Unhealthy eating and lack of physical activity increase the risk of obesity and associated chronic health problems, including heart disease, stroke, diabetes, arthritis and cancer. In New York City, 57 percent of adults and 39 percent of children are overweight or obese, and one in three adult New Yorkers has either diabetes or pre-diabetes. Obesity has increased significantly in the city in recent years—from 2002-2004, New Yorkers collectively gained 10 million pounds, and this trend continued through 2007. Obesity-related health problems account for almost 20 percent of Medicaid and Medicare expenditures.

When asked in a 2004 survey, 14 percent of New Yorkers reported eating no fruits or vegetables at all on the previous day. The majority of U.S. adults eat more than two times their recommended daily amount of salt and consume too much saturated fat. Eating more fruits and vegetables is one way to protect against many chronic conditions, such as heart disease and type 2 diabetes. Reducing the amount of high-sodium and high-fat foods consumed can help prevent high blood pressure and heart disease.

Americans consume about 250 more calories per day than 30 years ago: about half of these extra calories come from increased consumption of sugar-sweetened drinks.

Only one-quarter of New Yorkers report engaging in physical activity 30 minutes per day, four days per week. Being physically active is important for weight management—creating a healthy balance between calories consumed and burned—and for preventing a variety of chronic conditions and diseases, such as hypertension, diabetes, heart disease and some cancers.

Free Fitness Programs
Shape Up New York is a free family fitness program offered at parks sites, community centers and housing sites around New York City. Fitness classes are open to adults and children. Classes cover activities such as step aerobics, fitness walking, light weights, stretching and toning exercises.

Shape Up New York is designed to encourage the development of healthy lifestyles and help improve participant self-esteem through energizing physical activity in a non-competitive environment. The program is sponsored jointly by the City’s Health and Parks Departments.

Below is a list of a few of Manhattan’s Shape Up sites:
Alfred E. Smith Recreation Center
80 Catherine St.
212-285-0300

Recreation Center 54
348 E. 54th St.
212-754-5411

Hamilton Fish Recreation
128 Pitt St.
(212-387-7687

Thomas Jefferson Recreation Center
2180 1st Ave.
212-860-1383

Healthy School Ideas
With over 40 percent of New York City’s youth overweight or obese, it is important that schools promote healthy eating and regular exercise. Student success depends on a blend of academic skills, good health and physical and mental fitness.

Unfortunately, foods and beverages sold for fundraisers are often high in fat, sugar, salt and calories. Unhealthy food or beverage fundraisers send confusing and contradictory health messages, increase the availability of junk food in schools and teach kids to compromise their health for a profit.

Conversely, healthy food and non-food fundraisers send clear health messages and help change the school environment; increase the health of the students, school staff and parents; and help everyone make a profit.

Healthy Fundraiser Ideas
Sell produce (e.g., holiday baskets, Parent-Teacher Conference sale, concession stand, etc.)
Hold a student vs. faculty or student vs. alumni sporting event
Have an -athon (e.g., walk, dance, bike, hula hoop)
Offer evening parent classes (e.g., aerobics, dance)

It’s the same story every year: After weeks of indulging in cookies, cake, giant meals and more drinks than you can remember, the holidays have ended and you feel like a beached whale. Hence, one of the most popular New Year’s resolutions: Get in shape.

But just because you start the year strong doesn’t mean it stays that way. Work, family, money and life in general tend to get in the way as the cycle repeats itself. Just as it is the most common resolution, the “get in shape” mantra is usually broken.

This year, instead of falling prey to the usual routine, we asked some expert fitness trainers to share their tips and thoughts on how to first, get back to the gym, and second, stay there once you do.

The experts all said three basic things: If you haven’t been working out, start slow and build up; bring a like-minded buddy to help motivate you; and, if you can, get a trainer. They also said that part of getting fit is taking care of yourself. “It’s not just what you do in the gym, you have to sleep, eat well and cut out stress,” said Matthew Cole, director of Sculpt New York. “You need to maintain the health of all your faculties.”
What to do when you get there
There are a few approaches to getting in shape. The first is to take classes. Antonio Sini, owner of Nimble Fitness, recommends starting with Pilates, a dance class like salsa or tango and low impact yoga. “Learning some basic yoga moves is a great way to also take some exercise home,” he said.

