When you think about reaching the “ideal” weight, you may envision finally slipping into a specific size or looking like someone you know, but what really matters is aiming for a healthy weight—a goal that is absent of arbitrary numbers and is instead based on your body (specifically your height, frame and gender) and what it needs to function well.
For some—more than two-thirds of Americans, and growing—reaching a healthy weight does indeed mean shedding pounds to put less stress on the body. But for others, gaining weight may be necessary to sidestep health concerns.
Concerns That Come with Being Overweight
Research shows that being overweight or obese increases your risk of a laundry list of health problems: diabetes, heart disease, kidney disease, cancer, arthritis, back pain, infertility, asthma, sleep apnea, cataracts, gallstones, depression and more. Weight centered around the abdomen (belly fat) is of special concern, since it can affect your organs and be a greater indication of disease risk than fat found in other areas of the body. Getting to a healthy weight can not only reduce the risk of these concerns, but also improve the odds of living longer and maintaining a better quality of life.
Concerns That Come with Being Underweight
Being underweight poses its own set of health issues, particularly in the elderly. Though too much weight carries the risks noted above, a healthy amount of weight actually helps the body by keeping bones strong, providing protective cushioning, keeping you warm and more. Because of this, adults at a consistently low body weight have higher rates of infection, osteoporosis, injury, depression and premature death than people in a healthy weight range. Quality of life can be impacted due to lack of muscle strength, problems regulating body temperature, fatigue, irritability, lack of concentration and difficulty recovering from illness.
On the Road to a Healthy Weight
Even if you’ve always struggled with your weight, you can make transformative health changes at any point in your life. The first step on that journey is determining what a healthy weight is for you.
For this, many turn to body mass index (BMI)—an estimate of total body fat based on your height and weight. The result of the simple calculation (weight in pounds x 703 / your height in inches, squared) classifies you as follows:
Underweight Below 18.5
Healthy 18.5 to 24.9
Overweight 25.0 to 29.9
Obese 30.0 and above
But while BMI used to be considered a more useful tool, many experts now think of it strictly a guesstimate—one that is perhaps more helpful in understanding weight-loss research than getting true insight into an individual’s body. One important consideration with BMI is that it doesn’t account for lean muscle mass—the healthy kind of weight. A trim person who is also very muscular, for example, could very well fall into the obese category, according to the BMI scale.
You and your doctor, registered dietitian or exercise physiologist simply need more information to fully understand your body and its needs.
Believe it or not, she—after weighing you on a scale—may turn to a simple, inexpensive tool next: a tape measure. While everybody—and every body—is different, when it comes to weight gain, many people tend to fall into one of two categories: “apples” or “pears.” Pears tend to gain pounds in the hips and thighs as subcutaneous fat, the “pinch an inch” kind you can grab on to. Apples gain around the mid-section in the form of visceral fat, fat that lies deep beneath the surface of the skin. Visceral fat cells release hormones and certain chemicals into the body, disrupting your metabolic system and increasing your risk for heart disease and type 2 diabetes. So, what seems like a simple difference of body shape can actually tell a lot about your health.
Measuring waist circumference is an easy way to get a sense of how much abdominal fat you are carrying and whether you’re heading into riskier apple territory. You can do it at home, too: Place a measuring tape snugly around your waist, just above your hip bones, to get an accurate reading. The following results mean that you may be at increased risk for the above-mentioned diseases. Remember, you can be underweight and still have a sizable waistline.
Men: 40 inches or more
Women: 35 inches or more
Many health care professionals use waist circumference, along with weight and sometimes even BMI, to assess what your healthy weight is based on your age, height and gender. They may also use calipers, which measure the thickness of skin folds, to get a sense of how much fat you’re carrying (though, this is only an estimate). These details can go a long way in helping you and your practitioner get a handle on your situation.
However, in order to set the most accurate goals and make an effective plan for reaching them, you need to have the complete picture of your weight—and that only comes with an understanding of exactly what your weight is composed of. Two sophisticated tools can help provide true measurements, whereas the tools above can only provide estimates:
Dual Energy X-Ray Absorption (DEXA) Scans
Considered the gold standard by those on the cutting edge of weight research, a DEXA scan is the most accurate test of body composition. During this test, commonly used to detect osteoporosis, two low-dose X-rays reveal the amount of bone mass, fat and lean muscle in your body. This shows your doctor specifically where fat resides, so she can create the most informed weight loss, gain or maintenance plan possible.
DEXA testing is not available in all doctors’ offices, but it shouldn’t be hard to locate a nearby facility that performs the test. Just make sure you are clear about your needs: Some facilities with DEXA scans may use them strictly to detect osteoporosis and not body composition. Though expensive, a DEXA scan is the best option for those looking for the most accurate take on their weight, as well as the information needed to devise a highly effective plan for getting and staying on the right track. An exercise physiologist can use the results to personalize an exercise program with your body composition in mind.
Hydrostatic weighing, though not as accurate as a DEXA scan, is another great way to determine how much of your body weight comes from fat. It compares your weight on land versus your weight in water. Body fat is less dense than water, meaning it floats. So, the more fat you have, the less you’ll weigh when you’re submerged. Muscle, on the other hand, sinks. Because it’s denser than water, you’ll weigh more when you’re in a pool the more muscle you have.
While hydrostatic testing is useful in determining body fat percentage, it may not be as practical for you as the DEXA; research facilities and universities are typically the only places that perform the test, given the amount of space and equipment needed to carry it out.
With the knowledge from these assessments, a health professional can determine if you need to gain or lose, guide you toward a healthy number and help you manage and address factors that may be impeding your efforts, like diet, exercise, illness and emotional concerns. She can also inform you of any genetic issues that may be adversely affecting your weight.
Staying the Course
Make it a point to regularly measure your waist, and try to hop on a bathroom scale daily. Digital scales tend to provide a more accurate reading than older models; many also have bioelectrical impedance analysis (BIA) technology, which sends a safe signal through your body to calculate your percentage of body fat (although it tends to not be as accurate as doctors’ office versions or more sophisticated testing). Daily use is helpful in detecting any weight fluctuations, and our experts recommend weighing yourself each morning after you urinate, but before you eat breakfast. Just remember: An increase on the scale doesn’t necessarily mean you have gained fat; you could be gaining muscle. Likewise, a decrease could mean a loss of fat or muscle.
What you’re doing is not easy. Don’t be afraid to turn to friends and family for the emotional support you’ll need, and consider enlisting the help of additional professionals—a personal trainer or a therapist—who can keep you mindful, focused and motivated along the way.