Weight and health are not always the same thing
September 28, 2017
People of all sizes should focus on overall health, not just the number on the scale
Written By Lauren Glendenning
Brought to you by Kaiser Permanente
In a world with increasing obesity rates and a $60 billion-a-year weight loss industry, weight and health are not always inextricably linked.
While it's true that research shows those who are overweight and obese have increased risks for many serious diseases, the number on the scale doesn't always measure a person's health.
"It's not always true that overweight people are also unhealthy," said Dr. Michelle Glasgow, Family Medicine physician and Primary Care Chief at Kaiser Permanente's Spring Creek Medical Office.
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Body Mass Index is a screening tool health care professionals use to determine if someone is overweight or obese. The BMI is a person's weight in kilograms divided by the square of height in meters, according to the Centers for Disease Control and Prevention. A BMI between 25 and 30 is overweight, and a BMI of 30 or higher is obese, according to the scale.
"The BMI equation is a starting point. But your provider should get to know you, get an idea of your diet, your home life, your exercise routine or lack thereof," says Dr. Glasgow. "All of these items contribute to your true health–something that cannot be quantified by your BMI."
If the number on the scale classifies a person as technically overweight for their age and height, and even the BMI shows a person to be overweight, doctors still look at other factors when determining the patient's overall health.
The importance of daily exercise, even in the absence of weight loss
Glasgow said too much weight for a person is hard to classify. Overweight means above a weight considered normal or desirable, but many people might feel, look and on exam prove to be healthy even though their calculated BMI shows them to be overweight, she said.
"When your BMI rises above 30, you're technically in the obesity range and this is when we become more concerned about weight," she said. "A person should also be concerned about weight when they're diagnosed with chronic health issues like type 2 diabetes, hypertension or high cholesterol. Being overweight can also cause joint problems in the knees, hips and back resulting in osteoarthritis and chronic pain. When these issues arise, we need to get more serious about losing weight."
For those who contribute to the $60 billion-a-year diet industry by buying diet books, weight-loss supplements, meal-replacement shakes and other products, typically the best goal to concentrate on is exercising.
"Keep working on daily exercise. The benefits of daily exercise, even in the absence of weight loss, show more health benefits than anything else we do," Glasgow said. "Daily exercise benefits the heart, lungs, muscles, joints, and even mental health, resulting in a healthier, happier person."
For exercise goals, Glasgow recommends starting slowly by making small, incremental changes. Going into an exercise program or new routine too quickly can be painful and hard to follow.
"For every change you make, stick with it until it becomes a habit, then make another change," she said.
Realize that putting on the weight didn't happen overnight and it won't come off overnight, either, she said, adding that when one change doesn't work, try something else.
Overcoming the odds
In the United States, more than one-third of adults have obesity, according to the CDC, with an estimated annual medical cost of $150 billion.
Americans are working longer and harder in order to make money, often eating foods that are processed, cheap and easy along the way. Glasgow points out that fresh produce and lean meats are more expensive than the processed foods that are calorie-laden — a sharp contrast to the world Americans lived in about 50 years ago.
"Our lives are changing with technology to be fast paced with immediate gratification contributing to less exercise in our daily lives and poorer food choices," she said.
Glasgow tells her patients that weight is about 50 percent diet and 50 percent exercise. If you're exercising often yet not eating a healthy diet — and vice versa — problems like diabetes, hypertension and obesity can still arise.
"It takes a mix of both to reach top health," Glasgow said. "This does not mean you cannot indulge on a night out occasionally, but does mean staying true to healthy eating and exercising 90% of the time."
Anyone struggling to lose weight who feels they are doing well with diet and exercise should meet with a physician. Glasgow said doctors can do lab work and exams, as well as discuss the patient's current program to make sure there isn't a metabolic reason for the lack of progress. They can also make sure cholesterol and blood sugar levels are in a good range, and refer patients to dietitians, if necessary.
"Staying at a healthy is all about daily movement, eating fresh fruits, vegetables, whole grains, and lean meats," Glasgow said. "If we think about it easy like this then healthy weight tends to fall right in line."
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