Ideal Body Weight vs. An Attainable Weight
Goal
By Ahmed H. Kissebah,
M.D., Ph.D.
TOPS News,
August/September 2011
When an individual queries, “What is my ideal
body weight?” we have to consider why the question has been asked.
Let’s discuss the meaning of this term and the rationale behind the
choosing of an attainable weight goal.
“Ideal body weight” is the number of pounds or
kilograms one should weigh in order to prevent ill health and its
consequences. The concept of “ideal body weight” was derived from
life insurance tables published in the 1950s and ’60s. The major
drawback of these tables was that they did not include women and
children, due to the fact that the majority of these indi viduals
did not have life insurance policies during that period. Most
importantly, those tables indicated the weights associated with the
least amount of health effects and, therefore, termed the “ideal” or
“desirable” weight level. It did not, however, provide any realistic
experiences in what causes weight problems or, conversely, how
persons could reach this ideal weight once they had become
overweight or obese.
Advising the nation
In the 1980s, the
National Institutes of Health (NIH) invited a group of experts to
discuss ways of advising the nation about a desirable body weight
taking into account the individual’s height, sex and age. At the
conclusion of these meetings, the term Body Mass Index (BMI) was
adopted as the means of knowing about an individual’s degree of
weight (including both underweight and overweight) and its
association with health...
Determining your BMI
BMI can easily be
determined by looking at a special table based on your height and
weight (see pages 182 and 183 in TOPS’
The Choice Is Mine lifestyle guide). It can also be
calculated (see page 181) by multiplying your weight in pounds by
705 and dividing that number by the number you get when you multiply
your height in inches by your height in inches. (weight in pounds x
705) ÷ (height in inches x height in inches) The classification of
underweight, overweight, and obesity and their health risks are
provided on page 180 of your guide. Overweight is defined as a BMI
of 25.0 to 29.9 and is associated with the beginnings of increased
health risks in the form of diabetes and cardiovascular disease..
Reaching goal weight
We do know that some
overweight individuals struggle hard to reach this ideal body weight
without success. Some may become fixated to reach this perfect
weight. Others may want to only slim down to the size they were
during high school or on their wedding day. However, the majority of
us may find this goal is unreachable and, more importantly, harder
to maintain if reached. Science tells us that the natural history of
obesity tends to be a progressive disorder that increases over time.
Just maintaining one’s current weight while maintaining a healthy
diet, activity level, and lifestyle behaviors should be considered a
success and not a failure.
Losing just 10%
Recent research has
also shown that just losing approximately 10% of your current weight
is associated with a myriad of health benefits, including better
blood pressure control and better blood sugar and cholesterol
levels—which are indicative of a reduced risk for diabetes and heart
disease. In my opinion, this degree of weight loss is more
attainable and desirable. Setting one’s goal in the long run to
maintain this degree of weight reduction is not only realistic, but
also acceptable to most heath professionals.
The set point phenomenon
One of the major
discoveries attained from weight maintenance research is the “set
point” phenomenon. Just as body temperature is programmed to stay
around 98.6°F, the body’s weight is also programmed to stay within a
range of its present weight. This weight range is regulated by what
is known as the “set point” system. This system involves a complex
interaction between several hormones, biologic chemicals, and brain
hunger signals that are adapted to maintain the weight within this
range.
Although healthy
eating and lifestyle changes are very helpful in achieving a
desirable body weight, it is also the genetic makeup a person
inherits that determines this range—it is not solely what the person
eats and how much is expended in physical activities. However,
overeating and a sedentary lifestyle will undoubtedly swamp this
internal regulation and eventually overwhelm the desir-able body
weight, resulting in weight gain. Unfortunately, the body will then
readjust to this higher weight and reprogram itself with a higher
set point with the objective of now defending this higher weight.
Without strong will and even greater dietary control, this higher
set point—and, consequently, the higher weight—will be maintained.
Nevertheless, we all know the success stories of many TOPS members
who have been able to overcome this weight gain and restore the
lower set point, as we have witnessed with our KOPS.
Lifelong change
What is important to
remember is that, although these goals are atttainable and have
indeed been successfully maintained by many TOPS members, it did
require a great deal of self-control and, more significantly, the
support of family, friends and chapter members. It is also important
to understand that maintaining this lower weight requires a lifelong
change in eating behavior with fewer calories consumed than compared
to an individual of the same weight who never had a weight problem.
Please refer to the diagram on page 194 and the table on page 195 of
your lifestyle guide for further clarification of this ex-obese
phenomenon.
The step-by-step approachh
Health professionals
experienced with weight-control programs recommend that as an
initial weight goal, persons should plan on losing 10% of their
current weight over a reasonable period of time (approximately three
months). Once this amount is lost, individuals should then focus on
maintaining this reduced weight for another three months before
attempting to repeat the cycle of losing and then maintaining
another 10%. In this way, the body will adapt easier to the signals
of lowering the set point to the new range of the reduced-weight
state. This step-by-step approach of reaching incremental weight
goals is the preferred method. People need to be strong-willed but
also realistic in order to reach a weight goal that they can
maintain and be comfortable with. In this case, the individual will
sleep better, experience less joint pain, and likely be allowed to
reduce the number of medications for treatment of high blood
pressure and/or diabetes.
It is true that most people overestimate how
much weight they can lose. This can lead to frustration when the
desired goal cannot be reached. The likely result is that the person
will fluctuate through phases of losing and regaining weight, a
phenomenon known as “yo-yoing” or “weight cycling.” This condition
is not only frustrating, but also may cause depression—which can
seriously affect one’s health, including a progression to diabetes
and increased risk for cardiovascular disease.
Therefore, in order to determine one’s healthy
weight goal, one should review his or her weight history and
identify that specific weight that has been attained and maintained
for long periods of time in the past. That weight should be
considered the goal weight, instead of focusing on the weight scale.
One can then set up a healthy dietary, activity, and behavior plan
to reach that goal. In this regard,
The Choice Is Mine is a realistic guide in providing
help to do just that.