Weight management

Obesity is a chronic, progressive and relapsing disease, characterized by the presence of abnormal or excess adiposity (amount of body fat). It is considered a chronic disease because managing it is a lifelong process. Weight management is far more complex than just what you eat and drink and how much physical activity you participate in.

An estimated 80% to 90% of people with type 2 diabetes have overweight or obesity. Obesity is also becoming more prevalent in people with type 1 diabetes; one study reported a sevenfold increase in the last 20 years. Intensive insulin therapy and some antihyperglycemic medications are associated with weight gain which, in turn, contributes to obesity-related health conditions.

The relationship between increasing body fat accumulation and adverse health outcomes exists in men and women of all age groups. If you have overweight or obesity,  weight loss has been shown to improve glycemic control by increasing insulin sensitivity and glucose uptake and diminishing hepatic glucose output from the liver; however losing weight and maintaining that loss longer term is difficult. With multiple factors such as your environment, genes, emotional health, sleep, medications and other medical conditions potentially impacting your weight, it is best to speak with a healthcare provider to determine what might be the best approach for you as an individual.

Ways to measure overweight and obesity

There are a number of ways to measure obesity. The most traditional way is to measure Body Mass Index (BMI). BMI is a simple calculation that uses a person’s height and weight to assign a weight classification. The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is height in metres squared. This value is then matched to a weight classification on a BMI chart, where underweight, normal weight, overweight and obesity are defined based on specific cut-offs.

For most adults aged 18 to 65, a BMI of 25 to 29.9 is classified as overweight an, a BMI of 30 or more is is classified as obesity. It is important to note that everybody has its own unique size and shape and that the BMI does not take into consideration muscle vs adipose tissue, genetics, gender or other factors that influence weight and weight distribution. It is a good starting point but should be used as only one factor in determining your health risks associated.

Waist Circumference (WC) is another traditional way to measure overweight and obesity. It is the measurement around the waist. Weight is considered in assessing disease risk, but the amount of adipose (body fat) tissue is not the only consideration. Where the adipose tissue is found in the body matters too. Too much adipose tissue around the waist is has been linked to health risks, including type 2 diabetes, hypertension, heart disease, fatty liver and other metabolic concerns. WC goals differ depending on ethnic background and gender. In general, a healthy WC for men is less than 40 inches (102 cm) and for women it is less than 35 inches (88 cm).

If your BMI and WC are indicative of overweight or obesity, losing a small amount of weight, slowly over time, is a healthy way to help reduce chronic disease risk and/or enhance management.

Note: these assessments should not be used on pregnant or lactating women, very muscular adults, adults with very lean build or children. BMI values are age and gender independent, and may not be correct for all ethnic populations. Please discuss your individual situation with a healthcare professional.

Healthy living benefits

Research has shown that health can be achieved at a variety of sizes and shapes. Specific studies have shown that a healthy lifestyle can:

• help you prevent or manage type 2 diabetes
• improve blood sugar, blood pressure and blood lipids (fats)
• reduce the risk of complications such as heart disease and stroke
• improve general well-being and energy levels

Healthy eating and physical activity are a few of many factors in managing and preventing chronic health conditions. Specific to weight, many things can make managing weight a challenge, including access to healthy food, safe environments for exercise, stress, some medical conditions and certain medications. Be kind to yourself and start slowly. Sometimes having a friend or family member or a member of your healthcare team to talk to can also be beneficial.

Who can help me?

There are many healthcare providers (e.g., registered dietitian, doctor, certified diabetes educator, pharmacist) who can help. Have a conversation with them before starting a new routine that might include weight loss medications, supplements, a different or intensive exercise plan or major changes to your diet.

Believe in yourself

Each person’s body has its own size and shape. Feel good about yourself and the behaviour changes you make. Remember to think long-term, set goals that help you achieve better health whether they are weight-related or not and try to make changes gradually.