Unfortunately May discovered a lump in her right breast she told Roger the Doctor said it was breast cancer. She tried various vigorous treatments and once the cancer reduced it’s size but sadly when they was celebrating the fact it had gone it come back 3 times the size and had spread all over the body. The doctor said she had weeks to live.
Roger was heartbroken he quit his rugby and stopped all his daily activities so he could spend the rest of the time left he had with May. He took her to Florida so she could swim with dolphins and when they got back home that’s when May collapsed and died.
Roger was distraught he knew he would have to plan a funeral and it just hit him so bad because after the funeral he felt he had lost everything. He stopped socialising, keeping fit and kept himself withdrawn from the society. His only comfort was food.
He would have huge binges which consisted mainly of fats. Every month he would put pounds and pounds on then it became stones and stones. None of his clothes fitted he had to have them tailor maid he felt embarrassed going to work because he felt everyone was talking about his dramatic weight loss but actually everyone was concerned about his health. They all knew him as the fit, active, sporty guy.
Eventually Roger got to a point where he had panic attacks every time he went out, he developed asthma he couldn’t walk very far without getting out of breath and he would get in huge sweats and would get sore marks from his legs chafing together.
As well as that his appearance really disgusted him he couldn’t believe he let himself go and felt he would never meet a girl. He decided he has to lose weight because he missed his rugby and socialising and was sick of been depressed. But the only problem was limiting his portions because he was so used to eating things which were bad for him he didn’t know how the hell he could eat something that was good for him.
Another thing that worried him was joining a gym as he felt people would mock him on his weight and he would get laughed at. All these thoughts which entered his mind lowered his motivation to lose weight even more.
Case study discussion
Roger is a very troubled man losing his wife has affected him in a bad way everyone deals with losing someone differently and finds their own comfort from different things. For example you might find dealing with a death more manageable by listening to music, seeing friends, doing things or you might go from one extreme to another i.e. experimenting with drugs, not eating or eating a lot which in Roger’s case was his only comfort. But he has found he had developed a dangerous comfort and is dependant on his comfort. Even though he wants to stop binging his lack of confidence and his perception of himself to other people have affected him doing anything about his weight gain.
Solution
In order to do something about his weight he needs to build his self-esteem up and start chatting to people who can relate to him i.e. maybe the same size as him. He also needs to confide in his mates and family. Because the more he tells them what he wants to do the more support he will get which will totally spur him on and encourage him to join a gym and lose weight.
By isolating himself from everyone is making matters worse because he won’t resolve anything and will get more and more depressed which in time could turn into a much serious problem i.e. suicidal thoughts.
He should also see his doctor about his asthma and get medication for it which will help control his asthma. He should also tell his doctor that he wants to lose weight and then the doctor can help him find a solution to his problem i.e. get him to eat a healthy diet.
Another thing the doctor can do is refer him to a weight-loss counsellor who can sort out what caused his weight gain and what needs to be done for steady weight-loss and find out what his barriers are to losing weight so Roger’s barriers would be failure to comply to a healthy diet, lack of self-esteem and a low-opinion of himself which is what is causing him to not join a gym. Once Roger knows what to do about his weight and realises he isn’t alone and there’s a lot of support out there this will influence him even more to lose weight by adopting a healthy diet and exercising on a regular basis.
So what is obesity?
Obesity is more than just a few extra pounds.
Obesity is the heavy build-up of fat in your body to such a degree that it rapidly increases your risk of diseases that can damage your health and knock years off your life, such as heart disease and diabetes.
The fat may be equally distributed around the body or concentrated on the stomach (apple-shaped) or the hips and thighs (pear-shaped).
For medical purposes, the body mass index (BMI) is used to determine if your weight is in the healthy range.
Doctors use BMI because it compares your weight against your height.
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You are in the normal range if your BMI is between 18.5 and 25 (kg/m2).
- You are overweight if your BMI is between 25 and 30.
