Weight Management

• A lifestyle that combines sensible eating with regular physical activity is the key to good health.
• To be at their best, adults need to avoid gaining excess weight, many need to lose weight, and some are underweight.
• Being overweight or obese increases a person's risk for high blood pressure, heart disease, stroke, diabetes, certain types of cancer, arthritis, and breathing problems.
• A healthy weight is a major factor for a long, healthy life.

When it comes to adults and children, different methods are used to find out if weight is about right for height. Adults should learn their BMI (click here for calculations). Not all adults who have a BMI in the range labeled "healthy" are at their most healthy weight.

• Some may have lots of fat and little muscle.
• A BMI above the healthy range is less healthy for most people; but it may be fine if someone has lots of muscle, a large body frame, and little fat.
• The further one's BMI is above the healthy range, the higher one's weight-related risk. If a person's BMI is above the healthy range, he or she may benefit from weight loss, especially if there are other health risk factors.
• BMIs slightly below the healthy range may still be healthy unless they result from illness.

There is no single perfect body size for children. However, many children in the United States are overweight. If someone has concerns about his or her child's body size, talk with a health-care professional.

Keep track of one's weight and waist measurement, and take action if either of them increases. If someone's BMI is greater than 25, at least try to avoid further weight gain. If middle-aged or elderly and the waist measurement increases, one is probably gaining fat and losing muscle. If so, take steps to eat less and become more active.

1. Weigh oneself and have one's height measured. Find one's BMI category. The higher the BMI category, the greater the risk for health problems.
2. Measure around the waist while standing, just about the hip bones. If it is greater than 35 inches for women or 40 inches for men, there is probably excess abdominal fat. This excess fat may place one at greater risk of health problems, even if the BMI is about right.

Learn about other risk factors

The more of these risk factors someone has, the more he or she is likely to benefit from weight loss if overweight or obese.

1. Is there a personal or family history of heart disease?
2. Is the individual a male older than 45 years or a postmenopausal female?
3. Does the person smoke cigarettes?
4. Does that individual have a sedentary lifestyle?
5. Has a doctor told the person that he or she has high blood pressure, abnormal blood lipids (high LDL cholesterol, low HDL cholesterol, high triglycerides), or diabetes?

Managing weight

Genes affect one's tendency to gain weight. A tendency to gain weight is increased when food is plentiful and when using equipment and vehicles to save time and energy. Plentiful food and labor-saving devices can make it very difficult to avoid weight gain, but it is possible to manage one's weight through food and physical activity choices.

While a number of diet plans may work for taking off extra weight, these plans will only be successful if long-term changes are made to one's eating habits. Therefore, rather than following a restrictive diet that will be impossible or difficult to maintain forever, it is better to revise one's eating habits so that it's possible to not only lose weight but also maintain a healthy weight. To make it easier to manage one's weight, it's important to make long-term changes in eating behavior and physical activity. Here are some tips to accomplish this:

• Build a healthy base and make sensible choices.
• Choose a healthful assortment of food that include vegetables, fruits, grains (especially whole grains), skim milk, and fish, lean meat, poultry, or beans.
• Choose foods that are low in fat and added sugars most of the time.
• Eating mainly vegetables, fruits, and grains helps one feel full, achieve good health, and manage one's weight.
• Whatever the food, eat a sensible portion size.
• Try to be more active throughout the day.
• To maintain a healthy weight after weight loss, it helps for adults to do at least 45 minutes of moderate physical activity daily (at least 60 minutes daily for children).
• Over time, even a small decrease in calories eaten and a small increase in physical activity can prevent weight gain or help with weight loss.
• Don't give up after making a poor dietary choice and allow this to destroy a healthy eating plan. Accept the mistake and continue to make good choices as often as possible.

Keeping weight off requires long-term changes. No matter how successful the diet, the weight will return if someone returns to his or her pre-diet eating habits. As mentioned above, a "no-diet" approach to healthy eating based on modification of dietary habits has a better chance of success than following a highly restrictive diet for a limited time.

Being overweight is associated with a number of health risks and obesity (typically defined as having a body mass index, or BMI, over 30) is even more dangerous. Some of the health risks associated with overweight and obesity include the following:

• Type 2 diabetes and insulin resistance: Insulin resistance means that the pancreas has to produce increasing amount of insulin to allow glucose to enter cells and be used for fuel. Because fat cells are more resistant to insulin than muscle cells, people who are overweight tend to produce more insulin to keep blood glucose levels stable. Once the pancreas can no longer keep up with this increasing demand, blood glucose levels rise, leading to type 2 diabetes.
• Cancers: Obesity has been associated with an increased risk of developing certain cancers, including colon cancer, prostate cancer, endometrial cancer (cancer of the uterine lining), gallbladder cancer, and breast cancer in postmenopausal women.
• Heart attack and stroke
• Hypertension
• Osteoarthritis
• Gout
• Sleep apnea and other breathing problems, including an increased susceptibility to respiratory infection and asthma
• Heart failure
• Gallstones
• Stillbirth and hypertension of pregnancy
• Stress incontinence
• Increased risk of postsurgical infection and other complications of surgery
• Infertility
• Varicose veins
• Reflux esophagitis

Weight reduction and maintenance of a normal body weight can diminish many of these risks.

Being too thin (underweight, often defined as having a BMI of less than 18.5) can occur with anorexia nervosa, with other eating disorders, or loss of appetite. Many chronic medical conditions, cancers, and infections can also result in weight loss to the point of being underweight. Being underweight is linked to menstrual irregularity (which can lead to infertility) and osteoporosis in women, and greater risk of early death in both women and men.

Many people -- especially women -- are concerned about body weight, even when their weight is actually normal. Excessive concern about weight may cause or lead to unhealthy behaviors such as excessive exercise, self-induced vomiting, and the abuse of laxatives or other medications. These practices may only worsen the concern about weight.

Unexplained weight loss is sometimes an early clue to a health problem. If someone experiences sudden weight loss for unknown reasons when not attempting to reduce or lose weight, he or she should visit a doctor to determine if a medical condition is responsible for the weight loss.

Medical supervision is important when trying to regain a significant amount of weight. Just as weight loss involves taking in fewer calories than one burns through daily activities, weight gain involves the consumption of more calories than are needed to maintain body functions and activities. Even those trying to take in extra calories should pay attention to the nutritional content of their foods and limit high-fat foods, refined sugars, and other poor nutritional choices. Some experts also recommend weight training or other exercises to promote muscle development while attempting to gain weight. If someone needs to gain weight, a doctor can help decide on an eating and exercise plan to best help him or her accomplish this.

For those who are severely underweight and attempting to regain weight, a condition known as refeeding syndrome may occur as a complication of attempts to regain weight too rapidly. This syndrome is characterized by a number of metabolic abnormalities and imbalances in electrolyte levels that may result in serious or even fatal complications. Refeeding syndrome occurs most often in people who are extremely underweight, such as those suffering from severe anorexia nervosa (those with less than 75% of a normal body weight). Sometimes severe underweight requires hospitalization during the initial weight gain phase in order to monitor the individual's overall nutritional and metabolic status.