Dealing with Depression

Depression is one of the leading cause of morbidity in the UK.
Depression drains your energy, hope, and drive, making it difficult to do what you need to feel better. But while overcoming depression isn’t quick or easy, it’s far from impossible. You can’t beat it through sheer willpower, but you do have some control—even if your depression is severe and stubbornly persistent. The key is to start small and build from there. Feeling better takes time, but you can get there if you make positive choices for yourself each day.

Recovering from depression requires action, but taking action when you’re depressed is hard. In fact, just thinking about the things you should do to feel better, like going for a walk or spending time with friends, can be exhausting.

It’s the Catch-22 of depression recovery: The things that help the most are the things that are the most difficult to do. There’s a difference, however, between something that’s difficult and something that’s impossible.

Depression self-help tip 1: Cultivate supportive relationships

Getting the support you need plays a big role in lifting the fog of depression and keeping it away. On your own, it can be difficult to maintain perspective and sustain the effort required to beat depression, but the very nature of depression makes it difficult to reach out for help. However, isolation and loneliness make depression even worse, so maintaining your close relationships and social activities are important.

The thought of reaching out to even close family members and friends can seem overwhelming. You may feel ashamed, too exhausted to talk, or guilty for neglecting the relationship. Remind yourself that this is the depression talking. Reaching out is not a sign of weakness and it won’t mean you’re a burden to others. Your loved ones care about you and want to help. And remember, it’s never too late to build new friendships and improve your support network.
◾Turn to trusted friends and family members. Share what you’re going through with the people you love and trust, face to face if possible. The people you talk to don’t have to be able to fix you; they just need to be good listeners. Ask for the help and support you need. You may have retreated from your most treasured relationships, but they can get you through this tough time.
◾Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed, it feels more comfortable to retreat into your shell, but being around other people will make you feel less depressed.
◾Join a support group for depression. Being with others dealing with depression can go a long way in reducing your sense of isolation. You can also encourage each other, give and receive advice on how to cope, and share your experiences.

10 tips for reaching out and building relationships

◾Talk to one person about your feelings.
◾Help someone else by volunteering.
◾Have lunch or coffee with a friend.
◾Ask a loved one to check in with you regularly.
◾Accompany someone to the movies, a concert, or a small get-together.
◾Call or email an old friend.
◾Go for a walk with a workout buddy.
◾Schedule a weekly dinner date.
◾Meet new people by taking a class or joining a club.
◾Confide in a counselor, therapist, or clergy member.

Depression self-help tip 2: Challenge negative thinking

Depression puts a negative spin on everything, including the way you see yourself, the situations you encounter, and your expectations for the future.

But you can’t break out of this pessimistic mind frame by “just thinking positive.” Happy thoughts or wishful thinking won’t cut it. Rather, the trick is to replace negative thoughts with more balanced thoughts.

Ways to challenge negative thinking:
◾Think outside yourself. Ask yourself if you’d say what you’re thinking about yourself to someone else. If not, stop being so hard on yourself. Think about less harsh statements that offer more realistic descriptions.
◾Allow yourself to be less than perfect. Many depressed people are perfectionists, holding themselves to impossibly high standards and then beating themselves up when they fail to meet them. Battle this source of self-imposed stress by challenging your negative ways of thinking
◾Socialize with positive people. Notice how people who always look on the bright side deal with challenges, even minor ones, like not being able to find a parking space. Then consider how you would react in the same situation. Even if you have to pretend, try to adopt their optimism and persistence in the face of difficulty.
◾Keep a “negative thought log.” Whenever you experience a negative thought, jot down the thought and what triggered it in a notebook. Review your log when you’re in a good mood. Consider if the negativity was truly warranted. Ask yourself if there’s another way to view the situation. For example, let’s say your boyfriend was short with you and you automatically assumed that the relationship was in trouble. It’s possible, though, he’s just having a bad day.

Types of negative thinking that add to depression

All-or-nothing thinking – Looking at things in black-or-white categories, with no middle ground (“If I fall short of perfection, I’m a total failure.”)

Overgeneralization – Generalizing from a single negative experience, expecting it to hold true forever (“I can’t do anything right.”)

The mental filter – Ignoring positive events and focusing on the negative. Noticing the one thing that went wrong, rather than all the things that went right.

Diminishing the positive – Coming up with reasons why positive events don’t count (“She said she had a good time on our date, but I think she was just being nice.”)

Jumping to conclusions – Making negative interpretations without actual evidence. You act like a mind reader (“He must think I’m pathetic”) or a fortune teller (“I’ll be stuck in this dead end job forever”)

Emotional reasoning – Believing that the way you feel reflects reality (“I feel like such a loser. I really am no good!”)

‘Shoulds’ and ‘should-nots’ – Holding yourself to a strict list of what you should and shouldn’t do, and beating yourself up if you don’t live up to your rules.

Labeling – Labeling yourself based on mistakes and perceived shortcomings (“I’m a failure; an idiot; a loser.”)

Depression self-help tip 3: Take care of yourself

In order to overcome depression, you have to take care of yourself. This includes following a healthy lifestyle, learning to manage stress, setting limits on what you’re able to do, adopting healthy habits, and scheduling fun activities into your day.
◾Aim for eight hours of sleep. Depression typically involves sleep problems. Whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
◾Expose yourself to a little sunlight every day. Lack of sunlight can make depression worse. Make sure you’re getting enough. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day to boost your mood. If you live somewhere with little winter sunshine, try using a light therapy box.
◾Keep stress in check. Not only does stress prolong and worsen depression, but it can also trigger it. Figure out all the things in your life that stress you out. Examples include: work overload, unsupportive relationships, taking on too much, or health problems. Once you’ve identified your stressors, you can make a plan to avoid them or minimize their impact.
◾Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.
◾Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give you a sense of being needed—both powerful antidotes to depression.

Do things you enjoy (or used to)

While you can’t force yourself to have fun or experience pleasure, you can choose to do things that you used to enjoy. Pick up a former hobby or a sport you used to like. Express yourself creatively through music, art, or writing. Go out with friends. Take a day trip to a museum, the mountains, or the ballpark.

Push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.

