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Brad Phillips

“… diet, exercise and medications all have a role to play in weight loss”… or is there something more effective we could be doing??

Dr. Nicholas Chartres
5 min read

I recently spotted this article in The Sydney Morning Herald with the following headline “Why diet, exercise and medications all have a role to play in weight loss” 

The industrialized food industry (Coca-Cola, Nestle, McDonald’s et al.) along with the pharmaceutical drug companies that make these drugs love to read a headline such as this in our national newspapers.

In fact, they play a large role in this type of discursive framing. The industrialized food industry avoids being held accountable for causing the global obesity epidemic and the pharmaceutical industry profits from the medicalization of a condition that is preventable through strong government regulation.

As the headline suggests, this article discusses the need for new weight loss drugs to tackle obesity that have been shown to be effective in weight loss.

This article says that “the chorus of disapproval” for bringing new weight loss drugs onto the market is because people lack willpower and choose to be obese.

I strongly disagree.

As someone who has spent time working in the Metabolic and Obesity and Diabetes Unit in one of Sydney’s largest hospitals, I know (and evidence shows) that obesity is not caused by a lack of willpower. It was the main reason why I went from wanting to be a health practitioner trying to help an individual, to a researcher focused on identifying how various corporate actors like the industrialized food and pharmaceutical industries distort the science on the health harms of their products and undermine any regulatory efforts to limit their sale.

Obesity is caused by the industrialized food industry that has hijacked our food systems with Ultra Processed Foods (UPFs). Highly strategic food marketing practices coupled with biologically addictive properties of these highly affordable and available, high-calorie, nutrient-deficient UPFs mean that our willpower and innate physical and psychological mechanisms that control weight will always be overridden.

We didn’t/don’t blame an individual for being addicted to nicotine and smoking so we should not blame an individual for being addicted to these UPFs. They stimulate the same pathways in the brain. To limit the harm caused by smoking we regulated the tobacco industry.

“The chorus of disapproval” should be because pharmaceutical drugs are one of the leading causes of death with a large percentage of those who die having taken their drugs correctly. The article points to the success of the drugs in achieving weight loss in studies conducted up to 1 ½ years and their possible benefits in reducing heart disease and stroke.

But what about the long-term harms that these short-term studies can’t identify? As one of the experts points out – “we won’t know until they’ve been in use for a while”…. but the headline has already told us we need them to lose weight.

Additionally, health isn’t just about keeping weight off. If you continue to consume UPFs filled with chemicals and synthetic products, we know our risk of dying from cancerheart disease, and any causes will be higher than those who don’t. These drugs don’t change the quality of our food systems.

“The chorus of disapproval” should also be because as one of the experts highlights “people who need the help of these drugs most are often those who can least afford them”.

I recognize the urgent need for intervention for people that are obese and unable to lose weight (truly I do, with friends and family living with it), but this article exemplifies how our system of health care focuses on treatments (treatments that those that need them most can’t afford) rather than causes. Is this really what health care is?

And although both experts acknowledge the overconsumption of energy due to highly processed food and the role our genes play in us gaining weight and not being able to lose weight, nowhere in the article, however, do they say that we must regulate the food industry. Only at the bottom of the article was this one line “We also need other strategies, including a crackdown on marketing the junk food fueling obesity.”

My other main concern about an article like this is that the two experts that were quoted for this story have both received payments from the pharmaceutical company that makes the weight loss drug and this information wasn’t disclosed in the article (for one of the experts you can look this information up under the Medicines Australia “Payments to Healthcare Professionals”, for the other I searched their publications and funding).

This information is very important for the reader and should always be disclosed, especially when someone is recommending a new drug treatment.

Obesity and the health harms caused by obesity can only truly be addressed with systems-level change (so government regulation). This escalating burden of chronic disease, caused by entirely preventable lifestyle illnesses through the consumption of UPFs, along with the treatment of millions of Australians with drugs that may provide benefit without understanding the long-term harms, to me, is a health system completely broken and captured by the industrialized food and pharmaceutical industries.

While “Prevention and treatment are not the same”, how about we start with this framing first when discussing weight loss and obesity in the public domain:

  1. All clinicians, scientists, public health researchers, and consumers must advocate for regulation of the industrialized food industry, as we have with tobacco. For example – we must add graphic warning labels of breast cancer on UPFs that have been linked to such cancers; tax all sugar-sweetened beverages and UPFs that contain emulsifiers, colorings, or flavorings; ban all junk food advertising of sporting events and on television as we did with tobacco; pass legislation for subsidies that encourage farmers growing fruits, vegetables, and healthy whole foods and not farming to overproduce corn and soy used in the manufacture of UPFs.
  2. Drugs should only ever be recommended with extreme caution.
  3. If drugs are discussed publicly, explain to individuals that if you lose weight with drugs, you likely will need to keep taking the medications forever to keep the weight off and the long-term effects are unknown. All drugs have side effects and these weight loss drugs won’t improve your diet quality.
  4. Any experts that recommend the use of any pharmaceutical interventions disclose the financial conflicts of interest they have with the company that makes the drug they are recommending.

