Obesity in America: Are You Part of the Problem?

Despite our country's obsession with weight and appearance, most people who are medically overweight don't realize it. Although 39% of adults responding to a 2006 survey¹ said they believe they are overweight, the actual number of overweight or obese people in America, according to the National Institutes of Health (NIH) is much larger - about 60%, or 97 million adults aged 20 or over!

What we're talking about isn't annoying "love-handles" or a body that doesn't match the supermodels we see in magazines. Instead, we're talking about a condition that significantly threatens health, well-being, and longevity. Our collective weight problem is so bad that only cigarette smoking causes more preventable deaths in America than obesity does. That means that approximately 300,000 deaths each year are directly or indirectly related to obesity.

Certain groups are more prone to overweight and obesity than others. For example, women - who often tend to gain weight as they get older - are at higher risk than men. Black women are at higher risk than white women, and low-income minority women are the most likely to be overweight. In general, middle aged women are at the highest risk for becoming obese. Most troubling of all, children - even at very young ages - are more overweight and obese than ever before, setting the stage for lifelong weight-related health problems.

Assessing Body Composition: BMI and Waistline Measurements
How do you know if you are medically overweight or obese? Doctors use a formula that takes both height and weight into consideration to come up with a standardized measurement known as body mass index, or BMI. The BMI is a reliable indirect way of measuring total body fat content.

Your health care provider can help you figure out your BMI, or you can find an automatic BMI calculator at http://www.nhlbisupport.com/bmi/bmicalc.htm. You can also calculate your BMI by hand:
1) divide your weight (in pounds) by your height (in inches) squared. Then
2) multiply the result by 703

For example, if you are 5'5'' (65") tall and weigh 150 lbs: [150 ÷ (65)2] x 703 = [150 ÷ 4225] x 703 = 24.96.

The interpretation of BMI is based on health risk, not on a judgment about physical attractiveness. In general, the higher the BMI, the higher your health risks will be.

Even with a healthy BMI, however, white, black and Latina women with a waistline measurement of 35 inches or more, and Asian women with a waistline of 31 inches or more, may still be at risk for serious fat-related medical problems because the accumulation of "visceral" fat can be especially harmful. Measure your waist at the level of the points of your elbows when your arms are at your sides. Keep the tape measure parallel to the floor, and don't pull it so tight that it compresses your skin.

Causes of overweight and obesity
Why are so many Americans overweight? At least three general factors contribute to adult weight gain: behavior, environment, and genetics. Although we can't control our genetics, we do have some substantial control over behavior (our eating habits and physical activity) and of many aspects of our environment (things at home, school, and work that might affect our weight).

Behavior includes the personal decisions we make about diet and exercise. Many of us, perhaps tempted by appealing advertisements and the convenience of fast foods and take-out restaurants, eat more fattening and unhealthy foods than we intend to. Americans tend to favor large serving sizes and high-calorie, high fat, and high-sugar foods, which provide little nutrition and add many pounds. This includes fast food, sodas, sugary cereals, and processed foods. Too often we don't even realize it. For example, at some popular restaurants, one meal may have an entire day's worth of calories and far more fat and salt than our bodies can process in a day. Our favorite latte can have one-third of a day's calories.

Our environments contribute to weight control problems in a number of ways. The couch potato is a well-recognized stereotype of American life. And although most of us don't think that stereotype applies to us, the fact is that two-thirds of adults don't get the 30 minutes of exercise a day that is needed to stay fit. With cars, remote-controlled TV's (complete with frequent images of junk food), on-line shopping on home computers, and an array of labor-saving appliances at home and at work, many of us have become less active every year. Regular moderate exercise can get rid of the unhealthy visceral fat that accumulates around the waistline, even before the scales start to show an overall weight loss.

Scientists are still learning about how genetics affect obesity. The Center for Disease Control and Prevention (CDC) has found that some people are more likely to become obese, but they can't explain exactly why. One theory is that that thousands of years ago, some humans developed genes that allowed their bodies store more fat and helped them survive when food was scarce. Today, we don't need fat storage for survival, but some people still have the fat-storing genes passed down from their ancestors. Such people would have a very high chance of becoming obese, and would therefore need to work all the harder to avoid obesity.

Making a commitment to do something about being overweight
People don't need to be extremely thin to be healthy and happy. But being overweight or obese can diminish the quality and the length of your life. Some people can get their weight down on their own, and others can benefit from working with a health care provider, a nutritionist, a trainer, a buddy, or proven programs like Weight Watchers®. Whatever it takes for you, doing something about being overweight matters.

Eating a healthy diet with the right foods, limiting how much food you eat, and adding regular exercise to your daily routine can help you gain control and maintain a healthy weight.