Weight Management

Topic Overview

What is a healthy weight?

A healthy weight is a weight that lowers your risk for health problems. For most people, body mass index (BMI) and waist size are good ways to tell if they are at a healthy weight.

But reaching a healthy weight isn't just about reaching a certain number on the scale or a certain BMI. Having healthy eating and exercise habits is very important.

If you want to get to a healthy weight and stay there, healthy lifestyle changes will work better than dieting. Reaching a certain number on the scale is not as important as having a healthy lifestyle.

Why pay attention to your weight?

Staying at a healthy weight is one of the best things you can do for your health. It can help prevent serious health problems, including:

• Heart disease.
• Stroke.
• High blood pressure.
• Type 2 diabetes.
• Sleep apnea.

But weight is only one part of your health. Even if you carry some extra weight, eating healthy foods and being more active can help you feel better, have more energy, and lower your risk for disease.

Why isn't dieting a good idea?

In today's society, there is a lot of pressure to be thin. But being thin has very little to do with good health. Many of us long to be thin, even though we're already at a healthy weight. So we get desperate, and we turn to diets for help.

• Diets don't work.
  • Diets are temporary. When you diet, you're usually not eating the way you will need to eat over the long term. So when you quit dieting, the extra weight comes back.
  • Dieting usually means not letting yourself have many of the foods you love to eat. So when you quit dieting, you return to eating those foods as much as you used to-or more. And the extra weight comes back.
  • Dieting often means eating so little food that you're hungry all the time and don't have enough energy. So when you quit dieting, you return to eating as much as you did before-or more. And the extra weight comes back.
  • Most diet programs don't include an increase in activity, which is vital to staying at a healthy weight. So when you quit dieting, the weight comes back.

• Dieting can actually be bad for you.
  • After they quit dieting, most people regain the weight they lost-and many gain even more.
  • Many diets do not include the right balance of foods to keep you healthy.
  • Dieting leads to eating disorders in some people.
  • Some people feel so defeated after repeatedly failing to lose weight and keep it off that they give up altogether on healthy eating and being active.

Since dieting doesn't work, what can you do?

If you decide that you do need to make some changes, here are the three steps to reaching a healthy weight:

1. Improve your eating habits. Do it slowly. You may be tempted to do a diet overhaul and change everything about the way you eat. But you will be more successful at staying with the changes you make if you pick just one eating habit at a time to work on.
   • To find out how to improve your eating habits, see Healthy Eating.
2. Get moving. Try to make physical activity a regular part of your day, just like brushing your teeth.
   • To learn how to be more active, see Healthy Activity.
3. Change your thinking. Our thoughts have a lot to do with how we feel and what we do. If you can stop your brain from telling you discouraging things and have it start encouraging you instead, you may be surprised at how much healthier you'll be-in mind and body.
   • To find out how to change your thinking, see Getting to a Healthy Weight: Lifestyle Changes.

One Woman's Story: "The biggest key to my success is knowing that this is a process. It's not 'all or nothing at all.' It's a matter of making choices every day. One day I might decide to eat more than another day, and that's okay, as long as I'm paying attention. I finally realized it wasn't a time-limited thing. It became much more of a lifestyle change than a temporary diet. The idea that somehow I could go back to my old ways was just not there anymore."- Maggie Read more about how Maggie changed her life and lost 50 pounds.

Are You at a Healthy Weight?

Your first step to find out if you are at a healthy weight is to find out what your BMI, or body mass index, is and what your waist size is. For most people, these are good clues to whether they are at a healthy weight.

What's your BMI?

A healthy weight is one that is right for your body type and height and is based on your body mass index (BMI) and the size of your waist (waist circumference). If you are age 20 or older, use the Interactive Tool: Is Your BMI Increasing Your Health Risks?to check your BMI when you know your height in feet, weight in pounds, and waist circumference.

• If your BMI is less than 18.5, you are in the underweight category. Talk to your doctor to find out if your weight is a symptom of a medical problem. A registered dietitian can help you learn about healthy eating.
• If your BMI is between 18.5 and 24.9, you are in the recommended weight range for your height. But your health may still be at risk if you are not getting regular physical activity and practicing healthy eating.
• If your BMI is 25 to 29.9, you are in the overweight category. This may or may not be unhealthy, depending on some other things, like your waist size and other health problems you may have.
• If your BMI is 30 or higher, you're in the obese category. You may need to lose weight and change your eating and activity habits to get healthy and stay healthy. See the topic Obesity.

