National Heart, Lung and Blood Institute

Why Is a Healthy Weight Important?

Reaching and maintaining a healthy weight is important for overall health and can help you prevent and control many diseases and conditions. If you are overweight or obese, you are at higher risk of developing serious health problems, including heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. That is why maintaining a healthy weight is so important: It helps you lower your risk for developing these problems, helps you feel good about yourself, and gives you more energy to enjoy life. 

What Is Overweight and Obesity?

Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat. Body mass index (BMI) is a useful measure of overweight and obesity. The information on this Web site will provide you with information about BMI (including limitations of this measure) and how to reach and stay at a healthy weight. Talk to your health care provider if you are concerned about your BMI.

What Factors Contribute To a Healthy Weight?

Many factors can contribute to a person’s weight. These factors include environment, family history and genetics, metabolism (the way your body changes food and oxygen into energy), and behavior or habits.

Energy Balance

Energy balance is important for maintaining a healthy weight. The amount of energy or calories you get from food and drinks (energy IN) is balanced with the energy your body uses for things like breathing, digesting, and being physically active (energy OUT):

• The same amount of energy IN and energy OUT over time = weight stays the same (energy balance)
• More energy IN than OUT over time = weight gain
• More energy OUT than IN over time = weight loss

To maintain a healthy weight, your energy IN and OUT don’t have to balance exactly every day. It’s the balance over time that helps you maintain a healthy weight.

You can reach and maintain a healthy weight if you:

• Follow a healthy diet, and if you are overweight or obese, reduce your daily intake by 500 calories for weight loss
• Are physically active
• Limit the time you spend being physically inactive

Assessing Your Weight and Health Risk

Assessment of weight and health risk involves using three key measures:

1. Body mass index (BMI)
2. Waist circumference
3. Risk factors for diseases and conditions associated with obesity

Body Mass Index (BMI)

BMI is a useful measure of overweight and obesity. It is calculated from your height and weight. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers.

Although BMI can be used for most men and women, it does have some limits:

• 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.

Use the BMI Calculator or BMI Tables to estimate your body fat. The BMI score means the following:

Waist Circumference

Measuring waist circumference helps screen for possible health risks that come with overweight and obesity. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk goes up with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To correctly measure your waist, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.

The table Risks of Obesity-Associated Diseases by BMI and Waist Circumference provides you with an idea of whether your BMI combined with your waist circumference increases your risk for developing obesity-associated diseases or conditions.

Classification of Overweight and Obesity by BMI, Waist Circumference, and Associated Disease Risks

* Disease risk for type 2 diabetes, hypertension, and CVD.
+ Increased waist circumference also can be a marker for increased risk, even in persons of normal weight.

Risk Factors for Health Topics Associated With Obesity

Along with being overweight or obese, the following conditions will put you at greater risk for heart disease and other conditions:

Risk Factors

• 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

For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, it is recommended that you lose weight. Even a small weight loss (between 5 and 10 percent of your current weight) will help lower your risk of developing diseases associated with obesity. People who are overweight, do not have a high waist measurement, and have fewer than two risk factors may need to prevent further weight gain rather than lose weight.

Talk to your doctor to see whether you are at an increased risk and whether you should lose weight. Your doctor will evaluate your BMI, waist measurement, and other risk factors for heart disease.

The good news is even a small weight loss (between 5 and 10 percent of your current weight) will help lower your risk of developing those diseases.

Control Your Weight

Changing the way you approach weight loss can help you be more successful at weight management. Most people who are trying to lose weight focus on just the goal of weight loss. However, setting the right goals and focusing on lifestyle changes such as following a healthy eating plan, watching portion sizes, being physically active, and reducing sedentary time are much more effective.

Guide to Behavior Change

Your Weight Is Important

Over the past few years it has become clear that weight is an important health issue. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health care encounters in which they felt blamed, but not helped. Successful weight management is a long-term challenge.

Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who carry the excess weight. The amount of weight loss needed to improve your health may be much less than you wish to lose, when you consider how you evaluate your weight. Research has shown that your health can be greatly improved by a loss of 5–10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5–10 percent of your starting weight is both realistic and valuable.

Behaviors That Will Help You Lose Weight and Maintain It

Set the Right Goals
Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and physical activity changes that will lead to long-term weight change. Successful weight managers are those who select two or three goals at a time that are manageable.

Useful goals should be (1) specific; (2) attainable (doable); and (3) forgiving (less than perfect). "Exercise more" is a great goal, but it's not specific. "Walk 5 miles every day" is specific and measurable, but is it doable if you're just starting out? "Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, 5 days each week" is specific, doable, and forgiving. In short, a great goal!

