We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
I never anticipated spending so much of my clinical time in bathrooms. But drug overdose is the leading cause of death among the homeless individuals I take care of at a health center in Boston—and without homes or access to supervised consumption sites, people who are homeless frequently inject drugs behind the closed doors of public bathrooms, including ours...
A Scott Adams intervew with Dr. Drew explains that housing is not the issue. It's about mental illness, personality disorders, addiction, and mental insufficency and otherwise low-functioning people. That is a lot of people.
It is a tragedy of false compassion. Thousands of people who need help, when help is available, resist it. It's a free country. Freedom often means messy.
Of course, it depends on how you want to define "disease" Is a "personality disorder" a disease?
What about overweight and obesity? There has been a big debate about that, but the pressure to term overweight a disease rather than, say, a physical condition, is all about insurance coverage. Otherwise, such questions would matter little.
Speaking of desire, what about those magnetic attractions to one of those of the opposite (or, I suppose, same) sex? Those can be as powerful as drugs and make people behave just as crazy.
Yes it is. Your waist size is not your belt size or jeans size though, especially if you wear them on your hips which most people do these days. Your waist is above your belly button, the potentially narrow space below your rib cage.
How to Measure Your Waist
How do you measure your waist? Sounds simple enough, but it’s not always obvious where your waist is. Posture and other variables can affect the reading, so here are some basic guidelines to follow:
Position a tape measure at the narrowest point between your lower rib and the top of your hip bone, or at the midpoint in between. It should be snug but not compress the skin. If you can’t find the narrowest point (it may be difficult if you’re very overweight), measure just above your belly button.
Stand straight and breathe out normally; don’t suck in your belly.
Measure your waist first thing in the morning, before breakfast.
Though there’s no magic cutoff point, values over 37 inches for men and 32 inches for women indicate increased health risks, according to the World Health Organization; values over 40 for men and 35 for women represent substantially increased risk.
Many or most people in the US have used opioids whether for surgical or dental procedures, cancer pain, etc. The number of those people who become addicts is extremely low, but I do not have the numbers.
I know that there is some recreational use too, which seems, intuitively, more likely to lead towards addiction.
The few times I have used opioids (prescribed, of course), I have found them to be sort-of ok for pain relief but generally unpleasant (sleepy, stupid, unsettling) so I switch to NSAIDs or Tylenol as soon as I can.
Others find opioids to provide a feeling of deep, warm well-being if not euphoria. That sounds appealing, doesn't it?
“If you want to model the APA, you could do worse than a giant firehose that takes in pharmaceutical company money at one end, and shoots lectures about social justice out the other.”
A terrible meeting. I never attend.
My experience is that people like to mock or disparage Psychiatry. That is, until they or a family member need one.
Why, in the US, do Asians show higher levels of achievement than native whites? Why do African-Americans achieve less, on average, than whites? And why do immigrant blacks achieve at a higher level than US-born blacks?
I wish that we in the US would just stop categorizing people by race and, if social "scientists" want to study things like achievement, they would apply their time to studying the cultures and subcultures in which individuals develop.
It's an open secret that there are far more whites living in poverty in the US than blacks. That's culture too. Murray's Coming Apart portrays it well. Not everybody has either bourgeois values or conventional aspirations.
Cardio endurance training is one component of the Fitness Triad (strength, athleticism, endurance) or, as we usually divide it, strength, calisthenics, and cardio.
Unless one is a competitive runner, swimmer, biker, or rower, we believe it's good to mix up cardio exercises because just doing one improves one's efficiency too much for the cardiac stress you are looking for.
Cardio training (ie exercising your heart muscle) is like anything other muscle: you want to stress it without injuring it. That can either mean keeping your heart rate at 55-85% of your max heart rate for 30 minutes (depending on age), or it can mean HIIT cardio training with sprints. I recommend the latter for time efficiency and because it is gentler on your body.
I no longer recommend road-running, especially distance road running. A morning 5-mile jog is harmless but the main benefit is mental because few joggers get their heart rates very high. Distance runners/races (ie from marathoners to 50 milers to 100-milers) are admirable in their dedication and amazing endurance but it just isn't healthy for joints, heart, body inflammation, risk of kidney damage, and so forth. Pheidippides, who was a professional distance courier (before cell phones), died in Sparta.
Our current "Maggie's Recommended" general fitness training for the cardio component is roughly one hour of endurance cardio (a mix of elliptical, treadmill, stairmaster) keeping a solid (ie 55+% but sub-max heart rate; and 1/2 hour of HIIT cardio (30-60 second max sprints on rower, treadmill, combat bike, stairmaster, etc) with triple slow recovery times; and the mix of cardio and athleticism training in calisthenics/exercise classes.
I almost forgot to mention sports. Two hours of basketball is excellent cardio/athleticism exercise. Same for martial arts, or a tennis class.
Remember, unless you are in training for multiple hours daily, you can not lose weight by doing cardio exercise.
Celebrities are always touting the latest nutritional fads like "clean eating", veganism, etc. Now it's the Fasting Plan. Of course, these people know nothing. In fact, little is known about human nutritional needs but we do know some simple things to prevent starvation. For example, your nutrition requires fats.
