When losing weight means losing something else...

I admit it - I try to keep slim. But I still worry about the relentless emphasis on calorie counting that fills whole column yards in the media.

That's not only because too much emphasis on diet is counterproductive; time and again it's been proven that simply eating when you are hungry and stopping when you are full is the best way to keep weight under control. My worry about the calorie counting brigade is also because I am firmly convinced that most eating problems are underpinned by some sort of emotional element.

Personally, I'm convinced by my own behaviour - quite simply if I'm under stress I mysteriously find myself opening the fridge door... for the seventh time that evening.

Professionally, I'm convinced by the behaviour of my readers - who in letter after letter reveal to me just how closely their weight is linked with their emotional state.

Scenario number one: eating for confidence. Low self-esteem, relationship abuse, under-achievement women in particular fill the low confidence hole in their lives by filling their mouths with food. If they feel good about themselves, the pounds drop off.

Scenario number two: eating for protection. If a woman feels vulnerable around others, particularly around men, she eats to gain weight and make herself feel invisible. If she starts to feel more in control of her relationships and her life, she doesn't need to be weighty.

Scenario number three: eating for anaesthetisation. If a woman is furious - or grief stricken, or afraid - and she doesn't want to show her fury or grief at those she loves, then she may eat to dull the sensations. Resolve the anger or the mourning and she won't need to over-consume.

Lesson here, for all of us. Next time you open the fridge door, ask yourself if it's really food you want. Or is it a confidence boost... an increased sense of control... comfort... a good cry... or permission to protest something bad that is happening in your life. Simply close the fridge door and go for it direct.

Fantasy - good idea or bad girl?

I was recently asked to write a few hundred words for a very lovely erotica magazine on the topic of sexual fantasy. Of course I obliged - writing not so much about my own mental exploits (yes, I admit it, I do...) but about the fact that my readers often confide anxiously in me about their fantasies. What they angst about, typically, is whether, in the grand scheme of things, fantasy is normal, whether fantasising is bad, and whether one should worry if one fantasises about someone other than one's partner.

To which the answers are, respectively, yes, no and maybe.

Let's take those answers one by one. Yes, fantasy is normal. Almost 100% of men and nearly the same number of women have had a sexual fantasy - so if you're out there and you are dreaming, you are not alone.

And no, fantasy does not mean you are bad - or mad, or sad. Contrary to the myths, it's those with a healthy sexual appetite and repertoire who do it, not the No-Mates. More, those who fantasise are likely to have more orgasms and a much better sex life than those who don't - so, everything to celebrate. Equally, fantasising about something doesn't mean you're going to action it. Typically we dream about things, places and people that are out of our reach, impractical or just plain unwise; we dream instead of doing not as a prelude to it. So, nothing to fret about.

My only caveat - and it's a tiny one - is about whether fantasising when you're partnered means there's something wrong with your partnership. And here, it all depends on exactly who you're dreaming of... the nearer to home the fantasy, the more you ought to be on full alert. So think of your favourite celeb sweeping you off your feet and there's no problem. Find yourself floating away on a dream of your partner's best friend - who, come to think of it, has hinted pretty strongly that they'd be up for some action - and you may want to stop and decide whether you want to go that route.

But otherwise, to my mind, fantasy is a total gift and allowing your mind to wander in a sensuous direction something to be done with eagerness, application - and absolutely no guilt.

Life saving advice....

Went to (and presented at) a fascinating conference over the weekend courtesy of the Primary Care Sexual Dysfunction Society. In short, medics at the front line of British health care (general practitioners, practice nurses, therapists) often have to deal with sexual issues raised by their patients - PCSDS is an organisation to provide them with information, support and general networking.

Founded by Manchester GP Mike Callender the organisation holds its conference annually in the spring and - more or less annually - calls on me to cover what can only be described as the 'cuddly' side of the business. Perhaps a presentation on how male erectile dysfunction impacts on women partners. Perhaps a few guidelines on how to best support patients who are struggling with emotional issues. Feelings, relationships, counselling... you get the idea.