Nothing Succeeds Like Success

Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e.g., an initial reduction of fat intake from 40 percent of calories to 35 percent of calories, and later to 30 percent). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: (1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and (2) consecutive rewards keep the overall effort invigorated.

Reward Success (But Not With Food)

An effective reward is something that is desirable, timely, and dependent on meeting your goal. The rewards you choose may be material (e.g., a movie or music CD, or a payment toward buying a more costly item) or an act of self-kindness (e.g., an afternoon off from work or just an hour of quiet time away from family). Frequent small rewards, earned for meeting smaller goals, are more effective than bigger rewards that require a long, difficult effort.

Balance Your Food Checkbook

"Self-monitoring" refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, amount of physical activity, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually moves you closer to the desired direction and can produce "real-time" records for review by you and your health care provider. For example, keeping a record of your physical activity can let you and your provider know quickly how you're doing. When the record shows that your activity is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.

While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change from day to day, and water changes are often the result of things that have nothing to do with your weight-management efforts.

Avoid a Chain Reaction

Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to change the situation, such as by separating the association of eating from the cue (don't eat while watching television), avoiding or eliminating the cue (leave the coffee room immediately after pouring coffee), or changing the circumstances surrounding the cue (plan to meet your friend in a nonfood setting). In general, visible and reachable food items are often cues for unplanned eating.

Get the Fullness Message

Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message that you've been fed. Eating slowly will help you feel satisfied. Eating lots of vegetables and fruits can make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear too small. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.

Selecting a Weight-Loss Program

Check It Out: Before You Sign Up for Any Weight-Loss Program

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.

• Does the program provide counseling to help you change your eating activity and personal habits?
  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.
• Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists?
  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 followup visits by a doctor also are needed.
• Is training available on how to deal with times when you may feel stressed and slip back to old habits?
  The program should provide long-term strategies to deal with weight problems you may have in the future. These strategies might include things like setting up a support system and establishing a physical activity routine.
• Is attention paid to keeping the weight off? How long is this phase?
  Choose a program that teaches skills and techniques to make permanent changes in eating habits and levels of physical activity to prevent weight gain.
• Are food choices flexible and suitable? Are weight goals set by the client and the health professional?
  The program should consider your food likes and dislikes and your lifestyle when your weight-loss goals are planned.

There are other questions you can ask about how well a weight-loss program works. Because many programs don't gather this information, you may not get answers. But it's still important to ask them:

• What percentage of people complete the program?
• What is the average weight loss among people who finish the program?
• What percentage of people have problems or side effects? What are they?
• Are there fees or costs for additional items, such as dietary supplements?

Remember, quick weight loss methods don't provide lasting results. Weight-loss methods that rely on diet aids like drinks, prepackaged foods, or diet pills don't work in the long run. Whether you lose weight on your own or with a group, remember that the most important changes are long term. No matter how much weight you have to lose, modest goals and a slow course will increase your chances of both losing the weight and keeping it off.

Eat Right

To lose weight, it's important to make lifestyle changes with a focus on reducing calories from food and beverages, a healthy eating plan, and portion control. This section will provide you with guidance and tools on how to eat right. Over time, these changes will become part of your everyday routine.

• Healthy Eating Plan
• Menu Plans
• Food Exchange Lists
• Shopping Tips
• Portion Distortion
• Recipes
• Daily Food and Activity Diary
• Tip for Healthy Eating On the Go or At Home

Be Physically Active

Being physically active and eating fewer calories will help you lose weight and keep the weight off over time.

While people vary quite a bit in the amount of physical activity they need for weight control, many can maintain their weight by doing 150 to 300 minutes (2 ½ to 5 hours) a week of moderate-intensity activity such as brisk walking.

People who want to lose a large amount of weight (more than 5 percent of their body weight)—and people who want to keep off the weight that they’ve lost—may need to be physically active for more than 300 minutes of moderate-intensity activity each week.

For more information on these recommendations, check out the 2008 Physical Activity Guidelines for Americans. Or check out our fact sheet on physical activityon NHLBI’s Diseases and Conditions Index.

Healthy Weight Tools

BMI Calculator

The BMI Calculator is an easy-to-use online tool to help you estimate body fat. It is a measure of your weight relative to your height. Combining BMI with waist circumference measures and other risk factors for heart disease can yield your risk for developing obesity-associated diseases.

