The Collins family reunion was right around the corner. Every five years relatives from all over the country Atlanta, Los Angeles, Boston congregated in Chicago for a weekend celebration.To kick off the festivities, everybody gets together for a picnic in a park adjacent to a sandy beach right on Lake Michigan. Mike and Ann Collins were making their way to the big event.They had eloped about three years before, so this would be Ann’s first time meeting many members of the Collins clan.

Ann was extremely nervous about going to the reunion. Even though she had lost some weight, she was still a large woman, and she cringed at the thought of Mike’s family seeing her in a bathing suit. She had started losing weight in part because she and Mike were trying to conceive. She knew that obesity was linked with infertility, and after two years of trying, she’d consulted her gynecologist. After several tests, her doctor had concluded that she had polycystic ovary syndrome and recommended that she lose weight to improve her chances of conceiving. Ann had spent a great deal of time finding the right weight-loss program and had developed a keen interest in diet and health. Mike and Ann arrived at the picnic, and everybody loved Ann. In fact, she felt right at home because from what she could tell, the majority of Mike’s family was overweight, too. She spent the entire afternoon getting to know Mike’s siblings, cousins, aunts, uncles, and ninetyyear- old grandmother.

Everyone filled her in on the family history achievements and physical ailments. She found out that Grandpa John had type 2 diabetes and died from its many complications. In fact, according to Grandma, as far back as she could remember, most of the Collins men have had diabetes. Later that evening, driving back to their hotel, Ann told Mike that they needed to talk. She said: “Mike, I loved meeting your family, but I’m worried about your health.

Your grandmother told me that your dad and your two uncles have type 2 diabetes and your grandfather had it, too; she said that it runs in the family,mostly on the male side. I am concerned because you are built just like those guys thick around the middle and I’ve read that men who carry weight in that area are at a very high risk of developing diabetes.” Mike listened intently to Ann. He thought a few minutes about what she had said. It was true; diabetes did seem to run in his family, particularly in the guys, who were large and had a gut. He said: “Ann, you’re right. I really miss my grandfather, and my dad and uncles look so unhealthy. It’s time for me to get in shape. I promise you that as soon as we get home, I will call my doctor and schedule a physical.”

Weight is an issue for both women and men. At some point everyone with a weight issue must come to terms with the reality of being overweight and how it affects his or her health, physically and mentally. However, excess weight seems to affect women and men differently, as it did Mike and Ann. Like Ann, women often are better informed about how their weight affects their physical health. And carrying extra pounds causes many women to view their body image negatively.

That view can affect their emotional health, making them feel down or even depressed. Men, however, tend to be more like Mike. Many guys are unaware of how being overweight can increase their health risk for many preventable diseases such as type 2 diabetes, heart disease, high blood pressure, and possibly infertility. But once men personally experience one of those diseases and someone presents them with accurate information about how weight loss can help, they are usually more than willing to take action to solve their health problem. This article will compare and contrast some of the weight-related medical and psychological issues that women and men face when they weigh more than is healthy. Armed with this weighty knowledge, women and men will have a better understanding of what being at a healthy weight means and how losing weight can have a profoundly positive impact on their lives.

The Difference between Healthy Weight and Attractive Weight

Society seems to have clear definitions about what the ideal woman and man look like, and those definitions translate into a body weight that supports that ideal. The fact, however, is that the ideal weight according to society’s definition of what is attractive is not necessarily healthy for most people. And surprisingly, the gap between attractive and healthy is often reversed for men and women. Today’s women often feel that they need to be extraordinarily thin. The icons of beauty that they are exposed to daily, such as top fashion models and Hollywood celebrities, tend to be underweight by medical standards. Conversely, men are likely to see their ideal body as big and broad, like that of a linebacker.The reality is that the body weights that support both the male and the female points of view are not particularly healthy.

And that is unfortunate because weight is inextricably linked to health. For health’s sake, it’s important that both women and men understand that the weight at which health is optimized has little to do with these extreme ideals. BMI (body mass index) is the globally accepted standard used to classify weight status. Generally, people fall into one of four categories based on their BMI: underweight, which is associated with some health risks; healthy, the range at which health risks are minimized; overweight, which corresponds to an increased risk of several diseases; and obese, the point at which health risks sharply rise as weight increases. You can calculate BMI by plugging your body weight and height into a BMI formula or by looking them up on a chart.

