Do you need to lose weight to reduce your risk of heart disease? You can find out by taking three simple steps. First, check your “body mass index” (BMI). A BMI from 18.5 to 24.9 indicates a normal weight. A person with a BMI from 25 to 29.9 is overweight, while someone with a BMI of 30 or higher is obese. Those in the “overweight” or “obese” categories have a higher risk of heart disease.

The second step is to take your waist measurement. For women, a waist measurement of over 35 inches increases the risk of heart disease as well as the risks of high blood pressure, diabetes, and other serious health conditions. To measure your waist correctly, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.

The final step in determining your need to lose weight is to find out your other risk factors for heart disease. It is important to know whether you have any of the following: high blood pressure, high LDL cholesterol, low HDL cholesterol, high triglycerides, high blood glucose (blood sugar), a family history of early heart disease, physical inactivity, or cigarette smoking. Being age 55 or older, or having gone through menopause, also are heart disease risk factors. If you have a condition known as metabolic syndrome, your risk of heart disease is particularly high. If you aren’t sure whether you have some of these risk factors, consult with your doctor.

Once you have taken these three steps—found out your BMI, your waist measurement, and your other heart disease risk factors—you can use the information to decide if you need to take off pounds. While you should talk with your doctor about whether you should lose weight, keep these guidelines in mind:

• If you are overweight AND have two or more other risk factors, or if you are obese, you should lose weight.
• If you are overweight, have a waist measurement of over 35 inches, AND have two or more other risk factors, you should lose weight.
• If you are overweight, but do not have a high waist measurement, and have fewer than two other risk factors, you should avoid further weight gain.

Small Changes Make a Big Difference

If you need to lose weight, here is some good news: A small weight loss—just 5 to 10 percent of your current weight—will help to lower your risks of heart disease and other serious medical disorders.

The best way to take off pounds is to do so gradually, by getting more physical activity and eating a balanced diet that is lower in calories and fat. (High-fat foods contain more calories than the same amount of other foods, so they can make it hard for you to avoid excess calories.

But be careful—“lowfat” doesn’t always mean low in calories. Sometimes extra sugars are added to lowfat desserts, for example.) For some women at very high risk, medication also may be necessary. To develop a weight-loss or weight-maintenance program that works best for you, consult with your doctor, registered dietitian, or qualified nutritionist.

Tomorrow: Physical inactivity & heart disease