your Turn!

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It’s been an interesting week of responses from you on the series of personality disorders. The most common comment was a request for an ability to test oneself. I’ll provide that information to you, but beforehand, here are the links to the other Straight No Chaser posts on personality disorders.

  • Introduction: Understanding Personality Disorders
  • Cluster A: Paranoid, Schizoid and Schizotypal Personality Disorders
  • Cluster B: Narcissistic, Histrionic, Antisocial and Borderline Personality Disorders
  • Cluster C: Obsessive-Compulsive, Avoidant and Dependent Personality Disorders

We need a disclaimer here. The link to this personality quiz states pretty clearly that it’s for entertainment purposes only. The results will provide you with a trend, not a diagnosis. It’s a good way to reinforce the information from the previous posts and to learn a little bit more about yourself. In case you were wondering, I scored Doctor Personality Disorder.

ilovemyself

Here’s the link to the quiz:

http://www.helloquizzy.com/tests/the-personality-disorder-test-5

I welcome any feedback or questions you have about the topic or the quiz. I think it’s safe to say that most of you should have fun with this quiz.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Intersection of Health and Happiness, aka Merry Christmas!

 healthhappiness

Today is Christmas, and we want to celebrate the best parts of you! Even better, do that for yourself and allow that to translate into better health. We have previously discussed your bad habits and how they negatively impact your health. Click here for that discussion. The literature on negative energy and health is well documented and robust. In short, avoid negativity and those that bring it to you! That said, we’re following our own advice and going positive today. That’s the other half of the “health and emotions” equation:

STATE OF MIND = STATE OF BODY.

So here we go.

Research from the Harvard School of Public Health (Go, Crimson!) led by Laura Kubzansky, Associate Profession of Society, Human Development and Health, identified personal attributes that actually do translate into better health. Specifically these personality traits have been shown to help avoid or healthfully manage depression, diabetes, heart attacks, strokes and other diseases.
Her landmark 2007 study followed over 6,000 men and women for over 20 years, discovering that a sense of enthusiasm, hopefulness, engagement in life and the ability to face life’s stresses with emotional balance appears to reduce the risk of coronary heart disease. Her studies have also demonstrated that children with a positive outlook and ability to focus on a task at age seven are in better health with fewer illnesses 30 years later. An additional finding of hers is that optimism cuts the risk of coronary heart disease in half.
This isn’t that hard. It just requires a rewiring of some of our outlook on life. Make a change today. Become a more positive person; become a healthier person! Incorporate these mental lifestyle changes and reap the benefits.

  • Emotional vitality: a sense of enthusiasm, hopefulness, engagement
  • Optimism: the perspective that good things will happen and that one’s actions account for the good things that occur in life
  • Supportive networks of family and friends
  • Good “self-regulation,” i.e., bouncing back from stressful challenges and knowing that things will eventually look up again
  • Healthy behaviors such as physical activity and eating well
  • Avoidance of risky behaviors such as unsafe sex, drinking alcohol to excess, and regular overeating

xmashealth

Speaking of Christmas, the Straight, No Chaser team greatly appreciates your readership, support and feedback. In a matter of a few months, over 3,000 of you both follow us and like us on Facebook. We’ve had readers in over 105 countries around the world. Most of all you’ve helped us successfully launch www.SterlingMedicalAdvice.com (SMA). We’ll continue to give you information to make a difference in your lives. Please continue to share your stories. It is very fulfilling and fascinating to hear how these efforts have made a difference in your lives. Feel free to continue to send us topic requests. We generally find a way to work them into the schedule.

Thank you so much, Merry Christmas, Happy Hanukkah, Happy Kwanzaa, peace and blessings throughout the holiday season.

Feel free to ask your SMA expert consultant if you have any questions on this post.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

masstrauma nairobi shootings

This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack or the effects of war, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

Unfortunately, some just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid”. This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Click here for a related Straight, No Chaser on Mass Trauma, and here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
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Straight, No Chaser: Do medications work differently in older people?