If you are Asian, your recommended weight range may be lower. Talk to your doctor.

It's important to remember that your BMI is only one measure of your health. A person who is not at a "normal" weight according to BMI charts may be healthy if he or she has healthy eating habits and exercises regularly. People who are thin but don't exercise or eat nutritious foods aren't necessarily healthy just because they are thin.

What's your waist size?

After you know your BMI, it's time to look at your waist size.

Measuring your waist can help you find out how much fat you have stored around your belly. People who are "apple-shaped" and store fat around their belly are more likely to develop weight-related diseases than people who are "pear-shaped" and store most of their fat around their hips. Diseases that are related to weight include type 2 diabetes, heart disease, and high blood pressure.

Measure your waist size with a tape measure. The tape should fit snugly but not press into your skin.

For most people, the goal for a healthy waist is:^{footnote 1}

• Less than40 in. (102 cm) for men.
• Less than35 in. (88 cm) for women.

If you are Asian, the goal for a healthy waist is:

• Less than36 in. (91 cm) for men.
• Less than32 in. (81 cm) for women.

Your doctor may want to take another measurement, called a waist-to-hip ratio. This measurement is a comparison of your waist size to your hip size. A higher waist-to-hip ratio means that you are more "apple-shaped" than "pear-shaped" and therefore at a higher risk for weight-related disease.

Body fat testing is sometimes used to help find out if a person has a healthy percentage of body fat.

Do you have other health problems?

If you are in the overweight or obese category and your waist size is too high, it's important to talk to your doctor about weight-related health problems you may have, including:

• High cholesterol.
• Heart disease.
• High blood pressure.
• Sleep apnea.
• Type 2 diabetes.
• Metabolic syndrome.
• Osteoarthritis.
• Some forms of cancer, such as colon, breast, and prostate cancers.

If you have two or more of these health problems, your doctor may advise you to make some lifestyle changes and/or lose weight. He or she may also refer you to a dietitian, an expert in healthy eating.

• Interactive Tool: Is Your Weight Affecting Your Health Risks?

Are you unhappy with your weight?

If you're at a healthy weight but are still unhappy with your weight, you're not alone. Lots of people are.

It can be hard to be satisfied with how you look when TV and magazines show unrealistic images of what it means to be thin. Here are some things to think about:

• There is no "ideal" body shape or body size. We let society tell us what "ideal" means. But the way a skinny model looks in a magazine or TV ad is not normal or "ideal."
• Do you feel good and have plenty of energy? Can you do the activities you want to do? That's what healthy living is all about, no matter what your weight is.
• Trying to lose weight when you don't have to can actually be bad for you. Most people who diet end up gaining back the pounds they lost-and more.

What Affects Your Weight?

Genetic makeup-what you inherit-plays the biggest role

When we say "genetic makeup," we're talking about everything you inherited from your ancestors, from the color of your eyes or the shape of your toes to the way your brain works and the way your body stores fat.

Your genetic makeup has a very big effect on your weight. It affects:

• Your basal metabolic rate . That's the rate at which your body uses energy (calories) at rest. Some people are born with higher basic metabolic rates than others. These people naturally burn more calories than the rest of us.
  • Regular physical activity can raise your metabolic rate.
  • Very low-calorie diets will lower your metabolic rate. A lower metabolic rate makes it easier to gain weight, because you don't burn calories as fast.

• Your body signals , such as your appetite and feeling hungry or full.

• Your fat distribution.
  • Some people have slim legs, some have heavy legs. You can't change where your body stores fat.
  • Typically, men store fat in the abdomen while women store more in the hips and thighs. As women age, more fat is stored in the abdomen.

Nutrition-what and how you eat-also affects your weight

The average American meal contains too many calories. It also contains too much saturated fat, animal protein, salt, alcohol, and sugar.

