The good news is that seeing improvements in your management of type 2 diabetes doesn’t require dramatic weight loss. In a study published in September 2019 in Diabetic Medicine, researchers found that people with type 2 diabetes who lost at least 10 percent of their body weight during the first years after diagnosis had double the likelihood of seeing their disease go into remission compared with those who lost less weight or none at all. (The study authors defined diabetes remission as having an A1C below 6.5 percent without diabetes medication or bariatric surgery.) If that seems like a tall order, aim for a weight loss of 5 percent, says Jennifer Shrodes, RD, CDCES, at The Ohio State University Wexner Medical Center in Columbus. “Body fat is a component of insulin resistance. You want insulin to work as effectively and efficiently as possible, and when you lose some fat, you can usually see insulin resistance improve,” she explains. Along with lower and steadier blood sugar levels, weight loss may affect other aspects of your health, such as lipids and blood pressure, and getting a handle on these numbers is at the core of diabetes management, notes an August 2017 paper in Diabetes Spectrum. After all, people who have diabetes have double the risk for developing heart disease or having a stroke compared with those who don’t have diabetes, according to the Centers for Disease Control and Prevention (CDC). Lifestyle habits like reducing calories, staying active, and receiving the support you need to stick to the plan are some of the steps that can move the needle on the scale. But what you might not realize is that even if you think you’re doing everything right, you may be sabotaging your own your weight loss efforts without even knowing it. Here are seven surprising factors that may be standing between you and a healthier weight — and three diabetes experts’ tips to tackle these obstacles and get back on the path to success.
1. You’re Overwhelmed
Remedy: Commit. Renew the commitment daily — in increments, if necessary. If you’re overweight or have obesity, the prospect of losing weight then maintaining it can be daunting. “It’s a commitment and you need to renew that commitment every day,” says Margaret Powers, PhD, RD, a clinician and research scientist at the International Diabetes Center at Park Nicollet in Minneapolis. To make taking and keeping unwanted weight off less intimidating, she suggests thinking about the commitment as though you’re making it for just today. “Start by committing to making healthy choices in the morning,” she recommends. “And then add on.” Commit to making healthy choices at lunch, then at snack time, after work, at dinner, and so on. Do this each day and keep working at it even if you slip into old habits at times. “The hardest thing about losing weight is maintaining it,” Powers says. “It takes a lot of work, but renewing that commitment sets you up for success every day.” In addition, making changes that you can work into your lifestyle for the long term is key. “If you can’t sustain these changes, it will backfire,” says Shrodes. A certified diabetes care and education specialist (CDCES) can help provide the education you need and empower you to pinpoint the changes you can make for lasting results, she says. You can find one via the American Diabetes Care & Education Specialists. RELATED: 10 Medical Professionals Who Can Help You Manage Diabetes
2. You Don’t Get Enough Quality Sleep
Remedy: Aim to get seven to nine hours of quality zzz’s each night; choose diabetes-friendly nighttime snacks. Not only is a lack of sleep tied to insulin resistance, it can wreak havoc on hormones associated with weight gain. When you’re not getting enough sleep, your body makes more ghrelin (an appetite-stimulating hormone), and less leptin (an appetite suppressant), notes the National Sleep Foundation. Lack of sleep is also a stress on the body, says Shrodes: “One way the body reacts to stress is often with elevated blood sugar.” Yet another basic problem with staying up late, Powers says, is that people tend to eat more. “Being up late makes you more likely to snack,” she says. You may also be more inclined to choose high-calorie sweet, starchy, and salty late-night snacks, according to past research. Many starchy snacks are not the best choice for balancing your blood sugar, losing weight, or maintaining a healthy weight.
