This week I was asked to be an expert for an HLN story involving an 8 year old boy in Cuyahoga Falls, Ohio. This boy is morbidly obese, tipping the scales at 218 pounds. The Department of Children and Family Services took the boy into foster care after they felt the mother was unable to follow through with appropriate measures prescribed for the boy in order to lose weight. The mother’s defense was that she was going to school, in addition to working as an elementary teacher.  She felt that she could not monitor the child at all times.  Apparently, family members and friends were sneaking food to the boy.  DCFS reported that they had worked with mom for a year and saw no improvement. The State Health Department estimates that more than 12 percent of third graders statewide (Ohio) are severely obese. That could mean as many as 1,380 kids in Cuyahoga County alone. This story is the first time anyone could recall a child being taken from a parent strictly due to weight-related issues.

To consider the idea that the state can handle this issue by removing an obese child from the home and placing him in foster care is not only absurd, but dangerous to the development of children. Most likely, there will not be enough foster homes and even if there were, will the parents in those homes be able to handle the issues an obese child struggles with? According to recent polls, one out of every three children is morbidly obese. This is not a child crisis; instead, this is a family crisis. In this situation, the child suffered from sleep apnea, which meant he was hooked up to a machine at night that monitors and assists his breathing. Many obese children suffer asthma, diabetes, heart disease, hypertension, anxiety, and depression.

Obesity certainly has genetic components, but to simply throw your hands in the air with complete surrender to the fate is not being a responsible parent.  Taking a child away from the family he knows and loves borders on cruelty. Removal of a child from his/her home should only be done as a last resort to protect that child from imminent harm (the child in this case had no other medical conditions except for sleep apnea). Many times, removing a child from their home is experienced so intensely by the child that they would resort to food even more as the only thing they could control. Depression, anxiety, and a heightened loss of self-esteem may be the result. What are we telling a child if we allow them to be taken from us, because we were not able to change our lives enough to help him? I make it clear to all of the parents I work with that if you have a morbidly obese child, it takes a family to support them with a healthy lifestyle. There can be no enablers and “good guys or bad guys” with offering the child unhealthy foods or a lifestyle conducive to obesity.

If you have a child you are concerned with who struggles with obesity, you have more power within your family than any treatment facility known. The problem is that, many times, you know your child is hurting and that breaks your heart. The guilt you feel from that affects your ability to hold a firm and loving boundary that your child needs. These suggestions will help you get started.

1.     Talk to your pediatrician and tell them your concerns. Make a list of everything you have tried and go over this with your doctor. Don’t let your doctor make light of your concerns. No one knows your child as well as you.

2.     Have a family meeting, and rather than addressing any one child, address the whole family. Become a united team with everyone participating in a healthy lifestyle. Identify the foods that are the most problematic (soda, chips, candy, and pastries) and replace those with raw fruits and vegetables. Make these food visible, keep a basket of raw fruit on the kitchen counter, bottled water in the fridge (or fresh water in pitchers stored in the refrigerator) and vegetables peeled and ready to eat in the refrigerator. The best way to get rid of the junk food is to throw it away. It’s toxic, and why would you donate or give to someone else what is poisonous to their body?

3.     Quit telling yourself that in order for your kids to fit in they need junk food in the house. They don’t, and this thinking is keeping you from being an effective parent in helping your obese child. It is not fair to let the thin sibling eat junk food and not allow it for the child with weight issues. This builds resentment, so get rid of the junk food and make it forbidden for your whole family.

4.     Family activities are so helpful for your family as well as your marriage. Protect and prioritize these types of days. Take a family walk, go to the park, or (in the winter) go ice skating. Anything where there is movement will help everyone be healthier. Activities shared as a family helps the child who is overweight feel less isolated and alone.

5.     If you are unsure of foods and what to serve, a wise investment is to talk to a dietician. Many physician offices have dieticians on staff. Advice and attaining more knowledge of foods can help you help your child.

6.     If your obese child suffers from social anxiety or depression, seek help from a counselor. It is much wiser to begin counseling before your child’s self-esteem is destroyed. Rebuilding an obese child’s self-esteem is much more difficult than learning healthy coping mechanisms that can comfort them so they won’t resort to using food.

Child protective services have a huge job and they do it well. There are so many children that need to be placed with foster parents in order to survive. Morbid obesity should not be a reason we need to contact CPS. Parents must get serious with their children’s health and well being. Being a parent means taking care of your child and making sure they have all they need to be healthy. If your child is overweight and struggling with health issues, begin making changes to the whole family’s lifestyle today.

I work as an intimacy and relationship counselor with urologists and internists, who often see patients due to erectile dysfunction. Frequently, I see couples who worry about erectile dysfunction when the changes they are experiencing are completely normal. Aging, stress, and intimacy conflicts can all hinder achieving an erection. Erectile drugs, such as Viagra and Cialis, have made it easy to achieve an erection; however, medications may mask a problem that shouldn’t be ignored.

Many people medicate a symptom, such as an inability to achieve an erection, before understanding the underlying problem. Medical illnesses, such as diabetes, vascular disease, or urological and neurological conditions, can also cause erectile dysfunction. Heavy smokers and drinkers may suffer extensive damage to the small blood vessels, which include those in the penis. For many men, erectile dysfunction includes a combination of physical and psychological factors. If you address your diabetes, but don’t get help with the resentment you feel toward your partner, the penis is not going to perform to your satisfaction no matter what medication you use.  Men are dating later in life and, with dating, there is pressure on performance. Sometimes it is easy to become panicked or anxious when the penis doesn’t perform up to par. Below are common worries that men have, that may be signs of aging, anxiety, stress, and intimacy conflict rather than actual erectile dysfunction.

1. You no longer get an erection just from thinking about sex or seeing your partner in a seductive pose. For men over 40, this is quite common from time to time.
2. You need direct stimulation to get erect.
3. It takes longer for you to achieve an erection (this may be more pleasing to your partner).
4. Your erection is not as hard as it was when you were a teen or in your early twenties.
5. You need more recovery time after ejaculation (this changes with each passing year), and after ejaculation your erection subsides much quicker than it did when you were younger.

The partner plays a large role for the man who worries about erectile dysfunction. Reminding him that you love him and still enjoy intimacy together helps reassure him that he is still your lover and able to please you. Complaining that “all he thinks about is sex” is not only thoughtless, but sends him the direct message that he is being silly or superficial to be so concerned about his ability to feel like a man. If your man struggles with erectile dysfunction, these three tips may help improve the situation and reassure him of your love and desire for him:

1. Encourage him to make an appointment with an urologist and offer to go with him. Sometimes men want to do this on their own and, as their partner, you should honor that.
2. Make sure you save time each day to talk with him, and begin talking about exploring new options. The fact that most couples only know how to have sex one or two ways puts more pressure on the man. If he knows there are many ways to please you and if you remain open to new ideas, it will help both of you and your relationship.
3. Stress is highly correlated with erectile dysfunction, as is obesity. Movement every day can help alleviate both of these. Begin a walking program where you walk one to two miles each day. This is also a wonderful way to converse and enjoy each other’s company.

Erectile dysfunction is a real condition, but so are aging, stress, conflict, and anxiety. A medication may help relieve the symptoms of ED, but addressing the issues behind the condition may help cure it. Sex is important; it’s healthy and it is good for the marriage. Reassuring your partner that you are a team and will work with them is part of the cure.