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The report is an all-inclusive research study of the global Testosterone Replacement Therapy market taking into account the growth factors, recent trends, developments, opportunities, and competitive landscape. The market analysts and researchers have done extensive analysis of the global Testosterone Replacement Therapy market with the help of research methodologies such as PESTLE and Porters Five Forces analysis. They have provided accurate and reliable market data and useful recommendations with an aim to help the players gain an insight into the overall present and future market scenario. The Testosterone Replacement Therapy report comprises in-depth study of the potential segments including product type, application, and end user and their contribution to the overall market size.

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Segment by Type, the Testosterone Replacement Therapy market is segmented intoGelsInjectionsPatchesOther

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Regional and Country-level Analysis:North AmericaUnited StatesCanadaAsia-PacificChinaJapanSouth KoreaIndiaSoutheast AsiaAustraliaRest of Asia-PacificEuropeGermanyFranceU.K.ItalyRussiaNordic CountriesRest of EuropeLatin AmericaMexicoBrazilRest of Latin AmericaMiddle East & AfricaTurkeySaudi ArabiaUAERest of MEA

Competitive Landscape and Testosterone Replacement Therapy Market Share AnalysisTestosterone Replacement Therapy market competitive landscape provides details and data information by companies. The report offers comprehensive analysis and accurate statistics on revenue by the player for the period 2015-2020. It also offers detailed analysis supported by reliable statistics on sale and revenue by players for the period 2015-2020. Details included are company description, major business, Testosterone Replacement Therapy product introduction, recent developments, Testosterone Replacement Therapy sales by region, type, application and by sales channel.

The major companies include:AbbVieEndo InternationalEli lillyPfizerActavis (Allergan)BayerNovartisTevaMylanUpsher-SmithFerring PharmaceuticalsKyowa KirinAcerus Pharmaceuticals

A proper understanding of the Testosterone Replacement Therapy Market dynamics and their inter-relations helps in gauging the performance of the industry. The growth and revenue patterns can be revised and new strategic decisions taken by companies to avoid obstacles and roadblocks. It could also help in changing the patterns using which the market will generate revenues. The analysis includes an assessment of the production chain, supply chain, end user preferences, associated industries, proper availability of resources, and other indexes to help boost revenues.

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Market Segmentation based On Type, Application and Region:

The global Testosterone Replacement Therapy is analyzed for different segments to arrive at an insightful analysis. Such segmentation has been done based on type, application and Region.

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Testosterone Replacement Therapy Market Size, Analysis, and Forecast Report 2019-2025 - StartupNG

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VIRGINIA BEACH, Va. - A Virginia Beach Police officer was arrested Tuesday on multiple drug charges.

Earlier in the year, the Virginia Beach Police Department received information about one of its officers. This information led the department to start a criminal investigation and put the officer, 24-year-old Hugo Diaz-Rivera, on administrative assignment.

That investigation resulted in Diaz-Rivera to be charged with seven counts of possessing a schedule III substance without having a valid prescription.

According to the Drug Enforcement Administration (DEA), Schedule III drugs, substances or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples include products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids and testosterone.

Diaz-Rivera was immediately suspended without pay and is being held at the Virginia Beach Correctional Facility without bond.

He has been with VBPD since November 2018; he was assigned to the uniform patrol division. The Office of Internal Affairs will continue with the responsibility of conducting the appropriate internal administrative review.

This criminal investigation is being led by the DEA and is fully supported by the Virginia Beach Police Department. The criminal investigation is ongoing.

Stay with News 3 for updates.

Original post:
Virginia Beach Police officer arrested, charged with drug possession without having valid prescription - wtkr.com

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On the nights when the mental sexual images of children were most overwhelming, Joseph Parker took cold showers and baths, hoping the shock of freezing water would push his intrusive thoughts away. Other times, he would fixate on a picture of the Sri Lankan Buddhist monk Henepola Gunaratana, so that the monk's "wrinkly face" might replace the disturbing imagery in his head.

Parker, who is using a pseudonym to protect his identity, had known he was attracted to children since he was 17, but he didn't start having overpowering sexual urges until he was 24. (He's now 26.) These urges were the worst when he was falling asleep. "As soon as I tried to release myself from wakefulness, my mind would sink into the pool of sexual energy, and I would feel this horrible sense of joy and happiness towards children, he said.

He read online about medications that could lower testosterone levels and, as a result, sex drivea process sometimes referred to as "chemical castration." When he asked a psychiatrist for these drugs, he was given Risperidone, an antipsychotic, instead. He took that for about a year, then added on Sertraline, an antidepressant, but only found these drugs mildly helpful. He turned to the internet to get what he had wanted in the first place.

From a Turkish division of the pharmaceutical company Bayers, he ordered cyproterone acetate, which lowers testosterone, along with the female hormone estradiol, and now takes the two medications together. The website that processes the sales is frequently shut down because of its illicit nature: "To my knowledge this is their third or fourth website change, at least, since I came upon them 14 months ago," he said.

Parker wishes it wasn't this hard for pedophiles to get sex-drive reducing medications. But for many pedophilesand especially pedophiles who have not committed crimesaccess to even talk therapy, let alone medication, can be difficult to come by, and the process is riddled with fears about being reported to legal authorities.

In the past several decades, researchers have arrived at new understandings about pedophilia, the sexual attraction to children. Pedophilia appears to be an in-born sexual preference, something a person does not choose and cannot change. A pedophile's attraction to children is consistentnot a phaseand they develop their attraction to children around the same time that other people develop sexual attractions.

While researchers' knowledge has been evolving, access to widespread, up-to-date healthcare hasn't kept up pace. Outside of the handful of researchers who provide therapy and medication to pedophiles, the barriers to finding an informed therapist or psychiatrist remain high. This has led to a hodgepodge of therapeutic approaches in the community, or people self-medicating, like Parker did. Many pedophiles are only directed towards treatment in the context of the criminal justice system, where in some states, chemical castration is used on sex offenders.

