Weight Concerns

What is healthy body weight?

When we talk about weight and health - whether we are discussing pounds, kilos, or Body Mass Index, we are trying to assess the body's composition of fat and muscle deposits. The degree to which muscle and fat are present or absent in the body can have implications for overall physiological functioning and the risk of developing certain medical conditions. And that's the problem with the indices above: at best, they are an estimation of body composition, yet they are treated as gospel. We need to have additional ways to talk about body composition and health beyond "the numbers."

So what else can we look at to determine whether someone's body composition is healthy and normal for them? Here are some questions; the more often you answer "Yes," the more likely it is that your body is reflecting what is right for YOU:

  • Do you get feedback from your doctor that suggests that your pulse, blood pressure, and labwork results are healthy for someone of your age and gender?
  • If you have finished growing (and remember, many people will not finish growing until their early 20s), does your weight tend to stay in the same range, without a lot of significant ups and downs, and without any strenuous efforts on your part?
  • Do you find that you have plenty of energy throughout the day, and that you are not more likely to catch colds, flus, etc. than your peers?
  • Are you getting 30-60 minutes of enjoyable physical activity on most days of the week?
  • Do you generally eat only when you are hungry and stop when you are comfortably full?
  • Do you eat a wide variety of foods (covering all the food groups or food group substitutes)? Would you say that most (not all!) of your choices are high in nutrients and moderate in calories? Do you include lots of high-fiber choices?
  • Do you have a minimum of five servings a day of fruits/vegetables? If you drink alcohol, do you use it in moderation?
  • Does your body resemble the size and shape of other healthy members of your family?
  • If you are a woman, do you get your periods regularly, and is the flow pretty normal?
  • If you are an athlete, do you make it through training, games, or events with only a normal amount of fatigue? Are you able to recover fairly quickly?

But what about Body Mass Index, Ideal Body Weight, and Percent Body Fat?

We hesitate to provide calculations, numbers, or ranges because each body is different, and even these clinically-focused assessment tools need to be interpreted in the context of an individual's other health factors. Athletes, for instance, are likely to carry more muscle mass than a typical student; standard calculations don't take this into consideration, and might suggest that an athlete is "overweight." Likewise, some people have large, dense bone structures, and their healthy weight will be different from someone of equal height with a smaller frame. And lastly, some folks are meant to carry a higher percentage of body fat than others. There are large-framed students with a higher percentage of body fat who play a sport or exercise several times a week, and eat a healthy balanced diet. Other students may be very thin, have a low percentage of body fat but don't consume adequate nutrients or have a consistent relationship with physical activity. If you are really concerned about your weight or body composition, check with a medical provider at Health Services (401.863-3953) or in the community. Choose someone who is not affiliated with a commercial weight loss program; consulting with an unbiased health professional will help you get a more realistic idea of whether it would be healthy for you to gain or lose weight, and how to go about it wisely.

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Do you need to change your weight? Are you sure?

As we said a moment ago, if you are answering "Yes" to most of the questions above, your body is likely to be in the place that is normal and healthy for you. Every day, however, we get bombarded with images of "desirable" bodies that look radically different from what is normal and healthy. It can lead to a lot of body dissatisfaction, and the urge to significantly change the way we look. If that's the case, and you are trying to lose or gain weight even though you probably don't need to, you might want to think about some things first.

Researchers estimate that 40-70% of your weight is determined by genetics; we are programmed for certain bone structures, levels of adipose (body fat), and muscle development capacity. You would have to spend A LOT of time and energy to significantly change your adipose and muscle endowments; you would probably need to pathologically distort your relationship with food and exercise in order to do it; you'd have to be willing to divert resources from a lot of other important pastimes (school, work, relationships, hobbies), and you'd have to be able to keep that up for - well, the rest of your life. This is impossible to maintain and would seriously undermine your emotional and physical health.

The body strives for balance and stability, and as we stated above, it pays a price when it has to function too far from its comfort zone. This price tag includes decreased functioning mentally, emotionally, and physically. Researcher Ancel Keys conducted what is now considered the classic study on semi-starvation during World War II, and he noted the following outcomes among the conscientious objectors who volunteered:

  • Decrease in metabolic rate by 40% as caloric intake and weight dropped
  • Feelings of anxiety, depression and irritability
  • Dizziness, weakness, and fatigue
  • Withdrawal from important social relationships and disinterest in sex
  • Decreased interest in intellectual pursuits
  • Food preoccupation (e.g. collecting recipes, hoarding kitchen implements, constantly thinking and dreaming about food)
  • Development of distorted eating rituals: extremely slow consumption, cutting of food into small pieces, creation of weird and distasteful food concoctions
  • Feelings of embarrassment and guilt about perceived "overeating" episodes
  • Binges of thousands of calories per episode while on leave from the study
  • Self-induced vomiting (in some) to get rid of the post-binge discomfort

These men were chosen as highly intelligent, highly motivated, and psychologically stable volunteers, but it wasn't until 8 months later, when they returned to normal eating and were fully weight restored, that the changes in cognitions, behaviors, and mood completely subsided.

