Being disconnected from or being self-critical of your body can have serious health consequences. An 18-year-old woman had bilateral breast implants at an out-of-state clinic. Since her early teens, she had wanted this surgery because she thought her breasts were too small and unattractive. When she saw me the week after her surgery, her breasts were painful, tender, red and obviously infected. She was now ashamed and deeply regretted her decision to alter her body based on social pressure and images....



Anger can be a healthy emotional response or a serious health risk.  Managing anger appropriately does not require that we deny it, repress it or get completely rid of it. Brief, mild-to-moderate episodes of anger and righteous indignation can be a useful stimulus to positive and constructive action on both the personal and societal levels. However, severe, repeated or uncontrolled anger can lead to serious harm to oneself or others.  The body’s stress (“fight or flight”) response is triggered by anger.



The Harvard School of Public Health (HSPH) is the world’s premier nutrition education resource. Harvard Medical School and the Department of Nutrition at HSPH developed the Healthy Eating Plate to provide the general public with up-to-date, science-based nutrition education. They recognized the need to provide more scientifically accurate information than is provided by the U.S. Department of Agriculture’s (USDA) MyPlate, which does not accurately reflect current, science-based nutrition advice.


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I will never forget my patient who developed Type 1, insulin dependent diabetes after her spouse was violently murdered. While there is no research supporting a causal link between the two, it seemed to us both that the intense emotional trauma of this sudden, tragic, life-altering loss was a contributing factor to the onset of her diabetes.

Since stress is a natural consequence of life, it cannot be reduced to zero, but effective management of stress can help prevent the onset of diabetes and help manage diabetes once it develops. Although we hear a lot about stress and intuitively know what it is, it isn’t easy to define. The American Institute of Stress says, “While everyone can’t agree on a definition of stress, all of our experimental and clinical research confirms that the sense of having little or no control is always distressful – and that’s what stress is all about” (

Stress can involve your physical, mental, emotional and behavioral reactions to perceived danger. Even perceptions of danger that you are not consciously aware of can have an adverse impact on your physical, mental and emotional health. You are hard-wired to feel threatened by things that seem uncontrollable in your work life, home life and environmental surroundings. This lack of control often involves interpersonal relationships with other people and their behaviors, attitudes and positions of power or control over certain aspects of your life.

Due to our very old evolutionary hard-wiring, human beings respond to perceived threats by a set of responses, simplistically referred to as “fight, flight or freeze.” This hard-wiring was critical to our ancestors’ survival long ago. It helped them escape hostile predators and warring tribes. But today we can have this same reaction to our bank account balance, traffic, deadlines, co-workers, bosses, family members, computer hassles and our own internal experience of ourselves and the circumstances of our lives.

The short-term effects of the stress hormones cortisol and adrenaline include increases in certain bodily functions required to fight or flee, including blood flow to muscles and increased blood pressure, heart rate and breathing rate, as well as overall metabolic activity. If the stress is temporary, these changes usually return to normal without adverse health impacts. However, the long-term effects of elevated stress hormones include increased blood sugar (sometimes leading to or aggravating diabetes), high blood pressure, weight gain or loss, anxiety, depressionanger and irritability, muscle tension, head-aches, digestive problems, over or under-eating, sleeping too much or too little, impaired memory, teeth-grinding and many more symptoms.

Fortunately, there are several ways we can manage stress skillfully and effectively. Belonging to a supportive group of like-minded people who take health seriously and support one another is important. These groups may have special interests, such as physical activity, nutritional approaches to stress management or emotional well-being.

Sleep loss is a modern epidemic made worse by constant electronic connectivity and over-commitments. The most common complaint I hear from people who are having trouble sleeping is “I can’t turn my mind off.” Unlike our prehistoric ancestors who returned to baseline metabolic normality after the immediate threat was over, we can carry our internal and external stressors around in our head 24/7/365. You can learn to control this internal mental chatter. Several respected meditation programs can help you turn it down. There is increasingly good research supporting these programs’ effectiveness in stress management.

Transcendental meditation is a mantra-based technique that employs a silently repeated sound to gently focus the mind. Benson’s “relaxation response” is a similar approach that employs several mental and physical techniques to train the mind to remain focused and calm. Mindfulness-based stress reduction (MBSR) is a set of practices that utilize focused attention on the body, the breath, thoughts and emotions to train the mind to pay attention to the present moment. All three of these programs are highly regarded and highly recommended for relieving anxiety, depression, pain and the stress response that can aggravate diabetes.

The incidence of diabetes grew in every U.S. state between 50 percent and 100 percent between 1995 and 2010. This is a major public health problem, partly aggravated by stress. Thankfully, we have effective, non-drug approaches for managing stress. You can learn more from these sources:

•  National Institute of Mental Health Fact Sheet on Stress

•  Transcendental Meditation

•  Benson-Henry Institute for Mind Body Medicine (relaxation response)

•  Center for Mindfulness in Medicine, Health Care and Society


Dr. John Patterson is past president of the Kentucky Academy of Family Physicians and is board certified in family medicine and integrative holistic medicine. He is on the family practice faculty at the University of Kentucky College of Medicine and the University of Louisville School of Medicine, Saybrook University’s School of Mind Body Medicine (San Francisco) and the Center for Mind Body Medicine (Washington, D.C.). He operates the Mind Body Studio in Lexington, where he offers integrative medicine consultations

more articles by dr john patterson