Also called: IBS, Irritable colon

Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel habits. Some people with the disorder also have constipation or diarrhea.  Although IBS can cause a great deal of discomfort, it does not harm the intestines.

IBS is a common disorder and happens more often in women than men. No one knows the exact cause of IBS. There is no specific test for IBS. However, your doctor may run tests to be sure you don't have other diseases. These tests may include stool sampling, blood tests and x-rays. Your doctor may also do a test called a sigmoidoscopy or colonoscopy. Most people diagnosed with IBS can control their symptoms with diet, stress management and medicine.

Source:  http://www.nlm.nih.gov/medlineplus/irritablebowelsyndrome.html

Information

Irritable Bowel Syndrome   Information from MedlinePlus including overviews, diagnosis/symptoms, treatment, alternative therapy, nutrition, clinical trials, directories, and more.

Tools

Interactive Health Tutorial

Latest News

Irritable Bowel Syndrome Patients' Families More Prone to Symptoms Too(03/30/2010, Reuters Health)

Shift Work Linked to Irritable Bowel Syndrome(03/26/2010, HealthDay)

Health Tip: Symptoms of Irritable Bowel Syndrome(03/19/2010, HealthDay)

More News on Irritable Bowel Syndrome

More Information:

American Gastroenterological Association
International Foundation for Functional Gastrointestinal Disorders
National Digestive Diseases Information Clearinghouse (NDDIC)

If you would like more information, please contact a Lake Health Professional Librarian

Diaphragmatic breathing is a process that helps people improve their ability to focus their attention on their bodies. It involves breathing from your diaphragm instead of your chest. Your diaphragm is the muscle located just below your ribs. Breathing from the diaphragm involves slow deep breaths where the diaphragm actually pulls and pushes air in and out of the lungs. Breathing from the diaphragm promotes relaxation in the body as opposed to the shallow, rapid and tense breathing that occurs in the chest when you are anxious.

Relaxation methods enable you to effectively reduce both your mental anxiety and its physical signs. As you become more relaxed, you will be able to listen better to important things you want to say to yourself regarding your health. Relaxation is a self-control technique; you are in control of your level of relaxation. Like any skill, the more you practice, the better able you will become to relax more fully and in less ideal places.

Not only does this type of breathing make relaxation on a physical level much easier to achieve, it is also more efficient and subsequently increases the oxygen supply to the heart, brain, and other organs. By using this type of breathing you can reduce your stress, reduce anxiety and improve your mental and physical well being. Practice the following exercise on a regular basis until you are able to effectively use this breathing technique as needed, particularly when you're under stressful circumstances.

1. To begin the exercise, find a comfortable chair in a quiet room.
2. Place your hand on your abdomen below your rib cage. This where your diaphragm is located.
3. Concentrate on your breathing, taking slow, deep breaths. Breathe through your nose, inhale, and hold it.
4. Exhale slowly. You should be able to feel your stomach moving out when you inhale and in when you exhale.
5. Focus on your belly as it expands like a balloon when you inhale and deflates when you exhale.
6. Repeat several deep breaths. After you inhale, hesitate for a moment, and then slowly exhale.
7. Remember to slowly but deeply inhale and slowly but evenly exhale.
8. Avoid rapid, quick breath. This can lead to hyperventilation.
9. As you slowly blow all of the air out of your lungs, image all of the tension leaving.
10. Pause, and repeat this deep breathing until it has become a slow comfortable rhythm.
11. As you concentrate on slowing down your breathing, let your body sink into your comfortable chair. Notice how relaxed your arms feel against the chair; so do your legs, your back, and your neck. Notice that your breathing is slow, deep and regular. With each breath, you are becoming more relaxed and the tension is slowly fading.
12. You may wish to combine some imagery and positive self-statements with the breathing exercises. For example, when you exhale, imagine letting all of the tension in your body go with the breath; imagine that when you inhale, you are taking in energy and feeling stronger with every breath.          