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The elderly are living longer and more productively. Part of being able to do so is by maintaining an understanding of how your actions  affect you. One common action of many of the elderly is taking medications. You should be aware that medications have changing effects with aging, and there are many different reasons for that fact.
First of all, changes in our physiology due to aging make the effects of drugs less predictable and consistent than in younger people. A slower metabolism, increases in body fat and alterations in the function of the kidney and liver (major mechanisms for drug elimination) have important ramifications for what ingested substances will do. Thus, the elderly require more stringent monitoring of drug levels and effects, and you may find that your physician needs to adjust medication doses. This same consideration explains why side effects are more common among the elderly.
Be reminded the presence of other diseases brings additional effects and challenges. Just as with one’s own relatively diminished function, disease imposes the same type of changes onto the body. This can speed the presence of side effects and toxicity as well as adjust the effective dose of a medication.
Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
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Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
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Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

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For a review of PTSD signs, symptoms and those at risk, click here.
Not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

  • At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
  • At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
  • At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse, or other anxiety disorders.
PTSD is typically treated with either psychotherapy (“talk” therapy), medications, or both. Mental health professionals will review and discuss all treatment options with you prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft), and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger, and the feeling of numbness inside. Taking these medications often make it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

  • Headache
  • Nausea (feeling sick to your stomach)
  • Sleeplessness or drowsiness
  • Agitation (feeling jittery)
  • Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex.

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, it’s very simple. Please get evaluated and get the help you need.
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Straight, No Chaser: The Holiday Blues – Tips to Deal with Depression and Stress This Time of Year

HolidayDepression Holiday_Depression-300x199

I don’t mean to bring anyone down during what is supposed to be the ‘most wonderful time of the year’, but in reality there are many people hurting. For some, life’s tragedies happen this time of year the same as they might any other time. For others, this may have already happened, and this time of year is a permanent reminder of an unfortunate experience. For others still who struggle with depression, anxiety and mental illness all year, the holiday season can exacerbate these feelings and may make holidays especially long, depressing and potentially dangerous times.
My goal today is not to drag you into the dumps but to empower you with tips to assist you in the event this is a difficult time for you. By the way, I’m extremely thankful that you’ve chosen to give me moments of your day and life. I take that gift seriously and hope you continue to find it a worthwhile use of your time.
Here’s five tips for your holiday mental health:

  1. Remove yourself from stressful environments and avoid situations you know will create conflict, mental duress and/or danger. I can not emphasize this enough. If you put yourself in a bad situation, you can not be surprised when bad things happen.’
  2. Find support. Specifically, have ‘go-to’ friends and family that provide you comforting support. There’s a time and place for tough love, but in the midst of depression or suicidal ideation, ‘buck up’ is not good advice. Know where your support lies and be sure (in advance) that it will be accessible if you need it.
  3. Find success and happiness where it is. During the holidays, people tend to lament what isn’t. That’s not a formula for success. Yes, all of your family may not be around, but celebrating happy memories with the ones you can often fills the room with the joyous presence of loved ones not around. Enjoy the pleasures and successes you do have access to, whether big or small. Focusing on the positive keep you positive.
  4. If you’re struggling, admit it.  You already know you’re hurting. Often the first step to getting past it is acknowledging it. Once done, then you can put coping mechanisms in place to address your feelings.
  5. Avoid holiday activities that will create post-holiday angst. This applies to eating, drinking, shopping and personal interactions. Some use the holiday as an excuse to overindulge as if the consequences won’t be there afterwards. Reread #1 above.

