Obesity: Bad News, Good News
When it comes to the subject of Americans and weight, most of the news is dismal. But not all.
First, the bad news. More than half of adults are overweight or obese. That’s about 97 million Americans who are at increased risk for a whole host of diseases, any one of which can seriously impair quality of life or lead to an early death: Type 2 diabetes, high blood pressure, coronary heart disease, cholesterol and other lipid abnormalities, stroke, blood clots, sleep apnea, gallbladder disease, polycystic ovary disease, pregnancy-related problems, arthritis and other joint-related problems and some cancers.
In fact, being overweight or obese leads to the death of about 300,000 Americans a year, according to the Centers for Disease Control and Prevention. (Being overweight is defined as having a body mass index, or BMI, of 25 or higher; obesity is defined as a BMI of 30 or higher. BMI is kilograms divided by meters squared. To estimate your BMI, multiply your weight in pounds by 703, then divide by your height in inches squared.) What’s more troubling is the number of children and teens who also are overweight or obese and are facing many of the same life-threatening conditions at much younger ages.
Dr. William Dietz, director of the division of nutrition and physical activity at the CDC, said about 14% of teenagers and 13% of children ages 6 to 11 are overweight and obese. Type 2 diabetes, once a rare condition in the young, is becoming much more common, Dietz said at a recent American Medical Assn. briefing on obesity in Manhattan. And a study of overweight children ages 5 to 10 found that more than half have at least one risk factor for cardiovascular disease, such as high blood pressure, and 20% have two or more risk factors.
Now the good, or at least not so dismal, news. Everyone knows that the answer is to lose weight. Many of these conditions, such as diabetes or high blood pressure, improve or even disappear with as little as 10% sustained weight loss, experts say. And most people can lose weight: Witness the number of diet programs that advertise their success.
The problem for most Americans, experts say, is keeping it off. The statistic usually cited is that 95% of people regain their lost weight within one year.
Dr. James Hill, director of the center for human nutrition at the University of Colorado in Denver, said a better way to define success is to look at whether people have maintained for a year or more a loss of 10% or more of their weight. Hill, who also spoke at the AMA conference, said that according to a telephone survey, about 20% say they have managed to keep off 10% or more--not a huge percentage of people but a less depressing figure than the 95% said to regain their weight.
Hill is one of two researchers who started the National Weight Control Registry in 1993. People who have lost at least 30 pounds and have maintained the loss for at least one year can join the registry. So far the registry has more than 3,000 people, most of them white and about 80% of them women.
The idea, Hill said, was to figure out what made these people successful losers. This is what they have learned so far: The average weight loss was 66 pounds, and most people have kept it off 51/2 years or more. About half lost the weight on their own, and the other half used a formal weight-loss program. One group was no more successful than the other, Hill said. No one diet appeared more successful in terms of weight loss. To maintain the loss, most people report eating a low-fat, high-carbohydrate diet, comprising about 24% or less a day of fat, Hill said. Less than 1% report staying on a high-fat, high-protein diet. Ninety-one percent said they exercise regularly, doing about one hour a day of moderate exercise. That’s twice the government’s recommendation of 30 minutes a day of moderate exercise. About half walk regularly, Hill said, about 5 to 6 miles a day.
“They have figured out ways to re-engineer exercise into their lives,” Hill said. Most report they weigh themselves frequently. They also report that they don’t skip breakfast. Hill said this may keep them from overeating later in the day. “‘We don’t see much in common in the way they lost weight, but we see a lot in common in how they maintain the weight loss,” Hill said. And Hill says this is behavior within the control of most people.
More than two-thirds of the registrants said they were overweight as children, and 90% said they had failed at previous weight-loss attempts. “They tried all the wrong ways to do it, and then they figured out the right ways to do it,” Hill said. For more information about the registry, call (800) 606-NWCR.
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Ochs is a reporter for Newsday, a Tribune Company.
