eMindful

Study suggests that mindful eating can play a key role in long-term weight maintenance

By Ellen Goodman

updated 12:04 p.m. ET, Mon., June 29, 2009

Given the economic downturn and accompanying layoffs over the past year, you might think company wellness programs would be going the way of the matching 401(k). Not so.

In fact, many companies that have tried to trim their workers’ waistlines — and health care costs — may find themselves in a better position than ever to give workers a little nudge.

“The rising cost of medical care is unsustainable and is a huge and legitimate concern to employers that pay for it,” says labor attorney Hanan Kolko. “During the past decade or so, health care costs have been rising at three times the rate of inflation. Every nickel that goes to pay for rising medical costs can’t pay for raises, pensions or 401(k) matches.”

The median health care expense per employee last year was $7,173, according to a recent survey by Watson Wyatt and the National Business Group on Health.

But companies save from $1.49 to $4.91 in health-related expenses for every dollar spent on wellness programs, according to the U.S. Department of Health and Human Services.

That may be part of the reason why, despite the downturn, employers don’t seem to be skimping on their health and wellness initiatives.

A survey of about 500 human resources and benefit executives by professional services firm Towers Perrin found:

• 50 percent of companies have or will introduce or increase investments in wellness and health promotion in 2009 and 2010.
• 32 percent have or will introduce or increase financial incentives, such as bonuses or premium discounts, for wellness or health promotion activities in 2009 and 2010. Another 30 percent are considering this action.
• 45 percent say they are considering introducing or increasing penalties for nonparticipation in wellness or health promotion activities.

This is an opportune time for employers to focus on wellness, says Dave Guilmette, managing director of the Towers Perrin Health and Welfare practice. Employees, he says, are going to think: “If I want to keep my job, I better pay attention to what my employer is asking me to do.”

Treadmills in the office
Financial services firm USAA has been running a wellness program for five years.

“We think 50 to 80 percent of our medical costs are related to people who are overweight,” says Dr. Peter Wald, enterprise medical director for the firm, which has 20,000 employees.

While the San Antonio, Texas-based firm saw some improvements thanks to the wellness programs, the company had little success actually getting people to lose weight, Wald says.

Previously, workers received a lump sum of money just for participating, but now the company is tying incentives to actual weight loss. Employees have a year to lose 10 percent of their body weight. If they can pull it off, they’ll get $300.

At AstraZeneca US, saving money on medical costs and improving worker productivity are among the key reasons for a continued focus on promoting employee health.

Despite expected layoffs of 15,000 globally through 2013, the pharmaceutical firm has, for the most part, not allowed their wellness efforts to wane.

Due to economic issues, the company did end financial incentives for participation. However, AstraZeneca added a new program to encourage workers to ride their bikes to work every Friday. They also now offer a free two-week trial membership to the fitness center and encourage managers to lead by example by adopting healthy behaviors such as eating right and exercising.

“We know people are more pressured for time,” says Dr. Joe Henry, executive director of US Safety, Health and Environment for the Wilmington, Del.-based company. “If we are going to ask people to work harder and longer hours, we have to give them something.”

So AstraZeneca is making it easier for employees to exercise by scheduling morning meetings later — so workers can hit the gym — and also implementing ‘walk stations’ that allow employees to walk at a slow pace on a treadmill while working or in a meeting.

Ministry Health Care in Milwaukee is hoping financial incentives do the trick.

The hospital and clinic network has seen a cost increase of about 8 percent in its 2008 health insurance premiums and expects a 12 percent rise this year.

But Michael Knitter, director of total rewards at Ministry, is hoping to shave up to 4 percent off costs thanks to a rewards-based weight management program the company implemented last year.

Workers who take part in the program will get $5 every quarter and $5 for every 1 percent of weight loss up to 10 percent per quarter, he says. Also, by participating in the program and agreeing to a blood draw and testing, they can take $240 annually off their premiums.

Cathy Young, a 50-year-old Ministry employee, signed up because she wanted to lose 20 pounds.

“I’m one of those people that when I’m stressed, I eat,” she says. She credits the program with helping her stay on track.

“They give you e-mail reminders every single day to do things like get up and walk around, or grab a glass of water rather than soda,” she explains. “It’s been a big help.”

So far, Knitter says, the program has been successful with a 40 percent participation rate.

