THE TRUTH ABOUT WEIGHT AND DIABETES

Diabetes Australia suggests moderate weight loss should be part of a treatment plan for people with diabetes who have a high body mass index. But advice for weight loss may convey shame and blame – and can even be dangerous.

“I was sick for three years before my diabetes diagnosis. I knew I was sick, but since I passed my fasting blood [glucose] check, the diabetes was not caught by doctors. Instead, the doctor told me I wasn’t dieting and exercising hard enough,” says Lenza. “I injured my knee pursuing this doctor’s orders, and developed full-on eating disorder behaviour, desperately trying to starve myself [into being healthier].”

“We’ve come to have this societal expectation that losing weight should be easy,” says Puhl. “We see so many messages from the diet industry and media that you can achieve quick weight loss with a plethora of conventional options, and doctors and patients often have very unrealistic expectations.”

Jody Dushay, endocrinologist and director of the Wellpowered Wellness and Weight Loss Program at Beth Israel Deaconess Medical Center in

Boston, agrees. “I have seen patients have significant improvement in blood [glucose], cholesterol, blood pressure and non-alcoholic fatty liver disease with 3 per cent weight loss – just 3kg for someone who weighs 112kg,” she says.

Research suggests dietary changes and increased exercise alone can lead to better health measures, whether weight is lost or not, says Glenys Oyston, a dietitian who uses an approach to diabetes management that avoids focusing on weight loss. “What might people try to do when they attempt to lose weight? Increase their nutrient-dense foods, eat balanced meals, address any overeating issues, increase exercise,” she says. “All of those things improve insulin sensitivity on their own. I see people improve their blood [glucose] without any significant weight change. By not focusing on weight, they feel more relaxed about being able to care for themselves, instead of judged.”