Happiness and Joy

yca5goukzca3bsgiscayv8qu6calrd5htcawxvwywcai5tzp5ca638prkcao03wp6carurn13caaqs8k6cary9t9ucauctcd4ca4c4m66cauv9dx2caccxy8mcaxrtxrhca89nbddcamjimp0cajpt00aPeople have been concerned about happiness for a millennium. Two thousand years ago Seneca observed that his forefathers lived as well as they were living during his time. This was in spite of the fact that his forefathers found shelter in the ground, used their own hands to obtain and dress their meat and did not know the pride of owning and wearing gold and fine gems. He commented that it was what was in the mind that made a person rich: no one could be considered poor who had enough, or rich if they wanted more than they have.

Seneca’s observation is consistent with the Chinese saying from long ago that a person who is content is always happy. People can become so interested in acquiring things that they recklessly pursue fame and fortune. Living life in this manner limits people to the demands of fame and the restrictions of wealth. Their life energy is spent in pursuit of fame largely for the purpose of obtaining wealth. Ironically if you actually obtain great wealth it also opens the door to the possibility of great loss, including robbery, burglary, or even murder as others attempt to take what you have. On the other hand, the person who is content with what he has can spend his life energy in more truly satisfying endeavors. People who are content are said to be rich in the quality of their life, which is likely to include tranquility, peace and spiritual nourishment.

Today happiness researchers continue to find validation for these ancient concepts. Modern happiness researchers define happiness as a state of well-being which depends less on our circumstances and more on how we respond to them. While national affluence and a sense of well-being correlate, there is a stronger link between a secure democracy and well-being. In fact, the capacity for personal choice is a greater predictor of happiness than a country’s relative wealth. While indigent people concerned about losing the most essential necessities of life endure a sense of hopelessness, wealth alone does not guarantee a sense of purpose and life satisfaction.

People need enough money to provide the basic necessities of life on a continuing basis. However, having more than enough does not really boost our sense of well-being. This is because when we have the basics other needs come to the forefront—things such as a need for a sense of belonging, or a feeling that we are making a difference by our existence. The first serving of food tastes better than the second helping. In the same way once humans have basic rights, shelter, adequate food, meaningful activity in their lives and enriching friendships our level of happiness is surprisingly unaffected by more money. There is only a slight tendency for those who make lots of money to be more satisfied with what they have. True satisfaction is not really about getting what you want but wanting what you have. Larger incomes also don’t influence how satisfied we are with our spouse, children, friendships or even ourselves, but all of these relationships are important in determining our sense of well-being, i.e., our happiness.

Traits of happy people

Researchers have found that there are four inner traits that predispose positive attitudes and happiness. These traits are:

  • Self-esteem – happy people respect their value as a human being. When things get tough people with a firm sense of self-worth keep going.
  • Personal Control – happy people feel like they have control over what happens to them. They feel like they can control their destiny.
  • Optimism – happy people are filled with hope and expect to succeed when they try something new. They see the proverbial glass of life as half full, not half empty.
  • Extraversion – happy people tend to be outgoing and sociable.

Even in old age extraverted individuals tend to be cheerful and full of the joie de vivre, the joy for living. People who like themselves are confident that other people will like them too. They have many friends and they engage in rewarding social activities. More fulfilling social interactions result in their experiencing more affection and greater social support. This is very important because social support is the foundation behind their sense of well-being and positive outlook on life.

Becoming a happier person

Just because you are not born an extrovert with high self-esteem and an optimistic outlook does not mean that you cannot make changes in that direction. Pretend you are self-confident, pretend to be optimistic, try to be more outgoing with others. Research has shown that while telling people to act or talk positively sounds like you are asking them to be phony, in reality when people follow through and practice these traits amazing things happen. The phoniness gradually diminishes and the new behaviors and accompanying attitudes begin to fit, like a favorite comfortable pair of old jeans.

