How fat is too fat?

There is one thing I dread about my annual physical. It's not the bill. It's not the friendly doctor and his friendly probing finger. It isn't even the lame joke he makes when he does that thing he does.

It's the annual visit to the scale. I've weighed myself before, in my bathroom, at the fair. But this is different. This is The Scale. I step on it, and my doctor deftly adjusts the weights. A furrow creases his brow as he jots something in my chart. He isn't making any jokes now.

As my numbers creep up on my doctor's chart, winning me no prizes, I find myself wondering: How fat is too fat?

There are three ways to answer that question. You get a different answer to your question depending on which method you use. I am not sure why I am willing to do this, but I will illustrate with my own dimensions. At least it will be an exercise in humility, one of those character traits I keep threatening to develop.

Height/Weight Chart. This one is simple. Stand up against the wall ruler, get on the scale, and determine whether you have a small, medium or large frame.

Armed with these dimensions, you can find yourself on the Metropolitan Life charts (www.healthchecksystems.com/heightweightchart.htm or www.healthchecksystems.com/ heightweightchart.htm) and determine whether the friendly statisticians think you are fat or not.

I am 5'11", have a large frame and currently weigh 190. (OK, it's been a rough holiday season and too many intervening variables to my New Year Resolutions.) Plugging into the chart, I see that in order to be in the range of those with the lowest mortality rate, I would have to weigh between 161-184.

Yes, I know: Six pounds minimum.

Body Mass Index (BMI). For some time now, this measure of our weight to height ratio has been the Simon Callow of healthy-weight arbiters. But I am sensing a waning of the BMI's power to determine such things. Why? Because most of us will end up in the overweight category. Using my measurements (which I will not repeat), I end up with a score of 26.

This means I have squeaked into that overweight category. The range for a normal BMI is 18.5 to 25. Beyond that indicates overweight; more than 30 indicates obesity. Morbid obesity is calculated at a score of 40 or higher.

Hip/Waist Ratio. This is a simple calculation which asks you to divide your waist measurement by your hip measurement. That ratio tells more than you think. It indicates whether you carry your fat in your abdomen or your hips and buttocks. Abdominal fat is associated with such serious health risks as cardiovascular disease and type 2 diabetes.

Some recent research coming out of Toronto indicates that this easy calculation is a three-times better predictor of cardiovascular disease than the BMI. Women with a hip/waist ratio over .85 and men over .9 are at greater cardiovascular risk.

My 35/39 ratio gives me a squeaky pass with a ratio of .8975. Not that my body dimensions are any trip to Hollywood, but they do point out one of the problems with the Body Mass Index.

That much-publicized indicator of obesity fails to take into account where a person carries their fat or how muscular they are. As has been pointed out elsewhere, a skinny dude with a pot belly will look like a stud on the BMI charts while half of the NFL will show up as obese. Go figure.

I've humbled myself enough for one day. Now it's your turn.

You can easily calculate all three healthy weight measures discussed here by going to: http://diet.ivillage.com/healthcalc

Dr. Michael O.L. Seabaugh, a Cape Girardeau native, is a clinical psychologist who lives and works in Santa Barbara, Calif. Contact him at mseabaugh@semissourian.com.