Weight management – what works and is best for health

What is weight management?

“Let’s get this straight – healthy weight loss for women isn’t all about going on a weight loss journey,” says Dr Ann Nainan, family doctor and Healthily expert. “Instead, weight management is about getting into long-term habits that work for you, to help you get to or stay at your healthy weight.”

The aim? Helping you unlock the feel-good power of being in your healthiest body. “It’s not about being the ‘right’ size, but about being the right level of active and nourished,” says Dr Ann. “To feel your best now – and also in the long term – by cutting your risk of health problems and easing conditions you might already have.”

The benefits of being at your healthy weight

“Being at your healthy weight – and staying there by managing stress, being active and eating well – can help keep both your body and mind in good health,” says Dr Ann.

When you focus on weight management, you’re more likely to:

• Cut your risk of serious health conditions. Being at your healthy weight can cut your risk of heart disease, type 2 diabetes, high blood pressure and some cancers – all health conditions linked to being overweight. You’re also less likely to get the bone-health and mental-health challenges that can come with being underweight. (Find out more about the health risks you can help avoid with weight management).

• Find it easier to be active and flexible.
  “If you’re overweight, this can make it harder to do some types of exercise,” says Dr Ann. “Getting into weight management habits and being more active gives you more energy and flexibility, to make staying active easier.”

• Feel good psychologically. “Knowing you’re cutting your risk of long-term health conditions can help free you of worries – especially if you have a family history,” says Dr Ann. And there are other mental-health benefits to being your healthy weight:

  • according to a review of 36 medical studies, if you have weight to lose, shedding it can give you better self-esteem, body image, and health-related quality of life
  • managing your weight by getting active means you get the proven mood-lifting and stress-busting benefits of regular activity – and being active in a green space can also restore your mental energy

How to work out your healthy weight

Weight loss for women shouldn’t be about a ‘one size fits all’ approach. A healthy weight will be different for everybody. But it’s important to know what a healthy weight is for you.

“Knowing your healthy weight can help you work out how to gain weight or lose weight safely,” says Dr. Ann. “This may be completely different from the steps your sister, best friend or colleague need to take.”

Two of the most common ways to work out a healthy weight are body mass index (BMI) and waist-to-hip ratio.

BMI uses your height and your weight to work out a healthy weight range for you. Read about how to work out your BMI and what the results mean.

But this measurement isn’t 100% reliable for everyone. For example, if you’re very muscular or athletic, your BMI may show that you’re overweight or obese, as muscle weighs more than fat.

That’s why doctors recommend using another health measurement to find your healthy weight, such as your waist size or waist-to-hip ratio (WHR). Read about how to measure your waist size and WHR ratio and what the results mean.

The risks of being an unhealthy weight

“The weight management approach is good because it gets you into a healthy lifestyle for the long term, unlike some other ideas about weight loss for women” says Dr Ann. “Focusing on fad diets usually means your weight can go up and down, and you can end up being overweight or underweight at different times, increasing your health risks.”

Worrying can drive unhealthy behavior

“Worrying a lot about your weight – whether you weigh too much or too little – can lead to dangerous eating behaviors, such as anorexia or binge eating,” says Dr Ann.

“So finding ways to stay at your healthy weight can reduce stress and anxiety, as well as your risk of developing an unhealthy relationship with food.”

Increased health risks from being overweight

“Being overweight puts women at greater risk of developing some serious health conditions,” says Dr. Ann. These conditions include:

• high blood pressure
• type 2 diabetes
• high cholesterol
• heart disease
• several cancers, including breast cancer
• stroke
• Problems with getting or staying pregnant (fertility)
• breathing issues, such as sleep apnea
• too much visceral fat, also known as belly fat – which is linked to high cholesterol, heart disease and diabetes. Read about how to lose belly fat

Increased health risks from being underweight

“Being thin doesn’t always mean you’re healthy,” says Dr Ann. “If you’re underweight, you’re also at higher risk of some health conditions.” These include:

• weak bones (osteoporosis)
• lack of nutrients (malnutrition)
• problems with your periods – such as – no periods or issues getting pregnant
• anemia
• weak immune system
• lack of muscle strength
• depression

What stops women from being a healthy weight?