For David Barton, owner of David Barton Gym, the key for newbies is to start weight lifting slowly. “Strength training gives you the most results whether you have a little or a lot of time,” he said. “If time is limited, concentrate on the major muscle groups and do as many big compound movements as you can.” He added that 20 to 30 minutes of proper movement can be highly effective. Just make sure to not overtax yourself; just because you can manage to lift the heavy weights doesn’t mean you should.

Trainers
The first step in choosing a trainer is making sure they are right for you, your workout speed and your goals. “Most people don’t see the results they want and that’s why they quit,” said Barton. “A trainer will vary your workout at just the right time to outsmart your body’s natural flab-harboring tendencies so you can achieve your dream body.”  Cole said that if you can’t afford a personal trainer, make sure to bring a friend to help motivate you to go to the gym and to work harder.

Eating
“Food is a huge part of exercise and how it can benefit you,” said Sini. “It’s super important that people understand nutrition.” The first thing to understand is your body—are you trying to lose fat, gain muscle, tone or just feel more in shape? “You don’t want to work out on a completely empty stomach, so have an apple or breakfast bar an hour before,” said Sini. “But you don’t want to eat within 45 minutes of exercise, since the blood leaves your stomach and goes to your muscles.” The best approach: munch on a piece of fruit or plain yogurt an hour before working out, drink water during and have a light meal 45 minutes afterward.

“After you work out, your body wants to absorb nutrients and it’s one of the best times to eat,” said Sini. But, he added, “It has to be the best food, like something high in protein light in carbs and low in fat.”

Staying motivated
One piece of advice the experts agreed on appears odd, but makes sense when you think about it. Don’t tell your out-of-shape couch potato friends your goal. “Surround yourself with like-minded people,” said Sini. Often, he said, someone who is unmotivated will bash your goal, making it hard to push yourself.

Another way to motivate yourself, he said, is to figure out what will make you happy. “First, look at yourself in the mirror and decide if your goal is to look and feel better physically—if that is going to make you happy, then do it.” He also said it’s easier to keep a more general goal, like fitting into a pair of pants, rather than losing 20 pounds.

Cole also added, “Don’t think about supermodels or what you consider normal; think about you and your own body.” He suggests writing down your life for a day to see what you actually do and how you can incorporate more exercise into a daily routine.

And for those who think of exercise as real work, try Barton’s theory on going to the gym: “For that one hour of my day, that time is all mine. The gym, it’s like my sanctuary.”

The great thing about a new year is starting with a clean slate and looking at the next 12 months with a new set of goals. If you are a smoker, now is a great time to stop.

Let’s face it: Being a smoker in New York isn’t as easy as it used to be. Along with the difficulty of finding a place to smoke, huddling outside in an alley in the rain, snow and freezing temperatures, there is also the cost factor.

Cigarettes can now cost more than $10 a pack. Smoking a pack a day costs $3,650 a year—a nice vacation you are blowing away in smoke.

The most obvious reason to quit smoking is for your health. Smoking affects every organ in your body and is the No. 1 cause of preventable death in the United States, leading to 393,000 deaths annually. Tobacco smoke is harmful to smokers and nonsmokers. Cigarette smoking causes many types of cancer, including in the lungs, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach and cervix. It also causes heart disease, stroke, chronic bronchitis, emphysema, asthma, cataracts, macular degeneration and hip fractures.

A pregnant smoker is at higher risk of premature delivery and abnormally low birth weight. In addition, a woman who smokes during or after pregnancy increases her infant’s risk of death from Sudden Infant Death Syndrome. Secondhand smoke is especially harmful to young children and even pets, who can develop cancer and lymphomas from inhaling smoke. Cats can develop oral cancer from licking the cancer-causing carcinogens that accumulate on their fur and have a higher risk of developing malignant lymphoma. Dogs have an increased incidence of cancer in the nose and sinus area.

