Diabetes Self-Management Blog

Do you think overweight people bring Type 2 diabetes on themselves? It would be natural to think that, because doctors and other authorities have been blaming weight for years. Health "experts” call Type 2 a "lifestyle disease," implying that people choose it. Heavy people are called "obese," which comes from the Latin for "over/eating," as if that were the whole cause of overweight.

Heavy people are often pitied for being unhealthy and scorned for being unattractive. They can be turned down for jobs, refused insurance, even hounded out of stores. (”We don’t have anything your size, so why are you here?”) In my book, Diabetes: Sugar-coated Crisis, I point out that these attitudes are based on prejudice, not science or aesthetics. They are mostly about money, not health or beauty. Today’s blog entry starts to look at some of these issues.

Weight and Type 2 diabetes
So what is the relationship between weight and Type 2 diabetes? It’s true that excess weight (especially abdominal fat) is associated with Type 2, and that losing weight often makes it better. But that doesn’t mean overweight causes diabetes. Most overweight people do not have Type 2 diabetes. Other factors, chiefly genetic variation, stress, and lack of physical activity are probably responsible for both the weight and the diabetes.

It’s interesting to note that liposuction—draining fat from the body through a tube—does not seem to affect blood sugar levels much. But bariatric surgery, where some of the stomach and intestine are bypassed, sometimes (at least temporarily) halts diabetes immediately, even before weight loss occurs.

In other words, fat itself is not as damaging to health as the behaviors, conditions, and stresses that tend to make you fat. Those are what need to be changed. Heavy people who get themselves in condition, as shown by exercise tolerance and normal blood pressure, have little more health risk than lighter people. But the social stress of being fat, and the constant struggle to be thin and to deal with antifat attitudes, may add significantly to overall stress and help cause Type 2 diabetes.

If you’re very heavy, weight loss is definitely desirable. It takes pressure off your knees and hips, making it easier to be physically active. It often improves blood glucose control and cholesterol profiles and, in general, makes it easier to stay healthy, especially in our toxic food environment. Still, society’s negative attitudes toward overweight are far stronger than health concerns should dictate.

Class-based prejudice
Most social attitudes against weight have nothing to do with health. They’re about money. It used to be that only the rich could afford enough food to be heavy. Fat was associated with wealth, so fat was considered attractive. If you look at the sex symbols of 100 or even 50 years ago, they were much heavier than today’s media beauties. (Look at a picture of Mae West or Marilyn Monroe for example.) Now, when calories are easy to get, thinness is associated with wealth, fat is considered ugly, and the conventional model of beauty is way too thin to be healthy.

Overcoming fat prejudice
These prejudicial attitudes toward overweight people cause actual harm. Undeserved blame adds another burden to people who usually have hard lives already. Feeling guilty, ashamed, weak, or inadequate raises stress and blocks people from changing. Prejudice in social or job situations add to stress and economic difficulties.

In another blog entry, I’ll go into what we can do as individuals and communities to counter prejudice and discrimination against heavy people, perhaps including yourself. If you’re interested, you can check out, among others, these Web sites:

And don’t stop trying to get in shape. At any weight, fit is healthier than sedentary.

So what have been your experiences? Have you or someone you know been subjected to insulting or prejudiced behavior because of weight? Do you, loved ones, or friends blame yourselves for health conditions that are mainly environmental? Let us know what you think by commenting below.

Want to share your self-management story?
On another note, I’m working with the Institute for Healthcare Improvement on a Web site to help patients and health-care providers work together on self-management. I could use some stories about getting started with diabetes self-management, the problems you have overcome, and those you still have. If you’re willing to talk or correspond about your self-management story, send me an e-mail. People will benefit from your experience and wisdom.

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Comments
  1. am trying to find a good menu for an 81 year old with type 2 who is not overweight, in face quite slim. The diabetes was brought on by heart attack and is insulin dependent now. Also has borderline kidney function just a step away from dialysis. Heart is in failure and exercise is very limited, but breakfast suggestions would be appreciated. Everyone addresses weight loss and diabetes. He doesn’t need weight loss, only sugar control. Thanks Sue D.

    Posted by Sue D. |
  2. Hi Sue D.,

    You may want to check out dietitian Amy Campbell’s blog entries about breakfast, Getting Off to a Good Start with Breakfast: Part 1 and Getting Off to a Good Start with Breakfast: Part 2. The second part has a long list of breakfast suggestions.

    Posted by Tara Dairman, Web Editor |
  3. I’ve never been discriminated against because of my weight, tho I am overweight which I directly attribute to diabetes and taking Glucophage right after being diagnosed, tho of course, that is one drug that is supposed to help you lose weight!

