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Do You Really Need to Lose Weight?

7 questions that can help you decide.
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Weight and Health continued...

The April 20 Journal of the American Medical Association study reports that obesity is responsible for an estimated 112,000 deaths per year. Other studies have shown that obesity puts people at higher risk of health problems such as diabetes, heart disease, and osteoarthritis.

But even people who are obese may not need to drop much weight to improve their health.

"You don't need to lose a lot of weight in order to be healthier," says Cathy Nonas, RD, spokeswoman for the American Dietetic Association. Whether you weigh 200 pounds or 400, "the first 10% of weight that you lose - that's the most significant improvement in your health profile that you're going to see," she says.

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.

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