Don’t Weight for Wellness: What You Lose Can Help You Gain
There is a longstanding association between excess body weight and adverse health outcomes. Obesity is a modifiable risk factor for numerous chronic health conditions, including heart disease, high blood fats, high blood pressure, stroke, diabetes, metabolic syndrome, sleep apnea, irritable bowel syndrome, arthritis, depression, and some cancers. These outcomes may be more adverse when obesity-related diseases are compounded with multiple sclerosis (MS), creating comorbidities. Obesity and obesity-related comorbid conditions can also impact the symptomatic progression of MS itself.
An estimated 30% of adults in the United States are considered obese, which is defined as having a Body Mass Index (BMI) of 30.0 or higher. However, this figure may be much higher because BMI may underestimate body fat in older persons and others who have lost muscle mass. For example, an active athlete with large muscle mass and very little body fat may have a high BMI. Conversely, an inactive elderly or disabled person with low levels of muscle and bone mass may have a BMI in the normal range, even though they have quite a lot of body fat in comparison to their lean body mass (muscles). However, it is clear that having a higher BMI, particularly during adolescence, may be a risk factor for the development of MS. When MS does develop in people with high adolescent BMI, symptoms occur at an earlier age. Also, high BMI is associated with the progression of disability in people who already have MS.
Waist circumference is another helpful measure of obesity. It compares closely with your BMI and is a simple check to tell how much body fat you have and where it is placed around your body. Waist circumference may be more accurate measure of health risk in individuals with disabilities because it measures central adiposity (“belly fat”), which has been associated with adverse health outcomes. Given that loss of muscle mass is likely to impact BMI, waist circumference may be a more accurate measure of health risk in individuals with disabilities.
BMI Health Risks
- Less than 18.5, it falls within the underweight range.
- 5 to 24.9, it falls within the normal or healthy weight range.
- 0 to 29.9, it falls within the overweight range.
- 30.0 or higher, it falls within the obese range.
Waist Circumference Health Risks
- If you are a male and your waist circumference is > 40 inches
- If you are female and your waist circumference is > 35 inches
MS is an unpredictable disease that robs us of so many things…energy, strength, balance, cognition, mobility, and so much more. As a result, MS often leaves us feeling like there is little that we can change or improve- let alone control- particularly in today’s hectic world. The stress and psychological burden of living with an unpredictable chronic disease like MS add another layer of difficulty (or two!). Changes in mobility, balance, strength, and energy levels make it hard to exercise and often impact food choices. As MS zaps our energy and motivation for exercise, stress and fatigue prompt us to opt for the easiest meal option, even if it is not the most nutritious choice.
However, through aspects of our everyday life that we CAN control- particularly diet choices and physical activity- we can positively change and improve obesity and obesity-related comorbid health conditions. Exercise may influence body functions such as mood and cognition, mobility, and bowel and bladder functions. Exercise and physical activity may also have positive effects on the neuroplasticity of the brain, as well as enhancing the neuroprotective environment and minimizing inflammation.
Similarly, what you eat can greatly affect your overall health and well-being. We suggest a balanced diet that frequently includes these items:
- A variety of colorful vegetables and fruits
- Whole grains
- Nuts and seeds
- Lean proteins
- Healthy fats (fatty fish, olive oil or avocados)
Change is always difficult and there are really no shortcuts; you have to actually make sustainable changes to get results. BUT the payoff for your hard work is promising! Losing excess weight can make you feel better both physically and emotionally. Even a modest weight loss of 5%-10% of your starting weight can lead to significant health benefits.
As a bonus: Physical activity and good nutrition provide health benefits that are independent of weight loss. In other words, healthy habits are good for you even if you do not hit your weight loss target! Weight is an important health metric, but it is not the only one. Blood pressure, cholesterol, triglycerides, blood sugar control, bowel regularity, and sleep quality are all impacted by what you eat and how you move your body!
Don’t weight for wellness! Build your MS team to help you focus on what you can control! Recruit a physical therapist or exercise physiologist who understands MS to help you establish an exercise and/or physical activity routine that suits your ability levels. We also suggest seeking the guidance of a registered dietitian (RD or RDN) who understands the challenges of MS to help you make manageable and sustainable changes to your diet.
For more information and tips, watch our presentation, “Weight Management and Nutrition” by clicking on this link.