My thoughts vary here. First, I DO think that you can be healthy even if your weight doesn't fall into the range considered "healthy" for your age and height. My reasoning for this opinion is simple. There are LOTS of factors that affect the number we see on a scale. Body fat percentage, muscle mass, water weight percentage and bone mass can all affect that number. Knowing this, I think it is important look at one's body fat percentage, visceral fat percentage (the percentage of your fat that is held in the torso / abdomen / belly area, which surrounds your vital organs), muscle mass and body water percentage / ratio. You can learn a lot about a person's true level of health from these measurements as well as from assessing their overall fitness and endurance level.
For example, I am currently around 188 lbs. However, I do not "carry" my weight in the same way that others who are the same weight do. I have muscle definition and I hold slightly less fat in my torso / abdomen / belly region than some others with the same weight. I am also fairly flexible and may have better posture than some of the same weight, which can (in some cases) be an indication of one's cardiovascular health. I have "curves" as opposed to some others in the same weight range. Knowing this, should I be considered as having the same level of health as someone who weighs the same but perhaps has less muscle or holds more fat in their torso / abdomen / belly region? I don't think so. And there are likely plenty of people who weigh 188 lbs right now who are in better health and shape than I am!
The thing to understand is that human beings are not the same. We have all kinds of factors that can cause standard measurements to mean different things for each person across the board. The accuracy of BMI in determining and diagnosing obesity has been debatable for a LONG time. I don't think BMI is the only thing that should be taken into consideration. The problem is that the medical industry seems to want to hold to a standard measurement that can be used for everyone across the board, rather than taking each individual and assessing them on an individual level. My theory is that individualizing health, weight and fitness assessments will take more time and keep many doctors from taking in as many patients as they'd like per day. Having a standard measurement can allow them to treat their practice like an assembly line, but that isn't good for the health of society.
The best thing I can recommend (as someone now studying health and nutrition) is to keep track of the following measurements on your own at home and evaluate your progress on a monthly basis:
body fat % visceral fat % (again, fat around your torso / abdomen / belly & vital organs) muscle mass bone mass body water % level of flexibility and mobility blood pressure & heart rate through exercise & endurance training
The measurements above will give you a more complete picture of your health. For example, if you notice your body water % and muscle mass decreasing, you are likely not drinking enough water and need to focus on better and more regular hydration. If you see your body fat % and visceral fat % decrease, that's a GOOD thing (just don't go overboard on losing body fat as there IS a safety recommendation for men and women). If you notice that you're able to breathe and focus better over longer durations while exercising, that is an indication that your fitness level is improving. And obviously your blood pressure and blood sugar decreasing are good signs.
Also, use your common sense. Doctors are humans that were given specific, structured, one-size-fits-all training in terms of the way they approach patient care. Some doctors will branch off, specialize and focus on giving individualized attention. Some, however, will stick to industry-prescribed standards and rarely venture out of them when making recommendations or treating their patients. Many doctors are also money-focused (sad but true). They often choose to medicate an issue over exploring more natural ways of resolving a health issue (such as adjusting a nutritional profile to lower blood pressure, cholesterol or blood sugar). They may also recommend actions that are in line with "fad" diets (you may be able to spot this if they try to sell you weight loss supplements that they sell within their practice). For example, not every obese or overweight person should be placed on something like Atkins. That means that depending on the doctor you have, you may need to take their advice with a grain of low-sodium salt (or else switch to a doctor who is willing to treat you like the individual you are). Use your common sense about what you know of health. If what you're doing is increasing your blood pressure, cholesterol, blood sugar or weight, you need to adjust your current plan (not necessary with medication) to get those things under control. However, if what you're doing is lowering those measurements, you're feeling better and you're able to exercise longer and / or at higher intensities then your health is improving. There is not always a need to medicate or compound issues by medicating symptoms and side-effects caused by other medications. Health does not have to be as complicated as some of us make it. It can be simple to understand and manage if we just take the time to learn about our bodies and view things on an individual level rather than by a societal standard.
