How often should you jump on the scale?
For many years, I never recommended to patients to weigh themselves daily (first thing in the morning). The prevailing medical opinion was that weighing oneself triggered anxieties that might end in eating disorders like anorexia and bulimia.
Contrary to what I said to my patients, however, I have weighed myself my whole life (nearly) every morning – and have kept the same weight since age twelve. Except for pregnancies, gaining twenty pounds with my daughter, forty with my son. The difference? In both cases, relentless morning sickness. With my daughter, eating or even thinking of food made me throw up; with my son, eating calmed the sickness. During pregnancy, I did not care what I weighed and how I looked; all I cared was the baby I was expecting. So I followed my body’s whims and cravings. Including the incredible craving for a lobster at a very inconvenient time…
My body feels well only within a very tight margin: Two pounds less, and faintness grips me. Two pounds more, and stuffiness prevents me bending forward.
My personal weight story made me absolutely unacceptable for several overweight patients who stated that I had never been in their shoes and could therefore not advise them. I respect that view. But it would also mean that one can’t be a good doctor for a cancer patient if one didn’t have experience with the dreaded disease. Or could couldn’t treat a heart attack because … you are getting the idea. (On the other hand, the notion that better doctors come from personal experience with serious illness, is worth spinning out. The A+ nerds who populate our medical schools – half of them should be replaced with compassionate, common-sensical young men and women).
A study showed that people who weigh themselves more often also lost more weight. That takes this discussion beyond my personal story – and here it becomes interesting.
French women supposedly don't gain weight as they age. Which means if the scale tells them they have gained a pound or two, they take action. And responsibility. That might be part of the French Paradox - that the French live longer but eat more fat. Might be they eat fat - and then put in a salad day.
A scale is a reality check. If you want to avoid looking the facts in the face – your decision. I like to confront bad situations – weight gain, disease, divorce, death (why do nearly all adverse events start with a "d"?). That led me one time to lie down in a casket and pull the lid shut, just to see how it was. It was surprisingly peaceful. What I found out in the coffin: It was nothing to fear. Read More
Blog: On Health. On Writing. On Life. On Everything.
Food “Allergies”, Anyone?
April 29, 2010
What we often call food “allergies” might be forms of intolerance with different pathways, physiologically speaking. The poisonous effect of wheat gluten in gluten enteropathy worked via a different mechanism than dairy-induced asthma; or the poison ivy dermatitis; or likely immune-complex regulated arthritis. Science has not totally elucidated these mechanisms; food “allergy” might be the incorrect term but has become common.
The diagnosis is difficult to make and to confirm; but if you don’t even think of allergy, the diagnosis can’t be made. Many physicians are not trained in this. However, you might need professional help if self-observation does not solve the problem. Since all of these conditions can also be caused by far more serious diseases, by all means work with your doctor.
Here is a list of signs that should make you wonder if you have an unrecognized food issue:
Food cravings: The more you like a food the more likely it is that you are allergic to that food. The more frequent you eat a certain food or a food group the more likely is that you will develop an allergy to it.
Fatigue: After a meal you are tired. We all are tired after a heavy meal; but if you are extremely tired even after a smaller meal you should search for an allergy.
Abdominal discomfort after a meal - often within minutes but unfortunately it can even take a day or two - you feel bloated and distressed in your stomach. Diarrhea is already a more severe sign and, if chronic or intermittently recurrent, should be evaluated by a physician. Heartburn seldom is recognized as stemming from food allergies – but it often goes away when you stop eating nightshades (tomato, bell and hot peppers, eggplant, potato), nuts or dairy.
Weakness: About fifteen minutes after a meal lift your arms: If they feel heavy or ache more than usual - compared how light you felt in the morning - this might be a case of allergy.
Musculo-skeletal system: joint, tendon and muscle problems, bursitis, etc. Leave out nuts and dairy. Get evaluated for celiac disease (gluten intolerance).
Mouth: Burning in your mouth, tickling in your throat or sores in your buccal mucosa or on your tongue might signal an allergy.
Bladder: Slow flow of urine can be a sign of food allergy, due to a swelling of the urethra. Or burning of the urethra in males. Or recurrent signs of urinary tract infections – with or without bacteria growing out in culture. Irritable bladder (interstitial cystitis) might respond to leaving out coffee and certain foods.
Thirst! If you are thirstier than other people – always running around with a water bottle in your hand – think allergy.
Other diseases and complaints that might be caused - but not necessarily - by food allergies headaches, asthma, swollen glands, bleeding and inflamed gums, abdominal discomfort and bloating, diarrhea, skin problems and itching of perfectly normal looking skin, recurrent infections (sinus, UTI, etc.), itchy eyes, listlessness and mild depression, obesity and bulimia, anal itch and/or rashes, low blood pressure, dizziness, breast pain - a long list that is probably longer, recurrent phlebitis.
Most common food "allergies" I have encountered in patients: dairy, nightshade (tomato, potato, eggplant, all peppers except black pepper, chili, cayenne, paprika), nuts, wheat, corn, beef, food dyes and food preservatives. But basically every food can become a culprit. If you have pinpointed one food item as allergenic for you, compare it with other items in the same botanical family (like nightshade). Read More