Develop a wellness toolbox

Come up with a list of things that you can do for a quick mood boost. Include any strategies, activities, or skills that have helped in the past. The more “tools” for coping with depression, the better. Try and implement a few of these ideas each day, even if you’re feeling good.

◾Spend some time in nature
◾List what you like about yourself
◾Read a good book
◾Watch a funny movie or TV show
◾Take a long, hot bath
◾Take care of a few small tasks
◾Play with a pet
◾Talk to friends or family face-to-face
◾Listen to music
◾Do something spontaneous

Depression self-help tip 1: Cultivate supportive relationships

Getting the support you need plays a big role in lifting the fog of depression and keeping it away. On your own, it can be difficult to maintain perspective and sustain the effort required to beat depression, but the very nature of depression makes it difficult to reach out for help. However, isolation and loneliness make depression even worse, so maintaining your close relationships and social activities are important.

The thought of reaching out to even close family members and friends can seem overwhelming. You may feel ashamed, too exhausted to talk, or guilty for neglecting the relationship. Remind yourself that this is the depression talking. Reaching out is not a sign of weakness and it won’t mean you’re a burden to others. Your loved ones care about you and want to help. And remember, it’s never too late to build new friendships and improve your support network.
◾Turn to trusted friends and family members. Share what you’re going through with the people you love and trust, face to face if possible. The people you talk to don’t have to be able to fix you; they just need to be good listeners. Ask for the help and support you need. You may have retreated from your most treasured relationships, but they can get you through this tough time.
◾Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed, it feels more comfortable to retreat into your shell, but being around other people will make you feel less depressed.
◾Join a support group for depression. Being with others dealing with depression can go a long way in reducing your sense of isolation. You can also encourage each other, give and receive advice on how to cope, and share your experiences.

10 tips for reaching out and building relationships

◾Talk to one person about your feelings.
◾Help someone else by volunteering.
◾Have lunch or coffee with a friend.
◾Ask a loved one to check in with you regularly.
◾Accompany someone to the movies, a concert, or a small get-together.
◾Call or email an old friend.
◾Go for a walk with a workout buddy.
◾Schedule a weekly dinner date.
◾Meet new people by taking a class or joining a club.
◾Confide in a counselor, therapist, or clergy member.

Depression self-help tip 2: Challenge negative thinking

Depression puts a negative spin on everything, including the way you see yourself, the situations you encounter, and your expectations for the future.

But you can’t break out of this pessimistic mind frame by “just thinking positive.” Happy thoughts or wishful thinking won’t cut it. Rather, the trick is to replace negative thoughts with more balanced thoughts.

Ways to challenge negative thinking:
◾Think outside yourself. Ask yourself if you’d say what you’re thinking about yourself to someone else. If not, stop being so hard on yourself. Think about less harsh statements that offer more realistic descriptions.
◾Allow yourself to be less than perfect. Many depressed people are perfectionists, holding themselves to impossibly high standards and then beating themselves up when they fail to meet them. Battle this source of self-imposed stress by challenging your negative ways of thinking
◾Socialize with positive people. Notice how people who always look on the bright side deal with challenges, even minor ones, like not being able to find a parking space. Then consider how you would react in the same situation. Even if you have to pretend, try to adopt their optimism and persistence in the face of difficulty.
◾Keep a “negative thought log.” Whenever you experience a negative thought, jot down the thought and what triggered it in a notebook. Review your log when you’re in a good mood. Consider if the negativity was truly warranted. Ask yourself if there’s another way to view the situation. For example, let’s say your boyfriend was short with you and you automatically assumed that the relationship was in trouble. It’s possible, though, he’s just having a bad day.

Types of negative thinking that add to depression

All-or-nothing thinking – Looking at things in black-or-white categories, with no middle ground (“If I fall short of perfection, I’m a total failure.”)

Overgeneralization – Generalizing from a single negative experience, expecting it to hold true forever (“I can’t do anything right.”)

The mental filter – Ignoring positive events and focusing on the negative. Noticing the one thing that went wrong, rather than all the things that went right.

Diminishing the positive – Coming up with reasons why positive events don’t count (“She said she had a good time on our date, but I think she was just being nice.”)

Jumping to conclusions – Making negative interpretations without actual evidence. You act like a mind reader (“He must think I’m pathetic”) or a fortune teller (“I’ll be stuck in this dead end job forever”)

Emotional reasoning – Believing that the way you feel reflects reality (“I feel like such a loser. I really am no good!”)

‘Shoulds’ and ‘should-nots’ – Holding yourself to a strict list of what you should and shouldn’t do, and beating yourself up if you don’t live up to your rules.

Labeling – Labeling yourself based on mistakes and perceived shortcomings (“I’m a failure; an idiot; a loser.”)

Depression self-help tip 3: Take care of yourself

In order to overcome depression, you have to take care of yourself. This includes following a healthy lifestyle, learning to manage stress, setting limits on what you’re able to do, adopting healthy habits, and scheduling fun activities into your day.
◾Aim for eight hours of sleep. Depression typically involves sleep problems. Whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
◾Expose yourself to a little sunlight every day. Lack of sunlight can make depression worse. Make sure you’re getting enough. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day to boost your mood. If you live somewhere with little winter sunshine, try using a light therapy box.
◾Keep stress in check. Not only does stress prolong and worsen depression, but it can also trigger it. Figure out all the things in your life that stress you out. Examples include: work overload, unsupportive relationships, taking on too much, or health problems. Once you’ve identified your stressors, you can make a plan to avoid them or minimize their impact.
◾Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.
◾Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give you a sense of being needed—both powerful antidotes to depression.

Do things you enjoy (or used to)

While you can’t force yourself to have fun or experience pleasure, you can choose to do things that you used to enjoy. Pick up a former hobby or a sport you used to like. Express yourself creatively through music, art, or writing. Go out with friends. Take a day trip to a museum, the mountains, or the ballpark.

Push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.

Develop a wellness toolbox

Come up with a list of things that you can do for a quick mood boost. Include any strategies, activities, or skills that have helped in the past. The more “tools” for coping with depression, the better. Try and implement a few of these ideas each day, even if you’re feeling good.