It can be hard to make healthy food choices:

• Emotions and easy access to fast foods and snacks are among the many things that influence our food choices today.
• Lack of time leads many people to eat on an irregular schedule or skip meals. People who do that have more trouble staying at a healthy weight than people who eat regular meals.
• Sometimes a food that seems like a healthier choice may not be. A low-fat cookie may have less fat, but usually it is high in sugar and has the same number of calories as a regular cookie.

Physical activity-how much you move-is the third factor that affects your weight

Being physically active is an important part of staying at a healthy weight.

• Regular activity helps you stay fit. When you're fit, you feel better and have more energy for work and for your family. When you're fit, you burn more calories, even when you're resting.
• Even if you are overweight or obese, you will benefit from being more physically fit. Improving your fitness is good for your heart, lungs, bones, and joints. And it lowers your risk for heart attack, diabetes, high blood pressure, and some cancers. If you already have one or more of these problems, getting more fit may help you control other health problems and make you feel better.
• Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before you start an exercise program.

Getting to a Healthy Weight: Lifestyle Changes

What is a healthy lifestyle?

A healthy lifestyle means:

• Eating healthy foods. This includes fruits, vegetables, and whole grains. If you eat meat and dairy foods, choose lean meats and low-fat dairy foods most of the time. Healthy eating also means not eating too much sugar, fat, or fast foods. You can still have dessert and treats now and then. The goal is moderation. See Healthy Eating.
• Making some kind of physical activity part of your daily routine. "Physical activity" doesn't have to mean regular visits to the gym or running marathons. There are lots of other ways to fit activity into your life. See Healthy Activity.
• Not smoking. Weight gain is a big concern for many people who want to quit smoking. But many people don't gain weight. And it's more of a health risk to keep smoking than it is to gain a few extra pounds when you quit. For information, see the topic Quitting Smoking.
• Drinking only moderate amounts of alcohol. That's up to 2 drinks a day for men, 1 drink a day for women.
• Managing stress. Many people find that eating is their way of managing stress. If you have a lot of stress in your life, it can be hard to focus on making healthy changes to your lifestyle. For more information about how to deal with stress, see the topic Stress Management.

Becoming more active and improving your eating habits are the two main ways to reach a healthy weight.

One Woman's Story: "I see it as a whole life change. I actually get mad at people when they say, 'You've been on a diet.' I'm not on a diet. I've never been on a diet. I just changed the way I eat. I changed the way I live."- Jaci Read more about how Jaci lost 65 pounds.

First, change your thinking

If you need to make some lifestyle changes to get to a healthy weight, you'll have more success if you first change the way you think about certain things:

• Don't compare yourself to others. Healthy bodies come in all shapes and sizes. Our culture focuses much too much on thinness, and thinness is just not realistic or natural for most of us. Yet we feel bad when we can't achieve such an unrealistic body size. Body size isn't as important as being healthy.
• Pay attention to how hungry or how full you feel. When you eat, pay attention to why you're eating and how much you're eating.
• Forget about dieting. Dieting almost never works over the long term.
• Decide that you're going to improve your health instead of deciding to go on a diet. For example, you may want to:
  • Become more fit.
  • Lower your blood pressure.
  • Lower your blood sugar (if you have diabetes or prediabetes).
  • Lower your cholesterol.

One Woman's Story: "I finally realized it wasn't a time-limited thing. It wasn't like, 'Well, I'm going to be really good and stay on this food plan now until I get the weight off.' It was more a realization that, 'You know, at 62, if I want to weigh 130 to 135 pounds, then I have to do these things.' I can't stop doing them just because I lose the weight. So it became much more of a lifestyle change than a temporary diet. The idea that somehow I could go back to my old ways was just not there anymore."- Maggie Read more about how Maggie changed her life and lost 50 pounds.

How do you change your lifestyle?

Making any kind of change in the way you live your daily life is like being on a path. The path leads to success. Here are the first steps on that path:

1. Have your own reasons for making a change

2. Set goals you can reach

3. Measure how your health has improved

Before you make lifestyle changes, ask your doctor to check your cholesterol levels, blood pressure, and blood sugar. Your doctor can help you know your risk for heart attack and stroke.

Keep track of your weight.

