How important is weight loss?

[mccraith]

I have read that being overweight is a symptom not a cause of diabetes. I don’t know how true this is but as a newly diagnosed T2 diabetic I would like to know how important it is to lose weight. If I got closer to a normal BMI would my body heal itself and then be able to process sugar/carbs better or is the damage irreversible? If I could consistently control my blood sugars with a low carb diet and no medication, would I one day be able to eat pasta or bread again or has that ship sailed forever?

 

[mouseee]

As a T2 we are insulin resistant. Losing weight helps improve it. More to the point I think is that gaining weight is a symptom of T2 and a low carb diet and getting blood sugar under control will help reduce weight.

As to can you return to the same way of high carb eating? My opinion is no. You may find things effect your blood sugar a little less, I had a hash brown today and it didnt spike me. But go back to heavy carbs on a regular basis and control will be gone again and blood sugar will rise. Sorry!

But, you've come to the right place and going low carb is shown by many t2s on here to be really successful at managing it.

 

[Daibell]

I would say that weight gain is a symptom much of the time of having the wrong diet. If you have genes that make you more likely to be T2 then you will become T2. If you keep the carbs down and come into the right BMI range you may be able to avoid any meds and have reasonable BS levels but you will not be cured and need to treat the low-carb diet as life-style for life.

 

[LaoDan]

I have read that being overweight is a symptom not a cause of diabetes. I don’t know how true this is but as a newly diagnosed T2 diabetic I would like to know how important it is to lose weight. If I got closer to a normal BMI would my body heal itself and then be able to process sugar/carbs better or is the damage irreversible? If I could consistently control my blood sugars with a low carb diet and no medication, would I one day be able to eat pasta or bread again or has that ship sailed forever?

IMHO, getting to a normal BMI is the single most important thing(edit: besides getting control of BG levels) You may be able to tolerate more carbs at a normal BMI, but you certainly just can’t go back to your “old” way of life. Once you get back to a normal BMI, you’ll need to test how well your body absorbs what you eat. You may be able to eat your favorite pasta dish on occasion.

For long term maintenance, you should work out a plan that you can sustain. Maybe something like the 80/20 rule might fit. Where 80% of the time, you eat low carb, and relax that a bit for the rest.

one step at a time, get to a normal BMI, try to add lean mass. Then work out a maintenance plan.. that’s my plan lol

 

[BrianTheElder]

I, too, wonder about this.
In the same way that higher cholesterol is good for mortality, it is the case that a BMI above 25 is good as well. In both cases, not to excess.
Strange but true.
Ref Zoe Harcombe.

 

[Brunneria]

weight loss is a great goal - for those who can do it. Not all can, and there are many T2s out there who are not overweight or are even underweight, yet still have high blood glucose if they eat sufficient carbs.

As I said, losing excess weight is a good goal, but prioritising that over blood glucose control is IMO folly, and thinking that a bit of weight loss will enable a return to old eating and lifestyle habits is extremely short sighted. What happens when the years tick over and age, activity levels, and other health conditions change?

T2 is a long game, a life long one, and weight loss (if appropriate) is just one piece of the jigsaw puzzle.

 

[mccraith]

Thanks for your replies. I’ve been trying to lower my blood sugars since mid July. I haven’t had any bread, rice, pasta, potato, pastry (apart from one thing on 2nd Aug that spiked me to 12). No bananas, apples. I reduced the carbs I’m eating from ~60 to 25-35g a day on 7 Aug (thanks to this forum). Calories range between 1100-1500. I walk 5.5 miles six mornings a week. My blood sugars are now regularly under 7 which is good but I’ve lost just 1 lb in weight in a month which is disappointing. I think perhaps my body wouldn’t budge while I was eating higher carbs as I do ‘feel’ lighter in the last ten days so hopefully it will start coming off on the scales.

When you see Michael Mosley’s Lose a Stone in 21 Days, they are having 800 cals a day. I am wary of cutting that much as I have yoyo dieted many times in my life and I’d rather do it more slowly and keep it off.