◾Spend some time in nature
◾List what you like about yourself
◾Read a good book
◾Watch a funny movie or TV show
◾Take a long, hot bath
◾Take care of a few small tasks
◾Play with a pet
◾Talk to friends or family face-to-face
◾Listen to music
◾Do something spontaneous

Depression self-help tip 4: Get regular exercise

When you’re depressed, exercising may be the last thing you feel like doing. But exercise is a powerful tool for dealing with depression. In fact, studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue.

Scientists haven’t figured out exactly why exercise is such a potent antidepressant, but evidence suggests that physical activity triggers new cell growth in the brain, increases mood-enhancing neurotransmitters and endorphins, reduces stress, and relieves muscle tension—all things that can have a positive effect on depression.

To gain the most benefits, aim for 30 minutes of exercise per day. You can start small, though, as short 10-minute bursts of activity can have a positive effect on your mood. Here are a few easy ways to get moving:
◾Take the stairs rather than the elevator
◾Park your car in the farthest spot in the lot
◾Take your dog for a walk
◾Pair up with an exercise partner
◾Walk while you’re talking on the phone

As a next step, try incorporating walks or some other enjoyable, easy form of exercise into your daily routine. The key is to pick an activity you enjoy, so you’re more likely to keep up with it.

Exercise as an Antidepressant

The following exercise tips offer a powerful prescription for boosting mood:
◾Exercise now… and again. A 10-minute walk can improve your mood for two hours. The key to sustaining mood benefits is to exercise regularly.
◾Choose activities that are moderately intense. Aerobic exercise undoubtedly has mental health benefits, but you don’t need to sweat strenuously to see results.
◾Find exercises that are continuous and rhythmic (rather than intermittent). Walking, swimming, dancing, stationery biking, and yoga are good choices.
◾Add a mind-body element. Activities such as yoga and tai chi rest your mind and increase your energy. You can also add a meditative element to walking or swimming by repeating a mantra (a word or phrase) as you move.
◾Start slowly, and don’t overdo it. More isn’t better. Athletes who over train find their moods drop rather than lift.

Adapted from Johns Hopkins Health Alerts

Depression self-help tip 5: Eat a healthy, mood-boosting diet

What you eat has a direct impact on the way you feel. Aim for a balanced diet of low-fat protein, complex carbohydrates, fruits and vegetables. Reduce your intake of foods that can adversely affect your brain and mood, such as caffeine, alcohol, trans fats, saturated fats, and foods with high levels of chemical preservatives or hormones (such as certain meats).
◾Don’t skip meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours.
◾Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy.
◾Focus on complex carbohydrates. Foods such as baked potatoes, whole-wheat pasta, oatmeal, and whole grain breads can boost serotonin levels without a crash.
◾Boost your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To get more, take a B-complex vitamin supplement or eat more citrus fruit, leafy greens, beans, chicken, and eggs.
◾Try super-foods rich in nutrients that can boost mood, such as bananas (magnesium to decrease anxiety, vitamin B6 to promote alertness, tryptophan to boost feel-good serotonin levels), brown rice (serotonin, thiamine to support sociability), and spinach (magnesium, folate to reduce agitation and improve sleep).
◾Consider taking a chromium supplement. Some depression studies show that chromium picolinate reduces carbohydrate cravings, eases mood swings, and boosts energy. Supplementing with chromium picolinate is especially effective for people who tend to overeat and oversleep when depressed.

Omega-3 fatty acids play an essential role in stabilizing mood.
◾ Foods rich in certain omega-3 fats called EPA and DHA can give your mood a big boost. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, sardines, and some cold-water fish oil supplements. Canned albacore tuna and lake trout can also be good sources, depending on how the fish were raised and processed. When cooking fish, grill or bake rather than fry.
◾ You may hear a lot about getting your omega-3s from foods rich in ALA fatty acids, such as vegetable oils and nuts (especially walnuts), flax, soybeans, and tofu. Be aware that our bodies generally convert very little ALA into EPA and DHA, so you may not see as big of a benefit.
◾ Some people avoid seafood because they worry about mercury or other possible toxins, but most experts agree that the benefits of eating one or two servings a week of cold-water fatty fish outweigh the risks.

Depression self-help tip 6: Know when to get additional help

If you find your depression getting worse and worse, seek professional help. Needing additional help doesn’t mean you’re weak. Sometimes the negative thinking in depression can make you feel like you’re a lost cause, but depression can be treated and you can feel better!

Don’t forget about these self-help tips, though. Even if you’re receiving professional help, these tips can be part of your treatment plan, speeding your recovery and preventing depression from returning.

How to Manage Stress

About stress

What is stress?

Stress is a state of mental or emotional strain or tension resulting from adverse or demanding circumstances.
We all sometimes talk about stress, and feeling stressed, usually when we feel we have too much to do and too much on our minds, or other people are making unreasonable demands on us, or we are dealing with situations that we do not have control over.

Stress is not a medical diagnosis, but severe stress that continues for a long time may lead to a diagnosis of depression or anxiety, or more severe mental health problems.

You can reduce the effects of stress by being more conscious of the things that cause it, and learning to handle them better, using relaxation techniques as well as other lifestyle changes.

What causes stress?

Situations which are recognised to be very stressful are associated with change, and with lack of control over what is happening. Some of the causes of stress are happy events, but because they bring big changes or make unusual demands on you, they can still be stressful.

Some of the most stressful events are:
•moving house
•getting married
•having a baby
•bereavement
•serious illness in yourself or a friend or family member.

Stress is also caused by long-term difficult circumstances, such as:
•unemployment
•poverty
•relationship problems
•caring for a disabled family member or friend
•difficulties at work
•bad housing
•noisy neighbours.

Not having enough work, activities or change in your life can be just as stressful as have too much activity and change to deal with.

Is stress harmful?

Stress can have a positive side. A certain level of stress may be necessary and enjoyable in order to help you prepare for something or to actually do it – e.g. if you are taking part in a performance, taking an exam or you have to do an important piece of work for a deadline – it will be stressful even if you enjoy it, and the stress itself will keep you alert and focussed.

Our physical reactions to stress are determined by our biological history and the need to respond to sudden dangers that threatened us when we were still hunters and gatherers. In this situation, the response to danger was ‘fight or flight’. Our bodies still respond in this way, releasing the hormones adrenaline and cortisol.

Adrenaline

The release of adrenaline causes rapid changes to your blood flow and increases your breathing and heart rate, to get you ready to defend yourself (fight) or to run away (flight). You become pale, sweat more and your mouth becomes dry.

