Diabetes Self-Management Blog

Since we’ve been talking a lot about weight on The DSM Blog lately, I will highlight a few recent ideas about weight. You probably know most of them, but hopefully at least one will be helpful. This week is mostly about causes. Next week we’ll start on management. I would really like to get your feedback on these ideas.

1. Severe overweight is a chronic condition, like, say, arthritis. It has many causes — genetic, environmental, behavioral, and others. As with my own chronic condition (multiple sclerosis), there will probably never be a “cure.” But as with diabetes, you can manage it and get better.

Notice that I don’t use the term “obese.” I hate that term. It comes from the Latin for over (”ob”) - eating (”edere”), as if overeating was the whole cause of the problem. As several commenters wrote on Jan’s blog entry last week, body size doesn’t have much to do with how much you eat.

2. As I wrote last month, it’s probably not the fat itself that most harms your health. Instead, the stresses and behaviors that make you fat also cause diabetes, heart disease, and other illnesses usually associated with weight.

3. Weight loss is easy for most people. Keeping the weight off is hard. Read a really good article on weight loss maintenance here. As dietitian Jacquie Craig says in this article, our bodies hate to lose weight and have all kinds of tricks for getting us to gain the weight back.

When losing weight, bodies slow down their metabolism to burn fewer calories. They change production of hormones such as leptin so that you never feel full. So as weight comes off, you have to work even harder to keep it off. This effect may or may not wear off over time.

4. Overweight is an environmental illness. If there wasn’t so much unhealthy food so easily available, weight control would be a snap. If you had to walk everywhere instead of drive, you could eat all you wanted. If you lost 50 pounds and moved to the Ethiopian highlands, you would not regain the weight. But here in the land of sugar, stress, television, and cars, it’s a lot harder. I wrote Chapter 3 in my book Sugar-coated Crisis about this.

So the environment is set up to make people fat. Corporations spend billions on advertising to get us to live more fattening lifestyles. They set up all kinds of barriers to living a healthy life. Then they blame you for putting on weight and say you lack willpower. What a scam!

5. Stress is a major cause of overweight. Learning to reduce and cope with stress is key to getting control of one’s weight. An excellent article about coping with stress can be found here. My book The Art of Getting Well is also good on this.

6. Most overeating is emotional. Psychologist Joe Nelson says, “If we’re happy, sad, angry, celebrating, grieving, lonely, or bored, we eat [in response]. Emotions become connected with food. Some foods also can have the physical effect of actually helping us feel better, temporarily.”

If we can stop eating for comfort or company or distraction or love, it becomes a lot easier to control weight. According to the University of Texas Counseling and Mental Health Center, you can tell when eating is emotional because emotional hunger comes on suddenly and needs to be satisfied immediately, usually by one specific food. Physical hunger comes on more slowly and can be satisfied by a variety of foods.

Many times “emotional eating” and “stress eating” are the same thing. If we can heal some of the emotional hurt, we’ll be better able to resist the stress. If we can reduce the stress, there will be less pressure on our emotions.

Next week, with your help, we’ll get into self-management strategies. If you have any good ones, comment here or write me directly.

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Comments
  1. Dear David.

    Here is an idea. Not sure if it is the right way to go for weight loss people disagree on this.

    The idea is to limit insulin to a reasonable amount like 0.5 units per kg of body weight per day or less if your pancreas is still working a bit. And then try to control the blood sugars by diet and prodigious amounts of exercise. This is based on Dr.Unger’s idea that insulin is a make fat drug. This way you are just supplementing the normal amount or only slightly more than the pancreas supplies in non-diabetics.

    People disagree with this they say to use as much insulin as you need to keep the BG as close to normal as possible because high BG with be stored as fat. Somewhat diametrically opposed to the good doctor. Of course you must minimize the occurance of lows as these may convince the body that it is starving.

    Which concept do you thing is better?

    Posted by Calgarydiabetic |
  2. Hi CD,
    Well, Jan and I aren’t doctors, and I’m pretty sure no doctors have answers to your question either. As you and others have pointed out, increasing insulin to overcome increasing insulin resistance is a vicious cycle. But what are the alternatives?

    I know you’re already on a low-carb diet and exercise quite a bit. You could try to get even more intensive with those. You probably could increase the intensity of exercise (like with weights) more easily than the amount. You could possibly go even more low carb.

    But I would be worried that those things would stress you more. I think stress is the most likely culprit in your severe insulin resistance. So what can you do about that? I’m just asking.

    Posted by David Spero RN |
  3. Reduce stress? I had to quit working due to medical problems… so now I have no more work stress. Its been replaced by financial stress or better termed “lack of finances” stress. More and more things seem to be going wrong inside my body, so I have medical stress in the “I don’t know what is wrong” type and the “more Drs more tests” type.

    I have PTSD. Including very stressful nightmares. I have constant pain - thats very stressful on the body.

    How do you REDUCE stress? It seems like every time I reduce one kind of stress it increases in another area and I lose ground.

    Don’t suggest anti-depressants, pain relievers, etc… I’m already on them. Counseling? I’m going already. Pain management therapy? Had it. Relaxation techniques? Use them. Hor baths? Take them. I also read fiction and play non-timed computer games and watch movies to escape my own reality for short periods.

    Stress is my nemesis. I believe stress levels cause a lot of medical issues.

    Posted by Ephrenia |
  4. Hi, Ephrenia-sorry to respond or offer a response so late! But it sounds like you stay indoors too much! Try the park if its hot,try the shade(outdoors)to walk, do your reading outside also!Do some people watching outside your home! Get a pet and walk it if its a dog or cat! Take your medication as ordered and GET OUT OF THE HOUSE!!!! That my friend is the best advice I can give you!

    Posted by mag |

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Weight Loss
What Color Is Your Fat? (07/21/14)
Eating White Bread Ups Obesity Risk (06/10/14)
The Power of 5–10%: A Little Goes a Long Way (05/12/14)
Overweight People With Type 2 May Benefit From Gastric Banding (04/11/14)

General Diabetes & Health Issues
Ensuring a Successful Hospital Stay (07/22/14)
Summer of Health! (06/19/14)
First-Ever "MasterLab" for Diabetes Advocates (06/02/14)
Obamacare and Diabetes — Year Two (05/21/14)

Emotional Health
Diabetes Distress and Depression (07/09/14)
What Is Hardest About Diabetes for You? (05/28/14)
Diabetes Friends (05/06/14)
Attraction and Repulsion (04/24/14)

 

 

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