Weight Management: What's a Healthy Weight?
Many of us have a vague idea that we could stand shedding a few pounds. We are bombarded with weight loss messages all day and we are encouraged to do so for both our health and a certain standard of beauty that favors slim figures.
But who actually needs to lose weight and what exactly does it mean to have a healthy weight? It's not that easy to just step on the scales and see a magic number.
Measurements of a healthy weight
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Discussions about healthy weight often refer to BMI or body mass index as a measure of what is healthy or not. "BMI is currently used by medical professionals to quickly assess whether or not a person is of a healthy weight," says Antonette Hardie, a registered nutritionist at Ohio State University's Wexner Medical Center in Columbus.
"BMI is believed to give health professionals a sense of whether or not a person is at risk for certain chronic obesity-related conditions such as heart disease, high blood pressure, diabetes and other comorbidities," she adds.
The reason fat matters. BMI is a quick and dirty way to calculate if a person's weight is out of proportion to their height. When this happens, it is often assumed that the person is carrying excess fat - also called adipose tissue - which can increase the risk of several chronic conditions.
[Read: Focus On Wellness Instead of Weight Loss.]
Carrying excess white fat - cells stored under the skin or around organs can be dangerous. This is especially true if the excess fat builds up around the midsection, where the vital organs are located. Too much belly fat has been linked to an increased risk of heart disease, diabetes, cancer, and dementia. That's because these fat stores are metabolically active, which means the fat works like an endocrine organ, secreting hormones that affect the way your body works.
But thin people who still stick to the BMI scale can carry too much belly fat with them, which can increase the risk of chronic diseases. It's about where the fat is stored in the body and how it changes the way the metabolism works. Metabolism is the process by which your body converts calories from the food you eat into energy to power your activities and body functions every day. When you use more calories than you need to meet those needs, your body stores the excess as fat. And that's the problem when it comes to being overweight.
The BMI is designed to help doctors identify patients who may need to lose excess fat. Brenda Braslow, a registered nutritionist and certified diabetes care and education specialist at MyNetDiary, a calorie and exercise tracker launched in 2007, explains that BMI "should be used primarily as a screening tool to assess weight status."
[READ: Is Weight Loss Even Important?]
Calculating your BMI
You can determine your BMI with a relatively simple calculation that divides your weight in kilograms by your height in square meters: BMI = weight (kg) / height (m2). The National Institutes of Health also offers a free BMI calculator online.
You can use the resulting number to see which BMI category you fall into:
- A BMI less than 18.5 means you are underweight.
- A BMI between 18.5 and 24.9 means that you are of normal weight.
- A BMI of 25 to 29.9 means you are overweight.
- A BMI of 30 or higher means you are obese.
According to the BMI scale:
- A 5'8 "tall person who weighs 150 pounds has a BMI of 22.8 and is considered to be of normal weight.
- A 5'2 "tall person who is the same 150 pounds has a BMI of 27.4 and is in the middle of the overweight category.
BMI does not take into account an individual's body type, nor whether their weight is mostly muscle or fat. In fact, many Olympic athletes - whom we tend to consider the strongest in fit - would register as overweight or obese on the BMI scale because they have a greater percentage of strong muscle that is denser than fat.
[SEE 4 Body Image Lessons You Must Learn.]
The limitations of the BMI
Hardie notes that the BMI equation "was created by a mathematician in the 19th century based on the average white man." As such, it is simply "a mathematical equation of weight and height". This means that certain health questions related to weight cannot be adequately answered.
The BMI does not take into account some important determinants of health, including:
- muscle mass.
- bone density.
- body composition.
Because these factors are overlooked by the BMI scale, Hardie says it is "a totally inadequate and outdated measure of a person's health". The BMI tells us which "category" we fit in based on our weight and size. This can be an indicator that we may be at an increased risk of developing obesity related diseases such as high blood pressure, heart disease or diabetes. However, "a person's BMI is" not a comprehensive picture of health and wellbeing and should be used in conjunction with other health measures such as laboratory tests, body fat percentage, and waist size, "says Hardie.
Using these various measures can help get a far more accurate view of a person's overall metabolic health than simply calculating their height and weight.
Braslow notes that health determinants like body composition and bone density can vary widely from person to person depending on gender, genetics, and age. These variations can have a huge impact on what is actually considered a healthy weight. For example: "A woman's healthy weight is lighter than a man's because of the difference in muscle mass. Women have less muscle mass than men."
Find your optimal weight
Braslow agrees that the BMI is just one tool in their arsenal that health care providers and nutritionists should use to guide patients towards their ideal weight. "Measuring a person's metabolic health should ideally involve a combination of indicators."
There are many other methods of determining healthy weight, including:
- Other equations. Weight rating equations like Harris-Benedict, which takes into account age, height, weight, and gender, or Mifflin-St Jeor, which takes these factors into account and the basal metabolic rate, or the amount of calories your body burns to stay alive. offer a more nuanced view.
- waist circumference measurements. This method can help "determine metabolic health, as extra belly fat increases the risk of diseases such as heart disease and diabetes," says Braslow. "The risk increases with a waist size greater than 35" for women and 40 "for men."
- Other health measurements. Braslow says, "A more comprehensive assessment of a person's metabolic health looks at a person's current health, taking into account measures such as blood pressure, blood cholesterol, blood sugar, pulse, and oxygen supply." Basic blood tests can give your doctor much more details about your health and whether you are metabolically healthy and at a healthy weight than the BMI scale.
- Review of body composition. There are some special ways (using calipers that pinch some fat on your arm or stomach, or via a special immersion test) to get a detailed understanding of your body composition and the fat ratio you are carrying around. This information can provide more insight into whether you have too much fat - which can increase your risk of certain medical conditions. For example, some people may fall into the overweight category because they have bigger bones or muscles - not too much fat. "The BMI can lag far behind the mark when it comes to assessing an athlete's weight status," says Braslow.
- Personal and family medical history. "Personal and familial illnesses are factors that determine disease risk," said Braslow. Knowing what conditions may make you more common can help guide your health journey as you age. For example, a woman who weighs 150 pounds and has extra body fat in her hips and thighs with no disease, healthy blood pressure, cholesterol, and other vital signs can be told that her weight is okay. Another woman who weighs 150 pounds may have have an extra core body fat and have diabetes and high blood pressure and it may be recommended to lose 10 pounds for better health. Ideally, weight should be assessed in a comprehensive, personalized way. "
With this in mind, if the next time you visit your doctor you find out that you need to lose weight for health reasons, ask for more details as to why this recommendation is being made. If the advice is based solely on your BMI, see if you can do another assessment.
"BMI should never be interpreted as the truth of the gospel. A healthcare provider should not use it as a rigorous weight assessment tool without further studying a person's weight and health," says Braslow.
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