|
McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Obesity and Diet
If your weight is quite a bit above what is healthy for a
person with your body type, you may be considered obese.
Obesity is a more serious condition than being just a little
overweight because of the increased risk of:
- heart disease
- stroke
- high blood pressure
- diabetes
- arthritis
- cancer
- other medical problems.
Your health care provider can tell you if your weight puts
you in the category of being obese. The weight categories
shown in the following tables can help you determine how
overweight you are. Unless you are a very muscular person,
you are considered obese if your weight is 20% or more over
the midpoint of the ideal weight ranges listed in the
tables.
Ideal Weight for Women
-----------------------------------------------
Height Small Medium Large
in Shoes Frame Frame Frame
--------------------------------------------------------
6' 138 to 151 lb 148 to 162 lb 158 to 179 lb
5'11" 135 to 148 lb 145 to 159 lb 155 to 176 lb
5'10" 132 to 145 lb 142 to 156 lb 152 to 173 lb
5'9" 129 to 142 lb 139 to 153 lb 149 to 170 lb
5'8" 126 to 139 lb 136 to 150 lb 146 to 167 lb
5'7" 123 to 136 lb 133 to 147 lb 143 to 163 lb
5'6" 120 to 133 lb 130 to 144 lb 140 to 159 lb
5'5" 117 to 130 lb 127 to 141 lb 137 to 155 lb
5'4" 114 to 127 lb 124 to 138 lb 134 to 151 lb
5'3" 111 to 124 lb 121 to 135 lb 131 to 147 lb
5'2" 108 to 121 lb 118 to 132 lb 128 to 143 lb
5'1" 106 to 118 lb 115 to 129 lb 125 to 140 lb
5' 104 to 115 lb 113 to 126 lb 122 to 137 lb
4'11" 103 to 113 lb 111 to 123 lb 120 to 134 lb
4'10" 102 to 111 lb 109 to 121 lb 118 to 131 lb
--------------------------------------------------------
From height and weight tables of the Metropolitan Life
Insurance Company, 1983. The ideal weights given in these
tables are for ages 25 to 59. The weights assume you are
wearing shoes with 1-inch heels and indoor clothing
weighing 3 pounds.
Your frame size or body build is determined by the thickness
of the bones in your elbows, knees, ankles, and wrists. The
Metropolitan Life Insurance Company offers this method of
determining your body frame size: Extend your arm and bend
your forearm upward at a 90 degree angle. With your fingers
straight, turn the inside of your wrist toward your body.
Place your thumb and index finger of the other hand on the
two prominent bones of the elbow. Measure the space between
the fingers against a ruler or a tape measure. Compare your
measurement with the figures in the table below. Elbow
measurements less than those given indicate a small frame;
greater measurements indicate a large frame.
Height in Elbow Breadth for
1-inch Heels Medium Frame (Women)
--------------------------------------------
4'10" to 5'3" 2 1/4" to 2 1/2"
5'4" to 6'0" 2 3/8" to 2 5/8"
--------------------------------------------
Metropolitan Life Insurance Company, 1983.
It is important to consider body composition. If you are
muscular and athletic, you may weigh more than a sedentary
person of the same height and frame size, yet you may be
trim, while your sedentary counterpart may be overweight.
If your weight comes from muscle, you may fall technically
into the overweight category yet not be fat. However, in
general, as you approach 20% or more above your ideal
weight, your excess weight usually comes from fat.
Body fat percentage can be determined by several methods,
such as skinfold thickness, underwater weighing, total body
water (hydrometry), and whole body potassium.
Losing weight
Diets for losing weight involve controlling the amount and
types of food you eat. This most often means eating fewer
calories and avoiding fatty foods or empty-calorie foods.
Losing weight requires a change in behavior that almost
always involves:
- a better understanding of your own health
- healthy eating habits
- a plan for rewards for following your program
- an increase in regular physical activity.
A weight reduction diet needs to provide adequate nutrition,
a good variety of foods, and a reduction in calories. This
is usually best done by limiting fat, especially saturated
fat, in the diet. Pregnant women should not go on a weight
reduction diet.
What is most effective is a gradual change in eating and
physical activity habits that you can continue for the rest
of your life. The best diet is one that helps you lose
weight slowly but steadily, so you can maintain your ideal
weight after you have reached your goal. Ask your health
care provider for a safe, healthy, effective weight
reduction program.
Selecting foods to lose weight
Keep a food diary. As soon as you eat or drink, write it
down. It may be helpful to use a small pocket diary.
Seeing what you eat and drink will help you examine your
eating patterns and food habits.
To lose weight in a healthy manner, follow these guidelines:
- Drink at least six 8-ounce glasses of water each day.
- Choose unlimited amounts of vegetables and salads.
- Choose:
- lean meats, poultry, and fish
- baked or broiled meat, fish, and poultry
- salad dressing containing little or no oil.
- Choose regular but limited amounts of:
- low-fat or skim milk, cheeses, and yogurts
- legumes (lentils, peas, and beans)
- unrefined carbohydrates (whole wheat bread, whole
grain cereals without sugar)
- raw fruits.
- Significantly limit how much you eat of the following:
- refined carbohydrates (sugar) and foods containing
sugar
- refined grain products such as white rice and white
flour.
- Avoid:
- saturated fats such as butter, margarine, and fat on
meats
- other foods that contain fats, such as pastries,
cakes, and cheese
- fried foods
- processed meats
- alcoholic beverages.
To have a balanced diet, be sure to choose a variety of
foods from the basic food groups:
- dairy
- meat and other protein
- vegetables
- fruit
- bread and cereal.
