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What we get wrong about the weight loss revolution: Your Diabestie, Episode 16

Mila, a nutritionist and discussed the relationship between weight management and diabetes. she shared her personal journey and advocated for a balanced approach that combines weight loss drugs with lifestyle adjustments, emphasizing the need for support and understanding. The speaker also discussed the history and mechanisms of weight loss drugs like semaglutide and liraglutide, highlighting their potential benefits for managing diabetes and improving heart health.

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Obesity, Diabetes, Weight Loss Drugs and what we always get wrong | Your Diabestie Episode 16

Mila, a nutritionist and discussed the relationship between weight management and diabetes. she shared her personal journey and advocated for a balanced approach that combines weight loss drugs with lifestyle adjustments, emphasizing the need for support and understanding. The speaker also discussed the history and mechanisms of weight loss drugs like semaglutide and liraglutide, highlighting their potential benefits for managing diabetes and improving heart health.

They emphasized the importance of medical supervision, adherence to recommended dosages, and lifestyle changes as part of a comprehensive approach to weight management. The speaker stressed the significance of personalized advice from healthcare providers, balanced meals, and the supportive role of weight loss drugs as part of a comprehensive approach to wellness.

Key Questions:

0:00 – Mila Clarke
As a nutritionist and a fellow person with diabetes, I believe that nourishing your body should be a joyful experience. Starting somaglutide can increase bloat and uncomfortable gastrointestinal effects, but also promotes muscle loss over time. The chocolate and mixed fruit flavors of biocare nutrition are not only delicious, but also rich in essential nutrients and add a great amount of protein to your daily intake. Say goodbye to bland shakes and hello to a flavorful way to meet your nutritional needs while also soothing those side effects.

0:32 – Mila Clarke
Visit biocarenutrition.com and use the code hangrywoman on your upcoming order. Welcome to Your Diabesti, the podcast that ensures you never have to do diabetes alone. I’m your host, Mila, and I live with latent autoimmune diabetes in adults. In today’s episode, we’ll be discussing the sensitive topic of weight loss and how to balance medications with lifestyle changes. As individuals living with diabetes, it’s common to struggle with maintaining a healthy weight due to factors like insulin resistance, medication side effects, and fluctuating blood sugar levels.

1:18 – Mila Clarke
According to the Centers for Disease Control and Prevention, about 34.2 million Americans are living with diabetes, and approximately 90-95% of us have type 2 diabetes. This chronic disease is characterized by high levels of blood glucose, which can lead to serious complications like heart disease, nerve damage, and kidney failure. One of the major risks for developing type 2 diabetes is being overweight or obese. And in fact, about 8 out of 10 people with type 2 diabetes are overweight or obese.

1:54 – Mila Clarke
Excess weight can also worsen symptoms and complications for those already living with diabetes. It can increase insulin resistance, making it more difficult for the body to use insulin effectively, and leading to high blood sugar levels. Additionally, carrying extra weight can strain the heart and contribute to high blood pressure, which increases the risk of heart disease, which people with type 2 diabetes are already at an increased risk for. The struggle with weight management and the complexity of related health issues like obesity, type 2 diabetes, often leave us feeling like we’re at a crossroads and wondering what the best course of action is for our personal journey forward.

2:39 – Mila Clarke
For many, it involves considering the role of weight loss drugs, a topic that has sparked rich debate in healthcare circles. And I’ll clarify a little bit later why I’m calling them weight loss drugs, because you may know them as weight loss drugs. The broader population knows them as weight loss drugs, but they actually started as a means of blood sugar management for people with diabetes. For many, that crossroads involves considering the role of weight loss drugs, which is a topic that has sparked rich debate in health circles and beyond.

3:15 – Mila Clarke
I’m an interesting case study. I live with latent autoimmune diabetes in adults, a slow-progressing form of type 1 diabetes, but I’m also classified as obese according to my BMI. Genetically, I come from a family that has the presence of cancer, gestational diabetes, type 2 diabetes, hypertension, and heart attacks in our health history. Me getting diagnosed with LADA was, to be honest, a shock for me. While my treatment changed and I then became insulin dependent, the thing that I thought was so interesting about my treatment before LADA is that it always related back to my doctors telling me to lose weight.