Perhaps then we will see headlines such as “Why regulating the food industry is the key to weight loss”.

Dr. Nicholas Chartres is the Associate Director of Science and Policy at the Program on Reproductive Health and the Environment, University of California, San Francisco. Dr. Chartres conducted the first in-depth study of the association of industry sponsorship and its influence on primary nutrition research. He also analyzed how the food industry attempts to drive the research agenda by funding studies that measure the effects of nutrients, and not dietary patterns, that can be used to market food products. This research has contributed to an improved understanding of how these types of biases may influence the primary research that is used in informing the recommendations made in national dietary guidelines.

Corporate Wellbeing Provider, Good Mood Dudes, Rebrands to Good Mood Group

[Sydney, NSW] – A leading provider of evidence-based workplace wellbeing solutions, has today announced it is rebranding as Good Mood Group, effective immediately.

The rebrand reflects the evolution of Good Mood Dudes, from a small team of passionate wellbeing consultants to a well-rounded solution provider with a broad-reaching panel of highly regarded health experts.

The new name, Good Mood Group, has been chosen to reflect both growth of the business and its services.

Initially a provider of nutrition-focused wellbeing solutions, the business has shifted towards a model that covers what founder Dr Nick Chartres calls, a holistic model of evidence-based workplace wellbeing. 

“While some wellbeing providers focus on supporting organisations in one or two particular areas of wellbeing, Good Mood Group is committed to providing expert-led, evidence-based solutions across a range of areas we know are critical to individual mental health and physical wellbeing including sleep, stress management, along with nutrition and exercise or movement.”  

Good Mood Group’s solutions are designed to complement initiatives that may already be in place within an organisation, such as Employee Assistance Programs (EAPs) and/or company-led wellbeing awareness initiatives and employee benefits. 

“While discounted gym memberships, step challenges and complimentary fruit definitely have their place, Good Mood Group is focused on providing a done-for-you solution – we’re a way for companies to ensure they are providing high quality, evidence-based education on areas that will influence an individual’s wellbeing. We help companies go beyond the usual employee benefits and implement a program that creates good moods – wherever you may be working from. Our new name reflects this.” said Chartres.

Good Mood Group counts several highly qualified researchers among their programme advisors, including public health experts, sleep epidemiologists, psychologists, physiotherapists, and exercise physiologists.

“We’re excited to expand on the work we’ve done with clients such as KPMG, Centuria Capital, the Zenith and others. We’ve been able to create solutions that break through misinformation and foster community, despite the new normal – a world where flexibility and working from anywhere is here to stay.”

“As an employer competing for talent, an accessible, well-rounded wellbeing solution to support evidence-based positive lifestyle choices should be a no-brainer. Not only (and it’s now well established) because it is an investment that makes a difference to the bottom line and retention, but because more good moods are important to public health – mentally-well workers are better able to support families, their community and those around them.” concludes Chartres.

The Good Mood Group website, social media pages, and other communication channels have been updated to reflect the name change. Current and future clients can continue to expect the same level of high-quality service and support from Good Mood Group.

For more information about Good Mood Group, its experts and services, visit 


Media Contact:

Dr Nick Chartres

Good Mood Group


Phone: 0403 959 502

Does Yoga Help With Low Back Pain?

Michael Ferraro
3 min read

Over the course of our lives, almost all of us will experience low back pain. And when we do, many of us will have someone telling us that we should be engaging in physical activity to relieve it.

Yoga is one of the most common forms of exercise to treat low back pain, particularly when it persists. There are many explanations for the proposed therapeutic effects of yoga – increased muscular flexibility and strength, increased physical and mental relaxation, and improved body awareness. People who do yoga to help with low back pain often report that it is helpful; but what does the science tell us?

A recently published gold standard review sought to answer this question. 

The review authors looked at all studies that compared yoga to another treatment, or no treatment at all in people with ‘chronic’ low back pain – that is, low back pain that persists for three months or more. The study aimed to determine whether yoga is beneficial for:

  1. low back pain intensity, 
  2. back-related function (things like the ability to walk or perform house chores), and 
  3. mental and physical quality of life.

A total of 21 studies were included in the review. Studies were conducted in the USA, Canada, Croatia, Germany, Sweden and Turkey and mostly investigated iyengar, hatha, or viniyoga yoga practices. Most of the study participants were women aged between 40 and 50 years.

So what did the authors find? 

Well, compared with doing nothing at all, a three-month course of yoga probably reduces low back pain and improves low back-related function. The catch is that these benefits may be too small to meaningfully change the impact low back pain has on one’s life. 

