At any given time men and women, young and old, and persons of all colors and backgrounds in the United States are trying to lose weight. Whether in response to gorging ourselves on the Thanksgiving turkey and all the fixings, to noticing the “spare tire” or “love handles” on our midsections, or to other events, the attempt to lose a few pounds is a common practice in American society. Given the hundreds of different diets and endless expert advice available, why do we fail most of the time?

Determining What Triggers an Eating Behavior
Before you can change a given behavior, you must first determine what causes it. Why do you suddenly find yourself at the refrigerator door, eating everything in sight? Why do you take that second and third helping of potatoes or dessert when you know that you should be opting for fruit instead?
Many people have discovered that one of the best ways о assessing their eating behavior is to chart exactly when they feel like eating, where they are when they decide to eat, the amount of time they spend eating, other activities they engage in during the meal (watching television or reading), whether they eat alone or with others, what and how much they eat, and how they felt before they took their first bite. If you keep a detailed daily log of the triggers for at least a week, you will discover useful clues about what in your environment or in your emotional makeup causes you to want food. Typically, these dietary “triggers” center on problems in everyday living rather than on real hunger pangs. As you record this information, your reasons for eating will often become apparent. Many people find that they eat compulsively when stressed or when they have problems in their relationships. For other people, the exact same circumstances diminish their appetite, causing them to lose weight.

Changing Your Triggers
Once you recognize the factors that cause you to eat, removing the triggers or substituting other activities for them will help you develop more sensible eating patterns. Here are some examples of substitute behaviors:
1. When eating dinner, turn off all distractions, including the television and radio.
2. Replace snack breaks or coffee breaks with exercise break
3. Instead of gulping your food, force yourself to chew each bite slowly.
4. Vary the time of day when you eat. Instead of eating by the clock, do not eat until you are truly hungry. Allow yourself only a designated amount of time for eating – but do not rush. Try to become more aware of true feelings of hunger.
5. If you find that you generally eat all that you can cram on a plate, use smaller plates. Put your dinner plates away, and use the salad plates instead.
6. If you find that you are continually seeking your favorite high-fat foods in the cupboard, stop buying them or place them in a spot that is very inconvenient to reach. (Having to run upstairs for the sugar bowl will probably force you to think twice before using sugar.)
These are just suggestions. After recording your daily intake for a week, you will be able to devise a list of substitutes that are geared toward your particular eating behaviors.
*20/277/5*

In less than 10 years there has been a revolution in the standards of care for people with type 1 and type 2 diabetes. For 70 years after the discovery of insulin, debate raged in the scientific community about the benefits and risks of intensive control of the blood glucose to prevent complications in people with diabetes. The Diabetes Control and Complications Trial (DCCT), a landmark prospective, randomized trial, demonstrated conclusive and remarkable reduction in the risks for progression of retinopathy, nephropathy, and neuropathy in type 1 diabetes. The DCCT was followed by another seminal trial, the United Kingdom Prospective Diabetes Study (UKPDS), which revealed comparable results in people with type 2 diabetes. Suddenly physicians, other health professionals, and diabetic patients were faced with the necessity of achieving the best possible blood glucose control without severe hypoglycemia.
A second series of exciting advances rapidly changed the approach to prevention of major cardiovascular events in people with diabetes. Epidemiologic studies have shown that people with type 2 diabetes have at least a 2- to 4-fold increased risk of a major cardiovascular event than comparable nondiabetic people. A person with type 2 diabetes has the same risk of dying from a heart attack as a nondiabetic person who has already had one heart attack. Fortunately, a series of important clinical trials has shown definitive reduction in cardiovascular risk by intensive management of blood pressure, lipids, albuminuria, and the prothrom-botic state that is found in type 2 diabetes. Other risk factors are under intensive study, and major future advances in therapy are anticipated.
*1\357\8*

