Diabetes Care Community

Tag: weight management

  • The pros and cons of using body mass index (BMI)

    The pros and cons of using body mass index (BMI)

    [vc_row][vc_column][vc_column_text css=””]Body mass index (BMI) is a commonly used measure of body fat in adults. Maintaining a healthy weight and a normal BMI may help ensure your diabetes is well-managed and reduce your risk of complications. Read on to learn more about BMI and diabetes.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]What is BMI?

    BMI is a measure of body fat based on your height and weight. The higher your BMI, the more your health risks increase.

    Some of the risks associated with a high BMI are:

    • Type 2 diabetes
    • Heart disease
    • High blood pressure
    • Diabetes complications
    • Gall stones
    • Reduced mobility
    • Breathing problems
    • Certain cancers, including colorectal, kidney, uterine, pancreatic and liver cancer

    For people with pre-existing diabetes, it is important to maintain a healthy weight – and a BMI within the normal range – to prevent or reduce the risk of diabetes complications or other illnesses.[/vc_column_text][read-also-article article-slug=”how-do-i-know-if-i-am-at-a-healthy-weight/”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]How is BMI calculated?

    BMI is a simple calculation based on a person’s weight and height. Your weight in kilograms is divided by your height in metres squared, i.e. kg/m2.

    For example, a weight of 73 kilograms and height of 1.7 metres = 73 kilograms ÷ 2.9 metres = a BMI of 25.3 kg/m2. As per the classification below, this person would be considered ‘overweight’.

    The classification system for BMI is as follows:

    • Less than 18.5 = underweight
    • 5 to 24.9 = healthy weight
    • 0 to 29.9 = overweight
    • 0 or higher = obese

    Click here to use the Diabetes Care Community calculator to measure your BMI.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]What are the limitations of BMI?

    BMI measurements are not applicable to some people, including long-distance runners, weight lifters, pregnant women, the elderly and children. This is because BMI does not take into account whether the weight is carried as muscle or fat.[/vc_column_text][vc_single_image image=”40460″ img_size=”full” css=””][vc_column_text css=””]People with a higher muscle mass, such as athletes, may have a high BMI but not be at greater health risk. Those with a lower muscle mass, such as children who have not completed their growth or the elderly who may be losing some muscle mass, may have a lower BMI. During pregnancy a woman’s body composition changes, so BMI is not an appropriate measure at that time.

    What other methods are used to assess weight status?

    Besides BMI, some other methods can be used to assess your weight status. These include waist circumference and waist-to-hip ratio.

    Waist circumference is used to measure a person’s abdominal obesity. This is an important measure, as carrying too much fat around your waist is linked to complications of diabetes and other health risks.

    Waist circumference goals differ depending on a person’s ethnic background and gender. However, in general, a healthy waist circumference for men is less than 102 centimetres and for women it is less than 88 centimetres.[/vc_column_text][read-also-article article-slug=”the-role-of-diet-exercise-and-medication-for-weight-reduction-in-adults-with-type-2-diabetes/”][vc_column_text css=””]Waist-to-hip ratio is also used to measure abdominal obesity. It is calculated by measuring the waist and the hip, and then dividing the waist measurement by the hip measurement. For example, a person with a 75-centimetre waist and 95-centimetre hips has a waist-to-hip ratio of 0.79.

    A higher waist-to-hip ratio is associated with increased health risks, as well as increased risk of diabetes complications. The World Health Organization classifies waist-to-hip ratio and associated health risks as follows:

    Health risk Women Men
    Low 0.80 or lower 0.95 or lower
    Moderate 0.81 to 0.85 0.96 to 1.0
    High 0.86 or higher 1.0 or higher

    [/vc_column_text][read-also-article article-slug=”diabetes-and-weight-management-options/”][vc_column_text css=””]BMI is just one of many important measures that you can use to help manage your weight and reduce your risk of diabetes complications. Talk to your diabetes healthcare team about your BMI and what it means.[/vc_column_text][/vc_column][/vc_row]

  • BMI Calculator

    BMI Calculator

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    Welcome to Your BMI Calculator!

    Discover more about your body with our simple BMI Calculator. Just enter your height and weight, and let our tool do the rest. Whether you’re tracking your fitness goals or just curious, our calculator provides a quick assessment of your body mass index (BMI). Remember, while BMI is a useful indicator of weight-related health status, it’s not a comprehensive measure of overall health. Always consult with a healthcare provider for a complete health assessment. Start your journey to better health awareness now!

