Being overweight is a condition of abnormal or excessive fat in the body to the extent that it may have a negative effect on your health. By calculating the Body Mass Index (BMI), we can tell whether or not a person is overweight.

BMI =   __weight in kg__
           (height in metres)²

The ‘healthy’ range is 18.5 – 25. Overweight people score 25 - 30 and obese people, over 30. These cut-off points are not absolute and people with high muscle mass (such as body builders) may have a high BMI without being overweight.

Being overweight is the result of an energy imbalance where energy intake has been greater than the energy use over a period of many years. Obesity is rarely caused by a slow metabolism or hormonal problems. An excess of the wrong food and a lack of exercise are not the only causes of this imbalance. Other factors have also been associated with obesity:

• Family history of obesity
• The more pregnancies a woman has had, the more likely she is to be overweight
• In South Africa, low-income groups tend to be less overweight, except in communities where obesity is culturally regarded as attractive
• Alcohol consumption, cigarette smoking and negative emotions, such as depression, have been found to induce obesity

What are the dangers of being overweight?

Being overweight can increase the risk of developing:

• Heart disease (extra weight puts more strain on the heart)
• Certain cancers, arthritis, shortness of breath, gallstones, slower healing and increased susceptibility to infections
• Psychological problems - the obese person may feel insecure  
  The risk factors for developing heart disease include:

• High blood pressure (the risk of developing increased blood pressure is 2-6 times higher in overweight than healthy weight individuals)
• High blood cholesterol
• High triglycerides (another type of fat)
• Diabetes

The apple vs. the pear
It has been found that people with an android fat distribution (also called ‘apple’ form, i.e. more fat around the waist than around the hip area) have an increased risk of heart disease than those with the ‘pear’ shape (where the fat is mostly around the hips). The ‘apple’ form is more common in men. Body fat distribution is more strongly linked heart disease than a high BMI.  Waist circumference over 94cm in men and 80cm in women is considered as increased risk. Over 102cm in men and 88cm in women is seen as high risk.

How do I lose weight?
Obesity can be seen as a disease of lifestyle. By making small changes in our lifestyles, this problem can be overcome. Even small weight losses have been shown to have significant health benefits. Dieting does not mean eating small portions. The idea is to eat sensibly and make the right food choices:

• Have at least 3 meals per day. If you are constantly hungry, rather eat 5 - 6 smaller meals or healthy snacks between meals (e.g. Fruit)
• Eat breakfast. People who skip breakfast are more prone to obesity
• Reduce fat intake, especially saturated fats, i.e. animal fats and so-called ‘hidden’ fats found in cookies, pastries and processed foods

1g fat provides 38kJ compared with 1g of protein or 1g of carbohydrate that provide only 17kJ.

• Use healthy cooking methods such as steaming, boiling, grilling and baking. - Limit extra fats (cream, butter, mayonnaise, margarine, oil and dressings)
• Fibre makes you feel fuller for longer. Increase your intake by using whole wheat bread and pasta, brown rice, oats etc
• Eat at least five portions of fruit and vegetables every day
• Limit your salt intake. It makes your body retain water
• Drink at least 6-8 glasses of water per day
• Limit alcohol intake to 2 drinks for women and 3 for men per day, and choose drinks that are lower in energy (kJ) such as dry wine, ‘light’ beers and spirits diluted with soda water
• Regular physical exercise is just as important as adjusting your eating plan.
• Join a weight-loss group. Sharing problems/successes encourages people
• Self-motivation is very important. Work at changing your lifestyle to improve health, not just looks
• Remember that losing weight takes. Weight loss of ½kg - 1kg per week will ensure that it’s fat (not water) being lost

It is important to realise that the combination of exercise and diet is the most effective long-term approach to losing weight. The type of exercise (aerobic exercise) that should be done includes: brisk walking, jogging, cycling and swimming.

Additional benefits of aerobic exercise are:

• Building muscle
• Increasing metabolism
• Reducing body fat and improving body fat distribution
• Limiting weight regain

Individuals starting an exercise programme should consult their doctors first.

There are so many diets - which one should I go for?
Most of the ‘crash’ or ‘fad’ diets are in fact not healthy, and should be avoided.

How to spot a fad diet:

• Promises of large and rapid weight loss
• Short-term diet
• No exercise required
• Special garments or passive exercise machines involved
• Magical ingredients with special abilities to speed up metabolism
• Claims you can eat as much as you like and still lose weight
• Combinations of specific foods are advocated
• The use of only one or two types of food
• An exotic range of expensive and unusual foods
• Special powders, pills and meal replacements or injections
• Food replacements and vitamin/mineral supplements

Generally, these ‘magic’ cures are expensive and provide with only short-term results. With quick weight loss, it’s not usually fat that is lost, but fluid and muscle mass. These diets are typically low in energy, causing the body’s metabolism to slow down. As metabolism slows, the dietary intake also needs to be lowered to cause continuous weight loss, resulting in a slower weight loss or a complete stop. Additionally, these diets are nutritionally inadequate, so they usually require nutritional supplementation.

Ideally, consult a registered dietician for a healthy weight-loss diet.

How to spot a healthy weight-loss diet:

• Allows a choice of many different types of food and includes all food groups
• Promotes foods low in saturated fat and lower-fat cooking methods
• Promotes lifelong exercise
• Does not promise rapid results

This is one in a series of brochures. For the full series and more heart smart information call the Heart Mark diet line on 0860 1 43278 (0860 1 HEART) or visit www.heartfoundation.co.za.

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