Author: user

Regardless of your mental health history, a super-low-calorie diet may not be sustainable in the long term. We all need calories for survival. If your body senses it’s not getting enough, it will fight the process with a mechanism known as “starvation mode.” “Starvation mode is a defense mechanism that the body uses to prevent fat loss and starvation. The idea is, your body wants to use your fat to keep you alive, so you don’t burn as many calories,” says Felix Spiegel, MD, a bariatric surgeon at Memorial Hermann Medical Group in Houston. “This lowers your metabolic rate, which means you’re using less calories. If you cut back your calories too much, it hinders weight loss.”

To prevent weight loss plateaus, Dr. Spiegel recommends a goal of 1 to 2 pounds lost per week. “If you lose more than that, you’re losing body fluid and muscle mass.”

If you’re struggling to keep up with house cleaning duties due to depression, here are some simple ways to help you start tackling them.

1. Start Small

Try it by identifying your three most important house cleaning goals. Focus on completing the first of those tasks, then try to tackle the others one at a time.

Concentrating on just those small steps makes it easier to get started and build that inertia to keep going, says Karen Lynn Cassiday, PhD, a clinical psychologist and managing director of the Anxiety Treatment Center of Greater Chicago. “It’s like jump-starting a car when you have a battery that doesn’t work,” says Dr. Cassiday.

2. Reframe Negative Self-Talk

“People with depression will start to criticize themselves and say, ‘I’m so lazy,’” says Cassiday. This negative self-talk can actually end up hindering your productivity rather than motivating you to get things done, she says.

If you notice that you’re speaking negatively to yourself, it can help to immediately replace those thoughts with positive ones. Positive self-talk can help increase self-esteem and boost motivation, which in turn can lead to improved productivity, adds Cassiday.

• Be encouraging and gentle to yourself by looking at negative thoughts objectively. Then respond with a compassionate evaluation of what is good about yourself.
• Don’t say anything to yourself that you wouldn’t say to someone else.

3. Don’t Wait Until You Feel Good to Get Started

When people with depression have good days and they struggle less with their symptoms, they may use those feelings as motivation to complete a task, says Cassiday. For example, they may clean their kitchen because they know it will bring them a sense of satisfaction and accomplishment later on.

But you can’t rely on feeling good as your motivation strategy all the time. Part of the reality of having depression is recognizing that there will be some days when you don’t feel good — but you’ll still need to get things done on those days, too.

“So we have to teach people to first learn to ignore the part of themselves that says, ‘I need to feel good in order to do it,’” says Cassiday. “You can’t wait for feeling good. You have to think about something that’s really important, which is that action that creates motivation.”

4. Prioritize High-Impact Cleaning Tasks

Cassiday recommends choosing tasks that create a “high impact” first to help you better recognize the value of your efforts.

What that means: “A bed takes up a large chunk of space in a room, so if you actually make it, it has a rather large effect in terms of the aesthetic appearance as compared to, say, picking up five pieces of trash,” she says.

5. Ask for Help

If a family member or friend can assist you with cleaning duties, the extra help may jump-start your motivation.

“People with depression tend to withdraw and self-isolate. Reaching out to a friend or loved one is a big step toward combating depression and can have immediate effects, not just on the physical space, but also on the emotional,” says Mairanz.

If possible, Cassiday says, do your best to ask for help before you feel embarrassed by a mess. For instance, if you haven’t been able to fold and sort laundry for a few weeks, it’s a good idea to try to reach out for help before the situation becomes unmanageable.

Also, if you have the resources, hiring a cleaning service may be a valuable option.

6. Track Your Wins, No Matter How Small

Actually write them down, Cassiday says. Include cleaning-related accomplishments as well as other wins. She calls this a “what I did list,” as opposed to a “to-do list.”

“When people are depressed they tend to vastly underestimate the effect and value of their efforts,” Cassiday says. “This helps you see that you are actually getting somewhere.”

7. Give Yourself Grace

You may also need to adjust your expectations when it comes to keeping your living space clean. Realize you may not have the energy or focus that you used to — and that’s okay, says Cassiday.

