According to the World Health Organization (WHO), worldwide obesity has nearly tripled since 1975. In fact, more than 1.9 billion adults were overweight in 2016. Of the almost 2 billion adults, over 650 million were obese.
And the national obesity rates and trends are likely to grow, too.
The ramifications of such rates impact health at personal, populace, and economic levels. In fact, being overweight increases the risk of significant health problems that are costing Americans $130 billion a year. Truly, these risks should not be taken lightly.
However, societal euphemisms mostly imply obesity is a matter of image or appearance. The stigmas of "fat people" do not help, either. This distracts from the real issue that excess weight is hurting our health. But this is evidently far from the truth.
So just how fat is "too fat" and how do you know when to be concerned? When has body weight gone from a cosmetic issue to one of well-being?
How Fat Is Too Fat?
First off, the WHO defines overweight and obesity as "abnormal or excessive fat accumulation that may impair health." Body fat is often measured using body mass index (BMI).
BMI is derived using height and weight (mass) and applies to adult men and women. The equation for BMI is kg/m2, in which kg is a person's weight in kilograms. The m2 is the height in meters squared. In imperial units, the formula is BMI = lbs. x 703/in2.
The BMI calculates height and weight to come up with a score that is indicative of a class of health risk. A score of 18.5 to 25 is typically considered a healthy BMI. A BMI of 25 to 29.9 is considered overweight, while a BMI of 30 or greater is considered obese.
An overweight status begins to constitute a health risk. This is because excess weight contributes to problems such as high blood pressure, blood sugar, and cholesterol. If left uncontrolled, these biomarkers can all lead to serious health conditions such as a heart attack and diabetes. Health risks increase with weight, especially if lifestyle changes are not made.
To put this in perspective, a woman who is 5'5" weighing 155 pounds has a BMI of 27. This is considered to be overweight and puts her at higher risk for various health problems. But that same woman just 15 pounds heavier is considered clinically obese. She is at even greater risk for a host of major medical problems including cardiovascular disease and even cancer. Her risk of ultimately dying from those problems increases once she reaching and surpassing that 30 BMI mark.
However, BMI is not always the best measurement for health. It ignores gender and age differences and muscle versus fat mass. Overlooking fat distribution is especially dangerous if carrying too much belly fat.
How Much Belly Fat Is Too Much?
Where weight is distributed can be as critical as how much is there in total.
Weight deposited in the abdomen and belly is also referred to as the "apple" body type. It is also known as visceral fat, in which it surrounds internal organs, and stored at waist level. Visceral fat is much more dangerous than weight carried mainly on the hips and thighs, or the "pear" body type.
What's more, waist circumference (WC) is a stronger predictor of heart disease and diabetes than BMI. Waist circumference measures fat distribution in the abdomen, or just above the belly button and below the rib cage. Men and women are advised to keep waist circumference under 40 and 35 inches, respectively.
Another familiar measurement is the waist-hip ratio (WHR), the circumference of the waist to hips. It can be acquired by simply measuring the smallest circumference of the waist. Then, divide that number by the circumference of the hips at the widest part. The ideal WHR for men is less than 0.9 and 0.85 for women according to the World Health Organization.
Measuring body fat percentage is useful, too. It is the weight of total body fat divided by total body weight. The result helps indicate essential and storage fats.
Essential fat is the amount of fat needed that is essential to survive. Storage fat consists of fat accumulation, some of which protects our internal organs in the chest and abdomen. Other storage fat is excess that increases the risk of chronic disease.
Can You Be Overweight and Healthy?
Carrying excess body weight comes with a host of health risks. So, can someone be considered overweight and healthy?
The answer is complex, controversial, and individualized. For instance, an athlete sporting muscle may still be considered an overweight person based on BMI. Someone with a similar BMI may carry most of their weight as abdominal fat. Despite the comparable BMIs, the athlete is likely to be in better shape and more physically fit.
The idea of being "fit and fat" also became a new way to think about weight. It is also known as "metabolically healthy obesity (MHO)," implying health coexists despite carrying extra pounds. The concept has been welcomed by individuals practicing body acceptance. But it has also been deconstructed by researchers.
A study from the American Diabetes Association (ADA) aimed to determine the link between metabolically healthy obesity and mortality risk. Researchers found both metabolically healthy and unhealthy obese patients carry an elevated risk of mortality.
A more recent review of MHO examines the risks while still working through the complexity of the condition. For instance, some research has discovered a significantly higher risk of type 2 diabetes in those considered MHO. But the risk in the MHO group also varied according to the degree of systemic inflammation. Comprehensively, some studies show MHO poses no additional risk of disease, while others do.
This may be distressing for some, as weight is not always a card one may change. It can be the result of genetics, gender, and age. However, weight gain and associated health risks are tied to lifestyle factors within control.
How Can I Ensure a Healthy Weight?
First and foremost, consult with a healthcare professional to determine personal ideal body weights and disease risks. This may include a Registered Dietitian and/or physician.
In addition to assessing BMI, they can complete a more comprehensive and thorough health evaluation. They can devise a safe plan to meet individual needs and preferences that often encompass healthy lifestyle factors.
A healthy lifestyle often involves components of dietary patterns, exercise, sleep hygiene, and stress management. More specific recommendations include:
• Focusing on whole foods, such as whole grains, fresh produce, lean proteins, legumes, dairy products, and healthy fats.
• Reducing packaged, convenience foods laden in refined flour, sugar, oil, and salt.
• Being physically active at least 150 minutes of aerobic exercise weekly, including brisk walking, jogging, biking, and dancing.
• Incorporating resistance and strength training at least two to three times each week. This includes focusing on all the major muscle groups.
• Ensuring seven to nine hours of sleep nightly, as lack of sleep can cause weight gain.
• Managing stress with positive coping techniques, including yoga, meditation, and exercise.
• Considering a weight loss meal delivery service to provide balanced meals directly to doorsteps.
Individuals can also find motivation in knowing evidence shows even minor weight loss can lead to major outcomes. According to the CDC, losing 5 to 10 percent of total body weight can improve blood pressure, cholesterol, and sugars.
For someone weighing 200 pounds, a 5 percent weight loss equals 10 pounds lost. This brings weight down to 190 pounds and lowers health risks tied to weight. This serves true even if still considered in the overweight or obese category based on BMI.
People who lose weight gradually and steadily are also more likely to keep weight off for the long-term. So rather than being discouraged with a steep weight loss target, break it down into smaller goals. Truly, making small changes can lead to big results!