Health Care Reform

A delay of just the individual mandate would likely put the federal exchange system—which facilitates the sale of guaranteed issue, community-rated plans—on the same track.

(The administration, it should be noted, has made it quite clear that it thinks the mandate is absolutely essential to the larger insurance scheme, arguing repeatedly in court that the law cannot function without it.)

Now, it’s true, as The Incidental Economist’s Adrianna McIntrye points out, that there are risk adjustment mechanisms built into the law designed to protect insurers who end up with too many sick individuals. But as a Health Affairs brief on the law’s risk adjustment provisions makes clear, those provisions are designed to make sure that no one plan gets stuck with too many sick individuals. Plans with fewer sick people pay into a fund that creates a backstop for plans with a greater than expected share of sick policyholders.  That helps mitigate individual plan risk. But it doesn’t really solve the problem if the entire pool, across most all of the insurance plans, is smaller and sicker than expected. A death spiral that shifts some premium income around is still a death spiral.

The larger worry is that we may be on track for an insurance market meltdown no matter what happens with the individual mandate. If too few young and healthy people sign up for insurance through the exchanges, for whatever reason, insurers will have to adjust their prices eventually. The access problems in the exchanges exacerbate this risk by making it more frustrating to buy policies; as a result, only the most motivated people—which is to say, the sickest and most desirous of coverage—will end up buying coverage. The same goes for the high individual market premiums that many young adults will be faced with. A mandate delay would make the risk even higher. But it may be the case that Obamacare is heading toward a death spiral no matter what, and that if it remains in place, no plausible policy response will avoid it.

Information About Health Plan

New York state’s guaranteed issue and community rating rules—the two regulations that limit how insurers can charge based on health history and require them to sell policies to all comers—took effect in 1994. At the time, there were about 752,000 policyholders in the state’s individual market, or about 4.7 percent of the non-Medicare population. But by 2009, according to a Manhattan Institute report by Stephen Parente and Tarren Bragdon, the state’s individual market had practically disappeared, leaving just 34,000 participants, or about 0.2 percent of the non-elderly population. Individual insurance premiums, meanwhile, were among the highest in the nation—about $388 on average in 2007, compared with just $151 in California, another big Democratic-leaning state. In New York City, the annualized premium cost for individuals was more than $9,300 and more than $26,400 for a family.

The result, in other words, was a combination of sky-high premiums a

Around the same time that New York was overhauling its insurance market, Washington state was implementing a similar set of health plan rules. Insurers faced new regulations regarding plans sold to individuals with preexisting conditions, and the requirement that they sell to everyone. For a brief period, there was a coverage mandate, but that never went into effect. The state’s individual market deteriorated. One insurer raised premiums by 78 percent in a three year period. As premiums rose, relatively healthier people left the market, and insurers were left covering a lot of very sick, very expensive individuals. In the end, many insurers simply dropped out of the market rather than lose money. According to a report on the reforms commissioned by the insurance industry, there were 19 carriers in the individual market in 1993. By 1999, there were just two—and they weren’t taking new applicants.
nd far fewer insured individuals.

Health Insurance Death Spiral

This Is What a Health Insurance Death Spiral Looks Like

A handful of reports last night suggested that the Obama administration had moved to delay the health law’s individual mandate—the penalty the law imposes on those who are uninsured. That’s not quite right: Instead, the administration will align the 2014 penalty date, which had been February 15, with the end of Obamacare’s open enrollment period, March 31.

It had been possible to buy insurance between February 15 and March 31 next year and still pay a pro-rated uninsurance penalty—something the Obama administration only found out a few weeks ago when a tax prep firm let them know.

Delaying the individual mandate might seem like an obvious response to the ongoing failure of the federal exchange system. But it’s a rather drastic step. And, in isolation, a potentially problematic one.

That’s because the premiums that health insurers calculated for the exchanges this year were determined based on the assumption that the penalty for remaining uninsured would be in effect, and would encourage people to buy into the market.

If you change the enrollment requirements—by, for example, ditching the mandate—while leaving the law’s preexisting condition rules in place, health plan participation will likely be lower. The result, as one insurance official told NPR yesterday, is that insurers will want to change their premiums. And in this case, “change” means “raise.”

That’s where the real trouble starts. Insurers raising prices as a result of lower than anticipated enrollment is an early step toward an insurance death spiral, in which premiums spike and enrollment figures drop until the only participants who remain in the market are very people paying very high premiums. We know because we’ve seen it before—in New York, Washington, and handful of other states that enacted preexisting condition regulations similar to Obamacare’s but without an individual mandate.

Health care debate

For the most part, the debate over ObamaCare didn't explicitly deal with "the rights angle." ObamaCare's mandate was often described as a "responsibility." But the notion of health care as a right didn't exactly go away either.

Like the Clinton plan, ObamaCare attempts to achieve universal coverage by requiring individuals to obtain insurance. There are no government-backed cooperatives in ObamaCare, but there are government-run insurance marketplaces that regulate participating insurers. And thanks to the law's various Medicare payment reforms, which are supposed to create incentives for doctors and other providers to change their behavior, the new health law also ends up giving the government more influence over the practice of medicine.

In other words, the rights angle-and the belief that all unmet medical needs must be served, no matter what-lives on as the subtext of the health policy debate. In March, Health and Human Services Secretary Kathleen Sebelius argued that catastrophic health plans didn't count as real insurance, because they only cover the biggest medical expenses. And in August, Medicare chief Marilyn Tevenner told Congress that insurance isn't "true insurance" if it's not sufficiently comprehensive.

Health Care Rights and Responsibilities

Health Care Rights and Responsibilities

What happens when health care is thought to be a fundamental right? That's the question at the heart of David Kelley's January 1994 Reason story, "The Rights Angle."

What happens when health care is thought to be a fundamental right? That's the question at the heart of David Kelley's January 1994 reason story, "The Rights Angle." Kelley's piece examined the large-scale health-care overhaul proposed under President Bill Clinton. Kelley came away worried.

The "plan in its present form involves a massive increase in government control over physicians, insurers, employers, and-last but certainly not least-the patients who are supposed to be the beneficiaries of the plan," he wrote. "Most people will be forced to obtain their health insurance through purchasing cooperatives: government-backed monopolies that collect payments from consumers and set the terms on which medical providers can offer their services." Meanwhile, health providers will "be prohibited from dealing with patients directly," forced instead to work through highly regulated cooperatives-essentially government-run middlemen.

Kelley argued that this upending of the health system was fundamentally the result of a single assumption-"that if people have medical needs which are not being met, it is society's responsibility to meet them."

The Clinton health plan didn't pass. But almost two decades later, under a different Democratic president, another large-scale health policy overhaul did.

Health information about E-Cigarettes

Study Suggests E-Cigarettes Are Not a Gateway to the Conventional Kind

The activists and politicians pushing for strict regulation of electronic cigarettes claim to be thinking of the children, who supposedly are endangered by nicotine delivery devices that may lure them into deadly tobacco habits.

Hence e-cigarette alarmists jumped all over CDC survey data indicating that the percentage of teenagers who have tried e-cigarettes doubled (from 3.3 percent to 6.8 percent) between 2011 and 2012. "Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes," CDC Director Tom Frieden worried. But the survey data provided no evidence that e-cigarettes are a gateway to the conventional kind, and a new study casts further doubt on that hypothesis. In a survey of 1,300 college students, a team led by Theodore Wagener, an assistant professor of general and community pediatrics at the University of Oklahoma Health Sciences Center, found that only 43 (3.3 percent) said e-cigarettes were the first form of nicotine they'd tried. Of those, only one (2.3 percent) later started smoking conventional cigarettes. "It didn't seem as though it really proved to be a gateway to anything," said Wagener, who described his results at a meeting of the American Association for Cancer Research.

