What is a Healthy Weight? A Question to Ponder

[Joan E. Guthrie Medlen]

Since you're looking to write something, I would also like to toss out a
gliche in using BMI as a measure of health. For persons with developmental
disabilities, muscle tone is often affected. For some, the issue is
hypertonia, for others it is hypotonia. In both these situations, BMI is
affected. I'm currently trying to discern what a "healthy weight" and body
image is for adults with Down syndrome. We know there is a tendency for
weight gain, but as time goes on, people iwth Down syndrome are living
longer, have greater opportunities, and are in general making healthier
decisions. Even son, with low muscle tone, BMI measurements are too
restrictive and the body shape of a healthy person with Down synddrome is
much "softer" than what is presumed for the rest of the population.

I don't know if this fits into your essay or not, but it is a consideration
in my work.

Good luck!

Joan E. Guthrie Medlen, R.D.,L.D.

At 04:17 PM 1/24/01 -0800, you wrote:

>I am writing this because I wish to present an alternative response to the 

>question, "What is a healthy weight?" other than "It is a BMI of 25 or 

>less," or  "It is a BMI above the 95th percentile (for children).  As 

>stated in the essay, many dietitians, (not all, of course) feel 

>uncomfortable with these definitions and are searching for alternative 

>definitions.  I am proposing one and trying to get feedback about it.  The 

>internet offers a quick and easy way to do this.  I have done other 

>projects like this using the internet, i.e. development of the tenets of 

>size acceptance, that have been very helpful to those of us who are not 

>satisfied with the status quo and want to develop definitions we feel 

>comfortable using.  The behaviors that I described at the end of the essay 

>were included because dietitians often define a healthy lifestyle as 

>"eating a nutritious diet and exercising regularly."  Again, I feel 

>uncomfortable with such a narrow definition

>and wanted to expand it.  If I understand you correctly, you feel this is 

>to simplistic and flippant and should be much more detailed?  Thank you for 

>taking the time to share your thoughts....Joanne

>

>

>>What are you writing this for? Maybe you said but I when I read the last

>>paragraph, I though" way to simplistic for most things compared to

>>"perfect".     Being safe in a car is not just wearing a seat belt, it is

>>many defensive driving techniques too.

>>30 minutes of activity is a start, but for health we need strength ,

>>balance and endurance activity.  Just not practicing safe sex once can have

>>a lot more negative consequences than lots of empty calories.

>>Nothing in life is simplistic,  a BMI is just one measure in our overall

>>health. It is a little like saying my whole car is useless if the tire

>>pressure is very high. Just like tire pressure it takes a while to see

>>negative results but we know over time it matters.( when is tire pressure

>>too high?) There is a lot more to safe tires than pressure i.e., tread

>>depth, wear pattern, tread pattern for different surfaces and driving

>>conditions.

>>  There are lots of useful measurements to help us know about keeping our

>>bodies in good nutritional repair,  Blood pressure, lipids, BMI etc.    I

>>would hope what you write takes a much more positive approach about BMI.

>>We do need to write about many parts of health i.e. not smoking etc, but as

>>nutritionists what we know is Nutrition.  What do we know that can help

>>persons with a BMI above 25 in a positive way, but not compromise it's

>>usefulness to many others.

>>

>>

>> 

>>

>>                     jikeda 

> >

>>                     <jikeda at socrates.Berk        To:     "Public Health 

>> Nutrition Discussion and

>>                     eley.EDU>                    Information Group" 

>> <phnutr-l at u.washington.edu>

>>                     Sent 

>> by:                     cc:

>>                     PHNUTR-L-owner at u.wash        Subject:     What is a 

>> Healthy Weight? A Question

>>                     ington.edu                   to 

>> Ponder

>> 

>>

>> 

>>

>>                     01/22/01 07:06 

>> PM

>>                     Please respond 

>> to

>>                     phnutr-l 

> >

>> 

>>

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>>

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>>

>>What is a Healthy Weight?  A Question to Ponder

>>

>>          Many dietitians and nutritionists feel uneasy about giving people

>>a number or even a range of numbers when the question, "What is a healthy

>>weight?"  is asked.  Even with the advent of Body Mass Index, there is

>>still concern that setting a goal of a BMI of 25 or less for every

>>overweight person is unrealistic and unreasonable.  It is even more

>>troublesome with respect to pediatric overweight.  Is every child with a

>>BMI over the 95th percentile really overweight?  After all, 5% of the

>>pediatric population will naturally fall above the 95th

>>percentile.   Should these children be labeled overweight when they are

>>not?

>>

>>So how should a health professional respond when asked this question?  In

>>my opinion, a healthy weight is a weight that is achieved and maintained

>>with a healthy lifestyle.   Some people manage to achieve a BMI of 25 or

>>less by adopting unhealthy practices such as restrained eating, fasting,

>>smoking, compulsive exercising, disordered eating, and very low calorie

>>dieting.  Should they be complimented and told they are now at a "healthy

>>weight" even though they have endangered their health to achieve this

>>goal?  Should these dangerous practices be encouraged and reinforced?  Of

>>course not.  If a person loses weight by eating a more nutrient dense diet

>>and through increased activity, then s/he will have achieved a weight that

>>is healthy for them regardless of whether their BMI is 25 or less, and

>>regardless what percentile their BMI falls under.

>>

>>          There is no doubt that some people have achieved unhealthy weights

>>by practicing unhealthy lifestyles.  What about them?  Encouraging them to

>>lose weight at all costs is counterproductive.  Again, the focus is on

>>lifestyle, helping them adopt a healthier lifestyle in terms of eating and

>>activity.  But what if that doesn't result in a BMI of 25 or less, or put

>>them under the 95th percentile?  Or just does it temporarily?  Again, the

>>focus should be on lifestyle; a healthy weight is a weight that is achieved

>>and maintained by a healthy lifestyle.

>>

>>          A healthy lifestyle doesn't mean acting "perfectly" everyday in

>>every way.  It means that most of the time we eat a healthy diet, spend 30

>>minutes being active, use our seatbelts when riding in a car, brush our

>>teeth after eating, wash our hands after using the bathroom, have a sense

>>of humor, can solve differences without resorting to violence, practice

>>safe sex, manage stress in positive ways, enjoy friendships, and feel a

>>sense of positive purpose in life.

>>

>>

>>Feedback is eagerly solicited by the author, Joanne P. Ikeda,MA,RD,

>>Nutrition Education Specialist, Department of Nutritional Sciences and

>>Toxicology, 223 Morgan Hall, University of California, Berkeley, CA

>>94720-3104, phone (510)642-2790, FAX (510)642-4150, e-mail:<

>>jikeda at socrates.berkeley.edu>.

>

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