It’s important to remind yourself that a messy or disorganized house doesn’t mean you’ve failed in any way. “You are not alone with having a hard time with this, and it’s nothing to be embarrassed about. We all go through ups and downs with our mental health, and our space is often a reflection of that natural process,” says Mairanz.

Stress or Trauma During Childhood Can Lead to Numerous Health Issues

Evidence suggests that adverse childhood experiences (or ACEs) — stressful or traumatic events that children may face, such as physical, emotional, or sexual abuse, neglect, or family dysfunction — can impact both mental and physical health later in life.

The Divorce-Stroke Connection

To examine the link between divorce and stroke risk, researchers used data from more than 13,000 adults who were part of the 2022 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS, a collaborative project between state health departments and the Centers for Disease Control and Prevention, collects health-related data via telephone surveys.

The participants were 65 or older, and 57 percent female, 79 percent white, 9 percent Black, and 12 percent Hispanic or other races.

The researchers excluded participants who had been exposed to sexual or physical abuse, says senior author Esme Fuller-Thomson, PhD, a professor of social work and director for the Institute of Life Course and Aging at the University of Toronto.

“Our research wanted to clarify the association between parental divorce and stroke by avoiding any potential confounding with childhood abuse,” says Dr. Fuller-Thomson.

Of the participants, 7.3 percent had experienced stroke and 13.9 percent had parents who’d divorced before they turned 18 years old.

Researchers “were saddened, but not surprised,” that parental divorce was associated with greater odds of stroke, says Fuller-Thomson.

“But we were surprised that the association between parental divorce and stroke was of similar magnitude to two well-established risk factors for stroke: diabetes and male gender,” she says.

Staying in Childhood Home With Trusted Adult Didn’t Reduce Additional Stroke Risk

“We found that even when people hadn’t experienced childhood physical and sexual abuse, and had at least one adult who made them feel safe in their childhood home, they still were more likely to have a stroke if their parents had divorced,” said coauthor Philip Baiden, PhD, associate professor in the school of social work at the University of Texas in Arlington, in the press release.

Other forms of childhood adversity — emotional abuse, neglect, household mental illness, substance abuse, and exposure to parental domestic violence — were not significantly associated with stroke in this study.

Why Might Parents’ Divorce Increase Stroke Risk?

The study wasn’t designed to uncover why children of divorce could have a higher stroke risk, but the researchers speculate there could be both biological and social factors at play.

“From a biological embedding perspective, having your parents split up during childhood could lead to sustained high levels of stress hormones. Experiencing this as a child could have lasting influences on the developing brain and a child’s ability to respond to stress,” said Fuller-Thomson in the statement.

Socially, divorce was much less common for older generations, and much more stigmatizing. For these reasons the level of parental conflict that would have led to divorce may be higher, thereby making the experience more traumatic, the study authors wrote.

Fuller-Thomson acknowledges that this study only shows an association, not direct causation — it doesn’t prove that divorce causes an increase in stroke risk, only that the two things are related.

There are other additional limitations to the findings. Some people may have died from stroke before age 65, and therefore wouldn’t be included in the study group. The survey also couldn’t capture when the divorce occurred, or the level of contact with the noncustodial parent, the authors wrote.

Would Divorce Have the Same Impact on Gen-Xers and Millennials?

Trauma and associated stroke risk may or may not be present in younger people, including Gen-Xers and Millennials, according to the authors. “Future research is needed to investigate generational differences in the parental divorce-stroke association,” they wrote.

How to Reduce Your Stroke Risk

“We are hoping that adults with divorced parents will be particularly vigilant about their health,” says Fuller-Thomson.

She recommends the following steps to reduce your risk of stroke:

• Get regular check-ups.
• Maintain low blood pressure and low cholesterol.
• Don’t smoke.
• Keep physically active.
• Maintain a healthy weight.
• Eat more fruits and vegetables.
• Decrease salt intake.
• Don’t drink excessively.

Laura Hall was doing everything right.

After a lifetime of profound struggles with compulsive eating, the Fort Worth, Texas, resident had finally put together all the pieces of a healthy lifestyle. She was eating a plant-based diet and had cultivated healthy exercise habits. Around 2017, she hit her goal weight.