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     Understanding Your BMI Results

    Once you’ve entered your height and weight into our BMI calculator, you’ll receive a number indicating your BMI. This number places you within one of four main categories, each of which provides a general indication of your weight status and potential health risks. Here’s what each category means:

      • Underweight (BMI less than 18.5): Falling in this range may suggest that you are underweight, which could be associated with health issues like nutritional deficiencies and weakened immune function. It’s important to consult a healthcare provider to understand potential underlying causes and address them appropriately.
      • Normal Weight (BMI 18.5 to 24.9): A BMI in this range is generally considered healthy and associated with a lower risk of chronic diseases related to obesity. Maintaining a balanced diet and regular physical activity is recommended to stay within this range.
      • Overweight (BMI 25 to 29.9): This indicates that you may be carrying excess weight. Being overweight can increase your risk of developing conditions such as heart disease, type 2 diabetes, and high blood pressure. Discussing with a healthcare provider about your diet, physical activity, and other measures to manage your weight might be beneficial.
      • Obesity (BMI 30 or higher): This category is associated with higher risk levels for a variety of health conditions, including heart disease, diabetes, high blood pressure, and certain cancers. If your BMI falls into this range, it is advisable to seek medical guidance to develop a tailored plan that may include diet, exercise, and other treatments.

    BMI Categories Table

    BMI Range Category Health Risk Considerations
    Below 18.5 Underweight Increased risk of nutritional deficiencies
    18.5 – 24.9 Normal Weight Lower risk of chronic diseases related to obesity
    25 – 29.9 Overweight Increased risk of various health issues
    30 and above Obesity High risk of numerous health conditions

    NOTE: Rohrer’s Ponderal Index (PI) is an indication of a person’s weight relative to their height, and is used as a proxy measure of adiposity, similar to the Body Mass Index (BMI). PI is calculated as weight (kg) divided by cubed height (m3) (du V. Florey, 1970)

     

     

     

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  • Diabetes and weight management options

    Diabetes and weight management options

    [vc_row][vc_column][vc_column_text]Author: Dr. Stephen Glazer, MD FRCPC FCCP FAASM, Internal Medicine, Critical Care Medicine, Diplomat of the American Board of Obesity Medicine, President of the Canadian Association of Bariatric Physicians and Surgeons, Medical Director Bariatric Medical and Surgical Program, Humber River Hospital

    More than 5.7 million Canadians are living with diabetes and 11.7 million Canadians are living with either diabetes or prediabetes. The prevalence of diabetes has been increasing at an average rate of 3.3% per year. The incidence of obesity in adult Canadians is greater than 27%, or more than 7.3 million adults. Often diabetes and obesity coexist, and obesity is a risk factor for the development of diabetes. Read on to learn more about diabetes and weight management.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    How can nutritional intervention help with weight management?

    Healthy eating is important for all Canadians, regardless of their body size, weight or health. Canada’s Food Guide is an excellent resource for nutritional and food-related education. There are also many nutritional intervention options available for those living with obesity but there is no one-size-fits-all eating pattern for the management of obesity.

    Nutritional interventions should be based on your individual preferences. The focus should be medical nutrition therapy, which is the intake of specific types of foods and quantities directed at achieving healthy outcomes, in order to treat or minimize the consequences of obesity and other chronic diseases. When evaluating nutritional interventions, the focus should be on your eating patterns and food quality – as well as your relationship with food – and not exclusively numbers on a scale.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Is it important to watch your calories?

    Calorie restriction may be successful for short-term weight loss, but it is not sustainable in the long-term. Our brain is wired with complicated circuitry whose function is to control appetite and hunger, cravings and the regulation of body weight. Not only is the circuitry determined by our genes, other factors such as environmental, social, medication and illnesses, contribute to weight. Collaboration with a registered dietitian who has experience in obesity management and medical nutrition therapy to discuss calorie intake would be beneficial. You can ask your diabetes healthcare team to refer you to a dietitian.[/vc_column_text][read-also-article article-slug=”maintaining-a-healthy-weight-why-is-it-important-for-people-living-with-diabetes/”][vc_column_text]

    What is the role of exercise in weight management?

