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Some people arrive at a diabetes appointment with results that look reasonably good and still feel as though they are barely keeping up. There are medications to remember, food decisions to make, glucose readings to interpret and appointments to attend. A device can fail at the wrong moment. A low reading can interrupt work, sleep or time with family. Even on an ordinary day, diabetes can occupy a surprising amount of mental space. When someone responds with, "But you seem fi

Some people tell the nurse immediately: "I am afraid of needles." Others smile, say nothing and cancel the blood test for the third time. They may know that the procedure will take only a few seconds. Their body does not respond as if this is a minor event. Needle fear is not unusual, and it does not look the same in everyone. Some people experience intense anxiety, with a racing heart, tense muscles and an urgent need to leave. Others have a vasovagal response, which involve

A patient makes an appointment because of knee pain, poor sleep or difficulty becoming pregnant. Within minutes, the conversation moves to weight. Sometimes weight is medically relevant. Sometimes it becomes the explanation for everything before the original concern has been properly assessed. The problem is not that clinicians should never discuss weight. The problem is how the subject is introduced, what assumptions accompany it and whether it helps answer the question that

People going through fertility treatment hear a surprising amount of advice they did not ask for. Take a holiday. Stop thinking about it. Try to stay positive. Your body needs to relax. These comments are often meant kindly. They can still leave a person with one more burden: the fear that normal distress is reducing the chance of treatment success. Fertility treatment involves waiting, repeated decisions, invasive procedures and results that can change the shape of the next

Some thoughts about the body sound so familiar that they are barely noticed. How did I let myself get like this? I have no discipline. I will start going out again when I lose weight. These statements appear to be about appearance or habits. They often carry a much larger judgement about character, competence and the right to take part in life. This is where body image and self-worth begin to overlap. Body image includes the thoughts, emotions and perceptions a person has abo