Q: Should I avoid carbohydrates?
A: No. While advertising and the media have focused a lot of attention on low-carb diets, when it comes to successful, long-term weight loss, calories are the key, not carbs. By focusing on calories, you need not avoid entire food groups, buy special low-carb products or give up many of the foods you love.

Q: How do I know if I’m overweight or obese?
A: One easy way to assess obesity is using Body Mass Index (BMI), a measure of body fat based on height and weight. Individuals with a BMI of 25 to 29.9 are considered overweight, while individuals with a BMI of 30 or more are considered obese.  You can find out your BMI using the calculator at  www.nhlbisupport.com/bmi or the chart at http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.htm.

Q: I am concerned about my children’s eating and exercise habits. How can I keep my children healthy?
A: Many children today have a poor diet with little physical activity. They eat foods high in calories and saturated fat and don’t eat enough fruits and vegetables. They watch TV, play video games, or use the computer instead of being active. So kids are becoming overweight or obese and have a higher chance of becoming obese adults. Overweight children face health risks, like diabetes, gallstones, sleep apnea, and high blood pressure.

We know children do what they see — not always what they are told. Set a good example for your children. Your kids will learn to eat right and be active by watching you. Setting a good example can mean a lifetime of good habits for you and your kids.

Help your child become more active.

• Set limits on the amount of time the family watches TV, plays video games, and uses the computer.

• Encourage your children to get one hour of physical activity every day.

• Find out about activity programs in your community such as little league baseball or a swim team.

• Create family activities that involve physical activity, like hiking, walking, or playing ball.

• Make healthy snacks available such as fruits, cheese and calorie-free beverages. Avoid buying junk  foods.

• Have your children plan and cook healthy meals with you.

• Limit trips to fast-food restaurants.

• Involve the whole family in healthy eating. Don’t single out children by their weight.

Q: Do genetics affect weight?
A: To a degree, YES, but this does not mean you have no control over the outcome. You still have to manage your weight. Work with the genes you have; for example, being big-boned is no excuse for being 50 or 100 pounds overweight. You may have some extra challenges, and you may never be model-thin, but don't let that be your excuse.

Q: What about "magic" diets that promise quick results?
A: Make no mistake -- the billion-dollar diet industry tells you what you want to hear. But losing weight is hard work, every minute of every day. How hard are you willing to work? Do it right once, and you'll reach your goals much quicker than "seven pounds in seven days."

Q: My friend lost weight; why didn't her strategy work for me?
A: Everyone has different challenges, different resources and different gifts. Consequently, people must develop different strategies to accommodate their schedules. Find out what gives you results -- and don't quit if it doesn't seem apparent right away.

Q: What if I just really like food?
A: Just about everybody likes the taste of food, but you have to develop the maturity to balance your intake. Control the quality and the amount of what you eat.

Q: How is it that I can like everything about myself except the fat?
A: You don't feel 100 percent good about yourself. You can't be completely happy with yourself unless you're happy about everything that makes you who you are.

Q: I can't seem to get my appetite in check. What's wrong?
A: If you're overweight, then you're out of control. That's not a natural place to be. You're out of control with your impulses, your life or your schedule. Evaluate your behaviors, anticipate your personal challenges and restore balance.

Q: Why do I keep slipping into my old habits?
A: You can't break habits without forming new ones. If you take something out of your life, there's a void. And when there's a void, it's easy to drift back to what you used to do. You need to replace the bad habit with new, incompatible behavior that will crowd the bad behavior out.

Q: How can I heal poor body image?
A: Don't let low self-esteem be an excuse to not live your best life. Get over it! Stand up and use the gifts you have. Require more of yourself than what you have been requiring. Just because you aren't proud of yourself every minute doesn't mean that you don't get to participate in life. Get specific and define what low self-esteem means to you. Then, behave your way to success.

Q: I've always dealt with difficulties using food, but now I've solved my problems. Why am I still fat?
A: You're holding on to the response that you associated with your problems. Although the problem has been solved, the behavior -- in this case, overeating -- remains. When you solve a problem in your life, you must also stop "dealing" with it in negative ways.