Counting calories
A calorie is a unit of measurement used to express the
energy value of food. Your body burns calories to use for
basic body functions. Proteins, carbohydrates, and fats
contain calories and produce energy. To lose weight, reduce
the calories in the food you eat (without giving up
nutrition) and increase the number of calories you use in
physical activity.
Eating 500 calories less a day can result in losing 1 pound
a week. One to one and a half pounds (2 pounds maximum) is
the ideal amount to lose in a week. If you lose more than
that each week, you begin to lose muscle rather than fat.
Most weight reduction diets suggest 1200 to 1500 calories a
day for women. Ask your health care provider or dietitian
to help you determine how many calories you need a day.
The rate at which you can lose weight depends on your body's
metabolism. This is the rate at which your body uses the
energy from food for basic body functions. Metabolism can
be increased by increasing physical activity.
Weight loss may occur more quickly at the beginning of a
diet because the body releases extra water that was
retained.
Sit down and relax while you eat your meals. Avoid
distractions such as the phone and TV. Chewing your food
thoroughly helps digestion. Eating small, frequent meals
instead of three full meals a day is also helpful. You
should eat every 4 to 5 hours. This keeps your blood sugar
at a constant level and helps keep you from feeling hungry.
Finish your meals with a piece of fruit instead of a sweet
dessert.
You must eat a minimum quantity of appropriate food or your
body will shut down its metabolism in an effort to survive
the lean time. This happens when people go on "starvation
diets." The body's survival response prevents them from
losing weight.
Popular diets
Popular or fad diets may be dangerous. They can be divided
into several groups:
- high-protein diets
- specific food diets
- calorie-conscious commercial programs.
High-protein diets result in a quick initial loss of weight.
These diets allow unlimited amounts of high-protein foods,
but little or no carbohydrates. Examples include the Atkins
Diet, Cambridge Diet (The University Diet), Herbalife Diet
Plan, Stillman Diet, and Scarsdale Diet. The Federal Drug
Administration has reported cases of acute illness from the
Cambridge Diet requiring hospitalization, and a warning has
been added to the product label. The Herbalife Diet Plan
may cause diarrhea, nausea, heavy sweating, headaches, and
cramps. The Stillman Diet does not include the five basic
food groups and provides only small amounts of vitamins A
and C, thiamine, and iron. In the Scarsdale Diet there is
little iron, vitamin A, calcium, and riboflavin because the
diet limits milk, bread, and cereals. It can lead to
dehydration because fluids are limited to coffee, tea, and
water.
Specific food diets are based on food combinations. These
diets don't count calories, are monotonous, and encourage
unrealistic eating habits. You may develop vitamin and
mineral deficiencies can after a few days on one of these
diets. Examples of these diets are the Mayo (or grapefruit)
Diet, the Beverly Hills Diet, and high-carbohydrate diets.
- The Mayo diet is based on the belief that grapefruit
causes weight loss by causing fat to be burned off
faster. One of the problems is that the diet is high in
saturated fats and cholesterol.
- The Beverly Hills Diet is low in protein, vitamins, and
minerals such as iron, zinc, calcium, and magnesium.
- High-carbohydrate diets (for example, Jane Fonda,
Pritikin, Bloomingdale's Eat to Succeed) are based on
high-carbohydrate, high-fiber foods. Some are balanced,
others are not.
Calorie-conscious commercial programs and weight loss
clinics offer group support and motivation for the dieter, a
wide variety of foods, and a calorie intake between 500 and
1500 a day. These programs are often expensive and should
not be used without medical supervision. Some programs can
provide excellent support in changing bad eating habits and
maintaining a program over time.
Very low calorie diets and total fasting (eating less than
500 calories a day) are potentially fatal and require
medical supervision.
Protein-sparing modified fasting
Protein-sparing modified fasting is used for people who are
more than 30% to 40% over their ideal weight. Before
recommending this diet, your health care provider will
evaluate your cardiovascular system. You remain under your
provider's care while you are on this diet.
This diet is not recommended for children, adolescents,
pregnant women, nursing mothers, the elderly, those who are
moderately overweight, and those who have problems with
their health, such as high blood pressure or cardiovascular
disease.
A program that combines a very low calorie diet (to achieve
a large initial weight loss) with medical supervision,
counseling, an exercise program, and behavior modification
can provide some initial motivation for a person trying to
deal with obesity. However, the disadvantages of losing
muscle may outweigh any quick success benefit.
For those who compulsively overeat, Overeaters Anonymous may
help. The program is free. Write or call:
Overeaters Anonymous
World Service Office
4025 Spencer Street #203
Torrance, CA 90503
Phone: 1-310-542-8363
Another program that can help you lose weight is Weight
Watchers. To learn about Weight Watchers meetings and
programs in your region, call 1-800-651-6000.
Increasing physical activity to lose weight
In addition to diet, adding daily walking to your routine
can help you manage your weight. Start with a comfortable
goal: 5, 10, or 15 minutes a day. Walk this amount at least
4 to 7 times a week. Each week add 5 minutes to your time
until after several weeks you have worked up to 30 to 40
minutes per day. Invite someone to walk with you, for
example, your spouse or a child you've been meaning to spend
more time with.
In addition to the calories you are burning as you walk,
regular physical activity increases your metabolic rate.
Therefore, you will be using more calories 24 hours a day,
even as you sleep. If you are unable to walk, ask your
health care provider to recommend a different type of
exercise.
In addition to helping you lose or maintain your weight,
regular physical activity lowers your pulse, blood pressure,
cholesterol, and blood sugar. It also increases your energy
level.
|