Weight Gain Training

Training Weight

For the medical establishment, the era of tolerating fat is over. Not that anyone is advocating prejudice against fat people. But the United States has had a decidedly generous definition of overweight. And too many doctors have been treating diseases linked to obesity - without helping patients shed a few pounds.

That is about to change, if current calls for action are heeded. These calls are coming from all corners of the medical and scientific world, with the goal of getting Americans to be less complacent about excess pounds that weigh down their health. What we're trying to do is make it higher on doctors' radar scope that you need to talk to patients about losing weight, work with them, and follow up with them. Don't just hand somebody a diet and say, Follow this.

Dr. Robert Eckel, vice chairman of the American Heart Association's nutrition committee, said, "We want to send a message to both health-care providers and the public that the time has come to take weight gain training seriously."

Among the signs of change: * The National Heart, Lung and Blood Institute just issued the first-ever federal guidelines for identifying and treating overweight adults. The recommendations set a lower threshold for what is considered overweight, bringing the U.S. definition into line with the rest of the world's. * The American Heart Association last week upgraded obesity from a "contributing" risk factor for heart disease to a "major" risk factor, putting it on par with smoking, high cholesterol, high blood pressure and a sedentary lifestyle. * In an effort that should improve identification of children who are too fat, the federal government is revamping the height and weight charts used by pediatricians. The effort reflects mounting evidence that obesity-related health problems often begin in childhood. * Science, the journal of the world's largest scientific federation, last month devoted an issue to obesity. One article urged ambitious social changes to make the food supply healthier and deter sedentary pastimes, and said preventing obesity may require a public health campaign like those used to combat smoking and AIDS.

The Heart, Lung and Blood Institute's guidelines - developed by an expert panel and endorsed by major medical societies - address difficult questions, including: What constitutes overweight and obesity? When does weight become such a threat that weight loss is advisable? Who should use weight-loss drugs?

The most controversial aspect of the report is the new threshold for overweight. The guidelines define it as a body mass index (BMI) of 25 to 29.9 - the same definition used by the World Health Organization. Obesity is a BMI of 30 or more.

BMI is a formula invented 17 years ago to compare body weight to height, then relate this to health risks. (See chart to calculate your BMI.) Until now, most American experts have defined overweight as a BMI of 27 or more because at that point, obesity-related health risks and mortality increase significantly. But in recent years, U.S. experts have begun to see the validity of a more stringent cutoff.