If someone gave you a cocktail at a New Years Eve party and said, “Here’s a great drink; it’s addictive and is made from arsenic, benzene, cadmium, vinyl chloride, formaldehyde and toluene,” would you drink it? Hopefully, you would have the good sense to refuse it. Those chemicals are just a few of those packed into every cigarette.

So why is it so hard to quit smoking? Two reasons. The first is nicotine, a drug found naturally in tobacco that accounts for the physiological problems of smokers. Nicotine is absorbed into your bloodstream and is carried throughout your body, where it can stay three to four days after stopping.

The second component is the psychological aspect of smoking, or the excuses you make for smoking. “I’m bored,” “It helps me relax,” “I’m stressed and  “I only smoke when I go to a bar with my friend” are all excuses I have heard from smokers.

Several ex-smokers who were two- and three-pack-a-day smokers who were able to quit cold turkey without any help seemed to have something in common; they had an illness that scared them.

“I quit when my doctor refused to operate on me for triple bypass surgery unless I quit smoking,” said Mike, a cab driver and former three-pack-a-day smoker. “It was tough, but I did it and I feel so much better. I chewed gum, ate carrots and drank coffee. That was 20 years ago.”

Jim P. a 58-year-old stockbroker, used to smoke two packs a day. He quit when he got pleurisy and thought he was having a heart attack. He shared this thought: “If you believe enough in yourself, you can do anything and you will beat any addiction. You have to believe you have the power to change and that it will be real and permanent.”

For those who can’t do cold turkey, there is help. First, write down the day that you plan to quit and do it. Tell your family and friends, so they can help you keep your commitment. Nicotine replacement therapy in the form of gum and patches are now available over the counter and will provide the nicotine without the harmful chemicals in cigarettes. Prescription medication from your doctor, like Zyban and Chantix, may help you—but remember, there are always side effects to these medications.

Give your mouth something to fight the tobacco craving, like sugarless gum, nuts, sunflower seeds or green tea, which is great for weight loss. Go online and join a stop smoking program. Get more exercise and stay away from places where you used to smoke or people who smoke so you won’t be tempted. Some people have had good success with acupuncture, in which a staple is placed in the ear. Others have had success with hypnosis.

Whatever works for you to accomplish you goal, now is the time to do it. Remember, no one dies from cigarette cravings, and the benefits you reap from stopping smoking will add years to your life.

By Paulette Safdieh

Staying healthy requires more than an impulsive New Year’s resolution and a spanking new gym membership. To nix bad habits for good and maintain positive changes to your body in 2012, fitness experts argue that the first and biggest change starts with the mind.

The philosophies behind yoga, Pilates and meditation share the idea of a mind-body connection. These exercises require a certain awareness of the body that differs from running on the treadmill or breaking a sweat in Zumba class. Instead of counting the calories burned, practitioners believe a mental shift and commitment to change yield the best results.

“We live in a fast-paced, results-oriented society,” said Allan Lokos, founder of the Upper West Side’s Community Meditation Center. “If you stick with certain exercises long enough, you realize one day that you can now handle difficult situations with greater ease than you could have before.”

According to Lokos, 71, newcomers flock to classes as holiday bells start ringing. He says the human body doesn’t know how to differentiate between negative stress and the good stress brought on by the holidays, like shopping, overeating and traveling. People turn to meditation for the pleasant feeling of calm and quiet, but Lokos insists the sessions can be far from carefree.

“When you’re left alone with your body and your mind, all kinds of stuff comes up—and some might not be pleasant,” said Lokos, a two-time author on the topic. “Do I really want to lose weight? Do I really want to quit smoking? You get that clarity and it creates motivation.”

Meditation can help spur positive change—whether it’s dropping a few pounds or throwing out the cigarettes for good—if people have genuine concern for their well-being and the desire to change for themselves, not just because the doctor said so.

Unfortunately, the weight won’t slip off just by sitting in lotus position with your legs crossed a few times a week. To reap the most benefit from meditation, proper activity should be incorporated between the hours spent in the office cubicle. Lokos agrees that exercises like yoga and Pilates maintain a similar philosophy—being attuned to your body, making long-term changes and clearing your mind.

