Weight control: Eating right and keeping fit

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What is the body mass index?

The body mass index (BMI) is a tool that often is used to measure body fat. It is based on height and weight. To find out your BMI, you can use the online calculator at  www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

What BMI ranges are considered normal, overweight, and obese?

A person with a BMI of

  • 18.5 to 24.9 is a normal weight
  • 25–29.9 is overweight
  • 30 or higher is obese

About 4 in 10 women in the United States are obese.

What should I know about waist size?

If you are overweight or obese, you also should measure your waist size. Extra fat in the abdomen (an “apple” shape) is a greater health risk than extra fat in the hips and thighs (a “pear” shape).

To measure your waist, stand up and place a tape measure around your middle, just above your hip bones. Take the measurement just after you breathe out. If your waist size is 35 inches or greater, your risk of certain health issues associated with being overweight is increased.

Factors that Affect Weight

How does calorie intake affect my weight?

Every function of the body-from building cells to moving muscles—needs energy. Energy is measured in calories. Calories also measure how much fuel is in a certain food.

The body uses only as many calories as it needs for energy. Any calories that are left over are stored as fat in the body. Taking in more calories than you use up is the most important factor that leads to weight gain.

How can age affect my weight?

It is normal to gain a little weight as you grow older. You may not be as active as you were when you were younger. If you do not adjust your food intake, you may put on extra weight. Even as little as 100 extra calories a day can add up to an unhealthy weight.

How can genes affect my weight?

Genes may affect a person’s weight directly or indirectly. Some people have genetic disorders that lead to obesity. Others are at increased risk because being overweight or obese runs in their families.

How can pregnancy affect my weight?

After having a baby, a woman might not lose all of the weight she gained during pregnancy. If this happens with each pregnancy, the weight can add up.

Health Risks of Being Overweight

What health problems are associated with being overweight?

Many serious health problems are linked to being overweight or obese:

  • Cardiovascular disease- The name given to a variety of conditions that involve the heart and blood vessels.
  • Diabetes mellitus- A disease in which the level of glucose (sugar) in the blood is too high. In the most common type of diabetes (type 2 diabetes), the body’s cells are resistant to the effects of a hormone called insulin. Insulin is the chemical in the body that carries glucose to the body’s cells.
  • Metabolic syndrome- Both cardiovascular disease and diabetes are related to this condition. Metabolic syndrome is a combination of factors that includes high blood pressure, low levels of “good” cholesterol, a waist measurement of at least 35 inches (for women), and higher-than-normal levels of glucose and triglycerides in the blood. You have metabolic syndrome if you have at least three of these factors.
  • Gallbladder disease
  • Certain types of cancer, such as cancer of the endometrium, breast, colon, and gallbladder; obesity also may increase the risk of ovarian cancer.
  • Sleep apnea
  • Joint disease
  • Infertility

Losing Weight with Nutrition and Exercise

How can I lose weight?

If you are overweight or obese, losing weight can have many benefits for your health and well-being. Even a modest weight loss of 5 to 10 percent of your body weight can have a positive effect.

To lose weight, you need to use up more calories than you take in. You can do this by getting regular exercise combined with a program of healthy eating.

Losing weight this way usually is gradual. Think of losing weight as a lifestyle change. Once you lose weight, you need to be able to keep it off. You may lose weight more quickly with a “crash” diet, but these diets are not meant to be permanent. You are more likely to gain back the weight you lost if you go on a crash diet rather than make long-term lifestyle changes.

How can I get help with healthy eating?

Healthy eating should be the first step in weight loss. It is important to get the nutrients your body needs to replace worn-out tissue and to provide energy.

The MyPlate website from the U.S. Department of Agriculture (myplate.gov) can help you plan a balanced diet. It offers a diet-tracking program called MyPlate Plan that takes into account your age, sex, height, weight, and physical activity. MyPlate Plan gives you the amount you should have each day from each of these five food groups: grains, vegetables, fruits, dairy foods, and protein foods.

What should I eat at each meal?

All packaged foods and drinks must be clearly labeled with nutrition facts. Reading all food and drink labels can help you make smart choices. The labels will tell you how many calories and the amount of nutrients that are in each serving. It helps to understand these facts on a label:

Find more tips from the U.S. Food and Drug Administration (FDA) on how to understand and use food labels.

Why is it hard for me to lose weight?

