Taking Stock

Taking Stock

From Chicken Soup for the Soul: Say Hello to a Better Body!

Taking Stock

You Are HERE

You know those maps in shopping malls and on hiking trails? They always include a circle labeled “You are HERE.” Similarly, when you turn on the GPS in your car, it identifies your current location before calculating a route. The truth is, you can’t get where you want to go if you don’t know where you are.

The very first step in your journey to lose weight and get fit isn’t buying new cookbooks or signing up with a personal trainer. Before taking actions such as these, you need to do a little mental preparation. When I say this to the participants in my cardiovascular prevention group, they look at me like I’ve gone off the deep end. “What is there to think about?” they groan. “We’ve been thinking about losing weight and living a healthier lifestyle for years!” Perhaps you would say the same.

And yet, when I ask my patients to explain why they want to lose weight, or even to tell me whether they feel ready to make changes in their lives, they realize that despite years of on and off dieting and exercising, they’ve never really thought about these two very basic questions. Would you say the same?

On a piece of paper, copy these two questions and write down your answers:

1. Why do I want to lose weight and get fit? (In other words, why is it meaningful to me?)

2. How ready am I to make the permanent changes in my behavior necessary to meet theses goals? Am I:

a. Not even thinking about it.

b. Thinking about it, but not ready to act.

c. Making preparations to act (e.g., joined a gym, made an appointment with a dietician, etc.)

d. Already starting to make changes.

e. Accustomed to changes, which are a regular part of my life.

It’s preferable to write out the answers with pen and paper, in your own handwriting, as if signing a contract — which, in a sense, it is: a contract with yourself.

The answer to question #1 is your motivation. It may change, over time, but it is crucial to articulate it as specifically and as honestly as you can. Are you adopting new habits so that you can: Have enough energy to start a new business? Live to see your grandchildren grow up? Avoid the chronic diseases that plagued your parents? Simply to feel better than you do right now? The answer that is truest for you, personally, is your most powerful tool in losing weight and getting fit — but you must fully acknowledge and own it.

Question # 2, adapted from the “Stages of Change” devised by psychologist James Prochaska, gives you some important information as well. I’m assuming that if you are reading this book, you are not at “a,” and probably not at “e,” either (though even women who have already made lifestyle changes may be looking for new challenges). Prochaska’s insight was that these stages are like building blocks, and you can’t skip over one to rush to the next. For example, if you’re browsing through these pages, daydreaming about a healthier life, it likely won’t be effective to wake up tomorrow morning and, having done no preparation whatsoever, just decide to start eating better and exercising. And, come to think of it… how often have you tried to do just that, with disappointing results?

So now that you’ve written down your motivation for losing weight and getting fit, and assessed your readiness to work on those goals, it’s time to take a clear-eyed look at just how much excess weight you currently carry, as well as your level of fitness.

Let’s start with your weight. If you’ve been dieting on and off for many years, you likely have a “magic number,” a weight that you think is “ideal.” But it’s very possible that this number is unnecessarily low and that you need to lose less weight than you think in order to significantly improve your health.

Doctors and medical researchers now use a measurement called “body-mass index” (BMI) to determine whether people are at a healthy weight. You can calculate your BMI manually by plugging your height and weight into a mathematical equation (see below) — but it’s easier to use one of the many online calculators or a chart such as the one here.

TABLE 1 What’s your body mass index?

Height

Weight in pounds

4’10”

91

96

100

105

110

115

4’11”

94

99

104

109

114

119

5’0”

97

102

107

112

118

123

5’1”

100

106

111

116

122

127

5’2”

104

109

115

120

126

131

5’3”

107

113

118

124

130

135

5’4”

110

116

122

128

134

140

5’5”

114

120

126

132

138

144

5’6”

118

124

130

136

142

148

5’7”

121

127

134

140

146

153

5’8”

125

131

138

144

151

158

5’9”

128

135

142

149

155

162

5’10”

132

139

146

153

160

167

5’11”

136

143

150

157

165

172

6’0”

140

147

154

162

169

177

6’1”

144

151

159

166

174

182

6’2”

148

155

163

171

179

186

6’3”

152

160

168

176

184

192

6’4”

156

164

172

180

189

197

BMI

19

20

21

22

23

24

 

NORMAL

 

Height

Weight in pounds

4’10”

119

124

129

134

138

4’11”

124

128

133

138

143

5’0”

128

133

138

143

148

5’1”

132

137

143

148

153

5’2”

136

142

147

153

158

5’3”