Your body responds in this way to all types of stress as if it were a physical threat. You may merely be having an argument with someone, but your body may react as though you were facing a wolf. If the threat is physical, you use the effects of the adrenaline appropriately – to fight or to run, and when the danger is passed your body recovers. But if the stress is emotional, the effects of adrenaline subside more slowly, and you may go on feeling agitated for a long time. If the causes of stress are long-term, you may always be tensed up to deal with them and never relaxed. This is very bad for both your physical and your mental health.

Cortisol

The other stress hormone, cortisol, is present in your body all the time, but levels increase in response to danger and stress. In the short-term, its effects are positive, to help you deal with an immediate crisis, but long-term stress means that cortisol builds up and creates a number of stress-related health problems.

Short-term positive effects:
•a quick burst of energy
•decreased sensitivity to pain
•increase in immunity
•heightened memory.

Long-term negative effects:
•imbalances of blood sugar
•increase in abdominal fat storage
•suppressed thyroid activity
•decreased bone density
•decreased muscle mass
•high blood pressure
•lowered immunity
•less able to think clearly.

People’s tolerance of stress varies. A situation that is intolerable to one person may be stimulating to another. What you feel is determined not just by events and changes in the outside world, but how you perceive and respond to them.

The important point is that you can learn to recognise your own responses to stress and develop skills to deal with it well.

Identify the sources of stress in your life

Stress management starts with identifying the sources of stress in your life. This isn’t as easy as it sounds. Your true sources of stress aren’t always obvious, and it’s all too easy to overlook your own stress-inducing thoughts, feelings, and behaviors. Sure, you may know that you’re constantly worried about work deadlines. But maybe it’s your procrastination, rather than the actual job demands, that leads to deadline stress.

To identify your true sources of stress, look closely at your habits, attitude, and excuses:
◾ Do you explain away stress as temporary (“I just have a million things going on right now”) even though you can’t remember the last time you took a breather?
◾ Do you define stress as an integral part of your work or home life (“Things are always crazy around here”) or as a part of your personality (“I have a lot of nervous energy, that’s all”).
◾Do you blame your stress on other people or outside events, or view it as entirely normal and unexceptional?

Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control.

Start a Stress Journal

A stress journal can help you identify the regular stressors in your life and the way you deal with them. Each time you feel stressed, keep track of it in your journal. As you keep a daily log, you will begin to see patterns and common themes. Write down:
◾ What caused your stress (make a guess if you’re unsure)
◾ How you felt, both physically and emotionally
◾ How you acted in response
◾ What you did to make yourself feel better

Look at how you currently cope with stress

Think about the ways you currently manage and cope with stress in your life. Your stress journal can help you identify them. Are your coping strategies healthy or unhealthy, helpful or unproductive? Unfortunately, many people cope with stress in ways that compound the problem.

Unhealthy ways of coping with stress

These coping strategies may temporarily reduce stress, but they cause more damage in the long run:

◾Smoking
◾Drinking too much
◾ Overeating or underrating
◾Zoning out for hours in front of the TV or computer
◾ Withdrawing from friends, family, and activities
◾Using pills or drugs to relax
◾ Sleeping too much
◾ Procrastinating
◾ Filling up every minute of the day to avoid facing problems
◾ Taking out your stress on others (lashing out, angry outbursts, physical violence)

Learning healthier ways to manage stress

If your methods of coping with stress aren’t contributing to your greater emotional and physical health, it’s time to find healthier ones. There are many healthy ways to manage and cope with stress, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the four As: avoid, alter, adapt, or accept.

Since everyone has a unique response to stress, there is no “one size fits all” solution to managing it. No single method works for everyone or in every situation, so experiment with different techniques and strategies. Focus on what makes you feel calm and in control.

Dealing with Stressful Situations: The Four A’s

Change the situation:
◾ Avoid the stressor
◾ Alter the stressor

Change your reaction:
◾ Adapt to the stressor
◾ Accept the stressor

Stress management strategy 1: Avoid unnecessary stress

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. You may be surprised, however, by the number of stressors in your life that you can eliminate.
◾Learn how to say “no” – Know your limits and stick to them. Whether in your personal or professional life, taking on more than you can handle is a sure-fire recipe for stress.
◾Avoid people who stress you out – If someone consistently causes stress in your life and you can’t turn the relationship around, limit the amount of time you spend with that person or end the relationship entirely.
◾Take control of your environment – If the evening news makes you anxious, turn the TV off. If traffic’s got you tense, take a longer but less-travelled route. If going to the market is an unpleasant chore, do your grocery shopping online.
◾Avoid hot-button topics – If you get upset over religion or politics, cross them off your conversation list. If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.
◾Pare down your to-do list – Analyse your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely.

Stress management strategy 2: Alter the situation

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future. Often, this involves changing the way you communicate and operate in your daily life.
◾Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build and the situation will likely remain the same.
◾Be willing to compromise. When you ask someone to change their behaviour, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground.
◾Be more assertive. Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk.
◾Manage your time better. Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. But if you plan ahead and make sure you don’t overextend yourself, you can alter the amount of stress you’re under.

Stress management strategy 3: Adapt to the stressor

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.
◾Reframe problems. Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen to your favourite radio station, or enjoy some alone time.
◾Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. Will it matter in a month? A year? Is it really worth getting upset over? If the answer is no, focus your time and energy elsewhere.
◾Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”
◾Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts. This simple strategy can help you keep things in perspective.

Adjusting Your Attitude

How you think can have a profound effect on your emotional and physical well-being. Each time you think a negative thought about yourself, your body reacts as if it were in the throes of a tension-filled situation. If you see good things about yourself, you are more likely to feel good; the reverse is also true. Eliminate words such as “always,” “never,” “should,” and “must.” These are tell-tale marks of self-defeating thoughts.

Stress management strategy 4: Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.
◾Don’t try to control the uncontrollable. Many things in life are beyond our control— particularly the behaviour of other people. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems.
◾Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.
◾Share your feelings. Talk to a trusted friend face to face or make an appointment with a therapist. The simple act of expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation. Opening up is not a sign of weakness and it won’t make you a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them, and it will only strengthen your bond.
◾Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

Stress management strategy #5: Make time for fun and relaxation

Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by nurturing yourself. If you regularly make time for fun and relaxation, you’ll be in a better place to handle life’s stressors.

