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Prediabetes low body weight but waist ratio to hip makes me overweight!

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gowest12

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hi I’ve posted before but I’m none the wiser. I was diagnosed with hba1c of 42 shock as it was as I thought I wasn’t overweight well I wasn’t overweight I was a good weight which was lower end of normal but never did I think I had a problem especially with diabetes! Well I’m quite fed up as I’m going round in circles with how to actually deal with this. My problem is when I check my waist to hip ratio it makes me overweight and at risk of obese diseases! I’ve never been someone who exercised ate tons of carbs and yes the weight always ended up in the middle and it’s always been a problem area. But my question is how can I be almost underweight and have this problem?? Am I the only one??? I’m doing lowish carb higher fat but then I get scared when I see posts on certain sites saying if we eat too much protein we will damage our kidneys or have a heart attack with fat! I’m confused I’ve started going to exercise classes to see if I can get this waist measurement down. Any advice would be greatly appreciated. My mum had diabetes and was same shape as me and my sister is prediabetic and she has same belly problem! Yet my doctor doesn’t even listen when I tell him the belly is a problem he just says I’m very normal weight I don’t have to lose weight but I have to lose the fat! I’m getting very depressed! I wish I had more visible weight to lose!
 
Hi again @gowest12.

I do believe you need to do a deep dive into low-carb diets.

Have you been doing that in here already? In the low-carb section?

But there are some excellent books that you could access at the library, or even buy if you got enthusiastic about it - but all those books will be at any self-respecting large-city library. Because I feel you need to understand about macronutrients. As far as I know the idea that high protein diets will give you kidney damage is one of those exaggerated food-myths from yesteryear, and there is a ton of information and data saying that healthy fat does not in fact give you heart attacks. In fact, @gowest12 - you absolutely need protein and healthy fats to thrive. The one macro you can drop/avoid/lower is - carbs. But don't take my word for it - get thee to a library. Read up on it in this wonderful forum. Start watching youtubes recommended in here.

I strongly recommend you start a food journal - just because you seem to have such a high emotional response to the fact you are slender with a bit of weight around your belly - which is not so unusual at all. In your food journal - start noting how changing your diet makes you feel, as well as changes to your body composition - I think this will lower your anxiety around your dietary changes hugely. Or, it might alert you to problem food for you. Because you are so anxious, it might pay you to buy a blood glucose meter as well, so you can watch your blood glucose response to certain food.

Remember - getting an excess of high-carb high additive high bad fats food these days is the norm rather than the exception. It is just not so surprising even a slender person who is exposed to high-sugar and carbs in highly processed food gets a raised blood glucose reading, and a wee belly. As you are not a tall big-built person (I think you are under 5 foot, if I remember rightly?) you are probably just built to be a wiry creature. I always suggest to people that they take a good look at their relatives, and photos of your forebears, and notice the prevailing body type or types, to lower anxieties about being a slender person with some carb-intolerance.

If you can't see any wiry not-tall types in your family - it could be you have suffered some damage at cell-level, that has made you unusually susceptible to diabetic responses to glucose/sugar etc. If that is the case, this is sad indeed. But the right thing to do to deal with that is the same if you are by nature a small wiry type whose ancestors adapted to make the most of the energy in foods - and that is to up your protein and healthy fats, and lower the carbs to lower the fat storage around your belly, and halt the blood glucose rise now when it's at a low prediabetic level.
 
Edited to add - this is no way is to diss the previous post, but to add another dimension:
You are perfectly normal, and if your weight is good for your height, you are simply one of the many body-shapes that humans come in. You don't need to fret about/pay attention to waist-height ratio. Various of us carry weight on our shoulders, on arms and legs, on butt, on belly, on waist, depending on our genetic build. We can be fatter or thinner but we cannot change our basic shape. It is lovely for people who are the shape that fashion says we should be, but there are many perfectly safe healthy human shapes, and it would be a hot day in Manchester if health gurus would admit this. Look at various old paintings to see the fashionable body-shapes of past times and different countries, and you will see us in our infinite variety.
 