- You are obese if your BMI is 30 or higher.
- You are morbidly obese if your BMI is 40 or higher.
How common is obesity?
Around one in four men and one in three women in the UK are overweight, according to government statistics.
While slightly more women than men are obese (24 per cent versus 23 per cent), in the last ten years there has been a greater increase in the number of men who are obese.
The Department of Health predicts that if this trend continues, by 2010 around 6.6 million men will be obese compared to 6 million women.
Stomach obesity, where weight is concentrated on the tummy, is the most common type of obesity and affects 30 per cent of adult men.
Obesity and stomach obesity are rapidly increasing, especially in young people.
Around one in three children between the ages of 2 and 15 are overweight. While in total more girls than boys are overweight, a greater number of boys are obese.
- 14 per cent of boys are overweight.
- 17 per cent of girls are overweight.
- 19 per cent of boys are obese.
- 18 per cent of girls are obese.
Government statistics also show that children are more likely to have a weight problem if one parent is overweight, and this risk is increased if both parents are overweight or obese.
What to do to avoid becoming obese?
Increase amount of exercise
If you are looking to lose weight exercise is a crucial factor in weight loss so you should increase your amount of exercise as well as following a sensible healthy eating plan.
Exercise is important as it helps you maintain your weight and also makes you more mentally alert as well as physically. You should exercise at least 3-4 times a week this could be cut down by 30-60mins a day such as brisk walking, dancing, jogging etc.
However, exercise may be a problem which is why the 45 year old man is putting away a lot of weight this may be because he has an under-active thyroid, slow metabolism, medication may cause weight gain and he may have ailments’ which affect him exercising i.e. gout, arthritis etc. He also may have a low-self esteem and lack of confidence due to him being obese which is why he daren’t exercise where he knows he’s going to be seen in the public. So it’s important he has the will-power if he’s going to go out in the public or join the gym. So he needs lots of support from friends and family to do it.
If he doesn’t like sweating in a fitness studio there are fun alternatives.
- When going to the local park, nature trails or trips to the seaside, try to incorporate longer walks into the outing and take a picnic so you are in control of what you are going to eat that day.
- Always use the stairs instead of the lift. Bear in mind that every single step helps.
- Get off the bus a stop before the usual one and walk the rest of the way.
- Use commercial breaks between TV-programmes to stand up and do exercise, or consider using an exercise bicycle in your living room while watching your favourite programme
Reduce calories
- Hypnotism may influence healthy weight loss. Hypnotists such as Paul McKenna are renowned for their skills in helping someone think in a positive way by hypnotism. He produced a DVD which was cognitive therapy as it helped you think in a positive way which is beneficial for a lot of people.
- Boot camp – if you want a dramatic weight loss and want a different experience of losing weight then this might be right up your street. However, it isn’t for the faint hearted as it consists of intense, gruelling workouts which may completely drain you mentally and physically. It is a good way of making friends though and losing weight in a unique way.
- Weight-loss therapy classes – this is good if you want to confront your weight loss with a weight loss specialist and find out what is causing it so it can look into different aspects i.e. background, environmental, lifestyle etc to see what may be influencing your weight gain. It’s good if you want to have a positive weight-loss. A specialist can direct you in the right way so there’s lots of support and advice for you.
- Weight watchers club – this is where you go if you’re absolutely determined to lose those pounds and are highly-motivated too. This is the healthy way to lose weight and is good socially because you will speak to people who may have lost weight or are the same size as you and share stories.
- So you will make friends from this which is good because it will spur you on even more. You get healthy eating plans what you stick to and have personal trainers who devise an exercise a plan what is suitable for you and then you have a weigh in. Because you’re with loads of people the same size as you won’t feel as embarrassed as you would at a normal gym so there is more chance of you sticking to it and not quitting.
- Keep a diary - From the day you decide to lose weight, weigh yourself once or twice a week before breakfast. Keep a record of this weight and see the pattern that develops.
