How Do I Tell If I’m Overweight?

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We are constantly being bombarded by the media and health professionals (and health websites!) about the perils of being overweight or obese – the statistics are that at least two thirds of the UK adult population is now in one of these categories, and I now find myself having to use the term ‘healthy weight’ rather than ‘normal weight’ because to be ‘normal’ these days is to be overweight. But do we actually know what a ‘healthy’ weight is? A lot of people don’t, and a lot of this is due to the fact that we have become so used to overweight as a society that we have lost our sense of what is healthy and what is not.

There are a number of ways of assessing weight – most of us have heard of the Body Mass Index or BMI, that has been the traditional and most basic measure, but as our knowledge of obesity has improved, the health profession has become aware that the BMI is very little help in most cases. For the record, BMI is calculated by dividing your weight by your height squared. There are any number of BMI calculators on the internet if you want to know yours, and the healthy range is approximately 19-25, depending on who you ask. >25 is overweight, >30 is in the obese range, and >40 is morbidly obese. A recent, and previously unnecessary category is a BMI of >50, known as ‘supermorbidly obese’.

The problem with BMI is that it takes no account of body composition or fat distribution – some of the world’s greatest athletes will be in the overweight or obese categories and be extremely fit, their excess weight being muscle rather than fat. Also, two people with the same BMI can have very different health risks depending on where their fat is stored; those who store fat on their hips and thighs (pear shapes) have a lower risk of heart disease etc (all other things being equal) than those who store fat around their middles.

So newer methods of weight assessment have been thought of, each with their own benefits.

Body fat percentage is a useful one, and it is possible to buy bathroom scales that will calculate fat percentage fairly easily. Women should generally have a fat percentage of less than 30, and men less than 20. This has led to the concept of people who are described as ‘TOFIs’ – Thin on the Outside, Fat on the Inside’, those affected have greater risk of heart disease, diabetes etc than their opposites, the FOTIs ( I assume no explanation is needed!).

So body fat – useful, yes, but it still takes no account of where the fat is stored. This has led to the development of waist based measurements, and there are three of these. Originally the Waist: Hip ratio (WHR) was introduced; dividing the waist circumference by the hip circumference gives a number that reflects where people are storing their body fat, a high number suggests it is being stored around the waist, a low number suggests the hips. For men a WHR of <0.95 is low risk, 0.96-1.0 is moderate risk and >1.0 is high risk

For women <0.8 is low risk, 0.81-0.85 is moderate risk and >0.85 is high risk. This is all useful information, but it takes no account of overall size – it is possible to be morbidly obese and have a healthy WHR, surely not a good combination.

Next came the simple idea of the waist circumference – if your waist is small enough then you obviously don’t have obesity, and even if your hips measure the same as your waist you are still slim. A nice idea, and it does have some evidence to suggest it is useful, and no complicated complications here, just you, a measuring tape and an idea of what the numbers mean is all that is needed. Men are at increased risk of health problems if their waist measures more than 94cm (37 inches) and have a high risk if it measures 102cm (40 inches). Women are at increased risk of health problems if their waist measures more than 80cm (31.5 inches) and have a high risk if it measures 88cm (34.5 inches). As with all these concepts this is great information but maybe a bit simplistic on it’s own?

The latest one is a kind of combination of all of the above, being the waist: height ratio, simply put you divide your waist by your height, that gives you a number and as long as it’s in the normal range there is nothing to worry about! Again maybe a little bit simple but it’s one of my favourites as it allows for the fact that the shortest of us and the tallest of us do not necessarily need to have the same waistlines. This one is age related; if you are under 40 then you need to aim for a waist:height ratio of less than 0.5, if you are aged 40-50 then it’s 0.5-0.6, and if you are over 50 then less than 0.6 is fine.

Overall, I think a combination approach is best – ideally you should not be fixated about any one number, but build an overall picture of your weight using all the available methods. If you are more or less in the healthy range for a few of them then it doesn’t matter so much if one of the others is a bit out of range. I generally advise people to aim for a healthy waist measurement and then reassess – if your waist circumference is back in the normal range but you still have a high fat percentage, for example, then you still have work to do. Equally, if you find that most of your other weight related measurements are heading towards normal by now then you could consider that weight to be healthy for you as a unique individual.

The take home message is to not be obsessed with the numbers – they are a guide, not a cruel master! And a top tip from a self-confessed TOFI (me!) – the best way to get that waist lovely and slim again is to combine all that Spirit controlled eating with exercise. This is unusual in the medical world. Usually we get minimal benefits from minimal efforts, but in the case of trying to lose that dangerous abdominal fat, it is the first thing to go if you combine diet and exercise, a serious result!! I’ll leave the details of the exercise to our resident personal trainer, but moving more is definitely a way forward! Enjoy…

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