Many women report that it is hard for them to lose weight. No matter how much they cut down on their food intake and how much they exercise, they still cannot seem to shed the extra pounds. What is going on? Experts looking into this problem have proposed several different reasons for why weight loss may be difficult for some women:

  • Lack of sleep. Getting less than 6 to 8 hours of sleep a night may be linked to higher levels of body fat.
  • Your body’s set point. Some research suggests that the body regulates the amount of fat that is stored to stay within a certain weight range—the so-called “set point.” When you eat fewer calories than you usually do, you lose weight. However, once you stop eating fewer calories, you regain the lost pounds and return to your original weight. The set-point idea often is used to explain why dieting is not a good strategy for permanent weight loss.
  • Loss of muscle. As we age, we tend to lose muscle. Muscle burns calories at a faster rate than fat. As muscle is lost, calories are burned more slowly. If you do not take in fewer calories as you approach midlife, you may gain weight.
  • Hormones. The female hormones estrogen and progesterone may influence how fat is stored and distributed in the body. Hormones that control appetite also have been discovered. Levels of these hormones may be influenced by the type of food that is eaten and at what time of day it is eaten.

What should I do if I am having a hard time losing weight?

Talk with your health care professional if you are having trouble losing weight and keeping it off. You also can try one or more of the following strategies:

  • Do not start a diet that you cannot realistically stick with for the rest of your life. If you plan only to follow a certain plan until you lose weight and then return to your “normal” way of eating, you may find yourself regaining all of the weight that you lost.
  • Vary your fitness routine. Alternate exercise that builds endurance, like fast walking or cycling, with exercise that builds muscle mass, such as weight training.
  • Get at least 8 to 9 hours of sleep a night.
  • Instead of reducing portions of all foods, eat larger portions of foods that are low in calories, such as vegetables, salads, and broth-based soups, and smaller portions of high-fat, high-sugar, and high-calorie foods, such as french fries, desserts, and fatty meats. Eating a salad before a meal can help satisfy your hunger and reduce the number of calories that you take in. Using MyPlate can help you identify where you could add more low-calorie foods and where you could cut back on high-fat and high-sugar options.

How can I keep off lost weight?

Keeping the lost weight off may be harder than losing it. Maintaining a healthy weight requires a lifelong commitment to good nutrition and exercise. You need to make healthy food choices, eat moderate portions, and build physical activity into your daily life.

Most people who lose weight and keep it off stick to a low-fat, low-calorie diet. They also keep up a high level of physical activity. The following strategies also may help you maintain your weight loss:

  • Eat breakfast every day.
  • Weigh yourself at least once a week.
  • Watch fewer than 10 hours of television per week.
  • Exercise on average 1 hour per day.

Losing Weight With Medication and Surgery

When is medication an option to help with weight loss?

For some people, it may be hard to lose weight through diet and exercise alone. If you have a BMI greater than 30, or a BMI of at least 27 with certain medical conditions, such as diabetes or heart disease, medications may be able to help you lose weight. These medications should be combined with a healthy eating plan and regular physical activity.

There are several types of government-approved weight-loss medications available by prescription. They each work in different ways in the body and have different side effects. Talk with your health care professional about the type of medication that is best for you and how to manage side effects.

When is surgery an option to help with weight loss?

If diet and exercise do not work, a special type of surgery, bariatric surgery, may be an option for people who are very obese (a BMI of 40 or greater) or who have a BMI between 35 and 39 and also have major health problems caused by obesity. Bariatric surgery can result in significant weight loss. This may decrease the risk of the serious health problems associated with obesity.

What are the types of bariatric surgery?

Bariatric surgery can be divided into two main types:

  • Restrictive surgeries – Surgeries that reduce the amount of food the stomach can hold
  • Malabsorptive surgeries – Surgeries that change the way food is absorbed through the intestines

Each type of surgery has different benefits, risks, and success rates, which you should discuss in detail with your health care professional. Weight loss with restrictive surgery tends to be slow and steady, while weight loss with malabsorptive surgery may be more rapid and significant.

What are the risks of bariatric surgery?

The risks of bariatric surgery may include the following:

  • Leaking of stomach juices into the abdomen
  • Injury to other organs, such as the spleen
  • Wearing away of the band or staples used in the surgery
  • Infection
  • Complications from anesthesia
  • Death

What effects can bariatric surgery have on my body besides weight loss?

This surgery may have long-term effects on your body, such as changes in bowel habits and eating patterns. You should not have this surgery unless you are committed to making lifestyle changes, including restricting your diet and exercising regularly. You may need to take vitamin and mineral supplements, such as vitamin B12 and iron, for the rest of your life.

How long do I need to wait after bariatric surgery to get pregnant?

You should delay getting pregnant for 12 to 24 months after having bariatric surgery, when you will have the most rapid weight loss.