- Treat yourself – every pound or stone you lose, you should celebrate your success by treating yourself to a new piece of clothing, music or eat something naughty as a treat but still stick to your diet to prove you still have the will-power.
A 10 year old boy with a dairy allergy
My next client is a 10 year old boy with a dairy allergy. I am going to explain an over-view of the condition i.e. its affects and how his calcium deficiencies can be met and how it can help him in the long-run knowing how to deal with his condition.
Your child and dairy allergy
Many parents assume that their children absolutely need to have their daily pint of milk and it can come as quite a shock to be told that their child has a dairy allergy. A mixture of emotions may be left with the parents - relief that a specific cause to a problem has been found, shared with a concern that their child will suffer from dietary deficiencies from a lack of dairy products i.e. milk, cheese and yoghurt. Finding a solution can seem very difficult. Here is some facts about the dairy allergy.
Symptoms of Dairy allergy
* Asthma * Diarrhoea
* Bloating * Eczema
* Catarrh and mucus * Flatulence
* Constipation * Glue ear
* Dark eye circles * Upper respiratory
* Diabetes tract infections
Statistics of dairy intolerance symptoms
We are seeing a serious upswing in problems such as asthma, glue ear and diabetes amongst children. Both asthma and diabetes are increasing by about 10% a year and glue ear is suffered by 17 out of every 20 children by the age of six. There are direct links with these ailments to the quantity and frequency of dairy products in the diet.
How does the problem start?
The problem often starts in early years and a child can even be sensitised to milk protein when breast feeding, if the mother has milk and cheese in her diet. However, it is more usual for difficulties to start when small children are given formula milk or are introduced to whole milk and cheese. One reason for the increase of dairy-related problems, over previous generations, could be because we tend to breast feed for a shorter time than before - often weeks rather than months. If children can avoid cow’s milk for the first nine months of life, their risk of dairy allergy is significantly reduced. It is also quite possible for an intolerance to develop after a few years. This can be confusing for parents because a staple food which was fine suddenly becomes a problem - what to do?
Milk sugar blues
One basic problem is lactose intolerance. Lactose is milk sugar and some children lack the necessary enzyme, lactase, to digest the lactose. Because this milk sugar is left in the gut to ferment, the side effects can include the most uncomfortable wind and bloating - literally brewing up a storm.
SOLUTIONS TO LACTOSE INTOLERANCE
* Avoid milk, especially skimmed milk which has more lactose
* Drink lactose-free milk (found in large supermarkets)
* Drink calcium enriched soya milk (in moderation though as soya can lead to allergies as well).
* Add lactase enzymes to milk to ‘pre-digest’ it several hours before drinking it (available from good health food shops).
* Cheese usually does not cause a problem because it contains low levels of lactose.
*Yoghurt is often fine as the bacteria in it have already pre-digested the lactose.
*Butter has only a trace amount of lactose and is almost never an issue.
Protein problems
The other main reason for a dairy allergy is the thirty proteins found in cow’s milk.
• Casein, the main protein to cause problems, is a large molecule and is so dense in milk that in formula feeds its percentage has been reduced to reflect human milk. It is really designed for small cows, not small people. In the stomach these proteins group together into a large, hard to digest, lump which then takes a lot of work to break down. Goat’s milk forms into much easier, small lumps and human milk into tiny little drops. Goat’s milk has a different form of casein which is much better tolerated by children.
• You may have seen posters in your doctor’s surgery urging breast feeding entirely because of the increased risk of insulin-dependant diabetes amongst children. The reason that cow’s milk is believed to be the culprit is because of the anti-body, Bovine Serum Albumin. It is thought to attack the pancreas in easily affected children, responsible for the sharp upturn in this terrifying disease.
• Milk protein allergy can lead to the symptoms of asthma, eczema, digestive problems, constipation, diarrhoea and also to headaches and dark eye circles. In the worst cases anaphylactic shock has also been reported.