But during the latter part of 2008, the hospital saw an actual increase in weight gain among workers because of stress related to the bad economy. “That quarter was when the economy was tanking and people were losing money in their 403(b)s and 401(k)s,” he says. “Now we seem to be on track.”

Stressed-out employees
The recession has caused a lot of stress for workers, and some have seen their healthy habits go right out the window as a result. A recent survey from ZoneDiet.com found that 25 percent of Americans are turning to comfort food more because of the economy.

“Along with emotional eating, I am finding alcohol intake has increased considerably,” says Stephanie Middleberg, a New York dietitian. Many of her clients that used to have healthy food options at work, thanks to their employers, have seen most of those disappear.

Some workers whose companies offer few programs or incentives are taking matters into her own hands.

Judy Podvin, 45, a residential real estate agent from Howell, Mich., has gained about 10 pounds in the last year and says it’s partly due to the economic collapse that has hit Michigan hard.

“No one has any money, people are losing their homes, and half the deals don’t make it to the table even after months of work,” she explains. “It’s so depressing and stressful. You go home and feel sorry for yourself and wait for the next meal.”

She’s trying to eat better and has hired personal trainer Lori Wengle.

“I’ve only gone down 10 pounds and a size and a half, but I feel a million times better,” she explains. “It’s absolutely helped my jobs performance.”

Eve Tahmincioglu writes the weekly “Your Career” column for msnbc.com and chronicles workplace issues in her blog, CareerDiva.net.

by Edward W. McIntyre  April, 2009, edition of the MA Bar Association’s Lawyers Journal

Lawyers work at an increasingly frenetic pace, leaving limited time for contemplation and reflection. Little in our work seems to provide for opportunities to attune to one another, allowing for appropriate attention and awareness. This toxic pace and pattern increases our tendency to run on auto pilot.

“Living on automatic places us at risk of mindlessly reacting to situations, without reflecting on various options of response,” according to Dr. Jon Kabat-Zinn, founder of the University of Massachusetts Medical School’s Center for Mindfulness in Medicine, Health Care, and Society.

As an alternative approach, Kabat-Zinn and the center’s work concentrates on the benefits of mindfulness. Defined on the center’s Web site, mindfulness is “a way of learning to relate directly to whatever is happening in your life, a way of taking charge of your life, a way of doing something for yourself that no one else can do you for you — consciously and systematically working with your own stress, pain, illness and the challenges and demands of everyday life.”

Such an approach may serve our profession well.

During the past decade, researchers have found that of all professionals, lawyers are the most prone to stress, depression and alcohol problems. In the U.S., 15 to 18 percent of all lawyers abuse alcohol. Some believe that the problems stem from the inherent personalities of those drawn to our profession, whereas others believe that they are related to the nature of the job. Adding insult to injury, lawyers face the pressure of longer working weeks as well as juggling their roles of practitioners and office managers.

According to Sacha Pfeiffer, writing for the The Boston Globe in June 2000 and citing the Boston-based Lawyers Concerned for Lawyers, depression and anxiety have equaled or surpassed alcohol and drugs as what the group calls a “presenting problem” for five of the past 10 years. In 2005, depression or anxiety was cited by 26 percent of all lawyers who sought counseling, while alcohol or drugs were cited by 21 percent. The number of lawyers seeking depression counseling jumps to 60 percent when the tally includes those wanting help with “career/practice management.”

The American Bar Association’s Commission on Lawyer Assistance Programs reports that many try to cope with stress by turning to tobacco, alcohol, caffeine, herbal remedies and legal or illegal drugs, as well as other
harmful behaviors as diversions.

Some practitioners cope with more extreme action. Suicide ranks among the leading causes of premature death among lawyers. Surveys of lawyers in Washington and Arizona show that most lawyers suffering from depression
also have suicidal thoughts. The 1992 Annual Report of the National Institute of Occupational Safety and Health reported that male lawyers are twice as likely as the general population to commit suicide.

The mindlessness brought on by the crippling stress of our profession negatively impacts our ability as a whole to develop relationships with colleagues, to succeed in fair negotiation, and to sustain objectivity—all negatively affecting our ability to serve as counsel in a civil manner. We’ve all seen incivility in our colleagues or ourselves in the midst of a deposition, courthouse corridors, correspondence and conversations with opposing counsel or in many other unhealthy professional exchanges. Incivility impedes the administration of justice and reflects poorly upon our profession. In May 2006, the Massachusetts Bar Association’s House of Delegates addressed this topic in part by adopting Civility Guidelines for Family Law Attorneys.

