When Bigger Is Not Better

“I can’t fit into my clothes anymore,” bemoaned Rosa, age 35. “I am up to 190 pounds [86 kg] now, and I never imagined I would become so big!”

ROSA is not alone in worrying about her increasing weight. In the United States, where she resides, nearly a third of the nation is obese.a The proportion of obese adults in Britain doubled in ten years. And in Japan—where overweight used to be rare—obesity is becoming common.

Increasing numbers of children are heavier than they should be. Some 4.7 million American youths between the ages of 6 and 17 are severely overweight, while some 20 percent of Canadian children are obese. In recent years childhood obesity has shown a threefold increase in Singapore.

In some countries, being big from weight gain is viewed as evidence of prosperity and health, a far more desirable condition than poverty and undernourishment. But in Western lands, where food is often readily available, gaining weight is usually not considered desirable. On the contrary, it is generally a cause for serious concern. Why?

“Although most people believe obesity is an appearance problem,” says Dr. C. Everett Koop, former U.S. surgeon general, “it is in fact a serious disease.” Endocrinologist F. Xavier Pi-Sunyer of New York explains: “[The fattening of America is] putting more people at risk of diabetes, high blood pressure, stroke, heart disease, even some forms of cancer.”

More Weight, More Risk

Consider one study of 115,000 female American nurses, who were followed for 16 years. The study found that when adults gain even 11 to 18 pounds, it results in a higher risk of heart disease. This study, published in The New England Journal of Medicine of September 14, 1995, indicated that one third of cancer deaths and one half of cardiovascular deaths were due to overweight. According to a report in The Journal of the American Medical Association (JAMA) of May 22/29, 1996, “78% of hypertension in men and 65% in women can be directly attributable to obesity.” The American Cancer Society says that those who are “significantly overweight” (40 percent or more above ideal weight) “have a higher cancer risk.”

But it’s not just putting on extra weight that is a danger; the distribution of body fat also affects the risk of disease. Those who carry excess fat in the abdomen are actually at higher risk than those who carry more weight in their hips and thighs. Fat in the stomach area is associated with increased risk of diabetes, heart disease, breast cancer, and uterine cancer.

Similarly, overweight youths suffer from high blood pressure, elevated cholesterol levels, and prediabetic conditions. And they often become obese adults. The New York Times, using data published in the British medical journal The Lancet, reported that “people who were fat as children died earlier and suffered far more diseases at far younger ages than the general public.”

New Weight Guidelines

The U.S. government, convinced of a serious weight crisis, toughened its recommended weight guidelines in 1995. (See the box on the next page.) The updated guidelines identify “healthy weight,” “moderate overweight,” and “severe overweight.” The guidelines apply to both adult men and women, irrespective of age.

The 1990 guidelines made allowance for middle-body growth in middle age, often called middle-age spread. The new guidelines do not make this allowance, since indications are that adults should not gain weight over time.b Thus, a person who was formerly considered of normal weight may now find himself in the overweight category. For example, a five-foot-six-inch [168 cm] person between the ages of 35 and 65 who weighed 165 pounds [75 kg] would have been within the healthy weight range under the 1990 guidelines. But under the new guidelines, he or she would be ten pounds [5 kg] overweight!

How Did We Get So Big?

Genetic traits can influence a person’s tendency toward obesity, but they do not account for the weight gain in Western countries. Something else is responsible for the problem.

Health professionals agree that eating fat can make us fat. Much meat and many dairy products, baked goods, fast foods, snack foods, fried foods, sauces, gravies, and oils are loaded with fat, and eating them can lead to obesity. How so?

Well, consuming more calories in the food we eat than our body expends causes us to put on weight. Fat has nine calories per gram, compared to four calories in a gram of protein or a gram of carbohydrate. So we take in more calories when we eat fat. But there is another important factor—the way the human body uses the energy supplied by carbohydrates, protein, and fat. The body burns carbohydrates and protein first, then fat. The unused fat calories are converted into body fat. So cutting down on fatty foods is an important way to reduce weight.

Yet, some who believe that they have decreased their fat intake find that their bodies are still widening. Why? One reason is that they are eating large quantities of food. A nutritionist in the United States says: “We overeat because too much is served. When it’s there, we eat it.” People also tend to overconsume low-fat or fat-free foods. But an expert with a U.S. food-industry consulting firm explains: “Reduced-fat products often make up taste by increasing the [high-in-calories] sugar content.” Thus, The New York Times reported: “Two trends of the 90’s—getting value for money and eating low-fat, or fat-free, foods—have become invitations to gluttony,” hence to gaining weight.

The couch-potato life-style also promotes weight gain. A study in Britain found that more than a third of the adults in that land do less than 20 minutes of moderate exercise each week. Fewer than half ever engage in active sports. Car travel has replaced walking in many Western countries, and increased television viewing encourages both sloth and gluttony. In the United States, children sit and watch an estimated 26 hours of television each week, not to mention time spent with video games. Meanwhile, only some 36 percent of the schools still have physical education.

There are also psychological reasons for being overweight. “We eat out of emotional needs,” says Dr. Lawrence Cheskin, of the Johns Hopkins Weight Management Center. “We eat when we’re happy, we eat when we’re sad. We’ve grown up in a way that food is a substitute for many other things.”

Can We Succeed?

The issues of overweight are complex. Each year an estimated 80 million Americans go on a diet. But nearly all return to their former way of eating soon after losing some weight. Within five years, 95 percent regain the weight they have lost.

What are needed to lose weight and to keep it off are life-style changes. Such changes require effort and commitment, along with assistance from family and friends. In some cases the assistance of health professionals may also be needed.c For your efforts to succeed, however, positive motivation is a must. It is good to ask yourself, ‘Why do I want to lose weight?’ Your efforts to lose weight are more likely to succeed if the desire to avoid health dangers is accompanied by a desire to feel better and look better and to improve the quality of your life.

You can eat plenty of delicious and satisfying food that is both nutritious and low in calories. But before considering the foods that can help you lose weight, let us examine how certain elements of diet can become health risks.

[Footnotes]

[Chart on page 6]

Are you in the “healthy weight,” “moderate overweight,” or “severe overweight” range? The graph shown here will help you answer that question

1995 Weight Guidelines for Both Men and Women

(For fully formatted text, see publication)

Height *

6ʹ 6ʺ

6ʹ 0ʺ

5ʹ 6ʺ HEALTHY WEIGHT MODERATE OVERWEIGHT SEVERE OVERWEIGHT

5ʹ 0ʺ

50 lb 75 100 125 150 175 200 225 250

Weight†

Statistics based on: U.S. Department of Agriculture, U.S. Department of Health and Human Services

* Without shoes.

† Without clothes. The higher weights apply to people with more muscle and bone, such as many men.