risks and commitment

Source: National Heart, Lung and Blood Institute

According to the National Heart, Lung and Blood Institute guidelines, assessment of overweight involves using three key measures:

body mass index (BMI)
waist circumference, and
risk factors for diseases and conditions associated with obesity.

The BMI is a measure of your weight relative to your height and waist circumference measures abdominal fat. Combining these with information about your additional risk factors yields your risk for developing obesity-associated diseases.

What is Your Risk

1. Body Mass Index (BMI)

BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The score is valid for both men and women but it does have some limits. The limits are:

It may overestimate body fat in athletes and others who have a muscular build.
It may underestimate body fat in older persons and others who have lost muscle mass.

Use the BMI calculator to estimate your total body fat. The BMI score means the following:

	BMI
Underweight	Below 18.5
Normal	18.5 - 24.9
Overweight	25.0 - 29.9
Obesity	30.0 and Above

2. Waist Circumference

Determine your waist circumference by placing a measuring tape snugly around your waist. It is a good indicator of your abdominal fat which is another predictor of your risk for developing risk factors for heart disease and other diseases. This risk increases with a waist measurement of over 40 inches in men and over 35 inches in women

The table, Risks of Obesity-Associated Diseases by BMI and Waist Circumference (below), provides you with an idea of whether your BMI combined with your waist circumference increases your risk for developing obesity associated diseases or conditions.

3. Other Risk Factors

Besides being overweight or obese, there are additional risk factors to consider.

RISK FACTORS

high blood pressure (hypertension)
high LDL-cholesterol ("bad" cholesterol)
low HDL-cholesterol ("good" cholesterol)
high triglycerides
high blood glucose (sugar)
family history of premature heart disease
physical inactivity
cigarette smoking

4. Assessment

For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated with obesity. Patients who are overweight, do not have a high waist measurement, and have less than 2 risk factors may need to prevent further weight gain rather than lose weight.

Talk to your doctor to see if you are at an increased risk and if you should lose weight. Your doctor will evaluate your BMI, waist measurement, and others risk factors for heart disease. People who are overweight or obese have a greater chance of developing high blood pressure, high blood cholesterol or other lipid disorders, type 2 diabetes, heart disease, stroke, and certain cancers, and even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing those diseases.

Classification of Overweight and Obesity by BMI, Waist Circumference, and Associated Disease Risks
			*Disease Risk Relative to Normal Weight and Waist Circumference**
	BMI (kg/m²)	Obesity Class	Men 102 cm (40 in) or less Women 88 cm (35 in) or less	Men > 102 cm (40 in) Women > 88 cm (35 in)
Underweight	< 18.5		-	-
Normal	18.5 - 24.9		-	-
Overweight	25.0 - 29.9		Increased	High
Obesity	30.0 - 34.9	I	High	Very High
	35.0 - 39.9	II	Very High	Very High
Extreme Obesity	40.0 +	III	Extremely High	Extremely High

* Disease risk for type 2 diabetes, hypertension, and CVD.
+ Increased waist circumference can also be a marker for increased risk even in persons of normal weight.

Posted April 2007