3:56 – Mila Clarke
Even when I lost 30 pounds over a few weeks, I was met with a good job, a pat on the back rather than something might be wrong here. And when my A1C wasn’t improving, the solution from my care team was to lose more weight. Diabetes and weight can be associated and they often are, but weight loss is often looked at a kind of end-all be-all solution to curing what ails you. And it doesn’t always solve all of the things that we’re looking to solve. Let’s talk a little bit about obesity. The prevalence of obesity and diabetes in today’s society is not merely a statistical curve on a chart.

4:38 – Mila Clarke
It’s the story of individuals like you and me, wrestling with inner demons, societal pressures, and the genuine desire for a healthier, happier life. And that all happens while everyone is watching. Some people are judging, and some people don’t think that we know how to take care of our health in the best way. And then at the heart of this narrative lies an ever-evolving dialogue about the benefit for use of weight loss medications, a conversation that is laden with fears, hopes, and the potential for genuine transformation, but it also makes us think, how is society going to see us?

5:22 – Mila Clarke
Because if you’re obese or you’re overweight, try to do something about it. And in one breath, people will lob criticism at you for being fat and for having diabetes or for just overall not looking like the societal standard. And then if you decide that you want to take an injectable, that in the long-term scale can help you prioritize your health and help you get better, you’re lazy and you’re taking shortcuts. The truth is, while some of us are genetically predisposed, there are societal factors at play that make it harder for certain populations to maintain a healthy weight.

6:02 – Mila Clarke
We’re up against barriers like food deserts, poverty, lack of health care, lack of access to health care, a societal emphasis on being thin. Inability to be able to get fresh foods, the inability to be able to safely go walking in your neighborhood, those are all really important factors that sometimes are barriers to access for living a quote-unquote healthy life. Even when the social determinants of health aren’t at play, weight loss can still be a difficult journey. It’s not just about cutting calories or hitting the gym, It’s often an emotional battle that requires support and understanding from those around us, and sometimes much more support and understanding than we’re able to get.

6:53 – Mila Clarke
We don’t get the support sometimes, and that’s just the bottom line. And while losing weight can certainly improve health outcomes, it is not a one-size-all fit solution, and it also isn’t the only way that we can make health problems better. I am not here to hype up the virtues of a shot or a pill that is hyped by the media to say that it is the magic cure. Nor am I here to discredit the potential of these medications to complement our pursuit of better health. My position straddles the fence a little bit.

7:36 – Mila Clarke
I advocate for balance. So with the use of weight loss drugs to serve as a partner for deliberate style adjustments, that’s where I am. I don’t think that you can have one without the other because if not, the cycle just repeats itself. I think there are many variables to this equation, and there’s nothing wrong with using all of the tools that you can. In the past year or two, drugs like semaglutide, loraglutide, along with other GLP-1 agonists have been making headlines for their potential weight loss benefits.

8:11 – Mila Clarke
And I want to reiterate this because it often gets lost in the conversation that these drugs have existed for much longer than the media has portrayed them as a miracle drug for weight loss. Go back to my YouTube channel, for instance, I have a million views on a video from 2021 about Ozempic. They’ve been on the radar for people with diabetes as an option for a long time. For us, the focus has been on insulin sensitivity, blood sugar balance, and heart protection. An oral medication or a once-weekly injectable that has the ability to drastically improve your quality of life as someone with diabetes.

8:50 – Mila Clarke
Though these medications were originally created as a means of diabetes management and cardiovascular protection, Diet culture has thrust these drugs into a spotlight that has helped make billions for pharmaceutical companies, caused a shortage, and put emphasis on weight control. You can’t go anywhere without seeing a story about GLP-1s or Ozempic. Like Weight Watchers or WW, inviting plus-size influencers to their GLP-1 hype house, to ozempic jokes in the mainstream, and every tabloid from the East Coast to the West Coast speculating about what celebrities are taking advantage of the ozempic craze.

