Obesity/Weight Loss

Diagnosis

You can determine whether or not you are overweight by measuring your waist circumference and calculating your BMI [Figure 1][Figure 2]. Having a BMI of over 30 kg/m² indicates that you are obese. A BMI in the range of 25 to 29.9 indicates that you are overweight, while a BMI in the range of 18.5 to 24.9 represents a normal, healthy weight. For Asian Americans, a BMI of 23 to 29.9 is considered overweight. Since muscle weighs more than fat, you could have a high BMI if you are very fit and muscular. However, examples like these are relatively rare except in bodybuilders and football players.

If you have excess fat in your abdominal area rather than in your hips and thighs, you are also at a higher risk of developing diabetes, high blood pressure, heart disease, and other diseases. For women, risk increases when your waist is more than 35 inches around. For men, risk increases when your waist is more than 40 inches around.

People who have BMIs of 25 or more or high waist measurements and who also have two or more of the listed risk factors are strongly encouraged to lose weight.

Your waist-to-hip ratio helps to determine your risk of death from heart failure. Recent studies indicate that the disposition of fat around the trunk is associated with increased risk of dying from heart failure. The distribution of fat is assessed by calculating a waist/hip ratio. In other words, measure your waist circumference, and divide it by your hip circumference. Men who have a ratio greater than 1.0, and women with a ratio greater than 0.8 are at highest risk for heart failure.

Figure 2. Waist Measurement

If you have excess fat in your abdominal area (“apple” shape; woman on right) rather than in your hips and thighs (“pear” shape; woman on left), you are at a higher risk of developing diabetes, high blood pressure, heart disease, and other diseases. For women, risk for diabetes increases when your waist is more than 35 inches around. For men, risk increases when your waist is more than 40 inches around.

Prevention and Screening

Children should be taught healthy and nutritious eating and physical activity habits at an early age. Children, teens, and young adults should be taught to identify and overcome barriers to healthy eating and exercise. Studies show a direct correlation between the amount of television children watch and their body weight. Thus, children should be encouraged to watch TV less and exercise more.

Prevention efforts aimed at children, when supported by adults, can be successful. Although there is an epidemic of childhood obesity in the US, studies show that overweight children who lose excess weight are more likely to keep it off than are adults. In addition, studies show that it is easier to teach and motivate children to eat well and exercise than it is for adults to adopt similar behaviors later in life.