Thursday, 20 July 2017

Summertime Brings Warmer Weather—and Body Image Worries

With  the arrival of summer, our thoughts turn to poolside get-togethers, beach outings and barbecues. For some, summer is a more relaxed time of year, one where we enjoy the company of family and friends in the outdoors. For others, this time of year brings pressures to slim down or tone up in preparation for bathing suit and tank top weather. And it’s no wonder.

Advertisements for diet and exercise products showcase ideal bikini bodies, and tabloids harshly rate appearances, with articles like the “Best and Worst Celebrity Beach Bodies.”

As a psychiatrist specializing in the treatment of anorexia, bulimia and other eating disorders, I see how summertime presents a unique challenge for individuals who struggle with body image. Even for those with a healthy body image, beach “body ideal” can spark feelings of inadequacy and depression. In some cases, particularly among individuals with a family history of eating disorders and those with perfectionistic, people-pleasing and reward-dependent personality traits, seasonal pressures to lose weight can trigger unhealthy behaviors related to dieting and exercise.

In fact, many eating disorder treatment professionals observe an increase in patients and families needing eating disorder support as the weather heats up, and we shed our sweaters for shorts and swimsuits.
For youths and teens—and even young adults—the desire to lose weight to look good in skimpy summer fashions is not the only factor that can trigger an eating disorder. Young people who are more likely to develop eating disorders prefer structure and predictability, yet summertime’s unstructured “down time” takes the place of normal daily routines.

Additionally, summer is filled with milestones related to adolescent separation, attachment and “launching”—spending the summer away from home at camp or on a trip, preparing to leave home for college in the fall or graduating from college and entering the “real world.” These changes, transitions and new situations can result in anxiety and feeling out of control, triggering coping mechanisms in an effort to regain a feeling of control.

Dieting (including restricting calories, eliminating foods or whole food groups or purging calories) as well as excessive exercise helps alleviate this anxiety. Young people can easily control their calorie intake and energy output, oftentimes in secret and without drawing the attention of friends or loved ones. While these behaviors can be unhealthy and dangerous as a coping skill, they are difficult to identify in a culture that encourages and applauds dieting, exercise and weight loss.
To create a healthy summer environment, think beyond losing weight to achieve the coveted beach body and instead take steps to nurture your physical, emotional and spiritual health.

Consider these five tips for a healthy summer season:

Get moving. Try a new activity—find a yoga class for relaxation, go dancing with friends or play volleyball on the beach—with the goal of finding joy and connection with yourself, others and nature, not losing weight. Identify physical activities that make you feel good—physically, emotionally and spiritually.

Find your happy. If achieving a healthy weight or getting stronger is your goal, you’re more likely to be successful and less likely to develop an eating disorder if you are nurturing your emotional health as well. For those people who struggle to disengage from the strong seasonal pressure to lose weight, consider this—studies suggest a correlation between a positive emotional status and healthy body weight.

Take time to “stop and smell the roses.” It’s easy to get so caught up in our physical appearance or the appearance of others that we forget to enjoy the moment.  At the beach, don’t worry about how you or others look in a bathing suit. Instead, focus on the sun’s warmth on your skin (protected by sunscreen, of course!), the salty sea air smells and the sounds of crashing waves and kids laughing as they build sand castles.

Stay hydrated. The simple act of drinking sufficient water throughout the day supports overall health. In fact, research suggests a connection between proper hydration and a healthy body weight. And, adequate hydration allows us to engage meaningfully in summertime activities.

Make time to check in. Especially for adolescents and young adults, summer brings changes to the standard routines. Make time to talk to the young people in your life and discuss feelings related to seasonal changes and milestones, such as fear, anxiety, depression or a perceived loss of control. Identifying unhealthy coping strategies early means you can get help early.

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7 Ways To Fall Off the Exercise Wagon

We’re approaching the time of year where, despite our best efforts, schedules and obligations start to crowd out common sense.

There are shorter days with less sunlight. Once 5 p.m. comes around, we take the sun’s retreat to heart and feel like curling up and calling it a night.

There’s Thanksgiving planning and cooking, cleaning out closets (who ever said it had to just happen in the Spring?) holiday shopping (if you like to stay ahead) and general busy-ness.
All that adds up to neglecting certain matters.

Like exercise.

Unfortunately there’s a price to pay when you deep-six your exercise routine: You feel guilty, frustrated and more sluggish than ever. But something, you say, has got to give.

If you’re resisting the pull to join the masses on their exercise exodus, I’ve made it easy for you by telling you the tried and true ways to ditch the habit. After all, why not join the other 67 percent of people with gym memberships that never use them?