Information about Health insurance

The Times does intimate that canceled health insurance is perceived as a problem by those who experience it but repeatedly suggests that it's not that big a deal. "The affected population, those who bought insurance on their own, is a small fraction of an insurance market dominated by employer-sponsored health plans," it says. (Won't the government's new minimum coverage requirements force changes in those plans too, and won't that result in higher costs for employees?) "Tens of millions of people are finding that their insurance is largely unchanged [except for the cost?] by the new health care law," a sidebar notes. What about the others? "In many of those cases," the Times says, "the insured have been offered new plans, often with better coverage but also at higher prices." At a House Ways and Means Committee hearing yesterday, Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, likewise emphasized (as paraphrased by the Times) that "the new policies would provide more benefits and more consumer protections than many existing policies."

Tavenner seems to think that makes it OK to force people out of their old policies and into the new, government-approved ones. Yet people who buy coverage on the individual market already have weighed the tradeoffs and decided they do not want the benefits that the federal government insists they should have. Overriding those judgments is like demanding that car buyers looking for an economical subcompact buy a hybrid minivan instead. Sure, it costs more, but it's a better vehicle! Look at all that space for children! And if the buyer happened to be a bachelor, he would be in the same position as all the people compelled to buy "maternal coverage" or "substance abuse services" for which they have no use.

Even features that pretty much everyone would like if all other things were equal, such as low deductibles and generous prescription drug coverage, cost money. People who deliberately forgo them have decided they are not worth the price. By what right does the government tell them they are wrong?

The argument that the insurance mandated by Obamacare costs more, but it's worth it reminds me of the debate over the creeping federal ban on incandescent light bulbs. There, too, consumers had made a choice that politicians and bureaucrats did not like: They overwhelmingly preferred traditional bulbs, despite their inefficiency, because they were much cheaper than the alternatives. But consider the energy savings! "A household that upgrades 15 inefficient incandescent light bulbs," an Energy Department official enthused, "could save about $50 per year." Consumers unimpressed by that calculation were clearly too stupid to be making decisions for themselves, so they had to be forced into better (albeit more expensive) choices.

Better Health Plans

Why Aren't People Grateful for the Better Health Plans (or Light Bulbs) Mandated by the Government?

Shane Jansen Shane Jansen The New York Times notices that the Patient Protection and Affordable Care Act—under which, President Obama assured us, we could keep our health plans if we liked our health plans—has resulted in the cancellation of medical coverage for "hundreds of thousands of Americans in the individual insurance market." But the article treats this phenomenon mostly as a Republican talking point, as opposed to an actual problem. "

Cancellation of Health Care Plans Replaces Website Problems as Prime Target," says the headline.

 "After focusing for weeks on the technical failures of President Obama's health insurance website," says the lead, "Republicans on Tuesday broadened their criticism of the health care law, pointing to Americans whose health plans have been terminated because they do not meet the law's new coverage requirements." The Republicans even have props:

Baffled consumers are producing real letters from insurance companies that directly contradict Mr. Obama’s oft-repeated reassurances that if people like the insurance they have, they will be able to keep it....

The cancellation notices are proving to be a political gift to Republicans, who were increasingly concerned that their narrowly focused criticism of the problem-plagued Health Care could lead to a dead end, once the website's issues are addressed.

Ban against E-cigarettes

The new law is hardly an anomaly. Increasing numbers of town councils are passing ordinances that heavily regulate the sale, purchase, or public use of the smokeless, tobacco-less, tar-less e-cigarettes. The FDA, which considered completely banning e-cigarettes in 2009, is expected to propose extensive regulations for them by the end of this month.

Why are cities and health agencies cracking down on e-cigarettes? As Reason’s Jacob Sullum has extensively reported, such regulations fail to accurately account for their real (relatively harmless) risks:

Even the U.S. Centers for Disease Control and Prevention (CDC)… concedes "e-cigarettes appear to have far fewer of the toxins found in smoke compared to traditional cigarettes." Boston University public health professor Michael Siegel, who supports vaping as a harm-reducing alternative to smoking, notes that "we actually have a much better idea what is in electronic cigarette vapor than what is in tobacco smoke."

As a result, Sullum wrote, imposing these regulations could be seriously hazardous to smokers’ health:

Survey data indicate that e-cigarette use is overwhelmingly concentrated among current and former smokers.

It's in the shift from the former category to the latter that the disease-reducing potential of e-cigarettes lies. Impeding that transition by imposing arbitrary restrictions on e-cigarette advertising, sales, and flavors would be a literally fatal error.

For more Reason coverage of e-cigarettes, watch a Reason TV interview with the CEO of e-cigarette maker NJOY here. Watch a Reason TV video on the heavy price of FDA regulations below:

Town Bans E-Cigarettes

Oklahoma Town Bans E-Cigarettes on Public Property

In an attempt to mitigate the dangers of smoking, one Oklahoma town passed a surprising ordinance last week to ban the use of smokeless e-cigarettes on public property.

The ordinance, which was approved by the Ada City Council and will go into effect in November, bans the public use of traditional tobacco products as well as electronic cigarettes. Residents will soon be forbidden from lighting up—or vaping—on all government-owned property, ranging from parks to indoor and outdoor government facilities. Offenders could be fined up to $500 for violating the ban.

In an interview with local news station KWII, Angela Harjo, the Tobacco Prevention Coordinator for the Pontotoc County Health Department, explained the motivation for banning public use of e-cigarettes:

[E-cigarettes have] far less carcinogens, and we're not saying to completely outlaw or ban [them]. We're just asking to treat them as a tobacco product and limit the exposure and second hand exposure, especially exposure to our youth.

Ada City Councilman Bryan Morris said that while the ban is about “being considerate to those in parks and other public places,” the city could receive a $100,000 grant from the Oklahoma Tobacco Settlement Endowment Trust for including e-cigarettes in the ordinance.

information about Health planners

“Stripped of its linguistic pretense,” writes Judge Samuel Wilson of the Western District of Virginia in his concurring opinion, “the Commonwealth’s purpose is to protect established “community providers” (i.e. established in-state interests) from the effects of competition.”

Each year about 100 medical providers take up the gauntlet and apply for a CON in Virginia. No doubt many more take a hard look at the application process—which can take years, cost hundreds of thousands of dollars, and result in no certificate—and balk.

Established businesses can formally intervene in the hearings as well. Seven different local hospitals and clinics that already own CT scanners fought Dr. Baumel. Yes—even though none of them use their scanners to perform colonoscopies.

Earlier this year, a trial court threw out Dr. Baumel’s claims that the law treads on his constitutional rights. A three-judge panel reinstated his suit this week. “The district court gave a serious claim the back of its hand,” wrote Judge J. Harvie Wilkinson III. “This was error.” The case will now head back to a trial court for further proceedings.

Meanwhile, it’s been over four years since Dr. Baumel, who is represented by the Institute for Justice, first applied for a CON. (Full disclosure: I am working on a part-time project for IJ. This article is my own, however, and I thought ill of certificates of need well in advance and independent of this litigation.)

Health planners claim that CON laws allow states to improve on market outcomes through “managed” competition. Empirical support for this proposition is scant. Like all protectionist laws, CON laws restrict choice, raise costs, and stall innovation by blocking newcomers from entering the market.

As Virginia’s CON law demonstrates, the health system is bogged down by dynamism-destroying rules—rules that generate the very outcomes that supposedly justify the Affordable Care Act.

With the new law coming into effect, things are going to get worse before they get better.

A Rare Victory Against Health Care

A Rare Victory Against Health Care-Strangling Red Tape

With Obamacare coming into effect, things are going to get worse before they get better.

A telling example of this comes by way of the Fourth U.S. Circuit Court of Appeals, which ruled this week that the state of Virginia may have violated the Constitution when it prohibited a doctor from opening shop simply to shield other businesses from competition.

Dr. Mark Baumel, a gastroenterologist, wants to buy CT scanners, which he will use to detect cancerous intestinal polyps in patients at three clinics that he proposes to build. Colorectal cancer claims the lives of over a thousand Virginians each year and is the second-leading cause of cancer death nationally. In large part, that’s because more than half of the people who should be getting screened are not.

