Caffeine is a stimulant found in coffee, tea and soda and may help
ward off sleepiness. It is a commonly used drug that has been shown
to enhance vigilance, increase alertness and improve mood and reaction
time. It is generally considered safe for most people to consume
a moderate amount of caffeine, out 300 milligrams, or the amount
in two cups of coffee.

However, caffeine affects everyone a little differently and a lot
depends on how much you’re used to consuming. The more caffeine
you drink, the more of a “tolerance” you develop. If
you typically drink several cups of coffee each day, you would have
to drink even more than that in order to feel caffeine’s effects
like keeping you alert. The best strategy for both your health and
your grades may then be to only drink a cup of coffee or soda now
and then when your concentration could use a boost as opposed to
regularly.

Are there any side effects of having too much caffeine?

There are side effects of consuming caffeine. First of all, caffeine
temporarily stimulates the central nervous and cardiovascular systems,
increasing heart rate and blood pressure, stimulating muscles and
increasing urination. Secondly, caffeine at doses higher than someone
is accustomed to may cause jitters, anxiety and diarrhea. In addition,
someone who consumes caffeine regularly may experience withdrawal
symptoms, including jitters and headache, when caffeine is suddenly
decreased. But because people have different tolerances to caffeine
and some people are simply more sensitive to it, it is difficult
to quantify the number of milligrams at which point any side effects
will occur.

Caffeine can also increase calcium losses, but moderate amounts
(300 mg per day) seem to have little influence on bone health. The
Recommended Dietary Allowance (RDA) for calcium is 1000 mg and if
you choose a 12-ounce latte with skim milk, you’ll get 450
mg of calcium towards your daily total.

The Bottom Line

Caffeine has been shown to improve concentration and alertness the
most in people who don’t regularly consume it. Therefore, unless
your doctor tells you otherwise, it is generally safe to consume a
moderate amount of caffeine, less than 300 mg per day. If you haven’t
always been a latte lover and suddenly begin to consume a lot of caffeine
during the week of exams, you may find yourself jittery, nervous and
running to the bathroom.

A condition that occurs when the inner walls that line the main air passageways
of your lungs (bronchial tubes) become inflamed. Bronchitis often follows
a respiratory infection such as a cold. And just as most people get occasional
colds, virtually everyone has bronchitis at least once.

Most cases of acute bronchitis disappear within a few days without lasting
effects, although coughs may linger three weeks or more. But if you have
repeated bouts of bronchitis, see your doctor. You may have a more serious
health problem, such as asthma, chronic bronchitis or emphysema — a
disease that causes progressive lung damage. You’re much more likely to
develop these conditions if you smoke.

Signs and Symptoms

• Soreness and a feeling of constriction or burning in your chest
• Cough that brings up yellowish-gray or green mucus
• Breathlessness
• Wheezing
• Chills
• Overall malaise and slight fever

Causes

The same viruses that cause colds often cause acute bronchitis. But you
can also develop noninfectious bronchitis from exposure to your own or
someone else’s cigarette smoke and even from pollutants such as household
cleaners and smog.

When to Seek Medical Help

Most cases of bronchitis clear on their own in a few days, especially
if you rest, drink plenty of fluids, and keep the air in your home warm
and moist. But if you have a fever higher than 101 F, you’re breathless,
or you cough up bloody or yellow or green mucus, see your doctor. You may
have pneumonia. And if you have a cough that lasts six weeks or more, be
sure to seek medical care. The inflammation from a chronic infection can
lead to asthma in some people.

Also see your doctor if you have chronic lung or heart problems, including
asthma, emphysema or congestive heart failure, and think you may have developed
a case of bronchitis. These conditions put you at greater risk of developing
complications from bronchial infections.

If you have repeated bouts of bronchitis, tell your doctor. You may have
chronic bronchitis, or you may live or work in an environment that continually
irritates your airways. In some cases, you may have GERD or chronic sinusitis.
If so, your doctor may be able to pinpoint the cause of your problem and
suggest further testing and lifestyle changes that can help.