“It’s about sculpting yourself from the inside out, changing your mind’s perspective so your body will fall into place,” said Marissa Antebi, who has been a yoga instructor in Midtown for 11 years. “With any body issues, it’s about how you’re seeing something. You need to become aware of the bad patterns and grow from there.”

For Antebi, 40, January is the busiest time of year. Despite the holiday rush, not all newcomers tap into the endurance needed to stick it out and see results. Antebi suggests starting with something as minor as a walk in the park once a week and building from there.

Attending group sessions provides the support system of fellow classmates, further encouragement to stick with it. Soon enough, you’ll learn how to maintain your health and weight instead of experiencing the fluctuations of fad diets and cleanses.

Pilates instructor Donna Singer, of the Upper East Side’s Center for Movement, said that’s the common ground between yoga and Pilates—it becomes a way of life, not just a method of exercise.

“You become aware of your posture and alignment and understand that you don’t need intense exercise to feel limber, supple and stronger,” said Singer, 42, who opened her first studio with cousin Elle Jardim in 1998. “We don’t play music—we want you to keep your mind on what you’re doing. It encourages you to make positive steps to a healthy lifestyle and continue on that journey outside of the class.”

Pilates helps create strength without the bulk that comes along with weight training. Sessions at Center for Movement, on the Upper East Side and in Scarsdale, focus on flexibility and elongating the body though breathing. The goal is to do the movements correctly, increasing efficiency so fewer repetitions are required.

“As opposed to a spinning class, where you feel sore or you sweat, we teach a method,” said Singer. “After six sessions, you start to see subtle differences, like a flatter stomach and more flexibility. We want to help people meet their resolutions.”

Antebi agrees that sticking to your New Year’s resolution through mid-February can be long enough to earn a pat on the back.

“People get caught up in their goals for the year,” said Antebi. “If you put it on the back burner and just commit to becoming aware of your mind and body, positive changes will come from that.”

While department stores dress up their windows and shoppers search for the perfect gifts, those who work in the mental health profession prepare for the holidays in a different way: making sure New Yorkers stay healthy and happy during the holiday season.“The holidays are often markers for people,” said Lisa Brateman, a New York City-based psychotherapist and relationship specialist. “It’s a time when people compare themselves to others, whether in their career or their relationships.”

While the holidays are often expected to be the happiest time of the year, it is a time that can bring on sadness or depression as individuals compare their lives to others or contemplate where they were in their lives in the previous year, Brateman said.

“We’re bombarded this time of year by what it means to have someone. When a person doesn’t have someone, they start to wonder, ‘What’s wrong with me? Why can’t I have that?’” she said.

Images in the media are often to blame for setting these expectations. If someone is feeling lonely during the holidays, Brateman advises that they surround themselves with people they like and not isolate themselves further. For example, a person shouldn’t decide not to attend a party because he or she does not want to go alone.

Janet Pfeiffer, a motivational speaker and president of Pfeiffer Power Seminars, tells her clients to redefine what the holidays mean and create new traditions.

“I worked serving dinner to nursing home residents on Thanksgiving after my marriage ended,” she said. “I never enjoyed Thanksgiving as much as I did then.”

But even people who are not alone during the holidays can experience the holiday blues. Brateman said she often sees her past patients return during the holiday months, and she sees the largest number of new patients during this time than any other part of the year.

“Who to spend time with on Christmas Eve or New Year’s—unless you find a system that works for everyone, that’s a problem that repeatedly comes up every year,” she said. “That’s a matter of handling conflict and outside pressures from family.”

There are many sources of stress and anxiety during the holidays that can trigger depression, said Marty Forth, senior director of teen programs and service for the YMCA of Greater New York, who also oversees the organization’s mental health work.
“What we’ve seen is there’s a lot of stress in the parents or guardians and it manifests itself through them or through the kids,” he said.

The YMCA refers families to mental health services when appropriate, but one thing the organization does during the holidays is work with the families to make their lives easier. For example, they take on Christmas lists and recruit individuals to buy the gifts.

