A Little Bit of Math Adds Up to a Lot of Fat

You may remember the media excitement that followed the federal government's announcement a few weeks ago that it planned to lower the threshold defining who's overweight and obese. Newspapers, television and talk radio ran with the story, spurred by the revelation that the National Institutes of Health now considers 55% of the population--97 million American adults!--to be overweight or worse.

As mad as a killer bee, my friend Robert called me the morning the story broke. At 5 feet, 7 inches and 170 pounds, he's muscular, athletic, healthy and fit. And yet, according to the new guidelines, he was too heavy for his own good. "That's ridiculous," he said, pointing out that if he were to gain another 20 pounds, he'd be classified as obese. "Obviously, these people are wrong."

"These people" are, in fact, researchers at the National Heart, Lung and Blood Institute (NHLBI) who took a fresh look at how excess body weight increases one's risk of developing maladies like hypertension, diabetes and heart disease, as well as of dying prematurely; the heavier the person, the higher the chances. But how heavy and how high? That's what they wanted to determine.

Their statistical results are built around a standard formula that links height to weight, yielding something called a "body mass index." To find your body mass index, multiply your weight in pounds by 703, then divide that number by the square of your height in inches. To get mine, here's what I did. I'm 5 feet, 8 inches and weigh about 140. I multiplied my weight by 703 and got 98,420. My height in inches is 68, which squared (the number times itself) yields 4,624. Dividing the second number into the first number gives me a body mass index of 21.2.

The new guidelines state that a body mass index of between 25 and 30 puts you in the overweight category; above 30, obese. Like Robert (whose body mass index was nearly 27), commentators and reporters pounced on the information, accusing the federal government of promoting a culture of anorexia. Story after story featured people with Robert's body type and musculature who had high body mass indexes, and concluded that these new findings were, as Robert had said, ridiculous. And thus were they dismissed with a collective wave of the hand as too extreme.

Now, I am the first to point out the need for moderation in all things, and I've frequently and publicly noted that people too often mistake thin for fit. But having talked to Karen Donato, coordinator of the NHLBI Obesity Educational Initiative, I have to say that these findings shouldn't be rejected so easily.

Karen told me that all this hysteria is unnecessary, the result of an unauthorized leak to the media of only partial results of the study, which was never intended for public consumption. All along the way, the authors had planned to share the study's findings with physicians only. Why? Because physicians understand that danger doesn't necessarily come from weight alone but from diseases and illnesses that are more prevalent in the overweight and obese. Armed with these new standards as a guideline, physicians were expected to assess a patient's other risk factors as they relate to his or her body mass index. Factors like waist size, which is closely associated with abdominal fat, blood pressure, total cholesterol levels and family history.

"The report," Karen says emphatically, "is not a call to diet, and we're not advocating any particular therapy for weight loss." She adds that she and her colleagues understand that certain people, like my friend Robert, will have a high body mass index because of extra muscle or water weight; the report, in other words, doesn't fit everyone perfectly. But when viewed as an overall yardstick of our society, the guidelines are well within reason and fit our aging demographic well.

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More importantly, I think, the new guidelines now bring the United States into conformity with other countries, and are consistent with those issued by the World Health Organization. As one who has traveled in many other countries, I'm alarmed to see how many overweight and obese people there really are in this country. That 55% figure doesn't surprise me one bit.

Up until now, fat has been seen as an individual matter. What these findings suggest is that, perhaps, we should begin thinking of excess weight as a national problem. With people working so long and hard, they rarely have enough time to go outside and play with the kids and run around and plant the garden, and do a thousand other things that are good for them and good for society. As a result, fast food takes the place of home cooking and the car substitutes for the dining room table.

Here's what I hope happens once the angry clamor fades and the NHLBI has a chance to explain its new findings in a rational atmosphere. First, I hope that many of those 97 million adults will conclude that they have to do something about their weight problem. But beyond that, I hope we're goaded into a national debate that examines our rat race priorities and challenges our rush to rush for rushing's sake.

If we can do that, then the study's results will be seen as a real turning point in the evolution of our public good, and the group will be deserving of our undying thanks. Even Robert will have to agree.

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Copyright 1998 by Kathy Smith

Kathy Smith's fitness column appears weekly in Health. Reader questions are welcome and can be sent to Kathy Smith, Health, Los Angeles Times, Times Mirror Square, Los Angeles, CA 90053. If your question is selected, you will receive a free copy of her book "Getting Better All the Time." Please include your name, address and a daytime phone number with your question.

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