Beyond such guidelines and efforts to regulate our behavior and manner, each of us has to take the matter into our own hands and be more aware of our professional behavior — be more mindful.

Kabat-Zinn writes, “to provide effective counsel we need a mind that knows and sees in new ways — that is motivated differently — that aspires to compassion and empathy.”

Eighteen thousand people have attended Kabat-Zinn’s eight-week Mindfulness Based Stress Reduction clinic at UMass Medical School. The program has served as a national model, being replicated throughout the country and around the world. Studying Kabat-Zinn’s and similar work, I seek a better understanding of how to practice being mindful.

I look forward to Massachusetts attorneys bringing further clarity and compassion to our daily interactions. Reducing conflict and enabling better communication and understanding can only benefit our noble profession and better serve the interests of our clients.

To conclude, I leave you with a quote from William Butler Yeats:

We make our minds so like still water that beings gather about us that they may see, it may be, their own images, and so live for a moment with a clearer, perhaps even with a fiercer life because of our quiet.

The Celtic Twilight: Earth, Fire & Water (1902)

WASHINGTON – Mississippi’s still king of cellulite, but an ominous tide is rolling toward the Medicare doctors in neighboring Alabama: obese baby boomers.

It’s time for the nation’s annual obesity rankings and, outside of fairly lean Colorado, there’s little good news. Obesity rates among adults rose in 23 states over the past year and didn’t decline anywhere, says a new report from the Trust for America’s Health and the Robert Wood Johnson Foundation.

And while the nation has long been bracing for a surge in Medicare as the boomers start turning 65, the new report makes clear that fat, not just age, will fuel much of those bills. In every state, the rate of obesity is higher among 55- to 64-year-olds — the oldest boomers — than among today’s 65-and-beyond.

That translates into a coming jump of obese Medicare patients that ranges from 5.2 percent in New York to a high of 16.3 percent in Alabama, the report concluded. In Alabama, nearly 39 percent of the oldest boomers are obese.

Health economists once made the harsh financial calculation that the obese would save money by dying sooner, notes Jeff Levi, executive director of the Trust, a nonprofit public health group. But more recent research instead suggests they live nearly as long but are much sicker for longer, requiring such costly interventions as knee replacements and diabetes care and dialysis. Studies show Medicare spends anywhere from $1,400 to $6,000 more annually on health care for an obese senior than for the non-obese.

“There isn’t a magic bullet. We don’t have a pill for it,” said Levi, whose group is pushing for health reform legislation to include community-level programs that help people make healthier choices — like building sidewalks so people can walk their neighborhoods instead of drive, and providing healthier school lunches.

“It’s not going to be solved in the doctor’s office but in the community, where we change norms,” Levi said.

The Centers for Disease Control and Prevention has long said that nearly a third of Americans are obese. The Trust report uses somewhat more conservative CDC surveys for a closer state-by-state look. Among the findings:

- Mississippi had the highest rate of adult obesity, 32.5 percent, for the fifth year in a row.

- Three additional states now have adult obesity rates above 30 percent, including Alabama, 31.2 percent; West Virginia, 31.1 percent; and Tennessee, 30.2 percent.

- Colorado had the lowest rate of obese adults, at 18.9 percent, followed by Massachusetts, 21.2 percent; and Connecticut, 21.3 percent.

- Mississippi also had the highest rate of overweight and obese children, at 44.4 percent. It’s followed by Arkansas, 37.5 percent; and Georgia, 37.3 percent.

- Following Alabama, Michigan ranks No. 2 with the most obese 55- to 64-year-olds, 36 percent. Colorado has the lowest rate, 21.8 percent.

Chris Shaw Edited By: Leigha Baugham – myfoxatlanta.com

ATLANTA (MyFOX ATLANTA) – A new and potentially groundbreaking medical experiment is ongoing in Georgia which aims to bring peace to service members who come home from the war. Researchers at Emory Hospital are tracking the brain scans of service men and women to help them deal with Post-traumatic Stress Disorder.

