Weight Loss Management and Assessment

Most of us have some blind spots when it comes to seeing ourselves as others do, whether it's good or bad. Some of us can be a little insecure, and we see ourselves negatively. Some people can't walk past a reflective surface without criticizing themselves: I'm so fat. I can't believe I wore these shoes. Look at all those wrinkles!

Some folks, on the other hand, are excellent at spotting the flaws in others, but they can't quite assess themselves honestly. Many people don't realize they are overweight. Even if their weight is higher than recommended, they feel they really don't have any weight to lose. They may also perceive others as "fat" but not realize where their own weight level is.

Others have a distorted body image and are very thin, but feel they are fat. This article is all about assessing your current weight and health to get an accurate picture of where you really are.

How to weigh yourself Yes, it seems simple enough. Step on scale and be done with it. But as you may already know if you have ever used more than one scale in your life, not all scales are equal. You may weigh six or seven pounds more or less on one scale than on another. All humans vary in weight depending on time of day, hormones, extra ballast like shoes, clothing, hormones and other factors, but seeing huge weight variations every day will just confuse and frustrate you.

If you do not have a scale in your home, get one. You can get an inexpensive bathroom scale at a discount store, or if you want to spend the money, you can get the same kind doctors use, with the balancing weights. Keep your home scale somewhere convenient for you. Some people choose to keep theirs in the kitchen, others like the bathroom. Wherever you put it, the scale should have bare floor under it (not carpet) if at all possible. This will produce a truer reading. Also make sure the floor is level and not overly bumpy; you don't want to put it on top of a power cord or a threshold, for example.

When establishing your baseline weight, take off your shoes and strip down to minimal clothing or nothing at all.

If you haven't weighed yourself in a long time, you may not like what you see. In fact, you may be reading this right now and thinking that you are so afraid of the number on the scale that you don't even want to step on it. Try not to think of that number as the enemy. Try to think of it only as the baseline. The bottom. The pit, if you will. You have decided to take action and make positive change, and that number is only going to improve because of your commitment. So don't be afraid. If you realize you have 30 pounds to lose; that just means your number is going to go down a lot. If you have 100 pounds to lose, you will be able to be an inspirational story to others. But we're getting ahead of ourselves: Right now, all you have to do, is figure out where you are, and then determine where you want to be.

Talk to your doctor about your weight

There is no better place to start than your physician when you are ready to make a commitment to changing your eating and exercise habits. Your physician will be able to direct you to excellent educational resources, and can advise you on what level of activity your body is able to safely handle. He or she can also provide you with a target weight to work toward. If your weight is a serious risk factor, your doctor has probably already advised you to lose weight. However, if you are only slightly overweight, he or she may not have broached the subject with you yet, so you may need to take the initiative and ask during your next routine visit. Good starter questions are
,

Am I at a healthy weight?

I would like to lose 20 pounds. Can you give me some tips and advice?

What kinds of exercise are safe for me?

What activities should I avoid?

Consulting with your physician is especially important if you have a current condition that requires medical care or a managed diet.

Your physician will also be able to give you valuable information about your current blood pressure and blood cholesterol (if you have blood work done). These numbers are excellent points of reference as you progress on your fitness journey, because you can actually see real results in blood pressure and cholesterol management long before you reach your weight goal. Knowing that you are producing positive effects in your body can be a great incentive to keep going, and it's really helpful to know where you started so that you can track how much progress you have made.

What is Body Mass Index (BMI)? Body Mass Index, or BMI, is a ratio of height to weight. This is the calculation method the U.S. Centers for Disease Control (CDC) uses. It is a very simple and easy method of interpreting a body's "fatness." Before scientists developed BMI, people generally looked strictly at weight. As you know, weight varies greatly between individuals. What is a healthy weight for a 6-foot tall man would be extreme overweight for a person standing only 5-foot-five.

How do I calculate my BMI?

You can either calculate your BMI yourself or find a calculator online. To figure it out yourself, first weigh yourself and get an accurate measurement of your height.

The formula is: weight (pounds) / [height (inches)]² x 703

Interested in learning more? Why not take an online Weight Loss Management course?

Calculate your BMI by dividing your weight in pounds, by height in (inches-squared), and multiplying by a conversion factor of 703.

Example: Weight = 150 pounds, Height = 5'5" (65")

Calculation: [150 ÷ (65)2] x 703 = 24.96

Finding an online calculator is simple: just go to http://www.nhlbisupport.com/bmi/
or do an Internet search on "BMI calculator." Most doctors' offices also have a BMI chart in their office.

What does BMI mean?

· Adults with a BMI below 18.5 are considered underweight

· Adults with a BMI between 18.5–24.9 are considered at a normal weight

· Adults with a BMI above 25–29.9 are considered overweight

· Adults with a BMI over 30 are considered obese

What are the limits of BMI as a fatness calculator?

Although BMI is simple to use, it does have its limitations. It can overestimate body fat in athletes. An extremely athletic person, like a bodybuilder, would have a higher BMI due to larger-than-average muscle mass. Their BMI could even fall into the obese category, but just looking at the person would tell you they are far from obese.

On the other end of the scale, BMI can underestimate body fat in a very frail person. For example, someone in their eighties who has lost significant muscle mass due to aging or inactivity would weigh less and have a lower BMI than the bodybuilder, but might actually have more body fat than is healthy.