But in 2022, at age 52, Laura found herself putting on menopausal weight and didn’t seem able to stop gaining. And though she had largely gotten her binge eating under control, and she was satisfied with her wholesome diet, the compulsion to overeat still haunted every meal.

When she asked her doctor about semaglutide, the blockbuster weight loss drug sold as Ozempic and Wegovy, she wasn’t an obvious candidate for it. The drug is not recommended for people without diabetes or those who do not have a clear medical reason to lose weight, and Laura only wanted to lose about 30 pounds. Experts do not know if patients like Laura can use semaglutide safely.

As it turned out, semaglutide didn’t just help her get to her goal weight — it freed her from the intrusive and obsessive thoughts about food that had plagued her for decades.

“I never knew how to create ease around food and my body, and now I have it,” Laura says.

Semaglutide, she says, was “the last piece of the puzzle.”

A Lifetime of Compulsive Eating

Laura’s compulsive eating had an early and very traumatic beginning: “I was sexually abused as a kid, and food was my coping mechanism. I started overeating when I was very, very young.”

She also grew up in a genetic and cultural environment that seemed primed to encourage unhealthy eating habits. “My entire family is obese,” she says. One grandparent, who died of the complications of type 2 diabetes, weighed about 400 pounds.

Laura spent much of her adolescence with bulimia, repeatedly binge eating and then purging by making herself vomit. In college, she stopped vomiting but pivoted to exercise bulimia, working out “excessively,” she describes, to compensate for her compulsive eating. “I was still bulimic, but I wasn’t throwing up,” she explains. When she looks back, she’s shocked “at the amount of abuse I put my body through just so I could eat a bunch of s***.”

The binge eating never went away, and as she aged, Laura’s weight fluctuated depending on how much time she devoted to working out. In her early thirties, Laura taught aerobics, raced bikes, and competed in triathlons. But a career shift cut into her exercise time, and “that’s when the weight just piled on,” she says.

Laura took drastic action. She had laparoscopic adjustable gastric band (lap band) surgery, a procedure in which doctors place a silicone band around the stomach to reduce its capacity. At only 200 pounds and not yet clearly suffering from obesity-related health issues, Laura was not an ideal candidate for the procedure. Her insurance wouldn’t cover it, and she paid for the surgery out of her own pocket.

“If you eat too much, it displaces the lap band, and then you can’t eat anything — you can’t even keep water down. It’s a miserable experience,” she says. “I overate to the point where it slipped, and I had to get revision surgery, not once but twice.”

It was also a financial disaster for Laura. She had to cash out retirement funds to help pay for the additional procedures, and when she decided that she should have the band permanently removed, she couldn’t afford to have it done. Eventually, she flew to San Diego and crossed the border to Mexico, where a Tijuana clinic offered band removal surgery for a fraction of the price she would have paid in the United States.

Losing Weight the Hard Way

In early 2016, Laura weighed about 180 pounds, “heavier than I wanted or needed to be,” she says. A confluence of factors — including the death of her mother, a grueling experience, and the introduction of a community-led healthy living Blue Zones Project initiative in Fort Worth — finally inspired Laura to make healthy changes.

“I made a major lifestyle shift. I started eating a whole-foods, plant-based diet and stopped drinking alcohol. My weight dropped to about 125 pounds within a year,” she says. “I’d make one small change every few weeks. It wasn’t about weight — it was about health, and that was a new thing for me.”

Though her family initially mocked and doubted her, Laura stuck with the changes and is still enjoying her new diet today. “That was my life, and I was happy. It’s a good way to live,” she says.

But it was never easy. Though Laura was able to manage her eating compulsions for the first time in her life, “it was a constant, white-knuckle struggle — constant,” she describes.

An Extra 30 Pounds

Like so many others, Laura gained more than a few pounds during the pandemic. But when she got back on track with her good habits, the weight simply would not come off.

She attributes the difficulty to the hormonal shifts characteristic of the menopausal transition, which are known to affect metabolism and cause weight gain. “I was doing the exact same movement and eating routine, but I had 30 extra pounds on,” she says. “It doesn’t sound like much, but it was a lot to me.”