Yet importantly, researchers have established there's a distinction between pedophilia and child molestation, a difference between the attraction itself and the crime. Most people hear these words and think that they're synonyms. They're not, said James Cantor, a Canadian clinical psychologist and neuroscientist who studies pedophilia.

Only about half of child sex offenders are genuine pedophiles. The other half prefer adults sexually, and are abusing children because theyre available or easily manipulated. (Child porn offenders, on the other hand, are nearly always pedophiles because of the ready availability of adult porn alternatives.)

The goal of any modern, preventative treatment for pedophila should be to help people manage their sexual interests rather than try to change them, Cantor said. This can involve the voluntary use of hormone-reducing medication to control urges or therapy. Since pedophilia and sexual abuse are not synonymous, treatment for pedophilia is also not solely about preventing child sexual abuseits about helping people with their overall mental health and well-being too. Thats a concept that may be hard to accept. It involves recognizing that people who are sexually attracted to children deserve to live healthy and meaningful lives.

Online support groups for non-offending pedophiles have only recently entered the public eye. The most well-known group, the Virtuous Pedophiles, was formed in 2012 as a safe place for pedophiles to discuss their struggles and commitment to not offend. Parker belongs to the Virtuous Pedophiles and is known to the community as Double22. Another organization, the Association for Sexual Abuse Prevention (ASAP) was formed by some members of the Virtuous Pedophiles, and they are currently ramping up their goal to create a platform to connect pedophiles to mental health professionals.

"In my opinion, they should not be seen as second class patients.

In April of this year, the first randomized placebo-controlled study of a hormone-reducing drug for pedophilia took place in Sweden. Published in JAMA Psychiatry, it found that the drug reduced both high sexual desire and sexual attraction to children, and that the effects were noticeable within two weeks.

The study is the first to include people who self-identified as pedophiles and were seeking help of their own accord, not just people funneled from the criminal justice system. Whats even more remarkable about the study is that it included a placebo groupthe first pedophilia study to do so. In an editorial about the study, Peer Briken, a professor of sex research at the University Medical Centre Hamburg-Eppendorf in Germany, wrote that it marks a milestone in clinical sexual science and the field of forensic psychiatry.

I think one of the biggest problems is that people just don't understand this as a mental health issue, said Fred Berlin, an associate professor in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. Rightfully, people are concerned about protecting children. And so we just quickly stigmatize people who are attracted to children and often don't even see them as human beings with a problem who might be deserving of help.

"In my opinion, they should not be seen as second class patients.

In 2014, journalist Luke Malone wrote an article about young people, some of them minors, who were discovering that they were attracted to children, and how they were coping with it. It was adapted as an episode of This American Life, one of several high-profile media pieces about pedophiles that explored the complicated existence of being born attracted to childrenand how hard it is to get help.

When Adam, one of the young pedophiles in Malones story, admitted to a therapist what was wrong, she just became extremely cold and harsh, he told Malone. She even, a few times, almost got to the level of shouting. She ended up telling Adams mother.

There is a huge reason [pedophiles] would avoid therapists and doctorsthose people have an obligation to report them to police if they think children might be in danger in the future, said Ethan Edwards, one of the co-founders of the Virtuous Pedophiles, who uses a pseudonym.Especially if they are not specifically trained in the issue, and with the common belief that all pedophiles molest children sooner or later, it is very perilous for a pedophile to seek out a therapist.

Watch more from VICE:

Christoffer Rahm, a psychiatrist, researcher at the Karolinska Institute, and the senior author on the JAMA study from April, once worked at a clinic linked to a Swedish national helpline focused on sexuality, PrevenTell. Rahm ended up meeting some pedophiles who called in; one was a bus driver who brought children to school. The bus driver was struggling with his impulses and fantasies, but had not sexually offended in any way. Rahm looked for research to help determine the best treatment for his patient and found a gap in the literature: There were no rigorous comparisons of different medications, or recommendations about who might do best with therapy. (As far as we know, female pedophiles are rarer, and the research on treatment for them even more sparse.)

Cantor feels it's more than just a gap when it comes to pedophilia. It is a black hole, he said. This is a topic that scientists in the fields of mental health are not just uninterested init is actively repugnant."

Thats what motivated Rahm to conduct his study. If there are people seeking help for this, the best thing would be to manage it in a preventative phase before the damage is done, he said. Of course, society needs to say that any kind of abuse against a child is not okay. But it is counterproductive if these people can't even seek help with a professional.

The medication Rahm studied is Degarelix, approved by the FDA in 2006 for treatment of advanced prostate cancer. This is the first time that it's been used off-label for pedophilia. Its an injection that starts working right away and lasts for about three months. It works by shutting down signals from the brain to the body to produce testosterone.

In qualitative interviews Rahms team did during the study, they found that some of their participants experienced positive effects. They described feeling an inner calm, Rahm said. They felt less pressure, that they had a better intimate life with their partners. Some described that the annoying thoughts around children disappeared so they can focus on other things. And many described that they had lost that enervating impulse to masturbate, and were able to see children as just human beings and not sexual symbols. A majority of the participants in the group that got the active drug said that they would want to continue taking it.

Many of the therapies that have been used for pedophiles have not been validated this way, but deployed through forensic psychology and the criminal justice system. Though Berlin has prescribed hormone-reducing medications to countless patients, he feels that the legal system usually doesnt collaborate with doctors and scientists who are studying the use of these drugs. As a physician, I think that's completely inappropriate, he said.

If someone goes to prison being sexually attracted to children, theres nothing about prison that can get rid of that attraction, or enhance a persons ability to resist temptation later on, Berlin said. It also leads to a mistrust of treatment, because of a history of involuntary use of chemical castration and aversion therapya therapy that associates negative cues with images of young children to dissuade future attraction.

The idea that we can solve this simply through punishment and incarceration is very naive, Berlin said.

