Is Weight Worth Another Book?

By David Spero | February 4, 2009 5:09 pm

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[1] found.

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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[2]. 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[3]. 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[4], 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[5], and cholesterol[6] 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[7].

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[8] 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.”[9] Any exercise is better than none. So take that step!

Endnotes:
  1. this one in The New England Journal of Medicine: http://content.nejm.org/cgi/content/abstract/350/25/2549
  2. Look AHEAD (Action for Health in Diabetes) study: http://www.niddk.nih.gov/patient/SHOW/lookahead.htm
  3. only drug companies usually do: http://www.diabetesselfmanagement.com/blog/David_Spero/The_Misuse_of_Science
  4. an article in Reuters: http://www.reuters.com/article/healthNews/idUSTRE50Q7QT20090127
  5. HbA1c: http://www.diabetesselfmanagement.com/articles/Diabetes_Definitions/HbA1c
  6. cholesterol: http://www.diabetesselfmanagement.com/articles/Diabetes_Definitions/Cholesterol
  7. e-mail me directly: mailto:[email protected]
  8. three minutes a day of vigorous (not moderate) exercise: http://www.biomedcentral.com/1472-6823/9/3/abstract
  9. “the first step is the most important.”: http://www.diabetesselfmanagement.com/blog/David_Spero/New_Answers_on_Exercise

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David Spero: David Spero has been a nurse for 32 years and has lived with multiple sclerosis for 25 years. He is author of two books: The Art of Getting Well: Maximizing Health When You Have a Chronic Illness (Hunter House 2002), and Diabetes: Sugar-coated Crisis – Who Gets It, Who Profits, and How to Stop It (New Society 2006). He writes for Diabetes Self-Management and Arthritis Self-Management magazines. He is a project director with New Health Partnerships: Improving care by Engaging Patients, a project of the Institute for Healthcare Improvement.

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