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Do I Need to Lose Weight?

    • It happens. Time passes, and our weight increases. A little bit, slowly, until we can no longer fit into our high school jeans or our wedding dress, or whatever we wore as a younger person. Maybe we have had children, and gained a few pounds in the process.

      One day we look at the skinny models and movie stars, and ask of our middle-aged body: Am I TOO fat? Really? And if so, what should I do?

      In fact, some weight gain is almost inevitable, according to Karen Handy, MPH, educator and manager of the Palo Alto Medical Foundation Weight Management ProgramOpens new window in Burlingame. “Most Americans gain about a pound a year, starting in midlife. As we age, we lose lean muscle tissue. Since lean muscle tissues helps drive our metabolism, we began to burn fewer calories. So even if we eat the same diet, we can begin to gain weight.”

      And women often find post-pregnancy weight hard to lose. “Your body naturally gains weight during pregnancy, preparing you to breastfeed the baby,” notes Handy. “However, my patients report that after-baby life is so hectic, it’s harder to stay with habits that can help shed those extra pounds.”

    • How Much Weight is Too Much?

    • One good measurement of whether you are too heavy is the Body Mass Index or BMI. This measurement, a ratio of fat to total body weight, is a good place to start. A BMI under 25 is ideal, while a BMI of 35 and above can be a danger signal. A BMI above 40 indicates your weight is a real hazard to your health. The BMI has its limitations, however, especially for athletes with a high percent of lean muscle. Muscle is heavier than fat, so an athlete’s BMI (ratio of weight to height) can look too high when, in fact, it is not.

      Another measurement of “dangerous” fat is the waist circumference. Belly fat stored in the middle of the body, around the organs, is tied to more health conditions than weight stored on the hips or elsewhere. Women with a waist measurement of 35 or more, or men with a waist of 40 inches or above, should be concerned.

      But is our focus all about the scale or the measuring tape? Not according to our medical experts.

      Dr. Tom Hopkins, internal medicine physician with Sutter Weight Management Institute in Sacramento states that “Fitness counts, fatness doesn’t.” According to Dr. Hopkins, the most important factor is what you are doing with your body at your current weight – not the weight itself.

      “If you have a BMI of 35 and are sedentary, eat fatty and sugary foods, and smoking, then I would be very concerned. However, if you have a BMI of 35 and you eat healthy food and walk or exercise every day, that’s a very different story.”

      Both Dr. Hopkins and Handy emphasize that you should consider your entire health status, not simply your weight. “If you are not aware of your health risk factors, find out,” says Handy. Make an appointment to see your doctor to discuss whether your weight is a risk to your health. “No one dies of fatness,” says Dr. Hopkins. “They do die of health conditions that are influenced by weight.” Dr. Hopkins asks: “Is your weight limiting you? Is it slowing you down? Does it keep you from moving? Then I would be concerned.”

    • How to Begin the Weight Loss Process

    • If you know your weight is causing you concern, what can you do?

      “It never hurts to become more physically active – and to eat more fruits and vegetables,” says Handy. “Even if you don’t lose a pound, you will become healthier, and that’s really the goal.”

      She offers some simple tips that work for her clients:

      • Eat more fruit and vegetables, especially before your other foods. That apple can take the edge off of your hunger and crowd out higher calories food you might be eating.
      • Eat all day long – but smaller meals and healthy snacks. This will keep the edge off your hunger.
      • Get a pedometer to measure the steps you take in your everyday life. Use it to invent simple ways to increase your physical activity – take the stairs, park farther away and walk.

      Dr. Hopkins also focuses on a total plan for your healthy weight management. “Success depends on a ‘triangle’ approach with three important elements: mental, physical and nutritional. You can’t succeed with just one element.” Mental motivation is your first step.

      The next most important step is the focus on nutrition and calorie reduction. “I see people very disappointed when they increase their activity, but eat the same and expect to lose weight,” says Hopkins. “If you are eating an extra 1500 calories a day, you can’t exercise enough to burn that off. You will be disappointed, fire your personal trainer and quit the gym.”

      Instead, reduce calories first, and then exercise to keep yourself fit. The exercise will also serve to improve your mood and other health conditions.

      While these tips will work easily for someone who has seen 10-20 pounds creep onto the body, it is admittedly harder for someone who is more overweight. For those with a BMI of 40 or above – roughly 100 pounds over their desired weight – bariatric surgeryOpens new window may be an important option. For someone with that much weight to lose, there is a greater urgency. Carrying excessive weight is a real health hazard which will only increase over the years.

      “For some, surgery can help with one part of the triangle: calorie reduction,” notes Dr. Hopkins. He notes, however, that without all the elements in place, surgery is no magic bullet. “You undergo weight loss surgery with the same brain you had before. All bariatric surgery programs include a focus on all the elements: calorie reduction, better nutrition, physical activity and mental motivation to live a healthier life.”

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