Children’s Mental Health Legislation Heard

When the omnibus Act Relative To Children’s Mental Health (Chapter 321 of the Acts of 2008) was signed into law last year, there was one provision that was not included: reimbursement for collateral contacts by commercial insurance.

Collateral contacts can be more accurately referred to as coordination of care. When an adult is working with a mental health professional, the adult can typically express what is going on in his or her life directly to the clinician in such a way as to make treatment effective. When it is a seven year old, it’s not so simple.

Children are not little adults. To have treatment of mental health needs be effective, it is vital that the treating clinician speak to other people in the child’s life – parents, teachers, pediatrician, etc. Only through this coordination will the child have the best chance to have his or her mental health needs addressed properly.

Of course, to protect the privacy of the young people involved, this type of coordination would only be done with parental consent.

In Massachusetts, the state already reimburses mental health clinicians for collateral contacts when children are covered under MassHealth. Commercial insurance, on the other hand, does not provide this benefit. Mandating reimbursement for collateral contacts will ensure that care coordination is the standard practice rather than an exception to the rule.

The collateral contacts piece of Chapter 321 was not included in the final version of the law because a cost analysis had not been completed by the Division of Health Care Financing and Policy. The was completed late last year and it found that collateral contacts are extremely inexpensive – 5.5 cents per member per month or 0.01% of total premium costs.

This piece of the original omnibus bill was refiled for the current legislative session as H. 3586 / S. 757, An Act Relative To Coordination of Children’s Mental Health Care, and was heard yesterday by the Joint Committee on Mental Health and Substance Abuse.

Testimony was given in support of the legislation by two panels.

On the first panel, Dr. David DeMaso, Psychiatrist in Chief at Children’s Hospital Boston and Professor of Psychiatry and Pediatrics at Harvard Medical School, illustrated the importance of coordination of care by asking Senate Chair Jen Flanagan to imagine herself as a third grade teacher with a student displaying mood swings and classroom outbursts. In an effort to more effectively attend to the behaviors while also teaching the other students, isn’t it a good idea to talk with the child’s psychiatrist, Dr. DeMaso asked.

Similarly, Dr. DeMaso asked House Chair Liz Malia to put herself in the shoes of a pediatrician treating a young woman with severe asthma. Before changing her patient’s medication to address her asthma, wouldn’t it be responsible for her to speak to her patient’s mental health clinician to avoid a potentially dangerous interaction with her antidepressant medication?

The second panel featured testimony from Central Massachusetts: Cathy Apostolaris from the Winchendon Project, Tony Poti from the Choices Program, and Dr. David Keller, a pediatrician from Webster. For all three of these individuals, care coordination has been vital to the success of their work.

Passage and enactment of An Act Relative To Coordination of Children’s Mental Health Care is the top legislative priority of the Children’s Mental Health Care. More effective coordination of care is an important step in addressing the mental health needs of Massachusetts’ children.

Matt Noyes

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June 9th Public Health Committee Hearing on Health Disparities

On Tuesday June 9, 2009 at 10:00 am, the Joint Committee on Public Health Hearing will consider health disparities bills including the two legislative priorities, SB. 810 and SB. 811. Please join us and advocate for health equity at this important public hearing.

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The Joint Committee on Health Care Financing held a public hearing on Wednesday May 27th. Several bills were heard relating to insurance, the Insurance Partnership program, medical malpractice and the health care workforce.

Georgia Maheras testified on behalf of the Affordable Care Today (ACT!!) Coalition in strong support of Senator Montigny’s bill, An Act relative to coverage for chronic illness (S. 551). This bill would eliminate co-payments for all prescriptions and devices used for the treatment of chronic illness, a bold step forward in Massachusetts’s attempt to make quality health care affordable for everyone. Research has shown that increased cost sharing, especially in the course of treatment of chronic illness, serves as a barrier to patients who are seeking care. Even relatively small co-payments have been associated with lower rates of seeking preventive services and co-payments for treatment of chronic illness would only hinder the treatment’s rate of success. It makes economic and medical sense to eliminate chronic illness cost-sharing. Prevention will increase and costs will decrease. Estimates have shown savings of nearly $2,000 per patient annually, along with a decrease in mortality rates. Twelve states across the country have already eliminated it from their Medicaid programs, with successful results.

Mary Lou Buyse from the Mass. Association of Health Plans spoke in opposition to S. 551. Buyse argued that eliminating copays for chronic care would violate health reform’s mantra of shared responsibility and lead to increased costs and utilization. Buyse fervently stated that health care should not be free.