Prevention

• Avoid tobacco smoke. This includes your own smoke and
  secondhand smoke from others.
• Get an annual flu shot. Many cases of acute bronchitis
  result from influenza. Getting a yearly flu shot can
  help protect you from both bronchitis and the flu.
• Ask your doctor about a pneumonia shot.

People choose to become vegetarians for health, environmental, and/or
ethical reasons. For example, some vegetarians feel that one promotes
the meat industry by consuming eggs and dairy products. That is,
once dairy cows or egg-laying chickens are too old to be productive,
they are often sold as meat; and since male calves do not produce milk,
they usually are raised for veal or other products. Some people avoid
these items because of conditions associated with their production.

Many vegans choose this lifestyle to promote a more humane and caring
world. They know they are not perfect, but believe they have a responsibility
to try to do their best, while not being judgmental of others.

Nutrition

The key to a nutritionally sound vegan diet is variety. A healthy and
varied vegetarian diet includes fruits, vegetables, plenty of leafy
greens, whole grain products, nuts, seeds, and legumes.

Protein

It is very easy for a vegan diet to meet the recommendations for protein
as long as calorie intake is adequate. Strict protein planning or combining
is not necessary. The key is to eat a varied diet.

Almost all foods except for alcohol, sugar, and fats are good sources
of protein. Vegan sources include: potatoes, whole wheat bread, rice,
broccoli, spinach, almonds, peas, chickpeas, peanut butter, tofu, soy
milk, lentils, kale…

For example, if part of a day’s menu included the following foods,
you would meet the Recommended Dietary Allowance (RDA) for protein for
an adult male: 1 cup oatmeal, 1 cup soy milk, 2 slices whole wheat bread,
1 bagel, 2 Tablespoons peanut butter, 1 cup vegetarian baked beans,
5 ounces tofu, 2 Tablespoons of almonds, 1 cup broccoli, and 1 cup brown
rice.

Fat
Vegetarian diets are free of cholesterol and are generally low in
fat. Thus eating a vegetarian diet makes it easy to conform to recommendations
given to reduce the risk of major chronic diseases such as heart
disease and cancer. High-fat foods, which should be used sparingly,
include oils, margarine, nuts, nut butters, seed butters, avocado, and
coconut.

Vitamin D

Vitamin D is not found in the vegetarian diet but can be made by humans
following exposure to sunlight. At least ten to fifteen minutes of summer
sun on hands and face two to three times a week is recommended for adults
so that vitamin D production can occur.

Calcium
Calcium, needed for strong bones, is found in dark green vegetables,
tofu processed with calcium sulfate, and many other foods commonly eaten
by vegetarians. Calcium requirements for those on lower protein, plant-based
protein diets may be somewhat lower than requirements for those eating
a higher protein, flesh-based diet. However, it is important for vegans
to eat foods high in calcium and/or use a vegetarian calcium supplement
every day.

Zinc
Vegetarian diets can provide zinc at levels close to or even higher
than the RDA. Zinc is found in grains, legumes, and nuts.

Iron

Dried beans and dark green vegetables are especially good sources of
iron, better on a per calorie basis than meat. Iron absorption is increased
markedly by eating foods containing vitamin C along with foods containing
iron.

Sources of Iron

Soybeans, lentils, blackstrap molasses, kidney beans, chickpeas, black-eyed
peas, seitan, Swiss chard, tempeh, black beans, prune juice, beet greens,
tahini, peas, figs, bulghur, bok choy, raisins, watermelon, millet,
and kale.

Common Vegan Foods

Oatmeal, stir-fried vegetables, cereal, toast, orange juice, peanut
butter on whole wheat bread, frozen fruit desserts, lentil soup, salad
bar items like chickpeas and three bean salad, dates, apples, macaroni,
fruit smoothies, popcorn, spaghetti, vegetarian baked beans, guacamole,
chili, and more.

