Forget the scale. Make friends with your tape measure!

My job takes me to many interesting conferences, and many more than are more boring than watching paint dry. Today, I was privileged to hear a very interesting talk on weight and exercise while working at a conference on lung disease.

A wonderful professor of medicine gave a fascinating talk on how reducing belly fat is much more important than losing weight or lowering one's BMI (body mass index). Belly fat is the worst kind of fat one can accumulate and is associated with heart disease and other medical conditions. Reducing one's BMI through diet does not necessarily mean that the belly fat is being lost. The doctor went so far as to say that for people who are physically resistant to weight loss, despite serious efforts at diet modification and exercise (let's hear it for menopausal women!!!), it is more important to work on reducing belly fat through exercise than seeing the numbers go down on the scale. Of course, he said that ideally, we should be losing weight AND belly fat, but if you have to choose, any exercise that gets you panting and sweating is better than simply trying to lose weight.

Thus, if your BMI is going down, but your pot belly is not, you're not doing what's really necessary to be healthy.

So how do you know if you're losing belly fat? Well, the answer is really, really low-tech: a measuring tape. If your waist circumference and the distance between your pubic bone and your belly button are going down, you're on the right track.

This message really hit home for me: my wonderful, supportive husband has been "growing" a sizeable paunch during our almost 17 years of wedded bliss. He's not a junk-food junkie and I wouldn't say he's an overeater. He walks every day, and some days walks long distances. But the paunch is expanding every year. He's only 47 and I don't want to lose him any sooner than necessary. We had a little chat about this and it seemed like he was listening, but men are so resistant to change. I'll have to keep you posted on any positive changes!

Now, on to what this means for me. I too have quite a round tummy, though I carry a sizable amount of weight on my thighs too. I know that my cardio-vascular exercise is practically zero, due to arthritis of the knee. I do walk, but cannot walk fast enough to work up a sweat. Right now, the exercise bike, treadmill (see: cannot walk fast) and elliptical trainer are out because of my knee, which is permanently swollen and leaves me with a low-level of almost constant pain.

After having had one disastrous hip surgery (fortunately corrected by a second surgery, but I was out of commission for not far off two years in all), I am deathly afraid of even a small intervention on my knee. A friend who had her meniscus trimmed must now wear a leg brace whenever she goes out. I don't think that's very encouraging. But I have to do something to stabilize my knee so I can do some serious sweating.

I will be going out of town tomorrow for a few days of work half-way across the country. This being Canada, it means that I'm travelling far, far away. But when I get home, I'll be calling a sports medicine clinic and setting up an appointment with a doctor to see if I can't get a brace made specifically for exercising. I don't know if that's the solution, but nothing ventured, nothing gained.

In the meantime, I'd like to salute all you brave souls out there on the treadmill or the bike or whatever. Keep up the good work.

And try to forget (or lessen your dependency) on the scale. Go out and buy a tape measure!