By and large, penis-size problems begin above the neck, not below the waist. Psychologists say we got the itch for more inches as children when we first spied our father’s member. Compared to our toddler’s tool, Dad was hung like a bear—so we got hung up on size.
“Children don’t adjust for scale and make the logical conclusion that Dad’s penis is larger because he’s an adult,” says C. Steven Manley, Ph.D., staff psychologist at The Male Health Center in Dallas. “Some part of that initial perception stays with us.” Our shortsightedness can get reinforced in the locker rooms of junior high and high school, says Dr. Manley. “That’s where things can become traumatic, because at that age, there’s so much competition and intimidation and teasing and locker-room talk,” says Dr. Manley. Consequently, he and other psychologists have a full-time job helping men come to terms with their concerns. “It comes down to a self-esteem problem,” he says. “And men will often as not hang their esteem on one particular attribute.”
If you think you’re inadequate, Dr. Manley says knowing the statistics on penis sizes probably won’t make you feel any better. But just in case: The average adult penis ranges from four to six inches erect. Length is defined by the distance from the tip all the way to the base of the pubic bone, where the shaft of the penis first emerges from the abdomen—not the pubic hairline as many guys tend to think.
Biologically, the penis only has to be long enough to penetrate and inseminate—just a couple of inches in an erect state would do it. And as far as stimulating your partner goes, the most sensitive parts of the woman’s anatomy are in the first third of the vagina.
Granted, there are some cases where a penis can be too short. This is known as microphallus, a type of birth defect that can be effectively treated in infancy. But micro means micro—we’re talking less than four inches erect. If you do have this problem, it would be worth your while to see your urologist to determine how to cope with this unusual situation.
*501\257\8*

“I don’t want to hear it!” Ellen furiously told her husband, David, who was caught completely off-guard by her angry outburst. To tell you the truth, we were also surprised by her response, since it occurred just after David had begun to convey how much he loved Ellen and worried about her, trying to decide what to do when she had woken up in excruciating pain on the morning after her car accident. We had no reason to doubt his sincerity, but Ellen obviously did.
“None of this would have happened if you hadn’t made us move here,” she shouted at him. “If you ever cared about me at all, you never would have forced me to move to the godforsaken Midwest!”
As you may recall from the previous chapter, Ellen and David’s sex life and relationship had both gone downhill following an automobile accident that left Ellen in chronic pain. Up until this point, they had both blamed their problems on Ellen’s physical condition and her preoccupation with it. But now it was apparent that anger and resentment had been brewing inside Ellen and inhibiting her desire long before her car careened out of control on an icy highway.
Looking back on the months following the move they had made more than four years ago, David recalled, “Ellen used to pick arguments right before we went to bed. She’d just go on about something trivial and then walk away, leaving me top ticked off to sleep and definitely in no mood to have sex. The fights never had anything directly to do with the move. She never said anything about that, although she did seem a little down.”
“A little down!” Ellen gasped, finally able to let out the feelings she had suppressed for so long. “I was practically suicidal. I gave up my friends and my family and my home in the state where I had always lived so he could have the job he wanted. I hated the weather, our townhouse, the school where I was teaching. It was all I could do to get myself out of bed in the morning. I wasn’t just a little down—I was depressed.” And under the depression, she was seething with anger. David did not know any of this—not because he was exceptionally insensitive, but because Ellen had kept it all inside, never once objecting to a move she truly had not wanted to make.
*95\261\8*