Representatives from the small business, artist and insurance communities testified on the Insurance Partnership bills: S. 530/H.1083 An Act Improving the Insurance Partnership Program, H. 1071 An Act Relative to the Insurance Partnership and H. 1078 An Act Relative to Massachusetts Artists. Health Care For All is supportive of S.530/H. 1083, which would increase eligibility for the IP to 400% fpl from the current 300% fpl level. These bills also increase by 50% the payment to employers who participate in the plan by providing coverage to eligible employees. H. 1078 goes further than S.530/H. 1083 and raises the eligibility level to 400% fpl. It also makes more extensive changes to the program, including eliminating the 6-month look-back. This bill also would allow self-employed people to receive Commonwealth Care, expand the Section 125 requirement to firms with 5 or more employees, and direct the Department of Revenue to review how Adjusted Gross Income (AGI) is calculated for individuals with a combination of self-employment and wage income. HCFA opposes H. 1071, which appears to cut back on eligibility for the IP in 2009. We support an in-depth appraisal of the strengths and weaknesses of the IP and the other health assistance programs. A comprehensive, rational framework should be devised that equitably provides help to everyone who qualifies for assistance. To read our full testimony Kathy Bitetti, Executive Director of our ACT!! Coalition partner The Artists Foundation, also spoke in support of H. 1078 and H. 1083 and urged the Committee to not let self-employed people and people with combination incomes fall through the cracks.

Two sets of bills generated much discussion: childhood vaccines and medical malpractice reform. DPH Commissioner John Auerbach and several other experts from the fields of pediatrics and public health spoke in strong support of Rep. Wolf’s bill, H.3453 An Act establishing the Massachusetts childhood vaccine program and the Massachusetts immunization registry. The experts emphasized the need to ensure that all kids receive necessary and cost-effective vaccinations. Senator O’Leary as well as Mass. Medical Society President Mario E. Motta spoke in support of his medical malpractice reform bills – S. 573 An Act providing for a fair judgment interest rate for medical malpractice actions and S. 574 An Act relative to malpractice reform; representatives from the Mass. Academy of Trial Lawyers argued in opposition to these bills.

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Funding of Public Health – a Necessity now more then ever

Commissioner Jon Auerbach of the Massachusetts Department of Public Health (DPH) spoke Friday afternoon to a packed room as part of Brown Bag Luncheon Series. Commissioner Auerbach’s talk covered three hot-issue topics: the current H1N1 virus pandemic (more commonly known as Swine Flu), the effects of the current budget debates on DPH, and a new Public Health initiative to combat obesity, chronic disease, and promote wellness.

The Commissioner began his talk by addressing the government’s response to the H1N1 outbreak. Commissioner Auerbach stressed that while the spread of the disease was unfortunate, the occurrence has provided a great opportunity for the state to exercise its emergency response network. Moreover, he explained that the initial fear over the virus re-affirmed the need for the state to have a robust health system and method of accurate reporting in order to react to outbreaks of unexpected illnesses.

Commissioner Auerbach detailed many elements of the state’s response to Swine Flu. While early reports out of Mexico suggested that the virus was extremely deadly, Massachusetts did its due diligence in both monitoring and responding to the virus. The state has uncovered a wealth of information on H1N1 including the fact that the virus in general is not deadly (rather it is symptomatically consistent with the general flu) as well as some key differences between the general influenza virus and this strain. For example, while the general virus most severely affects the very young and the very old, the H1N1 virus is most prevalent in the 0-20 age group. While, DPH does expect the flu to become wide-spread, they plan to have a vaccine ready for dissemination by next flu season.

Moreover, the H1N1 outbreak has highlighted some considerable strength in Massachusetts’ health response system. Primary among these achievements was the state’s public communication and outreach. Within just 10 days after the first case in Massachusetts, educational materials were available in 14 languages, and state provider help-lines were able to provide medical information to over 4,000 callers, helping to stanch tides of concerned citizens looking to emergency rooms for care. As Commissioner Auerbach eloquently stated, “without a robust health system people will die, become more seriously ill or more injured than they otherwise would be.”

The Commissioner detailed how the current economy will affect DPH, as public health needs have only become greater as the economy has dipped. HCFA has advocated for level funding for many crucial public health programs, including funding for its quality bureau, oral health programs and tobacco cessation programs. Many programs in DPH have been reduced by over 20% in the past year. The Senate did include a proposal that was supported by the Governor and the Department, the removal of the sales tax exemption on alcohol. This revenue stream would dedicate an addition $70Million to critical programs for the states’ most venerable populations.