I may be considered "obese" according to my number weight, but my current focus is not just to get that number down. It is to focus on lowering my visceral fat %, body fat % while slightly increasing muscle mass, to ensure my water weight stays within acceptable ranges and to build my endurance and tolerance for physical activity. Toward that end I have purchased tools to help me monitor these things at home. When I start to see improvement in those measurements, I will know that my health is improving. When I go to the doctor in the Spring next year, I will listen closely to see how they view the numbers and progress. If the focus is only on BMI, "dieting" and medications, I will look for a new doctor who bothers to investigate additional ways of measuring overall health. We each need to take control of our own health levels. We cannot depend on a doctor (who is human, can sometimes make mistakes and who may in some cases be more motivated by money and the prestige of having a certain number of clients than a need to treat us as individual as our genetics, DNA and bodies say we are) for everything. Yes, go to the doctor when you are experiencing issue, symptoms or medical emergencies. Go to the doctor before starting a fitness or nutrition plan, when you are trying to become pregnant or when you become pregnant. But also be willing to take responsibility for your own health and be willing to assess and track it on a regular basis. Only then can you fully understand your individual level of health and fitness.
12/12/2013 9:19:27 AM
think some people just have larger body types than others, but saying that it's okay to be fat is a dangerous path to go down. The vast majority of overweight/obese people need to lose weight to increase their health and fitness levels, but articles like this give people an excuse to be lazy. Like everything, there are exceptions to the rules, but as a whole, if you are labelled obese due to your BMI, losing some weight isn't going to hurt you.
This is what I don't understand. A super skinny person who eats junk food and never exercise in their lives are never told that their lifestyle will eventually cause them harm. However, someone with great muscle tone but slightly bigger than normal but eats really healthy is deemed as unhealthy. Stop judging people. We live in a society where people run from judgement but those same people are judgmental. I thought doctors were smart? Take into account the WHOLE LIFESTYLE and not just what you see on a freaken scale. I'm tired of hearing about this nonsense. We live in such a superficial world. Take care of your inside first and foremost...the outside is just the icing to the glorious cake.
I think this is a great message to send to people. Stop worrying about the scale and worry about how you feel. The misconception that because I am fat I must be unfit is what make me as an overweight person feel so bad. People just assume that I must eat McDonald's and candy all day and never do anything more physical than walking to the fridge.
I think if we focus on improving out fitness the rest will follow. Too often we are stuck on the numbers and let that deter use from being successful. If we learned to focus on the "non-scale" victories we would be happier people I think
ive actually been very happy with my doctor. every time im in there they check weight and blood pressure and they always comment on how well im doing. i was told a while ago that my blood pressure was on the high side of normal so i should watch it. all i did was not put extra salt in my food. the next time i went in my blood pressure was normal. they were very impressed. my cholesterol is normal blood pressure normal i can walk 4 miles one way before i need a break and im very overweight. i have several medical conditions that make losing weight nearly impossible but my doctor is always encouraging. even if theres only a couple pounds lost when i go in they make a big deal about it. she has told me several times im in great shape just overweight. she jokes that i have all the muscles they are just shy and hide.
7/17/2013 4:39:48 PM
I'm 61, about 60 pounds overweight and hypothyroid, as well as a 15-year breast cancer survivor.
My blood pressure averages 115/75 (except at the doctor's office), my cholesterol and triglycerides are in the normal ranges, and my blood glucose is below 99. All my other blood tests are in the normal ranges.
I can work out on an elliptical machine for over 30 minutes with a variable resistance program, then go on to do a complete weight machine upper & lower body exercise routine. I can complete Leslie Sansone's 5-mile Advanced workout (60 minutes) while wearing 1.5 lb wrist weights on each hand.
My doctor's only concern is my high blood pressure at her office. So, I'm monitoring it at home daily for 6 weeks, then I'll bring in my tracking report and my home blood pressure monitor to compare it to the doctor's. The last time I did this - a few years ago - my home monitor matched the one in the doctor's office, so I have a confirmed case of "white coat syndrome" where my BP is higher than normal at the doctor's office.
I think this is a fabulous article! It's funny - we get mad at our docs when they mention our weight - it is important and needs to be dealt with - but I think it would also have gone a long way to praise the positive results as well.
I have a question regarding the metabolic syndrome criteria you posted. We also use fasting glucose as a measurement, and if it's 100 or higher, it's also considered a risk factor. I have not seen total cholesterol tied in with the HDL risk - I thought that was interesting. If you happen to see this post could you let me know where your guidelines came from? I'm just curious. Thanks!
Like SNAPSHOTSTACY below, and the person in the article, I had a similar experience. I had lost 40+ pounds and was so very excited not to be obese anymore. Sure, I was still overweight, but I had come a long way and was thrilled. So I had a work physical and that nut job doctor told me that I needed to start eating a certain way and exercising, etc. She did not listen to a word I said about my eating habits or exercise routines. I was so disgusted.