Talk therapy should focus on managing a person's sexual interests, with an explicit acknowledgment that those interests will likely never change. In the past, therapy sometimes focused on searching for trauma, because of the belief that a history of abuse led someone to abuse. The truth is a bit more complicated. Having been sexually abused in your own childhood could be a factor in committing sexual abuse as an adult, but is not necessarily a factor in pedophilia.

This is what Ive heard over and over, Cantor said. They knew. They always knew it. All their past therapists were telling them to focus on trauma, what happened in their childhood. But their genuine experience of it was that they were born this way.

We need to move on to the next generation of research and quality development.

Cantor said that once that basic framework of therapy changes from changing ones sexuality to managing it, people adapt very quickly. It makes more sense to his patients, and theyre able to better commit. If a person has looked at child porn or committed sexual abuse in the past, a therapist would help them examine how and why their self-control broke down, and how to set up their life so that it doesnt happen againnot how to stop being attracted to children.

For some people, this process could be paired with sex-drive reducing drugs. Some people find they would rather live in that state than with those nagging sex drive that they can't express and can do anything to do anything about, Cantor said.

Yet even in those states that have issued mandates for sex offenders to receive hormone-reducing drugs as punishment, it can be incredibly difficult for non-offending pedophiles who want it to get medication. I get letters from people around the country all the time wanting access and they can't even get access to it, Berlin said.

Rahm doesnt advocate for medication to be used for every pedophile for lifehis study explores whether this specific drug could help. He said a person may only want and need it for a few months. It could help a person through a difficult time, or be combined with the start of a behavioral therapy practice. We need to move on to the next generation of research and quality development, Rahm said. We need to evaluate our treatments and to get evidence-based treatments out there so we know what we're doing.

The word castration has a dark history, and dark connotations. It's often been wielded involuntarily: In Germany the number of involuntary castrations of sex offenders increased as a result of the Nazi German Act, with at least 2,800 sex offenders were castrated between 1934 and 1944. In the United States, Black men accused of raping or sexually assaulting white women could find themselves subject to castration. For reasons like these, Rahm is torn about calling Degarelix chemical castration." While he thinks researchers and clinicians should accurately describe what the drug is doing and its side effects, he worries that referring to it as castration could scare people away, or disregard the consent and autonomy of patients who want it.

Rahm said that every person who participated in their study did so voluntarily, and was informed in detail about any possible side effects from taking Degarelix. They had the option to quit the study at any moment. Hes also currently running another placebo-controlled study on a non-pharmacological option: therapy geared specifically towards pedophiles that they can access anonymously, through the dark web.

The mere existence of Rahm's studies is important, outside of the details of the findings. Doing placebo-controlled studies on pedophilia was previously thought to be impossible, because of the ethical implications of not giving an active treatment to a group of people attracted to children.

In Brikens editorial, he wrote that because the medication they used was fast-acting, and they allowed anyone with pedophilia into the studynot just those who were high-risk for offendingit helped make the placebo group ethically possible. Briken concluded that Rahm's study was the most important contribution to the field of pharmacotherapy of pedophilic disorders since the original study of hormone reducing drugs in 1998, and offers a starting point for a more comprehensive approach to pedophila treatment.

In Germany, Prevention Project Dunkelfeld, which offers therapy and medication, has 10 locations throughout Germany, and a person can get help while remaining completely anonymous.

The demand for their work is high: After a BBC documentary on the Dunkelfeld Institute aired, the Guardian reported that Dunkelfelds hotline was overwhelmed with calls from British pedophiles. One British man was so desperate, he moved to Germany to be able to access a Dunkelfeld programme, the Guardian wrote. In an email exchange with the Guardian, the man, who wished to remain anonymous, wrote: 'So far, all I have ever received from the NHS is doors slammed in my face.'"

There's not as well-known a center for pedophiles in the U.S. to go to. Richard Kramer, the educational director at B4U-ACT, an online community for pedophiles, said he figured out he was attracted to pubescent boys in his 20s. (His attraction is to boys around the age of 12 or 13, which is technically called hebephilia.) I was very ashamed about it and thought that I was seriously defective as a human being, Kramer said, who is using a pseudonym. I really wasn't able to find any information about it. I didn't want to go to the library for fear that people would see what I'm looking up.

When he began reading information online, he said, everything he encountered was very negative. It said that I would be a monster, I would have hundreds of victims, and that my entire life would be centered around an elaborate plot to deceive parents and to manipulate children into abusing them, he said. So I thought, well, this is what they think about me. I have no interest in seeing them and seeing a therapist.

A big part of being successful in therapy is having the support of family and friends, something that pedophiles can lack. They often are going through difficult treatments alone, and are unable to talk about it to others. You cant tell co-workers, or ask a boss for time off for your appointments. You have two choices, said Michael Seto, a forensic psychologist and sexologist at the University of Toronto. You don't do it or you lie about it.

When Kramer was ready to look for a therapist again, he didnt really care what kind of approach they used, but was more concerned about whether they understood enough about pedophiles to not treat him like a criminal. His goals didn't involve a struggle to control his impulses, but to manage the shame and sense of isolation from others because he couldnt be honest.

We have to insist that people who have this orientation not act upon it, Berlin said. If we think about that, that can be quite a burden. Its not surprising that some of these folks might be in need of mental health assistance, because of the effect of experiencing these attractions on their sense of self-esteem and self-worth.

Happy, mentally healthy people do not molest children.

Some pedophiles are attracted to adults and children; some, only children. For those who are exclusively attracted to children and dedicated to non-offending, Kramer said, there needs to be a space for helping them grieve over not being able to have romantic and sexual relationships. How do they deal with loneliness? he said. There are other concerns, some almost mundane: How, for instance, do they deal with answering questions friends and co-workers ask about their personal lives? Hes had friends who asked him if he was gay, and he said he wasnt sure how to answer.

I'm not exactly gay, but I'm definitely not straight and I'm definitely not asexual, he said. How do you respond to that?

