I went to a couple of interesting lectures at UC San Francisco this week, so I thought I’d share them with you.
One was about food insecurity. That means not having enough food, or being worried about not having food. Food insecurity is known to contribute to obesity, hypertension, and diabetes. But professor Elissa Epel, PhD, asked why. How could not having enough food make you fat? Is it the stress, she wondered, or is it different eating habits caused by worrying about food, or what?
Her associate Barbara Laraia, PhD, MPH, RD, decided to research this. She studied thousands of women, asking about food insecurity and comparing their answers with their weight gain and eating habits. Sure enough, fear of hunger predicted weight gain, and actual hunger predicted even more.
Drs. Epel and Laraia explained their results like this. Hunger, or anxiety about hunger, changes you psychologically and physically. You tend to crave food more; it starts to taste better. When it’s available, you eat more. Your body also starts putting on more fat, probably to protect against more times of hunger.
When food is short, your cortisol (the #1 stress hormone) goes up, which causes insulin resistance and makes you put on abdominal fat. Psychologically, you may find that sweets and fats make you feel even better than they usually do — your brain will be more sensitive to serotonin than usual, so your mood will be better.
What does this have to do with dieting? Think about it. When you diet, your body experiences food deprivation, just as if there were a famine or you were living in poverty. It might react the same way, by depositing fat and increasing hunger. So it could very well be that by dieting, you are setting yourself up for greater weight gain in the future.
That is what research has long found. Most people who lose weight on diets gain it back, no matter what kind of diet they put themselves on. In Dr. Laraia’s study, the people who gained the most had food insecurity plus “restrained eating,” which means a history of dieting and worrying about food.
What This Means for People with Type 2 Diabetes
As we know, almost everyone with Type 2 diabetes is told to lose weight. (If you’re one of the so-called “thin Type 2’s,” I again beg you to get checked for latent autoimmune diabetes of adults [LADA] or maturity-onset of diabetes of young [MODY].) But how does one lose weight if dieting actually promotes weight gain?
I think that dietitian Amy Campbell would agree that the best way is not to diet, but to get on a healthy eating plan you can stay with for life. A plan that doesn’t make you feel deprived, a diet that gives you some pleasure, even. Then stick with it, while gradually increasing your exercise. Then you will be less likely to regain weight.
One of the good things about not dieting is that you won’t be stressing about food so much. Stress is also a big weight promoter, so reducing stress increases your chances of getting in shape.
Of course, if you really are facing food insecurity, that’s different. Sometimes it makes sense to eat cheap, “energy-dense” (a fancy word for high-calorie) food, like a burger from the Dollar Menu or something, if you’ve only got a little money to spend. But you can try to get your vegetables at a food bank, farmers’ market, or produce stand. Vegetables help you fill up, so you feel less deprived, as well as being generally good for blood glucose control and providing vitamins.
Have you had experiences with dieting? Did it work for you? Were you able to keep the weight off? The government even keeps a weight-loss registry of people who have successfully kept weight off, and there aren’t that many people on it. Your stories would be appreciated.
Two Web sites you might want to check out:
- The Behavioral Diabetes Institute has great online programs (although most of their live stuff is in San Diego).
- TuDiabetes is a social networking site and forum for people with diabetes, mostly Type 1. A lot of interesting people are on there, so check it out.