National Strength and Conditioning Association Position Statements

Health Aspects of Resistance Exercise and Training

http://www.nsca-lift.org/publications/health aspects of resistance training.pdf

Youth Resistance Training

 http://www.nsca-lift.org/youthpositionpaper/Youth_Pos_Paper_200902.pdf

Basic Guidelines for the Resistance Training of Athletes

http://www.nsca-lift.org/publications/Basic guidelines for the resistance training of athletes.pdf

Explosive/ Plyometric Exercises

http://www.nsca-lift.org/publications/PLYOforWeb.pdf

The Squat Exercise in Athletic Conditioning

http://www.nsca-lift.org/publications/SQTforWeb.pdf

Introduction:

This on-going blog will provide a basic understanding for anyone who is interested in developing a sound strength and conditioning program to enhance their athletic performance. It is my goal to provide information to all levels of athletic individuals. This blog will give you an edge to help you succeed in your athletic accomplishments.

Keep in mind, even if you have no experience working out in a gym or at home you can still develop an effective training program.  Age does play a role in performance ability, but performance can improve with a proper strength and conditioning program and dedication.

Remember, there are no shortcuts or magic supplements. Please don’t be mislead by companies who guarantee false health benefits, such as, "This advanced dietary-fat inhibitor helps block the absorption of fat calories" or "Take 3 capsules before bedtime. Watch the fat disappear!"  Products that are not FDA regulated are not supported by reliable scientific evidence. Visit the FDA website for a list of distributors receiving warning letters:  http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/ComplianceEnforcement/ucm188136.htm

More information to come……

The patient in front of me is Mr. C, a 308 pound man who has been sent by one of my favorite referring doctors.  This doctor truly cares about the health of his patients and it shows.  In fact, Mr. C’s physician is a triathlete, eats for health and practices what he preaches.  He’s never been overweight.   His clients are devoted to him and Mr. C is no exception.  But Mr. C. is worried.  He genuinely wants to lose weight but the doctor he so much wants to please has told him that he needs to reach 170 pounds: the white or “healthy” zone of the BMI chart.  “Doc,” he says earnestly, “Is that possible? I’ve never been that light, not even in high school.”

With the advent of the internet, interactive tools like BMI calculators have become familiar to dieters.  Twenty years ago, BMI was part of the foreign language of doctors.  The measurement was recorded on the chart and remained obscure for patients.   Today, nearly every dieter understands, (and sometimes obsesses about), his or her niche on the BMI chart. 

BMI, or Body Mass Index, is shorthand that describes the relationship between your body height and weight.  The measurement first saw the light of day in the mid 1800s, invented by a scientist named Adolphe Quetelet.  In order to compare people’s masses, Quetelet proposed a method which divided weight by height squared.   Current BMI figures are still based on the same equation:  weight in kilograms/ height in meters squared. Today, high BMIs denote overweight and obesity, with the cut-offs being as follows:  BMI of 25 or less =normal, BMI of 25 to 30=overweight, BMI of 30 to 35= obesity, BMI of 35 or greater= morbid obesity.  On many BMI charts, the obese weights are colored red, the overweight weights yellow and the normal weights white.   (You can find a typical BMI chart on my practice website at www.weightmp.com).

Because BMI looks at weight without distinguishing whether it is coming from fat, bone, or muscle, people with denser bone structure or those with large muscles masses can have high BMIs.   I am frequently asked by patients whether a weight that increases or fails to drop might be coming from a new muscle-building gym regimen.  Alas, the answer is generally no.  Unless you are built like Dwight Howard or Arnold Schwarzenegger, the amount of muscle you gain in the average gym is not causing your BMI to rise.  This is especially true for women, who can get great toning and definition from lifting, but are generally not capable of building large amounts of new muscle mass.

However, the major problem with BMI is not that it is inaccurate for the Greek gods among us.  The major problem is in its low end, where it sets the bar for “normal”. The BMI chart, with its white, yellow and red sections shouts unequivocally that certain weights are unhealthy. These arbitrary divisions are at odds with the advice that obesity societies routinely give patients:  that weight loss of 5-10% of current poundage can greatly reduce medical risk.  So which is it? Do we need to lose just a bit or do we need to get ourselves all the way to the Promised Land….the white zone???