Gary Gibson founded the ASAP as one potential solution to this problem. Through an involvement with the Association for the Treatment of Sexual Abusers (ATSA), Gibson has been curating a list of therapists to whom he can refer pedophiles. The list is now around 400 names long. ASAP primarily focuses on non-offending pedophiles, but they will also help people who have offended and want to stop. People are just desperate out there, Gibson said.

He has worked with pedophiles who were so desperate for help that they underwent physical castrations. One man traveled to Mexico to have the operation done; when he returned, he tried to find a doctor to supervise his recovery and medications. I could not find a doctor who would take him on, Gibson said. They didn't want him in the office. I did find a therapist to work with him, and I kind of lost contact with him. Im worried about what happened to him.

Until recently ASAP has been handled almost entirely by Gibson, but ASAP is currently undergoing a significant expansion. It has increased its office and volunteer staff, is making a new, online database of mental healthcare providers, and creating a 24/7 helpline. Gibson said his dream is to get a multimillion dollar grant to create a mentor program for teenagers, aged 13 to 17, who are learning that theyre pedophiles. Ive applied three times, he said. Maybe the third time's the charm, because Ive been denied twice.

The goal is to help every non-offending person attracted to children find therapy if they want or need it, said Robert Hillman, a lifelong virtuous (non-offending) pedophile, and the new president of ASAP. Hillman said that the mantra is: All pedophiles are born non-offending, and the aim is to help keep it that way. Happy, mentally healthy people do not molest children," he said.

People do the most desperate things when they feel the most desperate, Cantor said. A lot of what these groups and therapy provide is helping people lead a life that is worth protecting. When they have a life worth protecting, thats when people get the energy and the willpower to control themselves, because they dont want to risk the life that they have.

What Hillman and Gibson want is the opportunity for any person attracted to children to chart their own path, and figure out what works best for them. That may include an experimentation with medication, and it may not. ASAP doesnt control their therapiststhey all operate independently, using different methods of treatment. They're not always successful. One guy has committed suicide that I know of, Gibson said said. But I think that we have probably saved a few lives and saved many children from being abused.

These support groups and therapy networks are providing a lifeline, but alone, they don't guarantee a consistency in treatment, nor fill the gaps in the scientific literature when it comes to which treatments might be best for a certain person. There might be certain hormone-reducing medications that are less risky or work better than others; certain pedophiles that fare better without drugs; certain therapeutic practices that are more helpful than others. Those answers aren't clear-cut.

As with all medications, some people have good experiences and others do not. Pedophiles can identify as ego-dystonic or ego-syntonic. Ego-syntonic people consider pedophilia as part of their identity, and can be okay with fantasizing and masturbating about children (though not with porn), while ego-dystonic people are not. It may be that treatment should be different with those who have different attitudes towards their attraction, even if members of both groups have the same commitment to not offend.

After about five weeks, Parker said that he felt better from the medication he had ordered online. It was night and day," he said. "I can't tell you what a weight was lifted off of me, or a pressure from under me that was relieved. Whenever I think about it I just lay back in my chair and breathe a contented sigh, knowing that I won't suffer like that again. Both physical urges in my body and intrusive imagery in my mind have disappeared."

He doesnt think that medication should be thought of only as a stop-gap to a person committing sexual abuse. Offending was never a danger for me in the first place, he said. He doesnt take the medication to stop himself from molesting a child, but as a way to improve his quality of life.

When Max Weber, who helps run a peer-support website for pedophiles in Germany, realized his attraction to young girls in his early 20s, he said, he was terrified. My picture of pedophilia at the time was the same wrong impression most parts of society have: that pedophiles were bound to offend, he said.

Weber got treatment at Dunkelfeld, and said he views medication like a pair of eyeglasses. You can put [them] on to help yourself focus on things that you want to change about your life.

To Weber, pedophilia was like being surrounded by deep water; he had to struggle to stand on his toes to avoid drowning. I needed all my strength to cope with it and dont drown in my own fears and self-hate, he said. As a result sexual impulses felt very powerful since, when you are standing on your toes, even the slightest push could throw you over.

He took medication for about nine months. During that time when his sexual feelings were repressed, he regained a foothold on his life, he said, and found that even without medication he is able to be around children without issue. I now know that I am in charge, and no one can make me offend other than myself, he said.

Two years ago, David, a 22 -year-old recent college graduate from New York and a volunteer for a peer-support group including pedophiles, desperately wanted to take hormone-altering medication. I hated myself for having feelings about children, and I just wanted to be like everyone else," he said. "I was also going online and finding articles about how to raise libido, and doing the opposite of all of the advice I found. But I couldnt find a therapist I felt safe coming out to.

Since then, he said that support groups like Virtuous Pedophiles have helped him realize that being attracted to children is not something he chose, and hes not tempted towards any illegal behaviors. In the end, there was no need for me to go through such a treatment with dangerous side effects," he said.

Though he never ended up trying medication, David thinks his experience with peer support reveals something important. Medications can help reduce physical symptoms, he said, but the restthe support, the isolation, the shameall needs to be addressed outside of just taking a pill.

I struggled with serious depression, anxiety, and self-hatred as a teenager starting to understand that I was a pedophile, David said. Becoming less isolated, having people to help when I was hurting, and being able to help others in the same way is what brought me back from that.

Hillman was a patient of Berlins about 25 years ago. I was on the brink of madness from the desires and from the shame and self-hatred and loathing, he said. "It was crushing me and I was not going to survive it. He took hormone-reducing medication with Berlin's help, and said that combined with therapy, it saved his life. Since I was at that time and have always been non-offending, my anti-androgen therapy was not mandatory in any way and thus I started and stopped it several times, because of the affordability issues, Hillman said. But I can attest that the medication did reduce my thoughts and therefore some of my distress.

Then he found the Virtuous Pedophiles group about one year ago, and the support hes culled from the others there has given him a new gusto for life, without medication. Now I am dedicated to living. And I am dedicated to making sure no one else has to waste their life just to be virtuous, he said.

Hillman said that these narratives reveal how all pedophiles are different. Some will benefit from meds and some will not, he said. Some are against medication, some are not.

