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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

Effective Steps for Managing Anxiety

Have you ever been in a situation that brought on sweats, rapid heartbeat and shortness of breath? You probably weren’t having a heart attack but an anxiety attack. If you suffer from anxiety disorders, learning to manage it is the first step to overcoming it.

Anxiety is characterized by extreme reactions to fearful situations. When someone follows you into a dark alley, those anxious feelings of a racing heartbeat and sweaty palms gives way to heightened senses and a rush of adrenalin that can save your life. This is the fight or flight syndrome.

In the case of frequent anxiety, the fearful feelings are dread of a particular situation and not the situation itself. Getting caught in traffic can cause an anxiety attack over what might happen when you get to work late. Starting a new job can bring on anxiety attacks. You don’t know anyone and fear of that unknown can send you into a panic.

Everyone experiences panic or anxiety in small ways. Like the fight or flight example, it can save your life. In new situations, we get panicky but when the outcome we fear fails to materialize, the anxiety stops. For someone with chronic anxiety, this is not the case.

Every situation that brings anxiety is not life-threatening. More than likely it is an extremely stressful situation that has brought on the anxiety as a way of dealing with it. The unchecked anxiety of this type can lead to depression.

If you suffer from anxiety attacks on occasion or a more frequent anxiety disorder, there are steps you can take to keep your anxiety under control.

1. See a professional. This is always a good first step. Self-diagnosis of any type of physical or mental condition is unwise and can be dangerous. A professional psychologist can help you understand your anxiety and prescribe medication or other effective techniques.

2. Get a good night’s sleep. During the sleep cycle, your body repairs itself. You feel more rested after several hours of restorative sleep, reaching the REM stage. Most people need eight hours a night which varies within an hour or two each way.

3. Exercise on a consistent basis. Exercise helps you to use oxygen more efficiently. It helps to get more oxygen to the brain. It also increases focus which may help you see solutions to problems rather than simply worrying about them.

4. Meditate. Meditation is more than chanting mantras. Yoga is an exercise that involves quieting the mind and controlling your breathing. Simple mediation such as taking 5 minutes to clear your mind every day can work wonders in the fight against anxiety.

5. Manage the worry. When you feel your pulse start to quicken, count backward from ten. As you count, focus on the situation. What has actually happened? Resist the urge to read anything more into the situation.

6. Don’t use alcohol. You might think that the glass of wine is relaxing your tension but alcohol is a depressant. In anxious situations, you could rely too heavily on it and gain another problem in the process.

7. Find some relaxing activities. Stress can rob you of your energy. On a regular basis, do something you like such as gardening, painting, reading or listening to music.

Anxiety can come into your life at any time. It’s normal. When the anxiety becomes frequent you could be at risk for more serious conditions. If you feel your anxiety is starting to take over your life or increasingly causing you problems, seek professional help immediately. There is no need to suffer this terrible condition in silence.

You will consider how people relate, how they think and behave, their experiences of the world and how they function in their everyday life. This will include exploring people’s social, economic, cultural, spiritual and physical health experiences. Counselling psychologists use psychological and psychotherapeutic theory and research. They work to reduce psychological distress and to promote the well-being of individuals, groups and families.

The relationship between you and your client is considered to be central to understanding particular psychological difficulties and how they apply to them. To help recognise the relationship between personal development and professional practice, you will be required to have personal therapy as a client as part of your training and continued professional development.