    Exercise is beneficial for achieving and maintaining weight loss. It can increase your metabolism to burn more calories and maintain or increase your lean body mass. In addition, regular physical activity is very important as it results in a wide range of health benefits in adults and may go beyond its effect on weight loss. It is recommended that you perform 30 to 60 minutes of moderate-to-vigorous-intensity aerobic physical activity at least 4 days per week, if not most days of the week. In addition, resistance training is effective in promoting weight maintenance and increasing muscle mass or fat-free mass and mobility. Aim to do resistance exercise 2 to 3 times per week.

    Regular physical activity may also improve blood sugar levels, insulin resistance, blood pressure and cholesterol. Beyond that, regular physical activity may improve quality of life, mood disorders such as depression and anxiety, and body image in adults living with overweight or obesity. Consult your healthcare team to see if it is safe to undergo increased physical activity. You can also seek guidance from trained experts in exercise programs.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    What about medications?

    For some individuals, there is a role for medications to help with the treatment of obesity. Medication should be part of a comprehensive approach to weight loss, including medical nutrition therapy and increased physical activity. Further discussion with your healthcare team about the use of medications for weight management should be considered on an individual basis.

    Can behaviour modification therapy help with weight management?

    Specialized programs that involve behaviour modification therapy in conjunction with meal replacements are available. These programs must be medically supervised and are accessed through centres of excellence for the treatment of obesity. Consult your healthcare team for further information and locations that offer these programs either in person, virtually or a combination of the two.

    What is the role of weight loss surgery and who is a candidate?

    At the present time, criteria for bariatric surgery are based on an individual’s body mass index (BMI), which is a calculation used to classify the degrees of obesity.

    • Class I obesity = individuals with a BMI greater than or equal to 30 kg/m2
    • Class II obesity = individuals with a BMI greater than or equal to 35 kg/m2
    • Class III obesity = individuals with BMIs greater than or equal to 40 kg/m2

    Although this measurement may have inherent inaccuracy in predicting individuals at risk for, or who possess the metabolic consequences of obesity, BMI remains the criteria for bariatric surgery based upon years of research.[/vc_column_text][read-also-article article-slug=”how-do-i-know-if-i-am-at-a-healthy-weight/”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont3′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Bariatric surgery is considered for individuals with a BMI greater than or equal to 35 kg/m2 who also have obesity-related comorbidities (such as diabetes, hypertension, sleep apnea or severe acid reflux) or individuals with a BMI greater than or equal to 40 kg/m2, even in the absence of obesity-related comorbidities. If you are currently smoking tobacco, you will not be eligible for bariatric surgery until you have stopped smoking.

    Several types of bariatric surgery are available, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch or single anastomosis duodeno-ileal bypass with a sleeve gastrectomy. Gastric banding is not considered a clinically useful tool for the management of weight loss as it is associated with significant complications, as well as failure in the management of weight loss.

    Surgery still remains the most effective tool for weight management with respect to quality of life, long-term weight management and resolution of obesity-related comorbidities such as diabetes, sleep apnea, fatty liver and elevated blood pressure. Bariatric surgery may also improve life expectancy. Long-term follow-up, including vitamin and mineral supplementation, is necessary for those undergoing bariatric surgery. These surgical procedures are performed in dedicated centres of excellence for bariatric surgery with a multidisciplinary team. To learn more about your eligibility for bariatric surgery, speak with your healthcare team.[/vc_column_text][read-also-article article-slug=”the-role-of-diet-exercise-and-medication-for-weight-reduction-in-adults-with-type-2-diabetes/”][/vc_column][/vc_row]

  • The role of diet, exercise and medication for weight reduction in adults with type 2 diabetes

    The role of diet, exercise and medication for weight reduction in adults with type 2 diabetes

    [vc_row][vc_column][vc_column_text]Type 2 diabetes and overweight or obesity commonly occur together. In Canada, two-thirds of all adults are overweight or obese, making overweight and obesity the most common chronic conditions in the country.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]During diabetes clinic, patients often tell me they want to lose weight. I find it is helpful to first discuss their current weight. The main tool we use for assessing and managing weight is body mass index (BMI), which is calculated using a patient’s height and weight.

    Although BMI may over- or under-estimate excess body weight in some circumstances, it is the most widely studied and easily available measure to classify weight. A normal BMI is 18.5 to 24.9 kg/m², overweight is 25 to 29.9 kg/m² and obese is 30 kg/m² or higher. Overweight and obese BMIs are associated with higher risks of certain health conditions, such as high blood pressure, type 2 diabetes and heart disease.[/vc_column_text][read-also-article article-slug=”how-do-i-know-if-i-am-at-a-healthy-weight/”][vc_column_text]

    What is a reasonable weight loss goal?

