Weight Management -- July 14, 2008 -- Dr. Samuel Bastian - NewsChannel5.com | Nashville News, Weather & Sports

Weight Management

About two-thirds of adults in the United States are overweight, and almost one-third are obese. This translates into Americans with higher blood pressure, higher cholesterol and increased rates of other weight-related health problems.

What is overweight?

Body mass index (BMI) is a tool that often is used to determine whether a person's health is at risk due to his or her weight. BMI is a calculation based on height and weight, and it is not gender-specific in adults. BMI does not directly measure percentage of body fat, but it is a more accurate indicator of overweight and obesity than relying on weight alone. To determine your BMI, use the BMI calculator at www.nhlbisupport.com/bmi.

Another way to determine if your weight is placing your health at risk is to measure your waist. Waist measurement does not determine if you are overweight, but it does indicate if you have excess fat in your abdomen. This is important because extra fat around your waist may increase health risks even more than fat elsewhere on your body. Women with a waist measurement of more than 35 inches and men with a waist measurement of more than 40 inches may have an increased risk for obesity-related diseases.

Cholesterol and blood pressure
High blood cholesterol and high blood pressure are two major risk factors of heart disease. However, weight management is one way to decrease your risk.

Your blood cholesterol level has a lot to do with your chances of getting heart disease. Heart disease is the number one killer of women and men in the United States. Each year, more than one million Americans have heart attacks, and about one-half million people die from heart disease.

You can have high blood pressure, or hypertension, and feel fine. That's because high blood pressure does not cause signs of illness that you can see or feel. Nevertheless, high blood pressure, sometimes called "the silent killer," is a major health problem. If high blood pressure isn't controlled with lifestyle changes and medicine, it can lead to stroke, heart disease, eye problems or kidney failure.

What can I do?

A variety of things can contribute to high blood pressure and cholesterol levels. There are many lifestyle changes you can make to lower your risk, including:

• Eat a healthy diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level. A diet rich in fruits, vegetables, whole grains and low-fat dairy products may help to lower blood pressure.
• Keep a healthy weight. Being overweight is a risk factor for heart disease and adds to your risk of high blood pressure. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
• Physical activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight and lower your risk of high blood pressure. You should try to be physically active for 30 minutes on most, if not all, days.

Other weight-related health risks

Weighing too much may increase your risk for developing many health problems. In addition to hypertension and high blood cholesterol, being overweight or obese can lead to:

• diabetes
• coronary heart disease
• stroke
• gallbladder disease
• osteoarthritis (degeneration of cartilage and bone of joints)
• sleep apnea and other breathing problems
• some forms of cancer (breast, colorectal, endometrial and kidney)

• complications of pregnancy
• menstrual irregularities
• hirsutism (presence of excess body and facial hair)
• stress incontinence (urine leakage caused by weak pelvic floor muscles)
• psychological disorders, such as depression
• increased surgical risk
• increased mortality

How can I lower my health risks?

You may be able to lower your health risks by losing weight, doing regular physical activity, and eating healthfully.

If you are overweight, losing as little as 5 percent of your body weight may lower your risk for several diseases, including coronary heart disease and type 2 diabetes. If you weigh 200 pounds, this means losing 10 pounds. Slow and steady weight loss of 1/2 to 2 pounds per week, and not more than 3 pounds per week, is the safest way to lose weight.

To lose weight, or to maintain weight loss, you likely will need to do more than 30 minutes of moderate physical activity daily.

Eat a healthful diet and get plenty of physical activity

Reaching and maintaining a healthy weight is important for your overall health and well-being. Weight management is a balancing act of "energy in" and "energy out," which means coordinating the number of calories you consume with the number of calories you burn each day.

• To maintain weight: Your weight will stay the same when the calories you eat and drink equal the calories you burn.
• To lose weight: You will lose weight when the calories you eat and drink are less than the calories you burn.
• To gain weight: You will gain weight when the calories you eat and drink are greater than the calories you burn.

To lose weight, you need to use more calories than you eat. You need to limit the number of calories you eat every day and/or increase your daily physical activity. Portion control is the key. Try eating smaller amounts of food and choosing foods that are low in calories.

Regular physical activity provides healthful benefits, which may help control your weight and may help:

• Reduce your risk of or manage chronic diseases, such as type 2 diabetes, high blood pressure and cholesterol, heart disease, osteoporosis, arthritis and some cancers.
• Build strong muscles, bones and joints.
• Improve flexibility.
• Ward off depression.
• Improve mood and sense of well-being.

Weight management is a key to healthy living. It's not too late to start eating right or exercising. Forming good habits now will not only help control weight, but also decrease the risk of dying from coronary heart disease and reduce the risk of developing diabetes, high blood pressure and some forms of cancer.

Alternative treatments

As with other chronic conditions, such as diabetes or high blood pressure, the use of prescription medications may be appropriate for some people who are overweight or obese. Prescription weight-loss medications should be used only by patients who are at increased medical risk because of their weight. They should not be used for cosmetic weight loss. In addition, studies show that weight-loss medications work best when combined with a weight-control program that helps you improve your eating and physical activity habits.

Weight-loss surgery may be an option if you are very obese and have tried unsuccessfully to lose weight on diet and exercise programs and are unlikely to lose weight successfully with nonsurgical methods. Gastric bypass is the most common weight-loss surgery. A newer procedure, called the Lap-Band, places a band around the upper part of the stomach, creating a small pouch to hold food. The band limits the amount of food you can eat, and increases the time it takes the intestines to digest the food. Your commitment to diet and exercise must be very strong because even after the surgery, you must stick to these lifestyle changes. Otherwise, you are likely to have complications from the surgery.

If you think you are a candidate for alternative treatments, talk with your health care provider about the best option for you.