JANICE WATT OF Smithfield, Rhode Island, developed Type 2 diabetes and was using insulin for about eight years. As anyone who uses insulin knows, that involves a lot of work and planning. Even just eating your next meal can involve taking an insulin shot first.
But earlier this year, Watt decided to join the Why WAIT program (short for weight achievement and intensive treatment) at the Joslin Diabetes Center in Boston. The program helped her lose 34 pounds. After seven weeks of losing weight and changing her habits, she was able to stop using insulin. Her hemoglobin A1C decreased from 7.5 to 6.1, which put her at the same level as someone with prediabetes.
“It’s so liberating not to have to take a shot before I eat something or before going to bed,” Watt says.
Watt’s story is just one example to illustrate the importance of weight loss when you have Type 2 diabetes. In fact, even just losing 5 percent of your body weight – that would mean 10 pounds if you are 200 pounds – can improve your blood sugar control, says Dr. Samar Hafida, an endocrinologist at Joslin Diabetes Center in Boston.
Weight loss helps with a host of other health issues when you have Type 2 diabetes. It helps to regulate your body’s resistance to insulin and reduces the amount of insulin you need, says Dr. Ronald Tamler, an endocrinologist and director of the Mount Sinai Clinical Diabetes Institute in New York.
Often, weight loss can reduce the number of diabetes medications you need to take.
As you’ve likely heard, being overweight or obese is associated with a slew of other health problems. When you lose weight, you can reduce the risks for these problems. For example, “Losing weight helps decrease inflammation overall in our vessels, which in turn reduces our overall cardiac risk,” says Dr. Holly Lofton, director of the medical weight management program at NYU Langone Health in New York.
What Are the Causes of Diabetes?
The role of weight loss in Type 2 diabetes and prediabetes is so important that the U.S. government studied it in its Diabetes Prevention Program. The program found that in 3,000 people who had prediabetes, those who lost 5 percent to 7 percent of their body weight reduced their risk for prediabetes by 58 percent. The numbers were even more impressive in those over age 60. All study participants were overweight and had high blood sugar.
The participants reversed their prediabetes with increased physical activity, healthier eating and behavior changes. Their results were better than another group in the study that used the common diabetes drug metformin.
Although weight loss via lifestyle changes is the gold standard to help Type 2 diabetes, certain patients benefit from bariatric weight loss surgery. “We now consider it bariatric and metabolic surgery because it’s more than just the anatomical change. … These surgeries are an excellent option for people who have not been able to maintain weight loss through other more conventional methods,” Lofton says. However, bariatric surgery isn’t for everyone. It’s typically reserved for patients with a body mass index of 40 or more or a BMI of 35 to 39 but who also have diabetes complications. Tamler also favors it in younger patients with diabetes within those BMI parameters and who may find it hard to take care of themselves while also raising a family.
There are also prescription drugs available to help people with diabetes lose weight, but they’re not the right choice for everyone. One concern Tamler has is if a patient will gain weight back after using the meds (they’re also pricey, he adds). Lofton presses patients to try diet and exercise changes first before she’ll prescribe the medications.
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Here are five steps to steer you on your journey if you’re serious about weight loss and you have diabetes:
Avoid diets. They’re tempting, but they can be dangerous, especially if you have diabetes. Juicing diets, cabbage soup diets and other similar trendy diets are out there, but they often don’t provide the nutrients your body needs. They also can restrict your ability to create muscle mass, and they can slow your metabolism, Lofton cautions.
Talk to your health care providers first. Your primary care doctor, registered dietitian (a great partner for weight loss if you don’t have one already) and certified diabetes educator can help you separate accurate and helpful weight-loss tips from less helpful information. “There’s a lot of misinformation on the internet and social media, so it’s important to speak with someone who can develop a plan specially made for you,” Lofton says.
Meeting with your health care providers at the start of a weight-loss plan also helps to educate you about your diabetes status, numbers and weight-loss treatment options, Hafida says.
Find your physical activity groove. One piece of advice Watt received when she finished Why WAIT was to “exercise, exercise, exercise.” Exercise helps keep you toned and can improve your mood as well as other health factors – of course, it can help with weight loss, too. Watt finds enjoyment in regular cardio and strength-training workouts. The general recommendation is 150 minutes of exercise a week (30 minutes, five times a week) that gets you huffing and puffing, Lofton says. You can break that time into smaller chunks if necessary.
Connect with others. One reason Watt thinks she was so successful with Why WAIT is because she felt accountable both to her registered dietitian as well as to others in the program. If you’re able to join a group with others who are losing weight, you can share stories to help each other. It’s also crucial to find support from family members and close friends as you embark on your weight loss, Tamler says.
Check in with your health care provider as you lose weight. Of course, you should already see your primary health care provider for regular blood sugar and hemoglobin A1C checks. However, he or she can also evaluate if medications need adjusting or if caloric or protein needs have changed because you have lost weight. For instance, taking too much medication as you lose weight could cause hypoglycemia, or low blood sugar.