By Dr. Susan Minsky

Couples often believe the easiest solution to frequent arguments that appear unresolvable is to threaten separation and divorce. Divorce is the last choice to resolve what initially may appear as unreconcilable differences. Marriages require the willingness on both parties to rebalance needs, expectations, hopes, on a consistent basis at various stress points and change which occur throughout a long term relationship. Clear, direct communication, hearing each other in an accurate manner is necessary to produce effective changes for both parties. Couples often require refresher courses and new skills to promote a growth oriented exchange during stressful times, in particular.

Come join the Columbia Counseling Center team who provide an integrated approach to promoting and strengthening the bonds between partners in relationships. Individual and couples therapy are offered simultaneously to promote more rapid and productive identification of issues that require resolution to enhance the lost intimacy and positive communication and interaction between partners.

According to the Centers for Disease Control more than a third of American adults—over 72 million people—were obese in 2005 and 2006 and they predicted that, unless we change our eating and exercise habits, 86 percent of the American population will be overweight or obese by the year 2030. People who are obese are more susceptible to serious health problems, such as high blood pressure, type 2 Diabetes, heart disease, orthopedic problems and stroke. But being overweight or obese doesn’t just affect your physical health. You may also have feelings of guilt, embarrassment, low energy, isolate yourself socially, and feel depressed. These feelings can definitely impact your physical health and even shorten your lifespan.

The Social Consequences of Being Overweight

While being fat was once seen as a sign of wealth and comfort, most people almost automatically assume that someone is overweight or obese because they overeat on pizza, cheeseburgers and ice cream. But it’s not that simple. We live in a society in which you can get great tasting, high-calorie, high fat foods at any time of the day or night. They actually have a name for this: “the obesogenic society.” Some obese people may have jobs that require them to work seated for long hours and just don’t have the time or energy to exercise. And, food is ALWAYS THERE. This results in eating many more calories than their level of activity can burn off and leads to constant gain weight.

Overweight and obese people may feel strongly stigmatized and experience discrimination because of their weight. Discrimination usually begins during early school years, when overweight persons are not chosen for school teams, and this discrimination extends into adult life. In schools and colleges, obese students face harassment, rejection from peers, and biased attitudes from teachers. At work, obese people commonly report they have experienced humiliation and discrimination related to their weight – such as not getting promotions. Obese employees are often viewed as less competent, sloppy, and lacking in self-discipline by co-workers and supervisors.

What can be done to reduce the stigma of obesity?

You have a voice at work and at home. You don’t have to accept discrimination in school or in your workplace. It’s okay to share with your co-workers that YOU ARE NOT YOUR WEIGHT.  Also, if you are trying to lose weight you should be sure to surround yourself with supportive, caring friends and family members. Be open about your weight loss goals and ask explicitly for a helping and motivating hand. Supportive friends and family are a vital part of your weight loss program

Finally, take the word “diet” out of your dictionary and vocabulary. Diets don’t work. Lifestyle change does. Eat healthier foods…eat smaller portions…exercise at least 30 minutes a day. And think happy thoughts.

Columbia Counseling is here to help you on your journey to a natural, healthy weight. Our caring therapists and medical staff can help you to look at your lifestyle and help you understand what you might do to successfully achieve your weight loss goals. Call us  at 410- 992 – 9149 for an initial appointment to begin a rational, sustainable and effective weight loss program.

My favorite season is winter. My wife calls me “a bear with furniture,” and like a bear, in winter the cold weather and shorter days give me the opportunity to slow down, pull my energy back into myself and prepare for spring. However, many men and women in winter have low energy, become irritable and gain weight because they eat too much, especially foods that contain a lot of carbohydrates. They don’t exercise as much, lose interest in getting out of the house and being with other people, sleep more and just stay “tired” all the time. In reality, all of these symptoms may be signs of depression. Some people get depressed because they lose their job or don’t like their job, get a divorce or there is a death in the family. There may also be a genetic basis for depression because it seems like everyone in the family is depressed. But some people get depressed every winter even without experiencing a stressor that would make any of us feel depressed and without a family history of depression.

Winter depression is sometimes called Seasonal Affective Disorder (SAD) and affects between 5 to 10 percent of the U.S. population. Another 10 to 20 percent of the population may suffer from more mild winter “blues.” SAD is more common in women, between the ages of 20-50, and is thought to be caused by the shorter hours of daylight the winter brings during its colder months of the year January and February.  Although the specific cause of this disorder isn’t known, some biological factors such as the circadian rhythm, which helps regulate the body’s internal clock, may be disrupted with the decreased amount sunlight in fall and winter. Also, the decreased amount of light may also cause a biochemical imbalance of the neurotransmitters serotonin and the sleep-related hormone melatonin in the brain.

As a psychiatrist I usually treat winter depression with antidepressant medication and individual or group psychotherapy, but I also use “light box therapy.”  Light box therapy uses a very strong source of broad-spectrum light for a half-hour or hour each day during the winter months to replace the missing hours of daylight. Research has shown that some people with SAD who are exposed to bright light treatments experience relief from depression because the light therapy mimics outdoor light and is thought to cause a biochemical change in the brain that improves mood.

Tips for Coping with Seasonal Affective Disorder

Besides using anti-depressant medication, individual group and light box therapies there are other very effective ways to deal with SAD and other types of depression.

Exercise – Physical exercise has huge health benefits. It’s one of the most powerful ways to prevent and treat depression. One of the first things I ask my patients is to become more active, “just start moving.” For example, instead of eating lunch at your desk, take a midday walk to get as much sun as possible (there’s that light thing again) and to breathe in fresh air.

