You Can Keep Off the Weight You Lose

Patient Expert
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Sadly, the “Biggest Losers” didn't keep off the pounds they lost. In fact, it was reported by the news media that 14 of the contestants on the popular reality TV contest actually regained most of their weight.

This certainly isn’t encouraging news, especially if you’re overweight and have Type 2 diabetes.  Having extra weight prevents the glucose in your blood from reaching the rest of your body, which it needs for energy. And when you aren’t able to keep your blood glucose level in the normal range -- below 6.0 percent -- the risks of complications goes up exponentially.

Sadly, Type 2 diabetes and being overweight often go hand in hand. According to the U.S. government’s Third National Health and Nutrition Examination Survey, more than 85 percent of Americans adults with diabetes are overweight. And almost everyone who has Type 2 diabetes has a body mass index that is above normal.

So while the situation may seem hopeless for those of us who struggle with our weight and type two diabetes, I’m here to say that isn’t necessarily the case.

Examining the study

The New York Times and other publications like CBS NewsABC News, and Medical Daily, made a big deal out of a study, published in the journal Obesity, which detailed the failures of these 14 reality show contestants. So let’s examine more closely what went wrong.

The average weight loss throughout the 30-week competition was roughly 129 pounds. Yet when the researchers followed up six years later, the contestants had regained an average of 90 pounds. Their average BMI was 49.5 at the beginning of the study, 30.2 at the end of the 30-week competition, and rose back to 43.8 when the researchers followed up six years later. All of these numbers are in the obese range.

More importantly, though, their normal metabolisms had slowed significantly by the time their diets ended. Consequently, their bodies weren’t burning enough calories to maintain the weight they had lost.

So is there a way to avoid what appears to be a catch-22?

My story

Like the contestants, I was once on the cusp of being morbidly obese. This was back in 1994 when a doctor’s test revealed that I had type 2 diabetes. Still, it wasn’t until 12 years later that I began to manage my weight by taking Byetta, which helped to control blood sugar levels. Back then, it was the first of a class of drugs called GLP-1 agonists, developed specifically for diabetes management. That morning, when my doctor put me on his scales, I weighed in upwards of 312 pounds.

But it wasn’t until 13 months later that was able to bring my weight down to 196 pounds, a more normal level. By then, I decided that I could manage my weight and blood glucose even better and without using any drugs by switching to a very-low carb diet. And after looking at a large study that shows a normal BMI on the low end to be even more healthy, I set on a path to get down to 156 pounds.

That new goal, I’m happy to say, was reached more than nine years ago, meaning I lost exactly half of my weight. And better yet, I’ve been able to not only keep the pounds from coming back but also stay couple of pounds under that target weight.

Different diets equal different results

The best explanation as to why I succeeded and these contestants failed likely has to do with the differences in our diets. The contestants followed a high-carb diet in which 30 percent of calories come from protein, 25 percent from fats and 45 percent from carbohydrates, according to a study published in The American Journal of Medicine in 2011.

Yet a study published in JAMA in 2012 that compared various diets, including a high carb version similar to that of the Biggest Losers, demonstrated that participants on a low-carb diet such as mine experienced the smallest decrease in their metabolism.

Social support helps, too

Another difference maker for me was the social support I received from others. Besides being a member of a diabetes support group, I am also part of the National Weight Control Registry, a group of more than 10,000 American adults who have maintained at least a 30 pound weight loss for one year or longer.

And though it’s helpful that the people featured on the “Biggest Loser” got the applause they needed while they were losing weight, it’s just as important that they continue receiving that support after the show ends.

The key here is to accept and announce your weight. By sharing how much you currently weigh and what your goal is, you reinforce that acceptance. And it’s only when you accept yourself as you are that the fundamental changes can take place. Studies have even shown that when people are watching, we do better.

There’s hope after all

While big news stories like this can make us feel downright demoralized, they should also be taken with a grain of salt. For instance, Dr. David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, has pointed out that one of the biggest shortcomings of the “Biggest Loser” study is the small sample size. With just 14 people and no control group, we can’t have confidence that the result is statistically significant.

So unlike these contestants, you can lose the pounds that you need to take off and keep them off. Just knowing that when your weight is normal, you can better manage your diabetes is all the incentive you need.

See more helpful articles:

Portion Control for Better Diabetes Management

12 Ways to Lose Weight and Manage Your Diabetes

A New Way for People with Diabetes to Lose Weight

Mindful Eating

How Eating Can Make You Hungry


David Mendosa is a journalist who learned in 1994 that he has type 2 diabetes, which he now writes about exclusively. He has written thousands of diabetes articles, two books about it, created one of the first diabetes websites, and publishes the month newsletter, “Diabetes Update.” His very low-carbohydrate diet, current A1C level of 5.3, and BMI of 19.8 keeps his diabetes in remission without any drugs.