141

146

152

158

163

5’4”

145

151

157

163

169

5’5”

150

156

162

168

174

5’6”

155

161

167

173

179

5’7”

159

166

172

178

185

5’8”

164

171

177

184

190

5’9”

169

176

182

189

196

5’10”

174

181

188

195

202

5’11”

179

186

193

200

208

6’0”

184

191

199

206

213

6’1”

189

197

204

212

219

6’2”

194

202

210

218

225

6’3”

200

208

216

224

232

6’4”

205

213

221

230

238

BMI

25

26

27

28

29

 

OVERWEIGHT

 

Height

Weight in pounds

4’10”

143

167

191

4’11”

148

173

198

5’0”

153

179

204

5’1”

158

185

211

5’2”

164

191

218

5’3”

169

197

225

5’4”

174

204

232

5’5”

180

210

240

5’6”

186

216

247

5’7”

191

223

255

5’8”

197

230

262

5’9”

203

236

270

5’10”

207

243

278

5’11”

215

250

286

6’0”

221

258

294

6’1”

227

265

302

6’2”

233

272

311

6’3”

240

279

319

6’4”

246

287

328

BMI

30

35

40

 

OBESE

* From a Harvard Health Publications Special Health Report: Diabetes: a plan for living.

BMI gives a rough estimate of total body fat. It’s not accurate in people who have large muscles (which are heavy, but not made of fat) and, over the past few years, the criteria for “normal,” “overweight,” and “obese” have been revised a bit. But knowing your BMI still gives you a pretty good idea of whether you need to lose weight and how much.

Weigh yourself and have your height measured (after menopause, thinning of the bones in your spine may have caused you to lose an inch or two), and then find your BMI on this chart. If you are in the “obese” range, what is the least amount of weight you’d need to lose to get into the “overweight” range? And if you are “overweight,” what’s the least amount of weight you need to lose to get to “normal? Those are good goals for now.

The most important, and most encouraging, thing to know about BMI is that the heavier you are, the less weight loss it takes to make a big impact on your health. Take a look at this graph. It shows how the risk of dying prematurely (from heart disease, stroke, diabetes, and other conditions) rises with increasing body weight:

Depending on how you view it, this could be a really scary graph, since it shows that going from a BMI of 34 to a BMI of 40 (that’s a gain of just 30 pounds for a 5’4” woman) doubles your likelihood of dying early. I like to think of it a different way: If you’re a 5’4” woman who weighs 230 pounds, you can cut your risk of dying prematurely in half simply by getting to 200 pounds! That may not be your final goal — optimally, you should try to get into the normal range — but you can accomplish quite a lot with a more modest weight loss.

It may take some psychological adjustment to set a weight goal that’s much higher than your old “magic number.” Many of us have long carried around a distorted view of what we “should” weigh. I realized this recently when a friend and I were leafing through pictures of ourselves at her wedding thirty years ago. “Look how thin we were,” we both said, “When we thought we were fat!”

Beyond the Scale

Weight (or BMI) isn’t the only measure of fitness. If you’re overweight and you work out regularly, you may be more fit than your skinny friend who never lifts anything heavier than her cell phone. And even two women who have the same BMI may have different degrees of health risk from their excess pounds.

People who accumulate extra weight in their waists (“apples”) have a greater risk of heart disease than people who carry extra weight in their hips (“pears”). Extra weight around the midsection, which sometimes first appears during menopause, can be a sign of the internal or “visceral” fat you’ve heard can cause heart disease, inflammation, and other health problems. It’s a common misconception that excess belly fat is impossible to shed after menopause, but that’s not true, as April Knight, author of “Reunion,” discovered.

A quick way to determine if you’re an “apple” is to measure your waist across the navel. If it’s 35 inches or greater (40 inches, for men), you likely fit the riskier “apple” profile. If, in addition to having extra weight in your midsection, you also have high blood pressure, and certain abnormal blood tests (see below) you may have what’s called “metabolic syndrome.” This syndrome, affecting nearly a quarter of all American women, greatly increases your risk of developing heart disease and diabetes. It’s important to know if you have metabolic syndrome. If you do, getting active and eating healthier are all the more crucial. Metabolic syndrome can be reversed.