The dr. at the beginning of this story is a moron. Lori may need to lose more weight, but for heaven's sake, praise the improvements that she HAS made! Good bp and cholesterol numbers are great progress. Then suggest that you hope she can keep it up and maybe see a little weight loss in the future!
I think the key phrase here is "When assessing overall health risk, we need to look at many factors, not just the number on the scale." Yes, someone who is a little overweight CAN be healthy if they maintain a healthy diet and a regular and consistent exercise program and, of course, if their physiological stats and test are indicative of a healthy person.
Having said all that, I personally have never known someone who was obese and was truly and honestly fit and healthy according to those standards (healthy diet, regular exercise plan and healthy stats and tests). While I definitely agree that an obese person can IMPROVE their overall health (and should definitely be commended for it), until they lose a significant amount of weight, they will probably not truly and honestly be "healthy" or "fit". "Healthier" and "fitter" yes.
On another note, I too agree that BMI is a ridiculous gauge of "health" and "fitness". Like others, I too know someone who according to his BMI would be categorized as "overweight" but to look at this guy is like looking at one of those airbrushed photos of a model. Yeah, his BMI is almost 26 but BFD!!! He is so buff and athletic looking!!!
Lastly, I have my own story of being healthy and fit where for the past few months I haven't lost any weight even though I have dieting and exercise just as hard and as consistently as I was when I lost the 62lbs. However, during this same time, I went from a size 10 to a size 8, which meant that even though I didn't lose anymore weight, I was still losing inches.
Even though I haven't reached my goal weight, which btw was set based on my "healthy" BMI when I started, I'm now considering tossing out that goal weight and just go with my actual body sizes and measurements as my new gauge. To me, this seems so much healthier than working towards some silly number on a scale that doesn't really reflect the true and honest assessment of my overall health and fitness. JMHO
As far as I can tell, there is NO evidence that BMI tells us anything specific about an individual. Yes, fat is implicated in some cancers and for some other conditions less is better, but there is NO reason to think than a BMI of 25 is magically better than 26. I have lost nearly 70 lbs, but still weigh 273. I am the healthiest I have ever been. My blood numbers are enviable and I bike 100-200 miles a week. I haven't been sick in four years. I know that my weight still puts me at risk, especially for orthopedic injuries, which could serious compromise my fitness level, so I am working to lose more weight. I know, however, that I am far more healthy than lots of people who weigh less.
My conclusion, based on looking at a lot of studies, is that fitness is the best SINGLE predictor of health and far, far, better that BMI or even percent fat. That said, excess fat is also not good for the body and in the absence of fitness is even more pernicious.
With regard to the doctor referenced in the article: get another doctor. Good motivation comes from supporting success, not undercutting them.
My husband died 021613 from heart disease. He was 46. He was thin (6ft tall 170 lbs). But his cholesterol was elevated but not scary high. His triglycerides were very high (400+). And he was a 2 pack a day smoker. But he did not consider himself to be unhealthy because he was thin even though his vitals said otherwise. He would put me down because of my weight even though my vitals were better than his (even though mine definitely have room for improvement). He refused to do anything that would improve his health. His death has been my wake up call. But I am looking at this as a life style change and not a diet. I am exercising at least 3 times/week now and am making healthy changes to my eating habits. I hope weight loss will be a side effect from these changes.
Quite honestly, I wish the whole diet industrial complex would finally get the message that BMI is a statistical tool meant for entire populations, not individuals. I'm at a higher point of the so-called "normal" BMI range, yet I'm far more likely to develop certain co-morbidities (e.g. a replacement knee) than people in the "obese" range simply because of my medical history and- oh no!- physical activities.
I agree that physical fitness is a better indicator of health (and future health) than any other, but I also think that's incredibly ableist, classist, and a host of other -ists. Waist circumference ratio is a good tool, I believe, but one that needs further testing against long-term mortality rates.
My final conclusion on the "weight issue"? Every person has to decide for themselves how they feel, whether they want to lose weight or not, whether they are fit or not, whether they are happy. The recent AMA classification of obesity as a disease makes me want to smash something in rage- obese people have been treated the way Lori has by her doctor for far too long, and the association obese=disease is only going to hurt more individuals. Obesity is NOT a disease, obese people are NOT a disease.
Weight is a non-issue for me in everyone who isn't myself. I'll never look at anyone and think "unhealthy" just because of their body shape. I can only hope that doctors, and society, will finally catch up and allow people to just be, without making them into a socio-economic and political tool.
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