I suppose I’m just impatient and want to see quicker results and hope that I can have an occasional slice of toast or treat at some point once I’ve got my HBA1C down - that’s the plan.

 

[Robbity]

I initially brought my glucose levels down to pre-diabetic levels within three months of diagnosis, but didn't start losing any weight immediately. However I ended up losing about half what I needed to very quickly, though over six years later I'm still at this same lower weight, and I've managed for most of that time to keep glucose levels down to low pre-diabetic levels. So my weight loss was more of a side effect and not my main aim (though maybe my GP thought otherwise!) I was originally on metformin, but for the last 3+ years I've not needed any diabetic medication.

I've eaten a low carb/ketogenic diet since diagnosis (aiming for less than 50g carbs a day), and have no intention of changing this, as it's much closer to my original and preferred diet - I have little doubt that if I did revert to a carb ridden diet, I'd end up back with high glucose levels.

If you want bread, etc, there are some suitable low carb options available to buy, and plenty of low carb recipes for bread or cakes.

 

[Antechinus]

My understanding is that sub cutaneous fat has a couple of negatives. It produces a hormone that makes you hungry, it increases resistance to blood flow so your heart has to work harder causing it to wear out, and it wears out you knees and hips and feet.
So good reasons to lose those pounds.

 

[NicoleC1971]

Thanks for your replies. I’ve been trying to lower my blood sugars since mid July. I haven’t had any bread, rice, pasta, potato, pastry (apart from one thing on 2nd Aug that spiked me to 12). No bananas, apples. I reduced the carbs I’m eating from ~60 to 25-35g a day on 7 Aug (thanks to this forum). Calories range between 1100-1500. I walk 5.5 miles six mornings a week. My blood sugars are now regularly under 7 which is good but I’ve lost just 1 lb in weight in a month which is disappointing. I think perhaps my body wouldn’t budge while I was eating higher carbs as I do ‘feel’ lighter in the last ten days so hopefully it will start coming off on the scales.

When you see Michael Mosley’s Lose a Stone in 21 Days, they are having 800 cals a day. I am wary of cutting that much as I have yoyo dieted many times in my life and I’d rather do it more slowly and keep it off.

I suppose I’m just impatient and want to see quicker results and hope that I can have an occasional slice of toast or treat at some point once I’ve got my HBA1C down - that’s the plan.

Well done on the blood sugars but i don't think you are going to be able to carry on with starvation rations! Michael Mosely is following the Direct study protocol which involves 12 weeks of 800 kcals a day to reverse diabetes or take it into remission or in this case to earn a buck from Channel 5 because obesity is back in the news again (thanks to Covid). This and bariatric surgery are methods of rapidly stripping the fat from around th the liver and pancreas which cause insulin resistance and thence type 2. In both cases you didn't have to lose all your fat to lose your diabetes which demonstrates how individual the 'fat threshhold' is! I believe the average loss was 8kg or those achieving remission.
However there are very obvious issues with a starvation diet namely if you can survive low rations for a few weeks then what happens when your body slows down its metabolism (sounds like your case) or you get ravenous and eat carbs again?
I'd say it is very hard to do low cal and low carb at the same time for this reason and there is no proof that exercise helps you to lose weight directly i..e burning calories, although it is brilliant for other health reasons.
I would go for eating low carb foods until you are full and stop counting calories but keep counting your blood sugars as they are a good indicator of your insulin resistance which you want to reduce (as is blood pressure and high trigs/low hdl if we are looking at clinical results).

 

[DCUKMod]

@mccraith - I am certainly not asking you how much you weigh, but I will ask if you carry extra weight weight?

For me, when diagnosed, I was wasn't hugely overweight, but did have stubborn love handles. Again, for me, I decided that my blood sugar levels were the important factor.

My rationale was that I would rather have healthy blood sugar levels, with a little extra padding, than be a skinny thing, with elevated blood sugar, potentially causing me more damage that the weight of my love handles.

As it transpired for me, as my numbers came down, my love handles melted away, and I have ended up quite slim.

Overall, I think being a healthy weight is advantageous, from all manner of perspectives, so trimming up is desirable, provided you have some weight to lose. If you are already slim, with a low BMI, losing weight might be challenging in other regards.