Through effective communication that intimacy is established and can grow. Thus, understanding how to communicate effectively is a cornerstone of interpersonal and sexual relations, yet few of us are taught the skills of intimate communications. In schools we learn to write essays and term papers and sometimes even learn the fundamentals of how to speak before a group or to debate, but when it comes to developing intimate communication skills, we are left alone. The following discussion provides some practical, commonsense suggestions for developing your ability to communicate effectively in personal relationships.
Communication usually begins with the intent to convey information to someone e! ,e. The sender must convert the intent into an actual message that is presented to the intended recipient. The message may be verbal (words, sounds) or nonverbal (consisting of a look, a touch, or an action). The recipient must not only receive the message but also understand and interpret its meaning. At each one of these seemingly simple steps, things can and do go wrong.
In many cases, the sender doesn’t succeed in saying what he or she really means. Sometimes, for example, people can’t find the right words to convey what they’re feeling, or what they need, so the messages they send are inaccurate. Even if the message has been accurately formulated, something may go wrong in the sending process so it’s never received at all or is received in a garbled fashion. How often has someone missed the main point of your message, and after you explained yourself (perhaps with some exasperation) said, “Oh, that wasn’t what 1 thought you said.”
Next, the receiver may not be turned on and so may miss the message (that is, a person may not be listening to what you’re saying), or he might hear what he would like or expect to hear, rather than what is actually said.
Possibly the single greatest source of communication trouble, however, is in the way messages are interpreted by those who receive them.
Man: I told you earlier this evening I didn’t want to make love tonight.
Woman: I thought you just meant you didn’t want to then, I didn’t realize you meant for the whole night.
Although the seemingly simple art of communication can often be difficult and complex, there are steps we can take to ensure that our messages are sent as clearly as possible and that we are open to receiving messages as efficiently as we can. We examine these steps in the following sections.

Sending Signals Clearly
Effective communication begins with the message sent from one person to another. If an unclear message goes out, even an attentive listener is likely to be confused and forced to guess about the intended meaning. There seem to be three main reasons for this lack of clarity.
Not saying what you mean. When people aren’t able to find the right words to express their feelings, they may not be fully in touch with their feelings. People may also avoid saying what they really mean so they won’t hurt someone they care about, so they won’t be embarrassed, or so they won’t risk being rejected.
Sending mixed messages. Mixed messages carry contradictory-meanings. This can happen when body language or a person’s tone of voice contradicts the spoken words. For instance, if someone says “That’s lovely,” but grimaces while speaking, the listener is apt to be confused. Likewise, a person who says “I am NOT upset” in a forced, slowly articulated voice is indicating just the opposite. Mixed messages also occur when there’s an inconsistency in the content of a message, as when one part of the message negates the other: “I love it when you’re rough with me, but I wish you’d be more gentle,” or “I really don’t want to worry you, but I think I may be pregnant” are examples of this type of problem.
3. Not being specific. Vague statements leave a listener frustrated and wondering “What did he/she mean?” For instance, being told “We should really have more romance in our lives” by your partner might lead you to ask yourself: “Does this mean there’s something wrong with our relationship? Am I being criticized? Should I be doing something new? Is my partner unhappy? What does my partner want?” A more specific statement such as “I’d love it if you would read me some love poems once in a while to help me feel romantic,” wouldn’t leave those loose ends.
Clarity in communications can be enhanced in a number of different ways. Here are some general suggestions to think about:
Think through what you want to say and how you’ll say it particularly if it’s an important or emotionally charged message.
Let your partner know what your priorities are; try not to crowd in so many requests and instructions that it’s difficult to grasp your key points.
Be concise. Long-winded discussions are more likely to confuse than clarify. On the other hand, being concise doesn’t mean being simplistic or superficial. Don’t leave out important information about your feelings or desires in order to be brief.
Don’t talk at your partner. Give him or her a chance to respond and interact.
Try not to begin communications by criticizing or blaming your partner. Starting on a negative note puts your partner on the defensive and makes objective listening difficult.
Don’t be afraid to put what you need to say in a letter if you’re having trouble saying it face-to-face. Writing it down shows that you cared enough to take the time to say it carefully.
7. Ask for feedback from your partner to be sure you’ve been understood and to get his or her reactions.

