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Diabetic Weight Loss in Five Steps
By Frederic J. Vagnini, M.D., FACS, and Lawrence D. Chilnick,
Authors of The Weight Loss Plan for Beating Diabetes: The 5-Step Program That Removes Metabolic Roadblocks, Sheds Pounds Safely, and Reverses Prediabetes and Diabetes

Weight loss for a diabetic, especially those told repeatedly by physicians or nutritionists that their daily diet is the problem, often feel stymied by this challenge that's very hard to meet. Here's a step-by-step method that targets the underlying effects of diabetes that are really causing weight gain. This approach can work for almost every type-2 diabetic, and is not a roller coaster ride on the branded, pre-packaged diets that never work over the long run.

This Five Step Plan has been shown to be very successful when tied together and followed in this logical order:

  • Education

  • Medication

  • Nutrition

  • Exercise

  • Lifestyle

Meeting the challenge of diabetic obesity and even keeping a desired weight in check requires defeating a set of roadblocks -- metabolic disorders -- that have to be treated properly. The Five Steps are successful because each focuses on eliminating the biological risks and reducing the effect of personal risk factors. In turn this helps maintain glycemic balance and fewer calories are consumed.

Step One: Education -- The More You Know The More You Can Lose

One key reason why so many people who are type-2 diabetics have lost control of their weight is that they do not understand their "risk factors" that were in play while they were pre-diabetic which led to full fledged type-2 diabetes. Learning all you can about the underlying roots and causes of your diabetic or pre-diabetic condition is a critical starting point to preventing over-eating and weight gain. A lengthy and in-depth medical history and work-up to determine the presence of both genetic diabetic and cardiovascular risk should be done by your physician before attempting any weight loss program. Knowledge gives you power, fortitude and greater ability to control your condition and to attack the metabolic roadblocks that diabetes has created.

Diabetics trying to lose weigh often face Metabolic Syndrome, a combination of lifestyle and "food-style" factors including:

  • Visceral Adiposity -- the belly fat, or roll of fat around the waist

  • High blood pressure

  • Low HDL ("good") cholesterol

  • High triglycerides

  • Elevated blood glucose levels causing organ damage.

Other weight loss roadblocks:

  • Inability to burn fat because of metabolic changes

  • Fluctuating insulin and glucose levels that provoke hunger cravings.

  • Fatigue.

  • Musculoskeletal problems often are secondary to diabetes and obesity

  • Post-prandial hyperglycemia -- a rise in blood sugar after a meal

  • Gastroenterological side effects

  • Carbohydrate addiction

  • Food allergies

  • Fluid retention

  • Low testosterone and low libido

  • Pulmonary

  • Cardio and peripheral vascular complications

Step Two: Medication -- Follow the Doctor's Orders

Diabetes medications are not a stand-alone solution for weight loss or glucose control, but they play an extremely important role in achieving your primary goal -- diabetes management leading to weight loss. One new approach is called the Triple Therapy Protocol to reduce elevated sugars, insulin resistance and beta cell preservation and regeneration using Metformin, TZD and Byetta. In general, all treatment decisions are geared to the spectrum of severity of the disease. Hormone treatments, testosterone, thyroid and adrenal function also should be discussed with your physician.

Step Three: Nutrition -- Eat Well and Lose Weight

Any diabetic weight loss program requires a sound nutritional program including targeted supplements and proper foods based on a modified Mediterranean diet. By seeking help from a specialist in diabetic diet you gain:

  • The benefits of a complete nutritional evaluation.

  • Development of a meal plan designed to stop weight gain and reduce it through a balance of proteins and carbohydrates

  • Control of glucose and insulin levels

  • Concentration on a wide range of proteins

  • Varied, moderate, low-carbohydrate meals

  • A correct level of carbohydrates/starches in each meal (grams per day)

  • The strong use of nutraceuticals (supplements and vitamins) to control appetite

  • Feeling satisfied/full without overeating or eating the wrong things

  • Enhanced thermogenesis (fat-burning effect)

  • Reduced beta-cell stress syndrome

  • Learning the value of high-fiber foods

  • Use of foods with high nutrient density

  • Identifying low-glycemic foods

  • Making a sound meal plan and stick to it

Step Four: Exercise -- Building Mind and Body

Exercise using the patient's own environment to improve both mind and body are essential to a stress reduction program aimed at ridding the patient of stressors at home and in the workplace. A structured program featuring low impact exercise, some weight work but also meditation, yoga and personal development activities (i.e. adult education) to improve lifestyle overall are essential.

There is definitive proof that if you are in a pre-diabetic state, exercise can keep you from becoming a diabetic -- even if all you do is some very moderate form of exercise on a regular basis. Other studies have indicated that even limited periods of exercise (e.g., two months) will have a positive effect on your A1C value and it can be significant. In one study A1C levels dropped from 8.31 to 7.65, despite the fact that there was no appreciable weight loss in the two groups of participants in the study.

Exercise, except in people who have injuries or severe health problems such as advanced heart disease, pulmonary conditions, or orthopedic restrictions, is always beneficial, no matter what level you can manage. For diabetic patients, exercise at least 30 minutes a day, 3-5 days a week. Exercise has one other great benefit -- it does wonders for mental health.

Step Five: Lifestyle -- Change Is Never Simple (But It Does Make a Difference)

For anyone who is at risk for type 2 diabetes or heart disease, making lifestyle changes is the final critical step in the five-step plan for diabetes control and weight loss. Lifestyle changes have been proven repeatedly to be one of the best ways to reduce the potential of pre-diabetes progressing to type 2 diabetes. Studies show that a better lifestyle can actually help you modify, reduce, and control the genetic roadblocks and risks you were born with.

Your own contribution to behavioral change may be the make-or-break factor. This doesn't mean you will be sent home from the doctor's office with an unbreakable list of do's and don'ts, rather a lifestyle plan you create together and that you implement, with a support system in place.

©2009 Frederic J. Vagnini, M.D., FACS, and Lawrence D. Chilnick, authors of The Weight Loss Plan for Beating Diabetes: The 5-Step Program That Removes Metabolic Roadblocks, Sheds Pounds Safely, and Reverses Prediabetes and Diabetes

Author Bios
Frederic J. Vagnini, M.D., FACS, coauthor of The Weight Loss Plan for Beating Diabetes: The 5-Step Program That Removes Metabolic Roadblocks, Sheds Pounds Safely, and Reverses Prediabetes and Diabetes, is a board-certified cardiovascular surgeon whose understanding of the ravages of cardiovascular diseases is grounded in twenty years as a cardiac surgeon. He hosts a popular call-in radio show and has published several books, including The Carbohydrate Addict's Healthy Heart Program, a New York Times bestseller.

Lawrence D. Chilnick, coauthor of The Weight Loss Plan for Beating Diabetes: The 5-Step Program That Removes Metabolic Roadblocks, Sheds Pounds Safely, and Reverses Prediabetes and Diabetes, is the authors and creator of the New York Times bestseller The Pill Book, which has sold 17 million copies and is still in print after more than two decades. He is a publishing executive, editor, teacher, journalist, broadcaster, and author of several popular health reference books, electronic products, audiotapes, and videos.

For more information please visit http://vagnini.com and fairwindspress.com.