It’s no mystery why. Traditional, invasive rectal inspections are more than mildly unpleasant and can cause infection and other complications. Dr. Baumel, however, proposes to conduct relatively cutting-edge “virtual colonoscopies,” eliminating the unpleasantness and minimizing health risks. Patients pay for a CT scan and, depending on the findings, can also opt for same-day polyp removal. (The procedure is recognized by the American Cancer Society and the American College of Gastroenterology.)

No other provider in Virginia offers the service, which has the potential to save many lives simply by improving screening rates. But state health officials won’t let Dr. Baumel spend his own money to buy a CT scanner.

To purchase expensive medical equipment in Virginia, one must first obtain permission from the government in the form of a “certificate of public need.” In the 36 states (and D.C.) with certificate-of-need (CON) laws, would-be providers must prove to health officials that there is a need for the service they wish to provide. Of course, in a market economy, entrepreneurs know they have hit upon a need after they set up shop and try to attract customers.

The Commonwealth of Virginia substitutes the market test with a panel of health planners who purport, as per the CON statute, to scrupulously evaluate 20 criteria, including whether a proposal might “undermine the ability of essential community providers to maintain their financial viability.”

FDA and the pregnancy category

The FDA has assigned buprenorphine to pregnancy category C, meaning "animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks." Oxycodone, by contrast, is in pregancy category B, meaning "animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester." So even if Beltran had not stopped taking Percocet, the existence of "a substantial risk" is highly questionable.

In an application for a writ of habeas corpus that they filed last month, Beltran's lawyers argue that Wisconsin's fetus-protection statute is unconstitutionally vague, inviting just this sort of arbitrary enforcement. They also argue that Beltran's detention violated her rights under the the Fourth, Fifth, Sixth, Eighth, and 14th Amendments. One of Beltran's lawyers, Lynne Paltrow, executive director of National Advocates for Pregnant Women (NAPW), tells the Times, "This is what happens when laws give officials the authority to treat fertilized eggs, embryos and fetuses as if they are already completely separate from the pregnant woman." At the hearing that led to Beltran's confinement, she had no lawyer, but the fetus inside of her did. "I didn’t know unborn children had lawyers," she says. "I said, 'Where's my lawyer?'"

 Although Beltran has been released, Paltrow and their colleagues are seeking a federal injunction blocking enforcement of the law under which she was detained. NAPW says this is the first federal challenge to statutes like Wisconsin's. According to the Times, "Wisconsin is one of four states, along with Minnesota, Oklahoma and South Dakota, with laws specifically granting authorities the power to confine pregnant women for substance abuse. But many other states use civil-confinement, child-protection or assorted criminal laws to force women into treatment programs or punish them for taking drugs." In an article published last January by the Journal of Health Politics, Policy and Law, Paltrow and Jeanne Flavin, president of NAPW's board, report that their organization has identified more than 400 cases between 1975 and 2005 where pregnancy was a critical factor leading to civil or criminal consequences such as arrest, detention, involuntary treatment, and enhanced jail or prison sentences. Such interventions are not only unjust but probably counterproductive, increasing risks to unborn children by scaring drug users away from prenatal care.

Some state courts have rejected aspects of the crackdown on women who use drugs during pregnancy. In 2008, for example, the South Carolina Supreme Court unanimously overturned the homicide conviction of a cocaine user whose baby was stillborn. Last February the New Jersey Supreme Court unanimously ruled that using illegal drugs during pregnancy does not by itself amount to child abuse or neglect under state law. By contrast, the Alabama Supreme Court has ruled that child endangerment laws can be applied at any point after conception.

Detention of Pregnant Drug Users

Woman Forced Into Treatment Challenges Wisconsin Law That Allows Detention of Pregnant Drug Users

The New York Times highlights the case of Alicia Beltran, a pregnant Wisconsin woman who was locked up because she admitted to a physician's assistant that she had had been hooked on Percocet (oxycodone). Beltran had stopped using Percocet with help from a substitute opiate, Suboxone (buprenorphine), and she was no longer using either drug. The physician's assistant nevertheless recommended that she start taking Suboxone again. After Beltran declined, social workers and cops got involved, the upshot being a court order sending her to Casa Clare, a drug treatment center in Appleton, where she was confined until October 4. Beltran, who is currently about 29 weeks into her pregnancy, also faces a charge of negligence that could theaten her parental rights after her baby is born.

All this was authorized by a 1997 Wisconsin law that allows detention and forced treatment of any pregnant woman who "habitually lacks self-control in the use of alcohol beverages, controlled substances or controlled substance analogs, exhibited to a severe degree, to the extent that there is a substantial risk that the physical health of the unborn child, and of the child when born, will be seriously affected or endangered unless the expectant mother receives prompt and adequate treatment for that habitual lack of self-control." In Beltran's case, the expectant mother was abstinent, a fact confirmed by urine tests, so it is hard to see in what sense she was experiencing a "habitual lack of self-control." Furthermore, the drug that the government wanted her to take, buprenorphine, seems to pose a greater hazard to fetuses than oxycodone, the drug to which she had been addicted.

Health Care Rights and Responsibilities

Health Care Rights and Responsibilities

What happens when health care is thought to be a fundamental right?

What happens when health care is thought to be a fundamental right? That's the question at the heart of David Kelley's January 1994 reason story, "The Rights Angle." Kelley's piece examined the large-scale health-care overhaul proposed under President Bill Clinton. Kelley came away worried.

The "plan in its present form involves a massive increase in government control over physicians, insurers, employers, and-last but certainly not least-the patients who are supposed to be the beneficiaries of the plan," he wrote. "Most people will be forced to obtain their health insurance through purchasing cooperatives: government-backed monopolies that collect payments from consumers and set the terms on which medical providers can offer their services." Meanwhile, health providers will "be prohibited from dealing with patients directly," forced instead to work through highly regulated cooperatives-essentially government-run middlemen.

Kelley argued that this upending of the health system was fundamentally the result of a single assumption-"that if people have medical needs which are not being met, it is society's responsibility to meet them."

The Clinton health plan didn't pass. But almost two decades later, under a different Democratic president, another large-scale health policy overhaul did.

For the most part, the debate over ObamaCare didn't explicitly deal with "the rights angle." ObamaCare's mandate was often described as a "responsibility." But the notion of health care as a right didn't exactly go away either.

Like the Clinton plan, ObamaCare attempts to achieve universal coverage by requiring individuals to obtain insurance. There are no government-backed cooperatives in ObamaCare, but there are government-run insurance marketplaces that regulate participating insurers. And thanks to the law's various Medicare payment reforms, which are supposed to create incentives for doctors and other providers to change their behavior, the new health law also ends up giving the government more influence over the practice of medicine.

In other words, the rights angle-and the belief that all unmet medical needs must be served, no matter what-lives on as the subtext of the health policy debate. In March, Health and Human Services Secretary Kathleen Sebelius argued that catastrophic health plans didn't count as real insurance, because they only cover the biggest medical expenses. And in August, Medicare chief Marilyn Tevenner told Congress that insurance isn't "true insurance" if it's not sufficiently comprehensive.

How To Have a Painless Workout

Share Your Plans on Social Media

We're not suggesting you share every detail of your workout with the world (We all have one of those people in our newsfeed), but getting feedback and support from your social network can help you stay on track towards reaching your fitness goals—especially at the crack of dawn when you need it most.

Post your workout plans the night before (Trying out a new Kettle bell class in the morning!). You might be more motivated to get out of bed after announcing it on your Twitter feed.

Prepare for a Painless Pre- and Post-Workout

Zap morning workout excuses by making your pre- and post-workout routine as simple as possible. Put your workout clothes, socks, shoes, even your hair elastic right next to your bed so you don't have to waste time fumbling around for your gear. And don't let the thought of sweaty hair keep you from a good training session before work. We are huge fans of dry shampoo (and polished ponytails) in cold weather, and a quick, water-only rinse in the shower on warmer days. Pick out simple work outfits (i.e. a dress versus a three-piece outfit) on days you know you'll be short on time.