Waist size

Another way to measure yourself is by literally measuring yourself. Take a tape measure and get your waist measurement. This sounds very simple, but it is actually challenging for one person to do alone. The tape measure needs to go all the way around your natural waist, above your hip bone and below your bellybutton. The tape shouldn't cut into your skin or have any twists or kinks. It also needs to be parallel to the floor all the way around. It is much easier if you have a buddy to it for you, but you will need to have your bare skin exposed, so it should be someone you are comfortable with. Also, just a word of warning--if you are wearing super-tight jeans, they will sort of squish up your flesh so that the reading at your waistline appears higher than it really is. Sales people who work in dress shops are particularly skilled at accurate waist measurements, so if you happen to know one, ask her for help.

When you get your reading, write it down somewhere. This is a number you will want to track periodically. The good news is that waist size, like cholesterol and blood pressure readings, tends to shift faster than the scale. That makes this particular measurement a great way to reinforce all the positive changes you are about to make.

What it means…

According to the National Heart Lung and Blood Institute, a waist size greater than 35 inches (88 cm) in women, and 40 inches (102 cm) in men, indicates an increased risk for Type 2 diabetes, hypertension, and cardiovascular disease.

What to do with your measurement

Once you know where you are, you can assess what your goal is. If your waistline currently exceeds the recommended limits, then your first goal might be to bring it back within the limits. However, if you measure your waistline, look at the recommended limits, and feel like a) crying or b) giving up in frustration, then set smaller, incremental goals. You might want to start by planning to decrease your waistline by five inches.

If your measurements are below the health-risk guidelines, you may want to set smaller goals that correspond with clothing sizes.

Body Composition Screening Weight, BMI, and waist circumference are all indirect methods that you can use to get a pretty good idea of what your body is composed of. There are also direct methods of measuring your body composition, but to do these, you will generally need the help of a trained professional. Fortunately, with just a little effort, you can find public events where body composition screenings are available for free.

If you don't mind paying, you can usually find an exercise physiologist at your local gym who has the right equipment to perform the screening. Your local hospital will also be able to refer you to professionals who perform this service. Very often, hospitals and other community organizations put together health fairs, and a frequent feature of these fairs is free body composition screening. If you like a bargain, keep your eye out for these opportunities. The procedure is quick and entirely painless, but it yields so much information. It's a great way to see what your body is really made of--and how much fat you're really carrying around. Most doctors agree that a healthy male should have somewhere between 12 to 22 percent body fat, and a healthy woman should have about 18 to 28 percent fat. There are two widely-used methods of body composition screening: bioelectrical impedance and skin fold testing.

Bioelectrical impedance The bioelectrical impedance method of body composition screening provides a very efficient and reliable means of estimating the percentage of body fat. A small machine, smaller than a toaster, does all the computation. The person basically holds on to two handles, which pass a mild electrical current through the body. You can't feel the current, and it doesn't hurt at all. Electricity moves through lean tissue faster than fat, so the machine uses the amount of time the current takes to pass through the body to estimate the body fat percentage.

Skin fold testing Skin fold testing is probably the most common method of body composition screening. In this method, the tester uses a special pair of calipers to measure the skin at a few points on the body. This is kind of like the old Special-K commercial: Can you pinch an inch? It is a very easy method of assessing body fat percentages, but there are some drawbacks. The readings can vary a lot for the same person, depending on the skill of the tester holding the calipers. That means if you have Fred at the gym measure your skin folds in May, and then you have Judy at the hospital do it in June, you could get two wildly different results. The other thing that some people don't like about skin fold testing is that the person administering the test does actually have to touch you. If you dislike personal contact by virtual strangers, this is probably not the ideal method for you.

Resting heart rate Although it won't tell you anything about your excess fat, measuring your resting heart rate (RHR) gives you a good idea of your general fitness level. It is also another number you can track as you progress on your fitness journey. You can measure your resting heart rate early in the morning, before you get out of bed. Try to do this on your day off, when you don't have an alarm clock blasting you out of bed at 5 a.m. On a slow day, you can wake up naturally and take your time counting your pulse. The night before your day off, you could put a chronometer (stopwatch) next to the bed, or make sure you have a clock with a second hand close enough to the bed that you can see it without having to get up to get your glasses (if needed). Then, when you wake up in the morning on your own, grab the stopwatch and find your pulse. The easiest place to count your pulse is either on your wrist or at your neck (don't press too hard if you use the neck artery). Hold your index and middle fingers here until you feel the beat, then start timing yourself. Let the stopwatch go for one full minute, counting heartbeats.

What is a good resting heart rate?

The better your fitness level, the more efficiently your heart will be beating. Highly conditioned athletes often have an RHR between 40 to 60 beats per minute (bpm). Most people will vary between 60 to 80 pbm, but there is a huge range of normal. A super-fast RHR (over 100) might be a signal to head to your doctor before starting a serious exercise program, but it could also be the result of anxiety, caffeine, or certain medications.

What do I do with this information?

As you progress along your fitness journey, you can try measuring your RHR about once a month, or so to see if it is changing at all. As your heart becomes more efficient as a result of exercise, you might see this number get lower and lower.

Realistically, resting heart rate is not something most people will ever measure. It is difficult to remember to take your pulse before you get out of bed in the morning. Even if you remember when you wake up, you might not have a clock anywhere near you. If you keep forgetting to do it, don't sweat it. This is just one of the many numbers you can use to track your fitness, and it is one of the numbers that helps to put the focus on your health rather than your weight.

Steps to measuring your resting heart rate

1. Wake up slowly on your own. Don't get out of bed!

2. Place your index and middle fingers either on your wrist, or at the side of your neck to find your pulse. Don't press too hard.

3. Count the beats while using a stopwatch to track one full minute.