The ADA Standards of Medical Care recommend a target weight loss of at least 7% of body weight and a minimum of 150 minutes of moderate physical activity, such as walking, at least three days a week for people considered to be at risk of developing Type 2 diabetes.
Dr. William Bestermann, the medical director of Chronic Condition Management at Holston Medical Group in Kingsport, Tennessee, also applies a team approach to weight loss at his clinic, similar to UAMS, with the person needing to lose weight at the center, and physicians and dietitians providing education and support.
“We talk with patients about their barriers and facilitators to weight loss and work together to address them. Ignoring these practical issues is a recipe for failure,” he writes in “Incorporating Practical Lifestyle Management for Obesity,” published in 2010 in a supplement to The Journal of Family Practice.
“By working closely with the patient, understanding and addressing specific areas of concern, and taking small steps and building on success, we have had patients lose impressive amounts of weight,” he says.
Dealing with setbacks
After his weight loss, Terry Sharp decided not to continue with the UAMS program. But after about 15 pounds “crept back on,” he reenrolled in January 2012, with a goal to lose another 40 pounds, he says.
“My goal is to develop the discipline to follow through,” he says, adding that the team effort has greatly contributed to his weight loss success. “I tried it on my own and it didn’t work. It’s given me the time to pay attention to myself and take time for me.”
Day says it is common for individuals to come back to the program, and that it can take up to three tries for people to fully maintain weight loss.
The program taught Sharp to be conscious of what he eats and to read labels. Sharp says his biggest challenge has been controlling what he eats on the weekends, which are not as structured as his weekdays. “The slippery slope is real,” he says.
Sharp says controlling his environment and enlisting the support of his family have been essential. He sometimes brings the program’s meal replacements to restaurants to ensure he knows what he’s eating. Sharp, the Development Director at Boy Scouts of America in Little Rock, Arkansas, has inspired others in his office, even those who do not have diabetes, to join the program.
In addition to eating better, Sharp began exercising more. He now walks three miles a night on his treadmill while watching ESPN. Before beginning the program, he walked about half a mile a day, he says.
The UAMS clinic epitomizes the “value of social and community support” in weight loss, says Day. Patients work together toward a common goal, and “having people clapping for you reinforces what you’re doing,” she says, adding that having someone to “commiserate with” is also valuable.
Finding a program
In addition to lowering blood glucose and blood pressure and improving heart health, losing excess weight relieves stress on joints, makes moving around and breathing easier, and often gives a person more energy.
Agarwal encourages people with diabetes to consult their physicians before beginning any type of weight-loss program, because a person’s blood glucose level should be checked often during the process.
“It is best to let a health-care professional help,” Agarwal says.
According to Day, there are programs and clinics similar to the one at UAMS all over the United States. Your health-care provider may know what’s available in your area or, if you live near a hospital with a diabetes care center, try calling and asking if they have a supervised weight-loss program for people with diabetes. Once you find a program, be sure to ask the questions listed in “What to Look For in a Weight-Loss Program” to make sure it’s a program that will work for you.