Healthy ways to relax and recharge

◾Go for a walk.
◾ Spend time in nature.
◾ Call a good friend.
◾ Sweat out tension with a good workout.
◾ Write in your journal.
◾ Take a long bath.
◾ Light scented candles.
◾Savour a warm cup of coffee or tea.
◾ Play with a pet.
◾ Work in your garden.
◾ Get a massage.
◾ Curl up with a good book.
◾ Listen to music.
◾ Watch a comedy.

Don’t get so caught up in the hustle and bustle of life that you forget to take care of your own needs. Nurturing yourself is a necessity, not a luxury.
◾Set aside relaxation time. Include rest and relaxation in your daily schedule. Don’t allow other obligations to encroach. This is your time to take a break from all responsibilities and recharge your batteries.
◾Connect with others. Spend time with positive people who enhance your life. A strong support system will buffer you from the negative effects of stress.
◾Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.
◾Keep your sense of humour. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress in a number of ways.

Stress management strategy #6: Adopt a healthy lifestyle

You can increase your resistance to stress by strengthening your physical health.
◾Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress. Make time for at least 30 minutes of exercise, three times per week. Nothing beats aerobic exercise for releasing pent-up stress and tension.
◾Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.
◾Reduce caffeine and sugar. The temporary “highs” caffeine and sugar provide often end in with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet, you’ll feel more relaxed and you’ll sleep better.
◾Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the issue at hand; deal with problems head on and with a clear mind.
◾Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally

How to Get a Flat Stomach

Part A. Following a Healthy Diet.

1. Don’t eat anything for two to three hours before sleep.

2. Eat healthier.

3.Reduce your portion sizes.

4. Eat low-glycaemic index foods: that is food low in sugar content.

5. Try to reduced as much sugar from your diet as possible.

6. Eat a protein-rich snack between 3 and 4 pm.

7. Eat small, frequent meals.

8. Drink plenty of water: replace the soda and coffee.

9. If you drink cut down on alcohol consumption.

Part B. Exercising for a Flat Stomach.

1. Do aerobic exercises daily.

2. Include plyometrics: these are exercises that require explosive power.

3. Do strength training to build muscle: Abdominal crunches.

I hope these tips well help you get a flat stomach.

How to stay fit and healthy.

Hi everyone I am writing about staying healthy and fit. As a doctor working in the accident and emergency department here in the UK I have seen a lot of unfit and unhealthy people.
As a person it is important to stay healthy and maintain an active lifestyle. Your body needs nutrition and exercise to function properly. When you are healthy, you will look and feel good about yourself. If you have some unhealthy habits in your life such as overeating, smoking or over-working, keep in mind that they may affect your health, either directly or indirectly. Staying healthy both physically and mentally will help you maintain peace of mind.

Step 1

Just like a car which need a yearly MOT so do we especially as we get on with age.
We should seek medical care frequently. This is very important for your physical health. Even if you feel well, get regular screenings for cardiovascular problems, cardiovascular disease and cancer. An annual check-up can assure that your physical health is in good shape. Routine blood test can help detect an underlying medical problem and allow you to get care immediately if needed. It is also important to have routine dental and eye care. For dental care I would say every six months and eye care testing every year. Practicing good oral hygiene and addressing dental problems as they come up will help keep your smile healthy.
You should visit your doctor if you are over 40 or have a history of disease before beginning a vigorous exercise routine. Men should have prostate cancer screenings beginning at age 50. Women should have a mammogram yearly starting at age 40 or before if you have a family history of breast cancer.

Step 2

Eat a balanced diet. All children and adults should get food and meals from the following food groups — milk, vegetables, grains, fruits, beans and meat and oils. This will assure that you are getting enough nutrition and avoiding sugary, processed foods, which can be harmful to your health.
We should eat five portions of fruits and vegetables per day.
Avoid overeating. When eating sweets or foods high in fat and calories, always eat in moderation.

Step 3

We all should exercise regularly. The American College of Sports Medicine recommends that adults under the age of 65 or in good health perform moderate cardiovascular exercise for at least 30 minutes a day, five days a week, for optimal health. You can create your own exercise routine or seek out a personal trainer. Examples include using fitness equipment, walking, swimming, jogging or engaging in extra-curricular sports. Doing a bit of Gardening after would could also help. One you will get your exercise in and secondly you will have healthy and nutritious food to eat from your own garden.

Step 4

Avoid alcoholic beverages and recreational drugs if you use them. Excessive and regular drinking of alcoholic beverages can lead to problems with your liver and digestive system and also spark addiction. The use of recreational drugs such as marijuana, cocaine or heroin is never a healthy idea. If you have a problem with substance abuse of any kind, seek medical treatment immediately.
You should also stop smoking as this increase the risk of cardiovascular diseases such as heart attacks and strokes. It also increase the risk of several cancers.

Step 5

Managing stress
Stress is a normal part of our daily life. It’s a natural physical and mental response needed to help you cope with emergencies and to perform at your best. But when stress is regular and doesn’t let up, it can damage your physical and mental health. Don’t wait for stress to get so bad that you start feeling depressed or helpless.

Try to work out what’s troubling you and then talk to someone about it who can help you. Talking to a friend or family member is a good way to start. Or you may want to talk to a teacher, counsellor, or your doctor. A doctor can help with a health concern that may be causing you stress.

Step 6

We should all get enough rest daily. Rest and sleep are just as important as eating healthy and exercising. Your body needs rest to recuperate and heal itself; often, it can only do this if we are asleep. Getting the right amount of sleep is also important. While every person’s sleep needs differ, the Mayo Clinic recommends that the average adult should get about seven to eight hours of sleep to maintain good health.

Losing weight and maintaining it.

