Do You Know What Your "Healthy Weight" Should Be?

by Jane Ashley

Recent studies show that about 2/3 of Americans are either overweight or obese — too much fat in relation to their lean muscle tissue. Many of us are just a few pounds “overweight” while a small percentage of Americans are “morbidly obese.” The causes for weight gain are complex — ranging from genetics, hormonal, and emotional to lifestyle and cultural influences — lower income families may lack the income to purchase fresh fruits and vegetables.


Once we’re diagnosed with cancer, we want to do what we can to get healthier, including our weight. But how do we determine what is a healthy weight for us?

Weight Gain during Cancer Treatment

The general public’s perception is that cancer patients lose weight. However, some patients gain weight during and after treatment causing additional distress to the patient.

All of the reasons for weight gain aren’t known.

• It’s believed that the steroids given to help prevent side effects before chemotherapy contributes to an increased appetite, fluid retention and higher blood sugar — all contributing factors to weight gain.
• Patients suffer fatigue from chemotherapy and radiation therapy and aren’t as active as they used to be.
• Hormone therapy used in breast and prostate cancer contribute to weight gain.

Some Patients Gain Weight

So some patients have a combination of factors that increase appetite and lower metabolism leading to weight gain.

Weight Loss during Cancer Treatment

For other patients, weight loss is a real and critical problem. In fact, for about 40 percent of patients, weight loss was one of the first symptoms that they have cancer. Losing weight (and especially muscle mass) contribute to weakness, lack of energy and fatigue.

Side effects contribute to weight loss:

• Nausea
• Vomiting
• Mouth sores
• Diarrhea
• Poor appetite

Some Patients Lose Weight

Weight loss may cause patients not to tolerate their treatments and have more severe side effects. If a patient is facing surgery, they may have their surgery delayed until they gain weight and become stronger.

What is BMI?

BMI stands for Body Mass Index. BMI is an estimate of the amount of body fat based on one’s height and weight. Most cancer treatment centers routinely calculate our BMI every time they weigh us. Here are the categories of BMI:
• Underweight = <18.5
• Normal weight = 18.5–24.9
• Overweight = 25–29.9
• Obesity = BMI of 30 or greater

But BMI is not the sole assessment of one’s health. It is possible to have a normal weight BMI but carry your body fat around your waist, putting you at increased risk for heart disease and Type 2 diabetes.

There is also a puzzling phenomenon called the “obesity paradox.” Some recent studies have shown that low-normal BMI patients have poorer outcomes than obese patients. Perhaps, it’s because the low-normal patients have already lost a substantial amount of weight. There are also significant differences between ethnic groups in BMI and the amount of lean muscle mass they have. For example, African-Americans have more lean body mass (muscle) and significantly less body fat than Latinos — even with virtually the same BMI measurements.

Researchers don’t know why this obesity paradox exists since obesity is associated with significant health problems, including heart disease, high blood pressure, stroke, diabetes and sleep apnea. Obesity is also related to the development of 13 cancer types including breast cancer in postmenopausal women, colorectal, liver, stomach, pancreas, kidney, ovaries, and uterus. More studies are needed to understand this paradox.

Find out what your BMI is with this calculator.

What’s the best weight for me?

Discuss your weight with your oncologist. You are partners with your medical team as they seek the best possible outcome. You may feel more motivated to cultivate healthier lifestyle choices, but it’s best to consult with your medical team to determine what’s right for you. Every patient is different, and the methods to help someone in active treatment for their cancer are not the same as for the general public.

Questions to Ask My Oncologist

Since our weight helps determine our overall health, these questions are essential. We need to be willing to have an open mind and listen carefully to what our oncologist says. We need to be honest with ourselves and not carry a grudge if we don’t hear what we want to hear. These questions can be tailored to either being overweight or underweight.

• Is my weight an unhealthy weight?
• How does my weight influence my health?
• How would getting to a more ideal weight improve my health?
• What is an ideal weight for me?
• Are there programs or treatments to help me attain that weight?
• Is there a support group that I could join?

Eat Plenty of Protein

The American public has heard so much about eating red meat and processed meats like ham and cold cuts that some cancer patients believe that they must go vegan during cancer treatment. Going vegan means not eating meats, eggs, dairy products or other foods processed with animal products.

Eat Enough Protein

Cancer patients need to eat protein. Protein helps prevent loss of muscle mass. Patients over 60 should be especially careful to eat enough protein — ask your oncologist how many grams of protein you should be eating.

Don’t Forget the Power of Exercise

It sounds counter-intuitive to suggest exercise to combat fatigue, but staying active not only helps maintain muscle mass but it helps build strength and stamina. Losing lean muscle mass leads to a poorer treatment outcome. It might just be that physical activity may be more important than weight when it comes to overall survival and prognosis. Ask your oncologist or physician’s assistant to refer you to an appropriate exercise program.

The Bottom Line…

Each of us is different. Ask your medical team if you need to lose or gain weight. Our nutritional needs are significantly different during our treatment.

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A Cheat Sheet To Achieving And Maintaining A Healthy Weight

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