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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

Communicating with someone who is suffering from depression can be challenging, as it can be difficult to know what to say or how to act. However, it is important to remember that your words and actions can have a significant impact on their mental health and well-being. Here are some tips for communicating with someone who is struggling with depression:

  1. Listen without judgment: Let them express their feelings and emotions without interrupting or dismissing them. Show empathy and understanding, and avoid criticizing or judging their thoughts and actions.

  2. Offer support: Let them know that you are there for them and that they are not alone. Offer to help them in any way that you can, whether it be through listening, providing practical support, or accompanying them to therapy appointments.

  3. Avoid giving advice: While it may be tempting to offer solutions or advice, it is important to recognize that depression is a complex condition that requires professional help. Instead, encourage them to seek support from a healthcare professional.

  4. Be patient: Recovery from depression takes time, and it is important to be patient and understanding. Avoid pressuring them to "snap out of it" or rushing their recovery process.

  5. Practice self-care: Supporting someone with depression can be emotionally taxing, so it is important to take care of your own mental health as well. Set boundaries, seek support from others, and prioritize your own self-care.

  6. Validate their feelings: Depression can be a lonely and isolating experience, so it is important to validate their feelings and let them know that it is okay to feel the way they do. Encourage them to express their emotions and offer reassurance that their feelings are valid and important.

  7. Encourage healthy habits: While it may not cure depression, maintaining healthy habits such as regular exercise, a balanced diet, and adequate sleep can help improve mental health and well-being. Encourage them to engage in these habits and offer to participate with them if possible.

In summary, communicating with someone who is struggling with depression requires patience, empathy, and understanding. By listening without judgment, offering support, avoiding giving advice, being patient, practicing self-care, validating their feelings, and encouraging healthy habits, you can help support them through their recovery process.

Love 

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.

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.