When Donnie Apted came home from the war, he dreamed he would come home to a happy life with his wife and two sons. For two years, that happy life was just a dream for Apted.

Apted served with the National Guard in Iraq during a violent period in 2004. Apted was stationed just north of Baghdad.

“We were getting hit just about everyday with mortar fire,” recalled Apted.

Like so many men and women who have served in Iraq and Afghanistan, Apted unintentionally brought terror and anguish back home with him. Apted’s condition made the life he returned home to almost unrecognizable.

“I had rage, issues with rage, and you would ask anybody that knew me before I left they would say, ‘Donnie, he was laid back,’” said Apted.

“So I always felt like I was trying to make up for that or trying to cover for him or make excuses for him being the way he was,” said Apted’s wife, Kari.

Things took a turn for the worse more than a year after Apted returned home. During dinner one evening, the family dog snatched a piece of pizza from Apted’s son’s hands.

“And he screeched. And I lost control and I went in, and I pinned my dog to the ground and I was just wailing on her. And it was like I couldn’t control myself,” Apted.

Apted sought help from an experimental treatment at Atlanta’s Emory Hospital after therapy and medication both failed to treat his PTSD.

The experimental treatment is called mindfulness based stress reduction and it is being tested on other service men and women who suffer from PTSD. The treatment incorporates meditation and relaxation techniques. Instead of trying to forget memories of war, patients are taught to handle their emotions when those thoughts arise.

“What’s important is developing a new relationship to these symptoms, so they change, so they’re not as scary anymore,” said therapist Kaye Coker.

Coker, the lead investigator in the study, said brain scan images show the treatment can work. The treatment is a potential breakthrough. Some estimates claim as many as 20 percent of Iraq War vets have PTSD.

“We don’t have a treatment that is uniformly helping most of the people most of the time,” said Dr. J. Douglas Bremmer. “I think it’s possible we could be getting better results than we’ve had with previous treatments.”

Apted called the breathing techniques he learned in the treatment a life-saver.

“Sometimes I’ll still get startled by something, but I’m aware enough to catch it early on and say, ‘that’s what that was, it’s nothing else,’” Apted said.

Some of the peace dreamed of after the war has returned to Apted’s family.

“We’re sort of new and improved, I guess. We’ve been through hell together. And we’ve made it through the other side,” said Kari Apted.

Researchers said the number of troops returning home from the wars in Iraq and Afghanistan with PTSD is about the same as it was during the Vietnam War. The disorder is better diagnosed these days.

Apted said his father served in Vietnam and his PTSD went untreated until just a couple of years ago.

For more information on PTSD and where you can find help, go to: FOX 5′s PTSD Information Page

Effective August 1, 2009, TriWest Healthcare Alliance will be implementing the new TriWest Online Care program, a program to increase behavioral health service for TRICARE active duty service members (ADSMs) and active duty family members (ADFMs) via telehealth services.

Providers can participate in this exciting opportunity as an Originating Site Facility or a Distant Site Facility. An Originating Site is the site where an eligible TRICARE beneficiary is located when the service is being furnished via a videoconferencing system. A Distant Site is the location where a TRICARE provider will render services being furnished via a videoconferencing system. TRICARE will reimburse for both types of services.

One of the areas in which we need to augment existing access to providers is in the area of behavioral health prescribers. Our TRICARE beneficiaries, particularly those located in rural areas, would benefit from additional access to those distant providers who can prescribe medications to behavioral health patients. Only network providers located in the West Region are currently eligible to participate in the demonstration project with TriWest.

By Sen. Tom Harkin (D-Iowa)

From The Yahoo! Newsroom Blog

Washington, DC — With the Senate health committee convening daily to craft a comprehensive health reform bill, the basic outline of this landmark legislation is now clear.

Yes, it will ensure access to affordable, quality care for every American.  But, just as important, it will hold down health care costs by creating a sharp new emphasis on disease prevention and public health.

As the lead Senator in drafting the Prevention and Public Health section of the bill, I view this legislation as our opportunity to recreate America as a genuine wellness society – a society that is focused on prevention, good nutrition, fitness, and public health.

The fact is, we currently do not have a health care system in the United States; we have a sick care system.  If you’re sick, you get care, whether through insurance, Medicare, Medicaid, SCHIP, community health centers, emergency rooms, or charity.  The problem is that this is all about patching things up after people develop serious illnesses and chronic conditions.