• Weigh yourself no more than once a week, unless your doctor tells to you to do so more often because of a health problem.
• Try to weigh yourself on the same scale, at the same time of day, in about the same amount of clothing.
• Remember that many things can affect your weight. It's normal for your weight to go up and down by a few pounds from one day to the next. Try to look at the general trend of your weight, rather than the day-to-day changes.
• Aim to lose no more than 1 to 2 pounds a week. Weight loss of more than that often means that you are not getting enough nutrients to be healthy. And some of the weight you lose may be from lean body tissue (muscle and organ tissue) or water loss, not fat.

Have your cholesterol, blood pressure, and blood sugar checked again after you have lost 5% to 10% of your weight or in 3 to 6 months. You can also check your blood pressure and blood sugar at home.

• Blood sugar levels can tell you whether your lifestyle changes or weight loss are helping to control your diabetes.
• Cholesterol and triglyceride levels can tell you whether your lifestyle changes or weight loss are lowering your risk for heart attack and stroke..
• Blood pressure can tell you whether your lifestyle changes or weight loss are lowering your risk for heart attack and stroke.

Another way to measure improvements is to look for changes in your fitness level. For example, are you able to walk longer and on more days than when you started? Can you climb a flight of stairs without getting as tired or out of breath? Do you have better strength and muscle tone? Do you have more energy?

4. Prepare for slip-ups

Here's one person's list of barriers to taking a brisk 30-minute walk every day, along with some possible solutions.

5. Get support

You can use a personal action plan (What is a PDF document?) to write down your goals and organize your support system.

Healthy Eating

Eating a healthy, balanced variety of foods is far more satisfying than following a strict weight-loss diet that leaves you feeling deprived and hungry. And healthy eating paired with increased activity is more likely to get you to a healthy weight-and keep you there-than dieting is.

Dieting is not healthy eating

Dieting may make you feel like a failure if you can't lose weight or stay on your diet. Instead of blaming the diets, people who are overweight tend to blame themselves. You may think, "If I could just stay on that diet, I would be thin." This doesn't take into account that your body has powerful regulators that affect your weight-things you can't do anything about. And if you've dieted again and again without success, you can get into a cycle of negative thinking-and even gain more weight.

When you go on a diet, you deprive yourself of food. For many people, that means being hungry most of the time and not having enough energy. It also can lead you to think about food all the time. So you're much more likely to overeat when you finally give yourself permission to eat. It's important to make healthy eating changes that you can keep doing, instead of dieting.

Many different diets and programs promise rapid weight loss but rarely work for the long term. Some might even be dangerous.

But what does healthy eating mean? Everywhere we turn, we get conflicting advice on what foods are good for our health. It can be hard to know where to start after you've decided to make a change.

• First, start paying attention to your body signals and to your hunger triggers.
• Then get smart about eating healthy foods and controlling your portions.

First, learn to pay attention

Know your body signals

Young children are good at paying attention to their body signals. They eat when they're hungry. They stop when they're full.

But as we grow older, and fast food, huge portions, and delicious snacks are everywhere, many of us start to ignore our body signals. We eat for other reasons-or sometimes without thinking at all.

You can ignore those body signals for a while, but they are powerful. And if you ignore them for a long time (by dieting, for example) you lose your ability to pay attention to them. You get out of practice.

• Healthy Eating: Recognizing Your Hunger Signals

Know your eating triggers

Common triggers to eating when you're not really hungry are:

• Feeling stressed, bored, lonely, or even happy, which can lead to emotional eating.
• Smells, sights, or social situations.
• The foods around you.
  • Healthy Eating: Changing Your Eating Habits

Identify your eating triggers by keeping an eating journal for a week or two. Write down everything you eat, plus the time of day and what you were feeling right before you ate.

Choose sensibly

After you understand why and how you eat, it's time to look at what and how much you eat.

Many people classify foods as "good" or "bad" based on their calorie or fat content and, sometimes, on how nutritious they are. But a healthy diet has room for all kinds of foods.

A healthy, balanced diet means getting the right amounts of:

• Fat. Choose unsaturated fats like olive and canola oil, nuts, and fish.
• Carbohydrate. Choose carbohydrate that comes from whole grains, fruits, vegetables, legumes, and low-fat dairy products.
• Protein. Choose lean protein as often as you can, such as all types of fish, poultry without skin, low-fat dairy products, and legumes (peas, beans, and lentils).
• Fiber. Fiber comes from plant foods, like whole grains, fruits, vegetables, legumes, and nuts.
• Vitamins.
• Minerals.

