Diabetes Self-Management Articles

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Why Can’t I Lose Weight?
Finding Your Trouble Spots

by Jacquie Craig, MS, RD, LD, CDE

Not all diabetes drugs that can cause weight gain have that effect on everyone. But if you suspect that a medicine you are taking is hindering your weight-loss efforts, talk with your doctor. Do not stop taking a medicine on your own. There may be a similar drug that is appropriate for you that is less likely to have weight-related side effects.

Underactive thyroid
Having an underactive thyroid can make losing weight difficult. The thyroid is a gland in the neck that secretes hormones that regulate the body’s metabolic rate. It is stimulated to produce these hormones by another hormone called thyroid- stimulating hormone, or TSH, which is produced in the pituitary gland. To see how well the thyroid is functioning, doctors measure the TSH level in the blood. A TSH value that is too low may indicate an overactive thyroid, and a value that is too high may reflect an underactive thyroid.

Signs and symptoms of underactive thyroid, or hypothyroidism, include fatigue, weakness, weight gain, constipation, brittle nails, cold intolerance, and memory problems. Once the condition is treated, by replacing the deficient thyroid hormone, weight loss is possible with lifestyle changes.

Eating out
By now we all know that many restaurants serve overly large portions, but refraining from eating the whole thing is still difficult for many people. Several short-term studies conducted by nutrition researcher Barbara J. Rolls, PhD, and colleagues have shown that people generally eat more when offered larger portions of food. However, the people who consumed larger portions of macaroni and cheese or larger sandwiches in Rolls’s experiments reported similar levels of hunger and fullness after eating as the people who had eaten smaller portions.

It seems that being served large portions over time causes “portion distortion.” In other words, a person gets used to the larger portions and begins to view them as normal. This can make it difficult to feel satisfied with a smaller, but calorically adequate, portion.

If you dine out frequently, therefore, you may be taking in more calories than you realize. Limiting how often you eat out, if possible, can help with weight loss. It can also help to periodically weigh and measure portions of food at home to train your eye to recognize appropriate portion sizes. Knowing how much you want to eat ahead of time, and having a mental image of the portion size, can help you control calories at restaurants. The information in “Estimating Portions” may also help you assess portion sizes. Once you’ve figured out how much of your restaurant portion you want to eat, put the extra food aside to take home and enjoy later.

Barbara Rolls’s book The Volumetrics Eating Plan offers another approach to calorie control if you enjoy eating large portions. She advocates eating more foods that have low energy density, or few calories per ounce. These tend to be foods that have a high water content, such as fruits, vegetables, nonfat or low-fat dairy products, broth-based soups, grains, beans, and legumes. The benefit to eating more of these foods is that larger portions will fill you up without providing a lot of calories.

Not enough physical activity
Increasing the amount of physical activity you do can get stalled weight loss going again. The American Heart Association recommends that people with Type 2 diabetes perform a minimum of 150 minutes (2 1/2 hours) of moderate-intensity physical activity each week or at least 90 minutes of vigorous activity a week. Doing resistance-training exercises three times per week is also encouraged.

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Also in this article:
Estimating Portions



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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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