Vegetarians Also Eat…

Tofu lasagna, homemade pancakes without eggs, hummus, eggless cookies,
soy ice cream, tempeh, corn chowder, soy yogurt, rice pudding, fava
beans, banana muffins, spinach pies, oat nut burgers, falafel, corn
fritters, French toast made with soy milk, soy hot dogs, vegetable burgers,
pumpkin casserole, scrambled tofu, seitan.

When Eating Out Try These Foods

Pizza without cheese, Chinese moo shu vegetables, Indian curries and
dahl, eggplant dishes without the cheese, bean tacos without the lard
and cheese (available from Taco Bell and other Mexican restaurants),
Middle Eastern hummus and tabouli, Ethiopian injera (flat bread) and
lentil stew, Thai vegetable curries…

Egg and Dairy Replacers

As a binder, substitute for each egg:

• 1/4 cup (2 ounces) soft tofu blended with the liquid ingredients
  of the recipe, or
• 1 small banana, mashed, or
• 1/4 cup applesauce, or
• 2 tablespoons cornstarch or arrowroot starch, or Ener-G Egg Replacer
  or another commercial mix found in health food stores.

The following substitutions can be made for dairy products:

• Soy milk, rice milk, potato milk, nut milk, or water (in some
  recipes) may be used.
• Buttermilk can be replaced with soured soy or rice milk. For
  each Cup of buttermilk, use 1 cup soymilk plus 1 tablespoon of
  vinegar.
• Soy cheese available in health food stores. (Be aware that many
  soy cheeses contain casein, which is a dairy product.)
• Crumbled tofu can be substituted for cottage cheese or ricotta
  cheese in lasagna and similar dishes.
• Several brands of nondairy cream cheese are available in some
  supermarkets and kosher stores.

• Being in a new environment and eating setting it is important
  to be conscious of what you eat and how much you eat. Here
  are some tips to avoid the “Freshman 15.”
• Avoid keeping high-calorie foods such as ice cream, candy
  and cookies in your room. Instead, eat a small portion for dessert
  after a meal once each day to satisfy your craving for something
  sweet.
• Eat breakfast! Breakfast can be a bagel and juice in your
  room or on the way to class; cereal, milk and fruit in the dining
  hall; or even a hot meal. Breakfast will get your body and brain
  ready for the day, and you’ll be less likely to snack due to
  mid-morning hunger attacks.
• Eat a variety of different foods. Instead of choosing peanut
  butter and jelly for lunch every day or stocking up on ramen
  noodles because they’re cheap, expand your horizons! Make sure
  to include fruit, vegetables, whole grains, protein and dairy products
  in your food choices every day.
• Stock a dorm refrigerator with fat-free milk, yogurt and
  individually portioned canned fruits, puddings, bags of ready-to-eat
  lettuce or carrots for quick meals or snacks.
• Make a goal of trying one new food each week. Share with
  a friend so you can both experiment
• Stay active! Check out
  the Coors Fitness Center in the
  Ritchie Center.

Winston Salem Health – Sexual Assault statistics are alarming – especially on college campuses.

Sexual Assault Facts

Campus Sexual Assault According to a 1993 survey of 6,000 college students:

• one of four college females reported being victims of rape or attempted rape during preceding year
• 90% of rapes go unreported
• 50% of males believe women say “no” when they actually mean “yes”
• women need to say “no” an average of three times before they are believed
• 30% of male students continued sexual advances after partner said “no” and one of every six admitted forcing sexual contact
  Acquaintance/Date Rape is a serious violation of the code of student conduct. The act will be handled as a campus disciplinary matter resulting in possible dismissal. Sexual assault is a crime in Colorado. Victims are strongly encouraged to report the crime to the local police.
• Over 84% of sexual assaults on a college campus are perpetrated by someone known to the survivor – a friend, partner, colleague, classmate, roommate, floor mate (Warshaw, R “I Never Called It Rape” 1988; Department Of Justice Report, 2001).