“It’s one less thing to worry about,” Forth said. “Finances are a huge part of the stress.”
Many YMCA locations also provide holiday meals, serving thousands of people with the help of donated food and local volunteers.

In addition to financial stress, overstretched schedules and simply trying to do too much can bring on the blues, Forth said. He advises doing everything in moderation and realizing that you can’t say yes to everything.

Holiday depression and holiday blues should not be confused with Seasonal Affective Disorder, which is a depression that affects people the same time each year, said Brateman. The symptoms are similar to regular depression, and while experts are unsure of the cause, it is often associated with a lack of sunlight.

“Holiday blues are different. The holidays can bring different feelings, but it is not seasonal depression,” she said.

The holidays can be an especially difficult time for someone mourning the loss of a loved one.

“There are a lot more reminders around the holidays, and you feel the loss a lot more,” Brateman said. “Take a moment or an hour to feel those feelings instead of acting busy and pretending you’re not feeling it.”

While holiday depression has many triggers, there are also effective solutions.
“I think one of the most important things is to not base how you feel on what everyone else is doing,” Brateman said. “What’s important is to keep one’s life in perspective.”

By: Dr. Cynthia Paulis

It’s that time of year again, when friends and family get together to celebrate the holidays and your diet gets ditched as you indulge in all of the wonderful and fattening treats of the season. But before you despair, there is actually one treat that is good for you: dark chocolate.For centuries, chocolate was revered more for its medicinal qualities than its taste. Aztecs reserved chocolate (which was usually consumed in liquid form) for priests and the very wealthy, but it was also given to soldiers because it was believed to make them strong.

When the Spanish explorer Hernán Cortés arrived in the court of Aztec ruler Montezuma in 1529, he was impressed by the magical drink and returned to Europe with trunkloads of cocoa beans, writing to the King of Spain that he had found a drink that built up resistance and fought fatigue.

The drink was quickly viewed as a cure-all, with eventually more than 100 medicinal uses for chocolate. In one document dating from 1590, a mixture of cacao beans, maize and herbs was used to reduce fever and panting and treat heart ailments. They even used it in baths, which were thought to cure fatigue in government officials and those who held public office. Maybe that’s what our Congress needs today!

In the 1800s, chocolate was given to pregnant women, since it was believed to help nourish the mother and child. Even Thomas Jefferson was quoted as saying, “The superiority of chocolate, both for health and nourishment, will soon give it the preference over tea and coffee in America which it has in Spain.” Soon, chocolate had sugar and milk added to it, taking away its medicinal qualities. At one point, Milton Hershey, the founder of Hershey Chocolate Company, advertised his milk chocolate bar as: “Hershey’s: More sustaining than meat.”

So why is dark chocolate so special? Chocolate is made from the cacao bean, which grows on the plant Theobroma cacao. The solid part of the bean is roasted and ground to a powder. Cacao powder, if not too sweetened, has anti-inflammatory and antiviral properties. The cacao has flavonoids that have antioxidants, enzymes capable of neutralizing the damaging effects of toxins in the body. One ounce of dark chocolate or cocoa has more antioxidants than blueberries, green tea or red wine.

Studies at the Cleveland Clinic and Mayo Clinic have shown that these flavonoids can improve blood flow and keep vessels healthy. One square of dark chocolate can benefit the cardiovascular system by enhancing blood flow and lowering blood pressure by two points. It can also prevent the buildup of plaque that can block arteries, and it possesses mild anti-blood clotting effects. Dark chocolate has also been known to lower LDL (bad) cholesterol by as much as five points.

Cocoa may have a beneficial effect on cholesterol levels because it consists mainly of good fat, mono or polyunsaturated fat in the form of stearic acid and oleic acid, the same fat that is found in olive oil.

Chocolate and cocoa contain copper, magnesium, iron and potassium, which are essential for good health. An average bar of dark chocolate has 4 percent of the daily requirement of copper, a mineral critical to the absorption of iron and key in skin-strengthening collagen. Copper also helps the heart.