Commissioner Auerbach concluded his talk on a positive note by discussing the state’s new public health campaign to combat obesity and prevent chronic disease Obesity, with a very high rate in Massachusetts, is a primary cause of many chronic diseases including diabetes and heart failure. In Commissioner Auerbach’s words, the aim of the campaign has been to “change default behaviors” so that diets and exercise feel more like every day life rather than a chore. The campaign has three main legs: the first has been a statewide regulation for restaurants to post the calorie contents of their foods. As studies of a similar law in New York City have shown, when armed with information, people alter their behaviors. Not only have patrons in New York changed their ordering habits once given caloric information, but restaurants themselves have altered their menus to provide consumers with healthier alternatives.

All in all, Commissioner Auerbach demonstrated how crucial strong public health programs can be and how important it is for Massachusetts to have, and to continue to have, a robust public health department.

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An Uneven Distribution of Oral Health Care

A recent Policy Brief on a Massachusetts Health Reform Survey funded by Blue Cross Blue Shield examined

Oral health is an important part of overall health, and dental disease is associated with other chronic diseases such as heart disease, stroke, diabetes, and preterm birth. The survey looked closely at access to oral health services, and found large disparities in dental care visits by region as well as race/ethnicity.

Highlights of the report include:

• Adults in the Western region were less likely to have had and dental care visits than adults in the MetroWest region, while those in the Southeast region were less likely to have a usual source of dental care visits.
• Adults in the Western and Southeast regions were more likely to report unmet need for dental care than were adults in the MetroWest region.
• Hispanic adults were significantly less likely to have had a dental care visit (69.8% versus 76.3%) than white adults.
• Black adults were also significantly less likely than white adults to have had a dental care visit in the last 12 months (66.0% versus 76.3%).

A large part of these disparities stem from a lack of enough dentists to go around. Nearly 25 percent of communities in the Commonwealth do not have a practicing dentist. This uneven distribution of oral health care means that many families, particularly those in Western Massachusetts, must travel long distances to get the care they need. This burden of travel often translates into an inability to access care.

We can do better than this. The state’s current system of oral health care is an uneven patchwork of services, so we need to be creative when developing ways to deliver oral health care to all communities. For more information about how to close the gaps in the oral health care system, please contact Christine Keeves, Oral Health Communications Coordinator at 617-275-2919 or ckeeves@hcfama.org, or visit

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Globe Editorial on Health Reform Affordability

The Boston Sunday Globe’s affirms the conclusions of th that health reform has been affordable for Massachusetts. Excerpt:

FOR ALL THE fiscal problems the Commonwealth now faces, its three-year-old universal health insurance reform cannot be blamed for driving up state government costs uncontrollably. That is the conclusion of a study released last week by the Massachusetts Taxpayers Foundation, the watchdog group that is usually quick to expose state budget-busters. At a time when Congress is weighing its own health reform bill, the study debunks the notion that health reform is just a Big Dig in scrubs.

The study estimates that reform is costing the state an extra $350 million a year. The foundation finds that amount “relatively modest and well within early projections of how much the state would have to spend to implement reform.” The recession has hurt the state’s ability to sustain the gains of health reform, just as it has curbed funding for other state programs. But the foundation applauds the achievements of health reform “for so few new public dollars.”

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MassHealth Smoking Cessation Works; Let’s Add it to CommCare, too

A found that since MassHealth added smoking cessation benefits, the smoking rate among MassHealth members dropped 26%. This means some 33,000 MassHealth members have quit smoking since 2006. The drop is more than twice the rate as the general population. This drop can be attributed in large part to a MassHealth benefit that provides prescription and over-the-counter medication to help individuals quit smoking and includes optional counseling opportunities.

The benefit was added to MassHealth as part of chapter 58, the 2006 health reform law. Adding the smoking cessation benefits was a key demand of the ACT! coalition. Health Care For All, along with the American Cancer Society, the Mass Medical Society, Tobacco Free Mass, and other groups pushed to include the new benefit in MassHealth.

These groups are now supporting Senator Moore’s bill to require Commonwealth Care plans to include tobacco cessation. The hearing for the bill is tomorrow, (Wednesday, June 3), 1:00 pm in State House room A-1.

Tobacco prevention and cessation services play an important role in keeping Massachusetts residents healthy, and reduce long-term healthcare costs. Smoking is the most common cause of preventable death and disease in Massachusetts. Luckily, there are effective ways to quit smoking. Department of Public Health Commissioner John Auerbach said “Three out of four smokers say that they want to quit, but the cost of medications that help with cravings is a significant financial barrier to many low income people. The success of the MassHealth benefit shows that smokers will utilize such a benefit, and they will quit in large numbers with the appropriate supports.”

