When the federal government issued its first clinical guidelines on obesity in late June, the weight-loss industry must have celebrated. Overnight, thousands of us joined the ranks of the overweight. The guidelines which were crafted by a panel of 24 experts under the auspices of the National Heart, Lung, and Blood Institute concluded that overweight increases the risk of heart disease, stroke, hypertension, lipid disorders, Type 2 diabetes, certain cancers, osteoarthritis, and other chronic conditions.
The new guidelines state that people with a Body Mass Index (BMI) of 25 to 29.9 are overweight and those with a BMI of 30 and above are obese. (The previous definition of overweight was a BMI of 27.) Under the new guidelines, 97 million or 55% of American adults are now considered overweight. Although some researchers do not consider BMI a valid indication of obesity, especially for very muscular or exceptionally tall people, it has become a standard in health risk studies and widely accepted in the medical field. Another exception are people over 65. In many of the studies the expert panel reviewed, risk of death did not increase until BMI reached 30 in older people.
In addition to BMI, health professionals are being urged to take their patient's waist measurement because of mounting evidence that excess visceral fat, the padding that cushions abdominal organs, increases the risk of heart disease and diabetes. Visceral fat appears to play a larger role in the disease process than sub-cutaneous fat - commonly referred to as "love handles". The theory is that abdominal fat cells produce certain compounds that may influence cholesterol and glucose metabolism. Waist size isn't a factor in people with a BMI of less than 25, but a measurement over 40 inches in men and 35 in women is a risk marker for those with a BMI of 25 to 34.9. The guidelines state that all people with a BMI over 30 need to lose weight but caution that if weight loss drugs are used, they should not be taken for more than a year because there are no safety tests for extended use. People with a BMI of 25 to 29 who have high blood pressure, high total cholesterol, or elevated blood sugar, should strive to lose weight because numerous studies have shown these conditions can be reversed by weight loss.
The expert panel did not offer any new weight loss strategies beyond eat less concentrating on fruits and vegetables, increase dietary fiber, and exercise on a regular basis.
National Institute of Diabetes and Digestive and Kidney Diseases
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