Aim for a healthy weight

Choose a lifestyle that combines sensible eating with regular physical activity. To be at their best, adults need to avoid gaining weight, and many need to lose weight. Being overweight or obese increases your risk for high blood pressure, high blood cholesterol, heart disease, stroke, diabetes, certain types of cancer, arthritis, and breathing problems. A healthy weight is key to a long, healthy life.

Evaluate your body weight

For adults and children, different methods are used to find out if weight is about right for height.  If you have concerns about your child's body size, talk with your health care provider.  Also see the section Encourage healthy weight in children.

If you are an adult, follow the directions in box 1 to evaluate your weight in relation to your height, or Body Mass Index (BMI). Not all adults who have a BMI in the range labeled "healthy" are at their most healthy weight. For example, some may have lots of fat and little muscle. A BMI above the healthy range is less healthy for most people; but it may be fine if you have lots of muscle and little fat. The further your BMI is above the healthy range, the higher your weight-related risk (see figure 1). If your BMI is above the healthy range, you may benefit from weight loss, especially if you have other health risk factors (see box 2).

BMI's slightly below the healthy range may still be healthy unless they result from illness. If your BMI is below the healthy range, you may have increased risk of menstrual irregularity, infertility, and osteoporosis. If you lose weight suddenly or for unknown reasons, see a health care provider.  Unexplained weight loss may be an early clue to a health problem.

Keep track of your weight and your waist measurement, and take action if either of them increases. If your BMI is greater than 25, or even if it is in the "healthy" range, at least try to avoid further weight gain.  If your waist measurement increases, you are probably gaining fat. If so, take steps to eat fewer calories and become more active.

Box 1

HOW TO EVALUATE YOUR WEIGHT (ADULTS) Weigh yourself and have your height measured. Find your BMI category in figure 1. The higher your BMI category, the greater the risk for health problems. Measure around your waist, just above your hip bones, while standing. Health risks increase as waist measurement increases, particularly if waist is greater than 35 inches for women or 40 inches for men. Excess abdominal fat may place you at greater risk of health problems, even if your BMI is about right. Use box 2 to find out how many other risk factors you have. The higher your BMI and waist measurement, and the more risk factors you have from box 2, the more you are likely to benefit from weight loss.   NOTE: Weight loss is usually not advisable for pregnant women.

Figure 1

BMI measures weight in relation to height.  The BMI ranges shown above are for adults.  They are not exact ranges of healthy and unhealthy weights.  However, they show that health risk increases at higher levels of overweight and obesity.  Even within the healthy BMI range, weight gains can carry health risks for adults.   Directions: Find your weight on the bottom of the graph.  Go straight up from that point until you come to the line that matches your height.  Then look to find your weight group.  Healthy Weight  BMI from 18.5 up to 25 refers to a healthy weight.   Overweight BMI from 25 up to 30 refers to overweight.  Obese  BMI 30 or higher refers to obesity.  Obese persons are also overweight.   Source: Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2000, page 3.

Box 2

FIND OUT YOUR OTHER RISK FACTORS FOR CHRONIC DISEASE The more of these risk factors you have, the more you are likely to benefit from weight loss if you are overweight or obese. Do you have a personal or family history of heart disease? Are you a male older than 45 years or a postmenopausal female? Do you smoke cigarettes? Do you have a sedentary lifestyle? Has your doctor told you that you have - high blood pressure? - abnormal blood lipids (high LDL cholesterol, low HDL cholesterol, high triglycerides)? - diabetes?

Manage your weight

Our genes affect our tendency to gain weight. A tendency to gain weight is increased when food is plentiful and when we use equipment and vehicles to save time and energy. However, it is possible to manage your weight through balancing the calories you eat with your physical activity choices.

To make it easier to manage your weight, make long-term changes in your eating behavior and physical activity. To do this, build a healthy base and make sensible choices. Choose a healthful assortment of foods that includes vegetables, fruits, grains (especially whole grains), skim milk, and fish, lean meat, poultry, or beans.  Choose foods that are low in fat and added sugars most of the time (see section Choose Sensibly). Whatever the food, eat a sensible portion size (see box 3).

Try to be more active throughout the day. The physical activity guideline (see section Be Physically Active Each Day) recommends that all adults get at least 30 minutes of moderate physical activity most or preferably all days of the week. To maintain a healthy weight after weight loss, adults will likely need to do more than 30 minutes of moderate physical activity daily. Over time, even a small decrease in calories eaten and a small increase in physical activity can keep you from gaining weight or help you lose weight.

