General

Losing Weight in a Diabetic or Non-Diabetic Patient: The Secret of a Holistic Slimming Program

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3 Jul 2016 - General
 

Ariel S. Torres, M.D.

Center Medical Doctor, International Slimming Center

 

 

When diabetic clients come in for a slimming program, the first thing that they say is, “Doc, I’m a diabetic so I cannot go on a diet.   So just recommend to me the treatments that I need to undergo but no diet, please.”   This is totally wrong.   Nothing can be farther from the truth because the diet given to a non-diabetic person in a slimming program is similar in many respects to what we give a diabetic patient.   In connection to sugar, there are 3 common denominators in persons who want to lose weight, whether diabetic or non-diabetic:    a) blood sugar levels should not dramatically go up or down, b) there should be no excess sugar that eventually will be stored as fat, and c) sugar burning should be promoted as a prequel to fat burning.   All these 3 are actually directly intermingled and related causally.  

 

Before I discuss what I mentioned above in more detail, let me first give you the secret of losing weight in a holistic slimming program.   There are those who go on crash diets and lose 10 lbs in 10 days.   There are those who exercise rigorously: morning, afternoon and night, and lose more weight together with additional body shaping and muscle firmness.   Then, there are those who take a cocktail of diet pills and not only lose weight but also several inches in body size in a dramatic “wardrobe-changing” fashion.   But if after 3-6 months they regain the pounds and inches they lost, then it’s as if they never lost them from the start.   This is called recidivism (losing weight intentionally and regaining the same weight unintentionally).   Most of the time due to rebound phenomenon, they even add more weight and inches from what they originally lost and they end up worse than when they started.   The secret of losing weight is actually being able to maintain whatever you will lose AND NOT HOW MUCH YOU CAN LOSE IN A SHORT SPAN OF TIME.   From the medical point of view, weight loss may be defined as any weight lost and maintained for at least a year.   Therefore, the weight loss should not only be apparent (for motivational purposes) but more importantly, sustainable.   This is where proper nutrition and good eating habits come in.   The food SHOULDN’T BE THE ONE RESPONSIBLE FOR YOU TO LOSE WEIGHT.   However, it should be able to maintain your weight and not add to the existing problem.   The food should just be enough for your daily activities.   So just by increasing your calorie burning processes whether thru physical exercises on your own or scientific treatments at internationally renowned slimming centers, you will lose weight.   Anytime you stop these additional activities, you won’t be regaining the weight you lost because you were maintaining your weight before you added these activities.   The only advantage of slimming centers is that the treatments do not increase your hunger stimulus since the parameters are set in a controlled and tested fashion, unlike physical exercise (especially anaerobic and strenuous types) that may sometimes increase your food intake.   In the latter cases, you won’t be losing weight because even though you increased your activity, you concurrently increased also your food intake.   Worse is when you stop exercising but do not lower the increased food intake commensurate to your decreased daily activity.   This is typical of what happens to athletes that go on retirement.   In some instances, this has led to their demise (and not necessarily old age or their mature age upon retirement).

 

Now going back to the 3 common denominators in persons who want to lose weight, whether diabetic or non-diabetic, being able to maintain weight is the final end result of these 3 for a non-diabetic client while being able to avoid the insidious deleterious multi-organ effects of abnormal blood sugar levels is the ultimate goal of these 3 for diabetic patients.   First, blood sugar levels should not go dramatically up or down.   The blood can maintain only a high sugar level for a short time.   The sugar then enters the cells for use as energy.   If not used, they are stored as glycogen in the muscles and the liver.   If still in excess, it is then stored as fat.   Therefore, high blood sugar levels should be avoided to prevent deposition of fat.   On the other hand, a low sugar level will promote hibernation.   The normal metabolic rate will slow down in response to starvation, which means less calorie burning.   Practical Application:   HAVE SMALL FREQUENT MEALS. AVOID LARGE MEALS THAT ARE FEW AND FAR BETWEEN.   Second, there should be no excess sugar that eventually will be stored as fat.   Metabolism is two parts:   catabolism and anabolism or in layman’s term breaking down to use energy and creating to store energy.   This happens concurrently in our body all throughout the day.   However, we are more catabolic at daytime and more anabolic at nighttime.   This is the diurnal variation of metabolism.   We need more energy at daytime for activities and we replenish or repair at nighttime when we rest and sleep.   Therefore, carbohydrates are good if you can burn them but are bad and turns to fat if you don’t burn them.   Practical Application:   HAVE MORE ENERGY FOOD DURING THE EARLY PART OF THE DAY BUT LESS DURING THE LATER PART OF YOUR DAY.   INSTEAD, HAVE MORE REPAIR FOOD DURING THE LATER PART OR YOUR DAY.   THIS ACTUALLY APPLIES EVEN DURING THE LATER PART OF YOUR LIFE (since older people get damaged tissues more easily and need more repair than younger ones).   Third, sugar burning should be promoted as a prequel to fat burning.   In order for sugar not to accumulate as glycogen and spill over as fat deposition, sugar should be burned by cells so that there would be continuous demand for its conversion from blood.   This is best done thru the oxygen rich process of glycolysis of sugar as against beta oxidation of fat.   Practical Application:   PROMOTE REPETITIVE LOW ENERGY AEROBIC ACTIVITIES AND AVOID SHORT TERM HIGH ENERGY ANAEROBIC ACTIVITIES.   However, doing simultaneous aerobic and anaerobic levels but intermittently in one specific type of exercise is still good since you burn sugar and fat at the same time.   A classic example would be running, wherein you sprint for a short time and then jog for a long time and repeat the process continuously.