    For patients with diabetes who also have overweight or obesity, weight loss improves risk factors for heart disease and may increase lifespan. I find it helpful to discuss with patients their weight loss goals. Studies have shown that as little as 5% weight loss has substantial health benefits, which is often much lower than someone’s own weight loss goal. This means, for example, that someone who weighs 90 kg (almost 200 pounds) would have substantial health benefits by losing 4.5 kg (10 pounds).

    Once we have determined that a patient is overweight or obese and established their weight loss goals, the next step is to discuss a strategy for weight loss. The backbone of any weight loss strategy is lifestyle modification, which includes a dietary plan, physical activity and behaviour changes. Let’s discuss each of these components in more detail.

    Is there a specific diet to consider?

    Several diets are effective for weight loss, including the Dietary Approaches to Stop Hypertension (DASH) diet, the Mediterranean diet, low-carbohydrate diets or low-fat diets. It is important to highlight that no single diet has been shown to work best. Maintaining a diet over the long-term is more important for sustained weight loss than choosing a specific diet, so I recommend choosing dietary changes that fit well with someone’s lifestyle and are sustainable. Often, this means making modest changes over time rather than following extreme and restrictive diets.

    Is physical activity important?

    Physical activity should include at least 150 minutes per week of moderate physical activity, such as brisk walking. Maintaining physical activity over the long-term is important for achieving and sustaining weight loss, so I encourage patients to choose physical activities that they enjoy.

    Weight loss strategies that incorporate behaviour changes are more effective. Behaviour changes can include monitoring food intake and weight, and understanding and overcoming reasons for eating that may be unrelated to hunger. Behavioural goals should be set using the SMART framework, which are goals that are Specific, Measurable, Achievable, Reasonable and Time-specific.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    What about medications?

    If people with type 2 diabetes do not reach their weight loss goals despite lifestyle modification, then medication therapy can be added. Medications are considered in those with type 2 diabetes with a BMI of at least 27 kg/m² or higher. In Canada, there are currently 3 types of medications approved for weight loss: glucagon-like peptide-1 (GLP-1) receptor agonists, orlistat, and bupropion/naltrexone. Of these, GLP-1 receptor agonists are used most commonly in people with diabetes. In addition to weight loss, these medications lower blood sugars and reduce the risk of heart disease. Although weight loss with GLP-1 receptor agonists varies between individuals, patients may achieve up to 10% to 15% of total body weight. Obesity is a chronic medical condition and therefore, as for other chronic conditions, these medications need to be continued indefinitely for weight loss to be maintained.

    Surgery may be considered for some

    One final strategy is weight loss surgery, which is typically considered for people with type 2 diabetes and a BMI of 30 kg/m² or higher.

    It is important for people with type 2 diabetes who are overweight or obese to discuss their current weight and weight loss goals with their healthcare team. Diet, physical activity and behaviour changes can all be incorporated into your diabetes management plan, to help you achieve sustainable, long-term weight loss. If your weight loss goals are not being met, or if there are other issues (such as prolonged high blood sugars or heart disease), then GLP-1 receptor agonists might also be considered as a component of a weight loss strategy.[/vc_column_text][read-also-article article-slug=”maintaining-a-healthy-weight-why-is-it-important-for-people-living-with-diabetes/”][/vc_column][/vc_row]

  • Chris: Watch your weight

    Chris: Watch your weight

    People with type 2 diabetes write back to their younger selves, to share personal insights and reflect on their experience of living with diabetes and starting on insulin therapy.   In this post, Chris reflects on living with diabetes.

    At 31, Chris wasn’t the sort of person who was eager to curtail his social life. Convivial and gregarious, he was working long hours in healthcare and putting in long hours partying with friends. He frequented private clubs during the week, where he taught line dancing, and ventured out to bars at weekends.

    By the time he was diagnosed with type 2 diabetes, which ran in his family, he had dropped down to going out one or two nights a week because he felt so tired and lethargic. By taking medication and trying to watch his diet, it wasn’t long before Chris was able to resume his social schedule.

    “I was out three or four nights a week. I was single, had no children and loving life,” he remembers. “My grandfather had type 2 diabetes and he managed pretty well with it. So was I – or so I thought.”

    Now 44, he works as a senior support worker in a residential care home and lives in Littlehampton, UK. Chris is writing to himself shortly after being diagnosed with diabetes.