In my book, Refuse to Regain, I reference the work of Dr. Walter Willett of Harvard’s School of Public Health. Dr. Willett has been in charge of the comprehensive Nurse’s Health Study for some years, a study which shows that the risk of diabetes, hypertension, gallbladder, and coronary artery disease starts to rise at BMIs that are far below the 25 we consider “just overweight.”  Dr. Willett has said that this data was known, but ignored when committees set the “normal” cutoff for BMI.  He believes that the reason is simple.  If normal BMI were lowered to somewhere around 22, the vast majority of America would be classified as overweight. 

While Dr. Willett is one my dietary and medical heroes, I have a somewhat different take on BMI.   Yes, we know that weight gain impacts our health negatively.  We know that even small amounts of weight gain put us at risk.  But what happens once the horse is out of the barn?  Once we have gained that weight, incurred that new risk, what then?  Are the rules for “healthy” BMI the same after gain has occurred?  This question brings us to a larger and more fascinating issue: is there some permanent change that occurs within us once we have been overweight that changes those rules?

I believe the answer is yes. What I call POWs (previously overweight people) seem to be quite different from NOWs (never overweight people).  As someone who was an NOW in my earlier years and is now a POW, I can attest to the fact that my physiology has changed. Can I prove this scientifically?  No. We have now crossed over into the area of observation and opinion.  Read on with that knowledge.

In my view, weight gain occurs when the normal mechanism that controls and stabilizes weight is damaged by over-exposure to elements of the SAD (standard American diet).  Once the damage is done, I believe that we remain prone to weight gain.  We can prevent this by avoiding the foods that caused the damage in the first place, but we must be extra careful.  Most POWs cannot eat “mindlessly” anymore. 

This tendency to weight regain may also have to do with fat cells which remain in the body, but which no longer contain fat.  No one knows if depleted, empty cells signal the brain or cause other kinds of hormonal havoc.

So what does this have to do with optimal BMI? When we gain weight, the body has to manufacture new fat cells to store the oily triglycerides which are being created. These cells are supported by a scaffolding of connective tissue and muscle.  After weight loss, the fat cells are emptied, but some of the tissue may remain. Many POWs find that they simply cannot lose enough weight to reach the white area of the BMI chart. This may well be because the BMI chart is based on the weights of those who have never been heavy, in other words, the weights of NOWs. Since they have never manufactured new fatty tissue, their baseline weights are lower. 

I love what I do, but I have written before about the one part of my job I don’t enjoy.  That would be the very last phase of a patient’s weight loss. Almost without exception, my patients are unhappy with their final weights. This happens even when they have lost 60, 80, or 150 pounds.  Each one longs to get down “just a little more!” Each one feels like a failure for not reaching the white zone.

This is the point at which BMI charts become tyrannical, and for no good reason. The rules for optimal BMI in the POW are different, just as pretty much everything else is different for POWs. Since there are no established guidelines for optimal weight in the POW, I can only offer my own take.

1. If you have been significantly overweight, a loss of 20% of your pounds is highly successful and is what I usually target. If you’ve lost more, great!!

2. Your optimal BMI should be the one at which you have eliminated or greatly minimized any weight related medical issues (especially blood pressure, diabetes, and lipids). In some people, remnants of the problem will remain, but the vast majority can expect significant improvement and decrease of medications.

3. Your optimal BMI should be one at which you can comfortably maintain.

Number three is probably the most important guideline, because weight loss is of no consequence if it ends in regain. POWs who push themselves to very low weights often do so at the expense of muscle tissue. If you start to look wasted, your vital muscle mass may be dissipating.  At such low weights, and without muscle to help out with calorie burning, you will have to make do with what I call “two peas and a bean”.  That’s not fun, that’s not life, and that’s not sustainable. 

Are BMI charts important at all?  Yes.  They remain vital for judging the weights of NOWs, like our kids, young adults and that minority who remains at normal weight.   If we can prevent them from converting to weight gainers, they will not have to deal with the permanent changes that dog the rest of us. As parents, educators, doctors and public citizens, this is a worthwhile goal and one that our health care system should be targeting.

But for the rest of us?  Shoot for maintenance, comfort, health, mobility.  These will stand you in good stead whatever your zone or color.

