Those of us who have diabetes pay a physical cost for it that we know all too well. But many of us aren't aware of the social cost that we pay for being overweight, which usually accompanies our diabetes.

Fat prejudice is even more subtle than our society's racial and gender biases and those against and gays and lesbians. Our most recent prejudice, of course, is that against those of the Muslim faith from the Middle East, and that prejudice is anything but subtle. Now, however, social scientists know how to measure fat prejudice.

If being prejudged by others for being fat weren't bad enough, fat people even dislike themselves for it. Many fat people in the fat acceptance crowd will deny that fact, and we do need to accept ourselves as we are before we can change ourselves for the better.

I had come to accept myself as a fat person, but at some deep level I did not like being fat, and I was a different person then than I am now. No longer a fat person, my personality has changed. I keep surprising myself with my new self-confidence and how I am now able to reach out much more to other individuals and groups of people.

As a journalist for a good part of my long life -- even long before I started to specialize in writing about diabetes -- I interviewed thousands of people. I preferred to talk with them on the phone to in person. Sure, calling them is more efficient than driving there, although you don't get any feeling for their milieu, which is important for feature articles.

The advantage for me of telephoning the people I wrote about was that they couldn't see me. So I didn't feel self-conscious.

My guess is that most of you structure your life is comparable ways. You may say that diabetes itself has its own social costs, and I agree and have written about those costs. But I think that the social costs of being overweight are even greater.

Diabetes and being overweight are so closely linked that many people believe that one condition causes the other. But in my second book, Losing Weight with Your Diabetes Medication: How Byetta and Other Drugs Can Help You Lose More Weight than You Ever Thought Possible, I devote a whole chapter, "Why Diabetes Doesn't Make You Fat," to showing that instead both conditions come from a common cause.

It's true that almost everyone who has type 2 diabetes is overweight. Our government's statistics show that 85 percent of all American adults with diabetes are overweight. But those statistics include the 5 to 10 percent of people with diabetes who have type 1, and type 1s are seldom overweight. This means that 90 to 95 percent of all type 2s in this country are overweight.

I know that I experienced fat prejudice not only from myself but also from others. At one point in my life I was a foreign service officer serving in the American Embassy in Blantyre, Malawi, as the head of the American aid program to that country. At that time the foreign service divided its annual personnel evaluations into two parts. The employee saw one part, but the other part went straight to his or her personnel file, where panels used it to make their promotion recommendations.