Q: Does cholesterol in the food we eat increase our blood LDL?
A: It used to be thought that eating foods that are rich in cholesterol (eggs, liver, cheese) would increase the levels of blood cholesterol in most people. This has been found to be incorrect. If a large quantity of cholesterol is eaten, the body usually compensates by reducing production of cholesterol in the liver. It is now believed that eating four or five eggs a week is unlikely to be harmful to heart health for the vast majority of people. As noted above, the small proportion of the population with inherited conditions that cause high LDL levels should always take their doctor's or dietitian's advice on appropriate diet.

Q: How do I lose weight off my face, butt, thighs, or stomach?
A: The process of losing weight anywhere (face, butt, thighs, stomach) is the same.  First, let us dispel a myth.  There is no such thing as spot training.  There isn't an exercise in the world that will take excess body fat off an area of your body you consider a problem spot such as the belly area.

When you lose weight it comes off all over the body in equal amounts.  Think of your extra body fat in layers.  For example, let’s say you have five layers around your hips, three around your arms and two in your cheeks.  As your body uses stored body fat as energy it draws equally from all these areas.  When you burn off a layer of fat you will now have four around your hips, two around your arms and one in your cheeks.  What really happens is the cellulite cells begin to shrink (as the adipose tissue inside is used for energy) and it becomes smaller, but the layer example is good for visualizing.

Q: Do I have to give up candy in order to lose weight?
A: You can eat just about anything you want and still lose weight. To lose weight all you have to do is be in a calorie deficit which means you have to burn more calories than you eat daily. All you have to do is know how many calories are contained in the candy you eat. As long as you stay in a calorie deficit, you will lose weight.

Q: How long does it take to lose one pound of body fat?
A: The answer is a simple math equation. You must burn 3,500 calories to lose one pound of body fat. If you burn 500 more calories than you eat for seven days, you will lose one pound of body fat. If you burn 1,000 calories more than you eat for seven days, you will lose two pounds of body fat. The key is to know how many calories are going in and out each day so you can accurately track your progress.

Q: How many calories make a pound of weight?
A: 3,500 calories are in a pound of weight.

Q: How many calories should I eat a day to lose weight?
A: The answer is as individual as you are. Each person will have a different caloric intake total, each day of the week, to reach the required 3,500 calorie deficit to lose one pound of body fat. If you burn 500 more calories than you eat a day, for seven days, you will burn 3,500 calories. On a day that you burn 2,500 calories, you can eat up to 2,000 calories. On a day that you burn 2,800 calories, you can eat up to 2,300 calories. Each person will be different and each day will be different.

Q: How many carbohydrates (carbs) should I eat a day?
A: The FDA recommends that you get 50% of your calories from carbohydrates.  The NAS (National Academy of Science's) Institute of Medicine, based on thousands recent of scientific studies, recommend a slightly different approach.  They recommend that adults get 45-65% of their calories from carbohydrates.  But, they both agree on the kind of carbs you should eat.

Whole grains, starchy vegetables, beans, soy foods, green vegetables, and fruits--foods served as nature grew them--are the carbohydrates that pack the highest nutritional octane. They're rich in compounds that support good health, including fiber, nutrients, and phytochemicals. A dietary pattern based on these foods lowers the risk of heart disease, stroke, diabetes, and many major cancers.

Highly processed carbohydrates, which are stripped of their nutritious germ and fiber, are another story. Unhealthful diets often contain too many carbohydrates processed into concentrated forms (corn syrup, white flour) that provide calories and little else. The bottom line: when you fill up with carbohydrates, only nature reliably pumps out high octane.

Q: I usually skip breakfast? Is this bad?
A: If your question is referring to weight loss, yes.  One of the best natural calorie burning tools you have is your digestive system.  It takes 6-8 hours to absorb and fully digest a meal.  This requires a ton of energy (calories burned).  If you eat dinner at 7:00 p.m., your digestive tract will be functioning until around 3:00 a.m.  Now if you get up and eat again a few hours later the whole process starts over.  But, if you don't, two things will occur.  First, your digestive system will lie dormant until you eat again, probably a full nine hours later.  This causes you to lose a large part of you basal metabolic rate (the amount of calories your body burns on its own).  Second, your body thinks it's starving and will slow the rest of your metabolism down as a survival instinct.  The end result is that you burn fewer calories naturally, making it harder for you to lose weight.

