Newsweek Health

November 2005, "Weighty Matters"

Our columnists examine when, and where, extra pounds can hurt you-and how to keep them off after the holidays pass. By Barbara Kantrowitz and Pat Wingert

It's the start of the holiday season and lots of parties, big family dinners and tempting leftovers beckoning from the fridge, which means that in January you might be stuck with an unwanted souvenir: extra pounds. That's especially unwelcome if-like many of us-you're already struggling to lose some weight. So this seems like a good time of year to talk about the risks of carrying around just a little bit of excess weight and how to maintain healthy habits through the holidays. "An ounce of prevention is worth a pound of weight gain," says Dr. Samuel Klein, director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis. "Preventing the increase in weight is a lot easier and better than actually gaining weight and trying to get it off again."

With all the emphasis that the media puts on being movie-star thin, most women think they're too fat-even if they're not. How can you tell how much you really need to lose? Doctors usually measure obesity by calculating your Body Mass Index (BMI). That's basically a ratio of weight to height. To see yours, check out this site at the Centers for Disease Control. You're considered normal weight if your BMI is 18.4 to 24.9, overweight if you're 25.0 to 29.9 and obese at 30.0 and above. Even being moderately overweight, with a BMI of 28, puts you at much higher risk for Type 2 diabetes, says Klein. The risk of other obesity-related conditions, such as high blood pressure and heart disease, increases with extra weight as well.

But BMI doesn't tell the whole story. A muscular athlete, like a female body builder, might have a relatively high BMI but won't really be overweight because she doesn't have extra body fat. Studies have shown that women are at higher risk of obesity-related diseases if their waist is 35 inches or wider (and don't cheat by pulling the measuring tape tighter). That's true even if your weight is close to normal. "Having weight in the middle is associated with cardiovascular diseases and increased risk for cancers within the body," says Dr. Jana Klauer, an obesity researcher at St. Luke's-Roosevelt Hospital in New York and author of the upcoming book "How the Rich Get Thin" (to be published by St. Martin's Press on Dec. 27).

Being moderately overweight can threaten your health at any age, but doctors say it's especially troublesome when you're a young adult. Even a 10-pound weight gain between the ages of 18 and 20 (remember the "Freshman 15?") is associated with later heart disease, high blood pressure, diabetes and gall-bladder disease, says Klein. Even those women who manage to stay slim through their 20s often find they gain weight during pregnancy and have trouble taking it off afterwards. Over the years, those pounds add up. Many women just shrug that off, accepting the gain as an inevitable byproduct of aging. But Klauer says that even though our metabolism slows somewhat as we age, that's not the main reason so many women gain weight as they get older. "What's more of a problem to women in our society is overconsumption and underactivation," says Klauer. "The latter increases with age. When your kids are younger, you spend more time running around after them. As people get older, they tend to become more sedentary."

The solution is simple to explain-eat less and exercise more-but hard to put into practice, especially at this time of year. But there are some simple steps you can take to help keep the pounds off from calorie-rich parties. Klein recommends staying as far away from the food as possible so you have to walk across the room to get to the buffet table, sticking with non-alcoholic drinks like water or diet soda (alcohol not only adds empty calories, but it stimulates the appetite and lowers willpower), munching on a salad (with low-calorie dressing) or raw vegetables before a dinner or party so you don't arrive starving, and keeping portion sizes extra small (if you're really tempted by high-calorie treats, have just a bite-that may be enough to satisfy your craving). And don't forget to exercise.

Studies of people who've lost weight and kept it off show that successful dieters keep track of their weight and food intake, exercise regularly and eat breakfast every day. When you're dieting, you should weigh yourself weekly because daily fluctuations (sometimes caused by fluid retention) can be discouraging. But after reaching your goal weight, a daily weigh-in seems to work best to keep the extra pounds off. A food diary often helps pinpoint trouble spots such as that mid-morning or late afternoon snack. An extra 150 or so calories a day, the amount in a single chocolate chip cookie, adds up to a pound of extra weight in just about three weeks. Regular exercise means real activity, not just sauntering from the car to the front door. You need 90 minutes a day of a moderate activity like walking, says Klein, or 30 minutes a day of more vigorous exercise like running or jogging. For more information on how to balance food intake and exercise, go to this Department of Agriculture Web site. Finally, there's breakfast, the meal many women skip in the mistaken belief that it's a good way to cut calories. "There is something magical about breakfast," says Klauer. "Breakfast, as the first meal of the day, kind of resets the body for a new day." If you start out not hungry, by eating something with protein, you're much less likely to overeat later on. And here's a little incentive from Klauer. "There's about eight pounds between dress sizes," she says. Being able to fit into a smaller size is the best holiday gift to yourself!

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