UP, DOWN, UP DOWN...

A certain sinking sensation occurs as the scale's digits fly, finally registering a number inconceivable a few years past.

With weight and health consciousness climbing in America, stepping onto the scales has become an integral part of morning rituals.

However, over one-fourth of Americans do not like what their scales, or their mirrors, reflect.

According to a 1993 Calorie Control Council national telephone survey, 27 percent of the population of the United States -- 51 million people -- consider themselves on a diet. Most of those dieters will lose weight. However, the greater difficulty lies in keeping the weight off, health professionals say.

"It's always so much more difficult to keep it off," than it is to lose the weight in the first place, said Anita Newcomer Smith, clinical dietitian at Southeast Missouri Hospital. That's because keeping the weight off "involves a permanent change in lifestyle," which includes both attention to healthy eating habits and exercise, she said.

Just as it's natural to resist change in habits, the body, likewise, will greet change kicking and screaming. As caloric intake is reduced, explained Virginia Heston, wellness specialist at Southeast Missouri Hospital's Fitness and Wellness Center in Jackson, the body goes on red alert. "It's out for survival," she said. "The body is pretty happy with its fat."

Research indicates that people who lose weight by means of drastic change in their eating habits will typically drop the extra pounds quickly, "but, as soon as you revert to your normal eating habits, even if they're healthy, your body sees it as excess," said Debbie Leoni, coordinator of Southeast Hospital's Fitness and Wellness Center. Plus, she said, the weight will typically come back as fat rather than muscle.

Many Americans recognize this form of repetition. It's called yo-yoing, and it's not a game.

The cycle carries with it some decidedly unhealthy mental and physical risks. With each repetition, it becomes more difficult to lose the weight, according to Dr. Katherine Martin, a San Diego family practitioner who holds special interest in weight reduction.

"Each time they lose weight then gain it back and add a little more, they've actually slowed down their metabolism," Martin explained. Plus, yo-yo dieting can contribute to other medical conditions linked with higher percentages of body fat such as hypertension, heart disease and gall bladder disease.

Then there's the depression and guilt that often accompanies a perceived failure.

Marty, who prefers to be identified simply by her first name, is a woman residing in the Cape Girardeau area who is intimately acquainted with the unpleasant realities of dramatic weight fluctuations.

Describing herself as a compulsive over-eater and a food addict, Marty, 38, is recovering from a recent relapse in her efforts to shed extra pounds. "This time, I have managed to catch the relapse long before I reached the point at which I started," she said.

However, that hasn't always been the case. Marty has come close to her desired weight of 125 pounds three times only to see her efforts squelched. "The first two times I rebounded to like 20 to 30 pounds above the point where I had started dieting," she said. At one point her weight climbed to 252 pounds.

Despite the many negative emotions that a regain of weight can elicit, "there are lessons to be learned even in relapses," she said. For instance, she said, the recent relapse prompted the realization that "I wasn't doing what needed to be done to take care of me."

Her resolve, she said, is strengthened through contact with the local arm of Overeaters Anonymous. The support group operates on principles similar to Alcoholics Anonymous, explained Barbara, who also participates in the organization's weekly meetings.

"We all go by first names, but that doesn't mean we don't know each other's last names," Barbara said. The anonymity, however, contributes to the overall focus of the group, she indicated. "Whatever's said in the meeting, stays there," Barbara explained. "People respect that."

Within Overeaters Anonymous, weight is not the central issue, Barbara said, noting, "Life is the issue ... It's how you cope.

"The weight is just a symptom."

Martin agrees. The physician maintains that added weight often results from the misappropriation of the use of food. "The food is supplying some other need. It makes them get a temporary good feeling, a satisfied feeling, a fullness," she explained.

But the satisfaction is fleeting, and the need seldom is satiated for long unless change in lifestyle occurs. And that change, for most, is affected more efficiently if brought on slowly, many health providers agree.

While, overall, it's considered healthy for persons who are overweight to shed the extra pounds, there are other considerations, noted Dr. Charles Pewitt, a physician with offices at Jackson Family Clinic. "You need to make sure you go about it the right way," he said of weight loss.

"When I talk to somebody about weight loss, first I make sure there are no underlying medical problems," he explained.

While overeating and lack of a good exercise routine account for most weight problems, people still tend to seek a quick fix, or, Pewitt said, "some kind of magic pill."

There simply is no such thing, the physician asserted.

It's a reality Marty began facing a few years ago, though she has struggled with her weight since childhood.

She describes her 34th year as when "life as I knew it fell apart and I had to find a way to survive." That's when she actively sought help.

For Marty, stepping away from the isolation that came with hiding her struggle with the weight was a tremendous relief. As she began to talk about her problem, she found support in many areas including her workplace, at the gym and through Overeaters Anonymous.

"I get selective amnesia," Marty said, "I forget that food will have me in its clutches if I don't do what I know I need to do.

"The realization has to continue on a daily basis."

Marty now concentrates on a healthy food plan that she has found works for her and regular exercise. "It took me 34 years to get this way, it's going to take me a while to change that, it's not going to happen over night."

"It's a lifelong road," she said.

For most people who are overweight, the road doesn't have to be as difficult as it's often perceived, according to clinical dietitian Smith. Healthy eating doesn't mean sacrificing your taste for things, she said. "One Hershey's kiss didn't do any of us in," she joked.

In Southeast Missouri Hospital's Living Lean program, set to begin in early April, Smith and others will focus on positive weight control behavior modification.

While studies indicate that approximately 28 percent of Americans are overweight, many researchers recommend getting away from the habit of gauging weight -- and therefore health -- simply by stepping on the scales.

Besides putting the body at greater risk, high percentages of body fat affect appearance, self esteem, and weight loss efforts.

"When your percentage of body fat is higher, you can eat the same as you did when you were 25 percent body fat and gain weight on it," Smith said.

The most effective way to lower body fat percentage is exercise, she said.

While studies indicate that most people can succeed in losing a least a small amount of weight, research also shows that there are hidden dangers, both physical and mental, in yo-yo dieting, which is the most common form of weight loss failure.

Persons considering weight loss must weigh their options carefully, seeking professional advice before embarking on major health changes.

For Marty, the effort is worth it. "Life is so different when I'm not enslaved to food," she said.