In addition to knowing your weight, BMI, and waist size, it’s helpful to be aware of some other measures of fitness. Cardiovascular (or aerobic) endurance, strength, flexibility, and balance all contribute to your health and wellbeing. After all, besides achieving a healthy weight, you also want to be able to avoid falls, run for a bus, and say “No thanks, I’ve got it!” when a younger person offers to hoist your suitcase into the overhead bin. The website www.adultfitnesstest.org, sponsored by the President’s Council on Physical Fitness and Sports, provides simple tests of various types of fitness. Repeat these tests periodically to see how far you’ve progressed. If you are now completely inactive, though, do not undertake tests such as brisk walking or running without first consulting your doctor.

A Health Inventory

I’ve seen smart women do some pretty dumb things in order to lose weight: starvation diets, extreme exercise routines, and over the counter or even illegal appetite suppressants. These unhealthy strategies never work in the long run, partly because they make you feel so awful. Who can stick to a plan that makes you hungry, achy, or jittery? It works much better — and makes much more sense, especially when you’re over fifty — to think of losing weight as part of an overall health improvement plan: one you’re motivated to stay with because, in addition to preventing illness, it makes you feel good.

So, as you’re taking stock of your weight and fitness, take a few minutes to look at the big picture of your health. Here are some questions you might ask yourself about your general medical care:

• Have I had a check up with my doctor in the last year? Am I up to date on all recommended cancer screening tests (mammograms, Pap smears, etc.) and immunizations?

• Have I had a bone density test to screen for osteoporosis (bone thinning)?

• Have I reviewed all my medications, including overthe-counter drugs and supplements, with my doctor? Am I taking anything, such as certain hormones and psychiatric medications, that causes weight gain? (Do NOT stop any medication without first consulting your doctor.)

• Am I due for a dental or eye exam? The condition of your teeth and gums can affect your heart and overall health, and poor vision can cause falls and derail an exercise program.

And, just as important to your health as your medical care, is your self-care:

• Am I getting adequate sleep? Do I make time for rest, vacations? (Sleep and rest deprivation contribute to weight gain.)

• Do I use too much caffeine or alcohol? (For women, limiting alcohol to one drink per day or fewer and caffeinated beverages to 3 cups a day or fewer are recommended.)

• Do I smoke?

• Is my home organized in such a way that I can find things when I need them? (Clutter and chaos are stressful!)

• Are there aspects of my daily life (my commute, my screen time, my To Do list) that could be altered to reduce my stress?

• Do I live, as much as possible, within my means?

• Do I spend as much time as I can with people I love, doing things that I truly value and enjoy?

The Next Step

How many times have you made the same New Year’s resolution (“lose weight,” “get in shape,” etc.)? One of the reasons these resolutions usually bite the dust before the Valentine’s Day flowers have wilted is that they’re too big, too vague — too overwhelming.

One technique that professional coaches use to help people set and tackle goals more effectively is the GROW model, which I’ve modified here:

Grab a pen and paper, and write down a Goal, based on one of the topics covered in this chapter or, after you’ve read them, in the coming chapters on eating and exercise. Perhaps you want to get more aerobically fit, get more sleep, eat less saturated fat, or have a more orderly home?

Now, do a Reality check. On a scale of 0 to 10, with 10 meaning that you’ve already achieved this goal and 0 meaning that you feel you’ve achieved absolutely nothing with regard to this goal, where are you right now? Write that number down.

Time to consider your Options. Write down the various ways you might try to pursue this goal. What roadblocks do you need to work around? For example, if your goal is to get more aerobically fit, you might start a walking program, or join a pool. If your goal is to get more sleep, a roadblock might be your addiction to late night TV, or caffeinated drinks. Cutting down on saturated fat? Maybe you want to try eating vegetarian dinners more frequently.

Here’s where the pedal meets the metal: Write down what you would you need to do to find the Way forward, to move just one half step closer to your goal than where you are now. For example, if you scored yourself a 4 on aerobic fitness, how can you get to 4.5? Would getting off the train one stop earlier, or buying a new pair of sneakers, do it? If you need more sleep and you’re currently at a 2, would putting your favorite late night show on DVR get you to 2.5? Would looking up a recipe for one meatless dish on the Internet move you from a 5 to a 5.5 in your vegetarian efforts?

You get the idea. And once you’ve progressed one half step, start the process over again and envision the next half step. You can apply this technique to any kind of goal you have, whether related to healthy eating, stress management — anything!

You’ll notice that the women who wrote the stories in this book all accomplished their goals by taking small, specific, manageable steps, one at a time: signing up for an exercise class, eliminating sugary drinks, making the decision to stop talking about diets. You can make similar steps forward. The late tennis champion, Arthur Ashe, once offered some succinct and helpful advice: “Start where you are. Use what you have. Do what you can.”

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