This is the only right way to know your correct weight

It’s time to say goodbye to desirable standard weight/height charts and tables that tell you if you’re too fat or too skinny.  Is there an ideal weight for you personally and what will really help you reach a healthy weight?  Let me try and help you untangle this conundrum.

Recent media hype around the issue of weight has taken spins in different directions.  On the one hand western governments are enacting laws governing what is allowed and not allowed in relation to advertising photos of skinny models, claiming that it encourages eating disorders in women and teenaged girls, and on the other hand there are attacks on round-figured women who model underwear or even present cooking programmes on TV. 

Too skinny is not healthy, too fat is not healthy – so what is the range that is considered healthy and what is considered correct weight?  Apparently there’s more than one correct answer.

The bottom line – probably – is that as long as you are healthy and physically active, and as long as your blood test results are good and your diet satisfies your body’s needs and you’re happy with what you see in the mirror (and some might add that your partner seems happy whilst looking at you) it means your weight is correct.  However, before you start jumping up at down and wanting to shower me with kisses for the good news, there’s more that needs to be said about blood test results which I’ll get into below.

You may definitely regard all the recommendation and all the charts as widely comparative but not necessarily compelling.  For example, does any woman whose 1.65m expected to weigh 52-56kg?

Is this the range in which she looks best and ought to feel best about herself? What is she weighs 5kg more or less than this ‘ideal’?  Does that mean she can’t feel happy and healthy? Do all women at a certain height need to weigh the same?

Do the charts represent figures that you should aspire to? Does every man with a BMI of above 30 has a higher risk of heart disease?

Weight/Height Charts: It all started with an insurance company

The first standard weight/height chart was introduced in 1943 by the Metropolitan Life Insurance Company.  In 1983 came up with a revised edition called ‘Desirable’ weights, which would indicate those persons with the lowest mortality rates[1].   Both were a result of large scale study which was carried out by Metropolitan over a lengthy period of time.  Their intention was to increase the premiums paid by fat people because they figured out that these are at a higher risk of dying younger as a direct result of related conditions such as diabetes or heart disease.

After several years of collecting and analysing information regarding hundreds or thousands of insured persons, there was sufficient data which was compiled in the standard weight/height charts.  If the chart indicated that your weight/height ratio is ‘ideal’, you would be charged the lowest premium.  Above that, the premium price would increase in direct correlation to the level of your weight excess.

After many years of using this chart for insurance purposes it was also ‘adopted’ by medical professionals.  After all, the weight that is attributed to highest longevity must also be the healthiest. Makes sense, no?

However, these charts had many down sides.  For instance, if you have a large muscle mass or a large skeletal frame you would not be considered as having ‘ideal’ weight despite the fact that you could be entirely healthy. Therefore, with time other charts started emerging which took into account people’s skeletal frame size, or their age. This is because some studies demonstrated that as the age advances body fat has an important function in preventing disease.  And there were other charts based on other researches and studies.

Furthermore, when you compared weights for corresponding heights on different tables you would get different results. Which means that essentially if you weren’t happy with one chart you could look for another who showed more ‘friendly’ results for your height.

And now an example:  About a year ago a 55 years old gentleman came to see me in relation to losing weight. When I first weighed him the scale showed 145kg.  He is 1.72m tall.  He was considering having a gastric bypass surgery but after receiving a recommendation had decided to consult me as last resource.  With sheer determination he managed to drop 55kg which meant that his weight is now 90kg.  According to the chart above he is considered obese and is ideal weight should be between 65-80kg.  Should he believe the charts?  He now looks great, he maintains a healthy diet, goes to the gym 3 times a week and feels overall great.  His blood test results are good and he feels happy with his new weight.  His wife is over the moon.  So should he aspire to reach the numbers on the charts or the way he feels is a better yardstick?

Body Mass Index (BMI) is a formula scientists came up with when they were searching for a quick and easy method to predict heart disease.  In order to calculate BMI you don’t need any clever weighing gadgets. All you need is pen and paper (and if you’re anything like me, a simple calculator). According to this formula, our BMI is our weight (in KG) divided by our height (meters) square.

 

 

 

 

 

For example: A man weighing 1.75m and weighs 70kg will have a BMI of 22.8

 

[1] Harrison GG, Height-weight tables. Ann Intern Med 1985; 103:489-94.

How does that apply?

Range of 19-25: healthy range with a low likelihood of heart disease

Range of 25-30: excess weight with an increased likelihood of heart disease.

Range above 30: Obese.

Is a person who is considered by the BMI formula to be obese at a definite health risk?  Absolutely not!

First of all, someone who is very fit and has a large muscle mass will considered by BMI to be at risk when in fact the reason for his increased weight is his muscle mass. Secondly, if you’re physically fit and have a high muscle mass and good blood test results you’re not at risk of heart disease just because the BMI formula says so.

Recent studies demonstrated that slim people have similar longevity to fat people and therefore BMI charts do not accurately reflect the connection between excess weight and health.  In addition, many studies showed that there is a great risk associated with losing a lot of weight only to regain it afterwards.  This is because every loss of fat is accompanied with loss of muscle.  Our heart is a muscle and regaining weight increases the chances of heart disease.

It’s time to say Bye Bye BMI

As you would expect other methods which determine ideal weight have come into existence. Here are the main ones:

Edmonton Obesity Staging System (EOSS)

According to this system some people can be considered entirely healthy even though they were deemed by the BMI formula as obese.  This system presents the following stages:

Stage 0: no sign or obesity-related risk factors. No physical symptoms. No psychological symptoms. No functional limitations. That means that people at this stage have good blood test results, good blood pressure and no other risk factors. If you’re at this stage, even if your weight is very high, you don’t need to lose weight.