The science behind weight loss
The science behind weight loss in some respect is quite simple. Your weight is a balance between how much energy you take in (calories in food and drink) and how much energy your body expends (burns):
• If the amount of calories that you eat equals the amount of energy that your body uses up, then your weight remains stable.
• If you take in more calories than you burn up, you will put on weight. The extra or excess energy is converted into fat and stored in your body.
• If you consume fewer calories than you burn up, you will lose weight. Your body will then begin to tap into its fat stores to get the extra energy to supply its needs.
In essence, to lose weight, you need a calorie deficit. You can achieve this calorie deficit by:
• Eating less: taking in fewer calories from food.
• Engage in more physical activities: burning up more calories.
There are 3,500 calories in one pound (0.45 kg) of fat. Therefore, cutting down your calories by about 500 calories each day can result in losing one pound of body weight each week.
It is not advice to lose weight too fast. You should aim to lose the weight gradually. If you lose more than a kilogram per week, you may lose muscle tissue rather than fat. This isn’t sustainable weight loss. So, it is recommended that you lose an average of 0.5 to 1 kg per week or about one to two pounds per week.
Losing weight required lifestyle change for life
Some people lose weight by strict dieting for a short period. However, as soon as their diet is over, they often go back to their old eating habits, and their weight goes straight back on. Losing weight and then keeping it off, needs a change in our lifestyle for life. This includes such things as:
• The type of food and drink that you normally consumed.
• The type of meals that you eat.
• Our eating pattern.
• The amount of physical activities that you do.
Tip: Work with family and friends to help and encourage you to stick to a healthy lifestyle. You can consider a lifestyle change for your whole family.