• Mucus build-up is one of the key down-sides of too much dairy and this can lead to one of the most common plagues to affect young children i.e. glue ear. By simply cutting back or cutting out milk and cheese can usually eliminate this avoiding the long and uncomfortable road of antibiotics and operations to insert a grommet into the ear. The NHS spends £15 million a year on this problem alone, never mind the trauma to so many little people and their parents.
What to look out for on labels
Usually it is enough just to cut back on dairy products i.e. cheese once a week and a couple of yoghurts a week along with a bit of milk in desserts is unlikely to be a problem for most children. Butter is often well tolerated as it is almost 100% fat, and yoghurt is easier to digest because of the action of the bacteria on the milk sugars and proteins.
In some cases however it can be an extremely serious allergy that all dairy products, including yoghurt and butter, must be avoided and this includes packaged products containing dairy. There are many unfamiliar terms for dairy ingredients to look out for in this case, and, in addition to the obvious (milk, cheese, cream, butter, yoghurt) include:
* Buttermilk * Lactic acid
* Casein / caseinate * Lactobacillus
* Crème Fraîche * Lactose
* Ghee * Quark
* Kefir * Whey
* Lactalbumin
Calcium from other sources
The main worry for parents who need to take dairy out of their child’s diets, or who may want to cut back as a preventative measure, is where to get calcium in the diet. Here are a few interesting points about calcium.
• Calcium is best used by the body with magnesium, and while dairy products are rich sources of calcium they offer only tiny amounts of magnesium. This means that while we can take in the calcium, we don’t necessarily use it for bone and tooth health unless it is balanced by magnesium.
• The foods that give the best ratio of calcium to magnesium are green leafy vegetables such as cabbage, Brussels sprouts, broccoli and spinach. Nuts (all types) and seeds (sunflower, pine nuts, and pumpkin) also give the ideal ratio. Baby cows and goats do not grow into healthy specimens by drinking milk - they eat grass, a rich source of calcium and magnesium-packed full of chlorophyll.
•A lot of parents moan that they can’t get their child to eat their vegetables but their child will drink their milk. One of the problems with large glasses of milk, given as a beverage, is that it is actually very filling. Children may enjoy their milk more than their food and it can be quite hard to get them to eat up their vegetables if they are simply not hungry.
• Children aged 2 to 7 need 1300-1700 calories. One of the temptations of whole milk is that it contributes significantly, at 100 calories per 150ml (1 small glass). However it fills up young tummies quickly, cutting their appetite for other foods. But it’s much better to quench their thirst with water or diluted juice, and include high fat foods in their meals such as olive oil, avocado, egg yolks, oily fish, coconut cream, tahini, almond nut butter and fresh nuts and seeds (But, beware of choking hazard).
• Between the ages of 2 and 7 youngsters need 600mg of calcium a day. If they have a varied, whole-food diet then sufficient calcium can be obtained. Even tap water from ‘hard-water’ areas or still mineral water provides significant amounts of calcium.
This menu will give around 600mg of calcium:
2 eggs 50mg
Handful of dates 25mg
1 orange 50mg
1 carrot in matchsticks 25mg
1/2 portion broccoli spears 35mg
Sunflower seeds (can be ground as cereal 20mg
topping but avoid if your child has nut allergies)
1/2 small tin pink salmon 75mg
1 calcium enriched soya yoghurt (on cereal) 100mg
2 slices wholemeal bread (or bread sticks) 50mg
2 portions of green vegetables 80mg
1 portion of baked beans 50mg
Fruit salad (kiwi, pear & melon) 40mg
Growing out of the problem
It does seem that many children grow out of milk allergies and, as their age moves out of single figures, symptoms such as asthma and eczema often resolve themselves. However, the less orthodox view is that the body is learning to adapt, as a survival mechanism, but that the symptoms will reappear in later years - thirties or forties - in another form, such as migraine or irritable bowel syndrome. Surely the most sensible approach, as no one can be really sure how the problem will develop in any given child, is to make sure that there is variety in the diet and not too much dependency on any one food group. Variety reduces the opportunity for allergy.