Exercise Your Pelvic Muscles

Your companion through every stage of womanhood, Ascella Hegel Exercisers are the perfect solution to prevent or overcome pelvic floor disorders – helping you effectively gain pelvic strength in an easy and comfortable way. The pelvic floor muscles are vital to leading a healthy feminine life, delivering an array of benefits that can protect your overall well-being.

Our exercisers are made of the highest quality materials for a safer and more hygienic workout. The spherical shaped weight naturally positions itself while providing you with a firm object to flex your muscles around. In addition, each exerciser features a weighted inner ball that offers the resistance you need to efficiently strengthen and also confirms its correct placement.

Staying true to Dr. Kegel's original method, the advanced design of our exercisers encourages the correct technique of lifting upwards and squeezing to ensure the best results.

Ascella Hegel Exercisers allow you to start with a weight that best suits your current level of strength and
progress from there.

• Light Resistance (28g/1oz) is ideal for women who have a weaker pelvic floor or for beginners.
• Moderate Resistance (38g/1.3oz) is perfect for those experienced in weight-free Kegel exercising.
• Higher Resistance 48g/1.7oz is best for women experienced in weighted Kegel exercising for the most advanced training.
5 reasons you'll love training with Laselle
• Made of 100% body-safe silicone
• Easy-to-use progressive weight training
• Up to 6 weight combinations
• Quickly see and feel results
• Completely personalized training

Motivating your self for Exercise

Psych (or Bribe) Yourself Up

Even if you have had 8 hours of sleep, it can still be a struggle to get up before the sun does. That's why we highly recommend bribery. If you love to start your day with Starbucks, make a deal with yourself that you'll only be allowed to stop on your way to work if you fit in your workout first (and make sure to avoid the high-calorie, sugar-packed drinks and pastries on the menu). Or if you've had your eye on an amazing new pair of shoes, treat yourself to them only if you make a month's worth of scheduled morning workouts. It may sound silly, but if the thought of your new shoes or skinny latte helps get you out of bed, it's worth trying!

Build a Motivating A.M. Mix

Never underestimate the power of great music to motivate you to get moving. And you don't have to wait until you're ready to exercise to turn on a rockin' mix! Start blasting your tracks as soon as you sit up (if you have a sleeping partner or family, we recommend using headphones).

Add your favorite songs—the ones that really get your heart racing—to your mix and change it often so it always feels fresh and inspiring. (Here are some pumpin' workout songs to try if you need some suggestions.)

Determine a Realistic Strategy for Success

Determine a Realistic Strategy for Success

Is the gym really the best option for you at 6 a.m.? Dragging yourself, work clothes, shoes, hair dryer, and makeup bags all the way to the gym—ugh, we're ready to go back to bed just thinking about it! Isn't there something easier you could do instead? A great workout DVD or a home circuit routine can be just as effective as a gym session.

More great options: Walk or jog around the neighborhood, or check for boot camp sessions at nearby parks. Find a way to make your morning workout something you'll look forward to and be able to stick with without a lot of extra effort (with the exception of the effort you'll put into your actual sweat session, of course).

Plan to Fail

Yes, you read that right. While we do love the expression "fail to plan, plan to fail," being prepared to fail truly is the best credo you can have when it comes to sticking with your fitness routine. Life happens, and you've got to be prepared with a backup plan. Maybe you decided your best morning workout strategy was running outdoors—so what happens when you wake up on a rainy day?
Decide ahead of time what you'll do if (when) something out of your control comes up. Create more than one alternative so that when your workout partner cancels (time to try that Tabata workout?) or that snowstorm hits (how about a workout DVD?), you'll still be able to rise, sweat, and shine.

Become a Morning Exerciser

7 Steps to Become a Morning Exerciser

Your guide to stop snoozing and start sweating. Yes, it is possible!

Impending deadlines, last-minute meetings, an impromptu dinner date. These are just a few of many schedule conflicts that keep you from fitting in your evening workout. It's a common problem with an obvious yet seemingly impossible solution: Work out in the morning! We know, it's so hard to get up when you could snooze for another hour! But becoming a morning exerciser is doable (even if  you've never been a morning person). Follow our step-by-step plan and you'll soon wonder how you ever started your day any other way!

Slowly Start Moving Up Your Bedtime

Working out in the morning is counterproductive if you're not getting enough sleep (numerous studies have linked a lack of sleep to everything from weight gain to an increased diabetes risk, not to mention low energy and fatigue), and trying to wake up early if you aren't fully rested is even more difficult.
Your strategy: First, decide what time you'll need to start waking up to make your workout happen, and then calculate what your new ideal bedtime should be (most experts recommend 7-8 hours of sleep each night for best health and weight-loss results).

If you usually hit the sack at midnight, don't expect to start falling asleep at 9 p.m. right away. Start going to bed 15 minutes earlier each night until you gradually reach your ideal bedtime (and remember, the hours you spend in bed are not the same as hours spent sleeping, so be sure to allow yourself some time to unwind and fall asleep too). In the meantime, you can still fit in a morning workout! Use this "sleep transition" period to focus on shorter, targeted workouts. This fat-blasting routine only takes 10 minutes!

Prescription Weight Loss Drugs

Prescription Weight Loss Drugs

Obesity often requires long-term treatment to lose weight and keep it off. Prescription weight loss drugs may help.

Keep in mind that these drugs are not a cure-all for obesity. Weight loss drugs should be combined with physical activity and a healthy diet to lose and maintain weight over the long term.

weight loss medicines

Begin Your Personal Diet Evaluator Now

Do I Need a Prescription Weight Loss Drug?

Using prescription weight loss drugs to treat obesity is an option for the following people:

People with a body mass index(BMI) of 30 or above People with a BMI of 27 or above with obesity-related conditions, such as diabetes or high blood pressure

Types of Prescription Weight Loss Drugs

Most weight loss drugs are for short-term use, meaning a few weeks or months.

One type of weight loss medication is "appetite suppressants." Appetite suppressants promote weight loss by tricking the body into believing that it is not hungry or that it is full. They decrease appetite by increasing serotonin or catecholamine, two brain chemicals that affect mood and appetite.

These drugs come in the form of tablets or extended-release capsules (pills that release medication over a long period of time). Appetite suppressants can be obtained by a doctor's prescription or bought over the counter. One common prescription appetite suppressant is phentermine. The FDA has also approved the appetite suppressant Belviq for long-term use in treating obesity. Side effects include dizziness, headache and tiredness.

The drug Qsymia combines phentermine with the seizure/migraine drug topiramate. Topiramate causes weight loss in several ways, including increasing feelings of fullness, making foods taste less appealing, and increasing calorie burning. Qsymia is designed to be taken long-term. However, it cannot be taken by pregnant women and is only sold through certified pharmacies.

Another type of prescription weight loss drug is a fat absorption inhibitor. They work by preventing your body from breaking down and absorbing fat eaten with your meals. This unabsorbed fat is eliminated in bowel movements.

Orlistat is the only drug of this type in the U.S. Orlistat works by blocking about 30% of dietary fat from being absorbed. Orlistat is available by prescription as Xenical and over-the-counter as Alli.
Does Xenical Really Work?

Xenical is moderately effective, leading to a 5% to 10% weight loss when taken along with a low calorie/low-fat diet. Most of the weight loss happens in the first six months.

Over the short term, weight loss from prescription drugs may reduce a number of health risks in obese people. But studies are needed to determine the effects of these medications over the long term.
The Risks of Prescription Weight Loss Drugs

When considering long-term weight loss drugs for obesity, the following concerns and risks should be discussed with your doctor:

Addiction. All prescription weight loss drugs except orlistat are "controlled substances." This means that doctors are required to follow certain restrictions when prescribing them since they could be addictive.
Tolerance. Most people's weight tends to level off after six months while taking a weight loss medication. This leads to a concern that the person has developed a tolerance for the medication, but this is unclear.
Side effects. Most side effects of weight loss drugs are mild (although some can be unpleasant) and usually improve as your body adjusts to the medication. Rarely, serious and even fatal side effects have been reported.