And what if you answered "No" to a lot of the Healthy Body Weight questions above? Lifestyle trends (rather than isolated actions) CAN affect the body's ability to maintain a healthy weight, so if you habitually underuse or overuse food and physical activity, you are more likely to be at a weight that isn't right for you and to have negative changes in heart rate, blood pressure, labwork, energy levels, reproductive functioning, and athletic performance. If underuse or overuse of food is an issue for you, check out our section on Eating Concerns. Brown students can consider calling 401.863-2794 to make an appointment with the Health Education Nutritionist, who can help you develop a more balanced lifestyle pattern.

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Does dieting help you lose weight?

There's no question about it: when you significantly change energy balance in the body, by repeatedly affecting either intake or expenditure, you're likely to see at least short-term changes in weight as muscle, adipose, and fluid status are impacted. But wait: the body is built to react strongly to systemic changes like this --particularly if the changes are drastic. The rate at which the body burns calories (metabolism) slows down every time you diet, in part because of the inevitable loss of muscle mass, our most "metabolically-active" tissue. Less muscle means the body doesn't need to spend as many calories in order to maintain itself. When you begin to eat normally again, your body is still functioning at the lower rate. So every time you diet, weight comes off more slowly and goes back on more quickly because your metabolism gets lower. And it isn't just muscle that determines how your body will respond to changes in energy balance. We are also programmed for a certain level of adiposity (body fat) --a level that is monitored very closely by the survival mechanisms of the body. Researchers are finding that adipose can be just as metabolically-active when the body perceives that survival and reproduction are being endangered, and that there are many chemical messengers whose function is to influence appetite, metabolism, and mobilization of fat stores in order to preserve or restore the status-quo. So under-nutrition and rapid weight loss can eventually result in preferential fat storage.

Once normal eating is resumed and maintained, the metabolism generally returns to normal. But the early stage of this metabolic adjustment can be scary for some people because they may put on a few pounds as the body attempts to reestablish equilibrium. Fearing that the weight gain will be too significant, or that it will last forever, they may go back on a diet - causing their body to downshift metabolically again, and promote fat storage.

Don't crash and burn.

Studies show that people who repeatedly go on and off crash diets actually gain weight over time. The sad fact is that the only thing crash dieters ever learn is how to starve. And suppressing your appetite with most diet pills risks a number of nasty side effects, such as irritability, insomnia, high blood pressure, and dependency. Plus, once you stop taking them, any weight you've lost will probably sneak right back on. Achieving and maintaining a healthy body weight means practicing a variety of good self-care behaviors --day in, and day out.

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What else goes along with dieting?

Although some people will engage in dieting behavior with little or no significant change in the way they think and feel, many people find that the legacy of dieting goes far beyond a transitory effect on their weight. The following are some side-effects of dieting that should be considered carefully:

  • Diets tend to polarize our attitudes towards foods, creating categories of "good" and "bad," that then go on to affect how we feel about ourselves when certain foods are eaten --whether or not we are currently dieting.
  • Diets tend to perpetuate the belief that control with food and eating exists only as a function of an external system of regulations; we forget that our bodies have an innate ability to self-regulate, and we mistrust the demands of our physiology.
  • Because of the externalized focus, and because the cookie-cutter approach of many diets will NOT be a match for our individual needs, diets can foster a disconnect between hunger and fullness. As a result, we lose touch with the primary mechanism by which the body self-regulates energy balance.
  • Because dieting may involve ignoring hunger and promoting inadequate fullness, and because much-loved foods are often re-categorized as "bad," we can experience enough perceived or real deprivation to make us feel tremendously preoccupied with food --particularly with the "bad" foods. As a result, we can wind up spending a lot of time and energy thinking about how we will consume or avoid certain foods. Even more painfully, we may wind up feeling vulnerable, out of control, and lacking in character as a result.
  • Although dieting and exercise are two different behaviors, viewing physical activity primarily as a means of losing weight or re-shaping the body is a shift in attitude that can often accompany dieting. People can respond to this by developing a driven, compulsive relationship with physical activity that pushes them to exercise when fatigued, ill, and injured, and that cuts into their ability to enjoy other things. People can also respond by developing an aversion or resistance to physical activity, because it has become associated with guilt, obligation, and anxiety for them.