Work space-try to locate where you sit in your office so that you are next to a window and are exposed to sunlight during the workday.  One of the things I’ve always put high on my priorities is to always have a window in my own office. Open the window for fresh air even in winter.

Sugar-Cut back on the amount of sugar and high fructose corn syrup (HFCS) in your diet. They have been shown to cause increased swings in mood and directly impact your brain function. All of us have experienced a “sugar rush” and “sugar crash” as your body uses up the sugar in your blood.

Foods-Eat protein and complex carbohydrates such as whole grains, fruits, and vegetables at every meal. Less sunlight means less Vitamin D and you can get Vitamin D from milk, most whole grain cereals and fish, especially cod, herring and sardines.

Greyhound Therapy- If it’s in your budget, get out of town and go someplace sunny. Just a change of scenery by itself can help you feel better.

Seek Professional Help-if the depression gets so bad that you find it difficult to get through the day, it’s important that you talk with someone about your struggles and depression. You are not alone and we can get through this working together.

Remember, if you have SAD, unless you live in Alaska or Greenland, the sun will shine, the air will get warm and you will feel better and more alive as the depression melts away with the snow.

If you have a headache…you take a pill and it goes away. If you have an upset stomach…you take a pill and it goes away. If you are overweight…well, you can’t just take a pill to lose weight even though there are thousands of advertisements on television and in magazines that promise to help you lose weight and “it takes no work at all!” I bet you wonder if there ARE weight loss pills that really work, or are they just a waste of time and money.

Why can’t just take a pill and lose weight?

The pharmaceutical companies are in a desperate multi-BILLION dollar race for an effective and safe “weight loss pill”. But they have failed in their search because feeling hungry or feeling full is based upon hormones in your body. The hormone levels constantly change depending on how much energy your body needs and how much and what type of foods you eat.

The most important hormones that control when and how much you eat are called Ghrelin and Leptin. There are other hormones such as Peptide YY, Adiponectin, Cholecystokinin, and Pancreatic polypeptide which are all involved in this energy balance but the main hormones are Grehlin and Leptin.Grehlin and leptin act together, but in opposite ways, to control your urge to eat or to stop eating. Grehlin tells your body to eat because it needs energy and Leptin lets your body know when it is full so you stop eating.

But it gets even more complicated. The level of Ghrelin, which is also called the ‘hormone of hunger,” is affected by many factors such as the type of food you eat, sleep deprivation, being overweight and drinking sweetened soda. Almost everyone drinks soda but grehlin levels don’t decrease after meals if you drink a lot of soda so you still feel hungry. The next time you buy a soda don’t buy the 64 ounce size or even better, drink water with your meals. Because it takes about 20 minutes for the hormones to interact and for you to feel full after you start to eat, always stop eating before you feel full.

When the pharmaceutical companies first discovered Leptin they thought it might be the “anti-fat” miracle drug and they spent an enormous amount of money on research and advertising. But it quickly became obvious that taking leptin or ghrelin as a pill does not control appetite or help people normalize their weight. Because of the difficulty in isolating these hormones and using them in a weight loss pill, don’t expect to see them in the ingredients listed on the pill boxes any time soon.

Prescription weight loss pills

But if we don’t have a pill that can specifically raise and lower the levels of Grhelin and Leptin (and the other appetite hormones) in our bodies, then what kind of pill CAN we take for weight loss? Most weight-loss medications you buy at drug stores, groceries or get by prescription are “appetite suppressant” medications and usually come in tablets or extended-release capsules. Appetite suppressants promote weight loss by tricking the body into believing that it is not hungry or that it is full by increasing brain chemicals, such as serotonin and norepinephrine, that affect mood and appetite.

Fat absorption inhibitors, another type of weight loss pills, work by preventing your body from breaking down and absorbing fat from the foods you eat. The fat which your body can’t digest goes out of your body in bowel movements and many people complain of oily stools, gas and frequent bowel movements. These side effects are especially bad with a high fat diet and can really be embarrassing. Fat absorption inhibitors also reduce the absorption of fat soluble vitamins A, D, E and K so you should take supplements containing these missing nutrients along with the fat absorption inhibitor.

But what about other side effects besides the oily stools? Luckily, the side effects of most weight loss medications are usually mild and become less bothersome the longer you take the medication.

Some of the common side effects of the different medications include increased heart rate and blood pressure, sweating, constipation, problems sleeping, excessive thirst, lightheadedness, headaches and anxiety. But some serious and even fatal outcomes from taking weight loss medications have also been reported. The most tragic example is the use of the appetite suppressor “phen-fen” which caused severe damage to the heart and lungs.

There is still little information on how safe and effective weight-loss medications are if you take them for more than just a few months.You should not expect to reach a “normal” body weight using just medications because most people have individual reactions to any most types of medications, and some people lose more weight than others.

Most people who take weight-loss medications lose about 10 pounds more than people who don’t take weight loss pills. Most weight loss occurs within 6 months of starting the medicine and then your weight will level off or even increase. Sadly, most people will regain the weight they lost when they stop taking weight-loss medications.The best weight loss pills on the market can be a big help for people who are struggling with losing weight.

If you combine weight loss pills with an exercise program and a healthy diet, prepared in a natural way, of fresh meats, fish and whole grains, you’ll see even faster results than you would without them.

Even if you don’t take weight loss pills, because obesity is a chronic disease, you should definitely include regular physical activity and a healthy diet to improve health and to reach and maintain a normal weight. A weight loss of even 5 to 10 percent of your body weight, for example from 200 pounds to 180 pounds, can markedly improve your health.