Rahm hopes to continue studying treatment options for pedophilia, in a rigorous way. In his view of a forthcoming modern pedophile treatment, each person would get an individual assessment and be offered an evidence-based treatment. It would work with helping a pedophile address both their personal feelings and concerns, and also their risk of offending.

In my vision, some people need therapy, some need medication, some need both, and some won't have any effect on any of these. They need something else, Rahm said. This is nothing novel or groundbreaking, he added. I would just like to apply modern psychiatric thinking to this group.

Follow Shayla Love onTwitter.

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Paedophilia Is a Mental Health Issue. It's Still Not Treated as One - VICE

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Don't confuse ketoacidosis with ketosis using fats for energy which is our natural state of being, nutritionist Nonie De Long says

Dear Nutritionist, Ive been trying to lose weight. Im a middle-aged female (54) and have done Weight Watchers, but didnt keep the weight off. Im interested in giving Keto a try. so I would like to know if you think its a fad and also is it safe? Betty

Dear Betty,

I get asked this question a lot actually. I will go into my reasons below, but the short answer is no, its not a fad and yes, keto is safe for almost all people.

There are some medical conditions that make keto problematic, but that is not the vast majority of folks. Lets unpack the keto diet a bit to understand why its not a fad.

We have all seen diets come and go. Across the board its safe to say they would be unnecessary if we ate only natural food that we are biologically adapted to eat, in the right proportions, with some moderate movement in our daily lives.

Its a myth that dieting is natural. If we look at the vast majority of our history as a species, its food scarcity and not overeating that impacted mortality. In the developed countries to varying degrees we have now gone in the other direction.

Its also a myth that we need to be gym rats to be fit. Just look at 80-year-old farmers around the globe. Staying fit has to do with staying active and that can be any activity from work to house keeping to gardening to walking the dog to my personal favourite dancing around the living room. Movement keeps us fit. But diet keeps us slim.

Please read that again if you are interested in losing weight. Body composition is determined by your diet. You can not exercise off a bad diet. And trying to will leave you frustrated and often injured.

Consuming a healthy, biologically appropriate diet will get you to a good body composition meaning the fat to lean tissue ratio, which is what we are talking about when we talk about weight loss. If you are short and stout by nature, with a lot of muscle, you are never going to diet yourself twiggy. But you can be lean, with a nice shape and healthy fat distribution.

What does that mean?

Well, a healthy person has a little fat just under their skin all over their body. An unhealthy body holds fat in the middle. That is the primary indicator of longevity, heart disease, diabetes, and a whole host of other disease states.

If you want to know your risk, look at your waist to hip ratio. If the waist is bigger or even close to your hips, youre in trouble. If you have a muffin top over your jeans or look pregnant when youre not, you can stand to lose fat, no matter how thin your overall frame is. This will reduce your disease risk more than anything you can do.

This is where keto comes in.

Historically, our ancestors had periods of plenty and periods of scarcity. They would migrate to follow food. They never got to choose a diet, as we do today. They never had processed foods.

Even growing crops and using grains is relatively new in terms of our development! For the vast majority of our development as a species, we existed on what we could pick or dig and what we could hunt and catch in terms of animals.

Its also noteworthy that we used the entire animal in times of scarcity and in times of plenty there is evidence that dogs (which co-evolved with humans) ate the muscle meat while we ate the organ meat and bones. The organs were often consumed raw after a kill. Today (when dogs and humans eat natural food) that trend is reversed.

In this respect, our paleolithic ancestors would have naturally had cycles of ketosis because ketosis is what happens when the body runs on fats for fuel rather than carbohydrates or protein.

When game is the primary source of sustenance, fat becomes the natural fuel source for the body. Healthy human bodies dont use protein for energy in the presence of fat. And they dont burn fat in the presence of carbs. In a time when carbs were scarce (fruit in season, which was far less sweet than it is now, and a few tribes that used tubers more often) the body would naturally default to using fats for energy. This is ketosis. It is our natural state of being.

And its why the body stores energy as fat (the primary human fuel source) for times of scarcity. If we look at this even a century ago, we can see that even agricultural societies before the advent of modern food production and storage technology would lend itself to ketosis because carb-rich foods are ready in the autumn and would be consumed to pad the body for the famine of winter. Then, when winter scarcity set in, the body was using its own fat to survive. This is ketosis.

With a keto diet, the body becomes more efficient at using fat for energy because during that time it burns its own fat stores, which many people now want to take advantage of. It also decreases the strain on the digestive organs and decreases inflammation (as insulin and adenosine are both highly inflammatory and both are down-regulated with this diet).

A keto diet is also very low in allergens and does not contain anti-nutrients that vegetarian proteins contain. Its easier to digest. And it contains bones, the perfect source of minerals. No other mineral source is as healthy or as sustainable. And no other nutrient group is as essential for human health and longevity.

Werent there carbs historically speaking?

For the most recent agrarian part of our development there have been carbohydrate-rich foods but there were ways of consuming the carbs that made them healthier for us than what we do today.

First of all, there were no factories and processing them was lengthy so they were less plentiful. Bread was not the sticky, glutenous gooey nonsense we have today. The crop was different and the processing was different. Access was minimal due to the work to process it.

Maize (corn) was not the sweet crop we know today and it was always processed with lime or ash. This process is called nixtamalization. You can read more about it here. When this was not done there was an upsurge in pellagra, which causes psychosis, thinking problems, skin rashes, photosensitivity, and aggression.

Is it a coincidence we now have improperly processed corn in so many of our processed foods and are experiencing so many mental health conditions with these features today? Hmmmm...

Thus, returning to a diet that mimics the natural, evolutionary state of being adapted to using fat for energy (ketosis) is natural and healthy. Its often dismissed as a fad by people who say its not balanced enough or simply because its popular.

But thats what people thought about the automobile when it first came out. A fad. And dangerous. Totally impractical technology. But just because something becomes popular does not make it transitory in nature. Look at televisions. Look at industrialization. There are many many more examples.