If you doubt this strategy force yourself to put on a big smile. Now frown, tighten your jaw and try to look angry. Try both again and this time pay close attention to how you feel. Can you tell a difference? Research shows that if you smile on the outside you will feel better on the inside.

The same goes for your interactions with other people. Smile. Act like you like someone and you may just find out that you do! And, as a bonus, you may also find out that you are beginning to like yourself better, that you feel more confident and that you are becoming more comfortable with other people. And these are the changes that can help you feel greater happiness in your life and more optimism for the future.

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Optimists Are Healthier

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Over the past two decades research from around the world has produced a steady stream of scientific evidence that psychological traits, especially optimism can contribute to good health. Optimism does this by:

  • Reducing that sense of helplessness that stifles constructive action.
  • Giving a person a reason to stick to health regimens and seek medical advice
  • Reducing the number of bad events a person experiences because optimists are more likely to take steps to stop bad events once they begin
  • Fostering social support, which is important because close friendships reduce the risk for disease, particularly the recurrence of chronic disorders

How is this possible? States of mind, such as hope, can affect the rest of the body. When a person is depressed, catecholamines, one type of neurotransmitter, become depleted. When catecholamines get depleted, the brain’s internal morphine( i.e., chemicals called endorphins) increase. When the level of endorphins increases the immune system detects this and turns itself down. This reduction in the immune system is temporary in grieving people. On the other hand, a pessimistic outlook on tends to lower immune activity independent of physical health problem and transient emotional states. Unlike temporary states such as sadness during a bereavement, or depression in the course of a divorce, or a bout of illness, pessimism may be able to impair your health over the course of your entire life span.

Traditional views do not acknowledge a major determinant of health, namely our own thoughts. The reality is that we have much more control than we probably think we do. For example:

  • How we think, especially about our health, can change our health.
  • Optimists catch fewer contagious disease than pessimists
  • Optimists are more motivated to maintain better health habits than pessimists
  • The immune system of an optimistic individual works better than the immune system of a pessimistic individual
  • There is even evidence that optimists live longer than pessimists.

One of the most intriguing studies in this area has been going on for decades. In the mid-1930’s the William T. Grant Foundation decided to study healthy men throughout the course of their adult lives. The investigators were interested in studying exceptionally gifted people to learn more about what determines success and good health. Subjects were selected from five Harvard freshman classes. Investigators selected men who were physically fit and intellectually and socially gifted. This group of men cooperated fully with this demanding study. Participants have received physical checkups every five years, were interviewed periodically and had to fill out endless questionnaires. Their diligence has provided a treasure of information about what makes a person healthy and successful.

As time passed and the original investigators aged they decided to ask a younger man, George Vaillant, a brilliant young researcher, to assume responsibility for the continuation of this longitudinal study. George Vaillant’s first important finding from the study was that wealth at age twenty does not guarantee either success or good health. Instead he found a high level of failure and poor health among the men in the study including failed marriages, bankruptcies, premature heart attacks, alcoholism, and suicide. Indeed these men experienced tragedy at almost the same rate as men born at the same time in the the poorest areas of the inner city.

The original research challenge had been to try to determine factors predictive of success and good health. So what was going on? If wealth did not guarantee good health and success what did? Vaillant began to focus in on how men in the study dealt with challenging events in their lives. Information that had been collected from the men indicated that even while in college some of them handled bad events with what may be described as “mature defenses.” They used humor, altruism, future-mindedness and the ability to delay gratification to meet the challenges thrown at them. Interestingly some of the men never used these strategies. Instead they used “immature defenses” such as denial, and projection, i.e., blaming others for their problems. By the time they were sixty years old none of the men who used mature defenses in their early twenties was chronically ill. On the other hand over one-third of the men without mature defenses at age twenty were in poor health by the time they were sixty.

