Is it possible to be overweight but healthy?
According to , a , weight is complex and influenced by genetics, environment, and behavior鈥攏ot simply a matter of willpower.
More than 70% of Americans are considered overweight, so Murphy, like most other weight loss specialists, focuses on having a more in depth conversation with her patients about this concern.
"Carrying excess weight doesn't necessarily mean someone is unhealthy, but it does increase the risk of developing serious health issues like type 2 diabetes, heart disease, and certain cancers," says Murphy, who sees patients at Rush Centers for Weight Loss and Bariatric Surgery in Aurora and northwest Indiana. She is also one of several weight management providers who see patients through virtual specialty care visits. 鈥淪ome of these conditions don鈥檛 have symptoms until the condition is quite serious.鈥
What is a healthy weight?
How can you determine if you鈥檙e at a healthy weight? This straightforward question can be difficult to answer. A common screening tool for weight is the body mass index (BMI), which assesses your weight relative to your height. But BMI does not tell the whole story about someone's health. It鈥檚 better used for general population-level risk, not for individual diagnosis.
BMI categories can also be different based on your race or ethnicity. For example, people who are South Asian, Chinese or Arab show similar risks of type 2 diabetes at lower BMIs than white people.
To confirm if someone has excess fat, other measurements like waist size or waist-to-hip ratio can give a clearer picture.
How Much Should I weigh?
Below are the standard BMI cutoffs. However, you should talk about your BMI, measurements and other health indicators with your care team to fully understand how your weight is affecting your health.
- Anything below 18.5 is considered underweight, which can be dangerous, too, as we need some fat to live.
- The range for a normal BMI is 18.5 to 24.9.
- A BMI of 25 to 29.9 is overweight.
- A BMI of 30-35 is categorized as class I obesity
- A BMI of 35-39.9 is class II obesity
- A BMI 40 and above is class III obesity
Nearly 40% of American adults are affected by obesity, and they are more likely to have risk factors for certain unhealthy conditions than people who are just overweight.
Can I get help for obesity-related conditions without losing weight?
It鈥檚 possible to address some of the conditions associated with carrying excess weight right now.
For example, sleep apnea, which can be caused by being overweight, is very treatable. Patients are often prescribed a continuous positive airway pressure device (CPAP) while sleeping. Zepbound is currently the only medication recently approved by the FDA for treatment of moderate or severe sleep apnea.
Other weight-related conditions like diabetes and hypertension may respond to medications and lifestyle changes (including getting better sleep and more exercise).
However, weight loss is likely to be a top recommendation from doctors for people who are affected by being overweight and have these conditions.
Getting down to a healthy weight may require a weight-loss program that includes behavioral changes. "The good news is that even achieving small weight loss goals can improve overall health," Murphy says 鈥 a loss as small as 5% to 10% of total body weight can make a difference.
Is all fat bad?
But the numbers on the scale alone do not tell the whole story. It's also important to consider how your weight is distributed.
While it gets a bad rap, fat actually plays an important role in a healthy life. First, stores of fat in our bodies are warehouses of energy against a time when we might not have enough to eat. In addition, fat protects our internal organs and keeps us warm.
"Fat plays many important roles in our body," Murphy explains. "Our brain is actually 60% fat. And including healthy fat in our diet is important for cognitive function and even mental health."
It is an endocrine organ in its own right, in addition to our brain, fat helps maintain other organ functions from the heart to reproduction, as well as bone health, digestion, growth and the immune system.
Humans have two kinds of fat: the subcutaneous type that's under the skin and between the muscles; and visceral adipose tissue (VAT), which we carry around our mid-sections. And too much VAT can be concerning. Excess VAT increases the risk of many metabolic diseases such as type 2 diabetes, cardiovascular disease, fatty liver and some cancers.
When you talk about the classic 鈥渁pple鈥 vs. 鈥減ear鈥 body type, the 鈥渁pple鈥 refers to people who have more VAT at the waistline. There is a surprisingly simple tool for measuring VAT 鈥 a tape measure. A woman's waist should measure no more than 35 inches; a man鈥檚 waist circumference should be no more than 40 inches. One easy way to measure your waist is to hold the tape measure at your belly button and measure evenly around.
A diet is a short-term project; good health is a lifelong endeavor.
Accentuate positive behaviors
Even though patients come to our clinic with the goal of weight loss, feeling good and healthy is not defined by the numbers on the scale, according to Murphy.
鈥淚 like to think of weight loss as a happy side effect of making healthier lifestyle changes.鈥
鈥淎long with healthy eating, weight can be influenced by quality of sleep, the stress in our lives, how active we are and even medications and our environments," she says.
For example, people who don't sleep well often weigh more than people who do, and studies have shown that poor sleeping might actually make a person hungrier.
With her own patients, Murphy says she focuses on the positive 鈥 starting with small goals that will promote good health and also contribute to weight loss. 鈥淕oing to bed a little earlier, having protein with each meal, drinking enough water or adding even a few minutes of activity each day can have an impact,鈥 she says.
Murphy does not, however, encourage her patients to swear off foods they love.
"That can set someone up for failure," she says. "It may be necessary to reduce portions or how often we have certain foods in order to achieve our goals, but finding a way to incorporate what we love is important."
The secret to weight loss success
There have been countless diet trends through the years that are almost impossible to sustain. It is important for us to change our mindset to achieve better health versus restrictive dieting. Weight loss is a short-term project; good health is a lifelong endeavor.
鈥淐hanging our mindset around weight loss is important, it is all about adopting a new lifestyle and finding something that is realistic to stick to forever" Murphy says. "Non-scale victories should always be celebrated as well. One of the most rewarding parts of my job is when a patient comes back for a visit and tells me they were able to walk all day on vacation and not feel tired or that they loved how they looked in a recent picture."
Maintaining a healthy lifestyle or even knowing where to start is something many people struggle with, Murphy says. She encourages those looking for guidance to reach out to their primary care physician for resources. Comprehensive programs like the Rush Centers for Weight Loss and Bariatric Surgery, with locations in Chicago at Rush鈥檚 downtown campus and Rush South Loop 鈥 as well as neighboring locations at Rush Oak Park Hospital, Rush Copley Medical Center, Rush Hinsdale, Rush Munster, Rush Oak Brook, Rush Oak Lawn 鈥 can also be a great one-stop resource. Many providers, including Rush鈥檚 team of weight loss experts, also offer convenient virtual specialty care visits that you can participate in from the comfort of your own home or workplace.
鈥淐reating a safe space for patients is the foundation of our practice. There are still so many biases and assumptions made about those who struggle to lose weight. Being given the opportunity to help someone change their life for the better is a gift that I do not take for granted.鈥