Magnesium reduces the risk of type 2 diabetes, hypertension and cardiovascular disease. One bar of dark chocolate can deliver 12 percent of your daily requirement. Magnesium deficiency can lead to leg cramps, migraines, fatigue, loss of appetite, depression, nausea and vomiting. In addition, an average bar of dark chocolate can deliver up to 7 percent of the amount of iron a body needs. Iron is essential for carrying oxygen to parts of your body. If you are low in iron, you can become anemic, fatigued, irritable and prone to headaches. Chocolate also contains potassium, a key element in lowering blood pressure and preventing strokes.

Chocolate also contains more than 500 natural chemical compounds that are mood-elevating and pleasure-inducing. One of these is theobromine, a mild stimulant similar to caffeine but not as strong. It has been used in medicines as a cough suppressant. Chocolate also releases mood-elevating chemicals known as endorphins and serotonin in your brain. Eating chocolate really does make you feel good!
Chocolate maker Marilyn Maguinness has a less scientific view of its benefits. “It gives you a good feeling when you get chocolate, roses or a box of candy,” she said. “I have heard that the dark chocolate is actually good for women, for their hearts, so I think you should eat chocolate every day.”

Remember that chocolate is still loaded with calories and fat, so limit your consumption to just one square a day. Look for chocolate that is at least 60 percent cacao; the higher the cacao number, the lower the sugar. A 75 percent cacao bar is 25 percent sugar, while a 65 percent cacao bar is 35 percent sugar.

Milk chocolate and white chocolate have no health benefits. Avoid drinking milk with dark chocolate because it binds with the antioxidants, making them unavailable.
When the big man in the red suit comes calling this month, instead of leaving cookies loaded with saturated fats, leave him a few squares of dark chocolate. Don’t forget some carrots for the reindeer, loaded with vitamin A, which are good for their night vision!

By Lisa Elaine Held

It’s just inevitable, with holiday parties at work, seasonal soirees with friends and multiple family occasions—almost every night is another opportunity to socialize and celebrate, cocktail in hand.The stress of the season doesn’t help, either. Long lines and crowded stores, your rapidly decreasing account balance, and hours spent with grouchy relatives who love to talk politics will drive anyone to throw back a hot toddy…or five.

And while it seems intuitive that health-minded individuals would be less likely to reach for the booze, the opposite may be true.

“People who are weight-conscious tend to hold back on the food and go for the drinks as an alternative,” said Lisa Cohn, a registered dietician and the founder of Park Avenue Nutrition on the Upper East Side.

It makes sense—if you have to pass on something, it may seem like a healthier choice to skip dessert and sip a martini. But overdrinking can seriously impact your physical and mental health, causing negative side effects like weight gain and depression.

Don’t worry; becoming a teetotaler is not your only option.

“A celebratory toast with glass in hand can actually enhance your healthy eating,” said Cohn. Allowing yourself occasional pleasures and partaking in socially enjoyable activities will have positive effects on your health.

You just have to do it right.

Here are some of Cohn’s easy tips for toasting your health without compromising it.

Pay attention to calories
Don’t become obsessive about adding them up on your iPhone calculator, but be aware that many drinks you indulge in could be adding empty calories to your already holiday-stressed diet.

The caloric danger is often not in the alcohol but in the mixer. “Avoid heavily sugared and highly salted mixers and creamy, rich options that are high in fats and sugars,” said Cohn.

Here are some handy calorie count estimates for standard servings of popular holiday beverages. The numbers are approximations—they can vary depending on the type and brand of the alcohol, on the bartender’s recipes and serving sizes.

Red wine (5 oz. glass): 125
Bailey’s Irish Cream (1.3 oz. on the rocks): 94
Eggnog (8 oz. glass): 224
Hot Toddy (6 oz. glass): 150
Scotch (1 oz.): 69
Irish Coffee: 100–200 (This is a hard one to peg. Some people make it with whiskey, some with Baileys, and the addition of creamer or whipped cream makes a huge difference.)

