Do You Really Need to Lose Weight?
7 questions that can help you decide.
Weight and Health continued...
The Medical University of South Carolina Weight Management Center also
recommends an initial loss of 10% of body weight, O'Neil says. "We know
that's an amount of weight loss that can be achieved by most people."
On the contrary, Campos says he's combed the scientific literature and has
found little evidence that shows weight loss is what matters with health.
"The idea that you have to be thin or so-called ideal weight in order to
be healthy is just a completely bogus notion," he says. "If you compare
people who have a healthy lifestyle to people with an unhealthy lifestyle, the
people with the healthy lifestyle have low relative risk and the people with
the unhealthy lifestyle have high relative risk, and this is true without
regard to weight."
To illustrate his point, Campos refers to another study that appears in the
April 20 issue of JAMA. That study showed that heart disease risk
factors such as high blood pressure, high cholesterol, and smoking have declined in all BMI
categories in the last 40 years.
"So-called obese people have (fewer) risk factors in terms of
cardiovascular disease now than so-called ideal-weight people had 20 years
ago," says Campos. He says that it's a person's lifestyle, not his or her
weight, that has the most effect on health.
Williamson agrees that lifestyle is important for good health. But he says
obesity remains a serious condition, even with improvements in heart disease
risk factors. Those improvements don't extend to diabetes, which is linked to
excess weight and which continues to increase in the general population.
The increased risk of diabetes that comes with being overweight can be
improved with even small amounts of weight loss, says Nonas. She adds that
being overweight can also put a strain on the joints, heart, liver, and
Nonas casts a skeptical eye on the recent JAMA studies' findings on
lower death risk for the overweight and on improvements in heart disease risk
factors for the overweight and obese.
"We have of late developed all these wonderful medications which can keep a
person alive and keep their cholesterol down, but it doesn't mean that they're
healthy," says Nonas. "We have heart attacks and neuropathies (nerve
problems caused by diabetes), and just because we can keep them alive, it
doesn't mean that we can keep them alive in a way in which any of us would
really want to live."
Who Should Lose Weight?
Tara Gidus, RD, a spokeswoman for the American Dietetic Association, says
it's possible to be fit and fat -- and that's better than being unfit and fat.
But if you're overweight, she says, you still need to lose weight.
The best time to start thinking about weight loss, says Gidus, is when you
hit the BMI range of 25 to 27 -- overweight and heading into obesity.
Another expert, Vincent Pera, MD, director of the Weight Management Program
at Brown University's Miriam Hospital, says the question of whether someone
needs to lose weight must be determined on a case-by-case basis. That's because
everyone's bodies and health profiles are different.
Also, he says, there are still a lot of unknown factors about obesity.
"We don't understand all the causes of obesity, and why it is so
difficult for some people to control their weight," says Pera. "We
don't understand why some people with obesity have so many problems and others
don't have those problems."