Despite her fastidious lifestyle, Laura was gaining about two pounds per month. This caused immense frustration because she was sure that she was making healthy diet and exercise choices. It seemed clear that she’d never again approach her goal weight without some kind of medicinal help. Finally, inspired by a friend’s success, she asked her doctor about semaglutide, the blockbuster weight loss drug originally developed to treat type 2 diabetes.

Although her doctor was willing to write her an off-label prescription, Laura couldn’t afford the $1,000 per month out-of-pocket cost.

To find affordable semaglutide, Laura turned to the internet, which hosts a growing network of online healthcare providers and weight loss programs offering less expensive compounded weight loss drugs with only a bare minimum of medical oversight. Laura took advantage of one supplier’s carelessness by fibbing on her intake form: “I added a few pounds and took off an inch of height, so I’d be sure to qualify,” she admits.

Experts have cautioned against using less scrupulous online healthcare providers, and the U.S. Food and Drug Administration has warned that compounded forms of semaglutide may lack the proven safety or efficacy of Ozempic and Wegovy.

But for Laura, the medicine has been transformative.

Food Noise Relief

Laura proclaims that semaglutide ended her lifelong battle with compulsive eating “immediately. The food noise in my head shut the f*** up for the first time in my life.”

Others have experienced the same relief. They say that semaglutide is helping silence their food noise. Although there’s no precise definition or measurable medical standard, food noise refers generally to intrusive thoughts and preoccupations about food. Laura spent most of her life obsessing over what she ate or was about to eat.

“It’s a freedom that I never thought I’d have,” she says, stifling tears. “I’ve been struggling with this since I was 8 years old. That’s a lot of years. I’m 52 years old — do the math.”

Semaglutide doesn’t just suppress hunger; it appears to have an effect on the brain’s reward system, too. Researchers believe that semaglutide could be a powerful anti-addiction drug, and anecdotal reports indicate that it may help quell compulsive behaviors such as nail-biting and binge shopping. On the flip side, some have found that squelching the desire for food takes the joy out of eating and isn’t worth it.

For Laura, her relief from food preoccupations has allowed her to reevaluate the history of her own diet failures. In recent years, for example, Laura experimented with intermittent fasting and blamed herself when the trendy eating pattern did not help assuage her compulsive tendencies. “I thought it was my fault that fasting wasn’t easy,” she says. Now she believes that her failures were chemical — an imbalance that semaglutide helps correct — rather than the result of insufficient willpower or commitment.

Better Living Through Chemistry

With her food noise and appetite suppressed, Laura easily lost the 30 pounds she wanted to lose. She’s holding steady at about 125 pounds.

Now that Laura has hit her goal weight, how long does she intend to use semaglutide or a related drug?

“Forever,” she says

She’s happy with where she is now in her weight loss journey.

“Life doesn’t have to be as hard as I’ve made it. Who says it has to be hard? Semaglutide makes it easy for me,” she says. “I’m gonna let it be easy.”

Everyday Health‘s Weight Loss Reframed Survey queried 3,144 Americans nationwide ages 18 and older who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.

“When it comes to weight loss, many approaches work, but the key is sustainability,” says Sean Hashmi, MD, a nephrologist and obesity medicine specialist in Southern California, a member of the American College of Lifestyle Medicine, and a member of Everyday Health’s Health Expert Network.

Other experts agree.

“When I’m helping patients find a plan for weight loss, I’m not saying, ‘Hey, let’s try this for 10 weeks and then switch,’” says Fatima Cody Stanford, MD, MPH, an obesity medicine physician at Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School in Boston. “We’re trying to find things someone will do consistently for the rest of their life.”

While consistency is crucial, Dr. Stanford says that doesn’t mean a person’s approach needs to be inflexible or oversimplified. According to the survey, people who lost weight tended to employ more tactics overall than people who did not lose weight. They also tended not to be rigid or routine about diet and exercise. “I tell people the flavor can change, but the structure should be the same,” she says.

For example, Stanford says people who are incorporating exercise into their weight loss plan should feel free to switch up their workouts from time to time. The important thing is that they continue to exercise regularly. “I need variety when I’m training in order to stay motivated and excited about working out,” she says.