Q: Why does BHWL&W recommend that I keep a food journal?
A: It's like asking "why keep a checkbook"? When you eat a dozen jelly donuts or eat a bag of potato chips--its like you just wrote a ton of calorie checks. Instead of your body sending you a "you ate too much message", it just stores the excess as fat.

After the years go by, the body will "collect" those calorie checks with heart disease or diabetes!

Frankly, you need to see the numbers yourself to truly appreciate why your gaining weight. Once you see that, you will be able to adjust your "spending."

Q: I am currently enrolled in a weight loss program and I’m doing great. My problem is social situations with friends and family. I don’t want to become a hermit for fear of the temptations that await me at these times. How do I socialize while trying to lose weight?
A: Getting together at social gatherings that involve food and drinks can be particularly challenging to the dieter. Some tips to help you get through these get-togethers.

•  Avoid arriving hungry. Eat a light, healthy snack before you go to the party.

• Limit or avoid alcohol. Drink a calorie-free beverage instead. Seltzer water with a lemon or lime wedge allows you to join your friends in a social drink.

• Avoid the chips, dip and other high fat fare available. Opt for the veggies, fruit and cheese. Stand away from the snack table if you are having challenges with will power that evening.

Q: My job is sedentary. I sit at my desk for 8 hours a day, five days a week. How can I get exercise in with a schedule like this?
A: Working at a job that offers very little opportunity for activity is difficult but not impossible. Some tips to increase calorie burning throughout the day:

• Avoid intercom systems or email. If you need to speak with someone in your company, take a walk to his or her office.

• Take the long way to the lunch room, the restroom or the meeting room. Those extra steps taken on a regular basis can really help.

• Use the stairs, not the elevators.

• During long phone calls, use the speaker phone function and pace or walk in place as you conference in on the call.

• If you have an hour lunch, use 30 minutes to walk either outside or around the building hallways and stairways if the weather is bad.

• Park as far away from the front door as possible.

Q: I’m on a weight loss diet. How do I prepare a meal for me and my family if neither my kids nor my husband need to lose weight?
A: There’s no need to change what you prepare for meals, but you will need to be aware of the size of your portions. Chances are that whatever you have prepared for them will be suitable for your program, too, just smaller portions. Begin by knowing exactly how much you need to eat. Second, add more vegetables to your plate, while skipping over the starches, fat and other higher calorie items. Always eat a small snack mid afternoon to keep your appetite from going into overdrive by dinner time.

Q: I chew gum to curb my appetite. Is this a good strategy?
A: Chewing stimulates salivary glands to produce ptyalin, a digestive enzyme that activates hunger. Although a piece of regular gum contains only half teaspoon of sugar, it is not uncommon for people to chew several sticks a day. Sugarless gums might be the answer to this, although the problem mentioned above still applies.

Q. I never seem to have time for breakfast. Can I just skip it?
A: Not to sound too cliché, but breakfast is “the most important meal of the day,” especially when it comes to weight loss and overall health. Rates of obesity and insulin resistance are 50 percent lower among people who eat breakfast compared with those who frequently skip it. Breakfast eaters burn more calories during the day, and are less apt to overeat at lunch and dinner leaving them trimmer than non-breakfast eaters.

Q: I noticed that our many weight loss programs encourage the use of proteins such as eggs, cheese and beef. Won’t eating these high-cholesterol foods make my cholesterol level go up?
A: Approximately 85% of the cholesterol in our body is produced by our liver. Dietary cholesterol (the kind that comes from food) contributes very little to high cholesterol levels in the blood. The liver produces cholesterol in response to certain hormones. One hormone in particular is insulin. This hormone gives the liver the signal to ramp up cholesterol production. Bottom line: eating cholesterol-rich foods usually doesn’t affect cholesterol levels significantly.

