I have been researching and practicing internal medicine for 20 years, with one of my particular foci being diabetes. Within that time there has been a growing body of evidence showing a relationship between type 2 diabetes and an excess of body fat, especially around the mid section. That is not to say that all patients with additional belly fat will develop diabetes or that all patients with type 2 diabetes are overweight, but studies have shown an irrefutable correlation between these two factors. In fact, all major medical sources now affirm that 85% of patients with type 2 diabetes are overweight.
There is another correlation as well, although many major diabetes organizations refrain from discussing it in mainstream articles. It has become commonly observed by many physicians, and demonstrated in controlled studies, that a reduction in body fat in overweight individuals with type 2 diabetes correlates with a reversing of their condition. In fact, most of those patients that reach their ideal body weight eliminate insulin resistance altogether and show perfectly normal blood glucose levels in all tests (effectively curing their diabetes).
This second correlation - although in essence simply a reversal of the first - has yet to get the same level of attention as the first, although I will not speculate as to why. Nevertheless, every physician concerned with diabetes that I have spoken with agrees that type 2 diabetes in overweight patients is reversible through weight loss. The question that remains among them is how to go about getting the patients to lose that weight and refrain from regaining it.
Optimizing the Correlation
Any method of weight loss can have a reversing effect on the symptoms of type 2 diabetes in obese adults or eliminate them altogether, so which is the most effective?
Of course there are invasive surgical shortcuts like liposuction and lap-band surgery to reduce weight quickly, but both of these can be prone to backsliding effects in the long term. Just because a person has made an instant physical change with surgery, doesn't mean they aren't the same person with the same patterns.
Many liposuction patients begin gaining weight again sometime afterwards, filling up the fat cells that remained after surgery. Lap-band patients will eat smaller portions after surgery and indeed lose weight initially. However, although their esophagus was banded to be smaller, over time the stomach can get bigger as they return to their old eating habits and levels of consumption. Habits and craving are very powerful things that remain in the mind, unaltered by surgery.
There is also a myriad of diets being offered that eliminate groups of foods, but follow-up studies show that patients rarely stick to them. It is hard enough for a patient to choose among all the diets, but nearly impossible for them to find one they enjoy. That is because the people who design the diets are trying to find a plan and set of food that works for everybody. The designer does end up creating one everyone agrees on: they agree it is difficult and unenjoyable.
These surgical and dietetic methods are missing one very important thing. They completely focus on a quick physical change in the patient with no consideration of the patient's current mentality, need for lifestyle changes, or long-term success. Advocates of these quick-fix methods are selling a temporary solution like an automobile mechanic wrapping a piece of tape around a leak and saying "all better now". Of course the patient can lose weight initially, but they will gain the weight back.
Please read more at reversedm2.com.
Dr. Nopparat Panthongwiriyakul, http://www.reversedm2.com
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