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Business has Role to Play in Kids’ Oral Health

Richard C. Lord, President and CEO of Associated Industries of Massachusetts, stated his strong support for oral health in the Boston Globe last Friday. In the final Watch Your Mouth advertorial of the year, he declared that “business owners in Massachusetts have diverse needs and interests, but we all have one thing in common: we need a capable and healthy workforce to make our businesses successful.”

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Monday Morning Health Reform Reading

Three health reform items released last Friday for your Monday morning reading list:

1. The Division of Health Care Finance and Policy released the latest edition of their quarterly report The report paints an overview of the Massachusetts health care landscape through data on health insurance coverage, the Health Safety Net, health insurance premiums, health plan financial performance, acute hospital and community health center financial performance and access to care. The latest report found that:

• Over 428,000 people have gained insurance coverage since health reform implementation began and Dec. 31, 2008.
• Growth in enrollment decreased slightly between June 30, 2008 and December 31, 2008, due to a decline in MassHealth and Commonwealth Care enrollment. (this decline has subsequently been erased, as CommCare has experienced substantial new enrollment this year).
• About half (49%) of residents enrolled in private group insurance are in self-insured plans.
  While financial performance for acute hospitals improved from FY03 to FY07, margins declined significantly from FY07 to FY08. In FY08, 23 hospitals (35%) experienced overall losses.
• Between 2007 and 2008, health plan profit margins declined for 7 health plans, and improved for 4 plans.

2. The Commonwealth Fund, a national foundation that promotes health care access and quality, released an issue brief last week that describes the structure and function of the Connector Authority, providing an introduction to health care reform for policymakers at both the state and national level. The study, by Amy M. Lischko, Sara S. Bachman, and Alyssa Vangeli, (all long-time friends of HCFA) can be viewed The authors describe how the Connector effectively streamlines administration, offers portability of coverage, and provides some standardization and choice of plans, and offer it as a model for future reform around the country.

These descriptive articles will pay an important role in introducing Massachusetts health reform to national audiences.

3. Jon Kingsdale, the executive director of the Connector, in Health Affairs on lessons learned from implementing health reform in Massachusetts. His key point defends the wisdom of Massachusetts health reform expanding coverage before tackling cost control:

At the strategic level, there is political advantage in conceptualizing comprehensive health reform as a continuous campaign. This is not the incrementalism of little steps: after all, most states have shied away from the individual mandate as too controversial, and California’s brave effort to build on the Massachusetts model stalled in the state Senate. Rather, this is recognition that the implementation of major reform takes years and will create unforeseen challenges, so a truly comprehensive approach must be sequenced. …

Massachusetts took the ethical high ground and chose to begin with near-universal coverage. To the standard arguments that we must reduce waste in order to control government spending and remain internationally competitive, we have added this imperative: only by controlling costs can Massachusetts sustain near-universal coverage.

Kingsdale warns that as Congress takes on national health care reform, coverage expansion and cost reduction will be difficult to attain simultaneously. If national universal health care is to become a reality, Congress must learn from both Massachusetts’s successes and sequence the steps needed to make health care both widely available and affordable.

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HEALTH SMART

.......MIGRAINES AND RISK OF STROKE...
______________________________________________________________

AS MANY AS

17 percent of women and 6 percent of men have experienced the debilitating of a migraine.
Research shows that women who have migraines accompanied by their distinctive "aura" symptoms are at greater risk of having a stroke than those who don't get migraines.

WHY THE LINK?

Migraine headaches are caused by inflammation of the arteries surrounding the brain.
Other arteries inside the brain may spasm during an attack as well, temporarily cutting off circulation, thus increasing the odds of a stroke.

ADDITIONAL RISKS

Abnormalities in the lining of arteries may also allow blood to clot more readily.
"And in rare cases, arteries leading to the brain may tear more easily," says Dr Gretchen Tietjen, a professor of neurology at the University of Toledro.
These tears can cause vessels to narrow and clots to form.
Extra oestrogen from oral contraceptives (especially in smokers) or hormone create a perfect storm for a stroke.

HOW TO REDUCE YOUR RISKS

Low-dose aspirin has been shown to decrease stroke risk in women over 45 and may prevent migraines too.
Doctors can help you reduce the risks associated with abnormal arteries.
Maintaining healthyblood pressure is one way, but also ask your physician to order a routine blood test to determine whether you have markers for increased clotting .
If you do, discuss aspirin therapy, anticlotting medications, or alternatives to hormone therapy.

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Challenge to change institutional mentality

Jennifer Foreshew | April 15, 2008

cio files | David Johnston

WHEN South Australian Health Department chief information officer David Johnston set out to deliver real and tangible e-health outcomes, he was told by many it could not be done.

