Weigh Your Choices
Not every medical decision you will make will be clear cut. For example, if you were seriously obese, you might be asked to consider gastric bypass surgery, a radical procedure in which most of the digestive system is bypassed, so you can’t eat very much, and what you do eat must be chosen very carefully. The surgery, or another procedure like it, might offer you a better chance for more dramatic, longerlasting results than diet and exercise alone can give you. On the other hand, the surgery is risky,greatly alters your body, requires major changes in lifestyle, and is irreversible. Only you and your doctor can decide the best course of action, based on your own priorities and your specific medical situation.Make sure that you fully understand all the benefits and side effects of each alternative before deciding on a treatment.
Learn To Examine Health Information Critically
These days, it’s easy to find health information, but hard to know what to trust. When you come across a new piece of medical information, ask critical questions before changing your behavior. Where is the information coming from? Is it based on anecdotal evidence, or were careful experiments conducted? Is it from a trustworthy university or research center, or from a fringe organization with a specific agenda? Is it being played up on the news just to get ratings? How does it compare with the information that is already out there? Has the idea been thoroughly tested, or is it just a promising hint from a single preliminary study? What does your doctor think of it? It’s important to adapt to new insights, but it’s just as important not to blindly follow every trendy suggestion that comes along. Remember, the stronger the original theory was,the more powerful the new evidence must be to overturn it.
Critical thinking is especially needed when you look for information on the Internet. When you type words into a search engine, the results that come up are not necessarily based on research.
Sometimes a company that wants to sell you its product may have created the page, and the product may not be based on scientific research or may not even be safe for you!
You should always question where information on the Internet comes from. Web sites from the government generally give good information, as do the sites listed in the “Resources” section of this book on page 79. You can also always ask a librarian if you have questions about whether a Web site is a good one to trust or not. [See Appendix 2 on page 75 for more information about how to examine health advertisements critically.]
Sleep Eating
Sleep eating is a sleep-related disorder, although some specialists consider it to be a combination of a sleep and an eating disorder. It is a relatively rare and little known condition that is gaining recognition in sleep medicine. Other names for sleep eating are sleep-related eating (disorder), nocturnal sleep-related eating disorder (NS-RED), and sleep-eating syndrome.
Sleep eating is characterized by sleepwalking and excessive nocturnal overeating (compulsive hyperphagia). Sleep eaters are comparable to sleepwalkers in many ways: they are at risk for self-injury during an episode, they may (or may not) experience excessive daytime sleepiness, and they are usually emotionally distressed, tired, angry, or anxious. Sleep eaters are also at risk for the same health complications as compulsive overeaters, with the added dangers of sleepwalking. Common concerns include excessive weight gain, daytime sleepiness, choking while eating, sleep disruption, and injury from cooking or preparing food such as from knives, utensils, or hot cooking surfaces. There is also the potential for starting a fire.
As with sleepwalkers, sleep eaters are unaware and unconscious of their behavior. If there is any memory of the episode, it is usually sketchy. A sleep eater will roam the house, particularly the kitchen, and may eat large quantities of food (as well as non-food items). In the morning, sleep eaters have no recollection of the episode. However, in many cases there are clues to their behavior. One woman woke up with a stomachache and chocolate smeared on her face and hands. Candy wrappers littered the kitchen floor. The next morning her husband informed her that she had been eating during the night. She was shocked and distressed because she had no recollection of the event.
As in the case described above, food consumed by sleep eaters tends to be either high sugar or high fat. Odd combinations of foods, such as potato chips dipped in peanut butter or butter smeared on hotdogs, as well as non-food items, have been reported. Oddly, one person was discovered cutting a bar of soap into slices and then eating it as if it were a slice of cheese!
Sleep eating is classified as a parasomnia. It is a rare version of sleepwalking, which is an arousal disorder. In 1968, Roger Broughton published a paper in Science (159: 1070-1078) that outlined the major features of arousal disorders. They are:
* Abnormal behavior that occurs during an arousal from slow wave sleep;
* The absence of awareness during the episode;
* Automatic and repetitive motor activity;
* Slow reaction time and reduced sensitivity to environment;
* Difficulty in waking despite vigorous attempts;
* No memory of the episode in the morning (retrograde amnesia); and
* No or little dream recall associated with the event.
Develop A Healthy Lifestyle
Learn all you can about keeping a healthy diet, and make that a priority. Avoid eating too many sweets, fats, and processed foods.
Increase your intake of fresh fruits and vegetables. Build exercise into your daily schedule. Even adding a 20- to 30-minute walk every day, taking the stairs instead of the elevator, or exercising while you watch TV can make a difference in your physical fitness. If you are overweight, work with your doctor to develop a plan for weight loss.
Create an active relationship with your doctor. The first step is obviously to find a doctor if you do not have one. If you are insured, ask your insurance company for a list of its providers. If you are uninsured, look for medical options in your area that may be affordable to you. Most major cities operate free or inexpensive health clinics. You may also be eligible for Medicaid (governmentassisted medical care). To find out more, call the Centers for Medicare and Medicaid Services toll free at 1-877-267-2323. Many U.S. states and private agencies also offer medical assistance programs for children.
Once you find a doctor, tell him or her all you know about your health and medical history. Do research on any conditions that you have, any diseases that run in your family, and any medications you are taking. Ask questions whenever something isn’t clear.Ask about the range of treatment options that are available to you.When you are given a medication or treatment plan to follow at home, be sure you understand exactly what you are supposed to do. Don’t be afraid to ask more questions if you don’t understand.