Ok, so doing yoga is a little better than doing nothing – unremarkable, I know! But is yoga better than doing other types of exercise for low back pain?

The authors concluded that there is probably little to no difference between yoga and other forms of back-specific exercises (think core training and physiotherapy rehabilitation exercises) on function. This is great news for those who don’t want to drop their sweaty Bikram class for an hour of pelvic floor exercises at the physio.

You might be one of the people that has indeed tried yoga for their back pain, but only found that it made it worse. Interestingly, exacerbation of back pain was the most commonly reported harm in these studies. The risk of an exacerbation was higher for yoga than for no yoga, but there was no difference in risk between yoga and other exercise forms. 

So, how do we make sense of this information? 

We know that exercise is beneficial for low back pain. While it seems that yoga only provides minimal benefits for low back pain, there is good reason to do it – for many people across the globe it is the only form of regular exercise they can adhere to. If yoga is not your cup of tea, there is no need to despair! Performing any form of exercise is likely to be beneficial for both your musculoskeletal and general health.

Michael Ferraro is a clinical researcher at the Centre for Pain IMPACT at Neuroscience Research Australia. 

His research is centred around the identification, development and evaluation of treatments for chronic pain, with a specific focus on rare pain conditions. You can follow Michael’s research on Google Scholar or Twitter.

Michael is part of the Good Mood Dudes network of experts available to support your wellbeing program. If you want to soundboard your wellbeing plan or hear how we’d get your program up and running, get in touch with our team for a complimentary strategy call today. 

Am I a good friend to myself?

On World Mental Health Day on 10/10/2022, the World Health Organisation (WHO) launched a campaign to “make mental health & well-being a global priority for all”, envisioning a world where mental health is “universally valued, promoted and protected”.

We have lived through very serious challenges to mental health during the past three years. The COVID-19 pandemic, major climate events, a war in Europe, and economic uncertainties have all added a series of long-term stresses to our lives. Chronic stress can undermine the mental health of many.

On World Mental Health Day, therefore, it is timely to pause and reflect on what we can do to “value, promote and protect” our own mental health, as well as the mental health of those around us.

In Australia and other economically developed nations, mental health is becoming increasingly accepted as a serious issue that needs discussion. Taboos around mental health struggles have been lifted by those who speak out about it, including famous sportspeople, actors and musicians. The positive contribution of these people to our ability to talk about mental health is immense.

So perhaps the most important thing we can do to protect our mental health is to start talking about it. Much like our physical health, mental health exists on a continuum. Sometimes we only need a little rest and support to get better, and other times we need assistance from a professional. When we feel a little more stressed or anxious than usual, turning to friends and family, someone who can listen and be present for us, can help a lot. But when we struggle with severe challenges, we need a specialist to help us get through.

Once we decide to seek help, the variety of mental health professionals available can be confusing. Where to start?

The best point of contact is your GP. Your GP can provide an initial assessment and a mental health care plan and refer you to a mental health professional supported by Medicare, usually a psychiatrist, a clinical psychologist, or a general psychologist.

What is the difference between these professions?

Psychiatrists are medical doctors who specialise and obtain further training in mental health. As such, they often use medication to treat mental health disorders. They usually see people with complex conditions that respond well to medication, such as schizophrenia or bipolar disorder (also known as manic depression).

Clinical psychologists have at least 6 years of education in psychology followed by a two-year psychology registrar program. They receive specialised training at the Master’s or PhD level in diagnosing and treating mental health conditions using a variety of psychotherapeutic techniques. Importantly, clinical psychology training programs are required to include treatments that are empirically supported: that is, several research studies have shown that the treatment works better than a placebo control condition. Clinical psychologists treat the whole range of mental health problems, but they do not prescribe medication.

General psychologists also have 6 years of education, but they have not completed a formal Master’s or PhD degree in clinical psychology. After studying psychology for 4 or 5 years at university, they usually obtain a Bachelor’s degree and further training through professional placements.

These professions are registered and regulated by the Australian Health Practitioner Regulation Agency (AHPRA), a government organisation that oversees health professionals’ training and professional standards to ensure the quality of care received by the public.

Other options to look after your mental health with the help of a professional include seeing a counsellor or a psychotherapist. In general, counsellors and psychotherapists provide services for people with problems and stresses in everyday living, rather than more serious concerns about mental health. Their services are not regulated by AHPRA, Medicare rebate is not available, and a doctor’s referral is not necessary.

‘Counsellor’ and ‘psychotherapist’ are titles that are not legally protected in Australia. This means that anybody can call themselves a counsellor or psychotherapist, irrespective of their background, level of education, or experience. If you decide to see a counsellor or psychotherapist (rather than an AHPRA-registered psychiatrist or psychologist), finding someone who is a member of one of their own accrediting associations, for example, the Psychotherapy and Counselling Federation of Australia (PACFA) would be advisable. These associations require their members to meet certain educational and professional standards. This would help to ensure that you see a person with an accepted level of education and professional experience in counselling and psychotherapy.