David Johnston is overseeing a revolution in SA

Joining the SA Department of Health in 2003 from SA Water Corporation, where he was chief information officer, Johnston found the technology division chronically under-funded and "largely ineffectual".

"Years have been spent subsequently by many people preparing detailed strategies, sourcing funding, setting up governance structures and establishing project management capability to enable a major reform," Johnston says.

"Now the rubber is hitting the road, and that is immensely satisfying."

The SA Health Department currently has an integrated $375 million decade-long program that consists of 65 interrelated individual projects, costing between $250,000 and $70 million.

The electronic health records program aims to link all clinicians and patient information.

…..

Establishing the technology base is one component, but building in the proper ongoing management and controls will be a challenge as we deal with over 27,000 staff."

At present, SA Health Department's ICT service has about 150 staff and an annual budget of about $40 million.

From July 1, all ICT functions across the health portfolio will be transferred to direct department control, increasing the staff to about 360 and the budget to about $110 million.

"The difference will be that the operational staff will be coming into ICT services, which means we can then start concentrating on consolidation of duplicated functions," Johnston says.

"For example, we have 17 help desks across health, so there are rather large efficiencies that we need to extract to reinvest in other areas such as information architecture and proactive network management."

The SA Health Department has 40 per cent of ICT staff in support roles, but Johnston expects this to drop to 15 per cent within five to six years. The staff who currently provide break-fix support services will be able to concentrate over time on much higher value-add activities to ensure the use of the ICT systems and infrastructure across health are maximised, he says.

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Health upgrade gets poor diagnosis

Nick Miller

April 17, 2008

THE State Government is grappling with another multimillion-dollar computer fiasco, this time involving a major upgrade of health technology systems.

Weeks after a scathing report on the introduction of the myki public transport ticket system, Auditor-General Des Pearson has raised concerns about the progress of the $323 million HealthSMART project.

HealthSMART was announced in 2003 to overhaul mismatched technology running the state's health system and introduce new systems such as electronic prescriptions to improve patient care and combat fraud.

But Mr Pearson, in a report released yesterday, said the original targets were overambitious, it was already two years behind its intended 2007 completion date and likely to slip further.

The report also found the program was already $34.8 million over budget and would need an extra $61 million in running costs, although the Government and Health Department dispute the first figure.

The worst-performing part of HealthSMART was a $96 million "clinical systems" plan to computerise prescriptions and diagnostic services. The report found that of 10 agencies that could use the system, only four planned to do so, and none would likely meet the June 2009 deadline.

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HealthSMART – A Pretty Bad Report Card.

The Victorian Auditor-General issued a report card on the Victorian HealthSMART project last week and it did not make great reading.

A sample of the reportage

Correspondents in Melbourne | April 16, 2008

A $320 million IT program to help streamline Victoria's health system is running late and over budget, a new report has found.

The auditor-general's report says the HealthSMART program will not be finalised as expected by June 2009. The 2009 target was reset from the initial projected completion date of June 2007.

However, the Department of Human Services (DHS) has not yet told the government of any need to revise the completion date, the report says.

HealthSMART is aimed at improving patient care, reducing the administrative burden on health care professionals and easing costs associated with IT in the public health system by standardising information systems.

The department has spent 57 per cent of the project's budget on just one-quarter of the planned installations, and delays in the project mean that it will have to be subsidised by an added $61 million of DHS funds.

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Weight Loss-Diet Tips to quick result

To Lose weight you have to be focused around completing a small goal by staying motivated. You should complete many goals in a short period of time. But there is much more to it than eating well and exercising. Follow thisese tips and you are on your way to success.

Work vegetables into meals instead of just serving them as sides on a plate.Eat at least 5 servings of fruits and vegetables per day. Start by focusing on getting the recommended 5-9 servings of fruits and vegetables each day. Fruits and vegetables are packed with beneficial fibers, vitamins and antioxidants.As much as possible do not remove the skins of fruits and vegetables since most of the nutrients are concentrated under the skin. They are also low in calories and helps to keep your calorie count low. Purchase fresh foods and avoid processed and convenient foods such as fast food. You need to understand food claims and labels. A product labelled with a fat-free label on the packaging claim does not mean that it is low in calories. Similarly a product labelled as low-sugar or low-carb does not mean it is low in fat or calories.Packaged and convenient foods are often higher in sodium and fat content. You can easily lose weight by packing a home-cooked lunch to work instead of eating out.