Before you get started
Motivation is crucial
To lose weight and to keep it off require you being motivated to really wanting to lose weight and to improve all aspects of your lifestyle. No weight-loss plan will work unless you have a serious desire to lose weight. You may not feel that being overweight or obese is a problem to you. So, you may have little motivation or desire to lose weight. That is fine, so long as you understand the health risks.
Tip: Write down the reasons why you would like to lose weight. Put it in a place that you can see at all times so you can keep referring to this list so as to keep motivating yourself.
Set goals with a realistic timescale
Based on the recommended rate of weight loss I explained above; set a clear weight loss goal with a realistic timescale for you. Some people aim to get down to a perfect body weight. However, this may be a lot of weight to lose for you and you may get fed up about poor progress, and give up. So, you may find it helpful to break up your weight loss goal. For example, you may wish to set yourself a goal to lose 4 kg over the following 4 to 6 weeks. Once you have achieved that goal, you can set yourself another.
For most people, you can start to get health benefits by losing even just 5-10% of your starting weight. For example, if your starting weight was 100 kg, losing 5-10 kg in weight will produce some health benefits for you, even if you are still not at your ideal weight.
Tip: Aim to lose weight steadily, around 0.5-1 kg per week. For most people, health benefits can come from losing the first 5-10% of their body weight. This is on average about 5-10 kg.
Set up an action plan
In addition to setting yourself realistic weight loss targets, it is also helpful to set yourself an action plan. Be realistic and consider what you feel will have the most impact on your weight. For example, if you currently have a piece of cake every day, your action plan could be to reduce this to trice per week only. Your action plan might start with three main goals, and once you have achieved these goals, you can reset your action plan and think about other changes you might be able to make. The idea is to make small, gradual changes that you can stick to for life.
Keep tab on your current food intake
It is helpful to know how much you normally eat. Try keeping a diary, writing down everything that you eat and drink over a week or so. Include even the smallest of snacks. Are there times of the day that you tend to snack more? Are you eating three meals a day? Are there some snacks that you don’t need? You may find it helpful to discuss your diary with your practice nurse, your doctor or a dietician. The simple fact is that, to lose weight, you must eat less than your current food intake.
Tip: Do not forget that some drinks contain large amount of calories, including alcohol and some fizzy drinks.
Eating to lose weight
Aim to eat a healthy balanced diet
Briefly, a healthy diet means:
• Making up the bulk of most meals with starch-based foods (such as cereals, bread, potatoes, rice, and pasta). Wholegrain starch-based foods should be eaten when possible.
• Eating plenty of fiber in your diet. Foods rich in fiber include wholegrain bread, brown rice and pasta, oats, peas, lentils, grain, beans, fruit, vegetables and seeds.
• Having at least five portions of a variety of fruit and vegetables per day. These should be in place of foods higher in fat and calories. For example, fruit makes a good, healthy snack if you feel hungry.
• Limiting fatty food such as fatty meats, cheeses, full-cream milk, fried foods, butter, etc. Use low-fat options where possible. Examples are:
o Skimmed or semi-skimmed instead of full-cream milk.
o Using low-fat, mono-unsaturated or polyunsaturated spreads instead of butter.
o If you eat meat, eating lean meat, or poultry such as chicken.
o Try to grill, bake or steam rather than fry food. If you do fry food, choose a vegetable oil such as sunflower, rapeseed or olive.
• Avoiding sugary drinks and foods such as chocolate, sweets, biscuits, cakes, etc.
• Limiting other foods likely to be high in fat or sugar such as some take-away or fast foods.
• Eating three meals a day and not skipping meals. Always have breakfast. Eat each meal slowly. Skipping meals will just make you feel more hungry, make you think more about food, and make you more likely to overeat in the evening or snack between meals.
• Trying not to add salt to food, and avoiding foods that are salty.
• Including 2-3 portions of fish per week. At least two of these should be ‘oily’ (such as herring, mackerel, sardines, kippers, pilchards, salmon, or fresh tuna).
Tip: Low-fat foods are generally best. But remember, some low-fat foods and drinks such as alcohol, sugary drinks, and sweets, are still high in calories.
Extra tips for losing weight
1. Eat regular meals. This can help you to burn calories at a faster rate and avoid becoming too hungry. It can help in regulating the hormones that are involved in controlling appetite. It can also help you adapt well to a routine, reduce the likelihood of unplanned temptations, and encourage you to develop good self-control.
2. Eat breakfast. Eating breakfast helps to control your blood sugar levels, can kick-start your metabolism and prevent you from snacking or eating impulsively later on. It has also been linked with increasing activity levels throughout the day, by replenishing your energy levels.
3. Make sure each meal is balanced. Think about what you’re putting on your plate at each meal time. Half your plate should be made up of fruit and/or vegetables. A quarter of the plate should contain your meat, fish, beans or other protein sources. The other quarter should contain your starchy carbohydrates such as rice, pasta, potatoes or bread. A balanced meal will provide you with all the nutrients you need while keeping your blood sugar levels steady and satisfying your hunger.
4. Don’t let yourself get too hungry. If you go for long periods without eating, this can result in you eating more when you eventually do eat and can cause you to crave unhealthy snacks. Eating every 3-4 hours will help to prevent this.
Plan what you eat
It is important to plan ahead. Perhaps you could plan each day’s meals and recipes the day before, or plan a week’s meals at a time. In this way you will know exactly how much food you will be eating. This is better than looking in the cupboard and fridge before mealtimes or snacks to see what is there.
It is best to separate eating from other activities. This helps you to keep to your planned eating for the day. So, try not to eat whilst on the move, whilst watching TV, during meetings, etc.
Tip: plan what you are going to eat tomorrow today.
Modify your eating habits
Do you have any eating habits that can improve?
• Are you eating larger and larger portions when you have a meal? Deliberately try to take smaller portions when you have a meal. Do not feel that you have to empty your plate. Perhaps change the plates in your cupboard which may be large to more medium-sized plates. In this way you will naturally serve up smaller portions.
• What do you have for snacks? Try changing chocolates, cakes or crisps for fruit.
• Do you have second helpings at mealtimes when you are really already full?
• Skipping meals is usually a bad idea. It sounds a good idea, but many people just become hungry, have snacks later in the day, and eat too much at the next meal. Eating at regular mealtimes may be a first important change. It is best to have three healthy meals a day.
• Do you always have a pudding? Will light yoghurt do instead of a sweet pastry?
• Do you eat quickly? Are you ready for a second helping before most people have half finished their first plateful? Overweight people, on average, eat faster than slimmer people. It is best to train yourself to chew each mouthful for longer, and to eat slowly.
• Do you give yourself time to feel full? It takes 15-20 minutes for the brain to register that you feel full. The hormones that regulate your appetite need time to kick in. So, eating slowly and allowing yourself time to feel full can help you to lose weight.
• Do you watch TV while you are eating? Sometimes having distractions and not concentrating on mealtimes can cause you to overeat. Sit down at the table during meals, focus on what you are eating, taste the food and become more aware of your food and eating habits.
Tips: eating three healthy meals each day, including breakfast, is better than skipping meals. Eat slowly, chew longer. Put your knife and fork or spoon down between each mouthful.
Change the food you buy
One step towards improving eating habits is to change the contents of your shopping basket. For example, if you never buy biscuits, they will not be in the cupboard to tempt you. Most food labels say what is in the food, so this can help you to buy healthier food. It may be helpful to plan a shopping list, and stick to it. However, whilst you are learning which the healthier foods are, it may also be helpful to spend some time comparing food labels before deciding on what to buy.
Tips: do not shop for food when you are hungry; after a meal is best. Remove temptations by changing the contents of your cupboards.
Try new recipes
Most people have a standard set of recipes and meals that they repeat. These may be old favourites, but you may need to adapt these and also find new, healthier recipes.
Tip: when you are on a weight-reducing diet, try to learn a new healthy recipe each week. When you have reached your goal weight, you should then have plenty of new healthy meal ideas to maintain the new weight.
Consider using more soup
There is some evidence that eating soup may fill you up for longer. Also, if you have soup as a starter to your meal, you are less likely to overeat for the rest of your meal. If you take, for example, chicken and vegetables and have this with a drink of water, you will feel full for a certain period of time afterwards. However, if you take the same food but blend it with the water to make a soup, eating the soup can keep your hunger satisfied for a longer period. This is thought to be due to the fact that your stomach empties more slowly if you eat soup than if you eat chicken and vegetables and drink water separately. As a result, your stomach wall is stretched for a longer period and messages are sent to your brain switching off the feeling of hunger for a greater period of time.
Tip: Avoid creamy or high-calorie soups and make sure that it is a low-fat soup that you are consuming.
Are you feeling physically hungry?
Your appetite is a very powerful thing. This is why many people find it so difficult to lose weight. It is true that some people feel hungry more often than others. However, feeling hungry does not always mean that your body physically needs food. Sometimes you can feel emotional hunger. That is feeling hungry because you are tired, bored, fed up or upset. Think about this and try to resist eating as soon as you feel hungry. Are you feeling physically hungry or are you just looking for food to fulfil an emotional hunger? If you do have a strong appetite, try to fill up at mealtimes with vegetables and fruit. These have a lot of fiber and bulk, but are low in calories.
Tips: drink lots or water and eat lots of fruit and vegetables to help counter physical hunger. Think about whether your hunger is for emotional reasons.
About special diets
Many special ‘wonder’ diets are advertised, but they are often not helpful. This is because your old eating habits will usually return after a short special diet, and weight often goes back on.
Tip: it is not usually a special diet that you need, but a lifelong change to a healthier diet as part of a healthier lifestyle.
Watch what you drink
Many people use drinks full of calories to quench their thirst. Sugary drinks, such as cola, tea and coffee with milk and sugar, milk, and alcoholic drinks, all contain calories. Alcoholic drinks also contain a lot of calories. One of the easiest ways to cut back on calories is simply to drink water as your main drink which is the best.
Top tips: keep some water in a plastic bottle in the fridge. Chilled water is surprisingly very refreshing. .
A research trial involving water
A study published in 2010 concluded that drinking water just before meals may also help people to lose weight. In the study, 48 overweight adults aged 55 to 75 were put into two groups. The first group was asked to eat a low-calorie diet but not to drink any extra water before meals. The second group was asked to eat the same diet but also to drink two glasses of water (500 ml) just before each meal. After 12 weeks the group drinking water had lost, on average, about 2 kg more than the non-water drinking group. The theory was that the group drinking water felt fuller during the meal and so ate less food at each meal.
This is just one small study and so it is difficult to base firm advice on it. However, it sounds logical and may be worth a try. Note: drinking excessive amounts of water is not helpful and, in rare cases, can be dangerous. There have been a few case reports of people dying from drinking excessive amounts of water. However, the extra 500 ml of water per meal in this study is good.
Increase your physical activity levels
It is recommended that all adults should aim for at least 30 minutes of moderate-intensity physical activity at least five days per week. However, if you are overweight or obese and are aiming to lose weight, if possible you should try to do around 60-90 minutes at least five days per week.
Moderate physical activity includes: brisk walking, jogging, dancing, swimming, badminton, tennis, etc. In addition, try to do more in your daily routines. For example, use stairs instead of lifts, walk or cycle to work or school, etc. Avoid sitting for too long in front of the television or a computer screen. Take regular breaks whilst working. The good news is that you don’t have to do this physical activity all in one chunk. You can break it up into blocks of 10-15 minutes.
Top tip: build your exercise levels up gradually. If you are not used to physical activity, try starting with a 30-minute brisk walk every day and then building up from there.
Monitor your behaviour and progress
Just as keeping a food diary can be helpful at the beginning if you are trying to lose weight, it can also be useful as a way to monitor your eating during your weight loss. Studies have shown that keeping a food diary can help people lose weight just through the process of writing things down. You can use the same diary to keep a track of your physical activity levels as well.
It is also important to weigh yourself regularly to monitor your progress. Once weekly is recommended. The first kilogram is the easiest to lose. This is because you lose water from your body at first as well as fat. Be aware that the first kilogram or so may seem to fall off, but then the weight loss slows down. This is normal. Also, don’t be disheartened by minor weight increases or levelling off in weight for a few days. Look for the overall trend in your weight loss over several months.
Top tip: regular weighing and encouragement by a practice nurse; your doctor or dietician may be helpful.
Get help and support
Some people may feel motivated enough and have all the information they need in order to lose weight without any help from others. However, you don’t have to try to lose weight alone. There is a wealth of help available. Ask your doctor or practice nurse for advice. A referral to a dietician may be helpful. One-on-one counselling or group counselling may be available in your area on the NHS. There may also be some local groups to help you increase your physical activity levels.
A number of commercial weight loss groups meet regularly in the UK. In fact, there is some research evidence to suggest that people who join a weight loss group are more likely to be successful in losing weight than those who don’t. There are also internet-based programmes and self-help books that can help you with your weight loss.
Treatment with medicines to help with weight loss
Medication to help with weight loss may be an option for some people who want to lose weight. However, there are no wonder medicines available, and lifestyle changes to improve your diet and increase your physical activity levels are still paramount.
The medicine called orlistat is available on prescription from your doctor. Low-dose orlistat is also available to buy over-the-counter in pharmacies. Doctors and pharmacists are given specific guidelines on when orlistat should be used. It cannot be used in everyone who wants to lose weight and is only recommended in people over a certain body mass index (BMI). For a doctor to prescribe orlistat, they also need to be sure that you have tried changing your diet and increasing your physical activity levels first.
Orlistat works by blocking chemicals (enzymes) in your gut (intestine) which digest fat. Nearly a third of the fat that you eat is blocked by orlistat. The undigested fat is not absorbed into your body, and is passed out with your stools (faeces). It is important to follow a low-calorie, low-fat diet and maintain regular physical activity if you are taking orlistat. You will also need regular follow-up with your doctor or pharmacist.

