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Diabetes

11 October 2019

You've lost the weight – now keep it off to keep diabetes at bay

In order to improve type 2 diabetes, great emphasis is placed on weight-loss. The key, however, is not to gain back those kilos.

The health of people with type 2 diabetes often improves dramatically with a 5% to 10% weight loss – but to sustain the benefits, you need to keep the weight off, new research claims.

After losing weight with a yearlong intervention, blood sugar and blood pressure levels go down and cholesterol results improve. People who kept at least 75% of that weight off for another three years retained or had even greater health benefits, the study reported.

'Don't revert to old habits'

"A lot of times, the emphasis is put on weight-loss programmes, but it's just as critical to help people maintain their weight loss," said study senior author Alice Lichtenstein. She's director of the Cardiovascular Nutrition Laboratory at Tufts University's Jean Mayer USDA Human Nutrition Research Center on Aging in Boston.

"People tend to think of diets as short-term, but it's really something that has to be lifelong. If you've found a successful way to lose weight, don't revert to old habits. Figure out how to incorporate the changes you made to lose weight," Lichtenstein suggested.

Excess weight is a major risk factor for developing type 2 diabetes. Studies have shown that losing weight can improve the symptoms of type 2 diabetes. And shedding around 10% of your body weight may even put the disease into remission, a recent study from Diabetic Medicine found.

The current study – published in the Journal of the American Heart Association – included more than 1 500 people with type 2 diabetes who were recruited for an intensive lifestyle intervention that lasted one year.

After losing weight, participants entered a three-year maintenance phase that included monthly group meetings. They were encouraged to get regular physical activity and to use a single meal replacement product each day.

Lichtenstein and her team looked at blood pressure and levels of blood sugar, triglycerides (a type of blood fat linked to heart disease), and HDL (or "good") cholesterol. They checked just after the weight loss and again after three years of maintenance.

Keeping weight off is no easy feat

The researchers tried to find the specific point where people started to lose the benefits of weight reduction, but couldn't find one. But they did find that when people who lost 10% or more of their initial weight regained about one-quarter of the lost pounds, the health benefits began to wane.

"The more weight loss that is maintained, the better people will be in terms of [heart and metabolic] health. There's a long-term benefit from maintaining weight loss," Lichtenstein said.

Dr Berhane Seyoum, chief of endocrinology at Detroit Medical Center, reviewed the study and said keeping weight off is no easy feat.

"Maintaining weight loss is the most difficult part as the body tries to bring back the weight that has been lost. Weight loss and maintenance is a lifetime struggle. You have to watch what you're eating and exercise," he said.

For type 2 diabetes patients who struggle with hunger, medications can help keep hunger at bay, Seyoum said.

Image credit: iStock

 

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Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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