Ways to Avoid Circumstances that Might lead to Sexual Assault

Men:

• Understand your sexual desires and limits. You are responsible for your actions as an individual and as a member of a group. Be aware of and resist negative social pressure.
• Being turned down when you ask for sexual relations is not a rejection of you personally. A woman who says “no” to sexual relations is not necessarily rejecting you; she is expressing her unwillingness to participate in a specific act at a specific time.
• Accept the woman’s decision. “No” means “no.” Don’t read in other meanings. Don’t continue after the woman says “no”.
• Don’t assume that just because a woman flirts or dresses in a manner you consider sexy that she wants to engage in sexual activity.
• Don’t assume that previous permission for sexual activity applies to the current situation.
• Avoid excessive use of alcohol and drugs.
  Alcohol and drugs interfere with clear thinking and effective communication.

Women:

• Understand your sexual desires and limits. Believe in your right to set those limits. If you are not sure, stop.
• Communicate your limits clearly. If someone starts to offend you, tell him so, firmly and promptly. Polite approaches might be misunderstood or ignored. Say “no” when you mean “no.
• Be assertive; passivity might be interpreted as permission. Be direct and firm with someone who is pressuring you sexually.
• Pay attention to what is happening around you. If you feel threatened, don’t be embarrassed to ask for help or to leave.
• Trust your intuition. If you feel you are being pressured into unwanted sexual relations, don’t hesitate to express your unwillingness, even if it might appear rude.
• Avoid excessive use of alcohol and drugs. Alcohol and drugs interfere with clear thinking, effective communication, and your ability to respond in your own best interest.

If You or a Friend have been Sexually Assaulted

Rape can be terrifying and traumatic. After a rape, it’s not uncommon to feel fearful, confused, guilty, ashamed, or isolated. You do not have to deal with these feelings alone. There are many concerned people at the University of Denver and in the community to help you.

What is Anxiety?

Anxiety can be a normal "alarm system" alerting you to danger.
Imagine coming home and finding a burglar in your living room. Your heart
beats fast. Your palms get sweaty. Your mind races. In this situation, anxiety
can provide an extra spark to help you get out of danger. In more normal
but busy situations, anxiety can give you the energy to get things done.

But sometimes anxiety can be out of control, giving you a sense of dread
and fear for no apparent reason. This kind of anxiety can disrupt your life.

Different types of anxiety

Anxiety can be a general feeling of worry, a sudden attack of panicky feelings,
a fear of a certain situation or a response to a traumatic experience.

What is generalized anxiety disorder?

Generalized anxiety disorder is ongoing worry or fear that isn’t related
to a particular event or situation, or is out of proportion to what you would
expect–for instance, constantly worrying about a child who is perfectly
healthy.

Symptoms of generalized anxiety disorder include muscle tension, trembling,
shortness of breath, fast heartbeat, dry mouth, dizziness, nausea, irritability,
loss of sleep and not being able to concentrate.

What is panic disorder?

Panic disorder is another type of anxiety. It occurs when you have repeated
periods of extreme panic, called panic attacks.

Suppose one day you’re getting out of your car to go to work. Suddenly,
your chest feels tight. Your heart races. You begin to feel dizzy and faint.
You start to choke. You feel as if the end is near. Was it all in your head?
No. Most likely, you had a panic attack.

Panic attacks last about 5 to 30 minutes. Panic attacks can lead to
phobias if they aren’t treated.

What is a phobia?

A phobia is an extreme, unreasonable fear in response to something specific.
Examples include fear of crowds, bridges, snakes, spiders, heights, open
places or social embarrassment.

A phobia is only considered a problem when it keeps you from living a normal
life. An example is being afraid to leave home because you are afraid of
having a panic attack or of not being able to escape if an attack starts.
This fear is called agoraphobia.

What causes anxiety disorders?