Know when you need professional help. If your support system doesn’t sufficiently address your needs, and you’re feeling severely depressed, can’t function or are suicidal or homicidal, find a physician or mental health professional ASAP. Of course, you can always contact your SterlingMedicalAdvice.com expert. If you type mental health, depression or other keywords into the search bar above, you can access many other Straight, No Chaser blogs on behavioral health concerns that may provide you the support you need. I wish you all the best today and throughout the year, and hopefully the picture below will reflect the only type of blues you’ll have to deal with this year.
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BBKING_SU_C_^_SUNDAY

Straight, No Chaser: When Eating Goes Wrong, Part I – Anorexia

anorexia-nervosa

Our society doesn’t do the job it should in promoting a normal image of health. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is obese by medical standards, this becomes even more of a problem, as individuals give up on realistic goals and settle into unhealthy eating habits that lead to disease due to obesity.
Most people are aware of two eating disorders–on the low side (obesity is another conversation): anorexia and bulimia. It is important to note that eating disorders are real medical and mental diseases. It is equally important to understand that they can be treated. It is vitally important to understand that when left untreated these disorders lead to a much higher incidence of death than in those without these conditions. These diseases cause severe disturbances in one’s diet, so much so that individuals spiral out of control toward severe disease and death in many instances. Sufferers of eating disorders often have a distorted self-image and ongoing concerns about weight and appearance. (This is as true for those pathologically overweight and in denial as it is for those pathologically underweight.)
Today, I’ll discuss anorexia. Anorexia nervosa is an eating disorder with nearly a 20 times greater likelihood of death that those in the general population of a similar age. Why, you ask? Simply put, they’re suffering the consequences of starving themselves. Anorexics have a maniacal and relentless pursuit of thinness, even in the face of being extremely thin. They couple an unwillingness to maintain a healthy weight with an intense fear of gaining weight. They possess a distorted view of their bodies and severely restrict their eating in response. They are obsessed.
Other symptoms and habits of anorexics include a lack of menstruation (among females, though men suffer from anorexia, too), binge-eating followed by extreme dieting and excessive exercise, misuse of diuretics, laxatives, enema and diet medications. The medical manifestations of anorexia are serious and can include osteoporosis or osteopenia (bone thinning), anemia, brittle hair and nails, dry skin, infertility, chronically low blood pressure, lethargy and fatigue, and heart and brain damage. It’s worth noting again that people die from anorexia. It is to be taken seriously.
The key components of treating eating disorders in general are stopping the behavior, reducing excessive exercise and maintaining or establishing adequate nutrition. The pursuit of adequate nutrition is vital enough that when patients develop dehydration and chemical imbalances (i.e., electrolyte abnormalities), they need hospitalization to correct deficiencies.
Specific management of anorexia involves addressing the psychological issues related to the eating disorder, obtaining a healthy weight, and consuming sufficient nutrition. This may involve various forms of behavioral therapy and medication. Regarding medication use, although some (such as antipsychotics or antidepressants) have been effective in addressing issues related to anorexia such as depression and anxiety, no medication has been proven effective in reversing weight loss and promoting weight gain back to a healthy/normal level. Similarly, behavioral therapy has been shown to assist in addressing the roots causes of anorexia but insufficient in addressing the medical issues that the disease contributed to or caused. Ultimately, it appears that a combination of medications, other medical interventions and behavioral therapy is the most effective course. As is the case with most illnesses, the earlier treatment is initiated, the better the outcome tends to be.
Please maintain a sufficient sensitivity toward those with anorexia. It’s a life-threatening condition, not the punch line of a joke about someone’s appearance.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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About SterlingMedicalAdvice.com: What's Next?

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SterlingMedicalAdvice.com is creating a virtual healthcare universe.  You can look forward to the following offerings.

Nov. 1: The launching of www.SterlingMedicalAdvice.com, including the Sterling Advice plan and the Sterling Advice Plus plan.  The Sterling Advice plan offers you personalized, immediate 24-hour advice and information from physicians and other medical specialists covering all medical specialties. The Sterling Advice Plus plan incorporates the offerings of the Sterling Advice plan and expands it to include pharmacy, mental health, dentistry, nutrition and personal training.

Dec. 1: The launching of SterlingMedicalAdvice.com’s Wellness and Smoking Cessation Programs. These modules will allow you to follow a best-practice program to improve your health over the long-term. This is a perfect addition to your employee benefits program. Employers, take note!

