The Health Blog

EVERYONE KNOWS that heart disease and cancer are devastating. A diagnosis of diabetes is taken more lightly — but diabetes can be just as devastating. The long-term complications of diabetes are disheartening: blindness, heart attack, stroke, kidney failure, nerve degeneration. Being diabetic puts you at higher risk for:

Heart Attacks And Strokes. The process of atherosclerosis (narrowing of arteries due to deposits of cholesterol along their walls) occurs earlier and may be more severe in patients of diabetes. People with insulin resistance also tend to have high levels of triglycerides and low levels of HDL (the high-density lipoprotein or good cholesterol that helps to remove fat from the walls of blood vessels.) Diabetes raises the risk of heart disease and heart attack as much as 400 per cent; of stroke, as much as 600 per cent.

Hypertension (High Blood Pressure). Poor control of diabetes also puts you at higher risk of hypertension because insulin, besides affecting sugar, also has other effects in the body. It stimulates the nervous system to release adrenalin into the bloodstream, which raises blood pressure and heart rate. Insulin also causes the kidneys to retain salt, which again contributes to high blood pressure.

Arteriole Damage. Even more insidiously, prolonged high blood sugar levels can damage the tiny arteries called ‘arterioles’ throughout the body. Scarring of these blood vessels can cause plaque deposits to accumulate, blocking the flow of blood through these tiny but important channels that supply oxygen to the heart muscle cells. As this silent process of damage continues, the heart muscle gets stressed and gives out.

Poor Healing, Recurrent Infections. Long-term, the compromised circulation resulting from diabetes can lead to poor healing of wounds and recurring skin and gum infections.

In advanced stages, diabetes may cause the circulatory blockage of blood in the lower extremities (the legs), with the possible complication of gangrene. An amputation above the  dead tissue may be required as a life-saving measure. The circulatory problems arising from diabetes make it the second leading cause of amputations, after Injuries and trauma.

Impaired Vision. Over a period of time, especially if diabetes

is poorly controlled, there is often a gradual proliferation of new

fragile blood vessels (“neovascularization”). If this occurs on the head of the optic nerve and on the retina, it carries the risk of the new vessels rupturing, causing potentially sight-threatening hemorrhages. About 8 in 10 diabetics have at least some vision loss.

Kidney Disease and Nerve Disease. Besides this, the damage caused by diabetes to the small blood vessels can also bring about kidney disease or diseases of the nerves. About 30 per cent of diabetics develop kidney disease. And diabetes is a leading cause of kidney failure.

The majority of diabetics have some nerve damage. If it is

severe, it can lead to total disability.

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Douglas, a 26-year-old single copywriter for an advertising agency, successfully conquered his binge-eating disorder while he was still a relatively young man. He had been large since childhood and he had been teased a great deal about his size and weight. His weight and appetite were a continual topic of conversation at home with his parents. It didn’t help that a younger brother was slim and could eat anything he wanted without gaining an ounce.

Douglas was always self-conscious about his size and developed a very shy, insecure personality. In high school his history teacher took a special interest in him and encouraged Douglas to pursue athletics. The teacher introduced Douglas to the football coach, who saw potential in the young man’s large stature. The high school was small and the coach was always on the lookout for students who were either fast or large.

After high school, Douglas went to a small liberal arts college and majored in English. He had a knack for writing and was very creative in his work. He tried out for the college football team but soon found out that college football was highly competitive and lacked the camaraderie of high school sports. He was not enthused about his participation in college football, and after suffering a mild concussion in one of the tryout sessions, he decided that he’d had enough. Without sports, Douglas’s weight during college increased dramatically. He gained 38 pounds during his freshman and sophomore years. Although he was studious, Douglas was shy with other people and did not make friends easily. He was a fun-loving, likeable boy, but very reserved around others. He was particularly shy around members of the opposite sex. As he gained weight, his self-esteem and self-confidence plummeted.

Douglas spent a great deal of time alone. He found solace in food and began to binge several times a week. As he gained more weight and his insecurities increased, his binge eating became worse. His eating was out of control. His weight and his binge eating embarrassed and frustrated him, but he was in no mood to do anything about them. He had given up.