3. You Go for Long Periods Without Eating
Remedy: Incorporate diabetes-friendly snacks into your meal plan and don’t skip meals. This is particularly common in newly diagnosed people with type 2 diabetes. “They’re afraid to eat something and affect their blood sugar,” explains Arycelis Segura, CDCES, a training specialist at Mount Sinai Health System in New York City. But they’re not the only ones. Segura says that it’s also a problem among people who’ve been managing diabetes for a while but haven’t been educated around dietary issues as well as in people who work double shifts, a situation that may make stopping for a meal difficult. But irregular eating habits are linked with weight gain, according to a study in April 2018 in the journal Eating Behaviors. RELATED: 7 Healthy Meal Tips for People With Diabetes
4. You Eat Healthy Foods but in Large Quantities
Remedy: Keep eating healthy foods, but watch portion sizes. Eating foods that are good for you is a basic tenet of a healthy diabetes diet, but serving sizes and portion control are also important. “Lots of times people equate ‘healthy’ to ‘unlimited,’” says Segura. “I have patients that are picking really healthy foods, like nuts, olive oil, and avocados, but failing to realize that they’re chock-full of calories.” For a fuss-free style of eating that doesn’t require measuring out portions, Shrodes suggests following the plate method. According to the American Diabetes Association’s plate method calls for filling ½ of your plate with nonstarchy veggies, ¼ with lean protein, and ¼ with starch. For example, you might fill your plate with a piece of cod, broccoli and peppers, and quinoa. “If you were overeating before and use this method, you’ll naturally manage your blood sugar, cut calories, and start to lose weight,” she says.
5. You’re Eating Lean Proteins but Using Unhealthy Cooking Techniques to Prepare Them
Remedy: Sauté using cooking spray or small amounts of olive oil. Instead of frying lean proteins, bake, broil, grill, steam, or stir-fry them. Proteins, like beef or poultry, don’t necessarily affect blood sugar, but fattier varieties, such as sausage, regular ground beef, or a heavily marbled steak, can affect cholesterol and your waistline, Segura says. Lean proteins are better for weight loss and they’re recommended as part of a healthy type 2 diabetes diet, but preparation is also important. “Frying or sautéing with butter or too much oil can sabotage weight loss,” Segura says. Avoid butter and margarine when cooking and switch to a healthy cooking oil, such as olive, peanut, or safflower oil, suggests the American Diabetes Association (ADA). Keep your portion size to one tablespoon, but often a teaspoon is plenty for cooking, the organization notes. RELATED: The Best and Worst Diabetes Food Advice Out There
6. You Graze Mindlessly
Remedy: Practice mindful snacking; replace grazing with a healthier alternative. Healthy snacking is encouraged in a diabetes diet, but mindlessly grazing can lead to extra calories and weight gain. “It only takes an extra 100 calories a day over what your body needs to put on 10 pounds a year,” Powers says. “That’s an extra slice of toast or about 6 ounces of juice.” Conversely, she says, if you cut back 100 extra calories a day, you could lose 10 pounds in a year. If you’re a mindless grazer, try scheduling and preparing diabetes-friendly snacks in advance. “Don’t eat as you’re walking through the kitchen. Sit down, enjoy, and be mindful of the food,” Powers advises. She also suggests replacing grazing with another behavior. For example, skip the trip to your pantry during the workday and grab an herbal tea with lemon instead.
7. You Think That Because You Exercised You Can Eat Dessert
Remedy: Exercise, but refrain from eating the dessert unless you’ve included it in your calorie and carb budget. Try to satisfy your sweet tooth in a way that’s low or no calorie, and fits within your carb goal. Managing diabetes well means controlling your blood sugar by balancing what you eat and drink with physical activity and any diabetes medication you take. There are certain trade-offs you can make when it comes to balancing blood sugar. For example, if you want to have a cookie or another sweet for dessert, Segura suggests keeping the prior meal starch-free. But “if your overall goal is to decrease calories and lose weight, then having that dessert isn’t necessarily the best choice,” Powers notes. This is because exercise is unlikely to offset the amount of calories in the dessert. “If you look at how many calories you expend when walking a mile it’s not a lot of calories,” says Powers. Remedying these obstacles to weight loss may not solve all of your problems, but it can help you make progress. If you’re still having trouble shedding pounds or maintaining a healthy weight, talk to your doctor or a CDCES about adjusting your plan. Some people may need more significant weight loss interventions and support to achieve their goals. Learn more about managing your weight while living with diabetes in Diabetes Daily’s article, “How to Lose Weight – For Real This Time.”
