Support for Overeating and Managing Obesity

The National Institutes of Health (2010) provides definitions for overweight and obesity along with how both are measured.

Body Mass Index (BMI) is the most commonly used method to measure body fat. BMI is a calculation based on a ratio of body weight to height. It is not gender or age specific. BMI does not directly measure percent of body fat, but it is a more accurate indicator of whether a person is overweight or obese than relying on weight alone. Body weight comes from fat, muscle, bone, and body water. BMI correlates with body fat but does not directly measure body fat. Therefore, people, such as athletes, can have a BMI that identifies them as overweight even though they do not have excess body fat.

The BMI Formula: Multiply weight in pounds by 704.5 then divide the result by height in inches. Divide that result by height in inches a second time. You can automatically calculate a BMI online at National Institutes of Health Body Mass Index.

BMI weight categories (National Institutes of Health, 2008):

Underweight: BMI < 18.5
Normal weight: BMI = 18.5-24.9
Overweight: BMI = 25-29.9
Obese: BMI > 30
Extreme Obesity: BMI > 40

Weight percentages is another method to calculate overweight or obesity. Weight falls in one of four categories depending on how much above normal an individual’s weight is for her/his height and age.

Overweight: 10%-20% above normal
Mild Obesity: 21%-40% above normal
Moderate Obesity: 41%-100% above normal
Severe Obesity" 100+% above normal

This kind of information does not measure overall health. Muscle mass is not accounted for and muscle weighs 20% more than fat. One person can be normal weight but have high blood pressure, cancer, heart disease, etc. Another person who is overweight can also be physically fit and healthy.

Body fat distribution matters as well. Where fat collects on the body affects the chances of developing health problems.

Pear-Shaped: Women typically have what is called a “pear” shape meaning that fat collects around the hips and buttocks.

Apple-Shaped: Men usually build up fat around their bellies, creating the shape of an “apple.”

This does not mean that either gender can’t have the opposite described shape; they can. If an individual carries fat mainly around the waist (meaning it’s surrounding the internal organs, especially the heart), they’re more likely to develop obesity-related problems (National Institutes of Health, 2004). An apple-shaped person and a pear-shaped person can weigh the same, yet the apple shape will be more at risk for heart disease, diabetes, or cancer. This is because “visceral fat” around the abdomen produces more inflammatory and clot-promoting compounds than “subcutaneous fat” distributed around the rest of the body (Underwood and Adler, 2004). Women with a waist measurement of more than 35 inches or men with 40 inches or more have a higher risk because of their fat distribution (National Institutes of Health, 2004). Hormone replacement therapy may prevent increase in abdominal fat in women just past menopause (Cartwright, 2000).

Nature vs. Nuture Controversy

People with weight problems have been considered weak-willed or failures for not controlling the amount of food they consume. However, the issue is more complicated than that. Biogenetic, sociocultural, familial, and intrapsychic factors all work together to create and exacerbate overweight and obesity.

As in most medical conditions, genetics and environment work in tandem. People are born with certain biological predispositions. The environment in which individuals grow up either enhances these traits or minimizes them. It is as if genetics are the ammunition in a gun and the environment either pulls the trigger or puts the gun down. Genetics and environment (societal and familial) lay the foundation for how people view and deal with food, the habits they form, their lifestyle choices, self-perceptions and mood, resiliency during stress, and— ultimately—what they’ll weigh.This is the reason why the only successful treatment for obesity are multidisciplinary.

The recovery process for someone struggling with an eating disorder encompasses four major components requiring a holistic approach to address:

• the physical self (physical body)
• the emotional self (emotional reactions and experiences)
• the mental self (beliefs and thought processes), and 
• the spiritual self (soul/spirit)

If you are interested in working toward a healthy eating lifestyle and improved weight management and health, I am the professional to call.