Posts Tagged ‘Overweight’

Not One ‘Plus Size’ Fits All

April 23rd, 2015 at 1:20 pm by timigustafson

When it comes to treating weight problems, even experts believe that similar methods can be applied almost universally: Put your patients on a diet, have them engage in regular exercise, and, if all else fails, recommend some surgical procedure. What gets rarely looked at are the differences between overweight individuals that may have led to their unhealthy weight gain in the first place. Only one such study has recently been published, and the results are eye-opening.

For the study, scientists from the universities of Sheffield, England, Harvard, United States, and Toronto, Canada, analyzed medical data of over 4,000 overweight or obese men and women in terms of common and distinguishing characteristics. In the end, they came up with six ‘categories’ or ‘types’ that helped them better understand their subjects’ eating behaviors and lifestyle choices.

The first group was identified as “heavy drinking males” whose excessively high alcohol intake resulted in weight problems. Getting members of this category to limit their consumption of alcoholic beverages would obviously be an important step toward successful weight control.

The second group, named “younger healthy females,” consisted of women who were generally healthy except for their weight issues. Eating patterns and exercise levels were viewed as largely acceptable but were interspersed with bouts of binge eating and occasional heavy drinking, which, again, contributed to weight gain. Remedies hereto would be similar to their male counterparts.

A third type was called “the affluent and healthy elderly,” seniors who enjoyed retirement life a bit too much and paid the price with an unhealthily expanding waistline. Tuning it down a little would be the appropriate strategy.

Another group of older individuals was diagnosed with one or more chronic health conditions like diabetes and high blood pressure, in addition to being overweight. Those “physically sick but otherwise happy” people were often unaware of how their weight aggravated their other ills. Counseling with the aim of diet and lifestyle changes could lead to major improvements in such cases.

Mental dysfunctions like anxiety and depression were also found to be increasingly damaging to people as they grew older. The “unhappy, anxious middle-aged,” as the researchers named this group, often showed a close connection between their inner feelings and their outer appearance, especially in terms of weight. As psychological disorders oftentimes manifest themselves physically, equal attention must be paid to both the roots and symptoms before any progress can be hoped for.

Lastly, the research team focused on those whom they found in the “poorest health.” The prevalence of weight problems and chronic illnesses was especially high in this group, and eating and lifestyle patterns were predictably dismal. Overweight and obese patients of this type require intensive care and should be treated with the most effective methods. Because of the severity of the health conditions typically found in this category, the researchers saw here justification for the clinical weight loss approaches now widely in use.

Obviously, attempts like these to find patterns in complex phenomena have their limits. There might be numerous additional factors leading to weight gain that have not received enough attention in this particular study. But its central take-away is that the overweight and obese are not a homogenous part of the population with the same health needs, says Dr. Mark Green of Sheffield University, the lead author of the study report, in a press release about his findings. If we don’t come up with better solutions and more customized, or as he calls it “bespoke,” forms of treatment, we will continue to fail serving those who need our help most.

As a dietitian and health counselor, I couldn’t agree more. After all, that is what one-on-one counseling entails. But, unfortunately, the system is not set up for this sort of effort. For instance, health insurance companies favor short-term treatments like weight loss surgery over open-ended approaches, including diet and lifestyle coaching. We can only hope that studies like this will eventually bring a different view to the agenda.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (


Instead of Dieting, Build a Healthy Lifestyle

January 9th, 2013 at 12:00 pm by timigustafson

Just in time for resolution season when many Americans try hard to lose the extra weight they gained over the holidays, a surprising study by the Centers for Disease Control and Prevention (CDC) has come out, seemingly suggesting that a few additional pounds may not do too much harm after all, and being a bit overweight may even reduce a person’s mortality risk. The findings, which were widely publicized in the press, quickly proved controversial and evoked some strong reactions from health experts and the public. Is this the end of the need for weight control?

“Not all weight is the same,” said Dr. Thomas Frieden, director of the CDC department that conducted the study, in an interview with USA TODAY. “If you work out and build muscle mass, you may increase weight and that’s healthy.”