9:32 – Mila Clarke
But what exactly are these drugs and how do they work? Simply put, these medications help regulate blood sugar levels by mimicking the effects of a hormone in the body called GLP-1. And that hormone does three things. It stimulates insulin production, reduces appetite, and slows down the rate at which food leaves the stomach, thereby slowing digestion. And as a result, patients taking these drugs experienced reduced hunger and cravings, and it led to weight loss over time.

10:06 – Mila Clarke
For people with diabetes, it also helped with blood sugar balance and insulin sensitivity, which means lower risk of diabetes complications and better overall health. And I don’t think that it can be understated. Diabetes complications cost us billions of dollars a year to treat, and they really impair the quality of life for people with diabetes. Diabetes complications are scary. And now there is this medic that is out there that can help you become more insulin sensitive, help you with blood sugar balance, and really help to lessen the impacts of this progressive disease.

10:46 – Mila Clarke
It’s remarkable. But in addition to their potential for weight loss, semaglutide, loraglutide, terzapatide, and other GLP-1 agonists have also been shown to improve overall heart health and lower the risk of cardiovascular events. And these medications can help control blood pressure and cholesterol levels, and it makes them a valuable tool for managing multiple aspects of someone’s health. These drugs undeniably offer an array of benefits, particularly in jump-starting the weight loss process.

11:19 – Mila Clarke
And for many, including myself, the initial rapid results are catalysts for major lifestyle changes that follow. The added layer of medical supervision provides a crucial safety net and ensures that the process is healthful and it’s also going well over time. Personal motive often surges during that period of positive enforcement where you can see visible progress. And that’s a psychological edge that’s hard to discount whenever you’re thinking about trying to lose weight.

11:52 – Mila Clarke
The more that you see your progress, the more that you want to keep going. Sometimes just living in your head, living in your body, it’s hard to see that progress. And so when you finally do and you’re seeing it at a rapid pace, it really helps with the motivation to keep on going. Weight loss drugs also reduce the phenomenon of food noise. So we live in a world with constant media bombardment on perfect bodies, celebrity diets, and the miracle cures that are out there and that people swear by.

12:22 – Mila Clarke
And it’s easy to forget that food is both nourishment and energy. But for those who are obese or overweight, hunger pangs and the background voice about hunger and satiety and when to stop can be distracting and deceptive. Weight loss drugs help lower this distraction so that you can focus on making sustainable changes. And you don’t necessarily think every moment about the next meal that you’re going to have or the next thing that you’re going to eat. As with anything, though, there are valid concerns and potential drawbacks to consider when incorporating these drugs.

12:59 – Mila Clarke
And any medicare is a potential risk and potential side effects. Weight loss drugs are no exception, which is why they are typically prescribed by A physician, after careful evaluation of someone’s health and goals, it’s important always to follow the recommended dosages and to regularly monitor changes in your body while taking these medications. But weight loss medications should be seen as part of a comprehensive approach to weight management, which includes healthy eating habits and regular physical activity.

13:30 – Mila Clarke
Additionally, these drugs are incredibly expensive, and sometimes it can be difficult to get insurance coverage or approval because of how costly they are. There’s also the issue of accessibility, with the financial burden often propping up a new wall between a medication and a person who genuinely needs it for better health. List prices for some of these drugs can sit up to $1,500 for a 30-day supply. It’s the average cost of a one-bedroom apartment in my city. Side effects are obviously another concern.

14:05 – Mila Clarke
Common side effects can include nausea, vomiting, constipation, dry mouth. These can make it difficult to stick to the medication and lead to other health issues if not managed properly. There are also some serious side effects that have been reported, like increased gallstones, increased heart rate and heart palpitations, thyroid cancer. So it’s important to note that weight loss drugs aren’t suitable for everyone, and they may interact with a certain medical condition or medications.

14:34 – Mila Clarke
So it’s really crucial to consult with a doctor before starting any type of weight loss medication. And I have to say it again, if weight loss drugs are the spark, lifestyle changes are the fire that sustains the burning desire for a healthier life. These adjustments, when internalized and integrated into the fabric of our daily routines, offer a path to genuine well-being and blood sugar balance. Sustained long-term changes to diet and exercise have implications that reach far beyond the number on the scale and they touch every facet of our health from cardiovascular well-being to mental acuity.

