Findings of the National Health and Morbidity Survey 2019 by the Ministry of Health Malaysia (MOH) showed that the prevalence of obesity rose from 17.7% (3.3 million Malaysians) in 2015 to 19.7% in 2019 [1].
Excessive weight gain or obesity can decrease life expectancy and put individuals at an increased risk of developing a number of severe health conditions such as heart disease, Type 2 diabetes and high blood pressure [1]. A 2015 review paper noted that obesity is observed in 75% Malaysians with type 2 diabetes [2].
Interestingly, a separate study found that every 5% reduction in fat was able to reduce an individual’s risk of diabetes by a whopping 25% [3]. Researchers also have shown that in people with Type 2 diabetes mellitus (T2DM) who achieve weight loss of 10% or more within five years of diagnosis are more than twice as likely to go into remission than people who maintain the same weight [4]. As such, it’s important for obese individuals to make lifestyle changes not only for the purpose of losing weight, but also lowering their risk of developing diabetes [1].
At the same time, when excess fat cells are “burned” through practicing healthy habits, it enables your body’s metabolic processes (a set of chemical reactions that occur in the cells of living organisms to sustain life) to achieve balance and re-adjust. This process and the sustained weight loss help patients with diabetes to manage their blood glucose levels within acceptable ranges.
Lifestyle Changes for Weight Loss and Better Diabetes Control
Lifestyle modification is the fundamental therapy to manage weight and diabetes. One essential lifestyle change that obese individuals should make to lose weight is to consume a nutritious and well-balanced diet. Obese patients with diabetes, on the other hand, can encourage both weight loss and effective diabetes control by emphasising carbohydrate intake through nutrient-dense sources that are rich in fibre, such as vegetables, fruits, legumes, whole grains, and dairy products, whilst ensuring an adequate intake of water on a daily basis [5].
Alternatively, patients can opt to consume foods that have a low glycaemic index (GI), or meals that contain a lesser amount of calories, as well as meals that vary in their carbohydrate, protein or fat content [6]. Patients can also list down their daily energy consumptions. This will help them to stay on the right track in their weight loss journey and help them to consume foods that meet their daily caloric needs [5].
Another lifestyle change that obese patients should make is to exercise more frequently. It is recommended that patients aim for a minimum of 150 minutes of moderate-intensity exercise, combined with strength or resistance training 2-3 times every week [7].
However, some individuals may still struggle with weight loss despite taking a healthier lifestyle approach.
Why Are You Still Unable to Lose Weight Despite Adopting a Healthier Lifestyle?
There are multiple factors contributing to this struggle. First, lack of sleep. Getting quality, restful sleep plays an important role in helping obese individuals to lose weight. If an individual is not getting enough sleep daily, it can cause them to experience an increase of appetite, which in turn contributes to a higher calorie intake than what is required [8].
Besides that, the use of certain types of medication for other illnesses may inhibit weight loss, and could potentially cause individuals to experience weight gain as a side effect [9].
Enter a new class of anti-diabetic medications known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which have been found to be effective in regulating a patient’s blood glucose levels and promoting healthy weight loss.
Are GLP-1 RAs Really Effective for Weight Loss and Diabetes?
Interestingly, yes. This is because the administration of GLP1-RAs promotes an increase in insulin secretion, a decrease in glucagon secretion, slow gastric emptying and increased satiety, which work in tandem to help diabetes patients achieve good glycaemic control, as well as healthy weight loss effectively.
This weight loss effect of GLP1-RAs can be attributed to the synergistic contribution of actions in the brain and gut, which is independent of the presence of food in the stomach or gastric emptying [10]. For instance, some small, long acting GLP-1 RAs such as liraglutide and semaglutide are effective for weight loss. This is mainly due to the medication’s ability to work centrally to promote a longer duration of satiety and improve reward and eating behaviour, thus reducing energy intake [10]. In fact, liraglutide is prescribed at a higher dose to manage obesity effectively in patients with or without diabetes [11].
That said, it is recommended for you to seek consultation with a doctor before opting to include GLP1-RAs as part of your diabetes management and weight loss plan. These medical professionals are best qualified to determine the impact of weight on your health when prescribing appropriate glucose-lowering therapy options [9].
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