About the time the men in the study were entering middle-age, around age forty-five, a study involving 99 randomly selected men from the ongoing study was conducted. The men’s identities and state of health were kept from a second set of investigators that were given essays the men wrote as they returned from service in the World War II in 1945-1946. The essays were compiled into an explanatory-style portrait of each man. These explanatory-style summaries were then returned to the original investigators so they could determine what had happened to these men and whether the second investigators’ designation of individuals as having an optimistic or pessimistic outlook on life made a difference. What was discovered is that the health of the men at age sixty was strongly related to optimism at age twenty-five. The pessimistic men came down with diseases of middle-age earlier than the optimistic men and by age forty-five the difference in health was large. In fact optimism stood out as a primary determinant of health beginning at age forty-five and continuing for the next twenty years. In the next decade researchers will be able to learn if optimism predicts a longer life in addition to predicting a healthier one. While we all cannot be born wealthy, we can modify our outlook on life—especially if taking a more optimistic view leads to better health.

Importance of Control

0ca3p4uqxcaezm5sbcamyhjjwca2mnuldcazu6gl3ca3ksr6jcagx1argcaeurabeca3ig8azcarzlqq0ca8f92m3cayx7cp6calutl4zcargwg02ca42s0zbcabyfabicav3f9nfcaxm4ai8caskz8neEllen Langer is one of the pioneers in the study of perceived control. Some of her most important findings come from field experiments with collaborator Judith Rodin which were conducted in nursing homes for the elderly. These studies pointed out the significant physical and mental gains that can be achieved in elderly people in institutional settings if they are given a sense that they are at least partially in control of their own lives by being able to choose some of their daily activities. Research has shown that perceived control is crucial not only for one’s psychological well-being but also for one’s physical health. Furthermore there is evidence that believing that one has control may be even more important than actually being able to make the overt responses to cause the desired outcome.

Langer’s theory suggests that conditions that allow people in situations governed by chance to behave as if skills count, benefit from an illusion of control. Skill-related behaviors such as: making choices, thinking about the task and possible strategies to be use, exerting effort while working on the task, learning about the materials and responses to be made, and competing with other people to evaluate ability, reduce a sense of helplessness. This perception gives individuals in a chance situation, in which they have no objective influence on outcome, an illusion of control. In this situation people became motivated to master their environment and to avoid the negative consequences of feeling like they are not in control. They perceive the simultaneous occurrence of chance and skill elements as clouding the difference between the two; and that their behavior is not “irrational” rather it is viewed as a possible opportunity for gain. People tend to make judgments about the causes of events and see themselves as having the ability to determine what will happen if an outcome is positive, even as they ignore the objective reality that they are overestimating the probability of success.

In short, people need to believe that they have some control over what happens to them. While there may be millions of losers in every big lottery, there are also winners. And there really are exceptional people, like the young mountain climber who amputated his own arm to free himself when a boulder imprisoned his arm in an accident. He climbed down a steep incline and walked six miles to safety when he surely would have died otherwise. There are also people like Lance Armstrong who overcame cancer and became the first person to ever win the grueling Tour de France bicycle race six times. There really are heroes. We need to believe that we too can beat the odds and overcome enormous obstacles that would crush lesser mortals. That mountain climber and Lance Armstrong believed they could control events when others might not do so.

According to Langer and her colleagues there are two kinds of control:

Primary control involves changing a situation. Owning our behavior and becoming more resilient requires that we realize that we are the authors of our lives. Instead of always trying to change everyone else we should ask what is it that I can do to change the situation? It is not just the elderly in nursing homes who benefit from feeling like they have some control of their daily activities, it is us all. Research supports the importance of personal control as a major factor in our physical and emotional well-being. A sense of control fosters optimism and optimism can be protective. Primary control means changing the situation.

Secondary control involves how we view a situation. Even in situations that we cannot directly change we can determine how we think about it. Even when faced with major life challenges like serious illness, death of a loved one, divorce, loss of employment and natural disasters a lot of what happens to us emotionally and physically is determined by how we look at the situation. Secondary control means changing the way we view the situation and how we feel about it.

