Читать книгу New Pounds and Inches - Richard Lipman M.D - Страница 7

The first issue that we need to address is the definition of obesity. Although I tell my patients that their ideal weight is the weight they feel comfortable with and the weight they can maintain without feeling anxious or deprived, everyone wants a number. We need to be careful here, because “ideal weight” based on fashion trends, celebrities’ physical appearance, or an idealistic body image rarely reflects healthy weight.

In 1998, the National Institutes of Health correlated excess weight with different health problems and determined three guidelines for defining overweight individuals.

These three guidelines are used for diagnosing obesity:

1.Ratio of body weight to height (BMI)

2.Circumference of one’s waist

3.Presence of risk factors related to heart disease

1. Body Mass Index (BMI)—Measures Fat and Muscle Mass

The ratio of body weight to height is called the body mass index (BMI), and reflects the total fat as related to one’s height and weight. Your BMI can be determined by using the following chart:

Find your height on the left side and follow the line until it intersects with the line representing your weight, as listed at the bottom. If your BMI is in the white zone, you are underweight; if it is in the green zone, you are of normal weight for your height; if in the Yellow zone, you are overweight; and if in the red zone, you are obese and are in the morbidly obese zone, or the high BMI group. BMI may give false information for muscular individuals because the extra weight may be because of the extra muscles. Calculate your BMI at http://www.bmi-calculator.net

Almost all medical professionals and nutritionists agree that if you are in the obese category, i.e., if your BMI is greater than 30, you are at serious risk and need to lose weight urgently. Those who fall into the overweight group (the yellow zone) need to lose weight as well, and modify their risk factors such as high blood pressure, high cholesterol, diabetes, and smoking should be considered.

BMI	Status	Obesity Treatment
Less than 17.9	Under weight	None
18 to 24.9	Normal weight	None
25.0 to 29.9	Overweight	Possible treatment, consider risk factors
30 to 39.9	Obese	Treatment needed
Above 40	Morbidly obese	Treatment mandatory

2. The Circumference of the Waist— Best Measure of Obesity Complications

More important than body weight or BMI, is the circumference of the waist because this is a direct measurement of accumulation of abnormal fat cells around and beneath the abdomen. As mentioned earlier in this chapter, it’s the fat inside the abdomen that causes all of the problems.

Clumped together, the fat cells just below the skin of your abdomen—surrounding all of your vital organs—are no larger than a bar of soap, but are the cause of all obesity-related medical problems. Since measuring the inner fat is difficult and expensive, researchers use the circumference of the waist as a good approximation. A waist circumference larger than 40 inches for men and 35 inches for women correlates with the critical amount of inner fat responsible for the development of the complications related to obesity: heart attacks, strokes, diabetes, and even polycystic ovary syndrome.