Box 3

CHOOSE SENSIBLE PORTION SIZES Control portion size. See guideline "Let the Pyramid guide your food choices" for sensible sizes and numbers of servings. If you're eating out, choose small portion sizes, share an entree with a friend, or take part of the food home (if you can chill it right away). Check product labels to learn how much food is considered to be a serving, and how many calories, grams of fat, and so forth are in the food. Many items sold as single portions actually provide 2 servings or more. Examples include a 20-ounce container of soft drink, a 12-ounce steak, a 3-ounce bag of chips, and a large bagel. Be especially careful to limit portion size of foods high in calories, such as cookies, cakes, other sweets, French fries, and fats, oils, and spreads.

The carbohydrates, fats, and proteins in food supply energy, which is measured in calories. High-fat foods contain more calories than the same amount of other foods, so they can make it difficult for you to avoid excess calories. However, low fat doesn't always mean low calorie. Sometimes extra sugars are added to low-fat muffins or desserts, for example, and they may be just as high in calories.

Your pattern of eating may be important. Snacks and meals eaten away from home provide a large part of daily calories for many people. Choose them wisely. Try fruits, vegetables, whole grain foods, or a cup of low-fat milk or yogurt for a snack. When eating out, choose small portions of foods. If you choose fish, poultry, or lean meat, ask that it be grilled rather than fried.

Like younger adults, overweight and obese older adults may improve their health by losing weight. The guidance of a health care provider is recommended, especially for obese children and older adults. Since older people tend to lose muscle mass, regular physical activity is a valuable part of a weight-loss plan. Building or maintaining muscle helps keep older adults active and reduces their risk of falls and fractures.  Staying active throughout your adult years helps maintain muscle mass and bone strength for your later years.

If you need to lose weight, do so gradually

If you are overweight, loss of 5 to 15 percent of your body weight may improve your health, ability to function, and quality of life. Aim to lose about 10 percent of your weight over about 6 months. This would be 20 pounds of weight loss for someone who weighs 200 pounds. Loss of 1/2 to 2 pounds per week is usually safe. Even if you have regained weight in the past, it's worthwhile to try again.

Encourage healthy weight in children

Children need enough food for proper growth, but too many calories and too little physical activity lead to overweight. The number of overweight U.S. children has risen dramatically in recent years. Encourage healthy weight by offering children grain products; vegetables and fruits; low-fat dairy products; and beans, lean meat, poultry, fish, or nuts-and let them see you enjoy eating the same foods. Let the child decide how much of these foods to eat. Offer only small amounts of food high in fat or added sugars. Encourage children to take part in vigorous activities (and join them whenever possible). Limit the time they spend in sedentary activities like watching television or playing computer or video games.

Help children to develop healthy eating habits. Make small changes. For example, serve low-fat milk rather than whole milk and offer one cookie instead of two. Since children still need to grow, weight loss is not recommended unless guided by a health care provider.

Serious eating disorders

Frequent binge eating, with or without periods of food restriction, may be a sign of a serious eating disorder. Other signs of eating disorders include preoccupation with body weight or food (or both-regardless of body weight), dramatic weight loss, excessive exercise, self-induced vomiting, and the abuse of laxatives. Seek help from a health care provider if any of these apply to you, a family member, or a friend.

ADVICE FOR TODAY

• Aim for a healthy weight. If you are at a healthy weight, aim to avoid weight gain. If you are already overweight, first aim to prevent further weight gain, and then lose weight to improve your health.
• Build a healthy base by eating vegetables, fruits, and grains (especially whole grains) with little added fat or sugar.
• Select sensible portion sizes.
• Get moving. Get regular physical activity to balance calories from the foods you eat.
• Set a good example for children by practicing healthy eating habits and enjoying regular physical activities together.
• Keep in mind that even though heredity and the environment are important influences, your behaviors help determine your body weight.

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Be physically active each day

Being physically active and maintaining a healthy weight are both needed for good health, but they benefit health in different ways. Children, teens, adults, and the elderly-all can improve their health and well-being and have fun by including moderate amounts of physical activity in their daily lives.  Physical activity involves moving the body.  A moderate physical activity is any activity that requires about as much energy as walking 2 miles in 30 minutes.

Aim to accumulate at least 30 minutes (adults) or 60 minutes (children) of moderate physical activity most days of the week, preferably daily. If you already get 30 minutes of physical activity daily, you can gain even more health benefits by increasing the amount of time that you are physically active or by taking part in more vigorous activities. No matter what activity you choose, you can do it all at once, or spread it out over two or three times during the day.

Make physical activity a regular part of your routine

Choose activities that you enjoy and that you can do regularly (see box 4). Some people prefer activities that fit into their daily routine, like gardening or taking extra trips up and down stairs. Others prefer a regular exercise program, such as a physical activity program at their worksite. Some do both. The important thing is to be physically active every day.