It’s worth mentioning that many employers provide Employee Assistance Programs (EAPs), which can include a limited number of sessions with a mental health professional. This may be with a counsellor, psychotherapist or psychologist, so it’s helpful to understand the differences.

Of course, prevention is often better than treatment, regarding both physical and mental health. There are many ways to look after our mental health, from making sure that we eat well, rest well and exercise well to nurturing or seeking out reliable, supportive, healthy social connections. A lack of social support is one of the best predictors of poor mental health in adults.

In general, however, a good way to look after our mental health is to ask ourselves whether we are our own best friend? Perhaps notice when you criticise yourself or berate yourself for a mistake, or when you tell yourself that you need to keep working even though you are running on empty.

Ask yourself: if my best friend, someone I care about and feel responsible for, were in this situation, what would I say? Would I criticise them? Would I berate them, would I push them, would I give them the same advice I am giving myself? Would I do this to my child?

If the answer is ‘no’, it is time to take notice of our self-talk and to develop an inner voice that is kinder and more understanding towards our own struggles. Becoming our own best friend is a great first step towards taking care of our mental health.


Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.

These harrowing cancer statistics can actually be good news. Wait, what?

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: These harrowing cancer statistics can actually be good news


When I first read this headline, I assumed that this article was going to discuss new government regulations on industry (alcohol in this instance), spurred by more unequivocal evidence on the already established health effects caused by harmful products like alcohol.

Instead, the story focused on what the individual can do to change their behaviour, with education being a key component of that behaviour change.

Seems reasonable, I hear you say.

Let me explain the shortcomings of this approach and why it is the narrative that the industries that produce these harmful products love to see published.

While the story points to the fact that smoking rates in Australia have dropped from 24% in 1995 to 11% in 2021, this was not done through education campaigns alone. It took an aggressive suite of regulatory measures for this to occur. These included an increase in sales taxes, a complete ban on advertising and marketing (sports advertising was one of the first to go), and the introduction of plain packaging, coupled with aggressive graphic health warnings by the Australian government.

Government action must be part of the solution.

I study the commercial determinants of health. This includes the strategies that industries like tobacco, alcohol, packaged food, and fossil fuels use to sell their products, as well as the political and economic systems that they operate within.

As economic globalization has intensified over the last two decades, these determinants of health have not only become the leading cause of disease but have also created health inequities within and across countries. For example, communities of color and low-income communities have experienced disproportionate consequences and impacts on their health due to either higher consumption rates of alcohol, tobacco, and ultra-processed foods or higher rates of exposure to toxic air pollution (due to the combustion of fossil fuels) and chemicals.

These industries use a suite of tactics aimed at preventing government regulation, which includes distorting the science on the human and planetary health effects of their products, undermining the policy process via lobbying, and shaping the narrative on their brands and products through evocative marketing and corporate social responsibility campaigns.

Now I love a beer and a pie at the footy. However, it’s vital that stories covering chronic health statistics should not be presented as a “really good news story” without being accompanied by perspectives addressing the need for government regulation to implement strategies like those mentioned above which have proven successful in tobacco control.

Without strong government action, these statistics will continue to increase, and I cannot see the silver lining in that.


Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

Understanding Burnout

After nearly three years of living with the COVID-19 pandemic and other worrying developments in the world, more and more of us feel ‘burnt out’.

But what is burnout? How is it different from being generally stressed or tired? What causes it, and how can we prevent it?

What is burnout?
The World Health Organisation defines burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. It refers specifically to experiences in the occupational context, rather than in other areas of life. Of course, if chronic stress is present in other areas of life, workplace stress will be more difficult to manage, and vice versa.

Burnout was first described by psychologist Christina Maslach and her colleagues in the 1970s. They identified this issue among professionals working in human services, such as doctors, nurses, or counsellors. Their research suggested that burnout has three distinct aspects: emotional exhaustion, depersonalization and a reduced sense of personal accomplishment.

Emotional exhaustion refers to a state of feeling overextended, constantly tired, and having a sense of depleted energy, or ‘running on empty’.

Depersonalization, which is sometimes also referred to as cynicism, is the interpersonal dimension of burnout. It is a negative, detached, insensitive, uncaring attitude to work and especially towards one’s clients.

Low personal accomplishment refers to a diminished sense of professional competence, and reduced productivity at work. The Maslach Burnout Inventory is a widely used questionnaire to assess these three aspects of burnout.

Burnout itself is not classified as a medical condition or psychological disorder. There is no ‘cut-off’ point on the questionnaire above which one can be called ‘burnt out’. Instead, high scores on a burnout questionnaire indicate that all is not well: you are exhausted, you don’t care about your clients, and you constantly feel that you are not doing a good enough job.

