1. Do You Need to Lose Weight?
Using BMI and Waist Circumference
According to the NHLBI, assessing overweight involves 2 key measurements – using the BMI table and measuring the waist circumference. This show will tell you how and also talk about the risks of being overweight. It is part of a 12-part series on weight management.

2. What You Will Learn Today
Assess Your Weight Status
What is BMI?
Waist Circumference
Overweight PLUS 2 of these = health reason to lose weight
What Do I Do – things to think about?
How to Choose A Weight Loss Program
Here are the topics we will cover today.
Change is a hard thing. We all get set in our ways and don’t realize that just little things can make a big difference. Hopefully we will help you decide that the benefits for losing a little weight far outweigh the effort needed to get to that goal.

3. Assess Your Weight Status
2 methods:
BMI
Waist Circumference

4. What is BMI?
Body mass index (BMI) is a measure based on height and weight that applies to both adult men and women
It may overestimate body fat in athletes and others who have a muscular build.
It may underestimate body fat in older persons and others who have lost muscle mass.
It is easy to find a BMI calculator on the internet – here is one we found at the National Institute of Health website –
(online calculator)

5. (BMI table found at National Institutes of Health website)
Here is what a BMI table looks like. Don’t worry about reading all of the numbers for now – we have a handout that will show you how to figure out your BMI. Note how the BMI number at the top increases as your weight per height increases.
Speaker: it is a good idea to print this and make it available to attendees so they can assess their own score and watch progress with their weight control program.
(BMI table found at National Institutes of Health website)

6. What Is Your BMI Score? Underweight Below 18.5 Normal 18.5 - 24.9
Overweight
Obesity 30.0 and Above
If you have a high BMI then you should lose weight. If your waist measurement is too high (we will check this out in upcoming slides) and or you have other disease risk factors then losing weight is imperative for your health.
If your BMI is greater than 24.9 then you should lose weight. This becomes MORE important as other risk factors are added.

7. BMI Is an Important Tool
Use the BMI chart to assess overweight and obesity
Body weight alone can be used to follow weight loss and to monitor therapy
Use the BMI scale to see if weight loss is needed and to monitor progress.
It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as overweight even though they do not have excess body fat.

8. Waist Circumference Find your waist measurement
Place a measuring tape snugly around your waist
Here is how to measure your waist circumference – it is easy – all you need is a tape measure.

9. Waist Circumference Good indicator of your abdominal fat
Increases risk for heart disease
Increased risk of disease if:
over 40 inches in men
over 35 inches in women
People who have more of an apple shape (waist is bigger than hips) are more at risk for heart disease – even if their weight is normal.

10. Caution on Increased Waist
Can be a marker for increased disease risk even in persons of normal weight
Type 2 diabetes
Hypertension
Cardiovascular disease
Syndrome X
Having a waist that is too large increases your risk of disease, even if you are normal weight. Exercise and keeping fit, along with eating the right foods, helps you avoid abdominal fat.

11. Disease Risk for Overweight
for type 2 diabetes, hypertension, and cardiovascular disease
BMI
Obesity
Class
Waist
<40” men
<35” women
>40” men
>35” women
Underweight
<18.5
Normal
Overweight
Increased
High I
Very High II
Extreme
40.0+
III
Extremely
Extremely High
Look at how your disease risk increases when your waist size increases (far right column)
The risk of disease is greater for persons who have a BMI of 25 or more – and even more so when the waist measurement is 40 or greater for men and 35 or greater for women.
Source: NHLBI

12. Overweight PLUS 2 of these = health reason to lose weight:
High blood pressure (hypertension)
High LDL-cholesterol ("bad" cholesterol)
Low HDL-cholesterol ("good" cholesterol)
High triglycerides
High blood glucose (sugar)
Family history of premature heart disease
Physical inactivity
Cigarette smoking
If you are obese or overweight and have 2 or more of these risk factors you should lose weight to improve your health.
People who are overweight or obese have a greater chance of developing high blood pressure, high blood cholesterol or other lipid disorders, type 2 diabetes, heart disease, stroke, and certain cancers, and even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing those diseases.

13. Even Small Weight Loss Helps
Even a small weight loss will help to lower your risk of developing diseases associated with obesity
This is not as hard as you think
It is never too late to start
Most experts agree that a loss of 10% of body weight over the first 6 months is a good attainable goal that will better your health.
To find your ideal healthy body weight, use the BMI chart – your healthy weight range is based on a healthy body mass index (BMI) of 18.5 to 24.9

14. What Do I Do? Reduce body weight by about 10 percent
With success, and if warranted, further weight loss can be attempted
10% of your body weight is a good weight loss goal to start and you should shoot to do this over a 6 month time period. If you adopt good eating and lifestyle habits and sustain them over time you will make a big difference to your health.
You did not put it all on in one night so you are not going to take it off in a night, week, month. It will take a sustained effort to take off and keep off the rest of your life.

15. Remember, quick weight loss methods don't provide lasting results.
Slow and Steady is Best
Weight loss should be about 1 to 2 pounds per week for a period of 6 months
Optimal BMI is equal to or less than 24.9
Remember, quick weight loss methods don't provide lasting results.
There are online calculators that calculate healthy body weight and has a calculator that can tell you how many calories you should consume for your desired weight and your activity level.