Scientists also use BMI to study the effects of weight and health. When researchers report their findings, they will generally state whether the weight and health connection was found at the overweight or obese level. For most studies, the risk of a negative health consequence increases as the individuals in the study go from being overweight to being obese. For most people, the BMI is a good indicator of the amount of body fat we have, and when it comes to weight and health, excess body fat is the crux of the problem. O

ne interesting fact is that the same BMI categories apply to both adult men and adult women. Why? Medical experts around the world have spent years evaluating the connection between weight and health. What they have learned is that as BMI increases above 25, so do health risks for certain diseases, such as cardiovascular disease and type 2 diabetes. And the BMIs at which those illnesses show up are about the same in men and women. In other words, despite the fact that men are biologically programmed to have less body fat than women, research has found that the major weightrelated diseases that affect both men and women occur at about the same BMI men get those diseases with a lower body fat content than women.

BMI and Waist Circumference: Know Both Numbers

Although BMI is the global standard for evaluating weight status, it does have limitations. While BMI is closely linked to total body fat, it does not provide any information about where the fat is located. And when it comes to weight and health, where fat is carried on the body is extremely important. Studies have found that excess fat stored at the waist or in the abdominal area places people at greater risk for certain health problems, like type 2 diabetes and heart disease, even if their BMI is in the healthy range.

To help compensate for this limitation, experts recommend that waist circumference be included in the assessment of an individual’s weight–health risk. For example, there are men with broad shoulders and lean hips who, according to the BMI formula, are overweight. These men have little abdominal fat, however, and their health risk will be low as well. Similarly, there are women who carry their fat in their hips and thighs and have small waists. Same story. Factoring the individual’s waist circumference into the BMI equation gives a more accurate picture of health risk than does BMI alone.

How is waist circumference determined? There are a variety of methods out there, but the easiest and most common way involves placing a tape measure around the waist just above the hips while standing. Health risk increases when the waist circumference exceeds 35 inches for women and 40 inches for men. The bottom line for women and men: know your BMI and waistcircumference numbers. If they are too high, it’s time to take action and lose weight.

FROM A WOMAN’S VIEWPOINT BMI AND WAIST CIRCUMFERENCE: KNOW BOTH NUMBERS

When it comes to gaining weight, most women know exactly where their extra pounds seem to end up in their rear, hips, and thighs. And several studies have confirmed women’s observations. But what many women don’t appreciate about their pear-shaped fat distribution is that it puts them at less of a health risk for type 2 diabetes and heart disease compared with guys, who tend to store fat in their middle. However, studies have also found that after menopause,women appear to lose their disease-prevention advantage. That’s because hormonal shifts trigger the accumulation of more fat in the tummy area, making women more like men and predisposing them to the same health risks.

FROM A MAN’S VIEWPOINT BMI AND WAIST CIRCUMFERENCE: KNOW BOTH NUMBERS

While most men are programmed by nature to have less fat than women, they also are programmed to gain weight in the biological danger zone their gut. Android fat, or apple-shaped fat, is more common in men than in women. Studies have concluded that fat that accumulates in the abdominal area is linked to an increased risk of developing type 2 diabetes and heart disease. But there is good news for guys. Studies have also found that men can significantly reduce their health risk by losing weight.

REAL-LIFE LESSON

Opposite Sex but Same BMI

Situation: My sister and I went in for physicals after our father died from a massive heart attack. The doctor told us that our BMIs were 28, which meant we were overweight. He encouraged us to lose weight because it would help us reduce our risk of heart disease and some other diseases, like diabetes. I am confused about the advice we were given.

I weigh 45 pounds more than my sister and look like an average guy. My sister definitely looks overweight. How can the doctor tell us that with respect to our weight, we’re the same and both of us need to lose weight? Strategies: The BMI calculation gets at the volume, or the amount of space a person takes up, and that, in turn, is linked to how much of that space is fat. The calculation uses both height and weight. So while you are taller and heavier than your sister, your BMIs can be the same. Because men typically weigh more than women and have less body fat, it seems intuitive that the BMI cutoffs should be different, and in fact most people would say that a woman with a BMI of 25 would look better if she lost a few pounds, while a man with a BMI of 25 looks thin.

The cutoffs used to link BMI and health risk do not take appearance into account, however. When scientists have looked at BMI and health risk in men and then at BMI and health risk in women, the similarities are striking. So from a health perspective, it doesn’t make sense to have different cutoffs. Your doctor is right. Your weight is putting you (and your sister) at an increased risk for heart disease. You’d be wise to take his advice and lose some weight. With your shared family history and shared desire to improve your heart health, perhaps you and your sister should work as a team at reaching a healthy body weight.