You know how to figure out what your weight should be, right? You just look at the chart in your doctor’s office, find you frame type and height, and that’s it. But wait! What about the rule that says: Start at 100 pounds and add five more for every inch over five feet? Or the stuff on body fat percentage, waist-hip ratio, or any number of other formulas that are supposed to tell you whether or not you’re overweight? Add to all this the fact that women feel pressured by our small-minded culture to be skinny — skinnier, in fact, than most of us ought to be — and it’s no wonder we’re so confused! That pressure increased with a highly publicized 1995 Harvard University study. According to some new reports, the study proved that the very skinniest among us were the healthiest — and putting on any weight with age was bad news. But that was a misinterpretation, says the study’s author, JoAnn Manson, M.D., codirector of women’s health at Brigham and Women’s Hospital at Harvard Medical School. The study tracked women ages 30 to 55 over a 16-year period, and Dr. Manson did find that the slimmest subjects in each height group had the lowest mortality rates. But a woman had to be really overweight for the risk to increase significantly. For example, in the case of a five feet five inch woman, risk factors didn’t kick in until after 150 pounds. Furthermore, the doctor points out that her study suggests avoiding substantial weight gain — that is, more than 20 to 25 pounds — with aging.
U.S. government guidelines, which were also revised in 1995, are consistent with Dr. Manson’s findings. A healthy weight for someone measuring five feet five inches, according to the guidelines, is in the 114- to 150-pound range. The big news, however, is not so much that “ideal” weights have changed, but that many experts are now thinking of those figures as merely a starting point. Ultimately, they hope to get people away from numbers, and closer to a more realistic and individual view of what healthy weight really means.
It’s important to understand that even the most up-to-the-minute guidelines for healthy weights are just
averages, and therefore don’t address individual susceptibilities — or strengths. “Look at Winston Churchill,” says Michael Hamilton, M.D., director of the Duke University Diet and Fitness Center in Durham, NC. “He overate, drank too much, smoked cigars, and you never saw a picture of him in a jogging suit — but
he lived to be ninety. It’s like gambling; being fat does increase your chances of dying or getting sick, but it doesn’t mean you’re going to.”
Similarly, being slim doesn’t guarantee you anything if you have bad health habits or genes working against you. Diane Cheatham, 37, of Port Republic, MD, is quite slender; at five feet six inches, she weighs only
115 pounds. But last year, she received a diagnosis of severe osteoporosis. A former heavy smoker and non- exerciser, she also has a family history of the disease. Cheatham is currently in a treatment program that includes workouts to help strengthen her muscles (and consequently, her bones), which will probably result in her gaining weight — and being healthier. That’s why the new guidelines provide such a wide range of acceptable weights: Many factors influence what’s right for you.
Figuring Your Weight Factors
Doctors worry most about patients’ excess pounds because of three potential killers: heart disease, high blood pressure; and diabetes. Anything that affects your chances of getting those diseases should figure into your decisions on whether to lose weight. Here, six points to consider:
* Family history. “Having grandfather who died of a heart attack at ninety has absolutely no significance,” says Reubin Andres, M.D., clinical director of the National Institute on Aging in Baltimore. “But if you have a primary relative — a parent or sibling — who had a heart attack before age sixty (for men, it’s
fifty), or a similarly strong family history of diabetes or high blood pressure, you’d probably be better off with your weight at the lower end of the normal range.”
* Your own medical profile. If you have low cholesterol, low blood pressure, and normal blood sugar, you don’t need to be as concerned about what might otherwise be considered excess weight, according to Dr. Hamilton. Exercise physiologist Dana Brown, of George Washington University School of Medicine’s Women’s, DC, works with a 41-year-old woman who, at five feet eight inches and 220 pounds, would normally fall in the health danger zone. “But by every measure — aerobic capacity, muscular strength, endurance, flexibility, blood pressure, blood sugar, cholesterol — she’s extremely healthy,” says Brown. “She’s here because she wants to slim down, which is fine. But it would be hard to justify telling her she should lose weight.”
* Weight distribution: “If your extra weight is around your hips, thighs, and buttocks, these are sort of safe places to have it,” says Dr. Andres. Conversely, if you’re thick through the middle, it means you probably have a fair amount of visceral fat — that is, fat within the abdominal cavity, which is strongly
linked to cardiovascular disease and diabetes risk. How do you know when your stomach size is unhealthy? The expect concensus is that a woman should take notice — and action — if her waist measures more than 35
* Diet. What you eat can count for more than how much you eat and what you weigh. A diet high in fats, especially saturated ones, trends to boost the amounts of visceral fat and blood cholesterol — and, consequently the risk of heart disease, high blood pressure, and diabetes.
* Exercise program. Even if exercise doesn’t help you lose an ounce, you still get a lot of health credits. It not only gives your heart a healthy workout, but it also minimizes visceral fat and decreases a variety of other risk factors for the Big Three killers.
* Lean body mass. If you work out regularly, you’re probably “thinner” in terms of body fat than the scale indicates. “There’s no easy way to measure your percentage of body fat, but you don’t need a sophisticated test,” says Dr. Hamilton, “Just take off your clothes, and stand in front of a mirror.” Have more muscle than mush? Then the odds are you can afford to pack more poundage than a couch potato of the same height. IF YOU CONCLUDE THAT YOU SHOULD slim down, “even a modest loss — as little as five to ten percent of your current weight — can have importance health benefits, such as lowering blood pressure, improving cholesterol levels, and lowering blood sugar,” says Dr. Manson. Even when a person is extremely overweight, the new medical emphasis is on the sort of loss that can be sustained. Actually, the first line of defense is to try to stop gaining weight, since we tend to put on pounds with
age. If you’re not overweight to begin with, ten to 15 more pounds, spread over a decade or two, isn’t going to make much difference healthwise, according to Dr. Manson. The gain should, however, serve as warning to change your eating and exercise habits so you don’t find yourself sliding up into the 20-pounds-plus area.