Physically fit riled by pocket pounds

When Dan Zukowski weighs in at his doctor’s office, he hears chuckles.

“A nurse told me I’m worse than the girls,” Zukowski said.

Zukowski empties his pockets, kicks off his shoes, removes as many outer layers as he can “without making it uncomfortable” and even discards his work nametag.

“They needed a chair for me to sit all my stuff on,” Zukowski said.

The 47-year-old Puyallup, Wash., resident used to approach weigh-ins with nonchalance. He’d leave his shoes on and wouldn’t even put down the magazine he’d been reading in the waiting room. Not anymore.

Many people are weighing in heavier than they should - and, yes, most of them are men, at least according to sources consulted for this report who mostly merely shared their impressions.

“I’ve seen men carry up to 5 pounds of extra weight in their pockets in the form of change, keys, cellphones, etc.,” said Chelsey Lindahl, a registered dietitian forthe MultiCare Center for Healthy Living in Tacoma, Wash.

While health-care professionals say these inaccuracies are almost always unimportant, they can bother patients.

During a visit last year, Zukowski looked at his recorded height and weight and then searched a chart for his body mass index. It said he was overweight.

How could this be? He is fit and exercises daily. He was running 100 miles per week while training for the Tacoma City Marathon. He biked to work. And he was the reigning champion of his local Turkey Trot.

His doctor told him not to worry. Clearly he was in great shape. The BMI scale is somewhat arbitrary when it lumps everybody with a score of 25 or higher into the “overweight” category, and it is notorious for placing muscular people outside the “normal” range.

“BMI is a great tool for the general population, but not as much for very fitness-minded folks,” said Dr. Mark Mariani, director of MultiCare’s orthopedics and sports medicine.

Even less so when those fit people get weighed with their shoes on and full pockets.

Despite assurances from his doctor, Zukowski was annoyed that his BMI was high. “I don’t want to have anything associated with me saying I’m overweight,” he said.

So a year later - a 3-hour, 46-minute marathon and another Turkey Trot title under his belt - Zukowski sheds as much as he can when he weighs in for his annual physical.

And this, health experts says, is a good approach for everybody, but not as important as being consistent about the way you weigh in.

Spokesmen for MultiCare and Franciscan Health System say they have guidelines for weighing in. Still, in many cases, it’s up to the patient to decide exactly what does and doesn’t go on the scale.

“There is very limited clinical value the majority of the time to see a one- to two-pound difference,” Mariani said. “Even in the situations where there is clinical sensitivity to a one- to two-pound difference [heart failure is a good example], the key thing then is measuring in a consistent fashion from visit to visit. The key information is not the total weight, but the change in weight.” IT ADDS UP

I decided to see just how much I could get away with at the scale during a doctor’s appointment.

First, I weighed myself at home. Naked (sorry if I just ruined your breakfast), I weighed 179 pounds. That gave me a BMI of 24.3. Normal.

Then I put on wool socks, sunglasses, my hiking boots, heavy jeans, a sweater, a hat and a down jacket and grabbed a magazine and a 32-ounce bottle of water. I weighed 191 pounds - “overweight” with a BMI of 25.9.

I wore all of this as I stepped on the scale in the doctor’s office. The nurse didn’t say a word.

I can’t say I blame her. The scale is a source of stress for many people of all shapes and sizes.

ON THE TABLE

Some patients even refuse to be weighed, said Scott Thompson, a spokesman for Franciscan Health System. At its new clinics, Franciscan has scales built into the exam tables.

“This way the patient can be weighed as soon as they sit down on the table without the angst of getting on the scale,” Thompson said.

So what is the right way to weigh in?

“Patients should be certain to empty their pockets, slip off shoes, and remove heavy outer clothing,” Lindahl said, adding that it’s also “a good idea” to wear lightweight clothing.

And don’t get too worked up about the number that pops up on the scale. This is more of a “ballpark figure,” said Dr. Joshua Purses of MultiCare Orthopedics and Sports Medicine.

“It is probably more important that the patient keep track of their weight on a scale at home and that they always do it at the same time of day and same method - in underwear or naked, whatever they typically do - so they can keep track of weight gains and losses,” Purses said.

But if you’re still bothered by what you see on the scale, you can dig deeper, said Lisa Lovejoy, MultiCare’s registered sports dietitian.

A body composition test will tell you precisely what you’re made of. A BMI that says you’re overweight doesn’t mean you’re “overfat,” Lovejoy said.

“My son is 5-foot-10 and 180 pounds,” a BMI of 25.8, overweight, Lovejoy said. But using the Bod Pod, a clinical tool for measuring body composition, showed the boy was only 11 percent fat.

Zukowski isn’t willing to pay for a Bod Pod test to confirm something he and his doctors already know. But when he weighs in, he will continue to empty his pockets and remove layers. Just because.