The Lake Health Carol DeJoy Resource Center offers access to electronic resources in addition to print resources. Health & Wellness Resource Center from Gale is a comprehensive resource that provides integrated access to medical, statistical, health, and related information. The Health & Wellness Resource Center features a fully updated, intuitive interface -- providing multiple pathways to key information.  You can browse the latest news, review a set of subject areas, review and select a particular resource, or search across the entire database.

Health & Wellness Resource Center delivers up-to-date reference material as well as full-text magazines, latest news topics, journals, and pamphlets from a wide variety of authoritative medical sources, including descriptions of and links to many pertinent websites, selected for their usefulness and appropriateness.

Health & Wellness Resource Center has partnered with Healthology, an industry leader in providing health and medical video content and physician-authored articles. You can access the Healthology content from the Health Highlights area of the home page. And whenever you perform a search using the search box or using the Advanced Search page, your results may include video content from Healthology as listed on the Video tab of your results list.

The Carol DeJoy Lake Health Resource Center also provides the add-on Alternative Health module which looks at health care from a holistic lens.

A single search brings together reference, periodical, pamphlets, news and multimedia content, organized into tabs that let you target the type of information you are seeking. Once you have linked to an article, pamphlet or multimedia resource, you will be able to print, e-mail and download the content.

In order to use this valuable resource, you must come to the Carol DeJoy Lake Health Resource Center.  The Resource Center is located in Suite 113 on the first floor in the Physician Pavilion adjacent to the TriPoint Medical Center.  Please call before visiting to ensure staff availability at (440) 639-4387 or (440) 375-8100, ext. 42019.

For more information, please contact a Lake Health Professional Librarian.

When presented with information about their health and the changes they need to make to their lifestyles, what exactly motivates people to make these changes? Well, the fear of death is a great motivator for change. Frequently, after patients suffer a heart attack for example, they begin to make changes in their life. They may quit smoking and improve their diets. However, it’s also not uncommon for people to lose their motivation to continue these changes. They may return to smoking or gradually return to their poor eating habits. Does this sound familiar?

Are there certain factors that help people stay committed to the changes they make? There are twenty-one commonly studied theories and models that explain how certain feelings and beliefs can contribute to healthy behaviors. The following basic themes and concepts of these theories will help you identify what motivates you and how you can stay committed to healthy behaviors.

Perceived Threat

This concept refers to whether or not you believe you’re going to get sick in the first place and if you accept your diagnosis. That is, what are your beliefs about your own susceptibility to developing an illness or disease?  Do you deny the impact of your behavior (smoking, weight, stress) on worsening or contributing to your illness?

• Obtain accurate and specific information from your doctor: Often patients will claim that the doctor never specifically said that their smoking or their diet can cause damage or disease. This miscommunication may be due in part to the patients not asking direct questions because then they can assume if it wasn’t directly stated, than it must not be that serious.
• Objectively evaluate the information you are given about changes in your lifestyle: We are often very comfortable giving advice to other people we care about. We can easily say, "You really shouldn’t smoke", or 'You need to better manage your stress." However, when it comes to us, the advice is often lost. Although you may be able to say to yourself, "I really should be exercising." You may also follow-up up with excuses that gives you permission to continue with the behavior. It is important that you listen objectively to what you are saying to yourself and then correct the self talk.

Beliefs about Immediate Benefits

We are unlikely to change our behavior unless we believe that there will be an immediate benefit to our health. Telling somebody to monitor the amount of saturated fats in their diet when they are not currently experiencing any medical concerns is unlikely to yield a change in behavior. Behavior change needs to be anchored to improvements that can be experienced now.

• Visualize yourself benefiting from the changes: If you are quitting smoking or improving your diet, visualize your arteries with blood flowing freely without the clogging effects from unhealthy behaviors. Imagine your heart pumping at a regular comfortable rate without having to work so hard.
• Remind yourself that you are making the right choices: For example, tell yourself as you exercise that you are lowering your cholesterol, keeping your weight down, and improving the overall functioning of your heart.