Most adults do not need to see their health care provider before starting to become more physically active. However, if you are planning to start a vigorous activity plan and have one or more of the conditions below, consult your health care provider:

• Chronic health problems such as heart disease, hypertension, diabetes, osteoporosis, or obesity.
• High risk for heart disease (see box 2).
• Over age 40 for men or 50 for women.

Health benefits of physical activity

Compared with being very sedentary, being physically active for at least 30 minutes on most days of the week reduces the risk of developing or dying of heart disease. It has other health benefits as well (see box 5). No one is too young or too old to enjoy the benefits of regular physical activity.

Two types of physical activity are especially beneficial:

• Aerobic activities. These are activities that speed your heart rate and breathing. They help cardiovascular fitness.
• Activities for strength and flexibility. Developing strength may help build and maintain your bones. Carrying groceries and lifting weights are two strength-building activities. Gentle stretching, dancing, or yoga can increase flexibility.

To get these health benefits, adults need moderate physical activity for a total of at least 30 minutes most days of the week, preferably daily, and children need at least 60 minutes per day.

Box 4

EXAMPLES OF PHYSICAL ACTIVITIES FOR ADULTS For at least 30 minutes most days of the week, preferably daily, do any one of the activities listed below-or combine activities. Look for additional opportunities among other activities that you enjoy.      As part of your routine activities: Walk, wheel, or bike ride more, drive less. Walk up stairs instead of taking an elevator. Get off the bus a few stops early and walk or wheel the remaining distance. Mow the lawn with a push mower. Rake leaves. Garden. Push a stroller. Clean the house. Do exercises or pedal a stationary bike while watching television. Play actively with children. Take a brisk 10-minute walk or wheel in the morning, at lunch, and after dinner.      As part of your exercise or recreational routine: Walk, wheel, or jog. Bicycle or use an arm pedal bicycle. Swim or do water aerobics. Play racket or wheelchair sports. Golf (pull cart or carry clubs). Canoe. Cross-country ski. Play basketball. Dance. Take part in an exercise program at work, home, school, or gym.

Box 5

HEALTH BENEFITS OF REGULAR PHYSICAL ACTIVITY Increases physical fitness. Helps build and maintain healthy bones, muscles, and joints. Builds endurance and muscular strength. Helps manage weight. Lowers risk factors for cardiovascular disease, colon cancer, and type 2 diabetes. Helps control blood pressure. Promotes psychological well-being and self-esteem. Reduces feelings of depression and anxiety.

Physical activity and nutrition

Physical activity and nutrition work together for better health. For example, physical activity increases the amount of calories you use. For those who have intentionally lost weight, being active makes it easier to maintain the weight loss. However, 30 minutes of activity daily may not be enough to lose weight or maintain weight loss. Read the preceding guideline "Aim for a Healthy Weight," for more information about weight management.

Physical activity and nutrition work together in more ways than weight management. Increasing the calories you use allows you to eat more, which makes it easier to get the nutrients you need. Physical activity and nutrition work together for bone health, too. Calcium and other nutrients are needed to build and maintain strong bones, but physical activity is needed as well.

Help children be physically active

Children and adolescents benefit from physical activity in many ways. They need at least 60 minutes of physical activity daily (see box 6). Parents can help:

• Set a good example.  For example, arrange active family events in which everyone takes part.  Join your children in physical activities.
• Encourage your children to be physically active at home, at school, and with friends by jumping rope, playing tag, riding a bike.
• Limit television watching, computer games, and other inactive forms of play by alternating with periods of physical activity.

Box 6

PHYSICAL ACTIVITIES FOR CHILDREN AND TEENS      Aim for at least 60 minutes total per day: Be spontaneously active. Play tag. Jump rope. Ride a bicycle or tricycle. Walk, wheel, skip, or run. Play actively during school recess. Roller skate or in-line skate. Take part in physical education activity classes during school. Join after-school or community physical activity programs. Dance.

Older people need to be physically active too

Older persons also need to be physically active.  Engage in moderate physical activity for at least 30 minutes most days of the week, preferably daily, and taking part in activities to strengthen muscles and to improve flexibility. Staying strong and flexible can reduce your risk of falling and breaking bones, preserve muscle, and improve your ability to live independently. Lifting small weights and carrying groceries are two ways to include strength building into your routine.

ADVICE FOR TODAY

• Engage in at least 30 minutes (adults) or 60 minutes (children) of moderate physical activity most, preferably all, days of the week.
• Become physically active if you are inactive.
• Maintain or increase physical activity if you are already active.
• Stay active throughout your life.
• Help children get at least 60 minutes of physical activity daily.
• Choose physical activities that fit in with your daily routine, or choose recreational or structured exercise programs, or both.
• Consult your health care provider before starting a new vigorous physical activity plan if you have a chronic health problem, or if you are over 40 (men) or 50 (women).