1. Don’t lay out clothes the night before. If you wake up and see your leggings, socks, running shoes and outfit waiting for you, you might find it too easy to get dressed and go. Get rid of all visual cues, including your gym bag and water bottle.

2. Don’t make promises. Committing to a workout with a friend, signing up for a class or booking a personal trainer all makes you accountable and less likely to cancel. Dump the threat of peer pressure and remain a loner – you won’t run the risk of disappointing anyone (but yourself).

3. Tell yourself “maybe.” This way you have the option to say no. Not writing it down on your calendar makes it so much easier to skip the exercise. Why commit to something you don’t really want, anyway?
4. Keep your expectations unrealistic. Say: “It’s 45 minutes of intense cardio five days a week – or nothing at all!”  three times in a row. Or try: “I must lift weights three days a week, or why bother?”  This way, if you’re not feeling up to your usual routine, or don’t live up to your hopes, you can say: “Why bother?”  Although it may be true that some exercise is better than none at all – and there are ways to fit it in – you need to have an “all or nothing” approach. Why do some – if you can do none?

5. Remain seated at all times. Just because you can use commercial time during your favorite TV show to fit in some jumping jacks, balance exercises or push-ups doesn’t mean you should do it.  Better yet, aim for the shows with no commercial breaks, or fast-forward through those pesky commercials, and you won’t even be tempted. And if you sit at a desk for much of the day, stay there. Taking frequent breaks to walk around, move your body and stretch will only make you feel more productive, both mentally and physically.
6. Sleep in. If you set your alarm an hour earlier and work out first thing in the morning, then you’ll be sure to do it. Making sure you don’t have the time – or putting it off for later – practically guarantees you’ll throw in the towel instead.

7. Embrace the silence. Listening to music will only help you feel more motivated, increase your enduranceand make exercise more fun – and may even distract you from the pain, fatigue and boredom that sometimes accompanies exercise.  Just because studies have shown that music helps people run further, bike longer and swim faster than usual – without even realizing it – doesn’t mean that you have to listen.

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The Awesome Pregnancy Perk a Start-Up Company Offers

If you’re pregnant and working in an office whose dress code isn’t stretchy yoga pants-friendly, your bank account will take a hit. Business maternity clothes aren’t cheap. One dress can cost hundreds of dollars, and that’s just one outfit.

To help pregnant women afford professional attire, Domo, a Utah-based computer software start-up, is offering expecting employees up to $2,000 to spend on maternity clothes. The mom will receive gift cards to Nordsroms, ASOS and A Pea in the Pod to basically go on a shopping spree to find new work-appropriate clothing that’s also comfortable.

This innovative policy started about a year ago when Domo CEO Josh James’ assistant became pregnant. James quickly realized the struggle she was facing to continue to dress professionally while dealing with a changing body.

The CEO tells People, “I’ve always believed that if you look good, you feel good, and if you feel good, you play good. We want our expectant employees to be able to treat themselves, and buy clothes that make them feel great.”

And while the stipend may just be a small gesture in the grand scheme of things, sometimes it’s the small things that make a big difference.

Domo employee and mother of two Erica Bartsch was one of the first women to take advantage of this benefit. She tells Fortune, “Pregnancy is an awkward time for your body. You’re doing this wonderful and amazing thing while going through so many changes … the image of what you have in your head is not reflected in the mirror. The benefit made me confident about what I was putting on.”

That’s not the only way this company is supporting working parents. They also have a paternity leave policy which gives new dads two weeks off fully paid (which may not seem much compared to the Netflix’s of the world, but keep in mind this is a very small start-up company,) and gives new parents a $1,000 “baby bonus.
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Why I Hope the FDA Approves “Female Viagra”

It’s not often a woman meets the man of her dreams when she’s in her 60s, but that’s exactly what happened to me. Just a year ago, I married the most wonderful man in the world. Bill is everything I’ve ever wished for in a husband.

He’s wonderful, kind and has a great sense of humor—not to mention he does more than his fair share around the house. He loves my parents, my children and grandchild. He even loves Sammy, my beagle. And—lucky me—he is handsome and sexy, too.

Bill and I have a wonderful relationship—except for one very important thing: My sexual desire is nonexistent.

For a while, I didn’t tell Bill what was or—more accurately—was NOT going on with me. I found myself making excuses not to have sex with him and avoiding any physical contact because it might lead to sex—which is crazy because I love this man so much.

But I was suffering, and keeping silent wasn’t an option for me. First, I talked to Bill to make sure he understood the problem was with me—not him. He has been so kind and understanding. I’m very lucky. Then, I had to forgive myself. Because I now know it’s not my fault either.

