Obesity and Diet

 

If your weight is substantially above what is healthy for a person with your body composition, genetic background, and overall health status (based on other risk factors you might have), you may be considered obese. Obesity is a more serious condition than just being a little overweight because of the increased risk of:

  • heart diseases
  • stroke
  • high blood pressure
  • diabetes
  • arthritis
  • cancer
  • asthma
  • other disorders.

Your doctor can give you a good sense of whether or not your weight puts you in the category of being obese. As a rule of thumb, you might find the weight categories shown in the following tables to be useful.

                       Ideal Weight for Women

          -----------------------------------------------
  Height      Small         Medium          Large 
 in Shoes     Frame         Frame           Frame 
 --------------------------------------------------------
 6'      138 to 151 lb   148 to 162 lb   158 to 179 lb 
 5'11"   135 to 148 lb   145 to 159 lb   155 to 176 lb 
 5'10"   132 to 145 lb   142 to 156 lb   152 to 173 lb 
 5'9"    129 to 142 lb   139 to 153 lb   149 to 170 lb 
 5'8"    126 to 139 lb   136 to 150 lb   146 to 167 lb 
 5'7"    123 to 136 lb   133 to 147 lb   143 to 163 lb 
 5'6"    120 to 133 lb   130 to 144 lb   140 to 159 lb 
 5'5"    117 to 130 lb   127 to 141 lb   137 to 155 lb 
 5'4"    114 to 127 lb   124 to 138 lb   134 to 151 lb 
 5'3"    111 to 124 lb   121 to 135 lb   131 to 147 lb 
 5'2"    108 to 121 lb   118 to 132 lb   128 to 143 lb 
 5'1"    106 to 118 lb   115 to 129 lb   125 to 140 lb 
 5'      104 to 115 lb   113 to 126 lb   122 to 137 lb 
 4'11"   103 to 113 lb   111 to 123 lb   120 to 134 lb 
 4'10"   102 to 111 lb   109 to 121 lb   118 to 131 lb 
 --------------------------------------------------------
 From height and weight tables of the Metropolitan Life 
 Insurance Company, 1983. The ideal weights given in these 
 tables are for ages 25 to 59. The weights assume you are 
 wearing shoes with 1-inch heels and indoor clothing 
 weighing 3 pounds. 

Your frame size or body build is determined by the thickness of the bones in your elbows, knees, ankles, and wrists. The Metropolitan Life Insurance Company offers this method of determining your body frame size: Extend your arm and bend your forearm upward at a 90 degree angle. With your fingers straight, turn the inside of your wrist toward your body. Place your thumb and index finger of the other hand on the two prominent bones of the elbow. Measure the space between the fingers against a ruler or a tape measure. Compare your measurement with the figures in the table below. Elbow measurements less than those given indicate a small frame; greater measurements indicate a large frame.

        Height in              Elbow Breadth for 
       1-inch Heels           Medium Frame (Women) 
       --------------------------------------------
       4'10" to 5'3"             2 1/4" to 2 1/2" 
       5'4" to 6'0"             2 3/8" to 2 5/8" 
       --------------------------------------------
       Metropolitan Life Insurance Company, 1983.  

It is important to consider body composition. If you are muscular and athletic, you may weigh more than a sedentary person of the same height and frame size, yet you may be trim, while your sedentary counterpart may be overweight. If your weight comes from muscle, you may fall technically into the overweight category yet not be fat. However, in general, as you approach 20% or more above your desirable weight, your excess weight usually comes from fat.

Body fat percentage can be determined by several methods, such as skinfold thickness, underwater weighing, total body water (hydrometry), and whole body potassium.

Losing weight

Diet is a term associated with controlling the amount and/or types of food eaten. It most often means a reduction in calories and/or elimination of specific fatty or empty calorie foods.

Losing weight requires a change in behavior that almost always involves:

  • a better understanding of your own health
  • healthy eating habits
  • a plan for rewards for following your program
  • an increase in the amount of physical activity you regularly engage in.

The most effective diet is not a diet at all, but a gradual change in eating and physical activity habits that you can continue for the rest of your life. The best way to find a safe, healthy, effective weight reduction program is to seek the advice of your doctor.

An efficient way to lose weight is to reduce the number of calories and improve the quality of the foods you choose. The best diet is one that helps you lose weight slowly but steadily, so you can maintain your ideal weight after you have reached your goal.

A weight reduction diet needs to provide adequate nutrition, a good variety of foods, and a reduction in calories. This is usually best done by limiting fat, especially saturated fat, in the diet. Pregnant women should not go on a weight reduction diet.

Talk to your doctor about making lifestyle changes to lose weight.

Selecting foods to lose weight

Keep a food diary. As soon as you eat or drink, write it down. It may be helpful to use a small pocket diary. Seeing what you eat and drink will help you examine your eating patterns and food habits.

To lose weight in a healthy manner, follow these guidelines:

  • Drink at least six 8-ounce glasses of water each day.
  • Choose unlimited amounts of vegetables and salads.
  • Choose:
  • lean meats, poultry, and fish
  • baked or broiled meat, fish, and poultry
  • salad dressing containing little or no oil.
  • Green leafy vegetables
  • Choose regular but limited amounts of:
  • low-fat or skim milk, cheeses, and yogurts
  • legumes (lentils, peas, and beans)
  • unrefined carbohydrates (whole wheat bread, whole grain cereals without sugar)
  • raw fruits.
  • Significantly limit how much you eat of the following:
  • refined carbohydrates (sugar) and foods containing sugar
  • refined grain products such as white rice and white flour.
  • Avoid:
  • saturated fats such as butter, margarine, and fat on meats
  • other foods that contain fats, such as pastries, cakes, and cheese
  • fried foods
  • processed meats
  • alcoholic beverages.