     

    Dear Big C

    Howdy. So, now you’re 31. Who’d have thought that would seem so old? You’ve just been diagnosed with type 2 diabetes. It seems so daunting, but really, it’s not. You’ll need to make alterations and a few years down the line it will seem a whole lot worse, but you will survive it all. You may lose control of your blood sugar levels at times, but you are capable of gaining back that control.

    So, what do you do now? Make changes to your diet. Watch what you drink. ‘It’s easy,’ they tell you. Well…we know it’s not. But you can do it if you try.

    The one big message I have is: watch your weight. I know you have always yo-yoed with your weight but now, more than ever, you need to gain control. The key is to change your lifestyle. So how do you do it? Start with taking command of your weight. Also, you don’t have to drink every weekend. Take some time off from drinking.

    The tablets and diet will work for a while and then the big one will land. The specialist will offer insulin therapy. Take it. You’ll think all sorts of negative things, but it’s not as bad as it seems. At work, you’ve drawn blood from enough people to know what you are doing. And let’s be honest, the needles are small.

    You’ll worry about hypoglycemia – the thought that you might suddenly experience an episode if you are driving or out of the house. In fact, at the start you’ll let your blood sugars run a little high if you know you are going out or having to drive so that the risk of a ‘hypo’ will be minimal. But later you’ll learn how to control your blood sugar levels and will be able to respond quickly. You can handle all this.

    As I – your future self at age 44 – write this now, I have hit another low. My blood sugar control is actually out of control, but I have a wonderful new diabetes nurse who is going to help me. So, just like you, I will need to look at my lifestyle and make a few changes. Also writing this letter to you is helping.

    It gets better. Honest.

    Love and hugs,

    Big C

    This story has been edited by Ellyn Spragins and shared with support from Novo Nordisk Canada. The views and opinions expressed are not representative of Novo Nordisk, and should not be considered treatment advice. Novo Nordisk has permission to share this letter and included personal details.

  • Diabetes diet cuts your risk of complications

    Diabetes diet cuts your risk of complications

    People living with diabetes are told how the diabetes diet can help keep blood glucose levels under control. But did you know that a diabetes diet cuts your risk of complications?

    It’s true! Heart disease, kidney disease, high blood pressure, eye problems and nerve damage are all high risk complications for people with diabetes, resulting from high blood glucose levels, high cholesterol, high blood pressure and poor weight control. These are all health issues that respond well to the diabetes diet.

    Check out how to cut your risk of the following health complications by making simple diabetes diet food choices.

    Food choices to cut the risk of heart disease

    The diabetes diet includes lots of high fibre grains and cereals, fruits, and vegetables. This reduces cholesterol and blood pressure levels and lowers your risk of heart attacks and stroke.

    Aim to include dietary pulses such as peas, lentils, chickpeas and dried beans. You can also substitute 2oz of unsalted nuts for daily carbohydrate choices.

    Make low-fat food choices, and especially aim to cut back on saturated fat. This means eating poultry without skin, lean meats, and low-fat dairy products. Keep meat portions to about the size of a deck of cards, and substitute fish for meat at least twice a week.

    Choose lower-fat cooking methods such as poaching, steaming, baking or grilling instead of frying. Cut back on processed foods.

    The diabetes diet also recommends reduced salt intake. This helps cut the risk of high blood pressure, which is a major contributor to heart disease.

    Food choices to cut the risk of kidney damage and eye damage

    The diabetes diet’s recommendations to manage blood pressure will also help cut your risk of kidney damage and eye damage.

    In addition to reducing the salt in your diet, aim to eat more high fibre grains, vegetables and fruits to help keep blood pressure within targets. Also increase your intake of nuts, fish, and pulses like dried beans and lentils.

    Other specific health benefits of the diabetes diet

    Following a diabetes diet will also give you other specific health benefits that will help cut your risk of numerous long-term complications. These benefits include healthier weight management and, of course, better management of blood glucose levels.

    Ask for a referral to the dietitian on your diabetes health care team for one-on-one discussion about the diabetes diet, and specific recommendations to suit your individual lifestyle and health needs.

    For a detailed chart of the health benefits of different food choices within the diabetes diet, see our expert dietitian’s blog Eating healthy to prevent diabetes complications.

    Quick tip –You will find some fantastic overall healthy eating tips in our videos on this site: Healthy eating for people with diabetes.