There seem to be all sorts of variants of the Fasting Fad, but there may be something useful in it. For example, no adult without an all-day manual labor job (or a heavy lifter or a distance runner) needs three meals/day unless they are underweight. Three meals/day was designed for farmers, just like summer school vacation.
Furthermore, most hunger is what we have described as "false hunger" (meaning it represents no need for significant nutrition) for anybody even 5-10 lbs overweight. Our fat cells are a massive storage battery waiting to be used.
So what about fasting, whether it means just skipping one of the conventional meals or even taking a day or two off from food every week? Not as a weight-loss plan, but just as a plan. Many find it increases their energy.
When you think about it, during almost all of the 300-500,000 years (except the past few thousand agricultural years) of human life and evolution, food scarcity was the norm. Humans are designed for food scarcity rather than for today's abundance. That's why eating is fun rather than necessary.
This month’s Harvard magazine has an article on just this topic. Scroll down to the section titled, ‘Eating to Excess: Metabolic Inflammation’.
“The metabolic stress that is a hallmark of modern life, the stress that the body has not evolved to handle, is constant eating, he continues. When people eat, energy and nutrients enter the body rapidly, are processed, produce in turn a lot of by-products, and then need to be reduced to “functional substances that are distributed throughout the body, and then disappear very quickly. Many cells and tissues actually undergo a huge amount of stress during this process,” he explains, “as they store appropriate nutrients and dispose of harmful intermediates.” Part of this process also involves mounting an immune response. “The pancreas, for example, must secrete four to five hundred milliliters of enzymes every day” to be able to manage the incoming energy load with every meal. “If you place these organs under constant stress, they start malfunctioning.” The consequence is that “right now, one out of every 10 individuals has diabetes. One out of every four individuals has fatty liver disease. And if you reach a certain age, one out of every three individuals will develop neurodegenerative disease.”
The metabolic stress that underlies these conditions comes from the daily imbalance between how much energy people consume and how much they need, and can process in a healthy manner. The long-term consequence of overconsumption, combined with lack of sufficient expenditure, is stored energy—the accumulation of fat...”
Also interesting in that article is a bit about the benefit of muscle inflammation due to stressful exercise. Muscle damage, of course, is how we build strength.
We have written about habitual, ritual, compulsive, and recreational eating several times. Except for growing kids, manual laborers, distance hikers, and people who lift, all the talk about "the most important meal" was nonsense.
Yet we hear it all the time. For most people nowadays, the best way to get fat is to eat three meals/day.
Extramarital affairs have tradtionally been normal among the social class extremes: the wealthy and aristocratic, and the poor. An interesting sociological topic might be why so many ordinary people do not see this as a good idea.
The cited motives listed are these:
Top Reasons for Men:
His wife’s libido has dropped after marriage, children, etc. His wife is more preoccupied with being a mother than a partner. His wife no longer makes him feel sexy, masculine, virile. He is nostalgic for his free and wild youth The relationship is dull. Same conversation over and over again, same position over and over again, etc.
Top Reasons for Women:
Her husband no longer makes her feel sexy/desirable. Wants to explore sexual desires (kinks) she was too immature or unaware of in her youth. Her husband views her as a caregiver not a sexual being. Her husband initiates sex like she is a robot. No slow burn. No romance. No passion, excitement, thrill.
It's a crazy subject, fraught with myth. Animals do not need to read articles about when to have a drink of water, but seemingly humans do.
Where I live most of the time, females go around with a plastic bottle of water. In the car, in the gym, on the tennis court, at the supermarket, as if living in the Sahara. There are hardly enough public bathrooms for them all.
A few points:
Coffee is not dehydrating. Beer is hydrating. When you work out hard, especially in the heat, a little water is good. There seem to be extremes: people who are insensitive to their thirst, and people who drink too much. If confused about one's needs for liquid, the frequency of peeing, and the concentration of one's pee, are good indicators.
I have had outdoor adventures when my fatigue was entirely due to a touch of dehydration, when I perked up like a wilted plant with a bottle of water.
Gloria Steinem once called sex differences research “anti-American crazy thinking.” Senior colleagues warned me as an untenured professor around the year 2000 that studying sex differences would be career suicide. This new book by Rippon marks the latest salvo by a very small but vocal group of anti-sex difference individuals determined to perpetuate this cultural myth...
It is always sad to see science politicized. Nothing good ever comes from it.
Furthermore, as is well-established now, being overweight is a major risk factor for dementia (#2 after genetic).
My view of overweight is Live and Let Live. Overweight people know all of the consequences, and accept them as adults. I do help pay their self-inflicted Medicare bills but that's life in the US today. As an outdoorsy, sporty, fitness person I feel that giving up on vitality is sad, but people must do what they want to and nobody needs to be like me.
If you care, it's easy to lose 1.5-2 lbs of fat/week in a healthy way with a smidgen of self-control. We have posted on that topic many times. Underweight is another issue entirely.
Rightly or wrongly, we reserved physical punishments for dangerous situations. For example, running into the road when told not to. For running into deep, wavy water before being adequate swimmers.
However, we were of the generation of gentle rather than authoritarian parents. Probably not the best. Now, I feel the youth need some fear of parents because it is parents' job to represent reality before the kids hit real reality.
Interesting book: 
How to Measure Your Waist