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Thank you for this. I understand we all have different shapes and body size. So you don’t think it’s a problem if my waist to hip ratio makes me overweight as everywhere I read my waist size is too big for my height which is 4ft 11! And on those scales which monitor body fat said 45 percent body fat which freaked me out as I’m 7 stone 5 you wouldn’t expect someone of such low weight to have excess fat??? Do you think i should be eating slow release carbs like lentils and chickpeas or beans? As I was referred to a dietician and she told me to so I have been eating a quarter of those on my plate daily I don’t know if that’s good or not. Are those scales in boots reliable with body fat ones? The reason I’m concerned about the belly fat is because I keep seeing articles saying I’m thin outside fat inside! And that scares me. What is cellular damage does that mean I can’t reverse this? Sorry for all the questions just trying to make sense
 
I would only repeat what I've suggested to you before: get exercising. I know it's not really your favourite thing, but there isn't anything better (in combination with low (ish) carb and plenty of fat and proteins) for improving body composition (more strong, lean muscle, less fat in the wrong places) and improving metabolic health. I know those measurements are bothering you, but that isn't helping you: I would urge you to redirect to healthy physical exertion the mental energy you are currently spending on worrying about numbers that will, with luck, improve over time as you get leaner and stronger. But please, please do nourish your body properly and don't be afraid of real food and plenty of it.
 
If I was to say to you my optimum low weight is ten stone and a couple of pounds, this was when I was misdiagnosed with T2 over fourteen years ago. In 2009!
I then by 2013, 18 stone plus and getting bigger and I was eating the eat well plate. As advised.
I was referred and my endo advised low carb, and a food diary.
it was explained to me that because of my over production of insulin was the cause of my weight issues.
the reason most T2s have diabetes is because of high circulating insulin levels because of insulin resistance, low levels of insulin on first phase, which is why carbs are very important to weight control.
the spikes are responsible over time to cause hyperglycaemia.
put it all together, avoiding carbs will help lose weight. It is not overnight, it will be difficult and by no means easy. The lower the carb intake the lower the spikes.
as soon as I went very low carb then keto because I had a fasting test in hospital, then stayed in keto, the weight dropped off me, including the bulge around my waist. I was morbidly obese, but three months later I was under twelve stone. I'm now roughly twelve and a half stone.
It worked for me, lowering your carb intake, and getting a balance of food that is healthy for you, tailored for you, by you. To suit your life, your lifestyle, your health.

Best wishes.
 
There’s such a thing as TOFI. Thin outside fat inside. Fundementally it means your gentic makeup is such that you (generic) gain weight around your internal organs (the belly) easily and less so else where. UnfortunatEly that also is the worst area for insulin resistance, metabolic issues and prediabetes. Unlike those who are obviously obese overall weight loss is t necessarily a panacea. Reducing carbs properly (all of them not just white ones) will address this. Protein is only a concern for already struggling kidneys according to every reputable source I’ve found and fat doesn’t increase cholesterol (the main concern) unless it’s the processed seed and vegetable oils.
 

I think it is more than likely an issue for you, to have belly fat/fat on the inside on the digestive system and liver and pancreas. But don't freak out about it - absolutely. I would advise - just lower your carbs, lower processed food, and you probably only need to lower them 'somewhtat'. And alas lentils, beans and chickpeas are all carbs! Are you a vegetarian?

It would really be incredibly helpful for you to get a blood glucose meter, and see how those lentils, beans and chickpeas are affecting your blood glucose. I think you wrote previously that you have a mother and sister with diabetes/raised blood glucose? Which means it would not be an over-reaction to having raised blood glucose now. this is the time to nip it in the bud.

If it is cellular damage, you can still get your blood glucose under control - lots of folks do, with all the different varieties of the diabetes. Your blood glucose might be different to another person with prediabetes or type two, but you can still set goals and reach them, for blood glucose/insulin health. All of us can.
 
Alas, @Outlier, waist height ratios out of range (ie more than .50) are big risk indicators for metabolic disease, including cardio vascular disease, some cancers, and of course - type two diabetes. I totally agree with you re the importance of recognising the wonderful variety of body types out there, and absolutely - slender folks with bigger bellies with excess carbs for them is one of the body types, but a body type responding negatively health-wise to our screwed up food environment, imho at any rate.
 
