HOLISTIC HEALTH NOTEBOOK

There has been a spurt of activity lately in what I call "extreme dieting." These programs are just short of literal starvation. What makes them scary is that many are heavily promoted by folks in the medi- cal community.

Let me explain the typical characteristics of extreme dieting:

. Extremely low calorie, often less than 600 calories per day in the beginning stages, and bumping up to 900 calories for long-term maintenance

. Vitamin shots to increase energy (fatigue is expected on a low calorie diet)

. Excluding or severely reducing the intake of whole categories of nutrients, especially carbohydrates and fats

The lure of these types of programs is that they are successful — in terms of weight loss. You will rapidly drop pounds and inches by starving yourself. But if you are tempted to starve yourself in the hopes of being thin by summer, please ask and answer a series of questions:

. How much am I willing to pay to be thin or put another way, how much will this program cost? Not in dollars and cents but in terms of health. How much of my health am I willing to sacrifice to achieve my ideal body image?

. How long am I willing to starve? (Remember: just because you feel full doesn't mean your body's nutrients needs are being met)

. Is body shape or weight the most important indicator of health?

. What are the typical longterm consequences of the program? (If you don't know, read my book "Weight Success for a Lifetime" in which I list the likely sequelae of every diet program on the market.)

. What will happen after I go off the program and resume my normal diet?

If any of these questions elicit an unsatisfactory answer, you may need a different program. The next question is this: "Can you lose weight and still be healthy?" Absolutely.

— Ms. Simontacchi is a certified lifestyle educator at the offices of Dr. Alan Gruning in Fort Myers and owner of the Island Nutrition Center on Sanibel.