Q: What causes high insulin levels?
A: High insulin levels are caused by eating too many carbohydrates, particularly starchy carbohydrates such as bread, pasta, potato and rice. Excess insulin signals the liver to make more cholesterol. As a result, people following a high-carbohydrate diet will have difficulty decreasing their cholesterol levels, despite cutting back cholesterol.

Q: I’ve lost 20 pounds and I feel great. My problem is family and friends, some of whom are not very encouraging or supportive of me. How do I deal with unsupportive people in my life?
A: Don’t be overly concerned with hurting the feelings of anybody who is trying to sabotage your weight loss progress. Speak up for yourself and let individuals know how much their encouragement means to you and how hurtful it is to not have their full support during this challenging time.

Q: My mother-in-law seems to take my efforts in weight loss lightly. She constantly offers me desserts, treats and other goodies knowing full well that I will not turn her down because I don’t want to hurt her feelings. How can I handle this?
A: It’s okay to say “no thank you,” and to decline food offers when you are not hungry. Give your mother-in-law a kind about how delicious a food looks, but state clearly and firmly that you are truly committed to your weight loss goals and must pass at this time. The first few times will be difficult, but she will see that you are serious and will back off on asking.

Q: My friends say that I’m no fun anymore now that I’m on a diet. I value my friendships very much and I’m seriously considering going off my diet just to please them. Help!
A: Your friends may be telling you that they don’t want you to change. Or maybe they are secretly jealous of your success and commitment to your goals. Be firm and honest. Let them know that you care about their feelings, but you have no intention of abandoning your weight loss program. If a friend still insists you are “no fun,” you may have to avoid seeing her for a while. True friends will realize that your goals are important to you and will be truly happy and supportive as you progress to your goal.

Q. What is a quick way to estimate my healthy weight?
A: Healthy Weight For Women

• Allow 105 pounds for 5 feet.

• If you are taller, add an extra 5 pounds per inch.

• If you are shorter, subtract 5 pounds per inch.

• The healthy weight range will be about 10 per cent either side of the final figure.

For example: If you are 5 feet 2 inches, allow yourself 105 pounds plus 2 x 5 pounds. This totals 115 pounds. The healthy weight range for you would be 103-127 pounds.

Q: I’m a middle-aged man. How do I determine a healthy weight for me?
A:

• Allow 110 pounds for 5 feet.

• If you are taller, add an extra 6 pounds per inch.

• If you are shorter, subtract 6 pounds per inch.

• The acceptable weight range will be 10 per cent either side of the final figure.

For example, if you are 5’10”, allow yourself 110 pounds plus 10 x 6. This totals 166 pounds. Your healthy weight range is 150-182 pounds.

Q: Are there any short cut tips to losing weight?
A: The biggest distraction or de-motivator for most dieters is the idea that there's a "short-cut" to losing weight. People who nurture this belief will always have difficulty losing weight. Patience and perseverance are vital for success.

Q: I’ve just starting exercising to lose weight. Which exercise is best to burn extra calories?
A: The best type of activity for "instant" calorie-burning is aerobic training such as walking, swimming or running. The best type of activity to raise metabolic rate and increase "longer-term calorie expenditure" is anaerobic training, like weight-lifting. The ideal calorie-burning training program involves a combination of both these types of exercises.

Q: I’m desperate to lose the fat around my belly. Dieting just doesn’t seem to work. My friend suggested liposuction. Are there any risks or complications associated with this?
A: Liposuction is a serious surgical procedure with all the usual risk of preoperative and post-operative health complications. That said, Liposuction is generally very safe, and post-operative problems are commonly minor and temporary.

Q: What are the main health risks of liposuction?
A: Common risks of liposuction include: blood clot on the lung, infection, visceral perforation, toxicity, blood loss, swelling (edema), hematoma, skin necrosis and anesthesia.

Q: How much body fat can be removed by liposuction?
A: Suctioning too much fat in a single session can be dangerous to health. There is a limit to the amount of surgical trauma that can safely be experienced by the human body. If the liposuction patient has a large amount of adipose tissue which needs removing, surgeons typically recommend dividing the liposuction into a series of separate surgeries spaced at least five weeks apart.

