Understanding Weight Management

Everyone should follow a healthy lifestyle and maintain a healthy weight, but this is even more important when you have diabetes. In this new column, I will take you on a journey to develop the skills and confidence with which to better manage your weight. First, you must understand weight management, which encompasses managing diet, physical activity, the mind, and social support.

Diet management

Recent research by Professor Roy Taylor and his team at Newcastle University, UK, shows that people who successfully lose weight by following a low-calorie diet reversed Type 2 diabetes. Their findings further suggest that if the weight is kept off, participants will remain free of diabetes, because when excess fat is removed from the pancreas and liver, insulin production can return to normal. “Motivation is the key matter,” said Taylor, “but so is the understanding that for overweight people, a major decrease in food intake is essential, and losing weight over a short period is generally more successful.”

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Physical activity management

But diet is not the only important factor in weight management. It is a combination of healthy food choices and an exercise program that brings long-term balance between energy intake and expenditure. “Exercise is important in that it helps to keep weight gain low and modestly reduces insulin resistance,” explained Taylor. Clinical psychologist Rosemary Flynn of the Center for Diabetes and Endocrinology (CDE) in Johannesburg, South Africa, endorses the role of exercise as a factor in preventing the early onset of Type 2 diabetes, saying, “It makes a big difference — in fact, it makes all the difference!” Indeed, a 2006 study cited in Diabetes Care revealed that if a person managed to meet both criteria of weight management — kilogram loss and physical exercise goals — then for every kilogram (approximately 2.2 pounds) of weight loss, there was a 16% reduction in the risk of developing diabetes.

Mind management

Energy in versus energy out is just the surface: Flynn points out that working on the mind is also important: “Changing lifestyle habits of a long time can take in-depth therapy if weight loss is to be long lasting.” An expert will be able to help with identifying patterns such as mindless eating in front of the computer; food conditioning — eating popcorn or chips when watching a movie; food as a coping mechanism when upset; eating irregular meals; or making the wrong food choices. A psychologist will also look at underlying issues that could lead to unhealthy eating patterns such as binge eating disorder.

Natasha, a concerned mother, illustrates an example of when counseling might be recommended. She described how her 21-year-old daughter recently was rushed to hospital with a suspected heart attack that proved to be a diabetes-related incident. “I don’t want my daughter to die,” Natasha said. “Over the past two years, I have paid for a personal trainer and a dietitian, but my daughter has not limited her food intake, nor attended the exercise sessions.” In this case, counseling may be necessary before weight loss can be effective.

Flynn explained that in her practice, “Our approach to weight loss is three-pronged—exercise, healthy nutrition, and psychotherapy — all ongoing throughout the person’s program of weight loss.” She advises focusing more on living a healthy lifestyle rather than just on weight.

Social support management

Maintaining motivation requires ongoing support. “We work with people for a year at a time,” said Flynn, “and hopefully, once they have established this alternate way of life, they will be able to sustain it thereafter.” This is when strong social support can play a fundamental role in successful weight management over the long term, said Taylor.