What is my Ideal Weight?
I saw a patient the other day, Jean*, who had been on weight management medication for twelve months. She had lost 22 kg and she had maintained this stable weight for a number of months.
She was doing so well - she had her dietary habits (largely!) in order, was doing a great mix of exercise and was off all of the medications she had needed prior to starting treatment, including her blood pressure and cholesterol medications. She could now get down on the floor and play with her grandkids. She could do up her own shoelaces and no longer needed to ask for an extender belt on the plane. She hadn’t been this weight since her teenage years!
I asked her if she had any further questions, and she divulged that she knows that she ‘should’ lose another 8kg and she wanted to know how she could go about doing this.
*Not her real name, details changed to provide anonymity
What Weight Should I Be?
This query started the conversation that I so often have in my consults - how much weight loss is enough?
When I dig deeper on this question, so often people have a figure in mind of what weight they feel that they should be.
It may be the weight they were pre kids
It may be the weight they were prior to COVID
It may be enough to get to a ‘normal’ BMI
It may be the weight that they estimate will mean that they can use the section of the wardrobe with the smaller sized clothes that have just been hanging out there unused!
It may be the weight suggested to them by a health professional to treat a medical condition.
So what is the answer??
In Short….
I tend to use the concept of Healthy and Happy Weight.
#1 What weight loss will improve your health?
#2 What weight loss will make you happy?
#3 What is attainable?
Healthy Weight
How do we work out our healthy weight?
Is it all to do with BMI?
BMI
We calculate BMI by taking an individual’s weight and dividing it by their height squared.
For a long time ‘healthy weight’ has been determined by society and medical professionals to be a weight that equals a BMI of 18.5-25.
Should this be the case?
I did a bit of a deep dive on BMI.
BMI was a calculation developed by a Belgian statistician in the 1800s to determine the ‘average Belgian man’. It was never originally medically driven.
BMI was then taken by the research and medical community and used to determine ‘healthy weight’.
There are a number of issues with BMI, most obviously that it is being used now to determine healthy weight for a population of people who largely don’t look like the average Belgian man of the 1800s like our fine fellow below….
BMI does have some uses in 2024, however we need to be careful that we do not put too much emphasis on this single calculation.
So if not by BMI, how do we determine a ‘healthy’ weight?
Interestingly enough this has more to do with the weight lost and maintained rather than the weight that you get to.
And you do not have to lose a whole lot of weight to achieve the health benefits associated with weight loss.
Depending on the medical condition we are hoping to treat, it can be as little as 2.5% of your total body weight.
That means if you weigh 100kg, losing even 2.5kg may have a positive effect on your health. Or an individual who is 200kg losing 5kg.
More benefits can come from 5, 10 up to 20% total body weight loss - depending on the medical issue that you are experiencing.
And the most important part is losing the amount that you can maintain over the long term.
Happy Weight
Most people have a weight in mind where they feel comfortable.
Be it in how they move, how their clothes fit, or how they feel they look.
You may feel that losing the suggested percentage of weight for health is not enough to make you happy about your weight. And that is a valid factor to take into account.
Sometimes we do need to adjust our expectations of whether we can get to our happy weight. Especially if that happy weight was when we were much younger, pre kids, pre busy work life, pre illness or other factors which have enforced an irreversible change on our body or our ability to make the lifestyle changes necessary.
Is it Attainable?
For every weight loss intervention, there is an average, realistic weight loss that we can hope for.
Of course this varies, there will always be people who lose less and those that lose more. However, trying to match the weight loss you desire with the intervention you would like is important.
Lifestyle only: 5-10%
Lifestyle + Medications: 7.5-20%
Lifestyle + Surgery 20-40%
Weight Maintenance
Sometimes the ideal weight is just what we can manage at this time.
That may be weight maintenance if your weight has been creeping up over a long period of time.
And the value of weight maintenance should not be underestimated!
In Summary….
There is no magical ideal weight for a given individual.
Often it is the process of weight loss that results in the desired health benefits.
Be kind to yourself! Realistic expectations are important.
Remember, we don't have as much control over our weight as we may like to think that we do, or that society tells us we do.
The approach I recommend is to get your habits in order.
Then your body will do with that what it will in terms of weight loss.
Reach out if you need tailored advice on refining your weight loss goals!
