Your height, weight and waist measurement are your new vital signs. Along with temperature, pulse, blood pressure and respiratory rate, doctors are being encouraged to use your body mass index (BMI) — which is calculated using height and weight — as well as your waist circumference to assess your overall health during regular check-ups.

If your measurements signal your health is at risk, you may find that stepping up the battle of the bulge could save your life. “There is no point pussyfooting around,” says Dr. David Lau, a physician, president of Obesity Canada, a not-for-profit organization aimed at reducing the occurrence of obesity in Canada, and lead author on Canada’s new obesity guidelines. “We have to tell patients their weight is too high.”

Many people who are overweight or obese consider the issue as a body image problem, says Lau, and may not realize that it is putting them at risk for serious diseases such as type 2 diabetes, hypertension, dyslipidemia, coronary artery disease, stroke, osteoarthritis and some types of cancer.

A majority (59%) of adults in Canada are overweight, meaning a BMI of more than 25. One-quarter of Canadian adults are worse than overweight — they are obese, with BMIs over 30, according to the latest Canadian community health survey done by Statistics Canada. Lau, who practises in Calgary, treats many patients who have BMIs in the 50, 60 and even the 70 range. (To calculate your BMI, go to www.nhlbisupport.com. )

Waist circumference is another important measurement. Research shows carrying excess weight around the waist puts people at higher risk for health problems than carrying it on the hips, thighs and buttocks. For men, the danger zone is a waist circumference of 100 cm (40 in.) or greater; for women it is 90 cm (35 in.) or more. (This fluctuates a bit according to ethnic heritage.)

“If the waist circumference is above the cut-point, we tell patients to talk to their family doctors or health professionals,” Lau says. “This may trigger further investigation or screening for health problems.”

Lau would like to see societal change and improvement in workplace nutrition. “We live in a culture in which there is always food,” he says. “We’re being fed all the time. Think about the high-calorie snacks often offered at meetings, such as donuts and cookies.”

Supermarket magazines bombard people with messages that they can lose a lot of weight quickly, but Lau does not recommend this. Modest weight loss is more desirable and sustainable, and can have huge benefits. “Even losing 5% of body weight can prevent diabetes by as much as 60%,” he says.

To lose weight, Lau and the 50 others who wrote the new guidelines recommend reducing calorie intake by 500 calories a day and undertaking 30 minutes of moderate daily physical activity, working toward 60 minutes on most days.

Do you need help to accomplish this? The National Weight Control Registry in the U.S. is a database that keeps track of 4,500 people who have successfully lost weight (average 30 kg or 66 lbs.) and kept it off for more than five years. Forty-five per cent of them lost the weight on their own, and 55% lost weight with the help of some kind of program.

“There is greater success with professional help, but people have done it on their own,” says Dina Brooks, associate professor in the department of physical therapy at the University of Toronto.

Other traits of people who successfully lost weight are: eating breakfast every day; weighing themselves at least once a week; avoiding excessive television; and exercising for about an hour a day.

Dr. Lau and his team assessed the many drugstore weight-loss products available in Canada and did not endorse any of them. But commercial programs such as Weight Watchers can be helpful, he says.

Dr. Yoni Freedhoff, medical director of the Bariatric Medical Institute in Ottawa, which helps people lose weight, agrees that while many lose weight without professional help, they are in the minority.

Controlling food intake is more important than physical activity, he says: “About 80% of weight management depends on the foods you choose and the other 20% depends on exercise.” To lose weight, you have to understand calories. But without exercise, he adds, you are more likely to regain lost weight.

@page_break@Like Lau, Freedhoff does not recommend crash diets. “A better idea is to cultivate a lifestyle you enjoy with fewer calories,” he says. He recommends eating every two to three hours, with protein a part of each meal and snack because it satisfies hunger longer. IE