“On a very basic level, eating more calories than your body uses can cause you to put on weight, while using more calories than you take in means you’ll become underweight,” says Dr Ann. But life isn’t that simple!

“A lot of research is being done on the causes of obesity and being overweight and underweight, but we still don’t know exactly why one person will put on weight in a certain situation and another person won’t,” says Dr Ann. “But we do know that some factors make it more likely for us to gain weight.

“And just like being overweight, the causes of being underweight are complicated and can affect everyone differently.”

Knowing these sometimes surprising influences on your weight can help you decide what day-to-day weight management choices you can make to best help you.

Changing lifestyles and your weight

• it’s easier to eat more calories than ever before – portion sizes, packaged food sizes and even tableware have all gotten bigger, so we’re eating more food at every meal. Plus, we eat more processed and takeaway foods that contain high-calorie ingredients such as high-fructose corn syrup, so the amount of calories in a portion can be higher. And more people drink more alcoholic drinks socially and at home – alcohol is high in calories, too
• we’re moving around a lot less – so we’re not burning off the calories we take in. Most American adults are now sedentary for an average of 7.7 hours every day. We do fewer physical jobs where we’re using up more energy, and more jobs that mean we sit at desks, or spend time in cars on a long drive to work or places to spend leisure time. Plus, more time on computers and cell phones means more hours not being active – US research shows this time has increased since 2001
• stress and lack of quality sleep – “stressful life events such as bereavement or divorce can cause people to lose appetite or to comfort eat, for example,” says Dr Ann. “Being stressed can also interfere with sleep – and you’re more likely to eat more high-sugar foods to keep you awake if you’re tired”

Social influences for weight gain

• as more people become more overweight or obese, our idea of what a usual weight is changes – so it’s easier to be less aware that you’re not at a healthy weight. More people now consider their weight to be “about right” when they’re in fact overweight than in the 1980s
• if your friends and family are overweight, you’re more likely to be – because we influence each other’s choices of activity, food and alcohol levels. Research has shown that a person’s chances of becoming obese increases by 57% if a close friend is obese, 40% if a sibling is obese, and 37% if a spouse is obese

Your neighborhood can make you put on weight

Your environment can affect your weight. An ‘obesogenic environment’ is one that makes it more likely that you’ll eat more calories than you use, and can make it feel harder or more overwhelming to lose weight.

For example:

• urban environments are growing, which can mean you live in the middle of a city with very little green space for exercise
• you may be more likely to walk past lots of fast-food restaurants every day, while not having access to fresh fruit and vegetables close by
• if there’s a lot of crime, you may not feel safe exercising outside
• broken sidewalks or uncared-for parks may also put you off physical activity
• some studies have linked air pollution with obesity, so living near roads with heavy traffic may have an effect

Your genes or racial background can affect healthy weight

Your background and weight gain

“We know that genes can have an influence on people becoming overweight or obese, but the details are still being investigated,” says Dr Ann. Here’s what we know so far:

• one theory is that you may have some ‘energy-thrifty genes’, which helped your ancestors store energy during times when there wasn’t enough food. Today, you probably have enough food all year round, but energy-thrifty genes may mean you still store extra calories and put on weight
• obesity tends to run in families, but there isn’t a specific ‘fat gene’ that some families carry and others don’t. Women with black, African-American, Hispanic or Latina heritage are more likely to be overweight or obese. “This could be due to genetics,” says Dr Ann. “But it could also be down to cultural influences, such as certain foods, family traditions, views on body type, or where your community lives”

Your genes and being underweight

• if your parents, brothers or sisters are naturally slim, the chances are you will be, too
• eating disorders, such as anorexia, can also run in families. This may be genetic, but could also be due to family behaviors around food and/or body type, or a combination of these factors

Your age can affect your weight

As you get older, you may also struggle to have a healthy weight. Factors can include:

• muscle mass reduces with age, so you burn calories more slowly
• hormonal changes of the menopause can be associated with weight gain
• a less active lifestyle may mean you’re more likely to put on weight
• loss of appetite can mean you’re not eating enough calories
• taking certain medications can contribute to weight changes

Health conditions and your weight

“Some health conditions or the medicines you need to take to manage them can make you more likely to gain or lose weight,” says Dr Ann.