After college, Douglas found a job as a copywriter with a regional advertising firm. He had a real talent for fresh ideas and innovative concepts as far as print media ads were concerned. Over the next few years his career flourished even though his personal life was lacking. Although he had two close friends, he spent most of his time alone. He rarely dated and always felt self-conscious about his weight. He continued to feel secretly embarrassed about his binge eating.

His decision to seek help for his binge eating and weight problem was precipitated by two events. His supervisor at work had a heart-to-heart talk with Douglas about his appearance. As Douglas gained more and more weight he became less concerned about his clothing and personal appearance. In addition, he found it extremely difficult to find clothes that fit him. His clothes shopping was limited exclusively to the “big and tall” men shops that catered to the larger sizes. The second impetus for Douglas’s coming to see me for help was that he met a young woman with whom he became infatuated. They had never actually dated but worked in the same office and enjoyed long conversations with each other.

Douglas was ready for a change. He felt that he really did not have much of a life. His career had potential but his personal life was going nowhere. He wanted to find a companion in life, get married, and have children. He was a caring, deeply sensitive person who had a lot to offer in a relationship.

After four months of treatment, Douglas gained control of his binge eating and began to lose weight. He was determined to change his life and put every one of my recommendations into practice with enthusiasm. He worked on his self-esteem and body image as well as his eating.

Douglas is a true success case. He overcame his binge eating, which is no longer a problem for him. He lost 78 pounds and began dating Patricia, the woman he met at work. He started working out at a local health club, met new people, and began to come out of his shell. Douglas was able to turn his life around. He developed confidence in himself and no longer felt self-conscious. Even before he began losing weight, he said to me, “Just by getting in control of my eating makes a tremendous difference in how I feel about myself. I didn’t think I could do it. You showed me that I could. I feel like I have my life back again. No . . . actually, I feel that my life is just beginning and I can do with it whatever I choose. My life is finally mine to live as I see fit. I can finally start to think about what kind of life I really want. Before I overcame my binge-eating disorder, I was just living life from day to day. I didn’t care. I was putting in my time. I guess I thought that’s how everybody lives. You taught me to put enthusiasm and passion into my life. You were right. Defeating my binge eating and losing weight were only the first steps. I know now that I will never go back to my old habits. Food will never be that important to me again. I simply won’t let it. There is more to my life than being alone and eating. I’m free and I’ll never allow myself to be controlled by food again.

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All comparison games are toxic. The drive for achievement and “success” is a major toxic pattern with strong cultural sanctions. The compulsion to excel creates an attitude of hostility and estrangement toward others and tends to trap the person into a limited, narrow focus on one aspect of his existence. The effect is further intensified by his neglect of other needs and potentials that must be fulfilled if he is to develop into a complete, integrated person.

Perhaps the most deadly of the comparison games is the one in which the person decides he must be the very best. Once he succeeds, his success is a trap: he has a “reputation,” which he must live up to. He poisons himself by functioning as if he had no choice but to maintain his image.

Some people poison themselves by creating idealized images which they hope will prop up their shaky identities. The “swinger” tries to convince the world that he is rejection-proof and that he is never lonely, frightened, or burdened with feelings of inadequacy. This is similar to the “Marine Sergeant image”—of a man who is so tough he can take anything without even feeling shaken.

Sustaining any idealized image drains the person’s energies away from his pursuit of broader experiences and fulfillment of other needs. The self-poisoning effect of attaining (and maintaining) an idealized image is inherent in the simple fact that it is not a natural way of being. It is inevitably a facade. Stuck with this comparison game, he finds his only satisfaction in subduing each opponent who appears on the scene to challenge his position. All the while he is aware of the obvious: sooner or later he will be dethroned. The more of his life energy he has invested in this goal, the more poisonous the effect of the dead end of achieving being the “best.”

Often when we feel that we must prove ourselves, we are really attempting to compensate for deeper irrational feelings of insecurity and inadequacy.

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