Yes I am aware that as soon as the words obesity and diabetes are mentioned on the same page, many folks here will tie tying their nickers into three knots, put on flack jackets and start lobbing grenades. That is ok, I am used to it.
I know that denial is an important stage of dealing with grief, and no doubt there are many who feel grief about their diabetes diagnosis. To those I would say, get over it, don’t dig your head any deeper into the sand.
More than 60 percent of America’s population are overweight, many of them obese. The USA is also the leading country in terms of diabetes type 2, Is that a coincidence? Today I saw a statistic showing that 72 percent of Texas adolescents are considered unfit for military duty due to their being too fat. No doubt the numbers are not much different in other states.
Taking off all or at least some of that excess weight is the best thing we can do when managing our diabetes type 2. I am speaking from experience, as someone who went from a 30 bmi (obese) of 124 lbs to 70 lbs in the course of a year of healthy activity, while dropping my Hba1c from 8.3 to 5.4 in the process.
Of course weight loss is not the only solution, some people are happy keeping their bg numbers down by not eating any carbohydrates, while others rely on insulin or meds.
But weightless is the one thing you can achieve without strenuous diets, expensive meds or whatever. Provided you have two legs that are capable of what they were born to do: walking.
That doesn’t always work for everyone. I lost 30 pounds in 4 months and saw no change in my insulin resistance. I was still overweight, but studies show that a 7 percent reduction in body fat will lower BG levels. It didn’t do anything for me. My grandfather was not fat and he was an insulin dependent type 2 diabetic. I think that being overweight might speed up the process of getting diabetes in some people who are genetically prone to it, but it is not the cause. My mother is overweight and can eat the same meal as me and have a BG level of 120 2 hours after the meal. When I eat the same meal, my BG will be over 200 2 hours after the meal. She has eaten whatever she wants for many years with normal BG levels. The same with my Grandmother. She was overweight for many years and had a poor high carbohydrate diet and she never got diabetes. She did have high blood pressure that went away when she lost weight, but no diabetes. Also, I think Mexico is the number 1 country for Diabetes, then the Asian countries are right behind the USA. Most Asians are thin and they still get type two diabetes. No one can figure that one out, but you do not see very many fat Asians. Yet they are the third largest ethnicity to suffer from diabetes. I think weight gain in some type 2 diabetics is a result of the disease process rather than the cause of disease itself. I never changed my diet and I began gaining 90 extra pounds over a 2 year period. Now that I have cut my daily foot intake in half, I am still the same size. I only lost weight when I was too sick to eat for four months. I was living on Ritz crackers and small meals. That’s hardly sustainable for the long term. I know this is a sore subject, but that is my take on the matter.
J
I wish walking would help me lose weight. I walk with the dog morning and evening and walk to the shops most days and have lost no weight. I also wasn’t obese when I was diagnosed, but was under a lot of stress at that time. Also the doctor thought it could have been caused by lymphoma which I had not long before dx.
I only lost weight when I was too sick to eat more than 1400 calories a day for four months. Anyone who is too sick to eat will definitely lose weight. But you can’t live like that forever. I have since gained some of the weight back. Walking helps some people, but others it does not. If one were to have sleep apnea, or other issues, losing weight could be almost impossible. That is true even with diet and exercise.
I live in Philippines and have travelled around Philippines, Malaysia, Hong Kong and China. While traditionally Asians were slim, sadly that is no longer the case.
Diabetes is a huge epidemic here too! In people of all sizes.
I read a report estimating that there now are close to 30 million type 2 diabetics in China. This largely coincides with the arrival of fast food chains like McDonalds, Pizzahut and Burgerking as well as a sharp rise in the number of obese Chinese citizens.
I think I should mention that the success I had with weight loss was not only due to walking. I switched to a diet that prioritized low GI carbs like barley, squash, beans, rye bread and steel cut oats - without that I don’t think I would have seen the results I did,
As many of you know, I worry about words and their meaning. And those of us with diabetes constantly are bombarded with words and conversations that either explicitly or implicitly communicate messages that make us feel blame, shame or stigma. And the conversation about obesity and diabetes is one of those areas rife with issues.
I am really proud of our members like @Vancouversailor who are able to manage their diabetes with weight loss and a good lifestyle program. And I certainly support the idea that his awesome weight loss helps him manage his diabetes. But we should remind ourselves to not talk about our diabetes being caused by being overweight. This is an association. In fact we have contrary evidence that having diabetes actually causes weight gain.
Many of us struggle with weight. Yes, most of us could attain better control if we lost some weight. But we don’t “cure” ourselves and we cannot “prevent” diabetes with weight loss. The DPP proved that.
What we should do is have some empathy for our own feelings. We of all people should not communicate the message that we “caused” our diabetes by eating poorly and lack of exercise or that we “failed” to cure our diabetes by not losing weight. That is just not true. We may have bad genes or we may have been influenced by environmental factors, but it isn’t our fault and it isn’t our fault that we can’t just “cure” ourselves.
I just ask that we carefully choose our words and our conversation to be empowering and to give each other a sense that we can be successful and happy. And we need to remind ourselves that success is when we do a great job of managing our diabetes.
ps. @Vancouversailor, I am confused about your weight loss. I figure that with a BMI of 30 and a weight of 124 lbs, you must be 4’ 6." And then after weight loss you got down to 74 lbs and a BMI of 17. Is that right?
