What's the right weight for you?

July 02, 1998|By KATE COLEMAN

What's your right weight?

So, what's the skinny on the first federal obesity guidelines released last month by National Institutes of Health?

They provide a new way for doctors to identify, evaluate and treat individuals who are overweight or obese - 97 million American adults, 55 percent of the population.

And it's not just about appearance.

--cont from lifestyle--

Those 97 million Americans are at increased risk of illness from hypertension (high blood pressure) type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems.

This problem carries a big fat price tag: Total costs of obesity-related disease approach $100 billion each year, according to NIH's National Heart, Lung and Blood Institute.


What is overweight and what is obesity?

Overweight is the excess amount of body weight including muscle, bone, fat and water; obesity is the excess accumulation of body fat, according to information on the Web site of the Weight-Control Information Network of the National Institute of Diabetes and Digestive and Kidney Diseases,

The guidelines' definition is based on research relating body mass index - a relationship of weight to height - to the risk of illness and death.

Three factors are involved in determining if a person is overweight:

1. Body mass index (BMI) describes body weight in relation to height and is strongly correlated with total body fat content in adults. BMI numbers apply to both men and women. Some very muscular people may have high body mass indexes without health risk.

HEIGHT="6" ALT="* " NATURALSIZEFLAG="0" ALIGN="BOTTOM"> BMI of 25 to 29.9 is identified as overweight

HEIGHT="6" ALT="* " NATURALSIZEFLAG="0" ALIGN="BOTTOM"> BMI of 30 and above is considered obese

As BMI levels rise, average blood pressure and total cholesterol levels increase, and average HDL or good cholesterol decreases. Men in the highest obesity category have more than twice the risk of hypertension, high blood cholesterol or both compared to those of normal weight. Women in the highest obesity category are at four times the risk of either or both factors.

2. Physicians are advised to measure the circumference of the waist, associated with abdominal fat, which is itself a sign of disease risk. If a man's waist measures more than 40 inches, and a woman's is more than 35 inches, it means an increased risk if their BMI is between 25 and 34.9.

3. The patient's risk factors, including higher blood pressure or blood cholesterol, or family history of diseases such as hypertension or type 2 diabetes, should be looked at. People with these additional risk factors are at a higher risk.

The guidelines tighten the belt a notch or two around what it means to be overweight. Earlier weight-for-height tables classified a man overweight if his BMI was higher than 27.8. In a woman's case, the cutoff was 27.3. In the new guidelines, overweight begins at a BMI of 25 for both men and women.

"They are certainly more tough than what they had been going by before," says Dr. Robert Parker, health officer for Washington County Health Department.

There is some controversy about the evidence used to develop the guidelines, Parker says.

Some experts don't consider people with a BMI of 25 overweight, says Barbara C. Hansen, a member of the National Heart, Lung and Blood Institute Education Initiative expert panel that developed the guidelines.

But experts agree risk increases as people get heavier, she says.

What do the guidelines mean?

The message is that people need to be aware of the risks even if they are below the cutoff point for overweight and obesity, Parker says.

You need to be conscious of what you eat and be thinking about exercise, he adds.

Adults should know what their body mass index and weigh themselves at least once a week to prevent weight gain, advises Hansen, a professor of physiology and director of Obesity and Diabetes Research Center at University of Maryland School of Medicine in Baltimore.

Those who need to lose weight can reduce calories, increase physical activity and change behavior, according to the guidelines.

"It's important for individuals to realize that it's something you work on gradually," Parker says.

People often try to do too much, like jogging five miles on their first time out. Then they give up exercising altogether.

Making sensible little changes, being more conscious of nutritional and caloric content of the food you eat - especially fat - can make a difference, Parker says.

And although there is a genetic-physiological basis for body weight, all people can improve their BMI, Hansen says. A loss of 10 to 15 pounds or dropping even a couple of units of BMI will improve your health.


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