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  • Q&A with Australian Health Practitioners

    Are obesity related type 2 diabeties symptoms reversible

    I have diabetes type 2 and have been over weight all my life. I have been diagnosed now as being Morbidly Obese and there are all sorts of new problems associated with it. The most worrying ones are my inability to breathe and the heart disputations and distress when I undertake the simplest of tasks around the house. I have always been big and strong but after turning 61 these symptoms have all just appeared within a period of one month after our mother died and the resulting stress and depression of the event have taken it's tole. MY general question is can this change in my health go from being strong and able to do things around the house etc. to not being able to even walk to the front door without great stress be anything else other than the Morbidly obese diagnosis can this “tipping point” in my weight and age happen so quickly, within one month? and obviously if I can loose weight will it reverse the problem? Thank you. Yours truly Stephen
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  • 2


    Stuart Donaldson

    Exercise Physiologist

    Accredited Exercise Physiologist with ESSA providing services to clients in the Hervey Bay region, including entitled DVA clients (Entitled Department of Veterans' Affairs clients may … View Profile

    Hi Stephen,
    Great to hear that you have decided to take action and sorry to hear about the passing of your mother. Often all of these life stresses converge and lead to major health problems.

    It is never too late to start exercising, ever. But you must consider your current fitness level when you start exercising. I would strongly recommend seeing an Accredited Exercise Physiologist for a specially tailored exercise program. Talk to your doctor and ask about the Chronic Disease Management program from which you can get some sessions funded by Medicare.

    Start with short sessions, even 5-10 minutes of exercise, such as walking, and try to get out every day. Gradually build this up, adding 1 minute or so every day until you are reaching 30 minutes per day. This process will take weeks and probably months, and that is ok! Better off taking it easy, given your health concerns. In the early stages, anything you do will be beneficial and you should see some results pretty quickly.

    As for Type 2 diabetes, you cannot ‘get rid of it’, but you can control it with exercise and health eating, and bring your blood sugar to a healthy level.

    Hopefully a dietitan will provide a response to this question regarding food intake.

    Slow and steady is the key. Just think, if you have been overweight for a long time, you have years and years of these health issues developing. You cannot expect them to go away overnight, so don't expect rapid changes.

    But get active, and soon enough you will see results.

    Good luck!

  • 1


    Weight loss is a long term goal for you. What is most important is not so much your weight is how much fat you have and where this is distributed. If you have been an athlete where body weight is mainly muscle then this is better for you. If this is fat then this is your probelm.
    Health and healthy eating is a journey not a destination. Each day you need to choose healthy lifestyle habits and be mindful of the things that you can do to be healthy. You can do it but remember it is for the rest of your life.

    The principles around weight loss are simple, the implementation is difficult. And what is worse the blogs on healthy eating from “experts” means we now have no idea how to do it.

    What we know about being overweight and T2 diabetes is-
    1. There is a genetic determination
    2. When this is combined with an obesigenic environment obesity occurs and T2 diabetes as well.

    Some starting dietary principles
    1. Get adequate protein to maintain muscle mass as weight is lost from FOOD, not supplements to maintain your metabolic rate as your reduce your energy and body weight.   A Dietitian will help you work this out. Don't resort to protein powders they give too much and your body doesn't use it and we want the other nutrienst that protein foods provide. We often eat enough protein already but new research shows having a small amount 20-30gm ( no more) before exercise helps maintain muscle mass. Milk is great.
    2. Get adequate amount of fresh fruit and vegetables. You do not need to restrict these. Despite what bloggers say the research here  just doesn't support restrictions of fresh fruit (not juiced) They extrapolate research to support their arguement.
    3. Get your carbohydrate from less processed forms like lentils, beans, legumes,wholegrain cereal grains like oat flakes, Quinoa, wholewheat flakes etc  and dairy products. Foods in packets are more processed.

    Make your own foods. A helpful tool is the Australian Healthy Food Guide, monthly magazine  which has meal plans in the back and recipes to help you. Only $5.70/mon. Another good dietary pattern is the Mediterranean diet which is neither low carbohydrate or high saturated fat.

    Meal Plans to avoid
    1. Low carbohydrate- No one knows what this is but they talk about it as if they are all the same.  It can be as low as 20gm/carbs a day which means you cannot eat any fruit and vegetables let alone dairy products. Or it can mean around  40%Energy from carbs which is about 200gm carbs  on a 2000Kcal/day diet. This can be much more realistic and achievable . A Dietitian can plan something around this level 40-45% which is easier to maintain long term and keep you healthy while you are at it. Or it can just can mean no bread, sugar, potatoes or starch vegetables, rice or pasta .
    2. High fat diet- this comes off the premise that a high carbohydrate diet is bad. High processed carbohydrate acts similarly to high saturated fat and bad for people with T2 diabetes. Research posted to support the high fat diet use high carbohydrate diets as a comparison with unknown source of Carbs , which could be mostly processed and work just like saturated fat.Anyone talking high carbohydrate without identifying the source of carbohydrate just doesn't understand the research. Any one telling you  low fat diet is bad without identifying the replacement nutrient when fat is reduced, just doesn't understand the research also. Usually processed carbs replace fat when fat  is reduced which works just like saturated fat as I have said before.

    Bariatric Surgery is often required when you are this big . However you need to consider that all bariatric surgery may distort eating long term and success rates vary. Even if you go through surgery you still need to learn to have healthy lifestyle habits.

    Whether you can reverse the damage from T2 diabetes is dependent on  how long you have had the disease, your pancreatic function, complications you have now , how much weight you lose, how fit you become and whether you can maintain this long term.

    I have seen very determined people who are big and have achieved weight loss without bariatric surgery but they need a supportive team around them for a long time. Good GP, Dietitian, Psychologist and Exercise physiologist.

  • Dr Kevin Lee

    Endocrinologist, Nuclear Medicine Physician

    Consultant Physician in Endocrinology, Diabetes & Nuclear Medicine. I am on Twitter @dr_kevinlee. I am on Facebook I help patients with obesity, diabetes, thyroid, … View Profile

    Very good posts about diet and exercise, which are very important management components.

    It also turns out that there is a real association between obesity/diabetes and depression.

    Symptoms of depression such as low mood, low self-esteem, guilt, lack of interest, tiredness, change in sleep, change in eating habits. In addition, suicide/self-harm thoughts. They can come on quite suddenly, especially after such a stressful event such as losing a loved one.

    If these symptoms are depression-related then there is good chance for them to go into remission with medical review, +/- cognitive behavioural therapy, +/- pharmacotherapy.

    Therefore you must be advised in the strongest terms to seek medical attention such as your GP or if unable to attend one promptly to consider using beyondblue's 24 hour hotline 1300 22 4636

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