Suppose the fire alarm goes off in your home. You race around frantically
to find the fire. Instead, you find that there is no fire–the alarm just
isn’t working properly.

It’s the same with anxiety disorders. Your body mistakenly triggers your
alarm system when there is no danger. This may be due to a chemical imbalance
in your body. It may also be related to an unconscious memory, to a side
effect of a medicine or to an illness.

Can anxiety disorders be treated?

Yes. Talk to a physician or counselor if you think you have an anxiety disorder.
He or she can help you form a plan to develop skills to cope with your anxiety.
Medication may also be helpful.

Tips on coping
with anxiety

Control your worry. Pick a place and time to do your worrying.
Make it the same place and time every day. Spend 30 minutes thinking about
your concerns and what you can do about them. Try not to dwell on what "might" happen.
Focus more on what’s really happening. Then let go of the worry and go on
with your day.

Learn ways to relax. These may include muscle relaxation,
yoga, or deep breathing (see box to the right).

Muscle relaxation is simple. Start by choosing a muscle and holding it tight
for a few seconds. Then relax the muscle. Do this with all of your muscles.
Try starting with your feet muscles and working your way up your body.

Exercise regularly. People who have anxiety often quit
exercising. But exercise can give you a sense of well-being and help decrease
feelings of anxiety.

Get plenty of sleep.

Avoid alcohol and drug abuse. It may seem that alcohol
or drugs relax you. But in the long run they make anxiety worse and cause
more problems.

Avoid caffeine. Caffeine is found in coffee, tea, soft
drinks and chocolate. Caffeine may increase your sense of anxiety because
it stimulates your nervous system. Also avoid over-the-counter diet pills,
and cough and cold medicines the contain a decongestant.

Confront the things that have made you anxious in the past. Begin
by just picturing yourself confronting these things. By doing this, you can
get used to the idea of confronting the things that make you anxious before
you actually do it. After you feel more comfortable picturing yourself confronting
these things, you can begin to actually face them.

If you feel yourself getting anxious, practice a relaxation technique or
focus on a simple task, such as counting backward from
100 to 0.

Although feelings of anxiety are scary, they won’t hurt you. Label the level
of your fear from 0 to 10 and keep track as it goes up and down. Notice that
it doesn’t stay at a very high level for more than a few seconds. When the
fear comes, accept it. Wait and give it time to pass without running away
from it.

Use medicine if it helps. Your physician may give you medicine
to help reduce your anxiety while you learn new ways to respond to the
things that make you anxious. Many types of medicine are available. You
and your physician will decide which medicine is right for you.

Winston Salem Health – When You Worry About a Friend’s Eating – is a follow up to yesterday’s post about Eating Disorders.

What do I say? What do I do? Who can help?

If you have a friend with an eating disorder, or you worry about what might be an eating disorder, you are not alone. Some estimates are that as many as 1 in 3 college women have struggled with weight, food, body image, disordered eating or an eating disorder by the time they graduate from college. Certainly, among your friends and acquaintances there are women and possibly men who have eating concerns.

Perhaps you have become aware of your friend’s problem because you have observed their weight changes, or you feel uncomfortable with his preoccupation with dietary restriction, or you have become aware that he/she abuses laxatives or vomits to purge him/herself of what he/she eats. You feel concerned and wonder how to bring up the subject. You worry that your friend will feel “accused” or “diagnosed” and will be angry with you. It’s important to keep in mind that hearing honest concern from others helps break denial and often is the first step on the path to acknowledging the problem and getting help.

What can you say?

First of all, you can make sure your friend knows that you care about them. You might say:
“I’m here for you if you need me. I know you’re struggling with a lot of stress lately. Let me know how I can help.”

You may want to go further and share with her/him what you have observed and talk about your specific concerns. For example:

“I’ve noticed you’ve lost so much weight and that you’re still dieting and losing. I’m worried about your health.”

