Weight GoalsSaturday, January 15, 2011
Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.
This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.
One of the first questions a patient will ask you as they embark on an intentional weight-loss effort is, “How much do you think I should weigh?” Unfortunately, there is no correct answer.
Patients often want to know their ideal weight or ideal BMI. While a variety of different classification schemes for obesity are available, their utility lies primarily in statistical analysis and research, not in the individual clinical encounter.
Telling a patient whose BMI is 50 that they need to lose virtually 50% of their present body weight to be healthy is an exceptionally unhelpful means of discussing weight. The patient may not have weighed that little in decades, and you will have only provided them with a goal that seems daunting if not wholly unattainable.
Waist circumference and waist-to-hip ratios are useful in ascertaining the medical risk a patient’s weight presents, but are no better than BMI in terms of goal-setting.
Even a 5% weight loss has been shown to produce medically measurable results, so any amount of weight loss is helpful. In some cases, rapid weight loss over the first few weeks of a weight-management program, as induced by a very low-calorie* diet, can increase motivation. However, this rapid rate of weight loss cannot be maintained and is likely to lead to frustration later in the program. As with any obesity treatment, the maintenance of lean body mass is crucial and rapid weight loss has been shown to disproportionately affect lean tissue. If a patient insists on rapid weight loss, you may need to reassess their underlying motivations and expectations.
© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.
The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.
Members of the Canadian Obesity Network can download Best Weight for free.