16. Sure Way to Lose is Two-Fold:
Calorie deficit
Exercise
The combination of a reduced calorie diet and increased physical activity is recommended since it produces weight loss that may also result in decreases in abdominal fat and increases in cardio-respiratory fitness.
We go into depth for diet and exercise in the other lessons in 12 Lessons of Wellness and Weight loss – but here is a quick overview and will get you thinking.
To lose weight, most people need to cut down on the number of calories (units of energy) they get from food and beverages and increase their physical activity. For a weight loss of 1–2 pounds per week, daily intake should be reduced by 500 to 1,000 calories.

17. Let’s Talk About the Diet…
500 to 1,000 calorie deficit
Not that hard
Make better choices
Watch portions
Increase calories burned by exercise and more activity (sit less)
Don’t have to “diet” and be hungry
You should seek the help of a dietitian to determine your calorie intake along with how to eat the right foods that will make you feel fuller on fewer calories without hunger. We have a lot of these tips in another show –fill up with the right foods.

18. Healthy Eating Plan A healthy eating plan:
Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
Includes lean meats, poultry, fish, beans, eggs, and nuts.
Is low in saturated fats, transfat, cholesterol, salt (sodium), and added sugars.
Controls portion sizes.

19. Let’s Talk About the Diet…
Follow healthy eating plan such as DASH diet
MyPyramid.gov
Better for your whole life
You should seek the help of a dietitian to determine your calorie intake along with how to eat the right foods that will make you feel fuller on fewer calories without hunger. We have a lot of these tips in another show –fill up with the right foods.
Eating plans containing 1,000–1,200 calories will help most women to lose weight safely. Eating plans between 1,200 calories and 1,600 calories each day are suitable for men and may also be appropriate for women who weigh 165 pounds or more or who exercise regularly.

20. Let’s Get Moving!
Initially, moderate levels of physical activity for 30 to 45 minutes, 5 days a week, should be encouraged
10,000 steps can really help you
Physical activity should be an integral part of weight loss therapy and weight maintenance.
90 minutes per day is even better and recommended by the Dietary Guidelines for Americans
FMI see

21. Let’s Get Moving! Work up to 60 minutes per day 6-7 days a week
FIT – frequency, intensity and time
If you have succeeded at something you should continue to improve it.

22. Why Exercise?
Contributes to weight loss in overweight and obese adults
May decrease abdominal fat
Increases cardiorespiratory fitness
Helps with maintenance of weight loss
Physical activity should be part of a comprehensive weight loss therapy and weight control program

23. Every Movement Helps Being more active and less sedentary is key
Cleaning and cooking burn twice as many calories as sitting
Start exercising slowly, and gradually increase the intensity. Trying too hard at first can lead to injury.

24. It All Adds Up
Your exercise can be done all at one time, or intermittently over the day
Initial activities may be walking or swimming at a slow pace
Every little bit counts – it is better to start slow and be more active than to try to do too much too soon too fast and get frustrated.

25. How to Be More Active Walk 30 minutes per day, every day
Reduce sedentary time each day
Increase daily activity – take the stairs, park farther away
More chores around the house
Add competitive sports when ready
You may also want to try:
flexibility exercise to attain full range of joint motion
strength or resistance exercise
aerobic conditioning

26. How to Choose A Weight Loss Program
Does the program provide counseling and support to help you change?
It is helpful to have your questions answered as needed.
Some people lose weight on their own; others like the support of a structured program. Overweight people who are successful at losing weight, and keeping it off, can reduce their risk factors for heart disease. If you decide to join any kind of weight control program, here are some questions to ask before you join.
Do you prefer individual counseling versus group counseling – this is something to consider so the program meets your needs.

27. How to Choose A Weight Loss Program
Is the staff made up of a variety of qualified health professionals such as registered dietitians, psychologists, and exercise physiologists?
You want to make sure the program is scientifically proven and sound.
You need to be evaluated by a physician if you have any health problems, are currently taking any medicine, or plan on taking any medicine, or plan to lose more than 15 to 20 pounds. If your weight control plan uses a very low-calorie diet (a special liquid formula that replaces all food for 1 to 4 months), an exam and follow up visits by a doctor are also needed.
You should run your program of choice by your physician – do you have medical issues that need to be addressed – like diabetes, heart disease or renal disease?

28. How to Choose A Weight Loss Program
Are food choices flexible and suitable?
Food recommended should be inexpensive and easily available.
The program should teach you how to change permanently those eating habits and lifestyle factors, such as lack of physical activity that have contributed to weight gain.

29. How to Choose A Weight Loss Program
Are weight goals set by the client and the health professional?
It is important that your goals are attainable and safe.
It is important to review your goals with a health professional. A general rule of thumb is to lose 10% of your body weight the first 6 months and then go slow and steady after that. You didn’t put it on in one day so you are not going to take it off in one day.

30. Goals Reduce body weight if overweight or obese.
Maintain a lower body weight over the long term.
Prevent further weight gain (a minimum goal).
Did you know that it is better to maintain a moderate weight loss over a longer period of time than it is to lose lots of weight and regain it?

31. Review Assess Your Weight Status
What is BMI?
Waist Circumference
Overweight PLUS 2 of these = health reason to lose weight
What Do I Do?
How to Choose A Weight Loss Program
Now is the time to review what you have learned and to accept questions from the audience.
Everyone can start thinking about what they need to do to adopt a healthier lifestyle and lose inches along the way – take it off and leave it off!

32. “Slow and steady wins the race.”
– Aesop (620 BC BC)
We hope you have enjoyed our show – if your BMI or waist are too high, and especially if you have other disease risk factors, your health and well-being depend on you being able to acknowledge that and lose weight. You will feel better, look better and be healthier – so don’t wait!
Thanks for watching our show!