Saturday, May 11, 2019

Retrospective #85: Goal Weight and the BMI Table

Like many who are overweight, obese or morbidly obese (what a dreadful term!), I have spent a lot of time over the years thinking – dreaming really, about my goal weight. Those dreams have turned to reality for some of us who have finally found a way to lose weight without hunger and have seen the pounds drop off easily. And they are fat pounds, because we have become “fat burners,” through ketosis, enabling us to burn fat for energy by severely restricting our carbohydrate intake. Now, we are wondering, how far can I go? How far do I really want to go? How thin could I be?
The “experts” tell us not to be too ambitious – to set modest goals, because they know how hard it is to lose weight and how common it is to fail. They tell us that even a 10% (or less) weight loss will make a big difference in our health markers and outcomes, especially for Cardiovascular Disease (CVD). Still, those of us who are losing weight easily can imagine ourselves as much thinner. As I was seeing two pounds of fat dissolve a week for a year (about 5 years ago), I imagined that I could be 187 pounds – half my original 375. At one point I had lost 170 pounds (45% of me) and was 205 pounds, when I stopped losing.
In early 2013 when I wrote this, after regaining 70 pounds over the last four years, I was starting to lose again. My goal was to lose just 50 of the 70 regained and to reach a more modest goal of 225. That would represent a loss of 150 pounds (40%) from the start. That weight was my new goal weight – the one I would strive to maintain for the rest of my life.
But what do all these numbers mean? My wife told me I would look like a scarecrow if I had lost 187 pounds. I would be “just half the man I used to be,” my wife joked. But at 225, I would still be clinically classified as obese. A neighbor who saw me on the street when I was near my low of 205 said, “Are you okay? Are you well?” Funny!
Goal weight is purely personal. Ideal weight is somewhat different. It’s a bit more impersonal. What I call my body type (“big boned”) might actually just be my body image from having lived a lifetime looking at it. Why else would there be just one clinical standard in the U.S. (since 1998 when we adopted the WHO standard) for judging weight?
Body Mass Index (BMI) is now the universal “scale” for both men and women. It requires only height and weight and is, in my opinion, totally unrealistic. Using this index, a person (male or female of any “body type”) who is now 5’-11” tall should weigh between 136 and 172 to be considered “normal “weight. The average “normal weight” for a person 5’-11” person would be 150 pounds. That’s ridiculous. It’s skeletal – as my wife said – a mere scarecrow. My father told me he weighed 150 pounds in the Great Depression, and again when he was diagnosed with Tuberculosis (TB) in 1950. A nine-month stay in the hospital put a little flesh on his bones. After, he weighed 175!
So, my “goal weight” of 225 pounds is still much higher than my “ideal weight.” It is in fact 75 pounds higher. It is higher even than the BMI range (179 to 208) allows for me to be considered “overweight.” In fact, 225 pounds is still considered “obese” for a 5’ – 11” person. The “obese” range is 215 to 279. But that’s okay. It’s my goal weight.
Lean Body Weight is another term that is sometimes used by athletes (and thin people). It includes only a small amount of body fat, to cushion the organs and provide a daily energy reserve and long-term illness. To me it is a foreign concept, an “exotic” species.  It is achievable, no doubt, and the most desirable weight to be, if you have the body type, a favorable set of genes, and a history of eating right and exercising regularly. That’s not me.
However, lean body weight is a very useful weight to use when deciding how much protein to eat to avoid unwanted gluconeogenesis. If you are a Type 2 diabetic who is working hard to achieve optimal glucose control and weight loss through diet, it’s useful. That’s me, but that’s another story.

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