    However, after just reading in the magazine Diabetes Self Management about the drugs Atenolol and Triam-Hctz having been found to cause diabetes and taking those two drugs, I was appalled to say the least! There is only one case of Juvenile Diabetes in our family, attributed to stress in College. I am 64, was diagnosed with Type 2 in 2002 -
    and now I am wondering - also, originally when tested drinking the orange “stuff”, I was 175 which I now see is considered “pre diabetic” not diabetic as I was told!

    I love your magazine and its information both in the mag and on the web! Thank you!!

    Posted by puddiekins |
  4. HUNTER/GATHERER VS. SUPERMARKET/FAST FOOD

    I have read that overweight/diabetes is related to our feast/famine instincts. The better a person was able to survive a famine the more more likely they were to have successful offspring. When weather and luck had more to do with how much food there was to eat, a person that was able to slow their metabolism down was much better off. In this day and age with super markets, fast food joints and seemingly endless quantities of sugar (in irresistible forms)…the “survivors” are staying fat (predetermined to carry weight for leaner times) because there are no longer leaner times. There have been cultures and eras that prized overweight women; being more likely to bear many children. What now? Women are honored for how well a dress “drapes” over her bones.

    Posted by basketcaz |
  5. Think outside the box. Breakfast doesn’t have to be breakfast foods.

    I’m also going to say something that may not be popular… He’s 81. He has heart problems. He takes insulin. He’s not likely to need to worry about long-term complications from the diabetes. I would concentrate on heart-healthy foods and let the insulin injections take care of the majority of the blood sugars. Keep him in the higher end of the healthy range to avoid hypoglycemia and let him enjoy what he can, while he can.

    Posted by Ephrenia |
  6. As a type 2 diabetic when I first was diagnosed with it I was about 20 lbs. overweight and was put on insulin. I have had diabetes for about 4 years and have found that if I stick with a diabetic diet that my weight is maintained at a sensible level. I went from over 200 lbs to about 190. I am no longer on insulin. I suppose what I am saying is I don’t understand how anyone with diabetes that follows “the diet” can become fat. I simply don’t believe in cheating, eating honey, candy and drinking wine or alcohol. Regardless of what is said alcohol still becomes sugar.

    Posted by wkmmarfa |
  7. Too avoid predujice, get rid of the fat. It is unnatural and must be controlled.

    Posted by qb235872 |
  8. Dear David. Being obese myself I still think we should as a society maintain some prejudice against obesity. Althought in my case I am not sure if this helps as a motivator to loose weight. Plus with greater America (including Canada) being 2/3 overweight or obese it is difficult to see that our favorite fashion models being quite bony have any impact on the problem. It is amazing to see the immediate impact on the Blood sugar control of eating a few calories less than you expend during a day. But even this is not a great motivator. With most of our ancestors and a lot of the Earth’s present population having to worry about starving to death, maybe most of us are not genetically or psychologically fit to survive modern day America.

    Posted by CalgaryDiabetic |
  9. Wow. We even encounter prejudice on here! Which you, qb235872, apparently cannot even spell correctly. I’d rather be fat than stupid.

    How can you say fat is “unnatural”? Is there any type of mammal that doesn’t have fat cells in its body? So you are saying that over half af all Americans are “unnatural” because they carry a few extra pounds? I’d like to talk to your science teacher and find out how much you slept in class.

    Posted by Ephrenia |
  10. Dear David. The American fashion moguls may be a main driving factor in the overweight epidemic. My wife who is a genetically skinny person that can survive America took a pair of emerald green silk pants sized 12 out of her hippy clothes closet. Yes she has kept every piece of clothing she ever purchased. Well she can still fit into modern size 12 with room to spare but not a chance of fitting into the size 12 of 40 years ago by about 2 inches of tummy grease. The same with male pants I found size 42( i.e. really 46) to be more and more accomodating as time goes by. It could possibly be that not fitting by 2 inches would be a motivating factor.

    Posted by CalgaryDiabetic |
  11. I have been diagnosed Type 2 diabetic for the last 12 years.
    For 30 years I have been fighting the battle of the bulge.
    My metabolism is poor so I have been on medication for most of that time.
    During those years I have tried every kind of weight loss program and joined many gym and aqua aerobics classes.
    However, I never seem to be able to reach what many would call a “normal weight”.
    Do you have any tips for my situation? I am not “morbidly obese” but to be “obese” on any level is distressing as my mother’s favourite term for me as a young mother was “the greyhound”.