It is really problematic to presume causal relationships without causal evidence. My best guess is that it’s a bidirectional relationship, with weight gain exacerbating insulin resistance for some, but also with insulin resistance contributing to weight gain.
For example, as a longtime Type 1, over a couple of years, I gained about 10-15 lbs, mostly in my belly (typically I’m a bottom-heavy hourglass shape, so that was unusual). I hadn’t made any diet or lifestyle changes. My endo suggested that maybe I’d started developing insulin resistance so to add metformin to the mix. Did that, and the extra weight came off really easily—was hoping I’d keep losing more, but now that I’m back to my baseline weight (still overweight), the loss slowed and is back to where it’s requiring much more intense effort. On the other hand, the metformin-derived weight loss has been easy to sustain, and I’m now planning to stay on the metformin indefinitely. To me it seems like that weight gain was entirely driven by insulin resistance, and I’m betting losing the weight without solving the insulin resistance (or in efforts to treat the insulin resistance if I’d assumed the reverse causal relationship) would have been exceedingly difficult.
The DPP proved that T2 can be delayed with only modest dietary changes.
Now, imagine a world where every newly-diagnosed T2 receives the following:
- Dr. Bernstein’s Diabetes Solution
- Insulin if low c-peptide
- Metformin
- Rx for aerobic exercise and resistance training
- Gram Scale along w/ a link to a good database
- 10 test strips a day for 30 days
Just remember that insulin resistance often happens first, is undiagnosed --for whatever reason–and that it causes the weight gain—not the other way around. When I went to 30 carbs or less, I did, indeed lose weight. I gained a bunch back while never changing the way I ate—and my numbers stayed steady, my A1c stayed in the low 5s. That is the “magic” of sustaining a low-carb way of eating, in my opinion…
What changed for me was the onset of health problems that made exercise painful and difficult, though I eventually figured out sitting exercise, for instance. But the point is, we are all different and our numbers and how they relate to what else is going on in our bodies involves an awful lot of variables…
Thank you for your response. It needed to be said. Shaming and guilt, blaming obesity help no one.
I found it wasn’t the weight loss, it was cutting back on the carbs, that got my A1c down to 5.3%. (Although Prof Taylor says every T2 has a fat threshold amount, where the fat has to be taken out of the liver and pancreas, he is worth a google).
I would cut the Sugars: including fruit/juice. Cut Starches: including breads, pasta, rice, potato etc. Eat lots of low carb vegetables, salad, moderate protein and add healthy fats… Use a home blood test meter, to see what will work.
This gives a simple overview to how it works for me. The more carbs I eat, the more carbs I want. They don’t give up easy and it’s biochemical
https://www.youtube.com/watch?v=cEayi6IBjZw&list=PLCD72F4109EDC4BD8&index=6
more info on low carb
A Low Carb Diet Guide for Beginners – Diet Doctor
what to expect the first week, besides being hungry for the first 2 days, then it stops
Preventing Carb Withdrawal on Low-Carb Diets
They had me on 1 test strip a day lol. I have a friend who only tests every couple days. What’s the point of that. I had to buy my own test strips and start monitoring things. I also agree that doc’s don’t explain enough. All my first doc said was that if I lost weight I could probably come off the Metformin. That’s it. No information at all about how to manage my diabetes.
Oh is that all I have to do? I wish someone had told me sooner! 
All I got was a bunch of brochures of Happy people who seemed to just LOVE being diabetic–at a time when all I was feeling was rage and despair. My pharmacist—blessings of the universe to him—taught me how to use a meter!..Somehow we figured it out—thanks to reading and paying attention and, of course, TuD!
@Brian_BSC. I worry about words as well. But in many cases “empathy” is not one I worry about.
I practice dentistry in San Antonio and I see a LOT of patients with T2. I empathize with most of them. But there are several who come in who have advanced periodontal disease because they haven’t brushed their teeth in years, have A1c’s off the chart because they haven’t taken the meds their doctor prescribed to them because they keep forgetting, and, invariably, they are obese and on a “see food” diet. They are killing themselves. And they don’t care.
I have no empathy for these people. I have only the objective, harsh, words that might shake them it out of their ignorant stupor. Empathy would only give them an excuse to kill themselves faster.
So, Brian, note that your empathetic words can sometimes be harmful.
I do not suffer insult well, even if its said with the best of intentions. I suspect that most people are the same in this regard. I welcome good advice and diet and exercise are good advice but when I am shamed, when I’m told its all because I am an overweight slob with no will power I will most likely mumble something not so nice under my breath and tune you out.
My position is that if you can’t empathize you are of no benefit to me.
Your job is to show empathy to every patient. You don’t know these people’s situation, yet you blame them for poor diabetes control. Show empathy to everyone, not just to the ones you think are doing well.
@Brian_BSC You are not using words very precisely. The patients I described do NOT deserve my empathy. They get my pity, and they get appropriate treatment, often for free. But I will not empathize with them and tell them they’re just fine.
Sometimes people in need really need someone to tell them the unvarnished truth in order to begin to fulfill their needs. Sometimes, in my profession, empathy can be akin to malpractice.