Beliefs about the Costs of Making a Change

When we are confronted with information about our health and the changes we need to make, a couple of thoughts usually come to mind. First, we begin to weigh the benefits of eating a healthy diet versus the loss of eating whatever you want. For example somebody who perceives that the benefits of eating a healthy diet includes marginally improving heart health but the cost of changing the diet that involves depriving oneself of "good foods," is "expensive" and "an inconvenience to family" is unlikely to stay motivated. The cost of the change clearly outweighs the benefits.

How do you view changes that you need to make in your life to improve your health? Try to do a cost-benefit analysis for yourself. Notice the language that you use and then honestly assess how real you believe the health risk of is for you and what cost you perceive yourself having to pay for your health.

Self Confidence

Do you listen to a health message and find yourself acknowledging that, while it makes sense, deep inside you’re thinking, "I could never really do that."

Confidence is built when we are able to have several small measures of success in high-risk situations. So if you notice that resisting high-fat foods is particularly difficult for you when you’re dining out with friends, then small improvements will be felt as success to be built upon. This will improve your confidence and commitment to sticking with your healthy behavior.

Environmental Cues

Many of the motivating factors we’ve talked about so far involve changes that you need to make inside yourself. There are also environmental changes you can make to support your efforts to change unhealthy behaviors. Surrounding yourself with cues to remind you of our commitment to change and help you sustain changes can be quite useful.

• Surround yourself with supportive people who share your commitment to a healthy lifestyle.
• Keep healthy foods readily available to you.
• Establish an exercise routine with a partner.
• Keep a list of your priorities and the amount time committed to each task as a reminder of your improve time management techniques.

Please join us for the Lake Health TriPoint Medical Center Physician Pavilion Open House  on Saturday, May 1, from 9 am until 12 noon.  You can tour our wonderful new resource center featuring:

• Print Books and Journals
• Health Information Databases
• Computers with Internet Access
• SmartBoard Technology
• Patient TV with On-Demand Entertainment and Education
• Flat Screen TV with DVD/VCR
• National Network Libraries of Medicine Exhibit featuring National Library of Medicine Resources
• Health Information Videos, and More! 

There will be raffle prizes (winners need not be present), technology demonstrations and demonstrations on searching for health information on the web. 

Other activities through the Pavilion will include:

• Receive a FREE Lake Health grocery tote to the first 500 visitors.
• Tours of Lake Health’s Outpatient Rehabilitation Center, The Wellness Institute, Community Health Center, and Quality Services.
• You will also have the chance to visit Physician Offices including Eastside ENT Specialists, Northeast Ohio Heart Associates, Northcoast Family Practice, Drs. Hill and Chapnick Pathology, Lake OB/GYN, and General Surgeon Karen Grassie, MD.
• Activities, Lectures and FREE Screenings will be available throughout the day!
  • Cholesterol, Glucose, and HDL Screenings
  • Heel Screenings
  • Blood Pressure Screenings
  • Balance Screen
• Diabetes Educators will be on hand to answer your questions!
• Chair Massages
• Acupuncture Demo
• Check out an exercise program from The Wellness Institute:
  Zumba, Yoga, Pilates, Core, Kickboxing, and Total Body Sculpt
• Lecture Schedule:
  9:15am -    What is Integrative Medicine? – Lori Stevic Rust, PhD
  10:00am -  Weight Management – Barbara Berkeley, MD
  10:45am -  Music Therapy Demo – Ellen Shetler, MT-BC

For more information call the Best of Health Line at 440-953-6000 or 800-454-9800.

Carol DeJoy Lake Health Resource Center
Lake Health TriPoint Physician Pavilion
7580 Auburn Road, Suite 113
Concord Township
Phone:  440-639-4387 or ext.42019
Email:   library@lakehealth.org

“Why can’t I lose weight?  There must be something wrong with my metabolism."

This question and its seemingly logical answer must be among the most commonly stated beliefs of overweight people.   But an answer that appears to be correct is not necessarily so simply because it has been stated repeatedly.  As long as we keep asking this question and answering it in the same way, I believe we will not move toward solving our obesity problem. 

What if we looked at this question in an entirely new light, starting with a different kind of assumption?  What if we began with the fact that the act of trying to lose weight intentionally is most likely an unnatural behavior for humans.