The idea that ketosis is dangerous is fuelled by people who dont understand metabolism. They confuse it with ketoacidosis, which is very dangerous. But its an entirely different thing. The truth about the keto diet is that it can reverse a host of health conditions that other diets cant. Diabetes and metabolic syndrome alone are good enough reason to hail this diet, as it does more to reverse them than any other.

The only time a keto diet is unhealthy or dangerous is when its composed of processed fatty foods like processed meats and bars and keto snacks. You will still lose weight on them, but they are not natural foods.

In the industry we call this dirty keto. Its far superior to return to a minimally processed animal based diet with natural animal fats and healthy veggies and occasional fruit.

This naturally puts us in and out of ketosis cyclically, with ample nutrients. This is the diet I advocate in my practice, not because it helps with weight loss (although it does) but because it reverses many disease states even serious mental health conditions like psychosis and seizures. Weight loss is actually just a side effect of eating for health. Its really not the goal.

Thank you, Betty, for the great question. I hope you have a better understanding of it now. As always, if readers have a health or nutrition related question, I welcome you to write to me at nonienutritionista@gmail.com. And if youre looking for more specific health information, check out my website at nonienutritionista.com, where I provide 1:1 health coaching for those who need it.

Namaste!

Nonie Nutritionista

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Truly - YouTube Tony Sander, 43, tells Brand New Me how a car accident led him to make some serious lifestyle changes, including addressing his issues with food and alcohol.

For Tony Sander, a packed and intense working schedule meant that he relied on an unhealthy diet to keep himself going. Over time, food, along with drinking, became a source of relief from that stress. "The food was as much of an addiction as alcohol ever was," he says in a recent episode of Brand New Me.

Then in 2016, Tony's car came off the road while he was driving home drunk. He shattered his knee in the accident, and doctors told him that at his current weight of 429 pounds, it wasn't safe to operate on him. This, he recalls, was the wake-up call he needed, and he started to make some serious lifestyle changes, starting with cutting out alcohol and changing his diet.

"My goal from the beginning was to save my life," he says. "My health was beyond a mess, so that was just self-preservation at the beginning, and then self-preservation turned into 'my health is getting better, let's get physically fit.'"

Working with his trainer Keith, Tony has now lost a staggering 210 pounds through working out and a strict diet plan, and has also found that exercise provides a healthier, more sustainable way to handle his stress and anxiety than food or alcohol.

"It's now my stress relief, going to the gym is my 90 minutes of my solace, it's my office, it's my time," he says. "The mental transformation that I've had, to be able to make the physical changes, I've had to come to terms with who I was, what my addictions were, and how I was going to fix them. The mental changes have been bigger than the physical."

The best advice he can offer to anybody who wants to start making changes to their lifestyle and lose weight: "Just start today. You don't have to wait for tomorrow, you don't have to have a great plan, there is a community out there that wants to help, there's people who have done it, and all they want to do is help other people do it."

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Gallery: Best Weight Loss Quotes to Push You Through the Toughest Moments (Men's Health)

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If it sounds too good to be true, it probably is. Thats the first thing I thought about as I began to write this article. But I assure you that this concept is as good as it sounds.

I have enjoyed the compliments from people that have noticed that I have lost weight during the past year or so. I have to admit though, that I really didnt do anything difficult or out of the ordinary to accomplish the weight loss, though. I didnt struggle mightily with workouts or exercise. I didnt sacrifice enjoyment or deny myself pleasure. I did make a couple of important choices that didnt seem so challenging.

I have studied the various weight loss plans over the years. At one time we offered a very good weight loss plan in our office that helped people lose weight in a very healthy way. There are numerous ways to assist people in losing weight.

I wasnt really interested specifically in weight loss when I developed this plan. I have been looking into how the body utilizes energy for general routine activities such as staying alive, digesting food, breathing, maintaining adequate warmth, pumping blood and so forth. Our bodies use a considerable amount of energy just living from one day to the next, before we add activities such as physical exertion.

I then looked into how much energy we consume each day in a typical American diet. What I found is that for decades people in our society have been slowly exceeding the amount of energy that we need by extraordinarily gross amounts. What seems like a normal amount of food to us now is considerably more than our bodies can possibly use during normal living.

Think of everything you eat as energy. Thats how your body sees it. A calorie is simply a measure of energy. No matter what you eat, thats how the body sees food. Whether it is a monstrous steak, a divine confectionary creation, a new vegetable dish, or a box of tasteless diet food you bought at the store hoping it would make you skinny; to the body it is all simply a load of energy.

Obviously, there are important nutrients such and vitamins and minerals included in the food, but for our purposes here we are simply looking at the sum of calories (energy) in each meal. Although our brains assess food from smell, taste, visual appeal and other perspectives, the body simply wants the energy. As far as our body is concerned, you could throw the whole plate of food into the blender and drink it down.

In fact, that is exactly what our digestive system does with each meal. No matter how artfully or carefully prepared, within a half hour of eating your food is simply a terribly unappetizing mass of protein, fat and carbohydrates. Thats when the body goes to work extracting the energy from each meal or snack.

Regardless of what your food habits and preferences are, if you are currently overweight, the fact is plain that you have consumed more food energy (calories) than you need for some time, possibly decades.

Knowing that, is it realistic to expect that anything can turn your body back into a lean, mean, energy balanced machine within a few weeks? Of course not. That is why most diets only produce temporary results.

However, our bodies are so amazing that it is possible to modify our body weight substantially in a matter of months. After a habit of overconsuming for years it is astounding how successful the human body can be in rebalancing in a matter of a few months.

Here is another key to the success of this simple plan. It is easy to continue following the plan for years. Once you think about it, it is easy to realize that if you want to slim down permanently, changes must be made that you can maintain indefinitely.

This plan is easy to follow because it includes real food that is enjoyable and satisfying. Although this discussion is about how your body uses the energy in food, at the end of the day we will still make decisions based on how appealing the food is. For this reason, it is important that you eat foods that you actually enjoy during the plan.

