Diabetes Self-Management Blog

I’m thinking about writing another book. It would be called something like From Weight to Wellness. The main idea is that numbers on a scale don’t mean all that much. People would do better to focus on living their healthiest possible life and stop worrying so much about weight.

It’s true that weight loss appears to be helpful in reducing blood glucose, but I wonder. How much of the improvement is due to weight loss, and how much is due to the things you did to achieve the weight loss? After all, you can lose weight really fast with liposuction surgery, but your blood glucose won’t change, as studies like this one in The New England Journal of Medicine found.

A recent article by Donald A. Williamson, PhD, et. al. at Louisiana State University reported on 145 obese people with diabetes in the Look AHEAD (Action for Health in Diabetes) study. Participants attended one individual and three group counseling sessions per month. They replaced some meals with shakes and meal bars provided by the experimenters. They had an exercise goal of 175 minutes or more per week.

Participants lost an average of about 19 pounds over the year. They also showed improvements in their physical and mental health-related quality of life. They felt better physically and had much less depression.

I really appreciate this study. It’s big; it’s expensive; it’s at multiple centers, the kind of thing only drug companies usually do. It’s wonderful that self-management approaches are finding this kind of support.

Analysis showed that only some of the quality-of-life benefits could be attributed to improvements in weight, fitness, and physical symptoms. According to an article in Reuters, researchers noted that “other factors, such as counseling, changes in the social environment, or improved functional abilities” might be involved.

Even for the benefits directly associated with weight, it could be that feelings of control and self-confidence associated with successful weight loss were more important than the actual loss. The most important finding to me is that sustained weight control is possible, and that an intervention program with groups and counseling helps.

The Power of Numbers
Of course, having numbers to record is helpful in monitoring your progress. Weight is one of these numbers, but other numbers such as waist size, fasting blood sugar, blood pressure, HbA1c, and cholesterol are probably more important than weight. And more important than numbers is how you feel and how much you can do! How active are you, how much energy do you have, how are you sleeping?

That’s what I call a wellness approach, and I think it might be the best way for many people to think about their weight. What do you think? Would you be willing to share your experiences (successful and otherwise) with weight issues? If you’re interested, you can comment here or e-mail me directly.

One other amazing number came out last week that we need to talk about soon. A British study seems to show that three minutes a day of vigorous (not moderate) exercise may get you most of the insulin function benefits of more sustained exercise. The 16 young male “somewhat out of shape” subjects did 30-second sprints on an exercise bike 4 to 6 times a day. Their insulin sensitivity improved by an average of 22%.

Well, it’s a start. It does confirm what I heard at the American Diabetes Association meeting last summer, that “the first step is the most important.” Any exercise is better than none. So take that step!


  1. my comments are about a 75 year old woman, who has lost hundreds of punds over life, and i say this, if after you lose 100 pounds and gain it back, it had something to do with a personality built over years of dieting ,that i could not behave in a way normal for a thin person.i.e. If one losses the fat and becomes another person because of it,that is the only reason i can think
    of I was heavy all my life and did not suffer the fat girl image propelled on tv. I had boy friends, I played tennis , and participated in all activities that I chose to, i finally heard the other shoe drop when i went to have a catscan and a group if technicins came out to tell me that I wouldnt fit in their machine,I then told the specialist(opthymoligist,and she said that i should call around to find an imaging office that could do the test, she did not want her staff looking for one for me. That was the day i found out what it is to be fat,iwas born in 1933, this happened in 1989 it was a bad day. I did find aaaaaaaaaaaaaaaaaaaaaanimaging center and had the test, no thanks to the dr..

    Posted by yoyo |
  2. Thanks for posting this honest story, Yoyo. If you’re interested in writing me some more about your story, it might help with the new book. E-mail me at nurse@davidsperorn.com.

    Posted by David Spero RN |

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