Healthy Curves: Real Advice for Diabetes Weight-Loss
There’s plenty of weight-loss advice out there, but not all of it is healthy or effective. This is especially true for the more than 34 million Americans currently living with diabetes, who need to manage their blood sugar levels in order to avoid health complications. The risk for complications is even greater for Hispanic/Latinx people, and while the message is clear—weight-management is key— the numbers on the scale or the size of your pants don’t necessarily need to be the main focus. Our experts explain how to set long-term health goals to keep your diabetes in check.
Focus on Health Benefits Versus Appearance
“Instead of aiming for arbitrary goal weights or focusing on appearance, we care about the health benefits associated with weight loss,” says Louis Aronne, M.D., medical director of the Comprehensive Weight Control Center at Weill Cornell and chief medical officer at Intellihealth in New York City. According to Dr. Aronne, losing 3% to 5% of your weight can lower blood sugar and triglycerides, while more can lead to improved cholesterol levels, lower blood pressure, and reduced need to take medications for diabetes. Weight loss can even reduce the risk of certain cancers and assist with sleep apnea.
Find New Ways to Measure Your Progress
If curves are in your genes (and jeans) that’s a good thing! Losing weight doesn’t equal losing your shape. “I like to recommend tracking changes in waist circumference versus the pounds on the scale as a loss of inches around the waistline means a reduction in visceral fat (belly fat)—that dangerous fat that wraps around internal organs like a blanket and increases inflammation,” says Erin Palinski-Wade, a registered dietician and nutrition consultant in Franklin, NJ. “Aiming to lose one inch around the waistline (in) two months ... is a reasonable goal that will directly improve health.”
Avoid Too-Good-to-Be-True Diets
Jo-Anne Rizzotto, R.D., director of educational services at Joslin Diabetes Center in Boston, says people with diabetes should steer clear of any fads in dieting. “Most fad diets are restrictive and unsustainable for long periods of time,” says Rizzotto. These types of diets in which certain foods are allowed while others aren’t simply don’t result in long-term positive health changes. Additionally, the Mayo Clinic warns that restrictive diets sometimes have connections to eating disorders such as bulimia, which make them even more dangerous to anyone susceptible to these types of disorders.
Put a Healthy Spin on Your Traditional Dishes
Your family’s favorite Hispanic foods are likely not the main culprit when it comes to keeping your blood sugar in check, says Lorena Alarcon-Casas Wright, M.D., director of the LatinX Diabetes Clinic at the University of Washington School of Medicine in Seattle. It’s the day-to-day food choices that really count (time to nix your afternoon soda or morning orange juice!). That said, Dr. Wright says, you can always modify traditional foods by, say, folding sauteed veggies into your enchiladas or serving grilled veggies alongside your pernil—Puerto-Rican roast pork. Olive oil can be subbed for butter or lard.
Pack Your Morning with Protein
A study in Current Diabetic Reports found that a diet that favors adequate protein is often recommended for people with diabetes. One way of ensuring you’re getting enough while also helping to manage cravings later in the day is by eating a high-protein breakfast, as it can help you feel full longer. “Eating carbohydrates like cereal or oatmeal for breakfast can make you more hungry, think about food more and eat more all day long,” says Katherine H. Saunders, M.D., an internal medicine specialist at Weill Cornell in New York. “Try to maximize protein for breakfast (eggs, cottage cheese, unsweetened Greek yogurt) to promote fullness that can last for hours.”
Make Sure to Balance Your Meals Properly
Everyone’s body is different, but for people with diabetes, making sure each meal has the right nutrient proportions is key to managing weight and symptoms. “Focus on having more balanced meals with 50% of the plate containing non-starchy vegetables, 25% lean protein, and 25% complex or whole grain carbohydrates like brown rice, quinoa, or beans,” suggests Heidi Guzman, M.D., an endocrinology, diabetes, and metabolism specialist and assistant professor of medicine at Columbia University Medical Center in New York City.
Eat Your Veggies and Proteins First
It’s easy to fill a plate full of veggies, protein, and carbs, only to eat all of your rice first and forget about most of your kale. To combat this, Dr. Saunders recommends another effective strategy: Eat in a certain “food order” within any given meal. “You may find it helpful to eat protein or vegetables first and carbohydrates last,” he says, “This eating strategy will help you first fill up on foods that will keep you fuller for longer and balance your blood sugar.”