Why do I say this?  Until very recently, there was arguably no time in man’s history when he would have thought of forcing his body to give up fat.  Since humans lived close to nature, their relationship to food was more like that of other living creatures out in the wild.   Fat storage, if it occurred, would have been beneficial, an insurance for lean times.

The evidence for the unnatural nature of forced weight loss can be seen in our body’s response to calorie restriction.  When we stop eating, our body does not just start happily burning fat.  What it actually tries to do is to avoid losing weight.   It does this by going into a sort of “economy” mode.   To better understand this, imagine a situation in which you were cash poor with a cold winter approaching and a full tank of heating oil sitting in your backyard.  Eventually, the cold sets in.    You have that tank of oil, but you’d rather not use it since you are facing a winter of uncertain length.   So you wisely decide to go into economy mode.   You turn down the heat in your house and wear sweaters instead.  You close off some rooms rather than burn fuel to keep them warm.  You wait and hope that winter will pass.  Meanwhile, your storage tank stays untouched, a hedge against true emergency.

This is exactly what your body does when you try to lose weight.   Your genes don’t know that the food shortage they are experiencing is called “Weight Watchers” or “Jenny Craig”.  They only know that they are suddenly facing a famine.   Ancient responses shift the body into economy mode, dialing down the energy used for heat (the reason many dieters feel cold) and slowing down less vital processes.  We call this “lowering the metabolism”, but basically it is the body’s attempt to keep weight stable during a food crisis. 

Doesn’t the body want to rid itself of harmful fat? Paradoxically, the answer seems to be no.  There is a perplexing propensity for the body to ignore its fat, almost to fail to realize that it’s there.  Overweight people experience this every day when they deal with elevated levels of hunger.  Why should the body continue to generate strong hunger signals when it is full up with fuel?  In the answer appears to lie a disconnect between fat and the brain.  Signals which should tell us that we have enough stored fat and that we should stop eating, simply fail to reach their mark.   Something inherent in the very process of gaining weight acts as a disruptor to the normal signals that control fat and appetite.  When it comes to weight loss, the body seems relatively determined to avoid burning its stored calories unless it is really pushed.

We are taught that the fundamental truth of weight loss is:  burn more calories than you take in and you will lose weight.  We are told that this is an immutable law of physics and that if it isn’t working, we must be doing something wrong.  But all dieters know that this central tenet of weight loss is simply wrong.  Adding more exercise often doesn’t lead to weight loss, nor does restricting calories.   What is the problem here?   The answer is quite simply the body’s ability to change the game by shifting into economy mode.  This is maddening for dieters who often feel unable to lose an ounce when they cut back on food.  But that problem reflects a simple truth:  when you eat less, your body will run on less.  A lot less.  This is the beauty of our construction, a metabolic balancing act that allowed us to survive for millions of years.   Yes, it’s frustrating.  But here’s the good news.  A solid understanding of this bodily behavior can help us figure out how to get around the problem.

In my experience, the biggest impediment to successful weight loss is something I call “calorie summarizing”.  Americans are hooked on calorie theory, which is peculiar because calorie counting is nearly impossible and doesn’t work very well at all.  When people diet, they tend to look at days or weeks as a block.  At the end of each block, they summarize what they ate.  They see that, when the days are lumped together and on average, they ate far, far less than what they had been eating before their diet.   They exercised far, far more.  According to prevailing calorie theory, this should guarantee weight loss.   Then they get on the scale, they’ve lost a couple of ounces, or nothing at all. Often, they abandon their attempts to lose weight.  How could they possibly succeed when they are so metabolically challenged?

But what has really occurred?  Far from being metabolically flawed, their bodies have simply been doing their job, protecting their clients from the ancient threat of famine.   From the point of view of the dieter, the problem was an inconsistent attempt to “scare” the body into using its stored fuel.   On one day, this dieter ate more because she’d been good on another.  Because she was so strict all week, it seemed fine to have that piece of birthday cake or that dinner out.  Because the week’s total calories were lower than they had been, it seemed fine to have a treat here and there.  In doing this, this dieter played right into her body’s hands.  She gave the body just enough to get by in economy mode and too much to force it into significant fat burning.