Exersies and Healthy goals

Learn how to set (and meet) healthy goals

Changes You Can Live With continued...

Adopting a new lifestyle means finding the behaviors and attitudes that led to weight gain and, once you've figured out your bad habits, gradually changing them into healthier patterns.

For example, are you a member of the "clean plate club"? Do you mindlessly consume your food in record time? Do you eat in front of the television? Are you always eating or drinking something?

Start to adopt more healthful behaviors such as leaving a few bites of food on your plate at each meal, slowing down and tasting every bite, eliminating interruptions to your meals, and filling your spare time with activities other than eating.

Or your own "better behaviors" might include wearing a pedometer and walking 5,000-10,000 steps each day; switching to fat-free or light food products; giving up fried foods; starting each day with a nutritious breakfast -- the options are endless. The trick is finding changes that are easy for you to incorporate into your life. And when you do something repeatedly, it soon becomes automatic.

So set "process goals" (such as eating five servings of vegetables each day or logging 10,000 steps three days in a row) instead of "outcome goals" (such as losing 30 pounds). Process goals are key to changing behaviors, and that's what will ultimately lead to permanent weight loss. Besides, a healthier lifestyle is more important in the long run than the number of pounds you shed.
The Top of the Mountain

In the beginning of your program, everyone is noticing your weight loss, passing out compliments and cheering you on. But get to the third month or so, and the cheerleaders often all but disappear.

Yet studies show that three to six months after making behavioral changes is an important time for reassessing your strategies. It's a critical point to continue moving forward while maintaining the new habits that got you there.

Think of this time as the top of the mountain -- and you need to get over the top for the new, healthier habits to become routine. Challenge yourself to find ways stay energized during this time: Experiment with new recipes, find a diet or exercise buddy, or try a new type of physical activity.
Take Stock

Take a minute right now to rethink your weight loss goals, and remember you are in this journey for the long haul. Accept that healthy weight loss is slow and steady. Your goal is to lose a pound or two a week. And even if you only lose half a pound, isn't that better than gaining?

Make a list of all the ways your life has improved because of your weight loss so far. Celebrate these victories, write them down, and revisit them often.

Realistic goals will improve your self-esteem and provide the reinforcement you need to help you continue the journey.

Weight Loss Goal

Is Your Weight Loss Goal Realistic?

Learn how to set (and meet) healthy goals

I once read a story about a woman who complained to her doctor about her frustration with weight loss. The woman had lost 25 pounds but was not satisfied. "I will not be happy until I lose 25 more pounds," she declared.

Her doctor then asked her a series of questions: Are you feeling better? Do you sleep better? Is it easier to climb a flight of stairs? Can you bend over and tie your shoes? Do you feel better about yourself? The patient answered "yes" to all of the questions.

Her doctor was incredulous. The 25-pound weight loss had substantially improved her health and her quality of life, yet the woman was still not satisfied.

It's not uncommon for dieters to set lofty weight loss goals for themselves. Some reach back umpteen years to their wedding day or college weights. Others fantasize about looking like a supermodel, even though their naturally large frames may make this an impossible goal.

A 2001 study from the University of Pennsylvania found that on average, overweight people set a goal of losing 32% of their body mass. That's three times the amount needed to achieve better health. The truth is, it's unlikely that most dieters will be able to lose one-third of their body weight. Setting extreme goals is a setup for disappointment and failure.

You can achieve your goal weight -- as long as it is reasonable and attainable. Remember that you're on a journey to improve your life and health and gain control over your weight. It's not about perfection.
Set Mini-Goals

Instead of shooting for a size that has not been seen in your closet for 10 years, set more attainable goals. Even modest weight loss can improve your blood pressure and your cholesterol, blood sugar, and triglyceride levels. Losing as little as 10 pounds can put the zip back in your step and make you feel terrific about yourself.

To help keep you motivated toward meeting your ultimate goal, set mini-goals you can reach within a month or so. Track your progress, and reward yourself along the way for improving your eating and exercise habits.

For example, on weeks when you get to the gym five times, treat yourself to flowers, a movie, or a ball game -- whatever feels like a reward to you. This will help keep your attitude positive and remind you of the benefits of a healthier lifestyle.
Changes You Can Live With

You can lose weight on virtually any diet. But to send those extra pounds packing without a round-trip ticket, you must find healthful strategies that you can stay with forever.

The reason we call the food component of the Weight Loss Clinic program an "eating plan" is because it is not a diet. A diet is something you can go on and off of; an eating plan is for life.

Exercise and Lose Weight Fast

Exercise and Lose Weight Fast

What kind of exercise -- and how much -- is best when you're trying to lose weight?

Keep in mind that exercise is just one portion of a successful weight loss program, say experts.

"Eating and exercise are not separate issues," says Church. "They're intimately connected. Too many people think these large doses of exercise are an excuse to eat whatever you want."

Unfortunately, today food is everywhere. There are candy bars at Home Depot and cheesecakes at Barnes & Noble. Gaesser says his kids can't believe a gas station used to be just a place to get gas. And portions are out of control, says Church -- just look at the size of the plates at restaurants.

"It's so much easier not to eat calories than to burn them off," says Quist.

And keep in mind that the definition of successful weight loss is keeping the weight off.

"It's not hard to lose weight," says Church. "Anyone can lose weight. What's hard is keeping it off. Those that combine both diet and exercise keep it off."

But what about metabolism? Many people who have struggled to lose weight believe they have unusually slow metabolisms.

Chances are, "you don't have a slow metabolism," says Church. "It is so rare that of all the metabolisms we've checked (and he does this daily), I can't remember one being legitimately slow."

The truth is, he says, "bigger people have a higher metabolism because they're bigger. Metabolism is how much mass you have. The more mass you have, the more energy you burn just sitting around."
How Much Do I Need to Exercise for Weight Loss?

Do the math: You need to burn 3,500 calories to lose a pound. So if you're burning 300 calories in one workout, it will take you nearly 12 workouts to lose one pound. If you cut your calorie intake by 300 calories in addition to burning 300, it will take you half as long to lose a pound.

If you want to lose weight, shoot for at least 200 minutes (more than three hours) a week of moderate intensity exercise with everything else consistent, says Church. If you cut calories and exercise, he says, you can get away with a minimum dose of 150 minutes (2 1/2 hours) a week.

If you're a beginner, says Gaesser, start with 50 minutes of exercise a week and work up to 200.

"You didn't put on that 20 pounds in the last six months; you're not going to take it off in six months," says Church.

"People don't want to hear about the patience aspect," he says. "They want instant gratification. But the cold, hard reality is if you want to lose weight and keep it off, it's work. No one loses weight and keeps it off without trying."

Here are eight tips to help you adhere to a weight loss workout and meet your goals.

Have an exercise buddy or partner. This is a must, according to the experts who spoke with WebMD. Having accountability to someone else, even if it's your Labrador, keeps you honest. "It's much easier to say no to yourself than to someone else," says Gaesser, who goes for bike rides regularly with friends.
 
Schedule your workouts. Keep a calendar that lists specific times for your workouts, says Gaesser. Make an appointment with exercise ahead of time, and you won't have the excuse of running out of time.
   
Weigh yourself daily. This is one of the best tools to see if you're slipping up, Church says. Weighing yourself daily can keep you on track so that you don't let 300 extra calories a day or one missed workout set you back.
 
Don't do too much, too fast. Don't get over-motivated, warns Quist. Lifting weights that are too heavy or starting out with six days a week of aerobic exercise is a mistake, says Quist. "People end up hurting themselves in the first week and then they give up," he says.
 