Good luck with it all.

 

[ringi]

I walk 5.5 miles six mornings a week

That level of exercise plus a high protain diet is likely to result in increased muscle mass and muscle weighs a lot more then fat. Maybe more useful to track waist measurement then weight.

 

[ringi]

Michael Mosely is following the Direct study

There is a big difference in that Michael Moseley teaches people how to plan, shop and cook their own food in the 8 weeks. His style of food is lower carb then what most people where eating before, hence giving then a much better start place when the 8 weeks is up.

(Michael Moseley 8 weeks blood suger diet predates the DiRECT study by a few years, and he does cover the work of Dr David Unwin in his books)

 

[NicoleC1971]

There is a big difference in that Michael Moseley teaches people how to plan, shop and cook their own food in the 8 weeks. His style of food is lower carb then what most people where eating before, hence giving then a much better start place when the 8 weeks is up.

(Michael Moseley 8 weeks blood suger diet predates the DiRECT study by a few years, and he does cover the work of Dr David Unwin in his books)

Thanks. That is interesting and I know he does balanced food rather than the shakes! It is just that it is 800 kcals and I think people should know that this has a consequence to the risk of regain even if he is teaching lifestyle skills and they are eating real food etc.
I have often wondered if the reversal effect is simply because at 800 kcals even if you ate only carbs you would be on 200g daily which is not low but lower than the average 240g!

 

[ringi]

It is just that it is 800 kcals and I think people should know that this has a consequence to the risk of regain

Personally I think low carb diets are a much better option then 800 kcals for most people with type2, however diet research has show that fast weight lose when weight is measured after a few year results in as least as much retained weight reduction as slow weight loss. I expect that partly this is due to quick measureble results being good at motivating people.

 

[ringi]

I have often wondered if the reversal effect is simply because at 800 kcals even if you ate only carbs you would be on 200g daily which is not low but lower than the average 240g!

When the liver has little stored glycogen, carbs have less of an effect. For example a high carb meal after fasting for two days may not increase BG much.

 

[NicoleC1971]

Personally I think low carb diets are a much better option then 800 kcals for most people with type2, however diet research has show that fast weight lose when weight is measured after a few year results in as least as much retained weight reduction as slow weight loss. I expect that partly this is due to quick measureble results being good at motivating people.

Post trial remission rate of 36% after 2 years which certainly beats 3% under the usual care. Down from the initial results but still impressive.
https://link.springer.com/article/10.1007/s00125-020-05224-2
Then if we compare low fat calorie controlled, low carb seems to work better:
https://phcuk.org/wp-content/uploads/2020/03/LC-v-LF-RCTs-T2D-04.03.2020.png
Good to have 2 tools that work at least but I agree with you that low carb with support might be the better way to go. I guess the threat of having to do another 12 weeks on 800 kcals might be enough to prevent some of relapsing!

 

[mouseee]

I also didnt lose much to start with but after a month or two thinking the weight would never go, it fell off really.

 

[MrsA2]

@mccraith many of the keto sites would say you are eating too little fat as your calories are too low for normal sedentary person let alone one doing that amount of exercise. Sounds like you may have slowed metabolism too much. A couple of spoonfuls of good olive oil added to salads or cooking may help.
I share your frustration, I lost intially but now nothing for months but im not hungry and everyone says I look good so I ignore the scales. I have just gone down another belt notch though... thats 6 in total over 5 months

 

[mccraith]

Thanks for all the additional replies and interesting discussions. For info, my BMI is 31.6. I’m 5ft1 and weigh 167lb so to reach a normal BMI I ought to lose at least 35lb. It sounds now like successive bouts of low fat diets over the decades (apart from a temporarily successful Atkins diet) probably haven’t helped my metabolism. nor has not eating breakfast until after my walk. PS. The 5.5 miles I walk isn’t a sudden increase, I’ve been doing it for a good while.

I think I’ll aim to lose one or two lbs a month and, more importantly, keep my blood sugars below 7. We’ll see how I get on! Thanks again and best of luck to you all in your aims/plans/targets.