Burnout is associated with serious physical and psychological health conditions, such as depression, insomnia, chronic pain,
increased susceptibility to respiratory infections, gastrointestinal problems, and cardiovascular diseases.

So, if you do feel burnt out, it is time to look at the causes and to begin doing something to improve the situation.

What causes burnout?
Christina Maslach’s original research showed that burnout was most likely to develop in people who had been suffering from chronic work stress. When a stressful event occurs, the body responds with the activation of a characteristic stress response, called the fight or flight response.

During evolution, the threats we faced were usually physical. We needed to run away or face a potential predator (flight or fight). Even though nowadays we are rarely in such physical danger, our biological system still reacts with the same flight or fight response to social stress, such as an unpleasant encounter at work.

When this response is activated, both body and mind increase preparedness to deal with a potential threat. For example, blood pressure increases, breathing patterns change, blood flow increases towards the large skeletal muscles and away from the guts.

This activation reduces processes needed for rest and recuperation, such as digestion or sleep. Importantly, these bodily changes are accompanied by changes in the mind: you become more vigilant for negative information, and it becomes more likely that you interpret ambiguous information as threatening. In other words, your thinking becomes more negative.

Humans evolved to deal with short term (acute) stress very well. When the stressful event ends, the body returns to its normal state, and it can rest and recuperate. However, if stress is ongoing (chronic), that rest and recuperation can not happen. The constant activation of the stress response can eventually cause physical and psychological health problems, including burnout.

We know that several work circumstances can increase employee stress. These include:

  • unreasonable time pressure
  • an unmanageable workload
  • a lack of role clarity
  • a lack of control and autonomy
  • a lack of communication and support from managers
  • unfair treatment from managers, clients, or co-workers.

However, not everybody reacts to stressful situations the same way.

Personality traits, strongly held beliefs and values, and certain thinking patterns can contribute as well. For example, people who are highly perfectionistic tend to experience more stress, which can then lead to burnout. Strong individual values placed on achievement can also cost personal wellbeing if they are not balanced with a sense of self-care and compassion. Sometimes underlying such tendencies for perfectionism and high achievement orientation is a deep-seated feeling that something is about to go wrong, and one needs to be constantly in control to stave off disaster – even if the nature of that disaster is not always clear in your mind.

What can we do about it?
As most of us are already aware, to avoid burnout, we must reduce chronic stress or manage stressful situations better. If the workplace is open to creating a healthier work environment, talking to a supervisor may solve the problem. Simple self-care strategies, like eating a healthy diet, getting enough exercise, social support, improving your sleep quality, and regular breaks from work may also help to fend off the effects of high-stress jobs. Sometimes a change of position or job is an option.

However, such strategies are often ineffective if one’s personality, beliefs or thinking are at least partially responsible for a tendency towards experiencing chronic stress. No amount of fresh green vegetables and lavender oil will solve the problem for a person whose thinking is habitually negative or self-critical, who keeps putting others’ needs ahead of their own, or who has difficulty relaxing control over minor aspects of life.

If you are that kind of person, start watching your thinking and asking yourself whether a healthier thinking pattern would also be helpful. It is hard work, but it is possible to change our thinking.

If you are experiencing chronic stress or burnout and you’re having difficulty finding your way out, it may be a good idea to seek professional support. Talking to a mental health professional can help clarify the problem and identify strategies to solve it. You deserve to feel your best.

References and further reading

  1. World Health Organization. (2019). ICD-11: International classification of diseases (11th revision).
  2. Maslach, C. and Jackson, S.E. (1981), The measurement of experienced burnout. Journal of Organizational Behavior, 2, 99-113. (full text)
  3. Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. (2017) Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 12(10):e0185781. doi: 10.1371/journal.pone.0185781. (full text)
  4. Renzo B, Guadalupe MG, Jean-Pierre R. (2021). Is burnout primarily linked to work-situated factors? a relative weight analytic study. Frontiers in Psychology, 11. (full text)

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.  

Do I have adult ADHD?

Until recently, Attention Deficit Hyperactivity Disorder (ADHD) has been considered primarily a childhood disorder, with only a minority of children continuing to have symptoms in adulthood. A surge in adult ADHD diagnoses occurred in recent years after changes to the diagnostic system made it easier to detect ADHD in adults. This increase has been accompanied by a lot of media
interest, with #ADHD trending on TikTok and other social media platforms as well.

Many people may have now encountered messages such as this:

  • Are you someone who can focus on some projects or activities so intensely that you completely lose touch with time?
  • At the same time, are you also a person who keeps forgetting appointments, can’t pay bills on time, is always late, can’t get organized, and can’t concentrate on unexciting projects, despite your best efforts?
  • Have you often wondered why you find “adulting” so difficult?

