Eight months ago, I went to see a doctor for a minor issue. After taking care of it, she scanned my chart. “Have you considered going on a diet?” she asked. “Your weight puts you at a higher risk of heart disease and diabetes.”
Blushing, I promised to follow up with my doc at home. It's not that I hadn't considered losing weight. What's different is that now, at 158 pounds, I'm clinically overweight. On the brighter side, I live a healthy life. I exercise almost every day — walks, weights, yoga. My diet is packed with fruit, vegetables, and whole grains — albeit in larger portions than a dietician might advise. I knit. I garden. I even meditate. Doesn't any of this count? Turns out, I'm not the only one asking these questions. Experts are divided on the danger posed by excess weight, especially if the person is generally healthy and fit. Much of the research linking excess weight and an increased risk of diabetes, heart disease, and cancer, among other chronic diseases, has been done on people who are obese, with a BMI of 30 or more. When the merely overweight folks are separated out, the health risks drop, and sometimes even disappear.
Recently, researchers from the National Cancer Institute (NCI) caused waves with a report analysing the death records of 37,000 adults. Although obese folks had a greater risk of dying from cancer or heart disease, those who were simply overweight had, surprisingly, no greater risk than normal-weight people. Even more amazing, the findings suggested that being overweight may actually protect against death from a multitude of diseases other than cancer and heart disease.
Critics responded that the study failed to consider quality-of-life issues caused by excess pounds and didn't appropriately control for unhealthy habits such as smoking, which can keep people lean but raise cancer risk. No one's debating that weight loss can be one part of an overall disease prevention plan. But, is it the most essential first step? That depends on how many other disease risk factors you have.
When I returned home, I did indeed follow up with my doctor. We discussed my high BMI, cholesterol, low blood pressure, fitness level, and C-reactive protein test (CRP) score — and then he calculated my Framingham Risk Score, a measure widely used to assess a 10-year risk of heart attacks. (You can take an online version of this test at prevention.com/links.) Thanks to no smoking, my family history, a good diet, and an active lifestyle, my risk level came up as “very low” at one per cent.
I should have felt vindicated, but felt like a quitter. Truth was, I hated that my knees hurt after a walk and that I dreaded bathing suit season. And so, I decided to slim down anyway but resolved to go about it as sensibly as I could. .
First, I dropped my fantasy goal of 130 pounds. Instead, I aimed low — five per cent of my body weight, or seven to eight pounds. (Experts advise shooting for no more than 10 per cent at a time.)
Researchers are adamant that the changes that bring about small losses — walking 15 minutes more a day, or using fat-free milk instead of cream in coffee — are more likely to become lasting ones. I didn't ban foods such as butter, cheese, ice cream, and bacon, but I switched to reduced-fat alternatives and smaller portions. I also intensified my exercise to at least an hour most days. I added jogging to my walking routine, and on weekends, I didn't do yoga or go on a hike; I did both.
I lost seven pounds in four months, and I'm fitter and stronger. My back and knees feel better; my cholesterol is a bit lower. Maintenance, though, is a daily struggle. The Framingham Risk Score with my new weight was still the same one per cent risk. Still, I realised something. Even if it wasn't about my heart health or my “relative risk of mortality,” it simply feels good to weigh less. I'm happy I can walk my dogs without pain, slide into my jeans without struggle, and buy a one-piece without cringing. If that's not quality of life, what is?
Risk Factors
Guidelines suggest that obese people slim down, but experts say overweight people may be fine, barring the risk factors below. If two or more apply to you, talk with your doc about reducing your weight by five to 10 per cent.
Heart disease risk: That means a family history of heart disease (men having heart attacks before 55 and women before 65), stroke, or high blood pressure.
Too little exercise: Anything less than 30 minutes four days a week is inadequate.
Diabetes risk: This includes a family history of the illness, as well as an impaired glucose test in the past.
Too much belly fat: For women, a waist measurement greater than 35 inches is a red flag.
Middle age: Because anyone 45 or older is at a higher risk of diabetes, and women's risk of heart disease begins to rise at 55, midlife is considered a risk factor all its own.