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So what DO you do to promote a healthy body weight?

Have breakfast within an hour of waking up.
Your body is craving fuel after a night's sleep. Not only does having breakfast support an optimal metabolism, but studies have shown that having breakfast helps our bodies with appetite control. Study participants were found to experience less hunger all day long when they had breakfast --there's something about that meal that is uniquely satisfying to the body. (And for those of you who are saying that you experience more hunger during the day when you eat breakfast, here's a news flash: the hunger you are experiencing is actually your REAL level of hunger. When you skip breakfast, your body sometimes begins to produce a chemical called a ketone that "covers up" your natural hunger signal. As a result, you may not notice significant hunger --until you eat or drink something with nutrients in it that "breaks" the ketosis, causing you to feel suddenly and ravenously hungry --a real set-up for overeating and feeling uncomfortable).

Be regular with meals and snacks; try to eat something every 3 to 4 hours.
Again, your metabolism is better supported when the body is fed in a regular, consistent way. Erratic eating patterns with more than 4 hours between meals and snacks may cause the body to fight back against what it perceives as deprivation and uncertainty. It may cause the metabolic rate to drop, and it may signal the body to preferentially store calories as fat instead of spending them freely.

Think of the peace symbol when you're planning your plate at lunch and dinner.
Aim to fill 2/3 of your plate with carbohydrates: a fruit serving, a cooked or raw vegetable serving, and a grain. The last third of your plate is for a serving of protein (animal or vegetable). Add a serving or 2 of fat to round things off, if your other food choices don't contain much fat. This meal mix: carbohydrate + protein + fat provides the fast acting and long acting sources of energy that keep people well-fueled and satisfied for a longer period of time. When you are well satisfied, you're less likely to feel compelled to "nibble" during the day, and you aren't likely to arrive at the next meal or snack over-hungry and prone to over-eat.

Get milk.
You can improve your meal mix (and bone health!) even further by having an 8 oz. serving of low-fat milk, yogurt, or their fortified soy-substitutes with each meal. These dairy servings contribute additional protein, which may boost appetite control for some people by creating and prolonging a sense of comfortable fullness.

Add high fiber choices to meals and snacks.
High-fiber foods like wholegrains, fruits, vegetables, beans, and legumes help us with energy balance by promoting a feeling of comfortable fullness. Both the bulk of these foods, and the more gradual way in which they are digested for energy, can help us to experience fullness at a meal and maintain a feeling of comfortable fullness for several hours.

Start eating when you are comfortably hungry, and stop eating when you are comfortably full.
Eating when you are at a comfortable level of physical hunger (instead of starving), and finishing when you are comfortably full (instead of stuffed) is one of the most powerful ways to make sure that your caloric intake stays appropriate. And the two are definitely related: by the time you are over-hungry, not only will you have a hard time slowing down your eating long enough to listen for a subtle fullness signal, you may also develop a preference for over-fullness in reaction to or as a defense against this uncomfortable level of hunger. Moreover, you may find yourself developing a preference for higher-fat, higher-sugar foods under these circumstances because of the brain chemicals (galanin - fat cravings, neuropeptide Y - sweet cravings) that are released when someone has gone for too long without eating.

But what if you have a hard time knowing whether you are really hungry?

Hunger is the physiological expression of the body's need for energy. There are some common symptoms of hunger that people may manifest in descending order as their blood sugar levels continue to drop. It's useful for you to identify your personal progression from slight hunger to over-hunger. You are more likely to begin a meal or a snack at a comfortable level of hunger if you eat within 5-10 minutes of your early hunger signals.

  • Rumbling, or empty stomach - early hunger
  • Decreased energy, particularly during physical activity
  • Decreased ability to focus
  • Irritability
  • Headache
  • Feeling weak or shaky
  • Nausea, cold sweats - late hunger

Appetite is our interest in food. It usually accompanies hunger, but it can also be stimulated by sensory triggers (walking past a bakery), habit ("I always have a snack at this time"), or emotions (wanting food when sad or anxious). Most of us are familiar with the experience of a food "calling to us" when we are clear that we are not hungry, and eating under these circumstances once in a while is totally normal. A frequent tendency to eat from appetite rather than hunger, however, is likely to create inappropriate weight gain because it promotes consumption of calories that the body has no use for. Appetite is linked to our innate need for pleasure, and can be aggravated by food deprivation, but it can also be exacerbated by a lack of fun, not enough relaxation, and insufficient outlets for soothing and comfort. Our appetite for food stays more manageable when we eat enough, when we eat things we really enjoy, and when we have many other ways of relaxing and having fun. To learn more about the link between emotions, self-care needs, and eating, look at our section on Emotional Eating below.