Surgery to help with weight loss
This may be an option if you are very obese. However, surgery is usually only offered if other ways to lose weight have not worked (including diet, increasing your physical activity levels and orlistat). Weight loss surgery usually gives very good results and most people do lose a lot of weight. But this is specialist surgery and it is a major operation. In some people, surgery may not be advised because health issues may mean that having an anaesthetic could be dangerous.
Surgery to aid weight loss is called bariatric surgery. There are different types of bariatric surgery available. In one type, the surgery reduces the size of your stomach so that you are not able to eat as much. You feel full more quickly. Another type of bariatric surgery makes the food that you eat bypass some of your intestine. This means that you are not able to absorb as many calories from food as you would normally. There are also newer techniques that have been developed to help weight loss, including intragastric balloons (small balloons that sit inside your stomach).
After surgery, you will need to make long-term changes to your eating habits. You will be given help and guidance with this. You will also need long-term medical follow-up.
Tempting situations and special occasions
It is natural that you will be tempted by different situations to put you off track with your eating and weight loss. It is important to recognise that holidays, festivals and eating out may affect your everyday food choices and what you had planned to eat.
Can you identify any tempting situations? Some people find that watching food programmes on TV makes them feel hungry. How about smells from the kitchen from someone cooking who is not aware that you are trying to lose weight? Do you get pressure from family or friends to eat or drink more? Can you avoid tempting situations? If not, think about ways of coping with them. If you are going to be faced with a tempting situation, create a plan of action. For example, if you are going out for dinner your plan of action might be to have a starter or a pudding rather than both.
Top tip: clean your teeth or take a short brisk walk when you are tempted to eat between meals.
Stress, depression and your weight
Many people eat as a comfort, or as a way of coping with stress. How do you cope with stress? Is stress, unhappiness or depression a reason for you to overeat or to binge eating? If so, can you plan alternative strategies such as relaxation tapes, going for a walk or talking to a friend?
Top tip: see a doctor if you feel that depression is a problem. Depression can often be treated.
Keeping the weight off
Many people lose weight but at the end of their ‘diet’, the weight goes back on. The main reason this happens is because their weight-reducing diet was only a temporary change to their unhealthy diet and lifestyle. To keep your weight off, it is important that you make permanent changes. This usually means:
• Keeping to a healthy diet.
• Exercising regularly.
• A change for the whole household. It is difficult for one member of a household to shop and eat differently to the rest. It is best that the whole household should eat a healthy diet.
It does not mean less enjoyment of food. However, it may take a while to learn to enjoy different foods, meals, and recipes. Some people need more support to keep to their new weight than when they were actually dieting and losing weight. A local support group may be able to help.
Top tip: after losing some weight, weigh yourself once a week to keep a check on your weight. This way you will see if your weight starts to increase again and you can do something about it early on.
Dealing with lapses
When we slip off track, it’s easy to feel like forgetting the whole thing altogether. Lapses are a very normal part of losing weight and the way you deal with it can either make or break your weight loss success. It’s better to learn from it and move on, rather than giving up completely. If you have a lapse, consider the following points:
1. What was the reason for going off track?
2. What other ways could I have dealt with it?
3. What can I do in the future to deal with the situation better?
Think back to the reasons why you wanted to lose weight in the first place. It can be helpful to consider the positive and successful aspects of your weight loss journey so far. Concentrating on the positive aspects and what you have achieved can help to re-motivate you and remind you not to give up on your weight lost programmed.