Q: Is liposuction an effective treatment for obesity?
A: No. Plastic surgeons do not recommend liposuction as a treatment for obesity or severe overweight. In fact, the best candidate for liposuction is a patient of normal weight who has localized pockets of excess fat.

Q: I’ve tried losing weight many times over the past 15 years. I’m 45 and heavier than ever. I heard about bariatric surgery for severe obesity, but my husband is concerned about the risks involved. What can you tell me about the procedure?
A: For some seriously obese patients, bariatric surgery is a last-chance option to improve their health and weight. There are two main types of obesity surgery: stomach banding and stomach bypass, both of which can be performed using traditional "open" techniques or laparoscopy. (During laparoscopic operations, the surgeon makes small incisions and views the interior of the abdomen on a video screen which is connected to the operating instruments.)

Q: What are the Risks of Surgery vs. Risks of Obesity?
A: Both gastric banding and gastric bypass are serious operations, and (like all major surgery) carry serious health risks. However, the possible risks and health complications of this type of invasive abdominal surgery must be balanced against the known health dangers of morbid/malignant obesity.

Q: What are the Health Risks of Bariatric Surgery?
A: The risks vary according to the type of gastric surgery performed and the technique used. In general, mortality and morbidity rates of follow-up operations are higher than those of initial surgeries.

Q: My friend just had her stomach stapled. She has lost 30 pounds and looks and feels great. I’m considering it, but want to know more. Are there risks? Is it reversible?
A: Gastric stapling surgeries are slightly easier to perform and carry a lower risk of post-operative complications than does bypass. Stapling of the stomach typically produces more effective weight reduction than adjustable banding procedures that only use a gastric band or ring, instead of staples. Although safer than gastric bypass, there are some risks involved:

• Breakage of staples

• Erosion of band

• Risk of vomiting if food is not properly chewed

• Some risk of nutritional deficiencies

• Reduced weight loss due to non-compliance with diet and exercise guidelines

Q: What is the “Lap-Band” surgery for obese people?
A: Lap-Band is a type of gastric surgery designed to reduce the size of the stomach. Unlike gastric bypass surgery which involves major alterations of the intestinal tract, lap-band surgeries are less drastic and therefore more popular than bypass operations. However, patients can "cheat" more easily, thus weight reduction tends to be smaller.

Q: Are there risks associated with Lap-Band surgery?
A: Yes, risks and complications do exist.

• Band slippage/leakage

• Risk of internal infection

• Stomach pains after meals (over-eating)

• Nutritional deficiencies during liquid diet phase

• Reduced weight loss due to non-compliance with post-op diet and exercise recommendations

Q: Should I Count Calories or Carbs?
A: To the best of my knowledge, no clinical weight loss study or research has ever demonstrated that weight reduction is possible without creating a calorie deficit. To put it simply, you can count whatever you like, but unless you consume fewer calories than you burn, you are not going to lose weight.

Q: I just had a baby. How do I lose the 40+ pounds I put on during my pregnancy?
A: It's quite common to want to return to your pre-pregnancy weight and regain your shape as soon as possible. But don't be too impatient. It takes up to 6 months after pregnancy for your body to return to normal. So even if you are not breast-feeding, don't be in too much of a hurry to cut calories. Rather than focusing on "weight loss", concentrate for the first several months on eating healthy food with enough calories and nutrients to give you the energy and nutrition to cope. Slow Weight Loss is Essential.   Eat Healthily and Give Your Body Time to Recover.

Q: Why is water beneficial for weight loss?
A: Water contains zero calories. Drinking water instead of milk, fruit juices or regular sodas helps to lower the calorie content of your diet and thus helps weight reduction. Water can fill you up. Some dieters find it helpful to drink a glass of water when they feel hungry between meals, or just before a meal. Keeping hydrated will help reduce cravings. Slight dehydration can be interpreted by your brain as hunger. In other words, you may be thirsty, but you think you’re hungry.