A terrific study that appeared in the New England Journal of Medicine a few years ago supports this hypothesis.  In this study, researchers compared average weight losses after one year on a number of different diets, including Atkins, Weight Watchers and the Zone.   They showed that the average loss was quite small, just a few pounds.  Initially, that looked pretty discouraging.  But on closer inspection, researchers noted that not every dieter was average.  Some actually gained weight, while some lost very large amounts.  What differentiated them?  In a stroke of brilliance, the researchers decided to look at their data through a new lens.  They asked each subject how consistently they had followed their diet on a scale of 1 to 10.  What developed was a perfect curve, the same for each and every diet that was studied.  Weight loss began to occur at compliance levels of 5 or better.  The largest amounts of weight loss were seen in those people who had been almost perfect in following their diet plan. 

It probably matters very little which diet plan you follow as long as you don’t try to alter or make up the rules yourself.  What seems to be fair, what seems to be scientifically correct, what seems to make sense, is often not the case during weight loss.  What is the case is that your body will economize and run itself on less until you force it to do otherwise.  Consistency, toughness and sticking with the plan---not just most of the time, but 90-100% of the time--- are the behaviors that work.   We must respect the fact that we are asking our body to do something it would rather not do.  All the diet commercials in the world can tell you how easy it is, how you can lose weight without really dieting, how you can do it without giving up the foods you love.  None of these assurances provide a hedge against the facts of life.

Please note that this particular post is not a maintenance post.  While consistency remains very important in maintenance, some degree of off-plan eating can be offset by exercise.  This is not the case during weight loss.  Unless you are very big (people with lots of fat to lose will generally lose weight with less effort, at least at first), complete consistency is the key. Now you know why.  If you have been trying to lose weight and have been bemoaning your slow metabolism, try rededicating yourself to the project by assessing your success from moment to moment rather than summarizing calories over time.  Keep food records and measure yourself by how well you stuck to your guns each and every day.  Convince your body that there is serious and ongoing food shortage in its environment and it will burn fat to take care of you.

Alcohol Awareness Month is an opportunity to raise awareness of alcohol abuse and encourage people to make healthy, safe choices.

Warning Signs of Alcohol Abuse
If you answer "yes" to any of the following questions, you may have a problem with alcohol:

• Do you drink alone when you feel angry or sad?
• Does your drinking ever make you late for work?
• Does your drinking worry your family?
• Do you ever drink after telling yourself you won't?
• Do you ever forget what you did while drinking?
• Do you get headaches or have a hangover after drinking?

Strategies to Cut Back or Quit Drinking
There are many strategies you can try to cut back or quit drinking. To get started:

• Keep track of your drinking and set a drinking limit.
• Try to avoid places where heavy drinking occurs.
• Ask for help from a doctor, family, or friends.
• If you keep alcohol in your home, keep only a limited supply.

Source: www.healthfinder.gov

Alcohol Awareness Resources
Quick Guide to Healthy Living

• Drink Alcohol Only in Moderation
• Talk to Your Kids About Tobacco, Alcohol, and Drugs
• Manage Stress

Personal Health Tools

• Alcohol-Related Disease Impact Software
• Alcohol Use Test
• Drink Size Calculator

More Information

• Alcohol.  Information from MedlinePlus including multimedia & cool tools, overviews, latest news, prevention/screening, research, multimedia, organizations, and more.
• Alcoholism.  Information from MedlinePlus including interactive tutorials, overviews, latest news, diagnosis/symptoms, treatment, prevention/screening, research, multimedia, research, and more.
• Alcohol Abuse.  Healthfinder.gov. 
• How to Cut Down on Your Drinking.  U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration.  National Clearinghouse for Alcohol & Drug Information. 
• Substance Abuse and Mental Health Services Administration Alcohol Awareness Month Sponsor
• Centers for Disease Control and Prevention, Personal Frequently Asked Questions: Alcohol and Public Health
• Department of Health and Human Services, Office on Women’s Health, Native Americans/Alaska Natives and Alcoholism
• National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, College Drinking Prevention
• National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Family History of Alcohol: Are You At Risk?
• National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, FAQ’s on Alcohol
• National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Tools
• National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Publications and Resources

If you would like more information, please contact a Lake Health Professional Librarian