Anger Can Be Poison

angerAnger is an emotion that is experienced by all people everywhere. Anger usually results from an emotional hurt. It is typically experienced as an unpleasant feeling that occurs when we feel injured, mistreated, or are opposed in long held views, or are faced with obstacles to attaining personal goals. Anger varies in its frequency, intensity, and duration. People also vary in how easily they get angry, their anger threshold, as well as with their comfort level with the emotion. Some people are always getting angry while others don’t even recognize that they feel angry. While some experts say that the average adult gets angry about once a day and annoyed or peeved around three times a day, those who work with people with anger management issues suggest that getting angry 15 times a day is average. In any case, anger is a common human emotional which we probably experience more often than we would like to admit.

It should be noted that anger can be constructive or destructive. When well managed, anger or annoyance has few detrimental health or interpersonal consequences; when mismanaged anger can be deadly. There is a difference in feeling angry and expressing your anger. To feel anger is to be human. The feeling contains information that can be of value. Expressing your anger inappropriately or prolonging the experience of anger can be dangerous. Not only can out of control anger damage personal relationships, it can lose you your job, land you in jail, damage your health or even kill you. For example, recent research suggests that men who have poor anger management skills are more likely to suffer a heart attack before age 55 than their more mild-mannered peers. A separate study involving 774 older white men (average age 60) indicated that high hostility levels were more predictive of developing coronary heart disease than risk factors like high cholesterol, alcohol intake, cigarette smoking. Older men with the highest levels of hostility were at the greatest risk for developing coronary heart disease independent of the effects of BMI (body mass index), waist-to-hip ratio, fasting blood-sugar levels, triglcyride levels, and blood pressure.

Anger can alienate friends, co-workers and family members. Your expressed anger elicits anger in others as a defense. Hostile, aggressive anger not only increases the risk for an early death but also the risk for social isolation, which is in itself a major risk factor for serious illness and death.

Anger is composed of the thoughts that trigger the emotion, the bodily arousal a person experiences, and whatever behaviors are exhibited, which are often culturally determined. The goal of anger is to protect or further our self-interests, or those of our loved ones, or uphold principles and causes we hold sacred. Instinctively anger often results in the desire to defend ourselves and strike back at its cause, often aggressively. Behind all anger is some form of pain, physical or emotional. It can start with not feeling well or feeling rejected, feeling threatened, or enduring a sense of loss. The type of pain does not matter; the point is that it is unpleasant and it makes you want to end the suffering. It is when these unpleasant feelings are associated with trigger thoughts that anger erupts. Trigger thoughts are assumptions, evaluations or your interpretation of situations that make you feel like you are being victimized or someone is deliberately trying to hurt you.

Many of our trigger thoughts have their roots in childhood. Often a person will overreact to a current situation because they learned earlier in life to be very angry when they experienced hurt, neglect or abuse. As an adult the person will have difficulty with situations and conflicts that threaten them with feeling unworthy, unloved or unsafe. Any time a situation “triggers” these old feelings of betrayal, the anger expressed will not only be about the current irritant but also about remnants of the pain felt before. When one of these old triggers is unleashed the degree of anger expressed is often excessive for the immediate aggravation. In addition if parental role models use anger to manipulate and control family members the children may learn destructive ways to manage anger. The children learn not only to be extremely angry because of the mistreatment they receive, but also how to express their anger in an inappropriately aggressive manner.

Stress and Health

5catdz8jzcaw3aackcazenv9mcabottr6caopqlifcao4qirqca4bwmqccaa8nn1hcaho32l4ca80lhhkca2voyzaca584yijcar59fr1cai16fetca8yolnfcax3z7clca7l4gj9ca9nw0sdcar6padvThere is growing evidence that stress is a major factor in maintaining health and well-being. Health means more than the absence of illness. In China and in ancient Greece health was thought of as being in balance with nature. The vital task was seen as maintaining equilibrium in the face of extensive demands. The World Health Organization (WHO) definition of health is a state of complete physical, mental and social well being.