Q: My daughter is a nurse. She recently told me that my excess weight (I’m ~75 pounds overweight), increases my risk of breast cancer. Is there any truth to this?
A: Unfortunately, your daughter is correct. There is a growing connection between obesity and breast cancer. Almost half of all breast cancer cases in postmenopausal women occur in those suffering from obesity. Scientists have yet to determine what causal factors may be contributing to this risk. Because of this link between obesity and breast cancer, it is important for all women to maintain control over their weight, especially as they enter menopause.

Q. Why can some people eat lots without gaining weight?
A: Because they have a higher, or faster metabolism. In other words, they burn calories at a faster rate than normal.

Q: What causes a person to have a faster metabolism?
A: It's uncertain. It may be due to hormones or genetics.

Q: How can I raise my own metabolism?
A: The only effective way to raise your metabolism is with exercise. The more you exercise, the faster your metabolic rate. Weight lifting and other weight-resistant exercise increases metabolism much faster and much longer than aerobic exercise.

Q. Will exercise make me hungry?
A: Yes and No. Yes, exercise may increase your appetite to begin with but this is perfectly natural - after all, you are burning a lot more calories. However, as your body adjusts you should experience a decrease in appetite. Research shows that exercise actually lowers appetite for up to several hours afterwards.

Q: My husband and I recently went to Aruba for our 20^th anniversary. While there, I spent a significant amount of time in my bathing suit. My husband really noticed the back of my thighs and said that I looked great except for my “fatty thighs.” I couldn’t get mad at him, he’s right. What kind of exercise can I use to get rid of them?
A: There is NO exercise which can reduce fat from a specific area of your body like your hips, thighs or butt. Exercise can improve the shape of a particular part of your body, by tightening muscles, but it can't reduce the fat in these areas. The only way to lose fat off your thighs, hips & butt is by changing your eating habits

If you have a lot of fat on your hips and thighs, you MUST be patient. Fat thighs do not disappear overnight. However, if you follow a sensible weight loss diet, your excess fat will gradually disappear.

Q: I’ve been a healthy weight all my life. I’m now 53 and have gained 15 pounds in the past two years. I haven’t changed my eating or exercise habits. My friends all report the same problem. Why is it so easy to gain weight as we age?
A: We need fewer calories as we get older. Calorie needs decrease by 2-4 percent for every 10 years after our 20s. So if you need about 2100 calories a day at 20 years of age, then by 50 years of age you need only about 1850 calories.

The most common reason why we need to eat fewer calories as we age is because our muscle mass tends to decrease as we age; approximately 30 percent loss by the time we reach our 70s. The reason for this is simple lack of exercise. Because muscle burns more calories, the less muscle we have, the fewer calories we need. Hormonal changes (e.g. thyroid function, adrenal function) may also slow down our metabolic rate and cause a drop in calorie needs.

Q: How much weight does the average American gain with age?
A: The average weight increase of men is about 5 pounds per decade, in women it is 3.5 pounds per decade.

Q: I just turned 40. My friends older than me tell me that I now have to be extra diligent about watching my weight. I’m a healthy weight now, but what can I do to minimize mid-life weight gain?
A: Because we need fewer calories as we get older, simply eat about 50-100 fewer calories per day, per decade, or increase calorie burning by about 50-100 calories a day per decade. An easy way to achieve this is to walking an extra mile a day (per decade).  Exercise is the number one remedy for minimizing the risk of age-related weight increase.

Q. After 3 months dieting I've lost 16 pounds, but I have less energy. What is wrong?
A: Your weight loss diet plan may lack essential vitamins, minerals and healthy carbohydrates. Suggestions

• Increase your fruit and vegetable intake (carbohydrates)

• Drink at least 8 glasses of water each day

• Do 30 minutes of exercise, 4 times weekly

• Add a daily vitamin/mineral supplement and get plenty of rest

• If the tiredness persists, see your doctor

Q. My 12 year old daughter is very overweight but she hardly eats a bite. Why is this?
A: Nine times out of ten, it's because she's eating too many high calorie foods, like: chips, pretzels, nachos, soda, candy and chocolate, but not enough proper food.

Suggestions

• Make sure she eats a sensible breakfast and dinner. For lunch give her healthy sandwiches with milk or 100 percent fruit juice.

