As Obesity Standard Drops, Dieters’ Spirits May Follow

Obesity experts predicted Thursday that new government guidelines on weight--millions of Americans had awakened to the grim news that they had been transformed overnight from fit to fat--could backfire.

Although no one is quibbling with the new numbers on what constitutes an overweight person--saying that the standards are finally in line with that of numerous other countries--many experts fear that the effect on the American public psyche may prove counterproductive, leading people to abandon their efforts altogether rather than trying to lose even a little weight. And even minimal weight loss can produce health benefits, they said.

“These new standards are probably better than the old ones, but their impact might be quite troublesome,” said Dr. Albert Stunkard of the University of Pennsylvania, one of the nation’s leading obesity researchers. “People may think, ‘Oh my God, they’re raising the bar again,’ and just give up. It is definitely a disincentive. It’s going to make a lot of people feel worse.”

Health professionals, including former Surgeon General C. Everett Koop, have been making known their concerns about the effect of the new standards, which will add an estimated 37 million Americans to the overweight category.

Koop, who has started his own organization, Shape Up America!, said through a spokeswoman that he fears people will react to the new standards by throwing up their hands in frustration and deciding to quit trying to lose excess pounds.

“What they did overnight was to declare 30 million people overweight,” Koop said. “They didn’t know it yesterday--and what do they do with this news today? They can be concerned about themselves and turn to fad diets and quick fixes. They can ask their doctor for pharmaceuticals [diet drugs], which is the wrong thing to do--or they can grin and bear it.”

Others agreed.

“People are struggling as it is now, so I find this very depressing,” said Sara Blumenthal, a nutritionist here. “I’m afraid they will now just say: ‘The hell with it.’ ”

The National Heart, Lung and Blood Institute, part of the National Institutes of Health, has said earlier standards for safe weight no longer apply and revised downward what its scientists believe is healthy.

This makes about 97 million American adults--55% of the population--overweight. And the numbers have consequences. Obesity can cause heart disease, diabetes, hypertension and even certain cancers.

The numbers are calculated using a formula known as the body mass index, or BMI, which measures weight in relation to height. The latest standards now say that anyone with a BMI of 25 or greater (for example, someone 5 feet, 4 inches and 145 pounds or 5 feet, 10 inches and 174 pounds) is overweight and anyone with a BMI higher than 30 (5 feet, 6 inches and 186 pounds or 6 feet and 221 pounds) is obese.

The government is also urging physicians to consider waist measurement in evaluating their patients, saying that a waist circumference of more than 40 inches in men and more than 35 inches in women signifies an increased health risk in those with a BMI of 25 to 34.9.

In the past, federal guidelines have used higher thresholds to determine overweight. Formerly, it was 27.3 for women and 27.8 for men. A BMI of 27 is 182 pounds for a 5-foot-9 person.

Dr. F. Xavier Pi-Sunyer, who chaired the NIH panel of scientists who wrote the new guidelines, insisted that they were not designed to discourage anyone. In fact, they seek to better clarify who should lose weight and who should avoid gaining additional weight, an important distinction, he stressed.

“We’re not saying that everyone has to lose weight,” said Pi-Sunyer, who directs the obesity research center of St. Luke’s/Roosevelt Hospital Center in New York. Rather, he said, the intent is to educate physicians to be alert to recognizing overweight in their patients.

“We are the most overweight country in the world, and we are getting more overweight all the time,” he said. “It takes a big health toll. We aren’t trying to hit people over the heads with this. But we have to tell the risk as it is--and the risk is there.”

Linda Webb Carilli, a dietitian and corporate affairs manager for Weight Watchers International, also defended the new guidelines, saying they are in line with her organization’s standards. “A BMI of 25 is, in fact, a generous weight,” she said.

But she agreed that some Americans could drop their weight-loss efforts if they think they can never meet their ultimate goal.

“If you are overweight and lose just 5% to 10% of what you need to lose, you still will start to see health benefits, even before you reach your healthy weight range,” she said. “People need to get to a health-ier weight, and then applaud themselves for making a health difference, even if it falls short of their goal.”

And Dr. Arthur Frank, medical director of the George Washington University Obesity Management Program here, faulted the guidelines for failing to provide practical advice on how to reach a desired weight.

“People are going to feel very exasperated,” he said. “The guidelines call attention to the problem, which is valuable, but don’t resolve it. They don’t offer people any help. People want to deal with it, but often they really don’t know how.”

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Who Are You Calling Fat?

The National Institutes of Health uses a measurement called body mass index to determine whether someone is overweight. To determine body mass index, multiply weight in pounds by 703. Then divide that result by height in inches squared. Here are some examples:

* A person, male or female, who is 5 feet 1 and weighs 132 pounds would have a body mass index of 25 and be considered overweight. At 158 pounds, the person would have a BMI of 30 and be considered obese.

* A person 5 feet 4, 145 pounds would have a BMI of 25. At 174 pounds, the BMI would be 30.

* A person 5 feet 7, 159 pounds would have a BMI of 25. At 191 pounds, the BMI would be 30.

* A person 5 feet 10, 174 pounds would have a BMI of 25. At 209 pounds, the BMI would be 30.

* A person 6 feet 1, 189 pounds would have a BMI of 25. At 227 pounds, the BMI would be 30.

Source: Associated Press