The challenge of writing an in-depth article regarding health is that I have limited space for this column each week. As you have probably guessed, the details of how the plan works will have to be spelled out next week.

Until then, take some time to think about the why. Why do you want to lose weight? Health reasons? You dont feel well anymore? You dont like the way your clothes fit? You are unable to do things you once could do with ease? Your doctor suggested it? Your family suggested it? You have known for a long time that you should and now its time?

Most eating decisions are made emotionally. Your emotional reasons for achieving lasting weight loss will be the absolute key to your success. Your why has to be significant to you, meaningful enough to see your way through to the changes you must embrace to succeed.

Next week, the rest of the story.

Dr. Mark Kestner is a licensed chiropractic physician in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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While there are many debates about which type of diet is best for weight loss and health, its often not the weight loss which is the biggest challenge, but rather avoiding weight regain afterwards. This can lead to cycles of dieting and weight gain, or yo-yo dieting, which can cause people to have a less healthy relationship with food, worse mental health and a higher body weight.

But recently, reverse dieting has gained popularity online as a post-diet eating plan that claims it can help you avoid weight regain by eating more. In simple terms, its a controlled and gradual way of increasing from a low calorie weight-loss eating plan back to your more normal pre-diet way of eating.

The idea with reverse dieting is that gradually increasing calorie intake following a deficit will allow your body and your metabolism to adjust so that you can avoid weight regain while eating more. However, there is currently no scientific evidence showing that reverse dieting works as advocates claim.

Reverse dieting is based around the theory that our body has baseline set points for metabolism and calorie intake hardwired into our biology, and if we go above these points we gain weight. The idea is that reverse dieting can shift these set points upwards if a person slowly increases the amount of calories eaten as food. This would theoretically boost their metabolism, allowing them to consume more food and calories without gaining weight.

However, the idea that as humans we have a set point, which we can manipulate with dietary changes, is not supported by research. The main reason for this is because a number of factors influence our weight and metabolism, including how it changes. Among them are how were brought up, what food we have access to, what type of exercise we do, and our genetics.

But the most important influence over how our body uses calories and therefore our weight is our resting (or basal) metabolic rate. This is the amount of calories our body needs in order to keep itself alive. This accounts for about 60%-70% of the calories we use daily.

Our basal metabolic rate is mostly determined by our age, weight, sex and muscle mass your diet has little effect on it. Eating at or below your basal metabolic rate will result in weight loss, and eating above it will result in weight gain. Our basal metabolic rate also increases as we gain weight or muscle mass, and decreases as we lose weight or muscle mass (the evidence shows that the more muscle your body has, the more calories it needs to function).

Exercise also increases how many calories we use, but usually not enough to massively affect our weight. And though a high protein diet can alter metabolic rate somewhat, our body weight and muscle mass have the greatest effect on it.

So reverse dieting only appears to work by controlling calorie intake. Theres currently no evidence that you can alter your metabolism or metabolic rate by introducing more calories slowly and gradually. Put simply, if you eat more calories than your body requires, you will gain weight. What we do know is that certain habits, like regularly eating breakfast and exercise, help people avoid weight regain after dieting.

While theres currently little research investigating the effects of reverse dieting on metabolism, it could still help people in other ways. When some people are losing weight, they may feel in control of how they eat. But for some people, stopping their diet could lead to perceived loss of control. Reverse dieting might give some people the confidence to return to a more sustainable way of eating, or help them move out of a cycle of restrictive dieting.

Advocates of reverse dieting suggest it can also help manage problems of appetite and cravings. This is because additional foods can be added in as the amount of calories and food eaten is increased. While fewer cravings can help with weight maintenance, this evidence does not come from studies where foods were slowly reintroduced.

For some people, counting calories or restrictive dieting can tend to lead to an unhealthy relationship with their bodies and the food they eat. Orthorexia nervosa is becoming increasingly common, and is characterised by an obsession with eating healthy which can lead to an unhealthy restriction of and relationship with foods. While wanting to eat a healthy diet can seem on the surface to be a good thing, when it becomes orthorexia and enjoyment of food is replaced by an anxiety of feeling the need to account for every calorie, this could lead to poor mental health.

Reverse dieting is one approach, but some would argue other methods, such as intuitive eating which emphasises listening to your bodys hunger cues and only eating when youre hungry might be psychologically healthier. Intuitive eating may help people both regain and trust their appetites, and stop the cycle of restriction and calorie counting.

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You can always count on your heart being there for you, faithfully pumping blood and oxygen through your body until it doesnt.

The old ticker may be something you dont think much about, but you might want to baby your heart a little more so it will keep working for you in old age. Heart disease kills 610,000 people each year, making it the leading cause of death for both men and women.

You cant change your family history, but there are a few things you can do to improve your chances of avoiding heart disease. Here are some things you can do today to keep your heart healthy:

Lose some weight

Stubborn belly fat is something many people battle continuously. It seems to hang on the longest, and trying to get rid of it can be frustrating. Losing that weight will not only help your clothes fit a little better, but it will improve your heart health as well, as stomach fat increases your risk for a heart attack. Keeping your heart healthy can be the motivation you need to lose a few extra pounds.

Eat for your heart

The right diet will help protect your heart by helping you to lose weight and by the addition of foods that can prevent heart disease. Fruits, vegetables and whole grains are high in fiber and contain nutrients that promote heart health. Limiting saturated and trans fats also can help control cholesterol and prevent narrowing of the arteries. Cut back on sodium to keep your blood pressure down.

Hopping on your bike a few times a week will do wonders for your heart. Exercise is a critical component in a heart-healthy routine. Aerobic exercise like biking, running, swimming and other activities improves circulation, blood pressure and heart rate. While strength training may not seem as important for heart health, it is an important part of a well-rounded exercise routine. It helps reduce fat, builds muscle and can help maintain healthy cholesterol levels. Incorporate at least 150 minutes of aerobic exercise and two days of strength training into your weekly workout goals for the best results.