It seems increasingly clear that the naive notion that a germ automatically leads to illness is no longer acceptable, although much of the lay public subscribes to the theory. Today we know that the idea of a single external cause, such as a germ, is oversimplified. The presence of the germ does not always cause the illness. The vulnerability of the person or the host animal is a major factor and that vulnerability is influenced by such factors as immunity and stress levels. So the cause of illness is not quite as simple as we once thought.

Stress vs. Distress

Another important distinction that came out of the seminal work of Hans Selye is between stress and distress. Both involve demands on the person to adapt to a challenging event. However, when we appraise the situation as being something we can handle it can be an exhilarating experience. When a person appraises the event as beyond their ability or as exceeding resources the situation is experienced as distress. Another way to look at it is that stress is positive and distress is negative. It is a valuable distinction since many people believe all stress is bad for you. It is not.

The diathesis-stress theory

The diathesis-stress theory of the origin of certain illnesses holds that we are born with certain biological predispositions but that whether or not an illness manifests itself is dependent on the level of stress one experiences and the resources one can use to overcome the stress. For example, although a person may have inherited a genetic deficiency in metabolizing alcohol, whether that person becomes an alcoholic or not also depends on the types and levels of stress they experience. Another person may have inherited a problem with glucose metabolism; however, it is factors such as the level of stress, or a sedentary life style or a combination of the two that result in development of type 2 diabetes. We may be born with certain vulnerabilities; it is stress that tips us into active illness.

Impact of stress on illnesses

Certain ailments have been recognized for some time as being influenced by stress. The most common example is intestinal distress such as indigestion and colitis. Other disorders like migraine, tension headaches, high blood pressure, arthritis and certain skin disorders may also be influenced by stress. In some instances, stress emotions seem to make an ailment worse, while in others stress may be a factor in bringing on illness. Research increasingly supports the hypothesis that stress may have at least some impact on many diseases.

There are several reasons for believing that stress contributes to the development of cardiovascular disease. First, stress emotions increase the level of low-density blood cholesterol and this leads to clogging of the arteries of the heart. Second, stress emotions result in maladaptive coping behaviors such as smoking, drinking and overeating, which can damage the heart and surrounding vessels. Finally, stress emotions result in the release of powerful hormones which result in increases in heart rate and blood pressure. One of these stress emotions is anger, and anger expressed in the form of hostility is known to increase the risk of cardiovascular disease.

Several hypotheses are being explored in the role of emotions in cancer. Again stress emotions may play an indirect role leading the person to smoke or drink excessively. More direct influence is attributed to a tendency to suppress or deny emotions. There is some evidence that those who suppress emotions are more susceptible to cancer. Again the mediating factor is hormonal activity.

At the 2002 meeting of the American Psychological Association a group-based stress management study was presented that indicated that group stress management training could lower blood glucose levels in Type 2 diabetes. Patients that received instruction regarding the health consequences of stress and instruction in the use of cognitive and behavioral skills such as deep breathing and recognition of major life stresses as well as instruction in progressive muscle relaxation lowered their glucose levels more than patients that did not have stress management training. Thirty-two percent of the patients receiving stress management lowered their A1C glucose levels by one percent or more as compared to 12% of the patients who did not receive this training. This modest change is larger than the half percent change that has been associated with significant reduction in microvasclar complications that can accompany out of control diabetes. While this change might move someone with tightly controlled diabetes to near normal levels; even those diabetics with poorer control would benefit from the reduction in glucose levels with fewer diabetic complications.

In summary, if you are a type 2 diabetic, learning to manage stress should have special health consequences for you. Although this was a group program, if none is available in your area, individual stress reduction strategies should be beneficial, especially if you have a friend or family member trying to learn stress management with you.

Stress and the immune system

The immune system has been called our liquid nervous system. With our growing knowledge of the human body has come an increasing conviction that stress may be a factor in susceptibility to colds, flu, mononucleosis and other infectious illnesses. It appears that some of the hormones secreted in the presence of stress emotions impair or weaken the immune process by reducing the number of disease-fighting components such as lymphocytes (white cells) thus leaving us more vulnerable to infection. This may be one of the reasons why so many people die within a year or so of their spouse’s death. Recently there has been research into why some HIV positive patients develop full blown AIDS while others do not. One interesting finding is that patients with a more effective style of coping with stress seem to have stronger resistance as a result. It is now reasonable to hypothesize that stress emotions increase secretion of certain hormones. These hormones weaken the immune system and that weakness results in an increased likelihood of infectious illness.

