Weight Management

Weight management is important in the management of Type 2 Diabetes. GPs and PNs are key advocates for highlighting the importance of a healthy lifestyle and to refer clients to additional supports as needed.

In 2007 50% of obese women described themselves as very overweight/obese compared to 34% in 2012. Only 25% of obese men described themselves as very overweight/obese.

Statistics

In Ireland:

61% of adults aged 16-65 years are currently overweight/obese
79% of adults >65 years are currently overweight/obese
Men are more likely to be overweight than women (42% vs 31%) with obesity being more closely aligned (25% men vs 22% women) ⁽¹⁾.

A health professional can assess whether a client's current weight is healthy or not. This means measuring weight and height accurately to calculate BMI.

BMI can be calculated using the BMI chart or use this online BMI calculator

Waist Circumference

Waist circumference (WC) is a useful measure to check if someone is carrying excess weight. WC is an independent risk factor for Cardiovascular Disease (CVD) regardless of weight.

A WC > 37” (94cm) for men or >32” (80cm) for women indicates an increased risk of CVD

A WC > 40” for men or >35” for women indicates a substantially increased risk of CVD

26% of adults in Ireland have an increased risk of CVD based on WC and 37% have a substantially increased risk ⁽¹⁾.

Learn how to measure WC accurately

Raising the issue

The topic of weight can be a sensitive area for a health professional to raise. The following can help:

If weight monitoring becomes a routine part of the consultation, then it becomes easier to discuss.
Discussing weight with the help of a BMI chart can be a useful way to broach the subject.
The ICGP published a Weight Management Treatment Algorithm and useful resources to help assist health professionals in the assessment and discussion of the benefits of weight-loss in the management of overweight adults.

It can be encouraging for clients to understand the benefits of 10% weight loss and linking the benefits of any weight-loss to the relevant co-morbidities.

For an individual with diabetes, the benefits of a 10% reduction in body weight include:

30% ↓ in diabetes-related death
50% ↓ in fasting blood glucose
10mmHg ↓ in blood pressure
30% ↓ in triglycerides
15% ↓ in LDL cholesterol
10%↓ in total cholesterol
8% ↓ in HDL cholesterol

It is important to be realistic when discussing weight loss. Firstly, stop further weight gain, then aim for 5-10% weight reduction of original weight- maximum weekly weight-loss of 0.5-1kg. ⁽³⁾

Assessing current lifestyle habits

Currently in Ireland:

27% eat 5+ portions of fruit/vegetables daily
60% eat 4 top-shelf portions daily
42% eat 6+ top-shelf portions daily
14% consume sugary drinks daily (22% aged 15-24)

Any dietary advice given should take current dietary patterns into consideration and dietary changes should modify existing dietary habits.

Therefore, taking the above statistics into account, a food diary or a fitness diary can be a helpful first step or ongoing self-monitoring tool to help identify areas in the diet to change eg top shelf/portion sizes.

Healthy eating and lifestyle advice

If overweight, lifestyle changes including diet or physical activity are the first steps to manage weight.

The three key messages from the Healthy Eating Guidelines:

Limit high-fat, sugar, salt foods/drinks from the Top Shelf
Eat more vegetable/fruit: 5-7 servings
Know your serving sizes

Below are resources that can be helpful to give clients

Healthy Eating Guidelines
Healthy Eating Advice for Type 2 Diabetes and Pre-Diabetes
Community Nutrition and Dietetics section has information on the dietetic individual and group services available in CHE for weight management.

Physical Activity

Changes to physical activity in conjunction with dietary changes are the first steps to managing weight. See the Physical Activity and Exercise section for information.