If you answered yes to these questions, you may have adult ADHD.

As usual, however, the story is more complicated.

How is ADHD diagnosed in adults?

What are the symptoms?

The diagnostic criteria for ADHD are essentially the same for adults and children. The current diagnostic manual lists 9 symptoms of inattention and 9 symptoms of hyperactivity. Children need to report 6 out of the 9 symptoms of either inattention or hyperactivity to receive a diagnosis of ADHD. Adults need to report only 5 out of the 9 symptoms in either group.

An example of an inattention symptom is “Often fails to give close attention to details or makes careless mistakes at school, work, or during other activities (e.g., overlooks or misses details, work is inaccurate”.

An example of a hyperactivity symptom is “Often blurts out an answer before a question has been completed (e.g., completes people’s sentences, can not wait for turn in conversation).” (DSM-5, APA, 2013)

Adults and females of all ages are more likely to have inattention, rather than hyperactivity symptoms.

However, saying ‘yes’ to 5 or more symptoms is not enough for a diagnosis. To have a clear picture, we need to ask further questions.

Do these symptoms interfere with important life functions?

We all become inattentive, unfocused, forgetful, or impatient sometimes. To receive a diagnosis of ADHD, the symptoms need to directly cause serious problems in the person’s life. For example, do these symptoms result in lower achievements at work or in education? Do they increase social and family problems? Could they be responsible for accident proneness, legal difficulties, or substance misuse in the person’s life?

Do the symptoms occur in several different situations?

If a person is hyperactive or inattentive in some situations (e.g., at work) but not in others (e.g. with friends or family), it is possible that the situation itself is responsible for the problem, not the person.

However, people are not always aware of the problems that their symptoms cause. It can be helpful to consult others in different settings (e.g., friends, spouses, co-workers) to find out whether they see any substantial, ongoing signs of inattention or hyperactivity in those settings.

Have the symptoms been present before age 12?

ADHD is a neurodevelopmental disorder. Therefore, it must have already been present in childhood. Because recall of childhood memories tends to be unreliable, it is important to consider family history very carefully and to find informants or school records to confirm that ADHD caused problems in several different settings (school, home, social situations) before age 12.

Is there an alternative explanation for these symptoms?

This question is perhaps the most important, but also the most difficult to answer.

Sometimes apparent symptoms of ADHD are better explained by another psychological condition or disorder. This other condition may have been with you since childhood. For example, anxiety, stress, depression, and adverse childhood experiences (i.e., family discord, mental health or substance use problems in the family, emotional or physical abuse or neglect of a child) can all cause attention and concentration problems, forgetfulness, impatience and impulsivity both in adults and in children. In those cases, a diagnosis of ADHD would not be helpful, and could in fact be harmful.

Only a very careful clinical assessment can disentangle the cause-and-effect relationships among these symptoms and disorders.

In summary

Symptoms need to be understood in the wider context of the person’s life, rather than just being a shopping list of items to be ticked off. Mental health professionals following best practice guidelines take a very thorough family history and, if possible, seek information from family, friends, significant others, and previous written records (with the client’s informed consent, of course). Therefore, establishing a diagnosis of ADHD with some certainty can be a lengthy and difficult process.

If you think that you have symptoms of ADHD

Don’t jump to conclusions. You may want to start with a well-validated screening questionnaire, such as this. Consider if your symptoms have been present since childhood and whether they are possibly better explained by other problems, such as anxiety, depression, stress, or adverse childhood experiences.

If you think that your experiences fit the diagnosis of ADHD, seek a full assessment from a clinical psychologist or a psychiatrist. Ideally, your mental health professional will follow best practice guidelines to make sure that they do not miss a diagnosis of ADHD, but also that they do not diagnose ADHD when the problems stem from alternative causes, such as anxiety, depression, stress, or early trauma.

Because the most effective treatment for ADHD is stimulant medication, we need to exercise extra caution about potential misdiagnoses. The prescription of stimulants for adults who do not in fact have ADHD can have many far-reaching consequences for the person and society.


References and further reading


Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.  

About those five serves of veg a day you’re not eating

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: About those five serves of veg a day you’re not eating


If you’re eating your 5 & 2 each day you’re in the minority in Australia.

But before you beat yourself up, Dr Nicholas Chartres, who conducted the first in-depth study on how industry sponsorship influences nutrition research, and is an expert in identifying and analyzing industry influence in the research process, encourages us to consider the role of government and ‘Big Food’ in all of this.

Here are his 3 takeaways from this story:

– ~6% of Australian adults and ~9% of children eat the recommended two serves of fruit and five serves of vegetables per day. This is actually up from 5.1% in 2014/15 and 4.2% in 2011-12.
– Affordability of buying vegetables is the single greatest barrier to consuming them (despite the unequivocal evidence that the more of them we eat, the lower our risk of dying a premature death from things like heart disease).
– “We need to move away from blaming the individual”.