Whether a few extra pounds matter much or not depends on how someone has acquired them, said Dr. Walter Willet, professor at Harvard School of Public Health, in the same interview. “If someone has always been muscular and is active and strong, and their blood pressure and levels of blood glucose and cholesterol are fine, then their health risks are probably minimal. However, if someone has gotten to this weight by putting on 10 pounds or more, has increased their waistline by more than two inches, or has elevations in blood pressure, glucose or cholesterol, then this weight can be a serious health risk.”

The problem is that the large majority of overweight people develop metabolic abnormalities such as high blood pressure, diabetes and many other conditions. That’s why most will benefit from losing weight, even if it’s only a modest amount, he added.

Even those who are still within a healthy weight range should take proactive steps to avoid weight increase by eating right and exercising regularly. Obviously, it is much easier to prevent any damage than to repair it.

Either way, successful weight management does not come in form of quick and temporary fixes but with a firm commitment to your overall health and well-being that lasts a lifetime. This may entail paying careful attention to your eating habits and, if necessary, making some changes, which can range from cutting back on portion sizes to learning entirely different eating styles. It can require going on more walks or making the gym your new obsession.

Those who are significantly overweight and face health threats because of that may have to take some immediate action. Even losing relatively small amounts of weight can be a lifesaver. In extreme cases, more drastic measures under medical supervision may be necessary.

Unfortunately, most dieters still focus too much on calorie reduction, in spite of the fact that deprivation rarely works. That’s why so many encounter a so-called ‘yo-yo’ effect, where they regain the weight they’ve lost and sometimes add more once the dieting is over.

No matter how extensive your efforts will need to be, they don’t have to be complicated. Most experts recommend to start small and set more ambitious goals over time. Aim for balance, variety and moderation in your eating pattern. Develop an exercise regimen that matches your needs and that you enjoy enough to stick with it.

Don’t try changing everything all at once. Allow for occasional treats, count on lapses, but don’t lose sight of your long-term goals. Ask for support from loved ones or seek professional help when the going gets too tough. In the end, what matters most is that you own your new and improved lifestyle and that it becomes part of who you are. And it will, if you try long and hard enough.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at You can follow Timi on Twitter and on Facebook.


Weight Issues Not as Harmless as Study May Suggest

January 5th, 2013 at 2:12 pm by timigustafson

Obesity may have multiple negative health effects, but higher mortality rates are not among them, according to a study that was recently published in the Journal of the American Medical Association (JAMA). Researchers found that people with weight problems don’t necessarily have shorter life expectancies than their normal-weight contemporaries. In fact, a few extra pounds could even lower the risk of an untimely death.

The findings were greeted with great interest in the press and welcomed as good news for the two-thirds of all Americans who, according to the Centers for Disease Control and Prevention (CDC), are considered overweight or obese.

Based on the results of this study, the government ought to redefine the meaning of “overweight” and “obese” and re-categorize a large part of the population as normal-weight and healthy, writes Paul Campus, author of “The Obesity Myth: Why America’s Obsession with Weight Is Hazardous to Your Health” (Penguin Group, 2004), in an op-ed piece in the New York Times.

“If the government were to redefine normal weight as one that doesn’t increase the risk of death, then 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead,” he says.

If only it were that easy.

What this particular study does say is that among all causes of mortality, not overall health risks, being overweight does not seem to stand out as a particularly significant factor. But that doesn’t mean the obesity crisis should no longer be treated as such.

In fact, the study, which investigated the causes of 270,000 deaths from around the world, also found that the morbidly obese had a 29 percent increased risk of dying prematurely compared to normal-weight and moderately overweight people.

It would be a mistake to conclude from this one study that Americans can keep overeating, says Dr. Thomas Frieden, director of the CDC department that conducted the research. “I don’t think anyone would disagree with the basic fact that being more physically active and eating a healthier diet is very important for your health,” he said in an interview with the Wall Street Journal.

Other experts agree. The body mass index (BMI) by which weight levels are commonly measured is an imperfect assessment of the risk of mortality, and additional factors like blood pressure, cholesterol and blood sugar must also be considered, says Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis, Missouri, in an interview with the New York Times in response to the study release.

But many of these diseases are diet and lifestyle related, and together they amount to over 60 percent of all causes of death in the world today, according to the World Health Organization (WHO).

