Blog 9 The dieting roller coaster

“Jane” is a 41 year old woman who struggles with her weight and her body image. As a young child, she was quite thin, being very physically active and having a normal appetite; however, as she entered puberty, she grew rapidly and became overweight. She was never obese but was uncomfortable with her size and shape, which soon became her major focus in life. Food was never a control issue or point of conflict as a young child, but her mother was thin and Jane always wanted to look like her. Jane’s mother was very supportive (she had been chubby as a young teen also) but she too was obsessed with weight, size and conforming to media-hyped body images. Together they were quite a pair. As a senior in high school, Jane went on a strict diet, lost about 50 pounds and exercised strenuously (she was an athlete in high school) – Jane feels she may have bordered on becoming anorexic. She said she had a lot of thoughts about making herself vomit after she ate because she had a friend who was bulimic, but she never did that. Her parents were divorced and her stepmother made constant comments about Jane’s size while her father never commented or supported her – so she thought he felt the same way her stepmother did. This just fueled her extreme dieting and exercise but no matter what she did her stepmother never had a positive comment. As she matured, she had a number of extreme weight fluctuations – she would diet until very thin, then gain all the weight back plus more. The weight gains seemed to correspond with her being content with relationships with men and the extreme dieting corresponded with periods when she was not involved with a man. After she married, the same pattern continued – happy equaled a heavier weight and times of marital struggle equaled extreme dieting and exercising. Jane has a high stress job which requires a lot of hours and she has children involved in lots of sports and activities as well, so she does not spend much time cooking or planning meals. She is always trying the next new “miracle” diet to lose weight rapidly. She knows her diet and uneven physical activity are not healthy but she feels trapped in the cycle. I asked about her goals for a healthy future and she responded that she knows that her future depends on better habits but she still searches for the “magic bullet” of weight loss.

Hormone Replacement Therapy - my choice

At the age of 30, my left ovary was removed due to a benign tumor. At 40, I had a hysterectomy due to fibroids, endometriosis and adenomyosis. I was adamant that the surgeon leave my one remaining ovary as I did not want to go through surgically induced menopause at 40 - I was really frightened at the thought of weight gain, hot flashes and looking and acting like an old woman. My doctor strongly advised that I have the one remaining ovary removed because of my history but I insisted and he finally agreed. Because of the one working ovary I didn't need to take HRT and the recovery was uneventful, as were the next 8 years. When I finally did start menopause, at 48, I elected to take HRT for hot flashes, night sweats and a host of other typical menopausal symptoms. I also had osteoporosis and the HRT was to treat that also. I took the pills for 7 years at which time my doctor advised that I stop them. I did, but at a price. The hot flashes, insomnia, "brain fog", etc returned. I chose to use some over the counter herbal remedies which did help some and after a couple of years, I was feeling comfortable again. And of course, the OTC remedies did not help the osteoporosis. I began taking Actonel, a medication to treat osteoporosis, but stopped due to the development of esophagitis. I'm not sorry I took HRT - it made a difficult time of my life more bearable and it did put off the worsening of the osteoporosis. I only take calcium, vitamin D, fish oil and a multivitamin now, and half a children's dose of benadryl at night to help with sleep (recommended by my ICU nurse daughter!). I am aware of the risks associated with HRT, but I think I would still take it if I had to do it over again - just maybe not for so long. I am opposed to taking prescription meds except in the most demanding of circumstances. I believe natural health is the way to go and it is working for me.

The Silent Partner - HIV in marriage (film)

In 2004, one third of all new HIV cases in Uganda occurred in married couples. In Zambia and Rwanda, half of all new cases were diagnosed in married or co-habiting couples. In Sub-Sahara Africa, 22 million people are living with HIV/AIDS - 5% of the total population. In some countries, the rate is 1-2% but in others, such as Swaziland and Botswana, the rate is over 20% (AVERT). Most of these Sub-Sahara African societies are patriarchal - women spend their lives being owned, first by their fathers and then by their husbands. In order to prove their strength and manhood, men have multiple sex partners outside marriage and married women are powerless to practice abstinence or demand condom use. Women's health, and even survival, depend on the sexual behavior of men and for the most part, their behavior is reckless and without regard for their own health or the health of their wives and children. For married women, there are no alternatives - they are taught to ask no questions and make no demands for the sake of their children because husbands are the providers. They are taught to always say yes to their husband's demands - if they don't, they can be physically chastised. Cultural attitudes foster acceptance of marital violence - in Kenya, 43% of women report being the victim of sexual violence from their husbands. A recent law against sexual violence in Kenya excludes marital rape as a crime. One problem is that leaders who recognize the urgency of stopping this life-threatening behavior have not identified ways to reach out to the men in these cultures. Millions of dollars in international aid have been thrown at the HIV/AIDS epidemic in Africa but until Africans themselves take ownership of the problem and begin to address the cause of the continuing epidemic it will continue. Women cannot be empowered to take control of their health until men are educated about the extreme risks posed by their behavior and until they are taught to value women. REFERENCES: AVERT, 2009. Averting HIV and AIDS. Statistics. Retrieved from http://www.avert.org/africa-hiv-aids-statistics.htm___ Population Action International, n.d. Silent Partner-HIV in Marriage. Video retrieved from http://www.populationaction.org/silentpartner/about.html#film

State of the World's Children, UNICEF 2007

Despite the monumental gains in health practices and life spans around the world, women still die in the perinatal period (28th week of pregnancy - 28 days postpartum) at a horrifying rate. Many of these deaths are in developing countries where girls, some as young as 8 years old, are married to older men. Young girls' bodies are not developed enough to give birth naturally so many of them die during childbirth or shortly thereafter. In Niger, 1 in 7 females will die in childbirth. Quite often the infant dies also. Keys to reversing this horror story include education, of children and their parents, and fostering empowerment of women to decide their own destinies. When women are educated and empowered to speak for themselves, they begin to demand resources for their children and everyone wins - children, mothers, families and communities. Gender equality is critical to child survival everywhere. Men in patriarchal societies must be taught that women are valuable and that preserving women's health is paramount to the survival of the society. REFERENCE: UNICEF, 2007. State of the World's Children 2007. Retrieved from http://www.youtube.com/watch?v=z8qXlhk2ig0&feature=player_embedded#!