Nonverbal Communications
After a lovemaking session one night, Cathy withdrew into a stubborn silence. When George asked her what was wrong, she said, “Nothing at all,” but the firm set of her lips and the way she rolled away to avoid his touch told George how to interpret these words — that in fact something was bothering her. With some patience and encouragement, George was finally able to find out what had upset Cathy. She hadn’t had an orgasm, and she felt the reason was that he had stopped stroking her clitoris too soon.
As this example shows, the nonverbal side of communication is often at least as important as the words that are spoken. In fact, one psychologist suggests that of the total feeling expressed by a spoken message, only 7 percent is verbal feeling, 38 percent is vocal feeling, and 55 percent is conveyed by facial expression. Posture and positioning (body language) also are powerful forms of nonverbal messages, sometimes saying “Keep away” and sometimes inviting intimacy and closeness. Sitting in a relaxed fashion sprawled out next to your partner usually conveys a sense of comfort and warmth, while sitting rigidly on the edge of your chair at a deliberate distance from your partner usually conveys a sense of withdrawal, annoyance, or preoccupation. Unspoken messages can also be powerfully transmitted by touch, which can suggest an attitude of caring and accessibility.
It’s important to recognize that inconsistencies between nonverbal cues and verbal content are usually resolved in favor of the former; in this sense, nonverbal messages are more “powerful” than spoken words alone. For this reason it’s useful to communicate in ways that maintain consistency between the verbal and nonverbal messages you send to your partner, taking care to avoid sending mixed messages by saying one thing with your words and something different with your body language or vocal tone. Thus, one way to improve the chances of communicating effectively is to be aware of your own nonverbal language
— an aspect of communicating to which many people never pay attention. It also helps to actually practice ways of sending positive nonverbal messages that express trust, commitment, and caring rather than suspicion, rejection, or impatience. You can do this by yourself, with the aid of a mirror or tape recorder, or with your partner’s help. Together you can discuss the nonverbal communication patterns in your relationship and see how they can be improved.
Not surprisingly, nonverbal messages apply in a special way to sexual interactions. At times, they indicate displeasure or resentment. For instance, if your partner’s body tenses up whenever you stimulate the genital area with your tongue, you may begin to think that he or she is uncomfortable with this caress no matter what is said. Likewise, if your partner usually moans with passion as you make love together, the sudden absence of such sounds may make you feel as if you were doing something wrong. At other times, nonverbal messages convey a sense of pleasure, involvement, warmth, or similar feelings. In addition, nonverbal communications during sex can help your partner see what you like without breaking the mood by words. And taking your partner’s hand and guiding it on your body, or showing your partner exactly how you’d like to be touched, can be a true gift of sexual intimacy.
Although touch can be used as an effective means of nonverbal communication in a variety of ways, intimate partners often seem to talk too much and touch too little, missing many opportunities to convey feelings of tenderness or affection to each other. In many situations, a long, tight hug says more about the way people feel about each other than a ten-minute dialogue. Likewise, stroking a partner’s hair or face, or leisurely kissing, or performing a sensual massage can convey a sense of caring and pleasure-that goes beyond words. On the other hand, if people confine their touching to sexual situations, they compartmentalize the physical side of their interaction, sometimes making sex seem like a bartered commodity used to attain closeness.
*117\342\2*

