How to Lose Weight and Prevent Diabetes Before It’s Too Late
Weight loss expert and digestive health surgeon Bipan Chand, MD, has devoted his career to treating obese patients, many of whom are diabetic or at high risk of developing type 2 diabetes. We asked Dr. Chand to explain why weight loss is important to preventing type 2 diabetes and to share the best strategies for losing weight.
In the United States, type 2 diabetes is predominantly related to obesity. So someone who is obese and is trying to control a prediabetic condition should focus on weight loss.
With excess fat, especially around the waist, the body has greater difficulty processing sugar and becomes resistant to insulin. As that happens, the level of sugar in the blood rises.
Someone whose blood sugar level is higher than normal (>100) but not too high is said to have prediabetes. That fasting blood sugar level is a snapshot of how your body is processing sugar at that one time. It’s a reasonable screening tool, but obesity is a more important factor.
An increasing Body Mass Index and growing waist size are better predictors of prediabetes. Insulin resistance and diabetes develop over years. Someone with a family history of diabetes and a high BMI for many years probably already has impaired pancreas function. So they may have had diabetes three to five years before it is diagnosed.
Each January, many people make New Year’s resolutions to lose weight. That is the wrong idea. You should not make a resolution. You should make a decision to review your health, work to improve it and commit to making long-term changes.
The best strategy to prevent diabetes is a structured, intensive weight loss program tailored to you. It must recognize your other health conditions, such as high blood pressure, high cholesterol or joint pain. Someone who is prediabetic is more likely to have other medical problems, including central obesity – that is excessive fat around the stomach and abdomen, which carries additional health risks.
How your obesity should be treated depends on how much weight needs to be lost, what efforts have been made in the past and which were successful. Your program shouldn’t focus only on dietary changes, or only exercise or only medication. It’s not one diet or one exercise plan.
A fitness program needs to be highly tailored to your individual goals and medical needs. An exercise plan for a cardiac patient will differ from one for a person who has a knee condition, or for someone who has no physical restrictions. There is a strategy for each person.
Small Steps Lead to Big Changes
Start by choosing a coach, such as a physician or a provider who is an obesity specialist. A doctor can coordinate care of your other medical issues, such as sleep apnea, high cholesterol, edema, high blood pressure or heart disease. Your provider may advise you to work with a coordinated care team, which may include a dietitian, exercise physiologist, therapist or a weight loss support group.
At Loyola, we work closely with patients on behavior modification and lifestyle changes. For example, our patients’ food plans or “diets” are not really diets at all. They are what your food consumption should be. We look at calorie intake versus calorie burning, which sounds like a simple formula, but it isn’t. It’s a misconception that someone who is obese consumes far more calories than a lean individual. Often, eating just a few too many calories over a very long period of time can lead to substantial weight gain.
Our team will assess a patient’s eating patterns find what habits need to be improved. While someone may eat one large meal a day, perhaps a high-calorie dinner, that is unhealthy and unnatural. The body wants energy throughout the day to reduce fluctuations in blood sugars and hormones.
Maintaining good sleep habits is also important to weight loss and overall health. Sleep deprivation is a common problem that leads to unhealthy rhythms in your body’s metabolism. So not getting enough sleep can be detrimental to your health and your weight loss efforts.
A consistent exercise pattern is important. Many people think you need to do a lot of vigorous exercise throughout the entire week. That isn’t true. You could do 30 minutes of moderate exercise on a daily basis and have good results.
These simple steps, small lifestyle changes, really can have a big, long-term impact.
Dr. Chand is director of the Loyola Center for Metabolic Surgery and Bariatric Care, which provides expert medical and surgical options for weight loss. Loyola offers the expertise of highly skilled surgeons, medical weight loss doctors, registered dietitians, psychologists and a caring staff who will partner with you in creating a weight loss program tailored to you.