8 Steps to Determine: Are YOU Dangerously Overweight?

Photo: Academy of Nutrition and Dietetics

My clients regularly ask me: Could the height/weight charts in doctors’ offices be correct?
Really?
My answer: That depends…
(This article was also published in The Huffington Post) 

 Don’t use height/weight charts alone to determine your ideal body weight. Researchers designed the latest body mass index (BMI) charts for use in combination with additional personal information. A group of scientists from the National Institutes of Health (NIH) who specialize in how weight affects health crafted the guidelines after reviewing hundreds of studies conducted over the past several decades — only then did the experts make their recommendations to health professionals.

The guidelines help physicians, and registered dietitians like me, evaluate and make recommendations for clients. But you can also use the BMI charts, along with your doctor’s advice, to help you decide what your appropriate weight should be.

8 Steps

1. Determine your Body Mass Index (BMI), or the relationship between weight and height that researchers have associated with body fat and health risk.  BMI is calculated by dividing your weight in kilograms by height in meters squared (kg/m2). But there is a BMI chart (below) so you don’t have to make the calculation yourself!
2. If you are categorized as “overweight,” it is ideal for you to lose weight. That said, weight loss treatment is particularly important – and recommended – when you have two or more health risk factors, such as smoking, inactivity. I would define “inactivity” as under 10,000 pedometer steps daily (averaged over a week), or any of the following: High blood pressure, low HDL (good) cholesterol, high LDL (bad) cholesterol, high triglycerides (blood fat), impaired fasting glucose, a family history of premature heart disease, or a high waist circumference – measured at the belly button – of greater than 35″ for women or 40″ for men. The presence of abdominal fat is correlated with disease risk. We used to think body fat was inert, but it isn’t, it’s toxic! Fat tissue produces hormones and pro-inflammatory chemicals, which regulate metabolism, the immune system, inflammation, the progression of artery hardening, and the development of cancers, so that when you have less body fat, you get many biological benefits.
3. If you are categorized as “obese,” weight loss treatment is recommended,
4. Your initial weight loss goal should be to reduce body weight by about 10% from your starting weight. This should take about six months, depending on how much you have to lose. You can lose one-half to three pounds per week safely (assuming your calorie intake is appropriate, the more cardiovascular exercise you do, the faster you can lose),
5. If more weight loss is needed, another attempt at weight reduction can be made,
6. After the desired weight loss is achieved, a weight maintenance program consisting of dietary therapy, physical activity, and behavior therapy should be continued indefinitely,
7. You will need to follow lifestyle therapy for at least six months, according to the NIH guidelines, before your doctor prescribes drug therapy or surgery.  Though the safety of drug therapy has not been established and 50% of surgery patients re-gain the weight,
8. For the very obese, with a BMI over 40, or a BMI over 35 with significant adverse health conditions, obesity surgery may be an appropriate option.

NOTE: Highly muscular people, usually professional athletes or body builders, may register as “overweight,” but that may be because of high muscle mass, instead of fat. More muscle is not generally thought of as unhealthy, so if you’re categorized as “overweight” because you have more muscle, weight loss would not be recommended in these cases.