Try eating protein at every meal.Getting enough protein helps preserve muscle mass and encourages fat burning while keeping you feeling full.Protein is also more satisfying than carbohydrates or fats, and thus may be the new secret weapon in weight control. So be sure to include healthy protein sources, like yogurt, cheese, nuts, or beans, at meals and snacksDiets higher in protein and moderate in carbs, along with a lifestyle of regular exercise, have an excellent potential to help weight loss.

Finding the time to get to the gym can be very difficult. Instead, focus on how great you feel, how much better you sleep and how much more energy you have when you exercise. Most authorities recommend 30 - 60 minutes of physical activity a day to stay healthy. Also try adding weight-bearing exercises at least 2 times a week. This will help burn some of the unwanted calories. Eight hours after waking up, our metabolism slows down that is why 30 minutes of exercise before dinner will increase the metabolism for about two to three hours. This produces an increase in burned fat even hours after the work out is over. Physical activity is good for you whether you are trying to lose weight or not, so keep it positive and build a lifelong habit.Although it may seem counterintuitive, don't use exercise either to punish yourself for eating or to "earn" the right to eat more. Once you've lost the weight, you need to keep it off.You need to pick a weight and vow to never get heavier than it again. It is normal for your body to fluctuate five to ten pounds. I recommend picking a weight that is ten pounds heavier than what you "normally" weigh and never weigh more than it again.

Drinking plenty of water or other calorie-free beverages everyday is obviously and broadly recommended.People sometimes confuse thirst with hunger. So you can end up eating extra calories when an ice-cold glass of water is really what you need. Drinking eight glasses of water per day helps you feel less hungry. On the days that I don't drink the water, I feel hungrier, earlier. A pint glass holds sixteen ounces so try drinking two pints of water in the morning and two in the afternoon.Even getting yourself warm water with just a squeeze of lemon juice before breakfast gets your metabolism going for the day. Drinking hot water instead of cold water in the morning can increase the speed of your metabolism and burn more calories.It also helps prevent constipation and is excellent for the skin. Juices, pop, cream & sugar in your coffee or tea all add up. In addition to providing hydration to your body, it will also help you feel full.

Eating small frequent meals help to balance your calorie intake throughout the day and also keeps your blood sugar level balanced. Skipping meals slicks the body into slowing down the metabolism, attempting to conserve calories during a period where limited fats and fuel are available.Hunger is your body's way of telling you that you need fuel, so when a craving doesn't come from hunger, eating will never satisfy it. Remember that eating increases the metabolism. Instead of eating 3 big meals, try to eat 5 - 6 smaller meals throughout the day or Complete three small meals and two snacks everyday instead of one or two huge meals.Keeping your portions reasonable will help you get more in touch with your feelings of hunger and fullness.Slowly eat and chew each bite during meals as this would decrease one's appetite.

Try not to diet on the weekends. Whenever you feel like eating, look for physical signs of hunger. You will see yourself tired, depressed, and unmotivated if you tried to continue your diet into the weekend. You may not find this necessary, especially in the first few weeks of a diet. However, as many weeks passed, the weekend will become a time for to celebrate your weekly successes and get yourself mentally prepared for another five days of dieting. It is simply a mental recharge.

Also rather than giving up what most diets say you should give up like soda, coffee, beer, caffeine, etc. just make healthier decisions. You wouldn't want to give anything up, so decide to make some changes instead. You can switch to diet soda, then a second switch to drinking black coffee. Cut out the sugar and creme, and you get the benefits of coffee without the calories. You can make your last major switch to healthy beer. You will be able to still enjoy a healthy social life while maintaining your diet.

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Weight Loss Tips - Live a healthy lifestyle

Obesity is one of the biggest problems faced by millions of people in America. This has resulted in a big weight loss corporate industry in the country like Weight watchers, Jenny Carig and many others. Although there are good programs, I feel people can themselves do quite a bit to reduce their weight. The two major factors in weight loss are exercise and controlled diet. I have put together several points which will be useful to individuals looking to reduce their weight.

1. Eat at least 5 servings of fruits and vegetables every day. Most fruits are low in calories and make you full sooner. Not to mention the other vitamins and fibers they also contain.

2. Read those nutrition fact labels: It is a good idea to know how many calories you are consuming. Some foods combo's can be deceptive, for example if you are having a plate of salad topped with lot of high calorie dressing and a soda, they you have just had more calories then you might get from a combination of grilled chicken sandwich (with no cheese and dressing) plus diet soda. So be smart with what you eat. Prefer home cooked food as much as possible.

3. Eating smaller frequent meals will also help you cut down the total intake of calories compared to 3 big meals a day.

4. Give yourself a break: Being too restrictive can anyway demotivate you, so to give yourself regular breaks. But do not over-eat at the same time, be conservative and try to make up for it in other meals.