We’ve had a lot of practice, so perhaps it’s not surprising that we both have a sixth sense about carbohydrate addiction. When a new-client arrives at our office, we usually know whether she is or isn’t even before tin- talk turns to food and eating habits. Sometimes, though, it isn’t obvious, even to us. Ann is a case in point.
She was a trim five-feet-four. 118 pounds, when she came to sec us. She’d never been overweight and only recently had developed a problem with carbohydrate cravings. We tried to get a sense of her to begin with, and it didn’t take long for some key facts to emerge.
A recent boyfriend had told her she was fat. Ann thought she loved him and wanted very much to please him. Despite the fact she- was old enough to know better :she was twenty-eight), she starved herself to near anorexia. Hut though Ann was below her ideal weight, her boyfriend was still not satisfied.
Ann then began to see herself as fat, too. She had tried a commercially available liquid diet that claimed to be high-protein (but which was, we knew from experience, also high in carbohydrates, with high levels of sucrose, the familiar white table sugar). She did lose some weight, but she also found herself developing recurring food cravings. She began sneaking food and gradually began to gain the weight back. Then her boyfriend left without any real explanation.
By the time we knew all these facts, we had a pretty good idea as to what Ann’s problem might be. We gave her the Carbohydrate Addict’s Test, and our suspicions were confirmed. Ann tested as a moderate carbohydrate addict, but from what she told us it was apparent that there; were other factors that had made her problem worse—namely, her severe, unnecessary, and repealed dieting and her destructive relationship.
The first challenge we put to Ann was to admit that she was a carbohydrate addict. She found it difficult to accept at first, but as we drew her out about her eating habits, the conclusion was inescapable. Finally, she admitted that she had a problem that she just couldn’t solve by herself.
The next step was to get her eating regular food in a controlled fashion. We introduced her to the Carbohydrate Addict’s Diet. Ann admitted she was a bit frightened. “My eating has been so mixed up,” she said. “I change my plan from day to day. 1 don’t know if 1 can be that disciplined.” We explained that the diet would help curb her desire to cheat, and we urged her to try it.
Ann succeeded with the plan, though success wasn’t a matter of weight loss in her case. Her success concerned her release from her addiction. “1 never knew what normal people felt like.” she told us. “I can’t believe I’ve been living with this most of my life.
“I feel different now. 1 feel like I can think. There’s a calmness in me now. I don’t feel driven. Do you know what 1 moan?”
We did.
*14\236\2*

African-American men are bigger. Caucasian men are smaller. Asians are smallest. The circumference of a man’s fist is proportional to his penis width. The size of his shoes has a direct bearing on his penis length.
These and countless other myths have been bandied around locker rooms and barrooms for ages. Irwin Goldstein, M.D., professor of urology at Boston University School of Medicine, has heard them all, but be has never seen any proof. So he set about getting some. At this writing, He’s conducting one of the largest scientific surveys of penis size among the races as well as correlations between penile dimensions and the measurements of other body parts. Here are some preliminary results.
“Big thumbs, well-hung” remains a myth, as do other old maxims about penis size in relation to other body parts. “For all ages and races, we found no correlation between penis size and arm length, height, weight, finger length or shoe size,” says Dr. Goldstein.
African-Americans ARE bigger at least when flaccid. Dr. Goldstein’s research says that, on average, a Black man’s flaccid penis is a couple inches longer than a White man’s. “There’s some truth to the myth,” he says.
White men CAN jump in penis size, once they become erect. “We found men whose penises can get as much as four times bigger than when they’re flaccid,” says Dr. Goldstein. “So we’ve found that Caucasians are more likely to have small flaccid penises and have significantly larger erections by comparison, whereas African-Americans are pretty sizable to begin with and get just a little bigger when erect.”
Asians ARE smaller than the average Caucasian, by as much as an inch, says Dr. Goldstein. But remember, these are flaccid measurements. “Once the blood starts pumping and the penis gets erect, the playing field starts to level out,” he says. Indeed, all men are created equal.
*502\257\8*

