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Body Weight or Body Image

There is no denying that the statistics about obesity in Canada are cause for concern. Sedentary lifestyles and technology have removed the need for physical activity in much of contemporary life. Still, not everyone with a BMI of over 25 has a clinical weight problem. What is the ethical thing to do when a client comes to you and says they want to lose weight?

“Ask why,” says Dr. Sharma, Professor of Medicine and Chair of the Cardiovascular Obesity Research and Management program, and Director of Edmonton Capital Health region’s interdisciplinary Weight Wise program. If an individual does not have any identifiable medical issues directly attributed to their weight, they do not really have a weight problem. “They have a body image problem.”

Instead, steer clients away from scale or weight-related goals and towards more sustainable goals—having more energy, finishing a local fun-run or race, busting stress, retaining functionality and mobility. It’s not surprising that people equate being thin with being happy considering the bombardment of happy, successful, thin people portrayed in mass media. The reality is, losing weight without a good medical reason to do so will probably not change your life at all. So, set reasonable, sustainable goals and expectations. A program seeking more than a 5% weight loss will generally not be sustainable over time. “It’s important to match the reality—what is possible—with what a client wants,” says Sharma. “Preventing weight regain is the hardest thing to do. Everything else is so much easier.” However, he says that even in a morbidly obese person—someone weighing perhaps over 300 pounds—5% weight loss can result in significant health improvement.

Weight Myth

BMI is not an absolute indicator of a “healthy weight.” Having a BMI of over 25 does not necessarily put you at risk for chronic weight-related disease. Dr. Sharma and his team are working on a new way of codifying obesity and risk. The “Edmonton Staging Protocol” ranks risk factors from zero to five, with zero indicating no risk factors evident due to weight, and three-plus indicating established medical risk and chronic disease. “Many people with a BMI of over 25 are really in the zero and one range.”

See more from Dr. Sharma in the fall/winter Fitness Informer

Dr. Sharma’s blog

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