Keep a food diary (What is a PDF document?), writing down everything you eat for a week or two. It will help you see which foods you need to eat more of and which foods you're eating too much of.

Tips for choosing your food sensibly

• Limit high-fat, sugary, and high-calorie foods. They taste so good that it's easy to eat too much.
  • Healthy Eating: Cutting Unhealthy Fats From Your Meals
• Eat plenty of fruits and vegetables.
  • Quick Tips: Adding Fruits and Vegetables to Your Diet
• Plan your meals (What is a PDF document?) ahead of time. You're less likely to grab something convenient-and high in fat, sugar, or salt-if you already know what to make for dinner tonight.
  • Healthy Eating: Making Healthy Choices When You Shop

Control your portions

Just cutting back on the size of your portions can be a great way to get to or stay at a healthy weight-without giving up any of your favorite foods.

• Healthy Eating: Making Healthy Choices When You Eat Out

One Woman's Story: "Before I gained the weight, I wish someone said, 'portion sizes.' If you're not thinking about it, you go to a restaurant, you think you're getting a portion size. You're not thinking they're serving you six plates of food." -Jaci Read more about how Jaci lost 65 pounds.

Healthy Activity

Regular activity makes you healthier

Physical activity is key to improving your health and preventing serious illness. Experts say to do either of these things to get and stay healthy:

• Moderate activity for at least 2½ hours a week. Moderate activity means things like brisk walking, brisk cycling, or shooting baskets. But any activities-including daily chores-that raise your heart rate can be included. You notice your heart beating faster with this kind of activity.
• Vigorous activity for at least 1¼ hours a week. Vigorous activity means things like jogging, cycling fast, or cross-country skiing. You breathe rapidly and your heart beats much faster with this kind of activity.

Physical activity for weight loss means burning more calories. Experts say more than 5 hours a week (aim for 60 to 90 minutes a day) of moderate activity can help.

Being active in several blocks of 10-minutes or more throughout the day can count toward these recommendations. You can choose to do one or both types of activity.

If you're not active right now, you don't have to start out at this level. Instead, start small and build up over time. Moderate activity is safe for most people. But it's always a good idea to talk to your doctor before you start an exercise program.

Regular moderate-intensity physical activity lowers your risk of:

• Heart disease.
• High blood pressure.
• Stroke.
• Type 2 diabetes.
• Obesity.
• Breast cancer, colon cancer, and cancers of the female reproductive system.
• Anxiety.
• Depression.

Work activity into your daily life

Brushing your teeth and getting dressed are regular parts of your day, right? You hardly think about it.

It can be that way with physical activity too. With practice and repetition, you can make activity-whether it's formal exercise or an activity like gardening or walking the dog-so routine that it becomes something you just do because it's part of your day and you enjoy it.

Like any lifestyle change, changing your activity level may be easier if you have a plan. Set small goals. Be creative. For more information, see Getting to a Healthy Weight: Making Lifestyle Changes.

Don't wait until you are "thin" to do the activities you want to do. Just make sure to start slowly. If you aren't active at all, talk to your doctor first.

No matter what you do, the key is making physical activity a regular, fun part of your life. And as soon as you start seeing the results, you'll be even more motivated to keep doing it.

What's the right amount?

It's best to get some moderate physical activity for at least 2½ hours a week. Brisk walking is one kind of moderate activity.

But if you're not active at all, work up to it. For example, you may want to start by walking around the block every morning, or walking for just 10 minutes. Over time, you can make your walks longer or walk more often throughout your day and week.

Here's how you can tell if an activity or exercise is making you work hard enough:

• If you can't talk while you do it, you're working too hard.
• You're at the right level if you can talk but not sing during the activity.

Walking is one of the easiest and cheapest ways to get moving for most people. Keep track of the number of steps you take each day with a phone app or pedometer. Using it may motivate you to walk more in order to increase your total steps.

Identify your barriers

There are lots of reasons why you may have trouble getting more active. These are called barriers.

These barriers can range from "I don't have time" to "I'm too embarrassed."

Figuring out your barriers and how you will respond to them is a big step in planning the lifestyle changes that will lead you to a healthy weight and help you stay there.