Check your BMI online

Menu Plans

A variety of reduced-calorie daily menus are provided to help make it easier for you to eat right and lose weight. The sample menus include ideas for traditional American meals as well as ethnic and vegetarian meals.

Portion Distortion

The Portion Distortion quiz is an interactive and fun way to assess your knowledge about how today's portions compare to the portions available 20 years ago. You also will learn about the amount of physical activity required to burn off the extra calories provided by today's portions.

Take the quiz

Key Recommendations

• Weight loss to lower elevated blood pressure in overweight and obese persons with high blood pressure.
• Weight loss to lower elevated levels of total cholesterol, LDL-cholesterol, and triglycerides, and to raise low levels of HDL-cholesterol, in overweight and obese persons with dyslipidemia.
• Weight loss to lower elevated blood glucose levels in overweight and obese persons with type 2 diabetes.
• Use the BMI to assess overweight and obesity. Body weight alone can be used to follow weight loss and to determine the effectiveness of therapy.
• Use the BMI to classify overweight and obesity and to estimate relative risk of disease compared to normal weight.
• The waist circumference should be used to assess abdominal fat content.
• The initial goal of weight-loss therapy should be to reduce body weight by about 10 percent from baseline. With success, and if warranted, further weight loss can be attempted.
• Weight loss should be about 1 to 2 pounds per week for a period of 6 months, with the subsequent strategy based on the amount of weight lost.
• Low-calorie diets (LCD) for weight loss in overweight and obese persons. Reducing fat as part of an LCD is a practical way to reduce calories.
• Reducing dietary fat alone without reducing calories is not sufficient for weight loss. However, reducing dietary fat, along with reducing dietary carbohydrates, can help reduce calories.
• A diet that is individually planned to help create a deficit of 500 to 1,000 kcal/day should be an intregal part of any program aimed at achieving a weight loss of 1 to 2 pounds per week.
• Physical activity should be part of a comprehensive weight loss therapy and weight control program because it (1) modestly contributes to weight loss in overweight and obese adults, (2) may decrease abdominal fat, (3) increases cardiorespiratory fitness, and (4) may help with maintenance of weight loss.
• Physical activity should be an integral part of weight-loss therapy and weight maintenance. Initially, moderate levels of physical activity for 30 to 45 minutes, 3 to 5 days a week, should be encouraged. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week.
• The combination of a reduced-calorie diet and increased physical activity is recommended, because it produces weight loss that also may result in decreases in abdominal fat and increases in cardiorespiratory fitness.
• Behavior therapy is a useful adjunct when incorporated into treatment for weight loss and weight maintenance.
• Weight-loss and weight-maintenance therapy should employ the combination of LCDs, increased physical activity, and behavior therapy.
• After successful weight loss, the likelihood of weight-loss maintenance is enhanced by a program consisting of dietary therapy, physical activity, and behavior therapy, which should be continued indefinitely. Drug therapy also can be used. However, drug safety and efficacy beyond 1 year of total treatment have not been established.
• A weight maintenance program should be a priority after the initial 6 months of weight-loss therapy.

https://www.nhlbi.nih.gov/health/educational/wecan/index.htm

Information for Health Professionals

Overweight and obesity is a serious health problem that affects millions of Americans. These conditions substantially increase the risk of morbidity from hypertension; dyslipidemia; type 2 diabetes; coronary heart disease; stroke; gallbladder disease; osteoarthritis; sleep apnea and respiratory problems; and endometrial, breast, prostate, and colon cancers. Higher body weights also are associated with increases in all-cause mortality.

Adults

According to the National Health and Nutrition Examination Survey (NHANES) data from 2007–08, the overall prevalence of overweight and obesity for adults was 68 percent (approximately 72 percent among men and 64 percent among women).

Among women, the overall prevalence of obesity was 35.5 percent.

Among men, the overall prevalence of obesity was 32.2 percent.

Children and Teens

Children have become heavier as well. In the past 30 years, the prevalence of childhood obesity has more than doubled among children ages 2-5, has tripled among youth ages 6-11, and has more than tripled among adolescents ages 12-19. However, recent data suggest that the rate of overweight in children did not increase significantly between 1999 and 2008, except in the heaviest boys (BMI for age greater than or equal to the 97th percentile).

This rate, though, remains alarmingly high. Statistics show about 17 percent of American children ages 2 to 19, or 1 in 6, are obese. Further, the latest data continue to suggest that overweight and obesity are having a greater effect on minorities, including blacks and Hispanics