Recent research indicates that brief time-limited stress that may be viewed as a challenge (e.g. passing an exam, good performance in sports, solving a difficult puzzle under pressure) may actually enhance the body’s immune response. However, chronic stress seems to reduce the effectiveness of the immune system and thus make the person more susceptible to diseases.

Stop Smoking

ocayaddeucaod94excawbukdacayvy779caemcgzuca3l62m8cai6nu5oca0calmhca84gs7lcaazu3tccal53ogjcagygv4bcazn8ml9ca37b4eccam19e1kcalq0ajvcajseop1casgqeoacahsi0dsNicotine activates the pleasure center of the brain. Within 10 seconds of inhaling a puff on a cigarette nicotine levels peak in the brain. The average smoker takes about 10 puffs on every cigarette smoked. Since the pleasurable effects of nicotine are short-lived the smoker soon craves another cigarette. If one cigarette supplies ten surges of nicotine to the brain, smoking 1½ packs of cigarettes a day provides a smoker 300 nicotine hits. Since cigars and pipe smokers usually do not inhale, their nicotine must be absorbed through the mucosal membranes in the mouth. The mucosal membranes are also the entrance way for nicotine delivered from smokeless tobacco. These other forms of tobacco use may not delivery their nicotine fix as efficiently as a cigarette, but it is delivered.

Some smokers say that smoking relaxes them while others say that it gives them a boost. According to the National Institute of Drug Abuse, nicotine does both—acting as both a stimulant and a sedative. A hit of nicotine stimulates the adrenal glands which cause a release of adrenaline. This release of adrenaline stimulates the body and causes a release of glucose, as well as an increase in respiration, blood pressure and heart rate. Meanwhile insulin output is suppressed which leaves smokers with slightly elevated levels of glucose in their bloodstream. Nicotine also causes the release of dopamine in the part of the brain that controls pleasure and motivation. A similar effect is caused by cocaine and heroin and is believed to be behind the pleasurable sensations reported by many smokers. Nicotine is also able to cause a sedative (calming) effect depending on a smoker’s nervous system arousal and how much nicotine is taken. These effects occur with the use of all tobacco products; cigarette smoking merely provides the most rapid dosing.

Frequent use of tobacco products results in addiction to nicotine. Repeated exposure to nicotine results in the development of tolerance for the drug. As tolerance is build it takes a higher dose of the drug to produce the same level of stimulation. Nicotine is metabolized rapidly which means it disappears from the body in a few hours. Thus morning doses of nicotine have a greater physiological effect on the body than those occurring later in the day because of a period of abstinence during the night.

The addictive properties of nicotine contribute significantly to the difficulty tobacco users have in giving up the habit. The withdrawal symptoms from discontinuing nicotine use can be challenging and often drive people back to tobacco use.

Psychological factors also influence the difficulty experienced by a user trying to break an addiction to tobacco. The pleasurable consequences of smoking are considerable and they affect not only the body but also the mind. While we rarely think of tobacco use as an addiction of the same caliber as a craving for cocaine or heroin, tobacco’s legal status does not prevent it from being highly addictive. Nicotine is a drug. The initial high from obtaining a hit of the substance relieves the immediate craving for the drug, which may be followed by the user feeling calm and relaxed. Unfortunately this satisfaction is very short-lived and a new craving quick to develop. A person attempting to quit smoking will miss the boost a cigarette gives them and/or the calming effect they perceive. Tobacco has become a dependable friend.