Health issues that mean you’re more likely to gain weight include:

• underactive thyroid – which is more common if you’re a woman
• Cushing’s syndrome – which often happens as a side effect of steroid medication
• taking some epilepsy or diabetes medicines, or mental-health medicines such as antidepressants or treatments for schizophrenia

Health issues that mean you’re more likely to lose weight include:

• overactive thyroid – which is more common if you’re a woman
• uncontrolled diabetes
• digestive system conditions such as celiac disease or Crohn’s disease
• mental-health conditions such as depression or anxiety

If you think you might have any of these issues, see your doctor as soon as possible.

Disordered eating

Eating disorders such as anorexia, binge eating, bulimia or restrictive eating can cause weight gain and weight loss. “The causes are a complex mix of genes, biology, psychology (including self-esteem) and social/environmental factors,” says Dr Ann.

“If you have an eating disorder or an unhealthy relationship with food or exercise (or think you might), speak to your doctor. Or reach out to a specialist charity – such as the National Eating Disorders Association (US) or Beat (UK).”

Learn more about eating disorders, including the signs and treatment options.

How to manage your weight

The feel-good factor of having a healthy weight can be empowering. But you may need to change the way you think to focus on feeling healthy, rather than worrying about your society’s ideas about what a woman should look like – whether that’s curvaceous and larger, or toned and thin.

Tap into the body neutrality and body positivity movements

“Remember that many of the models and other celebrities in the media have a lot of money and time to spend on their looks,” says Dr Ann. “And social media is full of filters that allow you to change your body shape, even in live video streaming. For most people, this isn’t the reality.”

Celebrate your body

“Rather than beating yourself up for being overweight or underweight, try to thank your body for all the amazing things it can do,” says Dr Ann. “Learning to love yourself with positive self-talk is one of the best things you can do to maintain a healthy weight. And if loving yourself feels like a step too far for you, ‘body neutrality’ is about accepting and respecting your body, which is also a great approach.”

Weight gain for women – the safe way

If you’re looking to gain weight, the Academy of Nutrition and Dietetics says it’s best to focus on eating healthy, nutrient-rich foods, rather than spending money on expensive powders or bulking bars.

According to the Academy, the key is quality over quantity. To gain weight safely:

• avoid unhealthy calorie-dense foods such as chocolates, crisps, or sugary sodas – stick to a healthy balanced diet(/is-your-diet-as-good-or-bad-as-you-think-it-is)
• try adding more calorie-dense foods to your meals – such as nuts in your porridge and healthy oils as dressings on salads
• eat more starchy carbohydrates such as brown rice, potatoes and whole wheat bread and pasta, and enjoy full-fat versions of yogurt and milk

You can also include some calorie-dense snacks during the day, such as:

• milkshakes made with full-fat milk and an extra helping of milk powder
• a slice of whole wheat toast with peanut butter or another nut butter
• avocado on toast – avocados are packed with healthy fats
• a handful of unsalted nuts

Read more about gaining weight safely.

When to see a doctor

See your doctor or a dietitian for support if:

• you have concerns about your weight
• you’re struggling to gain or lose weight
• your BMI is above 25 or under 18.5

Speak to your doctor as soon as possible if:

• you’re losing weight without meaning to, or have other symptoms such as pain in your tummy or pelvis, a change in your bowel habits, loss of appetite or you feel full quickly after eating
• you’re gaining weight without meaning to, or have noticed a swollen tummy or bloating that doesn’t go away
• you’re peeing more than usual, feel unusually thirsty or tired all the time, or have noticed a change in your periods
• your weight is affecting your mood
• you’re binge eating, making yourself sick, severely restricting your calorie intake, exercising excessively or using medication such as laxatives to lose weight