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And what if you aren't sure whether you are truly full?

Fullness is the physiological expression of the body having received enough energy at a meal or snack. The experience of fullness can be affected by a variety of food-related factors:

  • High-fiber wholegrains help to fill us up at meals and snacks, and keep us feeling full for longer.
  • Protein is best at promoting comfortable fullness at a meal or snack, and it will continue to promote comfortable fullness for several hours afterwards.
  • Although the presence of fat in a meal may not boost fullness in the moment because it is digested more slowly, it contributes significantly to long-lasting fullness.
  • Fruits, vegetables, and beans provide bulk and fiber that boosts fullness.
  • Hot foods and beverages tend to make us feel more full than cold ones.
  • Eaten alone, processed grains (e.g. low-fiber breakfast cereals) and sugary foods don't contribute to a significant feeling of fullness, and get used up too quickly to support long-lasting fullness.

Fullness is a more subtle physiological signal than hunger, and can more easily be overridden or missed --particularly if you are eating quickly or in a very distracting environment. The old guideline about taking a minimum of 20 minutes to eat still makes a lot of sense.

Like appetite and hunger, satisfaction can travel along with fullness, but there are other aspects that go beyond whether the body feels it has received enough energy. Satisfaction usually requires:

  • Reaching a preferred level of fullness, and
  • Achieving a reasonable "match" between the sensory characteristics you were craving (hot/cold, spicy/bland, crunchy, creamy, smooth, chewy, salty, bitter, sweet) and the foods you actually chose.

Most of us can identify with eating situations in which we've been physically full but not yet satisfied, and we usually found ourselves "grazing" afterwards, still searching for that satisfaction. This situation is even more likely to occur with dieting when people disallow themselves the types and amounts of foods they really want. Unfortunately, the result of under-cutting satisfaction is a tendency to eat when not hungry and eat beyond fullness --both of which contribute to inappropriate weight gain. So make sure that you choose foods you really like at meals and snacks --even if some of them are high in calories, you can have them in moderate portions and you'll be doing yourself a favor in the end!

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Emotional eating: eating too much

As a species, we have several strong biological imperatives: survival, pleasure-seeking, and pain-avoidance, to name just a few. Food and eating are connected to all three of these major themes, so is it any wonder that they get over-used sometimes? And possibly because our experience with food is so strongly reinforced on a physiological level, we have also developed a powerful emotional relationship with food. Food and eating seem to be "about" a lot of things: family, cultural values, security, fun, intimacy, personal identity, spirituality, sensuality, control, power, love… the list goes on, and on.

As a result, our relationship with food can get a little distorted when we are having a hard time coping in other areas of our lives. Food can be used as a way to meet other needs when we are depleted (e.g. eating a snack, when we really need to take a nap or have a study break). Food can also be used to manage emotions (e.g. eating to "numb-out," or relax). Everyone eats emotionally once in a while - that's normal. When emotional eating becomes frequent, however, it can be really disruptive and distressing. First of all, it confuses the body, which prefers to regulate its intake according to hunger and fullness. Secondly, it interferes with our ability to deal with our feelings and meet our real needs directly. It turns the language of feelings into the language of food, creating a situation in which you can begin to think that you have a "problem" with food. Food isn't the problem --it's a symptom of coping difficulties.

Here are some ways to manage emotional over-eating:

Take care of your basic needs for sleep, relaxation, social connection, and pleasure on a daily basis. There is a tendency, particularly during college, to treat these needs as optional: they are not. And ignoring the deficit doesn't make it go away; it simply goes underground and pops up someplace unexpected --like your relationship with food. Create academic, athletic, social, and work schedules that don't require you to sacrifice the foundation of well-being.

Find more supportive ways to comfort or distract yourself when things are difficult. Phoning a friend, taking a hot shower, going for a short walk while listening to your favorite music; these are some ways to take a break and boost your mood without using food.

Get help understanding and managing feelings. The transition to college life is exciting --and incredibly stressful. Everybody struggles with this in their own way, and a little coaching can help you to understand your situation better and feel more effective. For more information about all of the above suggestions, Psychological Services is a fantastic resource. You can reach them at 401.863-3476.

If you are going to eat emotionally, do it really, really, well. Like we said, everyone eats emotionally once in a while. So if you've considered other self-care options, and eating something feels like the most satisfying choice, make it count.