• Encourage exercise or any activity outside.

• Turn off the television.

• Lead by example.

Q. What's the biggest dieting mistake?
A: The biggest mistake dieters make, is not eating enough. It’s common to see food as the enemy. But food isn't the enemy: hunger is. Don't starve yourself! Remember: it's not how much you eat, that counts - it's what you eat.

Q: I am trying to lose weight and I have found that fresh fruit is a great substitute for snacks if I find myself hungry between meals. If I am counting calories, do I need to count the calories in fruit, or can I eat as much as I like?
A: You are right that fresh fruit, and vegetables are the best choice of snack for anyone who is watching their weight. An apple for example only contains around 50 calories, where a bar of chocolate around 250, a banana has 100 calories and a piece of cake 300, a peach has only 40 calories and a bag of chips up to 250! But fruit has calories so if you are on a calorie restricted diet, you will need to count them.

Q: I have lost 56lbs and have another 20lbs to go, but I cant seem to tip the scales in my favor. I have lowered my daily calorie intake to around 1000 cal from 1200cal, but this doesn’t seem to be working.  I have increased my exercise as well. Do you have any advice as to what I can do next?
A: At the beginning of dieting one always loses the most weight and then starts to slow down....keep up with what you are doing and you will begin to see results. As long as you consistently take in fewer calories than you expend, the weight will come off. Most people see a plateau one or more times during their weight loss. The last pounds always seem to take longer, but if you keep focused your weight loss will resume. I caution you, however, to not decrease your calories too much. Your body may “fight back” by decreasing your metabolism thereby conserving energy.

Q:  I’ve been on a weight loss program for 3 weeks and I haven’t lost a pound! When will I start losing weight?
A: If you've reduced your calories (by about 500 calories a day with diet AND exercise) and are consistent with your program, you will lose weight. But everyone loses body fat at a different rate depending on their gender, weight, age, fitness level and hereditary factors. To get past the frustration, focus on the results you're getting NOW - Aren't you feeling better? Walking faster or longer? Getting stronger? Sleeping better? More energetic? That's progress!

Q: I walk every day for 30 minutes and have been doing great with my weight loss program. My problem is that after 4 months I've stopped losing weight. I haven’t changed my diet. What am I doing wrong?
A: It sounds as if you have hit a plateau. Plateaus happen to everyone. When you do the same exercise over and over, your body adapts to it and your workout becomes less effective. If you've reached a plateau try these ideas:

• Increase your exercise intensity. Speed up your usual workout or add sprints or hills to boost your calorie-burnage.

• Try something new. Confuse your body by doing something you've never done--ride a bike or go for a swim to keep your muscles from becoming too accustomed to one exercise.

• Lift weights. Weight training is one of the best methods for increasing metabolism and calorie burning.

• Add another day of exercise. Even an extra 15-20 minutes a week can help you burn more calories.

Q: How do you squash that little voice - the one that whispers: "Just one bite!" or "You'll never do it" or "this diet is so boring"?
A: By having a strong incentive.

Strong incentives are SPECIFIC, SELFISH and TIME-RELATED.

For example:

• "My husband has promised me a 1-carat diamond for every 10 pounds I lose."

• "My 25^th high school reunion is in 8 weeks and I want to look my best!

• "I'm meeting my ex- at the end of the month."

These answers are specific, selfish and mostly time-related. As a result, they are MUCH more likely to keep you on track..

Example of How an Incentive Works

Helen is 49 years old, weighs 180 pounds and wants to be 140. When asked why she wants to be 140 pounds, she replies: [pointing to her belly] "Because I don't want to drag this around at my daughter’s wedding in 5 months!"

When Helen stands in front of her refrigerator and eyeballs the ice-cream, all she needs to do is imagine socializing with family and friends at her daughter’s wedding with a fat stomach bulging out in front of her!

As soon as she sees this terrible scene, she grabs the ice cream and dumps it in the garbage can. Her selfish desire to look good, outweighs her desire to eat the ice cream.

Note: if Helen’s incentive was something less selfish or less specific, like "I want to improve my health", or "my doctor says I should lose weight", the ice cream would have won.