Countless guides exist on how to lose weight, which makes it hard to figure out what approach is right for you. However, before you start trying to lose weight, it’s important to consider whether or not you should lose weight — and if so, how much is healthy.Therefore, you should consult with your doctor before beginning any weight loss program, as they can help you decide if losing weight is right for you. They can also help you determine the safest way to lose weight based on your own unique health needs. While shedding pounds may help decrease your risk for heart disease and diabetes, losing too much weight can also come with its own set of health conditions such as fatigue, weak bones, and fertility problems.

Once you’re in a healthy weight-loss plan, there’s always the risk of not losing as much weight as you like. Adjusting your diet or activity level might be all you need to do to see results. But sometimes, your efforts can fall flat. Here are some common reasons why you may be struggling to lose weight:

You’re eating too many calories

To lose weight, you need to take in fewer calories than you burn. This is called a calorie deficit. If you’re in a calorie surplus, your body stores those extra calories as fat.

To ensure you’re consuming the right amount of calories, monitor your caloric intake, as well as physical activity. You can do this by keeping track of the calories you’re eating and burning through fitness apps or in a food log. A large 2006 study found that those who planned meals and tracked calories successfully lost weight and maintained weight loss more than those who did not.

You’re drinking too much alcohol

Alcohol is energy dense, meaning it contains a high amount of calories per volume, says Ariana Chao, CRNP, the medical director of the Center for Weight and Eating Disorders at the University of Pennsylvania’s Perelman School of Medicine.

For reference, alcohol has about seven calories per gram, while a carbohydrate has four calories per gram. Alcohol can also reduce inhibitions about eating, making you more likely to choose high-calorie foods if you’re drinking, Chao says.

A large 2018 study of overweight and obese people with type 2 diabetes found that people who drank heavily lost less weight over a four-year period than those who did not drink and decreasing alcohol consumption may improve weight management in people with diabetes.

You’re not drinking enough water

Drinking water can help you lose weight by boosting your metabolism and suppressing your appetite, thus making you feel fuller.

A small 2007 study found that drinking 500 mL (two cups) of water increased energy expenditure by 24% in overweight or obese individuals. Additionally, a small 2015 study of obese people compared participants who drank two cups of water before meals with those who did not. It found those who drank water lost an average of almost three more pounds.

 Can stress cause high blood pressure?

Stress-and often how you cope with it-can make so many things worse, including your blood pressure.

A major risk factor for heart disease and stroke, high blood pressure stage 1 is defined as an upper or systolic blood pressure reading of 130-139 systolic millimeters of mercury (mm/ Hg) and a lower or diastolic pressure reading of 80-89 mm Hg. Systolic blood pressure is the pressure when your heart beats while pumping blood, and diastolic blood pressure is the pressure when your heart is at rest between beats. A blood pressure of less than 120/80 mm Hg is considered normal.

Stage 2 is when blood pressure consistently ranges at 140/90 mm Hg or higher. This is when doctors are likely to suggest medication and lifestyle changes, according to the American Heart Association.

Untreated, high blood pressure can set the stage for heart attack, stroke, and other complications by damaging blood vessels throughout your body. Stress can have both direct and indirect effects on blood pressure levels, explains Vijay Nambi, MD, associate professor of medicine, Baylor College of Medicine, Houston.

Here’s what you need to know about stress and how it affects your heart rate and blood pressure.

Stress triggers your body’s fight-or-flight response, and this is a good thing when you are faced with an immediate threat or scare, says Dr. Nambi.

“If something scares me and jumps in front of me, my blood pressure should go up,” he says. In these cases, stress stimulates your sympathetic nervous system which releases the stress hormones adrenaline and cortisol that can increase heart rate and blood pressure.

This is exactly what is supposed to happen to help you avoid harm, he notes.

Chronic stress—whether related to work, finances, personal relationships, or life in general—is another story altogether. Researchers are still trying to unravel how chronic stress directly impacts blood pressure. What they do know is that that stress gets in the way of making healthy choices, which will have indirect effects on your blood pressure.

When you are stressed, you are less likely to do the things that you know are good for you. This includes following a healthy diet and exercising regularly, says Stephen J. Huot, MD, professor of medicine (nephrology), associate dean and director of graduate medical education, Yale School of Medicine/Yale New Haven Hospital.