“It seems like we’re always talking about weight and food and exercise. You seem so worried about it and so unhappy with the way you look. I’m worried that maybe you don’t feel too good about yourself and that maybe you’re depressed.”

“I heard you throwing up 3 times last week. I know when that happened before you said you had the flu. I’m really worried that it’s more that. I’m scared something will happen to you.”

What can you expect?

Your friend may deny or minimize or may say “I used to have a problem but I’m better now,” or she may acknowledge the difficulty and want to talk about it. If she denies it and wants to avoid it, you may have to be satisfied to have expressed your concerns directly and let it be, for now. Let her know that you are still her friend and are there to talk if she wants to.

If your friend’s constant discussion of weight and what s/he eats interferes with your relationship, you may have to put some limits on that behavior. Those topics can be declared off-limits in your conversations with each other. If you are disturbed by your friend’s restrictive eating, for example, you may decide not to have meals together.

What if there are medical concerns?

If you are concerned that your friend may be in some medical jeopardy and feel you must do more than just express your concerns to them, you may need to ask for additional help — from family, a medical provider, or other professionals. You can also talk to an RA, Counseling Services, Health Services or Health Promotion for more advice.

What if they will talk about it?

If your friend is willing to talk and be open about the problem, it’s important to listen with empathy and without judgment. It may be hard to understand why someone who is attractive and well-liked would think they are “fat and ugly” or why someone would feel they needed to vomit if they had been “bad” by eating a chocolate chip cookie. It is so tempting to try to use logic, reality, and reason to talk someone out of these “irrational” ideas.

One of the most helpful things you can do is facilitate the person’s accessing professional help. For DU students, this is where the Student Health and Counseling Center can come in.  A registered nutritionist is available to see students individually to help evaluate their nutritional status and eating patterns. Health Services provides medical evaluations and Counseling Services evaluates the overall eating disorder in the context of the person’s current and past life, providing treatment recommendations.

What is not helpful?

One thing is almost NEVER helpful: monitoring what someone eats. To be told what to eat, how much to eat, to be watched while eating, etc. would create a problem with food for any of us. Imagine how it affects someone who is literally thinking about food all the time. Resist the pull to monitor, comment or advise about eating.

What can we do about cultural attitudes about weight?

There is something else we can do to help friends who are suffering from eating disorders; something that can enhance our well being and that of the community at large, as well. We need to do all we can to eradicate “fatism.” It is a form of prejudice and discrimination just like racism or sexism. It is based on the assumption that there is only one “right” or acceptable way to look. It equates thinness with attractiveness, intelligence, ambition, success, and worthiness. There is no room for variety, for difference, for valuing how we REALLY look instead of how we’re “supposed” to look.

What a wonderful world it would be if we focused on how each other FELT instead of how we looked. What if there were other ways to know deep inside we’re O.K., besides how much we weigh, or how small our waist is, or how big our biceps are? It will take a lot of effort on all our parts to change the way we think. Let’s start now. We can create an environment where our self-doubt and unfulfilled longings don’t have to be expressed in a war against our bodies.

General Information

• The three main symptoms of ADHD are inattention, hyperactivity, and impulsivity. Those with ADHD may have difficulty in school or at work, troubled relationships with family and peers, and low self-esteem.
• Many ADHD symptoms are also common to other mental health problems such as anxiety and depressive disorders. Thus, it is important to obtain a complete assessment prior to being diagnosed. Complete assessments include an interview and various psychological tests.
• Although ADHD symptoms are first noticed in childhood, some children’s symptoms continue into their adult lives.
• Inattention may be the primary problem with some patients, while hyperactivity and impulsivity may be the main problem with others. Most patients have problems in all three symptom areas, hence the prevalence of the Combined Type of ADHD. Many individuals occasionally have symptoms such as these, but patients with ADHD have these symptoms more often and to a greater extent than do others of the same age.
• These symptoms must be present for more than 6 months and must be having a negative effect on the patient’s functioning at school, on the job, or in social situations for the diagnosis of ADHD to be made.
• Although there is no “cure” for ADHD there are accepted treatments that specifically target its symptoms. These standard treatments include educational approaches, psychological or behavioral therapies, and medication.