So, the simple solution??

The government could subsidize farmers/primary producers to reduce the price of fruits and vegetable to consumers, increase their availability and in theory increase consumption (although removing the highly processed foods from our shopping aisles would also need to be addressed, I think to see meaningful change in consumption patterns of fruits and vegetables).

This would then lead to reductions in non-communicable disease risk and early dying, therefore significantly reducing our health care spending without any additional government spending. How?

The government could offset these subsidies by taxing ‘Big Food’ – the companies that reap millions of dollars from making our children sick with highly processed food commodities, that offer no nutritional value and are ubiquitous in our food systems and environment (think sugar-sweetened beverages – which have been taxed successfully in several countries of the world, leading to reduced consumption patterns).

Sounds simple, right?? Why isn’t it happening here?

It is due to the structural influence (economic and political) ‘Big Food’ has on our decision-makers.

However, there is hope. The Australian government led international efforts for cigarette plain packaging and a tobacco tax, which were successful in reducing smoking prevalence. And since obesity has overtaken smoking as the leading cause of premature death and illness in Australia, I think it’s time for government action.


Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

The US supreme court has declared war on the Earth’s future

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: The US supreme court has declared war on the Earth’s future 


As an academic working in US environmental science policy, and a father of three children, I was deeply concerned by the Supreme Court of the United States (SCOTUS) opinion in West Virginia vs. EPA that will significantly weaken the US Environmental Protection Agency’s (US EPA) authority to regulate carbon dioxide emissions from power plants (the second-largest source of planet-warming pollution). Let me explain why.

The Case

The original case is about the Clean Power Plan that sought to combat climate change by capping carbon pollution from power plants, a rule developed during the Obama administration. That would have allowed US EPA to use the most effective regulatory tools to address greenhouse gas emissions from power plants – a shift from coal to energy sources that produce fewer emissions. However, in an unprecedented action, the plan was put on hold in 2016 due to pressure from the coal industry.

Congress granted US EPA authority to regulate toxic pollutants through laws like the Clean Air Act (CAA) and Clean Water Act (CWA), which have led to vast improvements in the air and water quality in the US. Such authorities granted by Congress are critical as it gives an expert agency like US EPA the power to address significant and quickly evolving environmental health issues, as and when they arise.

SCOTUS was called to rule on whether the CAA allows US EPA to issue nationwide regulations over the power sector or if the Agency should be limited to regulating changes at individual power plants.

The Court Ruling

In a 6-3 opinion, consisting of the recent conservative Justice appointments made under the Trump Administration, SCOTUS sided with West Virginia and the coal industry in adopting a narrow interpretation of the CAA and rejected the idea that US EPA has the authority to regulate greenhouse gas (GHG) emissions.

SCOTUS ruled that if Congress wanted to give an administrative agency (like EPA) the power to make “decisions of vast economic and political significance,” it must explicitly state this. It did so by applying a doctrine it enshrined into the case law, the “major questions doctrine”. So if the court thinks an agency is overreaching in future cases it can strike down any manner of policies. This reasoning is a concerning departure from traditionally held deference to federal agencies to regulate and develop rules based on their expertise.

In the dissent, Justice Elena Kagan writes “Whatever else this Court may know about, it does not have a clue about how to address climate change…The Court appoints itself—instead of Congress or the expert agency—the decision-maker on climate policy. I cannot think of many things more frightening.”

Why I am so concerned

The precedence this ruling sets is deeply concerning as certain rulemakings across federal agencies like US EPA (along with the financial sector, health care and others) will now need to rely on clear legislative authority to withstand legal challenges, but with a narrowly divided House and Senate, which is in gridlock, these actions seem unlikely.

The most troubling thing for my children and others is that to cut GHG emissions by 50% by 2030 to prevent the catastrophic effects of climate change, we need the US government to have every policy tool at its disposal. Historically they have been the largest contributor to GHG in our atmosphere, and they are now number two only to China. So what they do really matters. This SCOTUS decision now takes one of the most important tools away and has the potential to undermine all federal authority and agency power.

Finally, this damaging court decision once again makes clear the importance of efforts to expose industry tactics and influence on the judicial, executive, and legislative branches of government.


Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

Expert Q&A: Introducing Dr Nick Chartres

1) Could you tell us a little about your career and areas of expertise/interest? 

I currently work in science policy in the United States. I work on environmental health research translation methods and the promotion of evidence-based federal policies to prevent exposures to harmful environmental chemicals.

A lot of my work is monitoring, evaluating and commenting on how the US Environmental Protection Agency regulates chemicals to ensure that they are consistent with the best scientific methods. Think of it like auditing. I look at whether an evaluation of a body of evidence examining a chemical, like asbestos, with a health outcome like cancer, is done accurately. I want to make sure there is no underestimation in the true risk posed by the chemical. This all sounds very esoteric, so why is this important? 