Stage 1: Patient has obesity-related subclinical risk factors – or- Mild physical symptoms – patient currently not requiring medical treatment or comorbidities – or- Mild obesity-related psychology and/or mild impairment of well-being.  That means that your blood tests are borderline, and/or your blood sugar is ‘iffy’ you may have slight hypertension and/or low level of fitness.  If you’re at this stage, you still don’t need to lose weight but it is recommended you modify your lifestyle, nutrition and physical activity.

Stage 2: Patient has established obesity-related comorbidities requiring medical intervention – or – moderate obesity-related psychological symptoms – or – moderate functional limitations in daily activities. People at this stage are fat and suffer from hypertension, diabetes, sleep apnoea and have limited mobility.  If you’re at this stage you require loss of weight and close medical supervision.

Stage 3: Patient has significant obesity-related end-organ damage – or – significant obesity-related psychological symptoms – or – significant functional limitations – or – significant impairment of well-being.

Stage 4: Severe (potential end stage) from obesity-related chronic disease – or – sever disabling psychological symptoms – or – sever functional limitations.

Stages 3 and 4 include patients who suffer from complications relating to obesity, diabetes, severe arthritis, depression, and severe limitations in mobility.  If you’re at this stage you need urgent medical intervention.

Waist Hip Ratio

Through the process of searching for efficient methods to predict disease it was found that the waist circumference is closely related to the development of diabetes.  According to statistics, waist circumference greater than 88cm in women and 102cm in men is an accurate indicator for a higher risk factor concerning cardiovascular disease.  It addition, it was established that there is an important correlation between waist and hip circumference.  In women the ideal ration if 0.7 and for men 0.9.  This ration is not dependent on overall body weight.

Body fat measurement using clippers

This is the traditional and reliable method of measuring body fat. I recommend using

an experienced professional to perform the measurements.  You can read more about it in

this guide .

Body fat measurement using Bioelectrical Impedance analysis

Might sound complicated and expensive but in fact you can get these from €30 upwards. They are usually integrated in a weighing scale or a hand held device and as long as you follow the instructions it will give you a fairly accurate reading with a deviation of no more than 10%.

 

 

 

 

 

 

 

 

 

You will need to enter some personal details such as age, gender, height, weight etc.  Please remember that electrical conductivity is influenced by amount of water in the body and therefore it’s important not to drink a lot prior to measurement. 

Recommended body fat percentage for men 10-20%. This will slightly increase with age. For women the recommended percentage is 20-30% and for women over 50 years of age 35% is normal.  Woman with less than 17% body fat are likely to experience hormonal problems leading to problems or cessation of monthly cycle.

Surface-based body shape index (SBSI)

This is the new kid on the block.  You can read more about it here.  It’s a bit scientific but well worth reading.

 

How often should you weigh yourself?

Weighing yourself daily is a common mistake that you should avoid. Not only that it’s impossible to observe a daily change.  In addition, it can lead to undesirable behaviour.  This is because regardless of whether we think we gained or lost weight, it can lead us to a greater food consumption.  Someone who thinks they lost weight may see it as an opportunity to compensate themselves by eating something ‘tasty’ and this way increase the daily caloric consumption.  Alternatively, if they think they gained weight or haven’t lost enough it can lead to frustration followed by ‘compensatory’ eating. 

It is enough to weigh yourself once a week or once fortnightly, even if you’re on a ‘diet’.  Our body is not only made from fat. 70% of our body composition is liquid.  Liquid can accumulate for various reasons. For example: monthly cycle, high consumption of sodium (salt) or even change in ambient temperature. Since liquid is heavier than fat, we will observe an increase in weight. But this ‘extra’ weight is likely to dissipate during the day.

Another reason why we may seem to be gaining weight has to do with the time we have our supper.  If we eat it after 9pm (even if it’s only salad) it means the digestion process will take place whist we sleep.  Digestion is slower whilst we sleeps and chances are that our supper will not be entirely digested by the time we wake up in the morning.  This will appear as extra weight until such time as this food is naturally eliminated later on in the day.

Most domestic weighing scales are inaccurate

Another reason for weighing yourself weekly or fortnightly is that even the modern digital units can have inaccuracies up to 100g.  100g is the recommended daily loss but you’re unlikely to be able to see it accurately.  In a week that would add up to 700g and in a month 3kg.  These are amounts that are more substantial and would let us see the ‘bigger’ picture. 

To Summarise

Despite the fact that there are several methods to determine if our weight is healthy or not, good blood test results, good physical fitness and a balanced nutrition are better indicators than any of these methods.  So even if you weigh more than the recommended number on this chart of another, or your BMI seems to be greater than ‘desired’ it does not mean you need to lose weight.

I do, however, feel that some elaboration is necessary in relation to blood tests.  The traditional approach is to do a ‘fasting’ blood test.  A fasting test gives you a 'bottom line'. This is the lowest you can expect the sugar and cholesterol figures to be.  If you have just eaten then the levels of sugar and cholesterol are determined by what you have just eaten – not by your body's ability to handle these substances.  If a non-fasting level is high, it might not mean anything at all is wrong. If a fasting level is high, then something is definitely wrong.  Like I said, this is the traditional approach which give us an accurate picture of that point in time.  However, it doesn’t give us an accurate picture of the ‘normal’.  The time when we are were not fasting. 

You should remember that ‘normal’ blood test results means a ‘statistical’ normal and not necessarily a healthy state. You should also remember that for the majority of doctors what is considered as ‘not normal’ is the stage when medication or treatment is necessary.  I’m sure you don’t want to arrive at this stage.  Therefore before you decide that your blood test results are healthy (rather than ‘not sick’) you should ensure that you had the latest tests and that the most up-to-date benchmarks are used. 

To that end I recommend you read this article.