We spend a staggering $2.3 trillion annually on health care – 16.5 percent of our GDP and far more than any other country spends on health care – yet the World Health Organization ranks U.S. health care only 37th among nations, on par with Serbia.

We spend twice as much per capita on health care as European countries, but we are twice as sick with chronic disease.

How can this be so?  The problem is that we have systematically neglected wellness and disease prevention.  Currently in the United States, 95 percent of every health care dollar is spent on treating illnesses and conditions after they occur.  But we spend peanuts on prevention.

The good news in these dismal statistics is that, by reforming our system and focusing on fighting and preventing chronic disease, we have a huge opportunity.  We can not only save hundreds of billions of dollars; we can also dramatically improve the health of the American people.

Consider this:  Right now, some 75 percent of health care costs are accounted for by heart disease, diabetes, prostate cancer, breast cancer, and obesity.  What these five diseases and conditions have in common is that they are largely preventable and even reversible by changes in nutrition, physical activity, and lifestyle.

Listen to what Dr. Dean Ornish told our Senate health committee: “Studies have shown that changing lifestyle could prevent at least 90 percent of all heart disease.  Thus, the disease that accounts for more premature deaths and costs Americans more than any other illness is almost completely preventable, and even reversible, simply by changing lifestyle.”

It’s not enough to talk about how to extend insurance coverage and how to pay for health care – as important as those things are.  It makes no sense just to figure out a better way to pay the bills for a system that is dysfunctional, ineffective, and broken.  We also have to change the health care system itself, beginning with a sharp new emphasis on prevention and public health.

We also have to realize that wellness and prevention must be truly comprehensive.  It is not only about what goes on in a doctor’s office.  It encompasses workplace wellness programs, community-wide wellness programs, building bike paths and walking trails, getting junk food out of our schools, making school breakfasts and lunches more nutritious, increasing the amount of physical activity our children get, and so much more.

I am heartened by the fact that the major players in this endeavor – Democrats and Republicans alike – all “get it” when it comes to prevention and public health.  We all agree that it must be at the heart of reform legislation.

As President Obama said in his speech to Congress earlier this year: “[It is time] to make the largest investment ever in preventive care, because that’s one of the best ways to keep our people healthy and our costs under control.”

No question, comprehensive health reform is an extraordinarily ambitious undertaking.  But what makes me optimistic is that all the major groups are playing a constructive role, including those that opposed the 1993-94 heath reform effort.  Everyone agrees that the current system is broken.

Winston Churchill famously said that “Americans always do the right thing – after they’ve tried everything else.”  Well, we’ve tried everything else, and it has led us to bad health and the brink of bankruptcy.

Comprehensive health reform legislation is our opportunity to change the paradigm.  We are going to extend health insurance to every American.  And we are going to give our citizens access to a 21st century health care system – one that is focused on helping us to live healthy, active, happy lives.

Sen. Tom Harkin (D-Iowa) is a senior member of the Senate Health, Education, Labor and Pensions Committee and chairs the Senate panel that funds medical research and health care..

In a new white paper published online in the journal Telemedicine and e-Health, several U.S. medical experts argue that telemedicine should be a key component of health care reform efforts, United Press International reports.

According to the white paper, telemedicine would help curb cost inflation and provide other benefits that would significantly outweigh the costs.

In a statement, lead authors Rashid Bashshur of the University of Michigan and Gary Shannon of the University of Kentucky said, “While not a panacea, telemedicine offers significant opportunities to address the issues of inequities in access to care, cost containment and quality enhancement” (United Press International, 6/23).

The white paper is available online (.pdf).

On Thursday, Maine Gov. John Baldacci (D) signed into law a bill (LD 1073) that requires health insurance plans in the state to cover telemedicine services, the Maine Public Broadcasting Network reports.

The measure, sponsored by Maine Rep. Anne Perry (D), covers health care services provided through interactive audio, video and other electronic media (Maine Public Broadcasting Network, 6/11).

In a statement, Baldacci said, “Telemedicine offers opportunities to increase the accessibility of health care, ensure that appropriate medical information is available, reduces medical errors and reduces health care costs,” adding, “This bill makes sense and I am pleased to sign it.”

The new law goes into effect 90 days after the close of the legislative session (Office of the Governor release, 6/11).