I absolutely support your different viewpoint because it adds value to the discussion. The reason I challenge the absolute of waist/height ratio is that it is a perspective not a medical fact and therefore a blunt instrument for people such as the opening poster who don't fit the theory. It's a very satisfying theory for the many people who naturally have a smaller waist and carry their weight elsewhere on their bodies. It can be very distressing for those who naturally have a different body ratio while not being overweight, even being very lean. If such people try to drop their weight to fit a theoretical ratio that they are never going to have until they are emaciated, they will cause themselves harm.

Therefore I simply add these observations to create a more rounded (!) discussion, and to help the confidence of people who have had this ideal presented as an indisputable necessity for health, and thus, as with OP, have become concerned about their health when there is no need.
 
Thank you for the reply. I do believe that’s probably what it is. That I have internal fat around the organs I’ve read alot about that! So you think low carb will help? As I said I’m low carb but on the advice of my dietician which the doctor referred me to I do eat lentils and beans. I understand they are all carbs but the dietician tells me we need the good carbs coz of the fibre! So I should be cutting them out altogether????? Is that right? I just find it hard to know what to eat then! I’m not vegetarian I eat fish and meat. And yes I keep getting advised to have. Carb at every meal
 
Yes, go lower.
In my experience you will not lose a lot of the weight you want to, if you are intolerant to carbs, you have dysregulation of blood glucose levels being kept too high by the intolerance you have.
Your dietician is wrong,
What is better for someone with carb intolerance?
Bacon and egg?
Pasta bake with lentils?


One according to dieticians is healthy, the other is not!

So called healthy super food.........porridge, no milk, no sugar, every morning, was giving me a spike repeatedly around 10am of over 12mmols from a pre meal reading of 5mmols.

The continuous spikes from carbs, sugars are one of the causes of hyperglycaemia. Which is diabetes T2.

Best wishes.
 
Thank you I will try to go lower with the carbs!!
 

At times like this I feel incredibly grateful for these forums - this one in particular, so yes - I agree Outlier, we are adding value to the discussion I am sure - and this is a privilege for me to engage on this topic with you. And gowest has been dealing with the whole diet and body composition issue and providing us with this opportunity to talk about these very - crucial perhaps? - topics. Especially the value of low-carbing!

So I have my breakfast buns in the oven (low-carb, via the diet doctor's website), I've had more than a few cups of coffee, and I most importantly I have looked up citations, both on waist-height ratios, and on gowest's body and situation! Ready to go -

First my biases: I am a big proponent of Prof Taylor's personal fat threshold theory, and a big fan of Dr Fung, who also supports the personal fat threshold theory behind metabolic mahem as a 'target' of diabetes if you will, and how it affects the individual.

And the waist-height ratio fits nicely into that theory also. And and, In my own 'diabetes journey' and all the experimentation I have done - it fits. Hence my bias perhaps.

I am personally not a naturally small waisted person. I don't have a big differentiation between my hips and my waist - even when slim as a youth, or normal weighted as I am now. I went through my 30s, as a plump/overweight/sometimes fat person constantly assuring folks I was not in fact pregnant. (As my legs and arms remained relatively normal-weighted looking, and as a slim hipped person the fat went outwards, not sideways.) I currently have a waist-height ratio of .44, but have lived most of my years with type two post iniitial large weight loss with a ratio ranging between .47 and .49, even as a normal weighted person. I have written up on this elsewhere on the forum. I am a weight-loss resistant type two person, regarding remission.