Likewise, dietary approaches to weight loss shouldn’t be too narrow or overly prescriptive. If your plan requires that you weigh all your food and count every calorie, Stanford says you will have a hard time sticking with it.

Finally, experts said that the tactics a person employs to lose weight shouldn’t be solely related to diet and exercise (although those are important). “We should broaden our focus to include things like stress levels, sleep quality, and mental health,” says Kayli Anderson, RDN, a nutrition expert and a member of the American College of Lifestyle Medicine and Everyday Health’s Health Expert Network.

For those interested in the newest weight loss medications, our experts say they’re worth considering. While the survey found that more than half of respondents were not interested in trying these medications, those who had tried them found them to be very effective.

“It’s not just hype,” Stanford says of these drugs. “Patients on these medications tell me they don’t even have to think about eating less.”

Key Finding 2: Arm Yourself With Information

Among the people in our survey who successfully lost weight, 70 percent started their weight loss journey with “a higher level of knowledge” on how to lose weight — compared with 52 percent of those who maintained or gained weight.

Also, according to our survey, 6 in 10 people reported they knew how to lose weight. Ten percent said they didn’t know where to start.

The survey also showed that a conversation about weight loss with a healthcare professional might be worthwhile: Fifty-nine percent of all respondents said their doctor or other healthcare provider had talked to them about losing weight, while 53 percent of all respondents said they had not asked their doctor or provider for help with weight loss.

Even if you feel you have a good handle on the best approaches to weight loss, consulting with an expert — either a registered dietitian-nutritionist or a medical doctor who specializes in weight loss — is a good idea. “They are trained in helping people set realistic health goals,” Anderson says. “They can also educate people about nutrition and help them develop personalized plans.”

Another reason to consult with an expert: Even evidence-backed weight loss strategies aren’t going to work for every person and every situation. “Treatment of excess weight doesn’t have a one-size-fits-all answer,” says Deepa Sannidhi, MD, an associate clinical professor at UC San Diego Health in California.

Key Finding 3: Understand Your Motivation and the Connection Between Weight and Mental Health

Of all the hurdles that stand between a person and their weight loss goals, survey respondents were most likely to highlight stress and motivational problems.

Obesity

Obesity is the most common risk factor for obstructive sleep apnea. “Fat deposits in the neck and around the tongue and palate make the airway much tighter and smaller,” says sleep medicine specialist Neeraj Kaplish, MD, medical director of sleep labs and clinics and clinical professor of neurology at the University of Michigan in Ann Arbor. “It becomes much more [closed up] during sleep when you’re lying down.” (It should be noted that thin people can also have obstructive sleep apnea and that not all individuals who are overweight have the condition.)

Large Adenoids or Tonsils

Jaw Misalignment or Size

Some conditions or genetic factors can lead to an imbalance in facial structure that can cause the tongue to sit farther back in the mouth and lead to sleep apnea, says Robson Capasso, MD, chief of sleep surgery and professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California.

For instance, a lower jaw that’s shorter than the upper jaw, or a palate (the roof of your mouth) that’s shaped a certain way and collapses more easily during sleep can contribute to obstructive sleep apnea.

Family History of Sleep Apnea

Chronic Nasal Congestion

Smoking

Using Alcohol, Sedatives, or Tranquilizers

Asthma

Having asthma is also a risk factor for obstructive sleep apnea. The relationship between the two conditions works both ways, Chervin explains: “Sleep apnea can make asthma worse and asthma can make sleep apnea worse.”

Medication, Such as Opioid Pain Relievers

The neurological communication that happens between the brain and body to regulate breathing can be numbed by benzodiazepines and opioids, says Dr. Capasso. As a result, these drugs reduce airway muscle activation and can contribute to sleep apnea.

Gender and Age

High Blood Pressure (Hypertension)

Diabetes

History of Stroke

Prior stroke is linked to both obstructive sleep apnea and central sleep apnea, but it’s not clear which is causing which, Dr. Chervin says. “As many as three-quarters of stroke patients have sleep apnea, and sleep apnea also raises the risk for stroke,” says Chervin. Sleep apnea leads to low oxygen levels and high blood pressure, both of which can increase one’s risk of a future stroke.