Jan. 1: The launching of SterlingMedicalAdvice.com’s Spanish language platform. All of the offerings of www.SterlingMedicalAdvice.com will be available in multiple languages for multiple audience.
Hablamos español!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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Straight, No Chaser: Save a Life, Save a Trip, Save Your Cash!

New Logo

In the last 20+ years of caring for patients in emergency rooms (ERs) in communities all over the country, and in 12 years of healthcare consulting in 36 states and countries, my team and I have had the unique privilege of serving all age groups, genders, and health conditions, from sprains to strains, moans and groans, sniffles and whistles, trauma and the flu.
However, in the ER setting, well over half of the people we see every single day would say they could have saved themselves the trip and the cost “…if I only knew.” Straight, No Chaser has given me the privilege to talk with you in a relaxed environment about urgent and non-urgent issues that concern you. It has been fun for me, especially because you have responded in a way that lets me know that my goal of empowering you with knowledge to make your own healthcare and financial decisions for you and your family is being realized. Because this works for your health and your wallet, I have expanded the service from Straight, No Chaser to http://www.SterlingMedicalAdvice.com. Not only will you have access to thousands of tips, fun facts, and frequently asked questions about the full spectrum of health topics, you will also have access to your own personal healthcare consulting team. That’s right, you can chat 24/7 with experts in medicine as well as fitness, dentistry, nutrition, mental health, pharmacy, and other healthcare entities.
So, when the time comes that you need to make an informed decision for yourself and/or your family member, we’re here for you. If this turns out as we desire, this service will become part of the national healthcare system and may be covered by your current insurance interests or as an employee benefit. Beginning today, November 1 at 12 noon Eastern Daylight Time, join me and hundreds of other healthcare experts who have signed up to turn the tide in our country by putting the power of your health back in your hands and saving you the time and costs of unnecessary visits to the emergency room and pharmacy. A subscription counts as payment toward your deductible (if you have insurance) and equates to less than a third of what Americans pay out-of-pocket EVERY YEAR for ER and doctor visits. Try us, and discover the difference having a team at your fingertips will make in your health. We at SterlingMedicalAdvice.com are looking forward to keeping the knowledge flowing,
Jeffrey Sterling, MD
President and CEO
SterlingMedicalAdvice.com
Your Personal and Immediate 24-Hour HealthCare Consultants

Straight, No Chaser: Keys to Mental (Un)Health and (Un)Happiness

Mental Health

Everyone has thoughts about the keys to happiness, but we can objectify the conversation and identify what’s most likely to make you unhappy and lead to depression. You may find this hard to believe, but outside of medical causes of psychiatric illness and factors outside of your control, there are actually three choices we make that most commonly adversely impact your happiness and good mental health. Take it for what you will, but the data is what it is. Stay away from these circumstances, and you’re less likely to be unhappy. Sometimes it’s about addition by subtraction.
Health Problems: People who are sick or have significant illness in their families generally aren’t happy. Although this may seem obvious and perhaps unfair, given that some illnesses and conditions are inherited or occur haphazardly, be mindful of the things you can control. Of course, this gets to the negative effects of obesity and smoking. More so than any other health-related activities/conditions, these will eventually lead to deteriorating health and subsequent unhappiness.
Job Problems: You don’t have enough to do with your time? Yep, an idle mind is the Devil’s workshop, as the saying goes. It should be pointed out that neither too much work nor the wrong type of work (i.e., low job satisfaction) seems to promote happiness. On average, people change careers seven times during their lifetimes. It’s often due to a search for happiness and actually is a good thing to do to avoid being stuck in a bad situation. Follow the job you love, and you’re more likely to be both happy and successful.
Relationship Problems: You make bad relationship choices? Well there’s one specific choice that is shown to be most likely to reduce your happiness—choosing a neurotic partner. What’s neurotic? For one particularly disruptive example, think about the so-called Drama Queen/King. A neurotic partner responds emotionally to events that wouldn’t affect most people, and their reactions tend to be more intense than normal. They’re more likely to interpret minor frustrations as hopelessly difficult. Their negative emotional reactions persist for unusually long periods of time. In short, if you want to be really unhappy, become attached to such a person. They will negatively affect your world, keeping you embroiled in drama and unhappiness, no matter how good the financial, physical, or other parts of your relationship.
Now your results may vary but probably won’t. I’m not make judgements, just sharing the data. Life choices have consequences. Choose wisely!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: “What are some warning signs of mental illness?”

