Help, My BMI Says I’m Overweight!

If you’ve ever measured your BMI and were startled to discover you fall into the ‘overweight’ or ‘obese’ category, you’re not alone. 73.6% of adults aged 20 and over are either overweight or obese based on BMI, according to the Centers for Disease Control and Prevention.

Being overweight or obese can increase the risk of many chronic conditions, including type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, heart disease, stroke, and even cirrhosis from fatty liver disease.

Achieving or maintaining a healthy weight can be a challenge for many people. If you are struggling, your primary care physician can help you create a personalized plan to reach your weight goals.

Why BMI Matters

Body mass index (BMI) measures body fat based on height and weight, providing a better picture than just weight alone. BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters. For an easier way to determine your BMI, you can use an online BMI calculator like this one. An ideal BMI is 18.5-24.9. A BMI of 25.0 to 29.9 is considered overweight, and a BMI of 30.0 or higher is considered obese.

Shore Physicians Group Primary Care Physician Dr. Maria Jose Jimenez Cerna believes all adult patients should have their BMI screened. BMI provides a baseline for those at a healthy weight and helps identify when patients may need help.

“We have screenings for cancer and many other chronic conditions, so we must screen patients for overweight and obesity as well. If our population experiences a drastic decline in obesity, we’d also see healthier people and a drastic decline in related chronic conditions,” says Dr. Cerna.

Dr. Cerna says that even people who are at a healthy weight benefit from regular BMI checks. “Generally, women between 40 and 60 experience a 1.5-lb weight gain yearly. Over ten years, that’s an extra 15 lbs, which can begin to affect your health adversely. When we screen for BMI, we can help our patients avoid entering those riskier weight categories. Talking about it early helps normalize conversations about BMI and weight.”

But BMI Isn’t Everything

According to Dr. Cerna, for some people, BMI can be skewed.

“If you have a lot of muscle mass, such as in athletes and bodybuilders, your BMI will be overestimated. In seniors and people with less muscle mass, BMI may be underestimated,” said Dr. Cerna.

Dr. Cerna also adds that BMI categories may vary for different ethnicities. “People who are Asian have a lower threshold for overweight and obesity. For them, the ideal BMI is 18.5–23.”

To gather further information about a patient’s weight, Dr. Cerna will also measure waist circumference because abdominal fat has a more severe effect on health than evenly distributed fat. For men, waist circumference should be less than 40″, and for women, less than 35″.

“If your BMI is high, but all your other numbers are fine, such as blood pressure, glucose, and cholesterol, I would measure your waist circumference. If that’s normal, sometimes you have a high BMI simply because of your genetics, and that’s okay. Medicine is about prevention, so if I start to see that you are becoming prediabetic or your cholesterol is going up, we need to start talking about your risk factors and what we can do to improve things,” says Dr. Cerna.

How Your Doctor Can Help You

One of the first things Dr. Cerna will do is a physical exam and a review of medications to see if anything contributes to weight struggles.

“If I know my patient is really trying, it could be a medication or thyroid problem. Antihistamines like loratadine or SSRIs for depression or anxiety could be making it tough to lose weight,” says Dr. Cerna. “Some women may be hitting menopause, making it hard to lose weight.”

Dr. Cerna likes to ask her patients what changes they can make first. “Most people know if they are snacking too much or not exercising enough. But sometimes, just having a physician working with you to set goals and follow through helps.”

Below are just some of the strategies Dr. Cerna will discuss with her patients:

  • Diet: “Studies show that there is no better diet than another,” says Dr. Cerna. “It’s all about what works for you. For some people, intermittent fasting works; for others, the ketogenic diet may work. But I like to talk about it as a diet modification, not going on a diet, because with strict diets, you’ll get sick of it and may slip back into your old habits. I also recommend the support of a dietitian. Sometimes, the more reinforcement we get, the easier it gets.”
  • Apps: “I recommend that my patients keep track of their calories using an app, such as MyFitnessPal. If you want to lose weight, eating less than 1,500 calories daily is a general rule. However, each person is different. Exercise also plays a role.”
  • Exercise: Dr. Cerna suggests patients follow the American Heart Association’s recommendations of getting at least 30 minutes of moderate to high-intensity exercise 5 times a week. “Exercise burns calories, makes you feel good, and improves cardiovascular health, strength, and metabolism.”
  • Weight loss medication: While Dr. Cerna always starts by helping her patients make lifestyle modifications, she says medication may eventually be the answer for some. “If you have BMI more than 28 and you have a comorbidity, such as hypertension, diabetes or heart disease, or your BMI is greater than 30, you’re already a candidate for weight loss medications. If my patient wants to try it, we can definitely discuss it. There are many options now, both oral and injections, such as Wegovy, which helps signal your brain that you are full. These medications can result in a 15-20% weight loss. It depends on what your insurance may cover.”

Dr. Cerna strives to create an open and honest relationship with her patients where they can feel comfortable talking about weight, no matter their BMI. Ultimately, her goal is to help her patients prevent chronic diseases and live a long and healthy life.

Dr. Cerna sees patients at Shore Physicians Group’s Northfield office, located at 2605 Shore Road. To schedule an appointment with her, please call 609-365-5300. To learn more about Dr. Cerna, visit her physician profile.