Heart Failure

When a flare hits, taking action early can make a big difference.

Immediate Steps

Some steps you can take immediately and on your own to soothe or manage your symptoms include:

• Resting up and engaging in relaxation techniques, such as deep breathing and guided imagery, to release both physical tension and emotional stress
• Using heat or cold therapy — heat to relax stiff muscles or cold to reduce swelling
• Taking a hot shower or gently stretching to relieve morning stiffness
• Using assistive devices such as splints and braces, walking canes, and button hooks, as needed

  [3]

• Distracting yourself from the pain by engaging in an activity you enjoy (that doesn’t heavily rely on your problematic joints) and keeping your mind busy while doing other activities

Also remember to lean on your support system. While your loved ones may not be able to take away your pain or other symptoms, they can help you with day-to-day activities, especially those that could make your symptoms worse.

Pharmaceutical Interventions

Various medications can also help to reduce symptoms. Always consult with your healthcare provider before starting new medications or changing your dosages of current medications.

Over-the-counter or prescription-strength pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, acetaminophen, and aspirin, can help provide quick relief for mild pain and inflammation during an RA flare.

Biologics are a more advanced type of DMARDs that target specific biological processes or molecules that cause RA-related inflammation. If you’re experiencing an RA flare with significant symptoms or one that’s not adequately controlled by other medications, your provider may start you on a biologic along with or instead of other drug therapies.

Holistic and Lifestyle Approaches

Other holistic and lifestyle approaches to treat your RA flare include:

• Improving your sleep hygiene for better sleep, such as by establishing set sleep and wake times, creating a comfortable sleep environment that’s dark and cool, and avoiding heavy meals before bed

  [13]

• Eating anti-inflammatory foods, such as those rich in omega-3 fatty and antioxidants, and avoiding those that promote inflammation

  [14]

• Engaging in gentle physical activity, such as hand exercises, swimming, and low-impact tai chi or yoga
• Adjusting your overall response to pain through mindfulness practices, deep breathing exercises, and counseling or psychotherapy

Hib bacteria usually live harmlessly in the nose and throat, but they can move to other parts of the body and cause different kinds of illnesses, all known as H. influenzae disease.

There are six types of H. influenzae bacteria, labeled a through f. Most people only need to worry about type b. It can cause these serious illnesses:

• Meningitis An infection of the brain and spinal cord membranes may lead to brain damage, hearing loss, or even death. Prior to the Hib vaccine, infection with Hib bacteria was the leading cause of bacterial meningitis in children under 5 years old in the United States.

  [4]

• Pneumonia A severe lung infection can make breathing difficult and cause long-term health problems.
• Epiglottitis An infection causes swelling of the epiglottis, the small flap in the throat, potentially blocking the airway and leading to difficulty breathing.
• Bloodstream Infections These can result in sepsis, a life-threatening condition in which the body’s excessive response to infection causes injury to organs.
• Cellulitis A deep skin infection causes painful swelling.
• Infectious Arthritis Also called septic arthritis, this is a painful infection of the joint.

Anyone can get H. influenzae, but serious cases, including Hib, mostly happen in children younger than 5 and adults 65 or older. Children under 1 have the highest rates of infection.

• 30 percent giving up vacations or major household purchases
• 22 percent increasing their credit card debt
• 21 percent cutting back on essentials like food, clothing, or basic household items

Take Ian Goldstein, 33, a comedian, writer, and social media ambassador for the Crohn’s & Colitis Foundation, who lives with Crohn’s disease. Ian is still paying off a surgery from 2021, when 2 feet of his small intestine were removed to clear strictures that had formed over a decade which caused problems like bowel obstructions and constant pain. Last July, he literally threw a party after meeting his healthcare deductible.

Despite reaching this milestone, Goldstein worries about his medicine not working, potentially causing another bowel obstruction that could lead to an emergency room visit or emergency surgery that could upend his finances.