I also started talking to some of my dear friends, and I found out I wasn’t alone. Many of my friends are going through the same thing. I also talked to my sister, who is a nurse practitioner, and she told me the number of women she sees in her practice with the same complaint as mine is huge. Her words? “It’s an epidemic!”

Recently I read in the news that an FDA advisory panel has recommended FDA approval of a medical treatment that could treat low sexual desire in women\ It’s actually the most common female sexual dysfunction and impacts millions of women. “low libido” problem that many women may experience, for example, after childbirth or if their relationship is on the rocks. It is an actual imbalance of chemicals in a woman’s brain that causes low desire.

The more I read about the condition, the more I realized that this could be exactly my problem.
I’ve since gone to my health care provider twice asking if there is anything that can help me and both times I was told there were no FDA-approved treatment options to help me.

Low sexual desire in women is a problem. A huge problem. An epidemic, as my sister believes. I’m living proof of it, but I’m not alone. Studies show that one in three women in the United States has low sexual desire.

What we also can’t forget is that this isn’t just a women’s issue; it’s an issue for their partners, too. You don’t have to be an expert to know how important a healthy, satisfying sex life is for a relationship.
Women deserve healthy, happy sex lives. Our relationships deserve it. Hopefully the FDA will think so, too.
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5 Ways to Beat the “I Don’t Have Time” Trap

When it comes to health, so many of us have good intentions.
We know the health rules, but remembering to actually do them or finding the time to fit them in remains a colossal challenge. We’re busy. We’re tired. We’re cranky.
Who has the time for one more thing, anyway?

You’re not alone: A 2010 Stress in America Survey found that 34 percent of adults found that the struggle they face balancing work and home life makes it difficult to find the time for health behaviors, like eating right and exercising regularly.

But that doesn’t mean you have to give up on those healthy ideals. There are ways to sneak them into your day.
At the end of that day, you’ll feel a real sense of accomplishment.
And then you’ll never again have to say, “I’m too busy to…”

Floss. Daily flossing helps prevent gum disease, cavities and tooth loss by removing plaque that brushing can’t. Most of us wait until we’re ready for bed to drag out the floss (if we remember at all); but by that time, we’re so tired, it’s the last thing we feel like adding to our list.

Fit it in: Floss any time of day—it doesn’t really matter when. Do it first thing in the morning or after lunch. It just matters that you do it. Buy a six-pack of floss (or you can also use another product like a dental pick, pre-threaded flosser or tiny brushes that reach between your teeth) and stash them in different places—in the shower, alongside the bathtub, in the car. The next best thing to flossing? Swish water around in your mouth after brushing to loosen particles left behind.

Strength Train. More important than ever before, you need strength training to increase your bone density and reduce the risk of osteoporosis. Gaining muscle helps your body burn calories more efficiently, too.
Fit it in: It’s not true a watched pot will never boil; chances are it will boil before you know it if, while you’re waiting for the bubbles to surface, you do some push-ups against the kitchen counter. That’s only one way to sneak in some bone-enhancing moves.

Take Off My Makeup. Besides leaving streaks on your nice clean pillowcase, sleeping in foundation can lead to clogged pores, which then can progress to blackheads and breakouts. That goes for your lashes, too: Mascara can dislodge and end up in your eyes, leading to eye irritation and even infection.
Fit it in: Many companies make premoistened makeup removal pads. No water necessary—a few quick swipes and you’re nice and clean. Quick and easy.

Snack Healthy. Sometimes you are too busy to stop and eat, and by the time your brain gets that “feed me” signal from your stomach, it’s too late. You reach for the first, most convenient thing—and that’s not always a healthy thing.

Fit it in: Prepare ahead of time by filling your fridge with easy-to-grab prepared snack bags containing cut-up carrots, celery and cherry tomatoes. You can do the same with a mix of unsalted pretzels, nuts and dried fruit. Other easy-to-make-and-grab options include hard-boiled eggs, low-fat cheese sticks, snack-size cottage cheese or yogurt, whole grain crackers. Snacking on healthy, fiber-filled foods will keep your energy up and keep you from feeling hopelessly hungry and frustratingly fatigued.

Stay in Touch With Friends and Family. What’s health got to do with it? Social support networks, according to many studies, have far-reaching health benefits. A strong social network helps people cope with stress—and stress is a health-buster. An Australian study that followed older people for 10 years found that those with a large network of friends outlived those with the fewest friends by 22 percent. Other studies have found that people with cancer who participated in support groups lived longer than those who didn’t.
Fit it in: If you don’t have time for a phone conversation, just texting or emailing mini-updates or messages (“I’m thinking about you!”) can help you feel connected, grounded and happier.
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The Gentle Cesarean: More Like A Birth Than An Operation

There are many reasons women need cesareans. For me, after 17 hours of labor, my daughter’s heartbeat slowed down, which results in my emergency c-section.

