Weight Control for Type 2 Diabetes
Even modest weight loss can reduce the risk factors for heart disease and diabetes. There are many approaches to dieting and many claims for great success with various fad diets. They include calories restriction, low-fat/high-fiber, or high protein and fat/low carbohydrates. Some evidence suggests that people may respond differently to specific diets depending on whether their weight is overly distributed around the abdomen or not. According to a 2003 report comparing four major diets (Atkins, the Zone, Ornish, and Weight Watchers), any healthful diet that achieves weight loss helps the heart. To date, although many diets achieve effective immediate weight loss, none has emerged as an effective tool for maintaining healthy weight. [For more detailed information,see Well-Connected Report #53 Weight and Diet.]
The following are some basic approaches to dieting depending on the severity of the weight problem:
- The simplest (but still difficult) approach to weight loss is reducing calories and exercising at least 150 minutes a week, assuming there are no health problems to preclude it.
- Behavioral and mental changes in eating habits and attitudes about food and weight are also essential to weight management.
- For people who are very overweight and cannot lose weight using lifestyle measures, a number of effective weight-loss medications are available.
- And for those with severe obesity, surgical procedures are proving to be very beneficial.
Some Tips for Losing Weight. The following offer some general suggestions for dieters:
- Start with realistic goals. Diet failure is extremely common and the odds of significant weight loss are low, particularly in people with the highest weights. People who are able to restrict calories, engage in an exercise program, and obtain help in making behavioral changes can expect to lose between 5% and 10% of their current body weight--which is generally all that is needed to achieve meaningful health changes. Certainly, the unwholesome and distorted image of a super-thin female shape should not be anyone's goal. (Anorexia, obesity's alter ego, is far less common but is the other side of this dysfunctional aspect of our culture.)
- Maintain a regular exercise program, assuming no precluding health problems. Choose one that is enjoyable. Check with a physician about any health considerations. [For more information, see Well-Connected Report #29 Exercise.]
- Do not use hunger pangs as cues to eat. A stomach that has been stretched by large meals will continue to signal hunger for large amounts of food until its size reduces over time with smaller meals.
- Be honest about how much you eat and start by recording all calories in writing. Studies suggest that when many people report their own calories intake they significantly underestimate their consumption of high-calorie and over-estimate the low-calorie foods. People who do not carefully note everything they eat tend to take in excessive calories when they believe they are dieting.
- Observe weekend eating. People tend to eat more on the weekends. If it is difficult to monitor all meals during the week, it be may be useful to at least track eating habits during these days.
- Once the pound are lost, strive to maintain the healthier weight. Make daily, even hourly, conscious decisions about eating and exercising activities. Such thinking, in many cases, can become automatic and not painful.
- Don't give up, even after repeated weight loss failure. Most studies indicate that yo-yo dieting or weight cycling has no adverse psychological or physical effects. Repeated dieting also does not impair the body's ability to burn calories efficiently.
- Weight loss, in any case, should not be the only or even the primary goal for people concerned about their health. The success of weight reduction efforts should be evaluated according to improvements in chronic disease risk factors or symptoms and by the adoption of healthy lifestyle habits, not by just the number of pounds lost.
Calorie Restriction
Calorie restriction has been the cornerstone of obesity treatment. Restricting calories in such cases also appears to have beneficial effects on cholesterol levels, including reducing LDL and triglycerides and increasing HDL levels. In fact, in a study of an African community, inhabitants had very-low-calorie diets and favorable cholesterol levels in spite of a relatively high intake of saturated fats.
The standard dietary recommendations for losing weight are the following:
- As a rough rule of thumb, one pound of fat equals about 3,500 calories, so one could lose a pound a week by reducing daily caloric intake by about 500 calories a day. Naturally, the more severe the daily calorie restriction, the faster the weight loss. Very-low calorie diets have also been associated with better success, but extreme diets can have some serious health consequences. [See Box Warning on Extreme Diets.]
- To determine the daily calories requirements for specific individuals, multiply the number of pounds of ideal weight by 12 to 15 calories. The number of calories per pound depends on gender, age, and activity levels. For instance a 50-year old moderately active woman who wants to maintain a weight of 135 pounds and is mildly active might require only 12 calories per pound (1,620 calories a day). A 25-year old female athlete who wants to maintain the same weight might require 25 calories per pound (2,025 calories a day).
- Fat intake should be no more than 30% of total calories. Most fats should be in the form of monounsaturated fats (such as olive oil). Saturated fats (found in animal products) should be avoided.
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