Books

• Edward M. Hallowell & John J. Ratey (1995), Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood. ISBN 0684801280
  This book is a valuable resource that offers a life-span perspective on attention disorders and emphasizes the effect such disorders can have on relationships, education, and careers. The book reviews the diagnosis of attention disorders, co-occurring disorders, and treatment strategies.
• Driven to Distraction Edward Hallowell, M.D. & John Ratey, M.D.
• Beyond ADD: Hunting for Reasons in the Past and PresentThom Hartmann
• Answers to DistractionEdward Hallowell, M.D. & John Ratey, M.D.
• You Mean I’m Not Lazy, Stupid, or Crazy!Kate Kelly & Peggy Ramundo
• Attention Deficit Disorder in AdultsLynn Weiss, Ph.D
• Adult ADDThomas Whiteman, Ph.D & Michelle Novotni, Ph.D
• Healing ADD: Simple Exercises That Will Change Your Daily LifeThom Hartmann
• The Down and Dirty Guide to Adult Attention Deficit DisorderMichael Gordon, Ph.D & F. Daniel McClure, Ph.D
• Adventures in Fast Forward: Life, Love, and Work for the ADD Adultby Kathleen G. Nadeau Ph.D.

Websites

• www.add.org

• www.chadd.org

Winston Salem Health – Eating Disorders are found in men and women.  In an age of wafer thin models and television personalities it’s not difficult to see why eating disorders are becoming more and more common.

What are Eating Disorders ?

Eating Disorders such as anorexia, bulimia, and binge eating disorder include extreme emotions, attitudes, and behaviors surrounding weight and food issues.

They are serious emotional and physical problems that can have life-threatening consequences for females and males.

ANOREXIA NERVOSA is characterized by self-starvation and excessive weight loss.

Symptoms include:

• Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level
• Intense fear of weight gain or being “fat”
• Feeling “fat” or overweight despite dramatic weight loss
• Loss of menstrual periods
• Extreme concern with body weight and shape

BULIMIA NERVOSA is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food-more than most people would eat in one meal-in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse, or over-exercising.

Symptoms include:

• Repeated episodes of bingeing and purging
• Feeling out of control during a binge and eating beyond the point of comfortable fullness
• Purging after a binge, (typically by self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, or fasting)
• Frequent dieting
• Extreme concern with body weight and shape

BINGE EATING DISORDER (also known as COMPULSIVE OVEREATING) is characterized primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge. People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating. Body weight may vary from normal to mild, moderate, or severe obesity.

OTHER EATING DISORDERS can include some combination of the signs and symptoms of anorexia, bulimia, and/or binge eating disorder. While these behaviors may not be clinically considered a full syndrome eating disorder, they can still be physically dangerous and emotionally draining. All eating disorders require professional help.

What is Acne?

Acne is a disorder resulting from the action of hormones on the skin’s
oil glands (sebaceous glands), which leads to plugged pores and outbreaks
of lesions commonly called pimples or zits. Acne lesions usually occur
on the face, neck, back, chest, and shoulders.

What Causes Acne?

The exact cause of acne is unknown, but doctors believe it results from
several related factors. One important factor is an increase in hormones
called androgens (male sex hormones). These increase in both boys and girls
during puberty and cause the sebaceous glands to enlarge and make more
sebum. Hormonal changes related to pregnancy or starting or stopping birth
control pills can also cause acne.

Another factor is heredity or genetics. Researchers believe that the tendency
to develop acne can be inherited from parents. For example, studies have
shown that many school-age boys with acne have a family history of the
disorder. Certain drugs, including androgens and lithium, are known to
cause acne. Greasy cosmetics may alter the cells of the follicles and make
them stick together, producing a plug.