Make better choices
You can take avoiding fatty mixers one step further by opting for drinks that have health benefits built in. Red wine, for example, has antioxidants like resveratrol, a polyphenol that has been shown to reduce heart disease risk factors in mice.

Practice moderation
No matter what you’re drinking, the amount you imbibe is key. Cohn suggests aiming for no more than two to four drinks per 24 hours.
Keep portion sizes in mind when drinking as well—12 ounces of a winter lager is not the same thing as 12 ounces of whiskey.

Counteract with healthy habits
Drinking taxes your liver and your brain, but there are lots of things you can do to help reduce its effects. Cohn says that staying hydrated is the most important; she recommends matching every ounce of alcohol with 16 ounces of water.
And the whole eating-instead-of-drinking thing? Forget it. It’s a bad idea to drink on an empty stomach, and it will seriously mess with your already strained digestive system. Snack on lean, healthy holiday foods like shrimp cocktail, roasted vegetables and turkey.

Speaking of your digestive system, it’s going to need some help to deal with all of that acid you’re adding. “Eat foods that are soothing,” Cohn suggests. “Blueberries, ginger tea, aloe beverages and coconut water can be helpful.”

If you’re unsuccessful and the holiday mania drives you to go a little overboard, don’t sleep all day (and don’t fall for the hair-of-the-dog approach). “Hydrate yourself and take a light walk to get the system moving,” Cohn said.

If nothing else, comfort yourself with the fact that it will all be over soon and you’ll be back to your healthy routine. “It may look dramatic,” said Cohn, “but in reality it’s just temporary.”

By Lisa Elaine Held

Diabetics live in a world ruled by measurements and numbers.

Doctors and other health care workers, such as Certified Diabetes Educators (CDEs), tell them what their blood sugar numbers should be, how to measure them and how much insulin to take.

But while numbers are crucial to controlling the disease, they make up just a tiny snapshot of the larger picture of diabetes management, a process that has emotional, psychological and social challenges.

Now, a small but growing sector of professionals is seeking to address those challenges through varied styles of coaching and counseling. In doing so, they believe they can help individuals accept and control the disease and live healthier, happier lives as a result.

“There’s a whole psychology behind it that goes beyond what are you eating and what your numbers are,” said Dana Hariton McQuade, a New York City life coach who works primarily with diabetics. “How you value yourself and how you take care of yourself are affected by how you embrace the disease.”

McQuade primarily works with women, many of whom are dealing with social challenges like dating while wearing an insulin pump or managing pregnancy or motherhood and blood sugar at the same time. Some of her clients harbor anger at their own misfortune, as did a 30-year-old woman she worked with who resented her disease and therefore had a hard time taking control of it.

Eliot LeBow, a New York social worker who counsels diabetics, said that anger is a huge issue with many of his clients, along with depression.

In fact, the Centers for Disease Control and Prevention’s National Diabetes Fact Sheet for 2011 reported that people with diabetes are twice as likely to battle depression.

They are also often misdiagnosed, said LeBow. If blood sugar levels are not under control, diabetics may exhibit the same symptoms as those suffering from clinical depression. “If their blood sugar levels are always high, they’re going to be lethargic and have no motivation and basically feel depressed,” he said.

In addition, the process of diabetes management is extremely stressful. It requires constant attention and measurement and is full of ups and downs each and every day.

Doctors and CDEs in clinical settings don’t usually have the time to look at the larger picture. They can tell patients what their numbers should be and the biological changes they need undergo to get there, but they won’t determine what in the patient’s life needs adjusting in order to make that happen.

That’s where life coaches and counselors come in. “When I get a new client in, I look at the whole picture,” said LeBow.

After determining what they need to work on, he guides them through making positive changes. “Most go on to have their blood sugar under control, and their emotional life gets better.”

This was true for Sysy Morales, a 28-year-old mother of twins who started a blog called The Girl’s Guide to Diabetes after getting her disease and depression under control with the help of a health coach. Morales said her coach mostly listened to what she said and then asked interesting questions she wouldn’t have thought to ask herself. This made her realize what the roots of her issues were and gave her a new sense of clarity.