To have a balanced diet, be sure to choose a variety of foods from the basic food groups:

  • dairy
  • meat and other protein
  • vegetables
  • fruit
  • bread and cereal.
Counting calories

A calorie is a unit of measurement used to express the energy value of food. Your body burns calories to use for basic body functions. Proteins, carbohydrates, and fats contain calories and produce energy. To lose weight, reduce your calorie intake (without giving up nutrition) while increasing the number of calories used in physical activity.

Eating 500 calories less a day can result in losing 1 pound a week. One to one and a half pounds (2 pounds maximum) is the ideal amount to lose in a week. If you lose more than that each week, you begin to lose muscle rather than fat.

The average woman needs 1800 to 2300 calories a day. Most weight reduction diets suggest 1200 to 1500 calories a day for women. Ask your doctor or dietitian to help you determine how many calories you need a day.

The rate at which you can lose weight depends on your body's metabolism. This is the rate at which your body uses the energy from food for basic body functions. Metabolism can be increased by increasing physical activity.

Weight loss may occur more quickly at the beginning of a diet because the body releases extra water that was retained.

Sit down and relax while you eat your meals. Avoid distractions such as the phone and TV. Chewing your food thoroughly helps digestion. Eating small, frequent meals instead of three full meals a day is also helpful. You should eat every 4 to 5 hours. This keeps your blood sugar at a constant level and helps keep you from feeling hungry. Finish your meals with a piece of fruit instead of a sweet dessert.

You must eat a minimum quantity of appropriate food or your body will shut down its metabolism in an effort to survive the lean time. This happens when people go on "starvation" diets. The body's survival response prevents them from losing weight.

Popular diets

Popular or fad diets may be dangerous. They can be divided into several groups:

  • high-protein diets
  • specific food diets
  • calorie-conscious commercial programs.

High-protein diets result in a quick initial loss of weight. These diets allow unlimited amounts of high-protein foods, but little or no carbohydrates.

Specific food diets are based on food combinations. These diets don't count calories, are monotonous, and encourage unrealistic eating habits. Vitamin and mineral deficiencies can appear after a few days. Some of these diets include the Mayo (or grapefruit) Diet, the Beverly Hills Diet, and high-carbohydrate diets.

The Mayo diet is based on the belief that grapefruit causes weight loss by causing fat to be burned off faster. One of the problems is that the diet is high in saturated fats and cholesterol. The Beverly Hills Diet is low in protein, vitamins, and minerals such as iron, zinc, calcium, and magnesium. High-carbohydrate diets (for example, Jane Fonda, Pritikin, Bloomingdale's Eat to Succeed) are based on high-carbohydrate, high-fiber foods. Some are balanced, others are not.

Calorie-conscious commercial programs and weight loss clinics offer group support and motivation for the dieter, a wide variety of foods, and a calorie intake between 500 and 1500 a day. These programs are often expensive and should not be used without medical supervision. Some programs can provide excellent support in changing bad eating habits and maintaining a program over time.

Very low calorie diets and total fasting (eating less than 500 calories a day) are potentially fatal and require medical supervision.

Make sure that you speak with your doctor if you choose any of the popular diets.

Protein-sparing modified fasting

Protein-sparing modified fasting is used for patients who are more than 30% to 40% over their ideal weight. Before recommending this diet, your doctor will evaluate your cardiovascular system. You remain under the doctor's care while you are on this diet.

This diet is not recommended for children, adolescents, pregnant women, nursing mothers, the elderly, those who are moderately overweight, and those who have problems with their health, such as high blood pressure or cardiovascular disease.

A program that combines a very low calorie diet (to achieve a large initial weight loss) with medical supervision, counseling, an exercise program, and behavior modification can provide some initial motivation for a person trying to deal with obesity. However, the disadvantages of losing muscle may outweigh any quick success benefit.

Resources:

For those who compulsively overeat, Overeaters Anonymous may help. The program is free. Write or call:

Overeaters Anonymous
World Service Office
4025 Spencer Street #203
Torrance, CA 90503

Phone: 1-310-542-8363

Another program that can help you lose weight is Weight Watchers. To learn about Weight Watchers meetings and programs in your region, call 1-800-651-6000.

Increasing physical activity to lose weight

The simplest weight management program is not a diet at all. It is adding daily walking to your routine. Start with a comfortable goal: 5, 10, or 15 minutes a day. Walk this amount at least four times a week--seven times, if you can manage it. Each week add 5 minutes to your time until after several weeks you have worked up to 30 to 40 minutes per day. Invite your spouse or a child you've been meaning to spend more time with.

In addition to the calories you are burning as you walk, regular physical activity increases your metabolic rate. Therefore, you will be using more calories 24 hours a day, even as you sleep. If you are unable to walk, ask your doctor to recommend an alternative exercise.

In addition to helping you lose or maintain your weight, regular physical activity lowers your pulse, blood pressure, cholesterol, and blood sugar. It also increases your energy level.

Talk to your health care provider about what type of physical activity is right for you.

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Published by iMcKesson Clinical Reference Products.
Copyright 1991-2000 iMcKesson LLC. All rights reserved.

Adapted from content provided by iMcKesson, LLC
Review Date: 7/25/2001