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Everyday Fitness

with Pamela Peeke, MD, MPH, FACP

This blog has been retired. We appreciate the wisdom and encouragement that Dr. Peeke has offered the WebMD Community.

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Monday, January 25, 2010

Just What IS an Average Woman’s Size Anymore?

The talented young actress Gabourey Sidibe, star of the widely acclaimed film Precious, graces the cover of the latest copy of V Magazine. It’s a special “size issue” of the publication, showcasing plus-size models and challenging the notion that the only women who can wear cool clothes are rail thin toothpicks with a two foot gap between their thighs. Sidibe has noted in interviews that she’s struggled with body image and excess weight for years, commencing with countless diets at the age of 6. At age 26, her present weight is estimated to be anywhere from 250-300 pounds, and it’s no surprise her size has been a focal point of heated discussions emanating from the bone-hungry, skinny-obsessed Hollywood crowd . Sidibe comports herself with self confidence borne of a resolution she made at age 21 to love herself as she is.

This V Magazine edition is timely. First, designers are getting ready for the unveiling of their 2010 ready-to-wear collections, and the fashion world waits in eager anticipation, wondering if plus size clothes and models will finally be hitting the runways. Second, the First Lady has just launched her fight against childhood obesity and is leading by example with her active and fit lifestyle. This program will be her legacy and she’s gearing up for an aggressive campaign encouraging the whole family to take themselves on, shed excess pounds and get fit and healthy. Third, as I had mentioned in a prior blog, the new Surgeon General, Dr. Regina Benjamin, is coordinating a national wellness program targeting obesity and physical inactivity in American’s lives. This is a powerful convergence of the worlds of retail, government and the White House. And, it appears everyone is jockeying for position as beauty and health are redefined for the American woman.

It’s no wonder that so many of you are scratching your heads and wondering just what are you supposed to be aiming for in this weight and size game. What size is “normal” – what is an average weight anymore?

To answer this question, let’s look at some facts. The average starlet is wearing a size 2 or 4 which is the sample size designers are making presently. Today, the average American woman is 5’4″, has a waist size of 34-35 inches and weighs between 140-150 lbs, with a dress size of 12-14. Fifty years ago, the average woman was 5’3-4″ with a waist size of approximately 24-25″, she weighed about 120 lbs and wore a size 8. Curiously, over the past twenty years, fashion model sizes have dropped from a size 8 to 0. Whenever I hear 0 I can’t help but envision an invisible woman. It gets more interesting when you look at changes in women’s bodies and dress sizes dating from the 1950′s. There was actually a uniform sizing system for women’s clothes until the US Department of Commerce dropped it in 1983 noting that the traditional sizes were no longer reflecting the size and shape of the average consumer. Today, in order to cater to women’s vanity, as women have gotten larger, designers have manipulated sizes so that truly larger sizes are marked as smaller. A size 8 in the 1950′s is now a size 4 or less today. Sizing from brand to brand is now so variable that most women fill their closets with at least two or three sizes.

My patients constantly ask me what size and weight they need to be in order to achieve their optimal fitness and wellness. I see this on my weight loss and fitness boards as well .. Who’s calling the shots on the definition of beauty as well as health? The fashion industry with their emaciated models? The fitness folks with their flat-ab’d muscle mavens? Celebrities from size 0 to Sidibe-sized stars? Government professionals armed with charts, graphs and committee reports?

The answer is all of the above. Each group is helping shape women’s perception of what is right for them. Women are turning their backs on the skin and bones coat hangers that have been the mainstay of the runway model. The ’80′s ushered in the fitness magazines and their meatier, curvier models. Women are starting to get smarter and realizing that reaching a jeans size with no fitness involved is an empty experience. Also, the fitter you are, the more you can weigh at a smaller size. Hey, sign me up! Most of us now roll our eyes at the weighty roller coaster antics of some celebrities (e.g., Kirstie Alley), and are saddened when others succumb to pills, depression and starvation. The First Lady bares her biceps and gets down and dirty planting an organic garden on the White House grounds. Women everywhere want those arms. And the Surgeon General takes herself on and personally as well as professionally commits to getting healthy and mentoring others as well. The Doctor in Chief is showing she’s human and asking folks to work together to solve this obesity problem.

So, where does all of this lead us? I believe that women want to be able to see a range of possibilities in the media as well as in government recommendations. Skip the starving or frankly obese models, and show a spectrum of active, fit women of a variety of shapes and sizes. Plunk them all into great clothes and show the world that a real diversity of women can look and feel great. We want to celebrate a wide spectrum of health and fitness, and run from the old stringent, “skinny” definitions of beauty that have haunted us, leading to eating disorders, eroded self esteem and scale hopping, pill popping madness.

What’s a healthy and appropriate size for you? The answer lies in this key list of health indicators:

  1. Know your waist size. Take a tape measure to your waist, measuring across your belly button. Your goal is a waist circumference less than 35″. More than that is unhealthy because it’s associated with too much internal belly fat, and that’s associated with heart disease and diabetes.
  2. Identify your shape. Pull out that mirror and embrace your hour glass, pear or apple shape. This is where genetics plays a significant role. Your job is to optimize your genetics. So long as your waist size is less than 35 inches, you’re OK. You apples need to be on red alert to rein that waist in for health’s sake. Pears should celebrate the fact that lower body fat is not usually associated with disease.
  3. Measure your body fat. You can buy a body fat scale or have a fitness professional perform a measurement at a health club. Average women should keep their body fat in the range of 20-29% until they become menopausal. After that time, body fat through age 60 can peak at about 32%. Too much body fat all over the body increases a woman’s risk for breast cancer. Too much inner abdominal fat leads to heart disease and diabetes.
  4. Calculate your BMI. Check out the BMI Calculator Plus on WebMD and plug in your weight and height for your BMI. It’s best to keep this in the range of 20- 25. If it’s greater, it’s associated with the consequences of overweight and obesity. If it’s less than that range, you may be too thin and headed for trouble. The only exceptions to the BMI rule are truly athletic and muscular people. That means their BMI may be higher than normal, but their body fat is usually lower than normal.
  5. Live a healthy lifestyle. If you’re
    eating a healthy diet and getting in at least 30 minutes of cardio activity 5 x week along with some form of strength training 2 x week, then you’re living an optimal lifestyle. No one’s perfect. The key is not to be sedentary all of the time, and eating trash 24/7. If you are, you’re living an unhealthy lifestyle fraught with increased disease risk. Also, you’ll never know your ideal clothing size or body shape unless you make better lifestyle choices. These healthy habits will correct the red zones you may be occupying right now in the other categories in this list.
  6. Note your clothing size. Whip out a piece of clothing (jeans) that fits you perfectly. That’s your current size. How do your other numbers look? If you find that you’re in an unhealthy range, you’ll need to shed some excess fat. Your clothing size will change with healthy lifestyle choices. Once you’re no longer in the red zone for health risk, look at your clothing size and that’s where you belong. The only way to continue to improve that size is to take it up a notch and add more intensity and exercise, while paring away excess calories.

The bottom line is that a healthy body (and body image) is nestled somewhere between the extremes of fashion’s scary skeletons and frank obesity. Do the work it takes to become healthy. And while you’re at it, define your own sense of beauty.

This is, after all, your life.

Posted by: Pamela Peeke, MD at 7:59 pm

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