12 Ways To Lose Weight And Manage Your Diabetesby David Mendosa Patient Advocate
Being overweight or obese is the medical condition that affects almost everyone who has type 2 diabetes and makes it harder to manage our blood sugar level. More than 85 percent of adults with diabetes were overweight in the U.S. government’s Third National Health and Nutrition Examination Survey. And almost 55 percent of the adults with diabetes were obese. But we now have great tools to help us lose weight.
Diabetes drugs may help you lose weight
When Byetta, the first GLP-1 mimetic, became available 10 years ago, we got a drug to manage our blood sugar that also led to weight loss. Most diabetes drugs lead to weight gain. But Byetta helped me so much that in 22 months I brought my weight down from 312 to 170 pounds, and my book, Losing Weight with Your Diabetes Medication, focuses on it. (Note: Patients should discuss the side effects and contraindications of GLP-1 drugs with their health care provider first.)
Ways to lose weight without drugs
Bariatric and metabolic surgeries are ways that people with diabetes lose weight. These procedures limit how much can be eaten. Since these operations are typically not reversible, doctors prescribe it only for people who are morbidly obese. It works well for some people, but not for others. Since it is expensive and may have complications, this is the last resort when other ways of managing weight don’t work.
Two small studies by British researchers show that eating an extremely low-calorie diet of 600 calories per day for a few weeks can take off a lot of pounds. You must be “strongly motivated to escape from diabetes” in order to lose enough weight this way, the lead author admits. But “substantial weight loss is entirely possible by decreasing food consumption.” (Note: The American Diabetes Association instead recommends medical nutrion therapy (MNT).)
A low-carb diet is another way for people with diabetes to manage blood sugar and weight without drugs. I’m one of those who follow this strategy and have brought my current weight down to 154 pound for a BMI of 19.5. A study compared people on a low-carb diet to those on a low fat diet, finding the participants on the low-carb diet lost more weight than those on the low-fat diet. (Note: Studies examining the ideal amount of carbohydrate intake for people with diabetes are inconclusive.)
The quickest way to lose a few pounds is to stop eating for a few hours. Fasting is a controversial subject and there is conflicting data about it. Experts believe that patients with diabetes who are on insulin therapy may develop hypoglycemia during fasting. Intermittent fasting should be done only with close medical supervision. (Note: Intermittent fasting is not recommended by the ADA or NIDDK.)
Weigh yourself daily
Weigh yourself every morning so you can immediately identify weight gain and make a plan right away.
The best time to lose weight is when you know you have diabetes. By taking off the pounds, you have a better chance of keeping your blood sugar and blood pressure levels under reasonably good control. If your BMI is over 25, anytime is a good time to start. Mine was 39.6 when I started to manage my weight 10 years after my type 2 diabetes diagnosis. According to the ADA, a weight loss of at least 5 percent benefits overweight or obese adults with type 2 diabetes or prediabetes.
Accept and announce your weight
Only when you accept yourself as you are can you make fundamental changes. It's a sign of commitment. When you accept that you weigh too much, you can reinforce it by sharing how much you weigh now and what your goal is.
Have you ever finished a meal and realized soon afterwards that you don’t remember what it tasted like? When we give more attention to the food we eat as we eat it, studies have shown that we don’t eat as much. Mindful eating means that we need to think more — not less about what we eat. It helps to put down the knife, fork, and spoon between bites. When we eat mindfully, we eat slower and savor our food and we avoid eating more when we are already full.
Wait for seconds
My trick is to set my kitchen time to go off in 15 or 20 minutes after finishing a meal. I promise myself that if I am still hungry then, I will have seconds. But the amazing thing is that by that time I almost always feel full.
Dealing with our cravings
Portion control is one of the first steps in managing our individual food cravings. The biggest key is to avoid buying the food that we crave the most. For me that is cheese, so I don’t keep it at home. Our temptations disappear with time. Losing weight gets easier with practice.