Log your steps. Logging the time that you work out will help you achieve your weekly goal, even if you get off track one day, Church says. It will also inspire you at the end of the week, when you can look back and see what you've accomplished.
 
Cook more often. Portions, and calories, are out of control when you eat out, says Church. You'll almost always consume fewer calories in a meal cooked and eaten at home. Save restaurants for special occasions, and get together with friends for a walk instead of a meal.

Don't turn water into wine. Not only does a glass of wine or beer add a couple hundred extra calories, after a few glasses, you're not as conscious of consuming more calories in your meal. You don't have to give up drinking, says Church, but do cut back.
 
Beware the one-way valve. You walk past the hors d'oeuvres at a party, grab some cheese and crackers, and quickly consume 300 calories before dinner even starts. "We have no problem randomly over-consuming extreme amounts of calories," says Church, "but we never randomly, sporadically have extreme bouts of caloric expenditure."

Exercise to Lose Weight

Exercise to Lose Weight

What kind of exercise -- and how much -- is best when you're trying to lose weight?

If someone told you right now what the absolute best exercise to lose weight was, would you do it? You might when you read this. Drum roll, please!

The best exercise to lose weight is: "the exercise you'll do," says Timothy Church, MD, MPH, PhD, a professor at Pennington Bio medical Research Center in Baton Rouge, La.

woman power walking

Other experts interviewed by Web MD said much the same thing about weight loss workouts.

"The two things that stop people from losing weight with exercise are either boredom or injury," says physical therapist and strength and conditioning specialist Ben Wist, PhD, NSCA.

The truth is that weight loss is about creating a calorie deficit -- in other words, burning more calories than you take in. So, they say, while running at an 8-minute-mile pace might be a great calorie burner, if you're not going to do it, it's not going to help you. Instead, start with something you can do, like walking or working out on an elliptical machine or exercise bike.
The Beef on Strength Training

In all cases, however, you'll burn more calories with cardio (aerobic) exercise than with strength or resistance training.

"Strength training itself will not lead to an appreciable amount of weight loss because it just doesn't burn enough calories," says Glenn Gaesser, PhD, FACSM, kinesiology professor and department head at the University of Virginia in Charlottesville.

But what about all that talk that more muscle mass equates to more calories burned, even when you're at rest?

"It's a myth. It's not going to happen," says Gaesser.

The only successful studies to show a significant calorie burn following a weight-lifting workout (afterburn) were done with serious lifters, working out for 60 to 90 minutes at a time and lifting as much as they could on every set.

In fact, Gasser says, at best, gaining one pound of muscle will help you burn 5 to 10 extra calories a day. You could do that chewing gum.

That's not to say that strength training isn't important for the overall health of the body. But when it comes to burning the most calories, go for cardiovascular exercise. And vary the intensity, says Wist.

"Do aerobic base-building workouts," he says, where you alternate between moderate and higher intensity, either within the same workout or on alternate days.

Wist also recommends cross-training -- that is, doing a range of different activities during your workouts. Not only does this help you keep from getting bored, it's better for your body. Doing different activities recruits different muscle groups. You're also less likely to develop an injury, says Quiet, since doing the same thing day after day creates wear patterns on your joints.

Get creative, says Gasser, whose graduate students teach an entire class on novel ways to burn calories. For example, he says, if you're a golfer, ditch the cart and walk with your clubs. You'll do what you love -- and burn more calories.

Exercise regime

Greg has a chiseled physique with insane proportions and won't stop until he wins an IFBB pro card. See his secrets to single-digit body fat that makes muscle pop on stage!

HOW DID YOUR BODYBUILDING JOURNEY BEGIN?

My Journey began when I entered my freshman year of college. I was no longer involved in soccer or track and needed a new hobby. I met a fellow college student who competed and told me to look into it. It sounded like fun so I started doing research on Bodybuilding.com to learn how to diet and exercise for a show.

In October 2012, I entered my first men's physique competition, won my height class, and was hooked. The following April, I did another competition to show off the hard work I put into the gym, took second place, and was very proud of myself. I was on a high from the support I had throughout prep. In June 2013, I entered my first national-level show, the NPC Junior Nationals. Unfortunately, I didn't place in the top five, but the experience was amazing.

Workout info

Joshua manipulated his fast metabolism with mass protein and a genius diet. See the methods he used to win bodybuilding competitions and why he won't stop!

HOW DID YOUR BODYBUILDING JOURNEY BEGIN?
My journey began three years ago when I was tired of being skinny. I was 5-foot-10 and 135 pounds. I was always lean and athletic, but never packed on size. I lifted off and on throughout high school during football with little gains due to a lack of knowledge about dieting and training.

I read and studied on Bodybuilding.com and created a workout regimen and bulking diet that helped me get up to 220 pounds at 14 percent body fat in two years. I added fat but also packed on muscle and size to sculpt the muscular physique I painted in my mind.

In February 2013, I decided to take it to next level and compete in my first bodybuilding show. I teamed up with one of the best contest prep coaches in the area and leaned out to 190 pounds at 4.5-5 percent body fat in 14 months. My fast metabolism that kept me from gaining mass earlier became useful during contest prep. I did two shows two weeks apart and won both. Winning the shows was an indescribable experience. The hard work, dedication, and relentless dieting were rewarded on stage. I urge anyone with the desire to compete to take the challenge and experience it.

Workout Program

Build strong, round shoulders with this mass-making deltoid workout from IFBB Figure pro Jessie Hilgenberg! With great symmetry comes a great physique.

ATHLETE PROFILE
   
I've been fortunate to have strong biceps, shapely calves, and great legs for most of my life. I've even had six-pack abs forever! My weak spot has definitely been my shoulders. For a long time, my delts performed a disappearing act.

To compete in figure, I had to take my training to a higher level and sculpt a new look for my body. I focused on building my back, creating a V-taper, and building big, round delts.

My shoulder work is centered on traditional bodybuilding moves. I focus on strength, growth, and rounding out the muscle. When I train, my goal is to force a lot of blood into my deltoids to create full caps for my shoulders.

If you want a set of symmetrical, strong deltoids, then this is the workout for you.

JESSIE HILGENBERG SHOULDER SMASH WORKOUT

You can lift all day, but if you don't train with intensity, you won't grow. Intensity doesn't necessarily mean grunting, screaming, or throwing around weights. I define intensity by how heavy you lift, how hard you work, and the brevity of your rest periods. You constantly need to ask yourself: How effective was my workout?

Do you walk out of any given session knowing that you chit-chatted for five minutes between sets, did some cardio, and left? Or, do you go in the gym, get it done, and come out knowing that you're making changes to your physique? If you go into the gym with intensity every single time, your body will change.

Apply that intensity to this workout. You'll build the arms you've always wanted and feel great about the hard work you put into your body. Our workout today focuses on big, compound movements for strength and size. We'll also do a little bit of medial-delt work to round the shoulders, as well as some rear-delt work for balance. It shouldn't take you more than 45-60 minutes.

EXERCISE 1 INCLINE BARBELL BENCH PRESS
WARM-UP: 2 SETS OF 10 REPS
WORKING SETS: 3 SETS OF 12 REPS WITH 50% MORE WEIGHT THAN WARM-UP
REST: 45 SECONDS AFTER EACH SET; STRETCH WORKING MUSCLES DURING REST
T
I usually do this exercise with a barbell, but the Smith machine will work just fine. I like this movement because it's a big, compound exercise that recruits a lot of different muscles. Because I don't train chest very often, it's a great way to get in a little upper-chest work.

I like to do compound movements at the beginning of a workout when I have the most strength and energy. To keep tension on my shoulders, I don't lock my elbows at the top of the exercise.

EXERCISE 2 45-DEGREE OVERHEAD BARBELL PRESS
WORKING SETS: 3 SETS OF 12-15 REPS PER ARM
REST: 45 SECONDS AFTER EACH SET; STRETCH WORKING MUSCLES DURING REST

You can do this in any gym. All you need is a 45-pound barbell. Shove one end into a corner, a piece of equipment, or a landmine. You recruit a lot of muscle for this exercise—you'll use your glutes, core, legs, and shoulders. Keep your core tight and shoulders square.