Our Unhealthy Lifestyle
In many ways, life today is much healthier than it was in the past.But for too many modern Americans, the advantages of medical technology are outweighed by unhealthy habits that are all too common in our society.
One of the biggest problems lies in our modern diet. For tens of thousands of years, our human ancestors lived in conditions where food was scarce and precious. So our bodies have evolved to extract as much energy as possible from the food we eat, to burn only what’s needed, and to store the leftovers as fat to protect us from starvation.
Over the past century, however, food has become astonishingly plentiful. Unfortunately, now our problem is not a lack of food, but too much food, or too much of the wrong kind of food.
Americans today are eating more than ever before. In restaurants and at home, our portion sizes (the amount of food we eat at one sitting) have gotten larger and larger over the past few decades. For example, in many fast-food restaurants, what was called a large order of French fries 30 years ago is the smallest size available today. A typical bagel has grown to about twice its original size and is smeared with nearly a whole package’s worth of cream cheese. All-youcan- eat buffets and huge servings at popular restaurant chains have trained us to believe that when it comes to food, more is always better. (Think of how many times words like “extralarge,” “jumbo,” “king-size,” and “supersize” pop up on menus and food packages and in advertisements.) Unfortunately, more food also has more calories—and calories add up fast: If you tack on just 150 calories to each of your meals (that’s about the number of calories in a 12-ounce can of soda or half a candy bar), you’ll take in over 164,000 extra calories per year. That’s enough to put on 47 pounds of fat!
We’re not only eating more than before—we’re also eating worse. Many popular foods today are highly processed, full of unhealthy saturated and trans fats, refined sugars and flours, excess sodium, and countless additives and preservatives. Fast foods and pre-packaged supermarket foods are the biggest culprits. These foods are also typically low in vitamins, nutrients, antioxidants, and dietary fiber—all of which improve health and fight against cancer and heart disease. Too many Americans rely far too heavily on these products and not enough on fresh, whole foods such as fruits, vegetables, beans, nuts, fish, and lean meats.
All these poor and excessive food choices have consequences, including rampant obesity. “Obese” means “extremely overweight.” In 2001, more than 20% of Americans were obese—nearly twice the rate from just a decade earlier. Obesity is dangerous because it leads to poor circulation, heart disease, high blood pressure, diabetes, heat exhaustion, and a lot of other problems. It is estimated that as many as 300,000 deaths per year in the U.S. are related to obesity. A recent report by the Centers for Disease Control said that obesity is ready to overtake tobacco as America’s leading cause of preventable death.
Apart from playing a role in obesity, a poor diet can affect us in other ways. Diets that are high in unhealthy fat and low in fiber, essential nutrients, and antioxidants have been linked to several kinds of cancer. Poor dietary choices can also cause bad forms of cholesterol to build up in your arteries, increasing your blood pressure and eventually leading to a heart attack. Improper nutrition can lower your body’s natural defenses against disease and make you feel sluggish and weak. It’s hard to believe, but many Americans are both obese and undernourished at the same time!
Besides taking more calories in, we’re burning fewer calories off than ever before. Over a century ago, your great-great-grandparents expended lots of energy every day, by lifting heavy loads, working in fields or in factories, building and fixing things with their hands, and walking almost everywhere they needed to go. Even housework used to be a vigorous workout.It was a hard life, but all that challenging physical activity helped to keep their bodies fit.
Nowadays, many of us can get through a whole day scarcely lifting a finger. We wake up and get right into a car, bus, or subway that takes us to work. We might spend the entire working day behind a desk or a counter, moving only a few steps at a time. People who work in factories or in the home have many kinds of machines that do the hardest work for them. At night, we can order a pizza delivered to our front door and eat it while watching TV—using a remote control so we don’t even have to get up to change the channel!
As you can see, our modern lifestyle is very convenient, but it’s cut way down on the amount of exercise we normally get in a day. In order to burn calories and stay physically fit, most of us need to go out of our way to exercise, whether it’s by walking, jogging, swimming, playing a sport, riding a bike, or going to a gym. Unfortunately, many people don’t exercise at all. If you’re one of them, you’re not alone. Maybe your job or your family leaves you with little or no free time.
Maybe your neighborhood isn’t safe. Maybe you don’t feel energetic enough to exercise. Maybe you’ve thought about it, but just haven’t made it a priority. Maybe you’re overwhelmed and you don’t know where to start.
The good news about lifestylerelated health problems is that people have a great deal of control over them. It takes discipline, willpower, and some background research, but anyone can improve his or her diet, get more exercise, and benefit from the results. The changes might be very simple. For example, if you live or work in a building with an elevator,you might start taking the stairs every day instead. You could walk, rather than drive or ride, to run nearby errands. You could do exercises in your apartment while you watch TV. You could save up to a thousand calories a week by swapping carrots or celery for french fries at lunchtime.
For those who are seriously overweight or who might have trouble sticking to a fitness plan, many support groups and weight-loss or nutrition programs are available to help. If you think you need to find one, ask your doctor for recommendations.
Even finding a friend to diet and exercise with can make a big difference. In extreme cases, there are medical treatments, ranging from prescription drugs to surgery, that can help combat obesity and overeating.
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