Factors That Can Make Acne Worse

• Friction caused by leaning on or rubbing the skin
• Pressure from bike helmets, backpacks, or tight collars
• Environmental irritants, such as pollution and high humidity
• Squeezing or picking at blemishes
• Hard scrubbing of the skin.

Myths About the Causes of Acne

There are many myths about what causes acne. Chocolate and greasy foods
are often blamed, but foods seem to have little effect on the development
and course of acne in most people. Another common myth is that dirty skin
causes acne; however, blackheads and other acne lesions are not caused
by dirt. Finally, stress does not cause acne.

How Is Acne Treated?

Acne is often treated by dermatologists. These doctors treat all kinds
of acne, particularly severe cases. Doctors who are general or family practitioners,
pediatricians, or internists may treat patients with milder cases of acne.

The goals of treatment are to heal existing lesions, stop new lesions
from forming, prevent scarring, and minimize the psychological stress and
embarrassment caused by this disease. Drug treatment is aimed at reducing
several problems that play a part in causing acne: abnormal clumping of
cells in the follicles, increased oil production, bacteria, and inflammation.
Depending on the extent of the person’s acne, the doctor will recommend
one of several over-the-counter (OTC) medicines or prescription medicines
that are topical (applied to the skin) or systemic (taken by mouth).

Benzoyl peroxide, resorcinol, salicylic acid, and sulfur are the most
common topical OTC medicines used to treat acne. Each works a little differently.
Benzoyl peroxide is best at killing P. acnes and may reduce oil
production. Resorcinol, salicylic acid, and sulfur help break down blackheads
and whiteheads. Salicylic acid also helps cut down the shedding of cells
lining the follicles of the oil glands. Topical OTC medications are available
in many forms, such as gel, lotion, cream, soap, or pad.

How Should People With Acne Care for Their Skin?

Clean Skin Gently

Most doctors recommend that people with acne gently wash their skin with
a mild cleanser, once in the morning and once in the evening and after
heavy exercise. Some people with acne may try to stop outbreaks and oil
production by scrubbing their skin and using strong detergent soaps and
rough scrub pads. However, scrubbing will not improve acne; in fact, it
can make the problem worse. Patients should ask their doctor or another
health professional for advice on the best type of cleanser to use. Patients
should wash their face from under the jaw to the hairline. It is important
that patients thoroughly rinse their skin after washing it. Astringents
are not recommended unless the skin is very oily, and then they should
be used only on oily spots. Doctors also recommend that patients regularly
shampoo their hair. Those with oily hair may want to shampoo it every day.

Avoid Frequent Handling of the Skin

People who squeeze, pinch, or pick their blemishes risk developing scars
or dark blotches. People should avoid rubbing and touching their skin lesions.

Shave Carefully

Men who shave and who have acne can test both electric and safety razors
to see which is more comfortable. Men who use a safety razor should use
a sharp blade and soften their beard thoroughly with soap and water before
applying shaving cream. Nicking blemishes can be avoided by shaving lightly
and only when necessary.

Avoid a Sunburn or Suntan

Many of the medicines used to treat acne can make a person more prone
to sunburn. A sunburn that reddens the skin or suntan that darkens the
skin may make blemishes less visible and make the skin feel drier. However,
these benefits are only temporary, and there are known risks of excessive
sun exposure, such as more rapid skin aging and a risk of developing skin
cancer.

Choose Cosmetics Carefully

People being treated for acne often need to change some of the cosmetics
they use. All cosmetics, such as foundation, blush, eye shadow, and moisturizers,
should be oil free. Patients may find it difficult to apply foundation evenly
during the first few weeks of treatment because the skin may be red or scaly,
particularly with the use of topical tretinoin or benzoyl peroxide. Oily
hair products may eventually spread over the forehead, causing closed comedones.
Products that are labeled as noncomedogenic (do not promote the formation
of closed pores) should be used; in some people, however, even these products
may cause acne.