45-DEGREE OVERHEAD BARBELL PRESS

I take about 30-45 seconds of rest between each set and between each arm. I take a rest between arms because the movement takes a lot of muscle and energy to do correctly.

If it were an isolation exercise like the lateral flye, I could go back and forth easily without resting. But this exercise is so heavy I need to rest and really stretch that muscle.

EXERCISE 3 SEATED DUMBBELL SHOULDER PRESS
WORKING SETS: 3 SETS OF 12-15 REPS
REST: 45 SECONDS AFTER EACH SET; STRETCH WORKING MUSCLES DURING REST

I don't lock out my elbows or bring the dumbbells together at the top. That helps keep my shoulders engaged and my traps out of it. I focus entirely on keeping that tension on my medial deltoid.

EXERCISE 4 REVERSE MACHINE FLYES
WORKING SETS: 3 SETS OF 12 REPS, ADD WEIGHT EACH SET
REST: 45 SECONDS AFTER EACH SET; STRETCH WORKING MUSCLES DURING REST

The rear delt flye is a really great exercise to keep in your shoulder routine because it builds the muscles in your back, pulls your shoulders back, and opens your chest so you appear wider and broader on top.

I love this movement because I can brace my torso against the pad and focus on working my rear delts. Keep a slight bend in your elbow during the exercise. If your elbows are locked, you'll use your triceps too much.

EXERCISE 5 SINGLE-ARM SIDE LATERAL RAISE
WORKING SETS: 3 SETS OF 15 REPS PER ARM
REST: 30 SECONDS AFTER EACH SET; STRETCH WORKING MUSCLES DURING REST

This exercise really hits the medial deltoid and helps round the shoulders. It's not a compound exercise, so I'm okay with having a shorter rest period. I take my 30-second rest after I've done both arms.

"DON'T USE MOMENTUM ON THIS EXERCISE. I LIKE TO USE ONE ARM SO I'M NOT INCLINED TO SWING THE WEIGHT TO GET IT UP."
Don't use momentum on this exercise. I like to use one arm so I'm not inclined to swing the weight to get it up. Perform each rep slow and controlled.

On shoulder day, I like to do a finisher. One of my favorite and effective techniques is called "running the rack." It's similar to a pyramid set. I start with 25-pound dumbbells and do at least 4-5 reps with them. Then I drop the weight and do as many reps as I can with 20-pound dumbbells. I continue stripping the weight until I'm doing as many reps as I can with 5 pounds.

Then, I take a 60-second break, stretch the muscles being worked, and start again. This time however, I start with the lightest weight, do as many reps as I can, and I keep going back up the rack until I do as many reps with the 25-pound dumbbells as I can.

Adding a finisher to my shoulder day really exhausts the muscles and ensures that I've done my job. I can barely hold the steering wheel on my way home. If you don't like this technique for a finisher, there are plenty of others to try. You can do a triple dropset, regular dropset, or rest-pause set.

Training Program

Jen Jewell's Training Program

JEN JEWELL'S TRAINING PROGRAM
Jen Jewell's fast-paced, circuit-style workouts are a brutal challenge, but they're also fast and fun. Spend a week in her shoes and follow Jen's split!

Jen Jewell's Nutrition Program
JEN JEWELL'S NUTRITION PROGRAM
Jen Jewell's nutrition philosophy is pretty simple: Find balance. No calorie-counting or food-weighing for this fitness queen! She stays ripped year-round through moderation and clean eating.

Jen Jewell's Supplement Program
JEN JEWELL'S SUPPLEMENT PROGRAM
Before she gets on stage, Jen Jewell has to look her absolute best. To get there, she trains hard, eats right, and follows an air-tight supplement plan. Learn more about what Jen uses to take her physique to pro level!

FULL-CIRCLE FITNESS

Throughout high school, Jen was active and worked as a successful personal trainer. When she moved to southern California for college, she brought her fit lifestyle with her. But things changed when tragedy came knocking. "My best friend was killed in a car wreck. I was in SoCal, I didn't have any friends or family nearby, and I was alone," Jen says. "I don't want to say I got depressed, but I was not my full self."

LIKE MOST OF US, JEN HAS STUMBLED ALONG THE WAY, BUT SHE HAS HER FEET PLANTED FIRMLY NOW IN THE WBFF.

To deal with her pain, Jen made new friends, started going out for dinner and desserts, and stopped training hard. "I wanted to take my mind off the fact that I had just lost my best friend."

All the food and socializing added up. Over a year or two, Jen went from 118 pounds to more than 160. "It just slowly crept on," she says. "My body fat was up to 35 percent."

At first, she didn't really pay attention to the weight she had gained. But when Jen stepped on a scale at the doctor's office, she realized she needed a change. "When I saw the number, I thought, 'Oh, that's why I have to buy a size 11 now.' I didn't need bigger pants because my legs were super muscular; I was just kind of a beefcake."

So, Jen got serious about her diet and her training. Because she was a personal trainer, she knew she had to start taking her own advice. "I stopped going out to eat every night. I'd just save it for the weekend," explains Jen, "and I only had dessert once per week."

Instead of going cold-turkey and putting herself on a strict contest-prep diet, Jen knew that she needed a nutrition plan that she could maintain.

She also kicked her training up a few gears. Instead of getting on the same elliptical for an hour like she had been doing, she made every minute count. Her change back into the fit body she'd had before was gradual. "It took 3-5 years for me to get down to 22 percent body fat," she recalls.

When she got there, Jen decided to do a contest. "I told myself I needed to do a show. I'd wanted to do one since I was a teenager. I knew that if I didn't try, I'd regret it forever." She set the date to begin her preparation exactly 12 weeks out from a show. And thus she began her career as a competitor.

"It's been an interesting journey," Jen says. "I want to be my best me, so I'm always striving to be the best possible version of myself. Being strong, fit, and healthy is important to me."

Now, with her online training business, Jen provides personal training to people all over the world. "I get emails from people in Australia who say they've gotten great results from my leg workout. It's really exciting for me and is a huge motivation factor."

Exercise Program

Jean Jewell's fast-paced, circuit-style workouts are challenging, but they're also really fun. Spend a week in her shoes and follow Jean's split!

To Jean Jewell, there's only one steadfast rule about training: It has to be fun! Instead of slogging through workouts that she hates, Jean does her best to create a program that's constantly changing, that she knows she'll enjoy doing, and that's going to challenge every aspect of her fitness level. Most importantly, it's a program that she knows she can maintain for years.

Jean doesn't like to do the same thing over and over again. For her sanity and well-being, she has to mix it up. "If I'm getting bored on the treadmill, then I do something new on the Step mill. Or, I'll do intervals of some crazy mix like jump roping and stair climbing." By keeping her fitness diverse, Jean saves herself from just walking on a moving belt.

She gives her clients the same advice: "If you absolutely despise the treadmill, elliptical, or other pieces of cardio equipment, clearly those machines are not for you. Do what you like. Anything from a boot camp, to a spin class, to a kickboxing class will be better than hating the gym and dreading the next workout."

She also likes to train outdoors. "I live in southern California. We have the Santa Monica Stairs, the beach, [and] we can go hiking. There are a million fun things to do. So whenever I need a break from the gym, I head into the sunshine."

STANDING BARBELL CURL

Although her program changes on a regular basis, it's not random. "I mix it up depending on what my goals are or what I'm getting ready for. Sometimes, I'll do a body part split. Sometimes I'll do total-body workouts."

But, because she holds a lot of muscle naturally, she never worries too much about bulking. "My main goal is to maintain my muscle mass and stay lean."

Right now, Jean is also concentrating on developing her hamstrings. "My quads are extremely developed from years of gymnastics and now weight training. So I'm bringing my hammies up to speed!"

She has a really busy schedule, so not all of her rest days fall on the same day of the week. "Each week is different. My workouts and rest days depend on my schedule."

