Drug Medical Information

WEIGHT PROBLEMS: HOW DO YOU KNOW WHETHER YOU'RE AN APPLE OR A PEAR?

Dr. Kissebeh has an easy system. First, at the narrowest level of your waist and then at the widest point of your hips, use a tape measure to find how many inches wide you are. Write down the number of inches for each. Divide the waist number by the hip number. For women, anything below 0.75 is a pear, above 0.85 is an apple. For men, the cutoff points are less than 0.80 and more than 0.95.

A woman with a 25-inch waist and 36-inch hips scores a little under 0.70 (a pear), and a man with a 36-inch waist and 35-inch hips scores over 1.0 (an apple).

The Greater Peril of Appleness

The apple-pear theory emerged in the 1940s when a French physician, Dr. Jean Vague of the University of Marseille, noticed that, of his patients, the pears were far healthier than the apples, who suffered more often from diabetes and heart problems.

And, 30 years later, Dr. Kissebeh found the first chemical sign of the peril of appleness: Apples had more sugar in their blood than did pears after drinking the sugary potion of a glucose tolerance test. In addition, apples - even those who were otherwise healthy-had early signs of diabetes.

A study of 15,000 obese women revealed that the apples among them ran 10 times more risk of diabetes than the pears. Dr. Kissebeh also showed that the cells of the apple-shaped person seemed resistant to insulin.

Then scientists discovered that the apples had higher blood pressure than the pears. Next, studies revealed that belly fat disrupted the body's cholesterol balance. The more belly fat, the more artery-clogging low density lipoprotein (LDL) cholesterol in the blood.

It is unclear why belly fat-particularly inside the belly-does such damage. Marielle Rebuffe-Scrive, a French scientist who worked at Yale University, contends that it's easier for apples (especially men) to draw the energy from belly fat and the visceral fat inside the belly than it is for pears to draw energy from the fat on their hips or thighs. That's why, when apple men diet, their bellies flatten quickly-that fat melts away. But when pear women lose weight, their thighs and buttocks remain large.

Kimberly Cox, of Newark, New Jersey, measured 5 feet, 6 inches tall and tipped the scales at 230 pounds. By medical standards, she was close to morbid obesity, a level that is terrifyingly dangerous. It is life threatening, eventually leaving the patient with high blood pressure, arteriosclerosis, diabetes, some cancers, arthritis, obstetrical complications, and a high risk of stroke.

But Mrs. Cox says, "I'm basically healthy." Her doctor agrees. Her pear shape has protected her health. Before pregnancy, she measured 33 inches at the waist and 53 inches at the hips. Using Dr. Kissebeh's method of dividing her waist measurement by her hip measurement, Mrs. Cox comes out at 0.6-a definite pear-with all her excess weight on her hips and thighs.

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