“Using positive thinking helped me, and I worked on changing my diet and lifestyle habits,” she said. “Getting out of the depression made me able to take care of my diabetes and that, in turn, made my mood even better.”

The woman Morales went to for help was a health coach. McQuade is a life coach, and LeBow is a licensed social worker. While their credentials and approaches are slightly different, they’re all working to address the emotional and psychological challenges associated with a disease that is often looked at as purely biological.

Most coaches and counselors in this field have another thing in common—they’re diabetics themselves. McQuade and LeBow were both diagnosed as children, a factor that allows them to understand their clients in a more profound way.

Their services tend to be sought out mainly by individuals with Type 1 diabetes. This may be because of their personal experience with Type 1, or because those living with Type 1 are dependent on insulin, making management a more difficult, consuming process.

If the field continues to grow, it may expand to reach a larger population. “I’m trying to get other people on board,” said LeBow, “so people will know that therapy is a big part of managing diabetes.”

As a unified concept in psychotherapy, life coaching is a recent addition to the field—and many psychotherapists still do not consider life coaching a legitimate part of the psychotherapy process. They see life coaching as a resource for emotionally together people who want to expand themselves in new ways with higher aspirations and psychotherapy as a process of exploring the past with emotionally disturbed people in order to help them understand how dysfunctional early life has negatively impacted them as adults. They see therapists as listening in a non-directive way, allowing clients to come to realizations on their own at their own pace.

However, psychotherapy is much more complex than empathic listening and realization. Many clients have never learned to develop the skills needed to grow up in healthy ways. Their “foundations” are weak and very vulnerable to self-loathing, anger, depression, anxiety and feelings of helplessness from lack of good-enough parenting. Or they may become traumatized later on by things like rape or war-related horrors. Clients who come to us are lost, anxious or depressed, and often act out their pain through anger and have little internal sense of reality to help them deal with the world.

And while it is important for therapists to help clients understand their past and how it impacts the present, it is also vital that they feel they can ask for advice and concrete help and that we therapists feel comfortable in giving them that guidance. They often need very direct tools on how to deal with troubling issues, education about how healthy relationships work, how to be better parents, how to deal with difficulties regarding jobs and career, sexuality, spirituality, separation, etc. This is what good-enough parents do for their children and what good-enough therapists must often do for their clients. And when they are successful in dealing with issues in which we have guided them, they need our reinforcement and our pleasure in their learning and growing. Surely this is a form of life coaching, whether acknowledged as such or not, that is vital to the therapy process. I am quite sure good-enough therapists have always been life coaches, even before it was called “life coaching.”

Lucille Barish is a licensed clinical social worker.

Life coaching is a rapidly expanding field, and although there is no legally required course work to declare yourself a life coach, there is a recognized certification organization: the International Coaching Federation. Here are a few Manhattan-based programs to get certification:

Columbia Coaching Certification Program
525 W. 120th St., 212-678-8240, $900–$8,700

The Teachers College at Columbia University and Columbia Business Schools together offer the Columbia Coaching Certification program. Students focus on learning guiding principles such as ethics, core competencies that help establish successful relationships with clients and the overall coaching process. Columbia offers five-day intensives for individuals looking to establish life coaching as a profession (external coaching) and for those looking to incorporate it into their existing jobs (internal coaching). Students have the option to continue on to coaching practicum, a semester of in-field coaching work, and a five-day wrap up advanced coach intensive for a certification in coaching. The program can be completed in as little as eight months, although schedules can be stretched out over longer periods of time.

Coaching for Transformation at the New York Open Center
22 E. 30th St., 212-219-2527, $5,485

The accredited program trains 36 people in each class in addition to one- and two-day seminars, which draw about 25 people twice a year. The courses are designed to accommodate the lives of busy, working professionals.

NYU School of Continuing and Professional Services
7 E. 12th St. #923, 212-998-7100, $895–$995

Students can choose to specialize in Personal/Life Coaching or Organizational/Executive Coaching as part of the leadership program and are required to complete seven classes. Mandatory instruction focuses on decision-making and communication and motivational skills, and may be complemented with courses in marketing and human relations.