On Sundays, when most people are resting, Jean hits the gym. "A lot of people like to take Sunday as a rest day. But I get some of my best workouts on Sunday. The gym is quiet, and I don't usually have a ton to do that day. Sundays are my day to concentrate on myself."

Healthy Physical Education

Physical Education

A Healthy Beginning:

The original SPARK Physical Education (PE) study was supported by the Heart, Lung, and Blood Institute of the National Institutes of Health. A team of internationally known researchers and educators were funded to create, implement, and evaluate new and innovative approaches to physical education content and instruction, then test them in “real world” settings.

SPARK PE was designed to be more inclusive, active, and fun than traditional PE classes, and SPARK was proven to work with both physical education specialists and classroom teachers. Today, after lessons learned from more than 20 years of ongoing research and field testing nationwide, SPARK PE is one of the best physical education programs in the world – a true solution to our growing problem of overweight and obese children.

SPARK's Positive Effects: Tested and Proven
Today, over 45 publications have documented the positive effects of SPARK PE -- such as:

Academic Achievement
Increased moderate to vigorous physical activity in students (to over 50% of class time)
Fitness achievement (as measured by the Fitnessgram test)
Sport skills development (throw, catch, kick)
Enjoyment of PE
Improved teacher instruction (quantity and quality)
SPARK effects are lasting (sustainability)
(For a complete list of publications, Click Here)

(For a list of awards and honors SPARK has earned, Click Here)

SPARK Physical Education Programs
SPARK PE includes the following four evidence-based programs:

Elementary Physical Education:

K-2 PE
3-6 PE
Secondary Physical Education:

Middle School PE
High School PE
Each SPARK program is a coordinated package of highly active curriculum, on-site staff development, extensive follow-up support, and expert selected, content-matched equipment.

- See more at: http://www.sparkpe.org/physical-education/#sthash.LPdIJv54.dpuf

Info Physical Education

Welcome to Physical Education

Regular Physical Activity is an important way to maintain and improve one's physical health. Students who participate in physical education are much more likely to become a healthy adult and continue lifetime physical activities. There are four aspects of physical education benefits for the primary and secondary education students.

These four aspects are physical, mental, social, and emotional. The physical aspect are improvements in cardiovascular fitness, muscular strength and endurance, flexibility, and body composition. The mental aspect of physical education classes are to set goals, improved confidence in one's skills and to be able to assume leadership roles.

The social aspect of physical education are learning teamwork and cooperation, building friendships, respecting others, discipline around peers, and social responsibility and growth. The emotional aspect of physical education are learning how to deal with pressure and defeat. Physical education teachers no longer just instruct on sports and movement skills.

Physical education teachers are now incorporating short health and nutrition lessons throughout the curriculum. A student for example would not just be shown the proper way to warm up for an activity, but also be told through a mini lesson why it's biologically important to warm up. While a student is participating in a calorie burning activity an instructor gives examples of how eating high calorie foods take more activity to burn the calories than a lower healthier alternative.

 Physical education is an essential discipline to the students experience. Through high-quality physical education instruction, students learn to become more confident, self-controlled, and have the ability to bounce back from adversity. Physical education significantly contributes to students’ well-being and ultimately improves their academic performance.

About Physical Education

The President's Challenge

The President's Challenge Physical Fitness Program is detailed here, with information about the awards available, qualifying standards, and state programs. This is a useful site for physical educators.

The Referee/Umpire Home Page

Site contains information on referees from high school to college level. Rule changes for baseball, basketball, football, soccer, softball, hockey, and wrestling. Also contains info on state and local groups, and camps.

Runner's World Online

This print publication has created a site helpful to the running enthusiast. There is a calendar of running events, information for the beginner, helpful information regarding injuries, and a nutrition area.

Schneid's Volleyball Page

This site has four distinct areas (general volleyball, exercise and fitness, sports medicine, and nutrition) with tons of information on the sport of volleyball. Includes a dictionary, as well as volleyball strategy.

Sports Media

This Belgian site is "a tool for PE teachers and everyone who is interested in Sports." It has lots to offer including a long list of sports links in many categories, PE lesson plans and listservs, coaching help, the chance to ask a question or select a pen pal, and more.

Tae Kwon Do Sparring

This site covers all the rules for running a safe Tae Kwon Do tournament, including equipment, rulings, weight classes, and scoring.

The United States Golf Association

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United States Professional Racquetball Association

The USPRA has put together a very informative and useful site pertaining to the sport of racquetball. Nicely done, easy to use.

United States Racquetball Association

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Welcome to Tennis ONE!

Tennis ONE offers tennis lessons, a place for posting questions and comments, and tennis information at the local level, as well as tennis fitness information.

National Association for Sport and Physical Education

This is the organization that sets the standard for physical education in the US.  There are many great resources on this page.  You can contact them for a link!

Physical Education information

Physical Education

We're continually reviewing new sites and adding resources, and appreciate your comments and suggestions. Suggest a link here

AYSO Online
The American Youth Soccer Organization offers lots of information for the soccer player and coach. You'll find coach and referree information, MLS Camps information, and even free software to download "which will help you better manage your team."

Amateur Softball Association
If you are interested in softball, this site is for you.. You can find out how to register your team, become a certified ASA umpire, and locate the local ASA representatives.

America's Sports Headquarters
This site has links to everything from spectator sports to outdoor adventures to recreational sports. If it's about sports and it's on the Internet, you will most likely find it here, and organized in a very useful manner.

Archery
With instruction, history, and listings of archery literature, this site offers quite a bit about the sport of archery.

The Archery Corner
This site presents the Guide to Shooting with a Bow, in English and Italian.

Australian Sport WWW

If you're looking for information about sports in Australia, this is where you'll find it. Learn about
organizations at a national, state, and local level, as well as information about Australia in the Olympics and the Commonwealth Games. You can find out about specific sports played in Australia (there are lots of them!), and the site is still being developed.

Coaching Science Abstracts

Presented here are abstracts of research articles for "practicing coaches and others interested in applied sport science." The most current issue is presented along with a number of previous issues. Each issue appears to focus on a specific topic. Past issue topics include Altitude Training, The Female Athlete, and Goal-setting.

Do It Sports
This site houses a vast amount of information about running, track and field, walking, cycling, and mountain biking. There are articles on training, as well as information regarding upcoming events specific to each sport.

Dr. Pribut's Running Injuries Page
Stephen M. Pribut, D.P.M., offers advice to runners on everything from common running injuries and how to avoid them to shoes and books.

FAIR PLAY
"The Official Publication for U.S. Soccer Referees" is an online magazine containing articles for the soccer referee.

Human Kinetics
The Human Kinetics Publishers (HK) website offers information on HK publications. The "information leader on physical activity" also provides information on FitForce, American Sport Education Program, and American Master Teacher Program. You'll also find InfoKinetics, a breadbasket of job listings, journals, information on conferences and events, and more.

LPGA.com
Home to the LPGA, this web site offers information about women's golf. You can look for a pro in your area or find out about tour events and course information. Check into the junior area to find out what's available for the young female golfer.

Melpomene Institute
Melpomene is a "nonprofit research organization dedicated to women's health and physical activity." They have an online catalog of useful books, information packets, and brochures pertaining to these topics.

The National Archery Association
This well designed site offers lots of information, including a history of archery, news about up-coming events, and recent tournament results.

PGA.com
This web site offers information about professional golfing, but even the amateur can get some tips here. Read the PGA Lesson Tee for a weekly tip from a PGA member, and stay on top of the championships and special PGA events here.

Physical Education Digest
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Physical Education Lesson Plans 1
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The Physician and Sports medicine Online
This is an incredibly useful site for the sports enthusiast, the sports professional, and the medical professional, with tons of information in the issues online since January 1996. One area on personal health covers such topics as Chronic Disease, Lifestyle, Safety, and Rehabilitation. This is a must-see for anyone who is physically active.