This year my contribution was twofold. First, a Cook's Tour of the psychological side of women's sexual problems, done as a two-hander with lovely Nottingham-based therapist Angela Gregory. Then - again with Angela - a debate on whether the G spot is important to women's pleasure. In between times, the medics took over, with discussions on cardiac sexology, contraceptive options, and whether one should support - or discourage - patients who want to buy their little blue pill over the Internet.

On one level, of course, all this is deeply strange. Surely everyone can see the slightly weird side of sitting in a Leicestershire business hotel on a sunny Saturday afternoon discussing whether it is advisable to investigate a male patient's sexual problems by sticking a finger up his bum - to check for prostate conditions, I hasten to add.

On the other hand, all this is also deeply important. The passion shown by all present to solving their patient's sexual problems as quickly, efficiently and supportively as possible was wonderful. The commitment displayed to giving the best possible service and generally getting it right was stunning.

Plus, I came away with one literally life-saving nugget - courtesy of Professor Graham Jackson - which I would encourage all readers of this blog to take on board for themselves if they are male (or for their male partners if they are female). It is this. There seems to be a direct link between a man's developing erectile dysfunction and his developing - an average of three years later - the sort of heart condition that results in a quick and fatal heart attack. And - this bit's vital - that link exists whether or not the man has had any worrying cardiac symptoms. Erectile dysfunction is - in the most literal sense of the words - an early warning system.

In other words, if he can't get it up - and that fact isn't linked to a night on the ale or a previously diagnosed medical problem - he should proceed immediately to his GP and get his cardia health checked out. Don't delay. This piece of information, courtesy of the PCSDS, could save a life...

Is my partner going off me?

I get asked this question so often. A reader spots that something is different at home - perhaps their partner is quieter, more withdrawn, or less sexual. And though these signs are often more indicative of an external problem - worries about work, lack of selfconfidence, depression - it could well be that something's wrong.

Here are five key checks if you suspect failing love:

1: Does your partner still remember your first days and weeks together with joy?
A partner who's falling out of love will 're-remember' the early days as being sad or spoiled. If when you talk about when you met there's regret or disillusionment in his (or her) reaction, then there's a problem. If his face still lights up, it's unlikely that there's real difficulty.

2: Does your partner still welcome affectionate physical contact?
Lacking desire or sexual feeling can be down to stress, tiredness or depression - but even when a partner feels like that, a nonsexual hug can still be welcomed. A partner who can't welcome it is usually feeling bad about the relationship.

3: Does your partner talk positively about you to others?
A disillusioned partner often can't express negative feelings directly - it'd be too threatening. Instead, she ( or he) often complains to friends and family - and if he does it in a joking way, there's often an edge behind the joke. If you spot this happening, then it's time to talk.

4: Does your partner still speak enthusiastically about a future together?
If the two of you can look ahead and make plans together - and genuinely welcome those plans - then however stressed you are right now, there's nothing seriously wrong. If when you try to talk about the future, he slides off the point, start worrying.

5: Does your partner still want to please you and make you happy?
If so, there's unlikely to be real problems. But if she blocks your wishes, fights you at every turn, simply doesn't want to give you what you want, then the goodwill has gone from your relationship and something's wrong.

What to do?
First and foremost, think carefully whether any of these bad signs could be otherwise explained. A partner who's lost his job, is recently bereaved or is worried about the children - could well be withdrawn. But when the problem's resolved itself, they'll come back into balance.

Second, talk about it. Simply asking what's wrong - and listening to the answer - can often sort the problem out.

Third, consider counselling. Even if your partner is unwilling to go, you can get support and guidance by seeing a counsellor. If you are in Britain, log on to www.relate.org.uk. If elsewhere in the world, ask your physician for a list of recommended counsellors.