Do you smoke cigarettes or engage in little physical activity? These factors can compound the risk represented by excess weight.
BMI and waist measurement are snapshots of your current weight. The medical history helps reveal your risk of being overweight or of developing weight-related diseases.
So what’s your healthy weight?
If your BMI shows that you’re not overweight, if you’re not carrying too much weight around your abdomen, and if you answered no to all of the medical history questions, there’s probably little health advantage to changing your weight. (But you may still improve your health through a healthy diet and physical activity.)
If your BMI is between 25 and 30 or your waist measurement exceeds healthy guidelines, and you answered yes to one or more of the medical history questions, you’ll probably benefit from losing a few pounds.
Talk to your doctor before you start to lose weight. And if your BMI is 30 or more, you’re considered obese. Losing weight should improve your health and reduce your risk of weight-related illnesses.
Now if your analysis shows that you’re at a healthy weight, but you’re still dissatisfied with the way you look, then you’ve got some thinking to do. If you’re at the middle or upper end of a healthy BMI, there’s probably little risk to losing a few pounds. But if you’re at the lower end of a healthy BMI range, and losing weight would push you into the underweight category (less than 18.5), then losing weight may put your health at risk.
role genes play is unclear. Scientists believe that obesity is more likely the result of a complex interaction between genes and environment. This means that although you may have a genetic predisposition to being overweight, it’s not fate. Ultimately, your weight is determined by how you interact with physical and social factors.
Psychological factors. People sometimes overeat to cope with problems or to deal with emotions such as boredom, sadness and frustration. In some people, a psychiatric illness called binge-eating disorder may contribute to obesity.
Other factors. These factors may contribute to weight gain but generally aren’t enough in and of themselves to lead to obesity:
Age — As you get older, the amount of muscle in your body tends to decrease, lowering metabolism. In addition, people tend to be less active as they get older. Both result in fewer calories burned.
Stopping smoking — Many smokers gain some weight after stopping smoking, but the benefits of stopping smoking outweigh whatever health risks may result from the weight gain.
Pregnancy — Some women may gain more weight than recommended during a pregnancy and may retain it afterward.
Medications and illnesses — Corticosteroids, tricyclic antidepressants, anticonvulsants, insulin and hormones may cause weight gain. Sometimes, alternative medications can be used. Only rarely can obesity can be traced to an endocrine disorder, such as low thyroid function or Cushing’s syndrome. Medical conditions can sometimes interfere with activity, making weight gain more likely.
Chapter 12
Understanding nutrition and weight control
Carbohydrates, fats, protein . . . oh my!
Sounds like a lot to keep track of. But more than anything, at its core, weight is about energy — and the balance between what you take in when you eat and what you burn through physical activity. This chapter gives some depth to that relationship.
Michael Jensen, M.D.
Endocrinology
A pound of fat will provide you with 3,500 calories. You can put this in perspective by calculating about how many calories you burn a day. Your basal metabolic rate (BMR) is the number of calories a day you would burn if you lay in bed doing nothing. Because very few people are that sedentary, almost everyone burns more than this. The range of “extra” calories above BMR that we commonly see in normal adults is 20 to 75%. That means that someone with a BMR of 1,500 calories a day probably really burns somewhere between 1,800 and 2,600 calories a day.
You can get a rough estimate your own BMR by multiplying your weight by 9 to 12 calories per pound. And if you know how many minutes you walk each day, you can also calculate about how many calories you expend walking — the most common way we burn extra calories.
Most women burn 1,700 to 2,200 calories a day and most men somewhere between 2,000 and 2,600. Now the 3,500 calories in a pound of fat can be put in perspective. It’s more calories than most of us burn in an entire day — and for some women, two days! In order to lose 1 pound of fat a week, the average woman would have to reduce calorie intake by one-fourth and the average man by one-fifth. That’s a lot of food to not eat just to lose a pound of fat.
It’s also why reducing body fat shouldn’t be looked at as a short-term goal but a long-term process.
All living things need energy to grow and develop, to function properly and, in short, to survive. Your body has a constant demand for energy. You replenish energy with the food you eat.
Weight is all about the balance between energy added through diet and energy
burned through activity. This energy balance equation is a basic principle of weight control.
Food energy is measured in units called calories. It’s easy to find lists of foods and the calories they contain. Energy burned in activity is also measured in calories, and there are lists to show you how many calories you can burn by doing certain activities. This knowledge is helpful in assessing your own energy balance and achieving or maintaining a healthy weight.
Tracking calories-in and calories-out in a journal is helpful in weight loss.
This may at first seem like a lot of work, but it’s not necessarily something you have to do forever. With practice, you can get to the point where you can keep your energy flow in balance without tracking it.