Fit for Duty. . . Fit for Life!    “Fit for Duty. . .Fit for Life!” is a lifestyle-based column provided by USPHS Dietitians/Nutritionists The following article has been adapted from Understanding Adult Obesity, a publication of the Weight-control Information Network (WIN), an information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health. WIN provides the general public, health professionals, the media, and Congress with up-to-date, science-based health information on weight control, obesity, physical activity, and related nutritional issues. Publications produced by WIN are carefully reviewed by both NIDDK scientists and outside experts. Understanding Adult Obesity (available in full text at http://www.win.niddk.nih.gov/publications/understanding.htm) is not copyrighted and WIN encourages duplication and distribution of its fact sheet, as desired.   Overweight and Obese: The Basics Submitted by CDR Nancy Sebring, USPHS   Today, more than 65 percent of adults in the United States are overweight or obese. Obesity puts people at increased risk for chronic diseases such as heart disease, type 2 diabetes, high blood pressure, stroke, and some forms of cancer. What is obesity? "Obesity" specifically refers to an excessive amount of body fat. "Overweight" refers to an excessive amount of body weight that includes muscle, bone, fat, and water. As a rule, women have more body fat than men. Most health care professionals agree that men with more than 25 percent body fat and women with more than 30 percent body fat are obese. These numbers should not be confused with the body mass index (BMI), however, which is more commonly used by health care professionals to determine the effect of body weight on the risk for some diseases. Body Mass Index (BMI) BMI is a tool used to assess overweight and obesity and monitor changes in body weight. Like the weight-for-height tables, BMI has its limitations because it does not measure body fat or muscle directly. BMI is calculated by dividing a person's weight in pounds by height in inches squared and multiplied by 703. A BMI of 25 to 29.9 indicates a person is overweight. A person with a BMI of 30 or higher is considered obese. Calculate your BMI at http://www.nhlbisupport.com/bmi/ Two people can have the same BMI, but different body fat percentages. A bodybuilder with a large muscle mass and low percentage of body fat may have the same BMI as a person who has more body fat. However, a BMI of 30 or higher usually indicates excess body fat. Body Fat Distribution Health care providers are concerned not only with how much fat a person has, but also where the fat is located on the body. Women typically collect fat in their hips and buttocks, giving them a ’pear’ shape. Men usually build up fat around their bellies, giving them more of an ’apple’ shape. Of course, some men are pear-shaped and some women become apple-shaped, especially after menopause. Excess abdominal fat is an important, independent risk factor for disease. Research has shown that waist circumference is directly associated with abdominal fat and can be used in the assessment of the risks associated with obesity or overweight. If you carry fat mainly around your waist, you are more likely to develop obesity-related health problems. Women with a waist measurement of more than 35 inches and men with a waist measurement of more than 40 inches may have more health risks than people with lower waist measurements because of their body fat distribution. Who should lose weight? Health care providers generally agree that people who have a BMI of 30 or greater can improve their health through weight loss. This is especially true for people with a BMI of 40 or greater, who are considered extremely obese. Preventing additional weight gain is recommended if you have a BMI between 25 and 29.9; however, if you have other risk factors for obesity-related diseases, obesity experts recommend you try to lose weight. Fortunately, a weight loss of 5 to 10 percent of your initial body weight can do much to improve health by lowering blood pressure and other risk factors for obesity-related diseases. In addition, research shows that a 5- to 7-percent weight loss brought about by moderate diet and exercise can delay or possibly prevent type 2 diabetes in people at high risk for the disease. For more information about pre-diabetes and diabetes, visit www.diabetes.niddk.nih.gov How is obesity treated? The method of treatment depends on your level of obesity, overall health condition, and readiness to lose weight. Treatment may include a combination of diet, exercise, behavior modification, and sometimes weight-loss drugs or surgery. Remember, weight control is a life-long effort, and having realistic expectations about weight loss is an important consideration. Eating a healthful diet and getting plenty of physical activity have important health benefits in addition to those related to weight control. For more information on obesity-related health risks, causes, and treatment options, refer to WIN publications at http://www.win.niddk.nih.gov/ Note: Look for Fit for Duty…Fit for Life! articles throughout 2009 addressing various issues related to weight management including diet and exercise tips.

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