“There have been times when I’ve delayed paying bills or started new payment plans just to afford my medication and treatments,” says Goldstein. “It’s a constant juggling act between managing my health and maintaining financial stability. I worry about future expenses. I worry about how my disease will be managed as I get older and my premiums and deductibles continue to rise. It’s a reality that many of us with IBD face every day.”

While advancements in IBD treatments have improved disease management options, systemic reforms are urgently needed to address the inequities in healthcare access. These reforms include:

• Insurance reforms to reduce restrictions like prior authorization and step therapy, which requires patients to try and fail on less expensive medications before accessing costlier doctor-prescribed treatments
• Drug pricing reforms to address the high cost of biologics and other specialty medications
• Expanding patient protections through federal legislation to complement state-level reforms

However, these changes face significant barriers, including resistance from insurers as well as the complexities of implementing policy reforms across diverse healthcare systems.

5 Ways to Manage Your IBD Costs Now

Goldstein’s story — and the stories of thousands like him — reminds us why this work is so important. No one should have to choose between managing their health and maintaining financial stability. Despite the progress we’ve made with IBD research and treatment options, many people still struggle to access the care they need without facing undue burden.

As a community, we must continue to advocate for reforms that ensure that all people with chronic illnesses, including IBD, can access necessary medications without financial hardship. While systemic change takes time, there are still steps you can take today to protect your finances and alleviate some financial strain while managing your IBD or other chronic illness.

1. Explore patient financial assistance programs. Many pharmaceutical companies offer financial assistance programs that provide discounts or free medications for eligible patients. The Crohn’s & Colitis Foundation’s IBD Help Center is available to help you navigate this process and provide guidance on available assistance options. You can also check with your healthcare provider or visit drug manufacturer websites for details.
2. Understand your insurance benefits. Familiarize yourself with your plan’s coverage details, including which providers are in network and what preventive services are fully covered. This can help you avoid unexpected costs.
3. Negotiate medical bills. If you receive an expensive bill, contact your healthcare provider’s billing department to discuss payment plans or potential discounts based on financial hardship.
4. Consider generic or biosimilar alternatives. When appropriate, ask your doctor about switching to less expensive generic drugs or biosimilars that are equally effective but cost significantly less than brand name drugs and biologics.
5. Use the Crohn’s & Colitis Foundation’s Copay Accumulator tool kit. Health insurance companies’ copay accumulator programs can prevent drug manufacturer copay assistance from counting toward your deductible or out-of-pocket maximums. The Crohn’s & Colitis Foundation’s Copay Accumulator tool kit provides resources to help you navigate these programs effectively and advocate for your rights as a patient.

The views and opinions expressed in this article are those of the author and not Everyday Health.

When falling asleep doesn’t come naturally, it’s easy to see the appeal of any number of sleep hacks trending on social media that promise rapid results without the hassle of seeing a doctor or getting a prescription for sleeping pills.

If you’re one of these people who has trouble falling asleep, there’s no harm in trying many sleep hacks — as long as you realize that they may not work for you, says Jessica Meers, PhD, a psychologist and owner of Rhythm Wellness and an assistant professor at Baylor College of Medicine in Houston, who specializes in sleep issues.

“If you are struggling with difficulty sleeping more often than not, I would encourage you to reach out to a mental health professional who specializes in sleep,” Dr. Meers says. “You don’t have to rely on hacks that may or may not help.”

Before you do try hacking your sleep routine, read on to get the facts on which trendy fixes might be your best bet.

Military Sleep Method

The military sleep method (as demonstrated on TikTok) promises to help you fall asleep in two minutes or less through a combination of deep breathing exercises and progressive muscle relaxation. You basically start relaxing the muscle in your head and face then slowly work down to your toes, not unlike the type of mindful muscle release you might do during some yoga sessions.

Unlike the Navy SEAL power nap, which promises to help you feel refreshed after a few minutes of resting with your feet elevated above your head, the military sleep method is designed to be done in bed and help you get to sleep quickly so you can be well-rested in the morning.

What the Experts Say: Try It

Deep breathing can indeed help you relax and improve your ability to fall asleep, says Marie-Pierre St-Onge, PhD, an associate professor and director of the Center of Excellence for Sleep and Circadian Research at Columbia University in New York City.

