"SAHELI in the COMMUNITY 2009:

October is Domestic Violence Awareness Month"

Read more on this important topic!

---

Saheli Organizes Second Health Seminar –

Women, Obesity and Depression

Collaboration between Saheli and the Lahey Clinic.
Seminar was held on June 10th, 2006, in the Lahey Clinic Auditorium, Burlington at 1:30 pm
Lija Joseph, MD, Boston University School of Medicine and a member of Saheli, introduced the two speakers.

• Speaker: Marie McDonnell MD, Boston University School of Medicine. Marie is a faculty member in Internal Medicine at Boston University School of Medicine and is also the Director of their Inpatient Diabetes Treatment Program.
• Sukanya Ray Ph. D, Assistant Professor of Psychology, Suffolk University. Sukanya is Associate Professor at Suffolk University and also is a clinical psychologist at The Asian Clinic of Cambridge Health Alliance affiliated with Harvard Medical School.

Dr. Marie McDonnell of Boston Medical Center specializes in Type II diabetes and works with issues of obesity both in men and women. She noted that taking your weight is not sufficient; every person needs to know their BMI. BMI is an index of the relationship of your weight to your height. A BMI of 18.5 to 24.9 is considered healthy, whereas over 25 you are considered overweight.

In some studies it has been noted that 62% of all women in the US are overweight, and the numbers are higher among African American women and Latina women. Ethnicity, food habits, level of physical activities, all play a role, and no single factor can explain obesity. Dr. McDonnell noted that she found in a survey done recently, 70% of the women in the sample worried about their weight, many fewer men worry about being overweight. In the age category 20-34 about 51.5 percent of the women were overweight; in the category 45-54 more than 64% were overweight. She noted, further, that obesity in elderly women is fast becoming a problem, and it poses significantly more risk for heart disease, diabetes and stroke.

Dr. McDonnell shared many other studies and their conclusions. For example, babies of obese mothers are at high risk of being obese themselves, mothers who watch a lot of TV are at greater risk for obesity, women watch 3 to 4 hours of TV a day in one survey. During pregnancy, weight gains of 25 are recommended; when you gain more than that it is significantly harder to shed it later on.

During menopause women gain roughly 5 lbs each year, mostly belly and intra-abdominal fat. Both these types of fatness, place woman at increased risk of heart disease, stroke, acid reflux disease, diabetes, back and joint pain. Today more women are dying from heart disease than before even more than those that are dying from cancer, which is also linked to obesity.

Dr. McDonnell noted that the four most popular diets–low fat, no fat, high protein, low carbs and others, work but often people gain it right back as they go off the diet. In order to lose weight and maintain a healthy weight, women need to make significant life-style changes that include healthy eating, physical activity, and careful weight monitoring.

Instead of fad diets she recommends that women reduce the quantity of food consumed intentionally. The main source of weight gain is the quantity consumed and the kinds of foods consumed. Her research indicates that the rule of thumb is to divide your dinner plate into halves. Fill one half with greens, salads, and vegetables. Divide the remaining half into further halves. In one of the quarters eat fats and carbohydrates in moderation, and chose carefully for nutrition and calories. In the other quarter consume high quality proteins.

She recommends that self monitoring and food journals are a good way to know what you eat and low calorie/low fat are strongly advised for all women regardless of age. Dr. McDonnell can be contacted at Boston Medical center at 617-638-8000, marie.mcdonnell@bmc.org

Dr. Sukanya Ray is a psychologist, clinician and associate professor at the Asian Clinic at Cambridge Health Alliance and Suffolk University. She counsels hundreds of South Asian families, couples, youth and children each year in the areas of depression, and she spoke to the audience about “food and mood.” She shared the results of her own research and others related to eating disorders, depression and related mental health issues in Asian populations.

From her work with South Asian families she found that food disorders often are related to emotional tension at the dinner table, controlling parents, lack of a relaxed atmosphere around food, food rituals, and antiquated ideas about good/bad foods. She quoted from the scriptures and noted that in ancient times foods were classified as--

• Sattvic – foods that promote tranquility are fresh, pure, nutritious, and easy to cook and digest.
• Rajasic – rich, spicy, salty foods that create restlessness, anger and anxiety
• Tamasic – foods that are prepared over a long period of time, create depression and confusion.

Food disorders can be traced to infancy and childhood and are typical in some south Asian families. Food disorders take many forms such as binge eating, restrictive eating, excessive dieting, fasting and binging and ritualistic eating.

South Asian families who seek therapy often mention that it is very difficult to discuss mental health issues even within the family. Women often complain about physical symptoms related to aches and pains, but in reality are suffering from depression, anxiety or stress and are unable to discuss them with their spouse or children or siblings due to cultural beliefs about mental health and disease. As a clinician she tries to trace the origin of depression and asks about food, and many women say, “Oh, I am too busy to eat, I hardly eat.” Yet, they may already be obese from overeating.

South Asian families further suffer from excessive control by parents, over achieving parents who push their children to succeed. Often times the children feel inadequate, and lapse into depression. Inability to talk as a family, communicate effectively, make known individual preferences, and likes and dislikes to parents, often lead to severe depression, or eating disorders. Parents often fail to understand the links between depression and eating disorders.

Youth and children are not the only groups with depression and eating disorders. Men, suffer depression due to lack of progress in the workplace, women during young adulthood and middle age, and during menopause women experience significant problems with both depression and eating disorders. Excessive eating and wrong food choices lead to obesity and many related diseases. Unexpressed feelings, helplessness, lack of support, are all causes of significant depression, bulimia and anorexia nervosa, all related to eating disorders. Dr. Ray can be contacted at sukanyaray@aol.com