In her Jpost column Uncommon Sense, Geulah responded to readers’ letters.

My 42-year-old husband was always healthy, though a bit chubby. Recently, blood tests connected to a stubborn fungus showed high levels of cholesterol and blood sugar. Our family doctor referred him to an endocrinologist, who in turn sent him to a dietician. The three made it clear that he must follow a strict regimen of regular mealtimes, nutritional balance, exercise, blood test s and medication. To my great chagrin, he is not complying. He’s not stupid, and completely understands that he is imperiling both the length and the quality of his life.

Why is he behaving this way? How can I change matters?

— Worried Wife —

Dear Worried ,

It sounds like your husband has NIDDM (non-insulin-dependent diabetes, once called “Type II”). Many people with this illness, which is less severe than “Type I” (“juvenile” or insulin-dependent diabetes), feel quite well during the initial years, making it easy for them to “forget” how important it is to adhere to physicians’ instructions in order to continue feeling well. However, in the long run, this carelessness can lead to vascular and renal (kidney) problems, recalcitrant infections, neurological damage, impotence, gangrene in feet and legs and even blindness. Since your husband is well aware of the risks, why he is ignoring medical advice?

First of all, the task he faces is very difficult — rapidly changing longstanding habits and resisting temptations. The boundaries aren’t always clear. For example, people who must give up smoking know that there is no such thing as a permitted cigarette, that every single puff is a “sin”. In contrast, dieters must eat, and it is very easy to slip into self-deception (“yesterday I didn’t eat much, so today it’s okay to have more margarine”; “there really isn’t much difference between a teaspoon and a tablespoon”).

Second, the very act of compliance with a medical regimen forces your husband to face, four or five times a day, the unpleasant fact that “Yesterday I was healthy and free. Today, and forever, I am ill and enslaved to a body that has betrayed me”. Ignoring doctors’ orders lets your husband forget, for a few hours, the disagreeable major changes in his life and his identity (“sick” instead of “healthy”).

At the practical level, you and the rest of the family can help by keeping out of the house “forbidden” foods that he finds irresistible. You might be able to exercise together (walking or swimming will probably benefit you too!). It is also important to let him know that health-status is only a small part of his identity. This is a great opportunity to tell and show him how much you value him, and why.

However, in the final analysis, responsibility for his health is HIS. If there is no improvement in his compliance with his regimen, counseling should be considered. There is no shame in needing psychological help. Your husband is having a normal reaction to an abnormal situation. Sensitive therapy can shorten and improve his adjustment to his new circumstances.