 

Special Note:   Though 60% of diabetics can be cured by diet alone, there will always be patients who will require medication.   These medications will either be dictated by the diet of the client or in rare instances the other way around.   In short, the medication and the food that will be given (either before or after) should be planned and go hand-in-hand in maintaining a trough level of blood sugar.   Before weight loss or slimming can occur in a diabetic patient, the blood sugar should be controlled first.   This means that the sugar is being drained from the blood and pushed into the cells for eventual use in oxidative phosphorylation in the mitochondria.   Otherwise, no amount of activity will make the patient lose weight since the sugar in the blood but outside the cells cannot be used.   In fact, metabolic acidosis will even be promoted if beta-oxidation of fat will be the one responsible for supplying energy for strenuous activity in a chronic manner.

Thanks Dr Ariel Torres. As you presented an article and guideline on diet for weight lost , I thought it will be a good idea to know more about the background of the article. It is only fair for me to judge each article on its merit before I apply it to my patient. I have requested references from all doctors who posted advice here for reference. I really mean literally everyone as it helps in our learning and I am sure all physicians here are curious about the source of your research. Please d...
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I was thinking of what to write as my second article (in order to get a raffle ticket for the contest on the 10 FitBit Flex Trackers c/o MIMS) and I think I’ll post tomorrow something about “The Timing and Type of Food” and its importance in Weight Maintenance as a precursor to Weight Loss. Thanks for giving me some ideas on what to post next. That will probably be my last article here in MIMS (since that will already qualify me for the contest). Like I said in my earlier post, I don’t rea...
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Hi Nurse Indira. Thanks also for appreciating my article. And yes, you are right. Breakfast is mandatory. Food Intake 2 hours upon waking up is important. Whatever large amount you ate the night before, only a small amount of it can be stored for use the next day. It’s a misnotion that you can use excess food the night before as a reason for missing breakfast the next day. Upon waking up, the small amount stored will start to be depleted and slow down your metabolism. So if you a...
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Regarding 60% of diabetics can be cured by diet alone; I don’t have any data on that. It was what I was taught during internship and residency by Endocrinologists at that time (1990’s). They didn’t want us giving Anti-DM Hypoglycemic medications left and right without trying natural methods (lifestyle changes) first. Not really sure if that has been debunked by the latest and current data but again from my own professional and clinical experience, a slight majority (> 50%) can be cure...
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The other tips that I wrote is based on my learned appreciation of the book, “Guyton’s Medical Physiology”. It’s all there - like the normal gastric emptying time is 8 hours so if you eat energy food (carbohydrates) during the later part of the day (dinner time and bedtime), glucose will become bioavailable once you are already sleeping (anabolic), so the liver immediately decides to create triglycerides from glucose (3 carbon molecules from Kreb Cycle after Glycolysis becomes 3 free fatty aci...
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Regarding the diagram on Weight Loss and Weight Re-gain, I made that one personally based on the data by physiologist Ancel Keys in his treatise on “The Minnesota Starvation Experiment” (The Biology of Human Starvation, Vol. 1 & 2, 1950) after personally hearing a lecture by Dr. Abdul Dulloo on his MATADOR Study – Minimizing Adaptive Thermogenesis And Decreased Obesity Rebound (Adipose-Specific Control of Thermogenesis in Body Weight Regulation, Int’l J. of Obesity, 2001) during the last Int...
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Hi Dr. Xie. Thanks for your inquisitive queries. No, I don’t have any Case Control Study or a Meta Analysis that will support the weight loss regimen that I pointed out. This is more of a “testimonial from my own clinical experience” in directly handling clients losing weight from 1998-2016. I did make an initial In-House Multiple Case study in 1999 involving 325 cases in one (1) Slimming Center wherein the result is half a pound per weight loss treatment (0.5195 lb by mean). I gave a...
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Hi Nurse Kathleen. Any chance that you are a fellow Filipino? Thank you for appreciating my article and your intention to share it with your patients. Regarding exercise, yes it’s good to do aerobic physical activity 3x a week but you need to do it for at least one hour. Better if you can do it more regularly 6x a week even for just 30 minutes. The least effective are weekend athletes who do sports activities for 3 whole hours but only 1x a week (on weekends). The last one may not be...
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First and foremost, I just want to say that I’m not “techie” so I’m not sure if this reply of mine will be posted and reach the concerned persons. I wanted to reply discretely - direct to the persons (my nurses tell me that you call it Private Messaging) but I don’t know your e-mail accounts and how to access them thru MIMS. I DO NOT HAVE any Social Networking accounts (Facebook, Tweeter, Instagram) but only a Professional Network account in LinkedIn. Second, I have to be honest that I only...
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Thank you Dr. Ariel Torres for sharing this information. There are many people who believe in intake of adequate diet at proper time intervals though fewer believe that eating habits and change in lifestyle is a way to maintain normal weight. Intake of adequate amount of food helps in proper metabolism and maintaining weight of the body. Diabetes patients require to be little more cautious than normal people as an imbalance may cause serious effects on their health. Breakfast is mandatory for di...
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Thanks Dr Ariel Torres. Is there a case control study or meta analysis which support the weight loss regimen you pointed out? It does sound convincing your explanation. What is the success rate at your center and the average weight loss , compliance rate etc? Is there any reference you can direct me to so I can give similar advice to my patients. Do you mean 60% of diabetics can be controlled by diet alone? You article may convince a lot of healthcare professional to communicate your advice to p...
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As a Diabetic Link nurse in my current workplace, this is something worth sharing to our patients. Especially to this one particular patient who is quite challenging to manage despite the fact that she is already suffering from ESRD plus Diabetes. She's a challenge because it seems like she doesn't bother anymore or doesn't look interested with whatever advice given to her. Every dialysis session, we can always see her eating a big amount of cold pasta. As for me, this lose weight ar...
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