Keep an eye on your heart

There are some risk factors for heart disease that you may not know you have if you dont check. For example, it is unlikely that you will notice your blood pressure increasing or your cholesterol changing unless you get tested. Talk to your doctor about testing your cholesterol levels and blood pressure so you can get treatment if you need it.

It is important to get your blood pressure checked regularly, even if your blood pressure is normally within a healthy range, says Robert Gerken, administrator at Newport Nursing and Rehabilitation Center. Your arteries can change as you age, making you more susceptible to high blood pressure and complications like a stroke or heart attack.

Quit smoking

There are so many reasons to stop smoking and heart health is a big one. Smoking and secondhand smoke can lead to heart disease, stroke and even death. Of all coronary heart disease deaths, nearly a third are due to smoking or secondhand smoke. So, protect your health and the people around you and stop smoking today.

Moderate your alcohol consumption

If you drink alcohol, do so in moderation. Alcohol affects everyone differently, but heavy drinking can contribute to a number of risks for your heart. It can increase triglycerides in your blood and raise your risk for high blood pressure and heart failure.

Your heart health should be something you think about at every stage of life. Get moving, eat right and develop healthy habits now that will pay dividends for you and your heart in the future.

Dr. Amy Osmond Cook is a health care technology consultant and VP of marketing at Simplus, a platinum Salesforce partner.

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Intermittent fasting can help in restoring good health

Intermittent fasting has been considered to be an effective way to lose weight and get on the path towards fitness. The eating pattern is said to have detoxing effects on the body. It is divided into two phases: fasting phase and eating phase. During the fasting phase, you are not supposed to eat or drink anything except plain water. But during the eating phase, it is important to eathealthy and filling foods so that you don't end up overeating. What you eat during the eating phase of intermittent fasting needs to be paid attention. Overeating or eating junk food during the eating phase can negate the whole purpose of following this eating pattern.

Firstly, know that you must never starve yourself during the fasting phase. According to lifestyle coach Luke Coutinho, you can break the fast when your body is craving for food. When you start with this eating pattern, the fasting phase can be as long as it suits your body.

Also read:Weight Loss: What Is Water Fasting? Know Pros And Cons Of This Unique Diet Plan

The fasting phase can be for 8, 10 or 12 hours initially. Once you ease into the eating pattern, the fasting phase can be extended. Having said that, it is also important to take note of the foods you eat.

While intermittent fasting is a few of those "diets" which are not restrictive in nature, it is also not one of those in which you can have junk or processed food without facing the consequences (just because you are following the fasting phase dedicatedly.

It is important to eat only healthy foods during eating phase of intermittent fastingPhoto Credit: iStock

1. During the eating phase, your diet should ideally include mostly home-cooked food.

2. Lots of fresh fruits and vegetables, whole grains, nuts and seeds, lentils and legumes, and other sources of healthy fats, proteins, carbs and fibre should be part of your diet.

Also read:Kareena Kapoor's Nutritionist Talks About 3 Fats That You Should Re-Introduce In Your Diet

3. Practice portion control and eat till your 80% full. Do not starve yourself. Feed yourself with nourishing food whenever you feel hungry, even if it requires breaking your fast.

4. Snack on healthy foods like ghee-roasted makhanas, roasted black chana, nuts and seeds trail milk, a seasonal fruit or a bowl of yogurt with some fruit and veggies.

What you eat and the pattern of your eating are going to determine how intermittent fasting will work for you.

Make sure that regular exercise is a part of your routine. Exercising will help you become stronger, more agile and fitter. It will keep the likes of back pain, knee pain and neck pain away and will also help you lose weight.

Also read:Weight Loss: This Upper-Body Chair Workout Is All The #MondayMotivation You Need

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Having a healthy lifestyle is crucial for any individual this entails both having a balanced diet and regularly partake in some sort of physical activity.

During physical activity, our body undergoes many changes and this provides many benefits for our bodies and overall health. Even though working out may make you feel exhausted and even nauseous in the short-term, these are signs that you are working hard.

The benefits of having an active lifestyle do not manifest themselves quickly and the key is to be consistent, in order to see the short and long-term benefits of working out. In this article, we will discuss how working out benefits you in the long run.

Mental awareness is our minds ability to stay alert and sharp during our daily activities. Having sufficient mental strength is required for anything, from paying attention to your job, driving, or even socializing with others. Working out consistently can actually improve your mental acuity in the long-term, by improving short-term memory, concentrating more easily as well as learning new tasks and skills quicker.

This may not sound believable, as physical activity will make you feel exhausted when you finish working out. However, in the long-term, you will see that your daily energy levels will increase and you feel less tired.

Empirical research has shown that exercise increases blood flow within your body, making it easier to absorb more oxygen, This, in turn, will make you feel more energized.

As previously mentioned, having a healthy lifestyle is essential for the health of our bodies. When you are consistent with exercise, you are much more likely to make healthier dietary choices that will improve your quality of life in the long run. A balanced diet along with regular exercise can help significantly reduce health issues such as cancer, heart disease, and type 2 diabetes. There are many ways you can become more active, either using gym equipment on your own or join CrossFit classes local to you. These provide you with high-intensity interval training that will make you feel the short and long-term results very quickly.

An obvious long-term benefit of working out helps you lose weight and maintain a healthy weight. Severe weight gain can have serious impacts on the obese individual, potentially even leading to death, and this remains a massive issue in many countries. The best way to prevent this is by living a healthy lifestyle.

A less known fact among many people is that working out actually increases your libido. Blood circulation has a great impact on sexual functions and, as mentioned above, blood flow improves when exercising. Additionally, when you start seeing the physical results of working out, you may start feeling more confident and less stressed, which in turn, results in increased sexual drive.

There are many benefits to exercising, that go way beyond looking good. In the long run you will feel more energized, and your mental health will also improve. Working out not only reduces the likelihood of serious health issues, but it also improves your own confidence and sex drive.

Aug 24, 2020shinywriter

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