Anyway - the study with great further references and readings included -

A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value

A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value - PubMed

This systematic review collated seventy-eight studies exploring waist-to-height ratio (WHtR) and waist circumference (WC) or BMI as predictors of diabetes and CVD, published in English between 1950 and 2008. Twenty-two prospective analyses showed that WHtR and WC were significant predictors of...
pubmed.ncbi.nlm.nih.gov

On to gowest. I probably have a false feeling of intimacy with gowest12's physique! As I have been responding to his/her/their call of distress for a few months now (and been unable to affect poor gowest12's high level of anxiety, alas). In one of my attempts to reassure I did a health-calc (my favourite data tracking site) graphic show for him/her. (I have to say - I have absolutely no idea what gender gowest12 is! But I also have to say - it doesn't matter, except perhaps re anxiety over body-fat composition issues, as that can differ between the genders rather a lot in many cultures and societies.)

Anyway - through putting in gowest's data, I showed him/her that s/he was not close to too thin at all, and, in fact had a close to borderline, or indeed slightly over the border waist height ratio, which would fit the prediabetes thing. Hence my assumption that gowest, with either close to over a waist circumferance close to or over his/her height - s/he does in fact have the classic fat storage pathway for insulin resistance - which is around the waist. The graphics I prepared from 'health-calc' can be seen in the 'Thin outside fat inside' thread in this prediabetes section from late November last year to December.

And as mentioned in here - gowest, I believe, has a mother and a sister with T2D, so has this scary high risk factor to deal with. So I do believe gowest's anxiety is not entirely misplaced - just his/her trust in the necessity of lots of carbs for good health is misplaced.

Whew! Well. I have eaten two of those dietdoctor swedish breakfast buns (I can't imagine my life post diagnosis without them!), drunken a whole pot of coffee, and am now about to move on with my morning.

I hope the study citation is helpful! And I always love to share the health-calc site. Or at the very least declared my biases.
 
Thank you so much for this! I am a 49 year old female and I’ve always had a problems with the belly fat!!! So I should ditch all carbs is this correct??? I’ve started exercising doing to exercise classes at the gym but are you saying I can get rid of this belly and get my waist abit smaller??? I am 4ft 11 and weigh 7 stone 5 so that’s not underweight??? I’m only going by the dietician I’ve been seeing and today I had another appointment and she was still going on about slow release carbs!! So I’m still learning about carbs! I always thought the slow release ones were safe??? She keeps telling me to add them in as I need the fibre! Today I actually thought she didn’t know what she was talking about! Also is there a list of low carb stuff we can eat??? I get stuck with what to have for breakfast lunch and dinner that is low carb. I also use a low carb seeded bread is that also no good?? Thank you for all your help! It’s making more sense as time goes on !
 

I think they said they were 4ft 11 inches and seven stone something, so I’m going with female but many apologies if I’m wrong
 
I don't want to deflect but it's important to remember that different dietitians will give you different advice.

The one who ran my NHS course after I was diagnosed was very clear: carbs are not essential in the diet. We can live quite happily without them. The Eatwell plate and the NHS insistence that we should be "basing meals around carbs" directly contributes to both the increase in T2 diabetes and the progression of the disease once acquired.

I follow his advice and I am pleased with the results.
 
My legs and arms are mostly "normal", my gut certainly isn't, and that's where the weight piles on. It ends up marbling my liver, giving me non-alcoholic- fatty liver disease for instance. Abdominal fat can add to insulin resistance and whatnot, worsening my T2. I fixed my wonky liver before by going low carb, and I'll have to get back with the program again after falling off the wagon some. I know it can be done, as I did it before, and kept it up for years. You can't outrun a bad (read, in a T2's case: carby diet), so while exercise certainly won't do any harm and I wholeheartedly encourage it, the diet is the most important thing to look to. From past experience I can say it does work. You've already heard about TOFI (Thin outside, fat inside), so yes, it is possible to be technically a good weight, but the fat distribution just not being optimal, and packing onto the organs that we do kind of need to function as well as they can. Low carb can indeed help.

Hang in there eh.
Jo
 
finzi1966 said:
I think they said they were 4ft 11 inches and seven stone something, so I’m going with female but many apologies if I’m wrong
Click to expand...
You are right I’m female and I am 4ft 11 and weigh 7 stone 5 but my waist is 29.5 inches and hips 34 which is not a good ratio according to all the waist to hip ratio calculators and the waist to height ratios! It’s just so depressing.
 
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