mental health

Symptoms of mental illness vary, but immediate and drastic changes in mood, thinking, and/or behaviors are common indicators. Should any such symptoms develop, seek medical attention immediately.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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“What should I look for as an indicator of poor mental health in children?”

Introduction

Today’s questions related to mental health in children.

“What should I look for in my child as an indicator of mental health issues?”

mental health in children
Today’s question is simple. The answer certainly is not. Be aware of changes in your child’s emotional, behavioral, and/or mental functioning. Remember that children often express sadness and feelings of depression in the form of anger, through outbursts, tantrums, etc. If the symptoms persist for more than a month, seek evaluation from your child’s doctor or a mental health professional. Sooner is better than later.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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From the Health Library of SterlingMedicalAdvice.com: How Do I Cope?

coping
What should I do if I’m having a hard time coping with recent changes in my life?
Adjusting to change or coping with a recent traumatic event is a difficult process and can lead to some of the same symptoms as mental illness if left unaddressed. Short-term treatment is often very effective to help prevent long-term distress, especially when you seek help sooner than later. Difficulty coping with change is normal, and talking with a professional to help make a healthy transition does not indicate you have a mental illness.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight No Chaser: The United States of Obesity – The Crossroads Between The Pursuit of Health and Happiness

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Obesity in the United States places many at a crossroad between self-esteem and health.  Often, larger frames are celebrated as more desirable.  Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise.  Of course, our culture embraces and contributes to obesity.  Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport.  I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health.  If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed.  As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:

Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.

Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.

‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
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Straight, No Chaser – The Week In Review

