Q: My mother has always had an issue with her weight. She was never very heavy, but since her early 40s she has always been trying some kind of diet. She is in her late 70s now and I cannot convince her to quit worrying about how fat she is! Her doctor just laughs when I bring this up during her check-ups. What is the "correct" weight for a 76-year-old woman? How can I convince my mom to stop obsessing about yet another diet? I think she could have bought herself a car with all the money she has spent on supplements and programs throughout her life. This has really affected my own perception of my weight. Is there help for both of us? — Samantha

A: Nothing is more characteristic of our American culture than our never-ending pursuit of the size 2 slim body. Other nations also get excited about it, but nothing like we see here. There are hundreds of diets, with the "special of the year" attacking us from every corner. There is a craze of diet pills, and fat-burning "you can still eat everything and be thin" supplements. There are weight-loss clubs, programs, support groups. The newest addition are companies that provide prepackaged meals that are ready to be warmed up and eaten. Well, as you can guess from the stern tone, I am not the biggest fan of dieting. I really do not believe that they work. Yes, I know I am going to get quite a few letters for this statement. What does work are small, but permanent long-term lifestyle changes.

Let's answer your question about

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the "correct" weight. There is a way to measure weight as compared to your overall size. The number, which you get when you use this special formula, is known as the body mass index, or BMI. The healthy range for the body mass index is 19 to 25. If you are less then 19 (as most models, movie stars and diet addicts are), you actually are at higher risk for health problems, especially when you are older. The 25-30 range means that the person is overweight. Once the number goes above 30, we are dealing with obesity and all its bad effects. Breathing problems, arthritis of the knees and back, sleep apnea, high blood pressure and cholesterol are all connected to excessive weight.

What can one do to lose weight? The first thing to focus on is eating habits. Eating fried, processed food, snacking, eating sweets and large amounts of soda all contribute to the inability to maintain a healthy weight. The other important concept is portion size. Most obese people eat more than they have to. People overeat out of boredom or stress. Finally, an inactive lifestyle with no regular exercise will "seal the deal." Here is my suggestion for chubby readers: think of one change you can implement every month to help with your weight. It has to be simple and you have to make it permanent. Say you will change the cream cheese to low-fat or substitute fried chips with baked ones. You will eat your sweet snack every other day. You will drink half the wine or beer you do (alcohol provides easily disguised calories). Next, commit to some form of physical activity, whatever you realistically can do. Expect to lose weight very slowly. Remember, even if you shed 5 to 10 percent of the excessive weight, the health benefits are there.

I also want to focus on the concept of pursuing weight loss despite having a thin body. This distorted body image is the hallmark of the disease called anorexia. Although mostly affecting young girls, we do see it sometimes as a lifelong problem for our aging patients. I do not think that your mom has this illness, but if she dieted despite being normal or low weight, she might. It is a very hard-to-control malady, and would require a team of dedicated professionals to conquer.

Samantha, calculate your mom's and your BMI and talk to her openly about your concerns. Support her in her striving for a healthy lifestyle. Accept small gains for both of you. In my opinion this is the only effective way to go. Dr. Beata Skudlarska is a Bridgeport geriatrician. Send questions to Bridgeport Hospital Center for Geriatrics, 95 Armory Road, Stratford CT 06614 or geriatricmd@aol.com.