Adopting scientific methods that accurately capture risks is critical to protecting health, particularly for marginalised communities, such as fenceline (a neighbourhood that is immediately adjacent to a company and is directly affected by the noise, odours, chemical emissions, traffic, parking, and operations of the company. Historically, polluting facilities have often been built in or near African American communities) and communities of colour that can face the highest exposures to toxic chemicals and pollutants.

Currently, every year, there’s about 15,000 kgs of chemicals produced for every person in the U.S. and many of these chemicals are persistent and bioaccumulative (so they never break down and just keep piling up in our water, soil and air) and end up in people, who are vulnerable and disproportionately exposed. Our studies have found ubiquitous exposure of pregnant women to more than 43 different industrial chemicals, many with serious health hazards. Babies are born with chemicals in their bodies, and our studies have also found significant links between prenatal exposures and health harms to children like loss of IQ. Leukemia in children has increased by ~40% over the last few decades. I have children and this worries me deeply. 

My other key area of work is examining bias, both methodological and financial conflicts of interest, in research. We know that in multiple areas of research that the presence of industry sponsorship leads to more favourable study outcomes towards the study sponsor, than those without industry sponsorship. So again, why is this important? Well, if the study results we use in things like the dietary guidelines are biased due to food industry sponsorship, then the recommendations that are made may not be valid. So I study this and work on strategies to try minimise its influence in research. I conducted the first in-depth study examining the association between industry sponsorship with the outcomes of primary nutrition research. 


2) What drew you to this line of work/research in the first place? 

I have a really deep interest in public health. I have had a privileged life and upbringing so I’m particularly interested in protecting marginalised communities that don’t have access to the same level of health I do. The corporate strategies that industries use to sell products that are harmful to the public’s health, like processed foods, tobacco, chemicals, fossil fuels and alcohol all disproportionately impact low income, indigenous and communities of colour. The products these industries produce are causing the global increase in non communicable diseases and death. The Global Burden of Disease estimates that approximately a third of deaths worldwide are attributable to behavioural risk factors that, at their core, have the consumption of unhealthful products and exposures produced by profit driven commercial entities.

A basic human right is that everyone’s children can grow up in a world that is toxic free, with access to a healthy food system. Unfortunately for 90% of the world that isn’t the case. So I’m interested in trying to make it more equitable. 


3) How do you look after your own physical and mental wellbeing?

The $64,000 Question… I’ve always had a pretty good relationship with food and exercise. If I don’t do something physical every morning before work my brain doesn’t work. I’ve always loved meat but as I have gotten older, the more plants I eat, the better I feel. I want to sleep more because that’s when I’m happiest and smartest but it’s not always possible. I try to play with my kids everyday, I’m not good at mindfulness but they make me mindful. I love drinking beer after work on a Thursday (the new Friday since having kids) or Friday night. 


4) Do you have a favourite post-workout cafe?

Ha. Yes, my kitchen. I exercise in my garage or go for a run from home so this is where I end up. In San Francisco there’s one place I get a coffee sometimes on a Saturday morning called the Roastery, which is super cool and old school. It has these huge hessian bags of the different coffee beans in the shop, so when you walk in the smell just smacks you. Magic.


5) What is one thing you wish people knew about wellbeing? 

That human connection and relationships are the most important thing to a healthy life (although I’m sure many people know this). I think being part of a community, contributing to that community and staying active is critical to anyone’s wellbeing. That’s a partly scientific answer and part anecdotal. Also just eat as many plants as you can. Buy a good recipe book and learn how to make them tasty for you and your kids. You will live much longer if you do.


6) What is one of the most ridiculous things you’ve read or seen about wellbeing that you know to be untrue? 

Ha. Other than the Ab Cruncher 2000 (I made that name up but you get the idea) that could melt stomach fat away in only 6 minutes a day! I see bad science everyday in my work. Going back to my work in nutrition I think the most ridiculous thing is that a lot of the food industry, especially Coca Cola have tried to frame the obesity epidemic around a lack of exercise as being the main determinant and not their highly processed food commodities.

They’ve spent a lot of money on funding research, researchers and developing marketing campaigns to confuse the public and persuade policy makers. If we removed highly processed food commodities from our food systems, or regulated their production, we would significantly reduce the number of people that die from diseases related to obesity. The economic impact and thus relief on our health care spending would be astronomical.


7) Do you have any favourite books, podcasts or websites on health or wellbeing that you’d recommend?

Marion Nestle Food Politics

Gyorgy Scrinis Nutritionism

Good Mood Dudes Podcast


8) What is your top tip for living a healthy and happy life? 

Probably the same as number 5. Being connected with a community and having a purpose (maybe that’s a little too existential for this question!). And eating lots of fruits and vegetables everyday.


See some of Nick’s published research here.