Obesity, its prevalence and the pressure an overweight nation puts on our healthcare system have all been making their way to the top of the health agenda in recent years. Recent surveys around obesity only reconfirm why this matter is so vital.


An expanding nation

In 2021 the Health Survey for England estimated that 25.9% of adults in England were classified as obese and a further 37.9% were overweight. The age group most likely to be affected – with almost three quarters of them fitting one of these classifications - are adults aged between 45-74. Indeed, adult obesity is on the rise with the percentage of adults overweight or obese climbing to 64.3% in 2022 from 59.2% in 1993.

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Why does your weight matter?

Carrying extra pounds, especially when this is body fat, is said to increase your risk of heart disease and type 2 diabetes, whereas carrying too little may increase your chance of developing osteoporosis. A high body fat percentage also puts you at risk of several types of cancer and early mortality.

Why are our waistlines expanding?

The National Obesity Forum highlight a lack of support from health care professionals and the increasing cost of healthy food, as some of the main reasons for our expanding waistlines. However, the overall picture is complex and may include:

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  • The last 50 years has seen a huge shift in food production with the focus on cheap, readily available convenience food that has mass appeal and a long shelf life; these ultra-processed foods are typically high in fat, salt and sugar.
  • More of us are adopting a sedentary lifestyle, with 1 in 3 men and 1 in 2 women not being active enough for good health.
  • Inequality is considered a major determinant of weight with 39.5% of women in the most deprived areas of England living with obesity, compared to 21.9% in less deprived areas.

How do I know if I am a healthy weight?

Stepping on the scales can help us keep track of fluctuating pounds, but it’s not always clear whether that extra half a stone puts you at an unhealthy weight. So how do you know if you are a heathy weight?

Body Mass Index (BMI) has long been the go-to tool - it’s a simple and quick way to check and is a measure of body fat based on height and weight. Obesity is defined as having a body mass index (BMI) of 30 or above, with a BMI of 25-30 being classified as ‘overweight.’

You can check yours using the NHS online calculator.

Many health practitioners also use the waist-to-hip ratio method in addition to BMI. This is because BMI doesn’t take into account a person's body frame or muscle mass. Waist to hip is also considered a more accurate assessment of body fat distribution and disease risk.

A type of fat called visceral fat, lies deep in the abdomen and accumulates around key organs like the liver, pancreas and intestines. This type of fat contributes to several chronic conditions including insulin resistance and fatty liver disease.

A woman measuring her waist with a tape measure

How can I check my waist to hip ratio?

You’ll need a flexible tape measure with which you take two measurements as follows:

1. Take your waist measurement

Your waist is halfway between your hip bone and your bottom rib, so feel for these markers and then place the tape measure evenly around your waist (a mirror may help you get the tape straight and parallel to the ground.) Note down the result in centimetres.

2. Take your hip measurement

Place your tape measure around the widest point of your buttocks – the position of this will vary from person to person. Note down the result in centimetres.

3. Now do the calculation

Divide your waist number by your hip number to get your ratio. According to a number of studies, you are at an increased risk of heart disease, high blood pressure, type-2 diabetes, many types of cancer and abnormal cholesterol if your numbers are:

  • Women – a ratio equal to or greater than 0.85
  • Men – a ratio equal to or greater than 1.00

Is BMI a useful measure for everyone?

No, BMI is not appropriate for all people. This is because the resulting figure can be distorted by pregnancy and high muscle mass, and it may be unreliable as a measure for children or the elderly. If you are pregnant and want to understand if your weight gain is healthy, seek advice from your GP or midwife.

For children and young people (aged two to 18 years), the BMI calculation takes account of age and gender, as well as height and weight. This is because children’s body composition varies as they age, and between girls and boys – physical maturity not being achieved until 15-18 years of age.

Does muscle weigh more than fat?

We often talk about muscle or lean mass weighing more than fat. In actual fact, a pound of muscle and a pound of fat weight exactly the same but the difference lies in their density. Muscle has a greater density than fat, with studies calculating this at about 1.06kg/L compared to fat at 0.9196kg/L. It’s this difference that accounts for how muscle looks – firm and toned compared to fat looking soft and malleable- and how it functions in the body – muscle increases metabolism and calorie-burning, fat acts as an insulator and fuel store.

Do body fat monitors work?

Studies suggest that commercially available body composition scales that provide information on weight, hydration levels, muscle mass, fat mass and percentage are not accurate when compared to the gold standard used for this purpose - dual x-ray absorptiometry (DEXA). However, given a DEXA is expensive and available to very few of us, at home body composition scales can be used to provide a rough guide as to the amount of fat a person is carrying and be used effectively to help manage and monitor this.

How to maintain a healthy weight

If you’re looking to lose weight, your best chance of losing pounds and keeping them off is to eat a healthy, balanced diet. Our helpful guides are designed to help you do this, offering tailored, expert advice for men, women, vegetarians, vegans and expectant mothers.

We also have a free Healthy Diet Plan to help you get in the habit of eating healthily.

Get more help to get fit, eat right and learn to cook healthy meals for weight loss from scratch – visit our health & nutrition hub for more recipes, tips and expert help.

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This article was last reviewed on 13 March 2024 by nutritionist Kerry Torrens.

A nutritionist (MBANT) Kerry Torrens is a contributing author to a number of nutritional and cookery publications including BBC Good Food magazine. Kerry is a member of the The Royal Society of Medicine, Complementary and Natural Healthcare Council (CNHC), British Association for Applied Nutrition and Nutritional Therapy (BANT).


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