My wife has not been well for a couple years.  She has had kidney problems, gall bladder problems, -she has problems with her intestines, and she has woman problems. She is overweight but only 10 to 20 pounds. She still wishes to lose weight so she just doesn't eat all day until dinner. Meanwhile she drinks coffee all day and wine in the evening and she smokes.  Does not seem to want to improve her health but prefers to live just as she wishes, even though she might spend the night physically sick.  It is impossible for me to say anything and if I do it probably will have an even more negative reaction so I do nothing and say nothing these days just hoping she will change. What can I do to help her?

Marvin (Name changed to protect privacy)

Dear Marvin

Although your wife is having many physical symptoms, the fact that she is doing nothing to help herself indicates a deeper issue. I am not qualified to diagnose anyone, but my sense is that she is depressed. Our moods and brain functions are dependant on bio-chemical processes, and we must feed our bodies a good balanced diet in order to function properly. Your wife’s lifestyle habits are sinking her more deeply into a depressed state, but this is a symptom and not the cause.  She is not taking care of herself and no amount of nagging from you will change that. She needs to be evaluated by her doctor and she needs to want to help herself.

Lorna