Learn When You’re Hungry and When You’re Full
“Listen to your body and feed it according to hunger and satiety cues,” advises Rizzotto. It’s the sort of thing we often advise parents to do when feeding their own children, but we can forget to do it for ourselves. Hunger cues vary and might include stomach grumbling, low energy, feeling weak, or being irritable (“hangry”). Once we identify these, we’ll know if we’re eating because we actually need food. Modeling this for our kids is key: A national study showed that among children under 19, the rate of newly diagnosed cases of type 1 diabetes increased most sharply in Hispanic youth.
Try Eating Mindfully When You Can
Once you’re sure you’re eating because you’re actually hungry, make sure to minimize the distractions around you. “It isn’t always what you eat but how you eat it that makes a big impact as well,” says Palinski-Wade. “Sitting down when eating, removing distractions, and being fully present when eating can help you to feel more satisfied with your food and often results in smaller portions and weight loss.” While you don’t have to give up enjoying dinner with a movie forever, try to have a few mindful meals a day to get out of the habit of overeating.
Prioritize How Much and How Well You Sleep
“My number one recommendation would be to start focusing on the quality of your sleep,” says Palinski-Wade. “If you aren’t sleeping well, not only can this increase insulin resistance, but it increases appetite and food cravings while reducing energy.” The Centers for Disease Control and Prevention (CDC) recommends at least seven hours each night, and more if you’re over 60. Reduce screen times before bed and try to stick to a regular bedtime each night to help ensure you get enough quality rest.
Prevent Late-Night Cravings
If you’re waking up for midnight snacks of milk and cookies, it might be time to stop. “Eating the majority of your calories in the evening or at night can make it easier to gain weight and harder to lose weight,” says Dr. Saunders. “Try to frontload your calories and stop eating earlier in the evening—even just a few days a week.” If you are still waking up hungry, try to eat more protein at dinner, or opt for a protein-based snack in the evening when necessary, like a hardboiled egg or some almonds.
Develop Some New Coping Mechanisms
Who hasn’t at one point or another fixed up a grilled cheese or dipped into some ice cream as a source of comfort during trying times? While it’s not the end of the world, Rizzotto warns against using eating as a coping mechanism for things like stress. “Identify five non-food strategies to cope with stress as your own action plan,” says Rizzotto. She recommends taking up meditation, breathing exercises, or other physical activity, leaning into arts and crafts, grabbing for a fidget toy, or reaching out for social support to avoid overeating.
Get Your Body Moving More Every Single Day
A sedentary lifestyle can increase insulin resistance, making weight loss a greater challenge. “Especially during the pandemic, it can be challenging to make time for exercise, but the goal is to move more even if you can fit in a few minutes here and there,” Dr. Saunders says, recommending at least 10 minutes a day.
“Start small and work your way up,” adds Dr. Guzman. “For example, get off the bus or train one to two stops early or walk in place during a TV commercial break.” Aim for 150 to 300 minutes of exercise per week for substantial health benefits.
Try Putting a Positive Spin on Weight Loss
“Focus on what you should eat more of, not what you want to take away,” says Palinski-Wade. “If we focus on what we can’t have, it drives feelings of deprivation and increases the desire to eat. Instead, focus on what you want to add to your diet to improve health and weight. Start by focusing on adding more fiber to your diet through increasing your intake of vegetables, fruit, and whole grains.” There’s never a better time to expand your culinary horizons and find new favorite meals and active hobbies.
- Risk for Complications in Hispanic/Latinx Americans: Centers for Disease Control and Prevention. (2019). “Hispanic/Latino Americans and Type 2 Diabetes.” cdc.gov/diabetes/library/features/hispanic-diabetes.html
- Type 2 Diabetes: Centers for Disease Control and Prevention (2021). “Type 2 Diabetes.” cdc.gov/diabetes/basics/type2.html
- Eating Disorders: Mayo Clinic. (2021). “Eating Disorders.” mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/syc-20353603
- Protein Content in Diabetes: Current Diabetes Reports. (2011). “Protein content in diabetes nutrition plan.” pubmed.ncbi.nlm.nih.gov/21207203/
- Diabetes Increase in Hispanic/Latinx Children: National Institutes of Health National Heart, Lung and Blood Institute. (project began 2006). Hispanic Community Study/Study of Latinos. nhlbi.nih.gov/science/hispanic-community-health-studystudy-latinos-hchssol
- How Much Sleep Do I Need?: Centers for Disease Control and Prevention (2021). “How Much Sleep Do I Need?” cdc.gov/sleep/about_sleep/how_much_sleep.html