"If youre looking to lose those extra pounds you should probably add reducing stress and getting the right amount of sleep to the list say researchers from Kaiser Permanentes Center for Health Research in Portland. In fact although diet and exercise are the usual prescription for dropping pounds high stress and too little sleep or too much of it can hinder weight loss even when people are on a diet the researchers report. We found that people who got more than six but less than eight hours of sleep and who reported the lowest levels of stress had the most success in a weightloss program said study author Dr. Charles Elder. Elder speculates if you are sleeping less or more than recommended and if your stress levels are high you will not be able to focus on making behavioral changes.  These factors may also have a biological impact he added. If you want to lose weight things that will help you include reducing stress and getting the right amount of sleep Elder said. The report funded by the U.S. National Institutes of Health is published in the March  online edition of the International Journal of Obesity. In this twostep trial  obese adults were first counseled about lifestyle changes over a week period. Recommendations included cutting  calories a day eating a diet rich in fruits vegetables and whole grains by following the Dietary Approaches to Stop Hypertension DASH diet approach and exercising at least three hours a week. In addition the researchers asked the participants questions about sleep time depression insomnia screen time and stress. During this part of the trial the participants lost an average of almost  pounds. The  percent of the participants who lost at least  pounds went on to take part in the next phase of the trial. Those in the second phase of the trial continued their diet and exercise program. Elders team found the right amount of sleep and stress reduction at the start of the trial predicted successful weight loss. Lower stress by itself predicted more weight loss during the first phase of the trial they added. Declines in stress and depression were also important in continuing to lose weight during both phases of the trial as were exercise minutes and keeping food diaries Elders group found. Dr. David L. Katz director of the Prevention Research Center at Yale University School of Medicine said that while we often tend to look at health one condition at a time the reality is that health is best viewed holistically. People who are healthy and vital tend to be healthy and vital not because of any one factor but because of many. And the factors that promote health  eating well being active not smoking sleeping enough controlling stress to name a few promote all aspects of health he added. This study shows that people are more likely to lose weight when not impeded by sleep deprivation stress or depression he said.  Anyone who has ever tried to lose weight probably could have said much the same from personal experience. Similarly weight loss reduced stress and depression. This too is suggested by sense and common experience as it is affirmed by the science reported here Katz said. The important message is that weight loss should not be looked at with tunnel vision Katz said.  Improving sleep may be as important to lasting weight control efforts as modifying diet or exercise. Managing stress is about physical health as well as mental health. This study encourages weight loss in a more holistic context he said. Another study presented earlier this month at the American Heart Association scientific sessions held in Atlanta found that people of normal weight eat more when they sleep less. Columbia University researchers discovered that sleepdeprived adults ate almost  calories more a day on average than those who got enough sleep. And the extra calories mostly came from saturated fat which can spell trouble for waistlines. The researchers came to their conclusions  which should be considered preliminary until published in a peerreviewed journal  after following  men and  women of normal weight. They monitored the eating habits of the participants as they spent six days sleeping four hours a night and then six days sleeping nine hours a night or the reverse. If sustained the dietary choices made by people undergoing short sleep could predispose them to obesity and increased risk of cardiovascular disease the researchers wrote in an American Heart Association news release. More information For more information on obesity visit the U.S. National Library of Medicine http SOURCES Charles Elder M.D. M.P.H. Center for Health Research Kaiser Permanente Portland Ore. David L. Katz M.D. M.P.H. director Prevention Research Center Yale University School of Medicine New Haven Conn. March   International Journal of Obesity online"