Want to know your vulnerability to heart disease? Like it or not, one of the best ways to know is to get on the scale. If you’re unhappy with what the scale tells you, you’re not alone. Despite our national obsession with thinness, Americans are heavier and less active than ever before. Over half of us are overweight, and self-esteem isn’t the only thing at stake. Even a few extra pounds can be hard on your heart. If you’re on the heavy side, you have the power to reduce much of that danger. By losing weight, you can give your heart a well-deserved break.
How much weight is too much?
Perceptions of fat and thin can change with the times. For an objective view, doctors use a measure called body mass index (BMI). A 5-foot, 10-inch person who weighs 175 pounds has a BMI of 25, which is considered overweight. (A BMI of 18.5 to 24.9 is considered a good weight.) A BMI of 30 and above is considered obese.
The biggest shortcoming of the BMI measurement is that it can’t distinguish fat from muscle. A chiseled 6-foot-tall football player could easily have a BMI over 30, but no one would call him dangerously overweight. But when the extra weight comes from fat, not muscles, even a small climb in BMI can make a big difference to the heart.
A study of nearly 116,000 nurses published in the Journal of the American Medical Association found that moderately overweight women (BMI between 25 and 28.9) were twice as likely as slender women (BMI less than 21) to develop coronary heart disease. For women with a BMI over 29, the risk nearly quadrupled. Likewise, a study of more than 29,000 middle-aged men found that a little heft (BMI between 25 and 29) led to a 70 percent increase in coronary heart disease.
In addition, research by the National Heart, Lung and Blood Institute adds more evidence that extra weight is bad for your heart: in a study of over 5,000 participants, the risk of heart failure increased with each additional point of a participant’s BMI (about 4 to 8 pounds). Men experienced a 5 percent risk increase with each additional point of BMI, while women had a 7 percent increase. In general, researchers found that the risk of heart failure was 34 percent higher for overweight individuals and 104 percent higher for people classified as “obese.”
Over the past 40 years, there has been a marked rise in obesity in the United States, which experts associate in large part with bigger portion sizes and overeating, a rise in fast food consumption, and a sedentary lifestyle in which many Americans do little more than walk to and from their cars. Today, nearly 42 percent of American adults are considered obese (that is, they have a BMI of 30 or above). That’s a lot of people with a higher-than-normal risk of developing heart disease.
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Despite the increase in obesity, one study found that only 42 percent of overweight adults have been told by their doctors or healthcare workers to lose weight, according to a report in the Annals of Internal Medicine. In another survey, the National Consumers League (NCL) found only 12 percent of U.S. adults had been told by a doctor or other healthcare professional that they were obese. In fact, the NCL survey found that most obese respondents thought of themselves as merely overweight.
That’s the reason why government health officials at the U.S. Preventive Services Task Force recommend that doctors assess patients to determine their BMI. If they’re obese, they should make weight loss counseling part of their talks.
How does being overweight harm the heart?
An extra-large body needs an extra-large amount of blood. When you gain weight, your heart has to