February 11, 2012

BMI, Part III – How to change it!

Posted in Weight Loss tagged , , , , , , , at 12:19 pm by Dr Michelle Torrance ND, LAc

This is the last piece of my BMI discussion, and really, at the end of the day, this is the only part of BMI that most of us care about: our weight.

Most of us would love to be truthful when we say that we manage our weight because we “want to be healthier“, but most of the time our primary motivation for weight loss is because we feel better at a lower weight than we do at a higher one. Simple as that. For many of us a lower weight means a smaller dress size. But I want you to think of some of the other benefits that a lower weight brings:

  • If you are active in any sport, a lower weight usually translates into increased endurance, less muscle and joint strain, fewer injuries and better performance. A good example of this is a patient of mine who recently started rock climbing again. His initial modest loss of 8 lbs has already become an advantage when he’s hanging off a wall. Don’t underestimate gravity!
  • Improved fertility. For many women and men, even a small 5-10% change in body weight can hugely impact your ability to conceive. Remember, in Part II, when I discussed the metabolic effects of adipocytes (fat cells)? Well, this is one of the negative effects of carrying around too much weight. That extra weight is increasing your estrogen, decreasing your insulin sensitivity, throwing your adrenal function out of whack and thereby creating havoc with your hormones and your ability to regulate them.
  • Mood. This is an easy one. If we feel better about our bodies, we tend to feel more optimistic about our lives in general.
  • Energy. When we eat right, we feel good. Simple. Many times the food we eat causes our systems to be sluggish. When we clean it up, we literally “run” more efficiently. Less puffiness, bloating, better GI function. All of this translates into better energy.
  • Sleep. Carrying extra weight, especially visceral fat (the fat within the abdominal cavity), causes many of us to have difficulty breathing at night. Snoring is more common in heavier individuals. Sleep apnea has many causes, but extra weight in the torso and neck can hugely impact our ability to inhale & exhale efficiently. If there is enough excess weight on our chest, our breathing can literally stop. If we can get more oxygen during the night, we will feel better in the morning.

These are just a few examples of the real-life ways that being at a healthy weight can impact our lives for the better.

So, how to get there?

Research has proven time and time again that there are really only three things that need to happen for a person to successfully reach their goal weight:

  1. Pick a plan and stick with it. Really, almost any eating plan will work as long as it is followed consistently. This doesn’t take into account eating preferences, health benefits, nutritional or performance goals. To find a plan that you like, that feels right for you and does meet your other health goals, I recommend working with your doctor or a nutritionist or a personal trainer who has the right education and experience to advise you.
  2. Journal. I know, we all hate it. But there is nothing that is more effective at showing the truth of what we consume. You don’t need to write down every gram and calorie, but you do need to make a list of everything that passes your lips. It is enlightening! Many of us have a faulty memory when it comes to what we eat. Generally, we believe that we consume far, far less than we truly do. This is often because our food choices leave us unsatisfied. By writing down what we eat, we can make educated decisions to make better and more effective choices.
  3. Accountability. Find someone to be responsible to. Granted, choosing to lose weight and make lifestyle changes needs to be personally driven decision. However, being accountable to another individual will help you realize your goals. Knowing that you will be following up with your doctor, weighing in with your nutritionist, meeting up with a friend for a workout or training with your personal trainer will help you make the best decision possible when a food temptation comes your way, or when you feel like blowing off a workout that day.

And that is the magic formula – pick a plan and do it, write it down every day and check-in with somebody!


January 30, 2012

BMI – Part II

Posted in Weight Loss tagged , , , , , , at 7:04 pm by Dr Michelle Torrance ND, LAc

Aesthetically, we all know what being overweight looks and feels like. But do you know what is happening on the inside?

Adipocytes, aka fat cells, are commonly visualized as fluffy square-like cells that are plumped up by the fat within them. For many years, adipocytes were thought of as fairly inert and unexciting storage units. Current research, however, is showing that these cells do far more than just sit there and store our excesses for future use.

Nowadays, a fat cell is being seen as an extension of our endocrine (hormone) system. A good example of this is estrogen and cortisol production. In overweight women, a measurable amount of estrogen is created by the aromatase secreted by the fat cells. In my practice, I have often seen the phenomenon where a peri- or menopausal woman will lose weight and have an increase in her night sweats or hot flashes, or some mild hair loss. Her body eventually adjusts to the lower amount of estrogen and the symptoms resolve. Aromatase can have a multitude of effects depending on the area of fat distribution. Aromatase also creates excess cortisol. Excess cortisol interferes with proper insulin secretion and sensitivity. This creates blood sugar problems (hyperglycemia and Type II Diabetes) as well as increased truncal obesity, greater deposition of visceral fat and increased health risks. In other words, excess fat is creates an environment that makes it easier to be fat.

Now, how do adipocytes relate to BMI? If your BMI number is greater than 30, then you are for sure carrying around more body fat (aka adipocytes) than you should be.

Men and women often disagree with where the “perfect” body weight is on the chart. Most women’s projection of their ideal body weight usually fits into the “Healthy” weight range pretty easily, or is just above at a BMI of 25-26. Most men would disagree with a BMI of 19-24.9. This is especially true for men who have a lot of muscle. To be in the “Healthy” weight range of BMI, they find it too lean and too difficult to maintain. Generally, many men would be very comfortable within the “Overweight” range, 25-29.9. Anything higher than that and the health risks certainly outweigh the benefits.

Naturally, there are exceptions to every rule, but they are few and far between here. This is not the place to use the “I’m just big boned” excuse to justify being in a higher bracket. Probable exceptions include body-builders, elite athletes and those very few individuals who genetically carry a higher amount of bone and lean muscle mass. The vast majority of us, however, fall within the guidelines for the general population.


January 28, 2012

BMI – What does it really mean?

Posted in Weight Loss tagged , , , , , , at 12:54 pm by Dr Michelle Torrance ND, LAc

We’ve all looked it up – plug in your height and your weight and you get a number. http://www.nhlbisupport.com/bmi/

But what does it mean? You can reference the table that is usually attached, and see where you fall in the graph. You can look at the calculator’s recommendation about where you “should” be. You can look at the titles, “Healthy”, “Overweight“, “Obese” and see which category relates to you.

But the question really is, what do all those definitions mean to you?

Part I of the Answer

Let’s define BMI. Essentially, all it is is a height/weight ratio. It is very broad in its scope and its only purpose is to give an easy to use guideline regarding healthy vs. unhealthy weight. The higher the your number, the higher your health risks from weight and obesity related diseases.

What BMI doesn’t tell you: It doesn’t estimate your body fat. It can’t tell you how much abdominal or visceral fat you carry. It doesn’t predict your cardiovascular risks. It doesn’t care about your body composition.

What BMI does tell you: People with bigger numbers tend to be more sick. The higher the number, generally, the larger percentage of fat a person carries. The difference between “Healthy” and “Overweight” is fairly mild from a morbidity (the rate of incidence of disease) and mortality (death) point of view. But past that…”Obese”, “Morbid” and “Super”… some serious problems begin to arise.

Part II will discuss some of the metabolic effects that extra fat cells (adipocytes) create, and Part III of this posting will discuss some of the ways we can personally change these outcomes!