Do you take oral contraceptives? If so, that may mean zinc problems, according to some research. Belgian scientists found that many women taking oral contraceptives have weak immune responses. After taking zinc for a month, the immune response of these women was completely re-energized.
Are you pregnant? If so, research by Dr. Lucille Hurley, at the University of California, may be important for you. She found that when female animals had chronic zinc deficiencies, their offspring had severe immune system problems throughout their whole lives. Moreover, even if those offspring were given enough zinc in their diet, their babies still showed severe immune damage. In fact, it took three full generations until animals with normal immune systems could be produced. This research is so new that we don’t yet know if the same thing happens in humans, but it does suggest that zinc levels are crucially important for pregnant women. If that’s you or someone you love, it may be time to sound the zinc alarm.
Are you overweight? If so, your extra fat is probably depleting your body’s zinc bank accounts, throwing you into a vicious immune-fat cycle. Low zinc levels disturb your immune system, which makes you binge when eating even more. Binging further damages your immune system, so that you gain weight and fall even further into the low-zinc danger zone.
Kelly’s case was one of my best zinc success stories. She was one of those patients with nothing and everything wrong with her. “I feel silly coming to see you, Dr. Berger,” she said. “There’s really nothing specifically wrong.”
Then she went on to describe a series of minor, fleeting, but bothersome ailments. In the six months before she came to see me, Kelly went through a series of low grade infections, a skin rash, and a prolonged case of athlete’s foot. She suffered from recurring vaginal and urinary tract infections and scratches she had gotten while hiking during the summer hadn’t healed several weeks later. Lately, she had felt her energy flagging, and had been finding it hard to concentrate at work. Because she was an air-traffic controller, she knew she needed to be razor-sharp on the job, and she was afraid that the lack of focus she was feeling could be dangerous.
Two things stood out: first, Kelly worked in one of the most stressful of jobs. That stress meant her vitamin and mineral reserves were taxed to the limit, and zinc is especially sensitive to stress levels. Second, she was taking an oral contraceptive, further lowering her reservoir of zinc. I put her on an immune power nutrition plan that included high zinc.
Kelly called six weeks later. “I feel like a new woman! I’m back to my old self at work, and I’ve got more energy than I’ve had since I was a kid. That stuff’s magic!” It’s not magic, I told her, just another example of immune power healing.
There are other symptoms that low zinc can cause. If you have any of the following, you may have a zinc deficiency:
Food doesn’t taste as good as it used to
Your sense of smell seems dull
Your fingernails have white flecks or spots on them
Scratches and wounds take a long time to heal
You feel mentally dull, find it hard to concentrate
You are losing your hair
*51\242\2*

Nourishing manipulation (an open, honest contract) in the same circumstance is illustrated in the following dialogue.
MRS. BROWN: Dear, I would like to invite Mother to stay with us for a week.
MR. BROWN: I don’t enjoy your mother’s visits. She disrupts our household with her criticisms, and in the past you and I have had some bitter fights because of her presence. I resent her staying with us.
MRS. BROWN: I know how you feel. I feel a conflict about her visits too. You are the most important person in the world to me and I do like to invite Mother out once every year or so. She’s getting old, and I know she’s lonely, and it means a lot to her. I feel I’m giving her something very important for her at this time in her life. I don’t particularly enjoy spending a great deal of time with her, but I do feel a certain commitment to give what I can to make her life a little more meaningful.
MR. BHOWN: HOW long do you want to invite her for?
MRS. B: I’d like to invite her for about ten days.
MR. B: I know how you feel about your mother, so I’m willing to go along with your invitation. I do wish that she was only going to be here a week, though.
MRS. B: Thank you. I plan to invite some of my girl friends and their mothers to lunch, and maybe Mother will receive some invitations to spend some time with them while she is visiting with us.
A nourishing relationship involves compromise. Each person never wholly has his way. The critical aspect illustrated in the above dialogue is the direct, honest statement of the situation (Mrs. Brown wants her mother to visit, rather than playing the deceptive game that her mother wants to come and Mrs. Brown doesn’t know how to get out of it). Mr. and Mrs. Brown are open and straight in telling each other how they feel about the situation. Mr. Brown decides that he is willing (he doesn’t have to want it) to go along with his wife’s request. She, in turn, directly asks him for what she wants and leaves it to him to decide whether he is willing or not. She does not play any game of enticement or deception or offer some kind of a “deal” to pay him back.
*169\350\8*