I remember taking deep breaths as they prepped me for the surgery. My husband had to wait in the hall. All I could tell myself was, “soon you’ll meet your daughter. Stay calm.”

C-sections are the most common surgery in America—about 1 in 3 babies are delivered this way. But even though it’s common, it was still difficult to accept. Now looking back, I’m not ashamed of my c-section. I wear my scar as a badge of honor because that’s what made me a mother, a title I treasure.

Looking forward to someday having another child, I plan to have another c-section. This time, there is the possibility to switch things up a bit. Some hospitals are offering small but significant changes to the procedure to make it seem more like a birth than major surgery.

The techniques are relatively easy and the main goals simple: Let moms see their babies being born if they want and put newborns immediately on the mother’s chest for skin-to-skin contact. This helps stimulate bonding and breastfeeding. This sounds amazing. My daughter face was held against my check after she was born, but I had to wait about 30 minutes to hold her.

Family-centered cesareans are a relatively new idea in the U.S., and many health care professionals and hospitals have no experience with them. The procedure requires some changes, including adding a nurse and bringing the neonatal team into the operating room. And there are a bunch of little adjustments, such as moving the EKG monitors from their usual location on top of the mother’s chest to her side. This allows the delivery team to place the newborn baby immediately on the mother’s chest. In addition, the mother’s hands are not strapped down and the intravenous line is put in the nondominant hand so mom can hold the baby.
Bravo to those health care professionals who are trying to make c-sections more like a birth and less like a surgery. Looking forward to someday having another baby, I hope I get to experience this.
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It’s Men’s Health Week: Time to Tend to Your Man’s Health

In 1994, Congress passed a bill to institute June as Men’s Health Month. Since that time, it’s been wonderful to see hundreds of workplaces, health care professionals, sports franchises and other institutions encouraging healthy behaviors among men and boys.

But how can we, as women, encourage our loved ones to take charge of their health and learn about what screenings they need?

A close friend of mine complained to me the other day that she was worn out from continually nagging her husband. “Yeah, I know how annoying and draining it can be to have to nag,” I replied in an effort at solidarity. But when I had spent time with this couple, the husband always pitched in, be it with the kids, housework or anything else. He was super-attentive. Nagging was the last thing I thought she had to do.
“He never goes to the doctor—unless I beg him to! And then, when I nag, he gets mad at me. I’m really at a loss.”

Sound familiar?

Chances are it does. While there are those self-reliant men out there who take charge of their health and schedule visits with their health care provider, the sad truth is that the majority doesn’t:  Men are 25 percent less likely than women to have visited a physician in the past year, finds the U.S. Agency for Healthcare Research and Quality. Another disturbing fact: men are 40 percent more likely than women to have skipped recommended cholesterol screenings.
And this is shocking, but true: women visit the doctor 150 percent as often as men!
“Why don’t you write him a letter?” I said, in an effort to help. After all, if one approach doesn’t work, maybe it’s time to try another. And being a nurse, wife and mother, I offered some suggestions for her to include in the letter. (Feel free to adapt these suggestions for your man.)
Dearest Man-in-My-Life,
This letter comes purely out of love and concern. And being that this week is Men’s Health Week, I have the perfect excuse for writing it.

It troubles me that you don’t pay attention to your health and see a doctor regularly or schedule appointments when you need them.

It’s a fact that we women are the ones who make the vast majority of health care decisions for our families. But I need you to give me a hand here. Your reluctance and hesitation don’t just affect your health and well-being; they affect both of us.

For one, if you do nothing, it puts all the worry on me. I know that’s not your intention—but that’s the outcome. And for another, if you’re not healthy, how can we do all the things we love to do and share together? Think about travel, exercise, sex … all things that are compromised or made impossible by bad health.

I’m not pulling out these facts to scare you, but imagine my worry when I see these statistics: Men live an average of seven years less than women. According to the U.S. Centers for Disease Control and Prevention, U.S. men are 1.5 times more likely than women to die from heart disease, cancer and respiratory diseases.
Are you concerned about hearing potentially bad news? I understand that might be worrisome; but try looking at the other side of that. Preventive health care is called that for a really good reason. It can find problems before they start—and prevent many of them. It can also help a doctor discover a condition or disease at an early stage, when it’s much more treatable and manageable.

So, let’s partner up. I’m happy to help you locate a doctor. I’ll even go with you, if you’d like. We can, together, learn about your health and any screenings you may need, like those for diabetes, cholesterol and blood pressure. How about we plan something really fun afterward?
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