Weight and Diabetes: Lose Pounds to Lower Your Risk

If you’re overweight, you’ve probably thought about shedding some pounds. If you have diabetes or are at risk for getting it, you should stop thinking and start doing -- now. Why? Because excess weight puts a strain on your body in all sorts of ways.

“If I suddenly take a bunch of gravel and throw it in the back of your car, you can still probably make 70 mph on the interstate. But you’re going to make the engine work a little harder. If I put 1,000 pounds in your car, that effect increases. I can probably put enough weight in so, eventually, your car no longer can perform like it needs to,” says David Marrero, PhD, president of health care and education for the American Diabetes Association.

It sounds harsh, but the truth is, that extra weight in your trunk? It can lead to a higher risk of heart disease, stroke, high blood pressure, cancer, and diabetes, according to the National Heart, Lung, and Blood Institute.

Your engine already is whining. Ditch the gravel. You might be surprised at how dropping just a few pounds can make a dramatic difference.

“What we know in diabetes prevention, and in prediabetes, is that a very modest amount of weight loss has this huge reduction in risk,” Marrero says. “You lose 7% of your body weight, you cut your risk [of developing diabetes] by 60%. And, in fact, if you’re over 65, it’s over 70%."

But how do you not just lose weight, but keep it off? Through a combination of exercise and watching what you eat.

The Exercise Factor

If you’re overweight and have diabetes, or are at risk of getting it, you have to exercise. There’s no way around it.

“In your body, what exercise does, is it allows you to bind or uptake insulin more efficiently,” Marrero says.

Your pancreas makes insulin, a hormone that “unlocks” the cells so they can use sugar from the food we eat as energy. “You have what they call receptor sites, and the more you exercise, the more active your receptor sites are. And the less you exercise, the less active and responsive they are,” Marrero says.

If you’re serious about losing weight, working out has to be part of the big plan. But check with your doctor before adding it to your routine.

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The Importance of Diet

It’s easy to talk about losing weight. But doing it and keeping it off can be tough.

“This is not something that has a beginning and an end, like you have an infection and you take an antibiotic,” says Lorena Drago, a dietitian and a spokesperson for the American Association of Diabetes Educators. “Imagine making changes every single day for the rest of your life.”

It can be hard to diet if you have diabetes. You have to inject insulin and check your blood sugar several times a day while you’re watching what you eat.

When it comes to food, too many people have no idea what’s good, what’s bad, and what’s too much, Marrero says. He tells the story of a woman at a diabetes seminar who complained she had nothing for breakfast but coffee and a muffin. Those two items came to 1,600 calories. “She wiped out seven-eighths of her dietary intake needs just with a simple cup of joe and a muffin,” he says.

“The thing that predicts weight loss the best is monitoring intake.We’ve seen several studies that have shown that if you become aware of how much you eat, you have a much better chance of regulating that in a way that makes sense.”

What to Eat

Both Drago and Marrero favor low-fat diets. Drago likes the more Mediterranean-type diet that includes healthy fats from oils and cutting back on carbohydrates.

“Look at your carbohydrates. Look at the source of the food with carbohydrates in your daily diet. And then start reducing the portions,” she says. “By doing that, then, immediately you’re also reducing the calories.”

The American Diabetes Association has some suggestions for “best food choices” that are good for everybody, diabetic or not:

  • More vegetables, especially non-starchy ones (no potatoes, corn, or peas). And watch the salt.
  • Whole-grain foods. (Think whole wheat bread) over refined grains and flour. Half the grains you eat should be whole grains.
  • Lean proteins . Fish at least twice a week, and bean or soy instead of meat, when you can. When you do eat meat, go lean (pork loin or sirloin). And remove the skin from your chicken.
  • Fruit. Fresh is best. If you choose canned or frozen, make sure it has no added sugar.
  • Fats. They’re OK in small amounts if you’re eating healthy fats, like those from avocados, olives, nuts, or seeds. Avoid the full-fat cheeses and full-fat milk. No regular butter or creamy sauces. And put back those potato chips and fatty snacks!

Drago says portion control important, too. For example, avocados are healthy -- unless you eat three of them in a sitting.

"But much of whether a diet works or not is up to the person trying to lose weight,” Drago says. “My personal view on this -- and I think it’s substantiated by a lot of practical clinical experience -- is that the best diet is the one that you can stay on.”

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The First Step

The CDC estimates that 21 million people in the United State have diabetes. More than 8 million don’t know it. Even more alarming: An estimated 37% of Americans 20 years old or older have prediabetes.

About 90% of people with type 2 diabetes, the most common type, are overweight or obese, according to a Harvard Health report. That’s the No. 1 risk factor for diabetes.

To cut your risk, change your diet, lose weight, and join a group that can help you find a plan and stick to it.

“It is a struggle. It’s not easy. The answers are not simplistic. The answers are not just stop eating and just move all day long,” Drago says. “Information and education have to be shared in a way that fits an individual’s lifestyle. And that’s what I try to do.”

Losing weight might be hard. But it shouldn’t be intimidating, Marrero says.

“People have been told that they have to lose extraordinary amounts of weight to have an impact,” Marrero says. But it’s not true. If you have prediabetes, your risk of developing full-blown diabetes drops 11% to 12% for every 2 pounds you lose.

That should be reason enough to start shoveling that gravel out of your trunk.

WebMD Feature Reviewed by Michael Dansinger, MD on December 01, 2015

Sources

SOURCES:

David Marrero, PhD, president, health care and education, American Diabetes Association; director, Diabetes Translational Research Center, Indiana University School of Medicine.

Lorena Drago, RD, MS, CDN, CDE, senior associate director, ambulatory care nutrition programs, Lincoln Hospital, Bronx, NY; spokesperson, American Association of Diabetes Educators.

National Heart, Lung, and Blood Institute: “What Are the Health Risks of Overweight and Obesity?”

CDC: “National Diabetes Statistics Report, 2014.”

Diabetes Prevention Program Research Group, New England Journal of Medicine, published online February 2002.

Obesity Action Coalition: “What Is Obesity?”

American Diabetes Association: “The Best Food Choices.”

Harvard Medical School: “How Excess Weight Affects Your Health.”

World Health Organization: “Obesity and Overweight.”

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