Psychologically, when you quit using tobacco you may go through a period of mourning for your longtime friend. Dr. Kübler-Ross analyzed the stages that human beings go through when in grief. The stages are: denial, bargaining, anger, sadness (depression), guilt and acceptance. It is definitely not an indictment of you if you miss smoking as a kind of friend and companion. It has been a big part of your life for a long time. Be kind to yourself if you have these feelings; they are part of being human. Work through the stages and they will set you free to go on as a non-smoker. Think positively. You can do this.

Obesity Epidemic

gcadshvjncaxaxcdbcaixc4kkcabfrd5wcaapjbgtcavvpddccad7t9mpcapy4999cayl3l3fcavevdrocav56sm8cae3cmh3ca0fhwjacaew128bca242os2cav195t9cau8jzvzca07mjifcaswut16Obesity is epidemic in the United States. The number of overweight and obese Americans has grown at a disturbing rate, especially over the past few years. Today more Americans are overweight than are normal weight. Over sixty percent of the population is now considered to be overweight, with over 30 percent of the population considered to be obese. This is tragic for America. A very large (and growing) percentage of our citizens are at increased risk for developing serious chronic diseases, and face the prospect of early death. Meanwhile the entire society struggles under the burden of the resulting increase in health care costs.

While genetics plays a role in the predisposition to obesity, the actual development of obesity is strongly influenced by environmental factors, most notably a sedentary lifestyle. Exercise is essential in weight management. For example, if an extra 100 calories a day is consumed above that needed by the body, in one year that will result in a ten pound weight gain. This is particularly tragic since a 20 minute walk is sufficient to burn those extra calories for many people! There are a number of web sites that allow a visitor free access to calculations on how many calories an individual would burn doing various activities based on weight http://www.realage.com/racafe/exest.aspx is one such site. Pick a favorite food, snack, whatever and see the energy cost of that item for you. It is quite illuminating!

Portion size is a large part of the problem. As our lives have become increasingly busy, more and more Americans have turned to restaurant food, sit down or take out, for many of their meals. In an effort to attract customers many establishments began to offer larger portions of high-calorie food at inexpensive prices. Ever fond of a bargain, Americans have been quick to take advantage of these supersized portions. Since people tend to eat more if given more in a portion, calorie consumption has significantly increased. In time the larger portions have come to be considered normal and expected. Thus the amount of food we eat has increased during the same time period that more and more people have become sedentary. Weight gain has been the result.

Risks of obesity include: coronary artery disease (CAD), heart attack, heart failure, angina, abnormal heartbeat, high blood pressure, elevated cholesterol and triglycerides levels, lowered beneficial HDL cholesterol levels, stroke, type 2 diabetes, and certain cancers such as prostate, gallbladder, colorectal, breast, endometrial and kidney. In addition, obesity increases the risk of developing gallstones (in women), liver problems such as an enlarged liver, cirrhosis, or a fatty liver, gastroesophageal reflux disease (GERD), sleep apnea, asthma, shallow breathing (Pickwickian syndrome) which can lead to heart disease, and arthritis. Obesity also increases the risk of reproductive problems such as irregular periods, an increased risk of birth defects, especially neural tube defects, and an increased risk of death of the mother and baby.

The risk of developing type 2 diabetes increases as a person gets heavier. This is very unfortunate as diabetes is a major risk factor for the development of heart disease. While obese individuals are more at risk for arthritis than normal weight individuals, each additional few pounds of weight gain increases the risk for developing this potentially debilitating condition. Finally, recent research suggests that being obese can increase the risk of lowered mental ability, especially in memory and learning, in men over time.

The location of body fat is also important in assessing risk. If the fat accumulates disproportionably around the abdomen, it is an independent predictor of increased risk and morbidity. Thus individuals whose fat accumulates around the abdomen are at greater risk than individuals whose fat accumulates around the hips and thighs. A man with a waist measurement of more than 40 inches or a woman with a waist measurement greater than 35 inches is considered at increased risk for type 2 diabetes, high blood pressure, high cholesterol, and coronary artery disease than normal weight individuals or those whose fat accumulates around the hips.