August 22, 2018
Leeway in Healthy Weight
Be Well

Leeway in Healthy Weight

by John Swartzberg, M.D.

Recently, a 65-year-old reader wrote to us about his problems achieving a healthy weight. When he retired four years ago, he weighed 260 pounds, at 5'10" tall. He changed the way he ate and started exercising more, and within a year dropped to 180 pounds, which is terrific. After that, he started losing ground, and now weighs 210 pounds.

“According to the BMI [body mass index] I should weigh in the low 170s,” he wrote. “I have not weighed that little since I played varsity basketball as a sophomore in high school. I still watch my diet, but I do treat myself occasionally. My doctor says I am healthy, and I take no medications. During the last four years, I work out four or five days a week at the gym with an hour of cardio on an elliptical trainer and half an hour of weight training. But my BMI says I am borderline obese. I want to be healthy and physically active, so I can achieve my goal of fly fishing around the world, but I do not need to be a pro athlete. How do I determine what’s a healthy weight for me???”

I’m sure a lot of you are in the same boat. Like this reader, you’re doing all the right things, but can’t come close to the desirable number on the weight chart. Keep in mind, BMI (a weight-to-height formula) is an imprecise tool, as are the other ways to assess weight, and its cutoff points are somewhat arbitrary. It doesn’t account for how much muscle you have or your body shape (carrying lots of excess pounds around your abdomen—but not your hips—is a cardiovascular risk factor). Your optimal weight depends on many factors, notably your fitness level, age, risk for various diseases and genes.

Moreover, while being obese has definite health risks, being merely overweight is a gray area. In April, for instance, we reported on a study of Australians age 70 to 75 that found that merely overweight people were less likely to die during the next decade than those who were underweight, obese or even normal weight. Those who were obese faced the greatest risk. Thus, guidelines defining overweight for younger people may not be appropriate at older ages. In fact, even for younger people, the health risks of being merely 10 to 30 pounds overweight are unclear. Some other good studies also suggest that being merely overweight is a healthy place to be, unless you have high blood pressure, high blood sugar or not-so-great cholesterol levels.

Back to our reader: You’re a success story. You’ve kept off 20 percent of your weight for five years. That’s better than nine out of ten dieters manage to do. Forget about your high school weight. The main thing is to make sure you don’t creep back up into the obese range. As long as your cholesterol, blood pressure and blood sugar numbers are okay, or only a little high, just try to stay below 200 or 210 pounds. That would keep you in the upper range of “overweight,” going by your BMI. Better yet, aim for 190. Make sure your waist is less than 40 inches (35 inches for women). Keep exercising and watching what you eat. And enjoy the fly fishing.