    Posted by janmac |
  12. WELL I HAVE JUST FOUND OUT I HAD DIABETES FOR 11 YEARS DIDN’T EVEN KNOW IT, BUT JUST FOUND OUT 3 MONTHS AGO.I LOST WEIGHT IN TWO WEEKS I WAS 180 POUNDS I WAS CONSTANTLY DRINKING LIQUIDS ALL THE TIME I HAD ALREADY PLAN TO LOOSE WEIGHT ANY WAY BUT THIS WAS NOT HOW I WANTED TO LOOSE WEIGHT. A FEW PEOPLE I WORKED WITH NOTICED I LOST TOO MUCH WEIGHT MY MOTHER FIRST NOTICED IT TOO.I MADE AN APPOINTMENT TO A DOCTOR TOLD ME I HOPE YOU DON’T HAVE IT THEY RAN SOME TEST ON ME THAT SAME DAY THEY ASKED ME DID I FEEL FINE?I SAID YES. ARE YOU SURE?YES. WELL I MUST TELL YOU WE HAVE TO RUSH YOU TO THE EMERGENCY ROOM I DON’T WANT TO SCARE YOU,THEY RAN SOME TEST ON ME I HAD A VERY HIGH SUGAR LEVEL IT WAS OVER 300.SO THEY KEPT ME THERE AT THE HOSPITAL UP TILL 8:30 THEY PUT SOME TUBES IN ME,BUT IF I WOULD HAVE WAITED THE NEXT DAY ,I WOULDN’T BEEN ALIVE.EVEN THOUGH I HAD IT A VERY LONG TIME THE DOCTORS SAID THAT STRESS AND DEPRESSION CAUSE IT THEN ON TOP OF THAT DIABETES RAN IN MY FAMILY ON BOTH SIDES AND OTHER PROBLEMS.DON’T LET PEOPLE WORRY YOU ABOUT YOUR WEIGHT YOU WILL HAVE MORE PROBLEMS TO DEAL WITH IF YOU LISTEN TO OTHER PEOPLE.IF YOU ARE OVER WEIGHT LET THE DOCTOR DETERMINE HOW MUCH WEIGHT YOU NEED TO LOOSE NOT OTHER PEOPLE.THAT’S THE PROBLEM I HAD. I LOST IT I WEAR A SIZE 8-10 AND STILL KEEPING IT OFF .I HAVE GOTTEN A LOT OF SUPPORT FROM PEOPLE WHO SAID I LOOKED VERY NICE HOW DID YOU DO IT ,I TOLD THEM WHAT I HAD.

    Posted by sdjustice |
  13. TRY FOODS IN FIBER RAISIN BRAN NO SUGAR ADDED TO IT .OR WHEATIES,TUNA WITH MAYONAISE ON WHEAT BREAD NOT HIGH ON CARBOHYDRATES AND SUGAR.DRINK A GLASS EVERY NIGHT BEFORE GOING TO BED IT WILL HELP FLUSH THE POISION OUT OF YOUR KIDNEYS.OR EAT VEGETABLES EVERYDAY WITH YOUR MEAL.EATING FOODS IN FIBER WILL REMOVE THINGS OUT OF YOUR INTESTINES.EAT SANDWHICHES WITH LETTUCE ON IT EVERYDAY.AND KEEP EXERCISING YOU WILL SEE A DIFFERENCE IN YOUR WEIGHT.

    Posted by SDJUSTICE |
  14. Well, I am 2 years late just found this blog, but I still wanted to share. I am 43 yrs old and have been overweight since I was preteen. I become very distraught about my weight, because people assume I eat all day.. I am considered now to be morbidly obese. I can hardly walk due to cellulitis. How can I excercise if I can’t walk. My mobility is very limited and I can’t believe I was told I could not get a bypass until I loss weight. Well, if I could lose it on my own I would not need a bypass. I am very frustrated and have now taken to my bedroom brcause I am tired of public ridicule.

    Posted by Anita |

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Weight Loss
Overweight People With Type 2 May Benefit From Gastric Banding (04/11/14)
FDA Panel Votes in Favor of Inhalable Insulin; Diet Drug Recalled (04/09/14)
Unconventional Ways to Lose Weight…Maybe (03/17/14)
Why Are Animals Getting Fat? (01/28/14)

Type 2 Diabetes
FDA Approves Weekly Type 2 Diabetes Medicine (04/18/14)
Study on Factors Influencing Type 2 Management (04/15/14)
What's Your Diabetes "Type"? Gestational, MODY, and Steroid-Induced (04/15/14)
Overweight People With Type 2 May Benefit From Gastric Banding (04/11/14)

Emotional Health
Worried About Diabetes? (03/26/14)
Diabetes Takes Courage (02/19/14)
The Stress Formula (02/04/14)
It's Not All in Your Head (But Your Head Can Help) (01/16/14)

 

 

Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.


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