15:14 – Mila Clarke
Lifestyle changes take work, effort, and accountability. What gets left in the footnotes is that these medications will help you lose weight, but you also have to do the work to make the habit changes stick. It goes hand in hand. And that’s really, really difficult. Losing weight can be a challenging task for anyone, but it’s especially important for people with diabetes to manage our weight in order to improve our overall health and well-being. It’s also important to approach lifestyle changes like weight loss in a safe and healthy and sustainable way.

15:51 – Mila Clarke
Crash diets, extreme exercise regimens, things that are really difficult to keep up with can have negative effects on health and blood sugars and your body image. So some strategies that people with diabetes can use to lose weight effectively. First, consult a healthcare provider. Before you start any weight loss plan, you need to know where you’re starting. So it’s important that people with diabetes consult their healthcare provider first. They can provide professional, personalized advice that’s evidence-based and guidance based on your individual medical history and your current health status.

16:30 – Mila Clarke
They can also help you monitor blood sugar levels and adjust medications as needed during the journey. Making lifestyle changes is so, so important, as I’ve underscored throughout this entire podcast. Incorporating small, sustainable changes into daily routines is the key to achieving long-term weight loss. This can include increasing physical activity, really taking a look at your food choices, managing stress levels, and paying attention to your mental health. I always advocate as a health coach for making gradual changes rather than drastic ones.

17:07 – Mila Clarke
Those can make it a lot easier to stick to a new routine and to see progress over time, but to actually stick through that routine for a long period of time. Choosing balanced meals is really important. People with diabetes can focus on incorporating a balance of carbohydrates, proteins, and healthy fats into our meals. And this can help to manage blood sugar levels while also providing necessary nutrients for the body. Work with a registered dietitian who can be helpful in creating meal plans, and working with a health coach can help keep you accountable in those times in between to be so, so diligent about your overall health goals.

17:47 – Mila Clarke
I believe that when approached with a balanced mindset and under the guidance of informed health care providers, weight loss drugs can steer people toward better health. As much as we might not like to admit it, they work. And they’re improving health overall for people with and without diabetes. But these medications are not a solitary savior. They are a supportive tool and a comprehensive kit for wellness that includes constructive lifestyle adjustments. In the grand debate on weight loss, my voice echoes the sentiment that two things together work.

18:28 – Mila Clarke
A composition of drug therapy, and everyday choices that hold the key to lasting positive change. Taking medications is not a moral failing. It doesn’t mean that you have done something wrong. If your body needs help, it needs help. And luckily for us living in modern times and with the progress there has been in science, we get to reap the benefits of these advances that strive to give us a better quality of life. And help us live longer and help us live better lives with the reduction of the risk of diabetes complications.

19:05 – Mila Clarke
So in my opinion, we need to embrace the wholeness of our health and acknowledge that every individual’s battles and victories matter deeply, deeply in the puzzle of human well-being. The scale may tip in favor of vacations or lifestyle changes at different moments, but the goal remains the same, and it’s to have a foundation of good, balanced health. Let me know what you think about this topic. Have you or someone you know have success with weight loss drugs? How did it impact your health and well-being?

19:44 – Mila Clarke
Share in the comments below and let’s have a conversation about it. You can also join my app, Glucose Guide, to continue the conversation on this topic. And that’s it for this episode. Get the full transcript, the video, episode, and more at diabestipod.com. Take care, and I’ll see you in the next one.

About Mila

Hi! I'm Mila.

I’m earning my Master’s degree in Applied nutrition.

I’m a journalist and Integrative Nutrition Health Coach living with  LADA (Latent Autoimmune Diabetes in Adults, a slow-progressing form of autoimmune Type 1 diabetes) I love food, travel, and my kitchen, and teaching you about diabetes self-management.

I’m here to help you live your best life possible diabetes by showing you how to create simple, blood-sugar friendly and delicious meals and tips on diabetes self-care.

Be sure to download my FREE Diabetes Community App Glucose Guide, or reach out for FREE 1:1 diabetes health and habit coaching.

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