“There is no risk to trying breathing exercises as a calming, winding-down routine before bedtime,” Dr. St-Onge says.

Relaxation is a necessary component of sleep, Meers notes. But the military sleep method may not work for everyone, and it’s unlikely to get anyone overnight results.

“However, if you are incorporating deep breathing and progressive muscle relaxation into a regular self-care routine and stress management, it could contribute to better sleep quality in the long term,” Meers says. “The key is consistency of practice.”

Eye Rolling

Eye rolling (demonstrated on TikTok) to help you fall asleep has nothing to do with silently expressing your opinions about something you find idiotic. It involves what’s known as ocular calisthenics, or a series of eye movements designed to mimic what happens during rapid eye movement (REM) sleep.

Influencers tout it as a way to promote the body’s release of melatonin, a hormone that plays a role in helping you fall asleep.

What the Experts Say: Skip It

Eye rolling at bedtime isn’t likely to release enough melatonin in time to help you fall asleep, Meers says.

“Melatonin gradually rises in the hours before bedtime while you are awake, serving as a time signal for the body that it is nighttime,” Meers says. Even if eye rolling did cause a small boost in melatonin, it wouldn’t release enough to help you fall asleep, Meers says.

It also might cause some eye strain, Meers adds, making it less appealing than some other sleep hacks without any known side effects.

Cricket Feet

Cricket feet exercises (as demonstrated on TikTok) involve rubbing your feet together in a variety of ways that are intended to soothe you to sleep. You do this by using one foot to rub the other one, massaging the soles or the spaces between your toes.

Some people swear by this calming ritual as a sure-fire way to fall asleep.

What the Experts Say: Try It

“I am not aware of any research on this and how this could be helpful, other than if the person who practices this finds it very soothing and appeasing, but there’s no risk in trying it,” St-Onge says.

Cricket feet might appeal to people who enjoy self-soothing exercises before bed, Meers says. “Some people may find it comforting, which can help you relax, but it’s not likely to be something that puts you to sleep,” Meers says.

Cognitive Shuffling

Influencers describe cognitive shuffling (as demonstrated on TikTok) as an easy and fast way to put yourself to sleep that doesn’t require any elaborate or time-consuming habits. All you need to do is cycle through a series of random, unconnected words — like “Tree. Swimming. Turkey. Yodel. Motorcycle. Mango.” — in your mind until you doze off, in theory mimicking what your brain is supposed to do naturally to help you power down for the night.

What The Experts Say: Skip It

The focus that it takes to think of words might be helpful in keeping you from thoughts that would otherwise keep you up at night, Meers says. But the effort it takes to consciously summon a list of words in your brain might actually be counterproductive when you’re trying to fall asleep.

“It can be challenging to a sleepy brain, and it might actually be more stimulating for some people,” Meers says. Particularly for people who are anxious or worried, stimulating the brain at bedtime can make it even harder to fall asleep.

Magnesium as the New Melatonin

Magnesium (on TikTok) is having a moment. Many influencers are promoting magnesium as a mild muscle relaxant and anti-anxiety supplement that may be better than melatonin at helping you fall asleep. It’s also a key ingredient in the trendy sleepy girl mocktail.

What the Experts Say: Try It

If you want to try magnesium, the best way to do it is by packing your diet with more magnesium-rich foods like avocados, almonds, nuts, and beans, says St-Onge.

“Magnesium from foods has been shown to be associated with better sleep,” St-Onge says. There’s not as much evidence, however, that magnesium supplements work. Beyond this, high doses of magnesium supplements can cause gastrointestinal side effects and calcium deficiency, she adds.

While magnesium supplements may work for some people, it’s not clear if they work any better than melatonin supplements, Meers says. “They are about equal in my book.”

If you’re thinking about taking daily supplements to help you sleep, you’re better off seeing a doctor first to determine if you have any vitamin or mineral deficiencies that might explain your sleep issues, Meers says.

“Magnesium really is all the rage now,” Meers says. “But it is far from a sleep aid. The route through which it may be helpful is due more towards muscle relaxation rather than inducing sleepiness.”