  • Pick out a food that gets as close as possible to your craving, so that you get the sensory satisfaction you are looking for.
  • If you can, aim for a single-serving portion of whatever you are craving; remember --you can always have more afterwards if you truly want it.
  • Sit down and concentrate on what you are eating; take your time and stay in touch with how good it tastes.
  • Give yourself permission to enjoy whatever you are eating --without guilt. Feeling guilty increases the likelihood that you will "numb-out" and rush through your eating, making you prone to eat more because either you missed out on the pleasure, or you are having to comfort yourself for feeling so guilty.

Emotional eating: not eating enough

Sometimes dealing with emotions results in the opposite problem --under-eating and weight loss. Here are some emotional under-eating issues, and some ideas that may be useful:

  • Feeling stressed-out about making time for meals and snacks because your schedule is so tight. Healthy eating gives you the energy to do what you want to do, so make it a priority. Avoid painting yourself into a corner by creating a schedule that allows you to put self-care first.
  • Feeling overwhelmed by the crowds and atmosphere of the dining halls. Try coming at a time when the crowds are smaller (Noon to 1 pm is usually the busiest time of day.). Since the Ratty is the largest of the dining facilities, try the V-Dub or another location if you need a smaller and less hectic eating environment --even if it means a few extra steps in your usual routine. Plan to go with a friend if you are uncertain about trying a new place alone.
  • Arriving at meals too stressed to eat, having no appetite, or getting an upset stomach after eating. Some of the same brain and endocrine chemicals that start to cascade during our experience of stress also have receptors in the gut - no wonder people lose their interest in food or get an upset stomach. Do what you can to arrive at meals in a relaxed frame of mind. Leaving plenty of time so that you can arrive, eat, and hang out for a little while afterwards can really improve interest in eating, and definitely cuts down on stomach discomfort afterwards. Practicing deep, abdominal breathing, progressive muscle relaxation, or doing some mini-visualizations can also help people manage their stress before heading into a meal. To learn more about these and other techniques for stress management on-the-go, visit our page on stress.
  • Feeling anxious about the types of foods available and how they are prepared. Getting used to new foods or foods that are prepared differently is sometimes difficult. You can't ask for "made to order" dishes, but you can experiment with creating some of your own dishes with items already available in the dining facilities. Think about trying one new food each week, so that you can begin to broaden your tastes and bring down your anxiety level. If you suspect that your anxiety about food and eating is related to disordered eating or weight concerns, visit our page on eating concerns.

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Resources at Brown

Health Education 401.863-2794
Located on the third floor of Health Services.
Confidential information or care is available through individual appointments with a Nutritionist to discuss the many types of eating concerns you may have regarding yourself, a friend, roommate or teammate. Health Education also offers workshops, pamphlets, and reading materials covering these and related issues. Health Education services are free as part of your Health Services fee.

University Health Services  401.863-3953
Located at 13 Brown Street across from Keeney Quad.
Confidential information and care is available for initial, current or past disordered eating patients.

Psychological Services  401.863-3476  
Located on the fifth floor of J. Walter Wilson.
Confidential appointments are available at Psychological Services for students concerned about their eating issues. Guidance is also available for those who are concerned about a friend, roommate, or teammate's eating. Services include crisis intervention, short-term psychotherapy and referrals. Appointments at Psychological Services are free as part of your Health Services fee.

Links you can use

Nourishing Connections
Established by dietitian Karin Kratina, one of the foremost leaders in the Health At Every Size approach, this web site is a great place to go for a balanced clinical counterpoint to the "war on obesity." Having recently completed her PhD in Cultural Anthropology, Karin's work is particularly useful for anyone interested in exploring the symbolic and socio-cultural aspects of food, eating, exercise, and body image.

The American Dietetic Association
Daily Tips and Feature Topics often have articles of interest. By sending an email to findnrd@eatright.org, you can ask questions directly of registered dietitians in your area. Nutrition Network is a national referral service for registered dietitians. Award winning web site.

Body Positive
This site looks at ways we can feel good in the bodies we have. One of their slogans: "Remember, your body hears everything you think." Other topics on the web site: Size Acceptance; What do you say when everyone around you is dieting? 200 Ways to Love the Body You Have; Dieting Detox; Evaluating Weight Loss Programs: What are the Red Flags? Free subscription to email newsletter "Body Positive Pages."

Adios Barbie
As a project of Loveyourbody.org, the mission of this site is to promote healthy body image and self-image for people of all cultures and sizes.

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Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.