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I hope this was another week of good health for you.  Let’s review how Straight, No Chaser tried to contribute to your health and wellness.  Don’t forget to click on any of the underlined topics for links to the original posts.
On Sunday, we reviewed eye emergencies.  Don’t forget that even transient vision loss could be a stroke in progress, and certain causes of vision loss have a limited window of time in which treatment must occur.  Act quickly!  By the way, I didn’t mention this information that occurs more commonly than you’d think: If you ever have eye discharge so copious that it seems like you’re tearing pus, this is probably gonorrhea.  Get it treated, lest you could lose an eye.  Now that I have your attention…
On Monday, we reviewed syncope (aka fainting) in two parts, talking about the entity (click here) and the life-threatening conditions associated with faints.  You’re way too cavalier with faints; please get them evaluated.  Faints can either be the result of significant disease or can secondarily produce significant head and neck injuries from the falls.  Stop going to the bathroom (with all the hard stuff in there) when you’re feeling dizzy.  That’s not a good place to black out!
On Tuesday, we discussed suicide and depression in-depth, reviewing demographic information, information for your self-assessment, and tips on how to recognize when help is needed (and how you can avoid depression).  I’m pleased that you’ve made these topics the most read topics yet, and I sincerely hope this information helps some of you.
On Wednesday, we reviewed the overuse of the emergency room, which will become a major theme of this blog.  Those creature comfort visits are 8 times more expensive than the same visits done at a primary care physician’s office.  In Texas, the average ER cost is $1020.  Just because you’re not necessarily paying up front doesn’t mean the hospital won’t ensure you’ll pay eventually.  Remember, hospital bills are the #1 cause of personal bankruptcy in the U.S.  Straight, No Chaser was created to point you toward better options.  Stick around, and we’ll get you there.  Wednesday also brought a review of vomiting and diarrhea (viral gastroenteritis).  Learn about oral rehydration therapy.  Viral gastroenteritis is a good example of something that feels really… bad but is usually self-limited and will go away on its own, as long as you stay hydrated.
On Thursday, we reviewed end of life decision-making.  I know this struck home for a lot of you, bringing back not so fond memories.  That said, you must begin to think about how you want to be treated in your last days.  There are many tragedies during this time that tear families apart.  Use the tools discussed on the post on living wills, power of attorney designations and DNR considerations to make sure your interests are the only consideration being addressed when the time comes.
On Friday, we seemed to prick a nerve or two (no pun intended) discussing circumcision.  If nothing else, be an educated consumer.  Even now, considerations are perhaps best summed up by the posture of the American Academy of Pediatrics, which declines to recommend routine circumcisions for all newborns but notes that if you are inclined to get the procedure (which should be a big if), the benefits outweigh the risks.  Friday afternoon, we reviewed hearing loss and the damage the activities of daily living produce.  This is a pretty good example of how we take our health for granted.  Just a little bit of protection and prevention over the first 40 years of your life will make a big difference later on.
Saturday, we discussed two different types of sounds that come out of you.  First, we discussed snoring (which is always annoying but never boring) and gave you some Quick Tips to overcome it.  We also discussed hiccups, which everyone gets at some point, but no one ever wants.  We also gave you Quick Tips on hiccup cures here.  Remember those ABCDEs!
We continue to listen to your comments and feedback, and over the next few months, some major changes will be occurring.  Please continue to forward your topic requests.  I promise I’ll get to them all eventually.  Maybe I’ll start doing reader submission posts.  As we continue to grow, your support, referrals and follows are much appreciated.  Have a happy and healthy week.
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Straight, No Chaser: Depression Quick Tips – How to Avoid It, When to Get Help

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As a physician, I’m not willing to advise you on how to ‘care’ for yourself at home if you’re clinically depressed.  I can discuss how to avoid depression (to the extent possible) and what warning signs should prompt emergent access to care.  If you’re good at accomplishing the items listed below, you have less of a chance of being unhappy and clinically depressed.

  • Avoid alcohol and other mood-altering drugs.
  • Eat healthily.
  • Exercise regularly.
  • Get enough sleep.
  • Remove yourself from negativity, including your choices in friends, mates and work environments.
  • Surround yourself with positivity, including your choices in friends, mates and work environments (Please note this is a different consideration than the previous bullet point.).
  • Learn how to relax and where to go to relax (These considerations include such things as yoga, meditation and your religion/spirituality, not the business end of a bottle or drug use.).

Look out for these potential warning signs for suicide: Remember that approximately 30% of suicides are preceded by the individual declaring intent.  Be alert for the following additional considerations:

  • Increasing levels of depression, withdrawal, reckless behavior, alcohol and other drug use, and/or desperation.
  • Notice activity that could be a prelude to a suicide attempt, such as obtaining knives, firearms or large quantities of medication.
  • Changing one’s will and settling one’s life affairs in the midst of depression
  • Ongoing comments about lack of worth and desire to end it all.

The following considerations should prompt an immediate visit to an emergency room or other treatment facility.

  • You have a compelling, overwhelming feeling that you want to hurt yourself, with or without an actual plan.
  • You have a compelling, overwhelming feeling that you want to hurt someone else, with or without an actual plan.
  • You hear voices or see things or people who are not there.
  • You find yourself crying often and uncontrollably for no apparent cause.
  • Your depression has affected your activities of daily living (work, school, consistent forms of recreation or family life) for longer than 2 weeks.
  • You think your current medications are affecting you abnormally and are possibly contributing to making you feel depressed.
  • You have been told or believe that you should cut back on drinking or other drug use.

I wish you and your loved ones all the best in avoiding and/or dealing with this disastrous condition.  I welcome any comments, thoughts or questions.

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