Maintaining a healthy weight range may not automatically produce longevity. It may have little or no influence on one’s life expectancy at all, as this study seems to indicate. But we can say with certainty that struggling with weight problems and other related health issues significantly takes away from the quality of life a person can enjoy, and increasingly so with age. A report published in the American Journal of Preventive Medicine (AJPM) found that “Quality-Adjusted Life Years (QALYs) lost to U.S. adults due to morbidity and mortality from obesity have more than doubled from 1993 to 2008 and the prevalence of obesity has increased 89.9 percent during the same period.”

If we only look at statistics, we may not understand how weight problems affect people in so many ways. Being unable to move without pain, being dependent on medications, getting out of breath at the slightest physical strain, those are the consequences that may not actually shorten life but make it so much harder – and unnecessarily so.

If you enjoyed this article, you may also enjoy reading  “Nearly Half of All Americans Will Be Obese Within Two Decades, Study Projects.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at You can follow Timi on Twitter and on Facebook.


What Do You Really Know About Healthy Eating?

September 12th, 2012 at 7:07 am by timigustafson

Most Americans think they’re healthier than they actually are. Considering that well over 60 percent of the U.S. population is struggling with weight problems, that is quite surprising. Yet 80 percent of participants in a recent survey identified themselves as “extremely healthy” or “very healthy.” But only 20 percent claimed to have what is considered an all-around healthy diet, according to the NPD group, a leading market research company that conducted the study.

Despite of the overly positive self-assessment, about half of the almost 2,000 adults who were interviewed agreed that their existing diet could use some help. Roughly half of those said that changing their eating habits would require some exclusion of certain foods (presumably of lesser nutritional quality) as well as inclusion of others (presumably of higher nutritional quality). 26 percent saw the need to add more healthy foods, and only 19 percent thought they needed to cut back on what they usually ate. There were slightly fewer respondents claiming to be on a weight loss diet than in previous years when similar research was done.

Other studies have found that it is not rare for people who are overweight or obese to misjudge their size, sometimes considerably. Researchers from the University of Illinois at Urbana-Champaign found in a study on weight problems among young Hispanics that only a minority of overweight or obese participants judged their body size accurately. Nearly 60 percent of those whose BMI identified them as overweight described themselves as normal weight, while 75 percent of those who were obese thought they were merely overweight. One in three women does not realize when she gains five pounds and 15 percent aren’t aware of weight increases of more then 10 pounds, according to a survey by the University of Texas in Galveston.

Even for Americans who are interested in eating better and keeping their waistline from expanding, maintaining a healthier lifestyle remains an uphill battle. Food prices, especially for fresh produce, are high and keep rising. Contradictory messages like a recent study that questioned the benefits of buying organic add more uncertainty. Many consumers either give up altogether or make inconsistent dietary decisions. “There’s complete confusion,” said Maria Mogelonsky, a food analyst for a global marketing firm in an interview with the New York Times on the subject. “Most people have a randomly arranged set of diet principles. They buy organics sometimes. They buy based on price sometimes. Very few people are completely committed to one cause,” she said.

So what advice is there to give?

• The first thing I tell my clients is not to make their dietary improvements too complicated. If your new regimen doesn’t fit your lifestyle, it won’t stick, no matter how hard you try.

• Learn a few basic facts about nutrition (your body needs over 40 different nutrients every day), and how you can achieve and maintain balance in your diet.

• Don’t start controlling your food intake by counting calories. Rather, watch your portion sizes. Your stomach’s size is roughly equivalent to the size of your fist. Your servings should not exceed that.

• Gradually increase your consumption of healthy foods like fruits and vegetables. At the same time, decrease your intake of processed and packaged foods.

• Buy fresh produce as much and as often as it fits your budget. To save costs, choose locally grown, seasonal items whenever possible. Farmers markets can offer better quality at lower prices than supermarkets.

• Prepare most of your meals from scratch. Eating out or grabbing some take-out on the way home should be the exception, not the rule.

• Make water your primary beverage. Avoid sodas and keep caffeine and alcohol to a minimum.

• Get enough exercise to burn off calories your body doesn’t need.

If all or some of this is too challenging for you right now, take the steps you can manage and work toward the rest as you go.

If you enjoyed this article, you may also be interested in “Will Rising Food Prices Change America’s Eating Habits.”

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (, and at You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit

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