5. Drinks: Soda, juice, cream are all loaded with sugars which we usually do not account into out diet plan. Drink water instead.

6. Exercise: Do not always depend on your car for everything, walk wherever you can. Go hiking and those backpacks help to burn extra calories. Make friends who have a active lifestyle, join gym or get a treadmill in your home. Remember to increase your exercise in a progressive manner day by day instead of doing strenuous exercise from day one. Be practical on what your body can take and avoid overexertion.

7. Get motivation: Talk to people who have had success in weight loss and they will give you a lot of inspiration.

8. Get enough sleep, reduce stress and live happy.

9. Reward yourself when you reach your monthly weight loss milestones.

10. Never give up, even if you have failed a few times previously.

11. Eating slowly can lead to weight loss: Did you ever notice that thin people take an awfully long time to eat their food? Eating slowly is one method that can help take off pounds. That's because from the time you begin eating it takes the brain 20 minutes to start signaling feelings of fullness. Fast eaters often eat beyond their true level of fullness before the 20 minute signal has had a chance to set in. The amount of calories consumed before you begin to feel full can vary significantly depending on how quickly you eat. So slow down, take smaller bites and enjoy and savor every tasty morsel.

I am not an expert so it is advisable to consult your doctor before starting any weight loss effort and they will also tell you if you have any medical condition that may prevent you to follow these tips.

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Which Are The Best Over The Counter Weight Loss Diet Pills?

So, you are thinking of buying an over the counter weight loss pill. Should you go ahead - and what should you keep in mind?

First of all, just because a doctor hasn't prescribed a diet aid, doesn't mean that it doesn't work. I have an opinion that doesn't make me very popular among medical circles:

Most (not all) doctors are "disease professionals" and not "health professionals." If you have a headache, they tell you to take a pill and get rid of the pain. But, when it comes to improving your fitness level and quality of life, most of them are really clueless. Just look how out-of-shape most doctors are.

Also, did you know that many doctors are actually *paid* by the drug companies in order to prescribe their products? That's right - with every prescription they sign "ca-ching" - they make more money. Yes, I know that they will never admit it to you but that's the reality (surprise, surprise). Don't even get me started on that stuff...

Anyway - here are the main types of OTC weight loss pills:

Appetite suppressants:

These curb your appetite so you eat less. It works well, if you have a larger than normal appetite and eat more than you really need. They will usually not work if the reasons of your over-eating are psychological (like anxiety, anger or depression). In those cases you may want to talk to a competent therapist. Probably the best-known appetite suppressant is Hoodia, which is a cactus that comes from the Kalahari desert. It basically tells your brain that "you are full" - so you don't over eat...

Thermogenics:

These cause "thermogenesis" which basically means "heat generation." They raise your metabolism and help your body burn more calories so you lose your extra weight over time. Some known thermogenics include Yerba mate, Guarana and Cayenne.

Fat Blockers:

These basically allow you to eat "fatty foods" but without ingesting all the fat in them. Basically, you take them with your meals that contain high amounts of fat. Then, these "fat binders" will absorb part of the fat and they will be eliminated by the body "the natural way" later. Two well known fat binders are chitosan and NeoPuntia.

There are also weight loss diet pills that combine several of the above ingredients in order to give you a more "well-rounded" approach to losing weight.

Here's what to look for, when "shopping around" for an over-the-counter diet pill:

- Is the product guaranteed? What if it doesn't work for you for any reason. Will you be able to get your money back? Look for companies that offer at least a 60-day money-back guarantee...

- What is the "general verdict" on it? What do previous customers say? On the internet, it's easy to search for reviews and comments about a company...

- Try to purchase from a company that gives you "value-added" services. Some companies offer discounts for bulk purchases, or they offer extra bonuses like weight-loss guides etc...

The top over the counter diet pills should pass all the tests above. If you keep these things in mind, you will find a weight loss pill that will work for you...

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Achieve Weight Loss, Health and Vitality

When you think about all the toxins in our current environment it just makes sense that we would need to detox our bodies periodically. Once detoxed your body feels renewed, refreshed and cleansed or "decluttered" from the environment.

If you are ready to commit to your weight loss goals, a body detox can get you off to a great start. By starting your weight loss diet with a body detox you are preparing your mind and your body for what's ahead. You are "rinsing" away the toxins that cause you to crave foods making it easier to begin the committed actions toward weight loss.

Detoxing your body is a simple process. You can accomplish a complete body detox in only 12 simple steps. as a result you will feel energy and vitality at a level you had as a young adult or teenager.

