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Introduction

Nearly 7% of the world population is obese1 and about 66% of the adults in the United States are overweight or obese.2 Obesity is associated with a number of adverse medical conditions including increased risk of gallbladder disease, hypertension, type 2 diabetes mellitus, coronary heart disease (CHD), osteoarthritis, cancer death and reduced life expectancy.3–8 Obesity is also associated with adverse social and psychological consequences, including bias, discrimination and decreased quality of life.9,10

More effective treatment strategies are urgently needed for obesity management. The total caloric intake or energy density of one’s diet appears to be associated with obesity11–14 and a diet that induces a negative energy balance continues to be an important part of obesity management. Strategies to achieve the difficult task of eating less than desired include reduction of the energy density of foods by increasing food volume by the addition of fluids,15,16 bulk17–19 or their combination;20 or by increasing satiety by various anorectic drugs or macronutrient combinations of high satiety value.

Satiety is positively associated with the protein, fiber and water content of foods and negatively with fat and palatability ratings.21,22 However, within food groups, there may be as much as a twofold difference in satiety values, suggesting that certain foods promote greater satiety independent of macronutrient content or energy density. An egg is an example of such a food that has a 50% greater satiety index compared to white bread or ready-to-eat breakfast cereal.21 Compared to an isocaloric bagel breakfast of equal weight, an egg breakfast had a greater satiating effect, which translated into a lower caloric intake at lunch.23 The resulting decrease in energy consumption lasted for at least 24 h after the egg breakfast.

This study was undertaken to exploit the short-term satiating benefits of an egg breakfast23 for weight loss in a longer-term trial. The objectives were to determine if the incorporation of an egg breakfast in the diet by overweight or obese subjects would (1) induce reduced energy intake and unintentional weight loss, even when not attempting weight reduction; or (2) enhance weight loss when following a reduced energy diet. We compared the effects of an egg vs isocaloric bagel breakfast of equal weight on weight loss, indices of body size and composition, dietary compliance, food cravings and health-specific quality of life.Materials and methods

The study was approved by the institutional review boards at Pennington Biomedical Research Center and at Saint Louis University. Written informed consent was obtained from the participants. We certify that all applicable institutional and governmental regulations regarding the ethical use of human volunteers were followed during this research.

Participants

Of the 160 participants enrolled, 8 did not complete the trial. The final study sample included 152 participants (131 women and 21 men; mean age 45.0±9.4 years; black participants 47.7% and white participants 52.3%). Demographic characteristics of the participants are provided inTable 1

Billy always listens to his mother. He always does what she says. If his mother says, “Brush your teeth” , Billy brushes his teeth. If his mother says, “Go to bed”, Billy goes to bed. Billy is a very good boy. A good boy listens to his mother. His mother doesn’t have to ask him again. She asks him to do something one time, and she doesn’t ask again. Billy is a good boy. He does what his mother asks the first time. She doesn’t have to ask again. She tells Billy, “You are my best child.” Of course Billy is her best child. Billy is her only child.

Love songs are everywhere. But does anyone have a definition of love, which — people claim — makes the world go around? Sure, it’s easy to tell when you’re in love with someone. [The heart pounds and you act like an idiot.] But it’s much harder to say if you actually love someone.

Enter the mind of Harry Jenkins, as he is about to make love to Natasha,

And then he laughed at himself as he sank beneath the covers. No sane man would question such free and voluptuous pleasure, as if it could only be valued through thought. Only an idiot or a fool would try to analyze love and passion

Nonetheless, like the fool, I seek a definition. Perhaps it is the lawyer in me. On the subject of love, Carl Jung, the Swiss psychiatrist, is a sobering read. All of us, supposedly, carry within us, an animus [if you’re female] and an anima [if you’re male], which is the idealized image of the person you love. And so, when you are in love you are projecting this idealized image on a real, live person who might be naturally quite entitled to be different.

After the honeymoon, those annoying little cracks in the image appear, which could certainly explain the high divorce rate. When you find the real person doesn’t exactly match your superimposed ideal, what do you do?

All of these thoughts led me to explore people’s ideas of all kinds of love, not just the romantic variety, in Final Paradox, the second in The Osgoode Trilogy.

Harry Jenkins is the lawyer protagonist throughout the trilogy, which contain storylines of murder and fraud. He is in the thrall of the beautiful Natasha. His aging father, who abandoned him as a child, has just asked his forgiveness. Harry can’t seem to find that in his heart. Natasha asks him—

What do you think love is?
He shrugged. “I don’t know. It’s about wanting someone as part of your life. Wanting them always with you.” He looked into her eyes. “Why? What do you think?”

“I think it’s about getting outside yourself and seeing another person’s life from their point of view. At least that’s a start,” Natasha replied.

Harry heard his father’s words. It’s all about you, is it? Would he always be the kid, he wondered?

Another character musing about love is Norma Dinnick — an elderly client of Harry’s who trips back and forth between lucidity and madness. She recollects her stew of feelings for various men.

Going back to her hotel, Norma tried to understand. She knew about affection and caring for Arthur, her husband, who kept her safe from the emptiness. But she did not understand this business of love, which David talked about. She did know that such emotions gave her a sense of power. The sheer lust she experienced in the presence of George made her feel weak and vulnerable.

Norma simply doesn’t understand about love and neither does Bronwyn — another character. An embittered soul, she has married a gay man and on her honeymoon – She wandered the narrow beach of sand and stone where the boats ferried back and forth to the grottos. No Peter. But then she saw him at a distance on the beach walking slowly with a younger man she did not know. Where had they come from? Right from the start, she had known. Of course, the bargain was unspoken but well understood. For money and security, Bronwyn had sacrificed any chance for love.

But in the end, Harry does begin to get it. In bed with the lovely Natasha, he was

…transported outside his own body, he was overcome with the desire to know the dreams, fantasies, and mysteries she held within. He would enter her world with love and understanding and never leave. The awe he felt in her closeness made his breathing slow and deepen in rhythm with hers. He watched his hand reach out of the shadows to smooth the sheet. She was at last in his bed and, fearing a mirage, he dared not wake her. In the past two weeks, his world had been shaken. His mind had become a jumble of colliding, conflicting events and consequences. Now he felt her power to draw his life together. A still peace gently settled over him like a silken web of meaning.