If you’ve been to a doctor’s office any time during the last two decades, chances are, you’ve seen or talked with your doctor about the charts that use height and weight calculations to determine various categories of weight, from underweight to morbidly obese. The implication has been that if you fall into the heavier ranges, you are not healthy.
But is it possible to be both overweight and healthy?
Well, it’s complicated.
“While these guidelines, which we call body mass index, or BMI, give us a starting point in understanding where a person is in terms of health, a BMI is not the only factor in determining health,” said Erika La Vella, DO, a surgeon from Samaritan Weight Management Institute.
Weight Is Individual
Healthy weight depends on the individual, she said.
“One basic flaw of those charts is that the numbers cannot evaluate a person’s muscle and bone mass,” she said.
If, for example, you are an athlete with a muscular build, your body fat will likely be overestimated by your BMI, and if you are a someone who has lost muscle due to age or illness, your BMI may be underestimated.
“A BMI is just one tool. Also important is a person’s health history, physical activity, genetics and age. A number of factors help us get the full picture of an individual’s health,” said La Vella.
“If you fall into the obese category with your BMI and you also smoke and have high blood pressure, then excess weight to you becomes a greater risk than to someone who doesn’t have other risk factors,” La Vella said.
The National Health, Lung, and Blood Institute (NHLBI) lists these factors that increase risk for heart disease, diabetes and stroke.
- High blood pressure (hypertension).
- High LDL cholesterol (“bad” cholesterol).
- Low HDL cholesterol (“good” cholesterol).
- High triglycerides.
- High blood glucose (sugar).
- Family history of premature heart disease.
- Physical inactivity.
- Cigarette smoking.
“There are clear links between excess weight and disease and shortened lifespans, so especially if a person has these other risk factors, then losing weight is highly recommended,” she noted.
Where a person carries their weight is also important.
There are two types of fat – subcutaneous, which is the squishy type of fat you can pinch, and visceral fat, which is stored in the abdomen and wraps around vital organs. While you will notice an expanding waistline with visceral fat, much of the fat is out of reach deep in the belly.
“You may have heard it said that it’s better to have a pear-shaped body than an apple-shaped body. That is because abdominal fat is more dangerous. Visceral fat can cause metabolic disturbances that are linked to heart disease, Type 2 diabetes, insulin resistance and some cancers,” said La Vella.
According to NHLBI, risks for those diseases increase when a woman’s waist is greater than 35 inches and a man’s greater than 40 inches. Find your measurement by pulling a tape measure around your waist, level with your navel.
Fit But Unhealthy
But if you don’t have any of these risk factors, is being overweight still a problem?
La Vella noted that some people who are overweight are fortunate enough not to have any health problems and are considered “metabolically healthy,” meaning that they exercise regularly, lack other risk factors for heart disease, but are still overweight.
“There have been studies that followed people who had metabolically healthy obesity, and in many cases, researchers found that carrying the extra weight eventually leads to developing hypertension, elevated cholesterol or diabetes – the very risk factors they didn’t have in the beginning,” she noted.
Rather than focus on how to make the extra weight work, consider exploring what keeps you from eating better and exercising, and make changes to make your health a higher priority, said La Vella.
Small changes can make a difference, she noted, such as eating smaller portions, adding more vegetables and fruit, substituting lean meats for fatty ones and taking a brisk walk on most days of the week.
“We are healthier when we are at the weight that is best for our body type, when we are physically active and when we eat a heart-healthy diet,” said La Vella.
And when it comes to losing weight, there is some good news.
“Sometimes, we feel we must lose all our extra weight at once, and that can feel pretty overwhelming. But you don’t have to lose that much weight to lower your risk for disease,” La Vella said. “Studies have shown that losing just 5 to 10% of your current weight can lessen the risk significantly, and even reverse some issues altogether.”
Get tips for losing weight as you contemplate resolutions for 2021. For more information on this topic or to learn about the weight management program at Samaritan, visit samhealth.org/WeightLoss or call 541-768-4280.