TheWellnessLiving Health Tips

The goal of a behavioral management of obesity is to train an individual with the skills that will allow him/her to promote a healthy weight level. The concept involves a number of strategies which are conducted in a way to help obese patients in making gradual but steady changes that can be incorporated into their everyday habits in a realistic way.

The effectivity of behavioral programs in curing obesity is promising. Results from several studies demonstrate an 8% to 10% reduction in initial weight during the first 6 months to 1 year of treatment. The long-term effectivity of these treatments are more difficult to assess and still remains unclear. It appears that many individuals tend to regain weight lost over time but the causes are still obscure and it is unknown whether they are related to the method.

In spite of the uncertainty, an effective behavioral approach will constitute a very god option as it lacks many of the drawbacks from other weightloss methods. Efforts such as the Diabetes Prevention Program and the Look AHEAD (Action for Health in Diabetes) trials are starting to provide strong data on the long-term results of intensive behavioral management interventions.

The March issue of the American Journal of Psychiatry published a note by Dr. Jerald Block in which he argues that Internet addiction should be included in the next update of the DSM handbook, the Bible of mental health conditions.

Dr Block says that the diagnosis of Internet addiction is a type of compulsive-impulsive disorder that involves online and/or offline computer usage. He recognizes three subtypes, characterised by a) excessive gaming, b) sexual preoccupations, and c) e-mail/text messaging.

In turn, these variants have the following four components:

1) excessive use (through loss of sense of time)

2) withdrawal (characterised by feelings of anger and/or depression when the computer is not available)

3) tolerance (need for better computer equipment, more software, or more hours of use)

4) negative repercussions in social life (arguments, lying, poor achievement, social isolation, and fatigue)

Some countries are already deeply concerned about this problem, such as Korea and China, where studies have shown that large numbers of adolescents are in need of psychiatric counseling or even medication and hospitalization due to Internet and gaming addiction. Data from USA is lacking because the vast majority of Internet users access the network from home (in Asia, use of Internet cafés is more widespread) and so it is difficult to assess, but the situation seems not much different.

Inclusion into DSM-V is a critical goal for many professionals who investigate new or poorly described mental conditions. Being listed in DSM is a sort of ‘official recognition’ as a disease and thus it is more likely to get grants or other forms of financial help to carry out studies and trials, which will lead to improving the chances for treatment.

Smoking is the most importan cause of preventable death in the developed world. In spite of this, tocacco dependence is still viewed by many just as a bad habit. Because of the strong bonds created by the dependence, most smokers wanting to quit find it difficult and many fail if not following a strict treatment.

In a recent article in the specialized journal “Annals of Internal Medicine”, Dr Steinberg and collaborators from the University of Medicine and Dentistry of New Jersey discussed the importance of regarding tobacco dependence as a medical condition that requires a specific medical treatment, rather than a bad habit or a lifestyle choice. They compare smoking to diabetes. Diabetes, they say, is similar to tobacco dependence in “their potential to exacerbate other diseases, their behavioral components of treatment, and their effectiveness of medications”. In spite of this, treatments for diabetes are amply covered by health insurance plans, whereas coverage for tobacco cessation products and treatments are usually very limited.

In the article, the authors review some of the available treatments that usually have satisfactory results. Among the safest options is behavioral counseling, but there are also pharmacotherapies that are safe and effective. “Nicotine replacement therapy effectively delivers nicotine in safer doses without exposure to the toxins and chemicals in cigarette smoke”. As everybody is different, optimal duration of tobacco dependence treatment cannot be established, and some smokers may require more extended courses or treatment than others.

They conclude that limited coverage constitutes a severe downside for this important problem. For those smokers for whom normal methods don’t work, health care providers should encourage using long-term cessation treatments and insurance carriers should cover them. To achieve this, “tobacco dependence should share the status of other chronic illnesses, with effective treatments given as long as is necessary to achieve successful clinical outcomes”.