Case history
THE PROBLEM: Sara and Lawrence were almost at their wit’s end. Their third child, three year old James, was in agonies trying to go to the toilet. He had even stopped pushing and straining and was going for as long as he could without sitting on his potty - sometimes two or three days. He would cry with the discomfort from being so constipated, and frequently there was blood in his stools.
His GP was fast running out of ideas and referred his parents to a specialist at Great Ormond Street Hospital for Children. By then several medications had been tried, including high doses of Lactulose - a lactose (milk sugar) based aid to relieving constipation.
DIAGNOSIS: The doctor took a comprehensive case history and was interested to note a few hints from James’s past: when he was about four months old he had been passing mucus into his nappy when introduced to formula milk; there was a history of allergies in the family, including his brother Peter who had asthma triggered by milk; James had also developed mild eczema when he was put onto formula milk.
The doctor told Sara that around 20% of children with milk allergy had very bad constipation as a major symptom. When told that milk allergy could be at the root of James’s problem, Sara jumped at the chance to solve her son’s predicament. The dietician gave her a long list of foods to avoid and foods that were OK, but on checking with the specialist her mind was put at rest that it need not be so awkward - a little milk in a biscuit or slice of cake was unlikely to be a problem, it was more likely that the glasses of milk and wedges of cheese were to blame.
SUCCESS: She resolved to deal with this immediately despite going away on holiday to Cornwall the next day. She phoned ahead and asked the hotel to provide soya milk - they were totally accommodating. Within three days Sara and Lawrence noticed that James was a changed child. His energy levels improved dramatically, no longer desperate to sleep for two hours in the afternoon, his complexion improved and his appetite was better. Sara’s husband, who was fairly sceptical initially, also noticed the immediate change for the better. When they returned from holiday Sara’s mother remarked on how well he looked and, again, that he was a changed child. His toilet problems resolved during that two week holiday and they were able to cut back his medication over time.
Now, an active five year old, James enjoys a variety of milk substitutes and while he tends to be a picky eater, preferring snacks to sit-down meals, Sara is relaxed because she knows that the snacks she offers are healthy and that calcium can be obtained from a wide variety of foods in his diet.
Sources of calcium
So if the 10 year old with the dairy allergy is introduced to other foods that provide good sources of calcium which won’t harm her health then she won’t get bored of eating the same staple diet she can be eating a different choice of foods. Now if she is also told by her parents what she can’t have in her diet and why it’s important it will help her socially, mentally, physically and intellectually. It will help her socially because she will be able to eat with mates because as long as she is told what foods to avoid from her parents and has an idea of what she can and can’t eat this won’t affect her socialising with her mates. It will help her intellectually because she will have great knowledge about her condition so it will reflect on her on every stage of her development right up to her teens it will just be an auto-matic instinct to just double-check food packaging to ensure no unwanted dairy ingredients which will aggravate her diary intolerance consist in whatever she decides to eat. She will also know how vital it is to ask when eating out that nothing foreign is in her meals, in order to prevent getting a reaction. If she is eating at friends houses she will ask what ingredients are being put into the cooking so that she can check they are appropriate for her to eat. She will be mentally alright so won’t be depressed or anything about her condition as she has extended her knowledge throughout her development regarding her condition so knows how to treat it and what are the hazards which provoke her condition to a severe level. She will be physically fit because she will be following a dairy-free diet accordingly so will have a good balance of health and enough calcium and will be experimenting with different foods so she will be very keen at trying new things and exploring with different ingredients. But also being cautious about what goes in what she eats before taking a mouthful.
http//www.dairyallergy stuf.htm/accessed at 13.15pm on the 25th of April 2008, online, URL.
A 30 year old Male Alcoholic