If you are feeling fatigue much of the time, you are a candidate for detoxing your body regardless of whether you need to commit to weight loss. If you are in need of weight loss, it is natural you may also feel fatigue. When our bodies are out of shape and full to toxins, we can expect fatigue at the top of the list of all sorts of other health issues that can transpire.

Habits got you into the position of needing a weight loss diet and re-framing the habit can get you out of the same position. A complete body detox can begin the discipline needed to form the habit for effective weight loss and maintaining the weight loss once your weight loss diet has ended. At that time a good weight loss product could be used periodically when the weight may begin to creep back at various times.

Juanita Bellavance is an internet marketing mentor with a focus on passive income streams combining internet technologies with other business models. As health and weight loss are constant issues in life for many people, Juanita often mentors clients who need a breakthrough in these areas.

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Best Way to Lose Weight - What is it?

There are several ways to lose weight but how to determine which one is the best among them is the big question. The best way to lose weight is to choose a program or a weight loss plan which suits one's body. Do you know that you would never lose weight unless you choose the best weight loss plan or program which suits your body. It is not necessary that is a certain weight loss program or a plan works on someone else than it would be the best way to lose weight for you also. Read on to discover the best ways to lose weight and how to achieve your weight loss goals.

Depends on your body- As mentioned above the best way to lose weight for you would be a plan which suits your body. For this it's best to consult a physical trainer or a consultant. You might work hard day and night but unless it's the weight loss plan which best suits your body you would never lose weight.

Change eating patterns- Diet has a lot to do when it comes to weight loss and achieve the desired weight loss goals. Small adjustments in diets can get you exceptional which would be the best way to lose weight for your body. Avoid processed foods as much as possible and try to add fiber into your daily diet. The best way to really lose weight would be to have small frequent meals a day than to stick to heavy occasional meals.

Stick to your plan- The best way to lose weight is to stick to whatever you are doing. One of the main reasons why many people never lose weight is simply due to the fact that they are not able to stick to a specific plan and give up too early. Some people tend to shift from one weight loss plan to another or a mixture of many thinking it's best to mix them up. This would not help you lose weight at all.

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Are You Mentally Prepared For Weight Loss? Learn A Short Cut To Weight Loss!

When people think of losing weight the first thing they think about is exercise and starvation. However, realistically weight loss is over 90% mental!

For example: 5% of 24 hours = 12 minutes a day or 84 minutes a week. That is two active 30 minute days and one 24 minute day per week. Ten percent = 2 hours and 48 minutes per week. Over 90% mental! So, would it not make perfect sense to develop a weight loss program that is 90% mental?

I received a letter from a customer asking me if I supported a certain diet. My response was "the
only diet I support is the one you design yourself. After all who knows you better than you?" You
and only you will determine what you will and will not do.

You are what you think! The more you think about food, the more food you will consume. The more you think about fitness the more active you will become. The key to permanent weight loss is learning
how to control your thoughts. In order to control your thoughts you must first become aware of them
and understand why you think the things you do. Study your personal history! When did you start
gaining weight? As an infant, teen, adult, etc. Why? Your upbringing, habits, stress, emotions, etc...
Only after you become able to see and acknowledge your mistakes and understand why you made them, will you gain the power to change them.

Need a short cut to permanent weight loss? Learn to master your thoughts first and every thing else will be easy!

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All Girl Weight Loss Camp - Why it's Better

Attending a weight loss camp may be embarrassing enough – and it can get even more uncomfortable if you have to attend it alongside boys. That’s why all girl weight loss camps are becoming more and more popular. All girl weight loss camps offer you effective weight loss programs designed with young women in mind. You are guaranteed to lose weight and gain even lifelong friends with other girls your own age. Here are just some reasons why enrolling in a all girl weight loss camp summer program may change your life.

Safe and supportive environment

A women’s weight loss camp allows you to work out and diet with young girls just like you in an environment that is extremely supportive and safe. You need not worry about unruly boys and young men playing tricks or teasing you. In an all girl weight loss camp, you can truly be yourself.

Group effort

Most all girl weight loss camps divide their programs into three categories – young girls (around 12 to 14 years of age), middle ‘camp’ (for girls 15 to 17 years old), and older ‘camp’ (for women 18 years old and up).

Lose the weight for good

Unlike most weight loss programs that help you lose weight only so you can gain it back several months later, good all girl weight loss camps teach you life skills that help you lose weight and keep it off – for good. Some of the best camps use cognitive behavioral therapies in group sessions, designed to take full advantage of your weight loss and imbibe lasting behavioral and lifestyle changes. Some of these therapies continue even after the camp ends – sometimes for as long as three months. Many all girl weight loss camps claim that their participants lose four pounds per week, or 16 pounds in a month.

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