In many overweight diabetics, blood sugar levels improve after weight loss. Therefore, for overweight patients with Type 2 diabetes mellitus, losing weight is the key to successful therapy.
Weight loss is always achieved when energy expenditure is greater than energy intake (law of energy conservation). To do this, energy intake must be reduced and energy consumption increased through higher metabolism and physical activity.
Eating is pleasure and enhances quality of life. Most therapy programs fail because they change patients’ lifestyle habits and reduce their quality of life.
Crash diets, starvation, or rigid dieting lead to loss of muscle mass and a lower basal metabolic rate. This results in the so-called yo-yo effect, meaning that after ending the diet, weight increases significantly.
To reduce weight long-term, a permanent dietary change is necessary — a process that cannot be achieved overnight.
New eating behavior must be learned and stabilized long-term and should not feel like a loss of quality of life — on the contrary, see it as a new beginning toward healthy eating that tastes good and is satisfying.
Fat and alcohol contain many calories – saving calories helps with weight loss.
A low-fat diet and less alcohol lead to weight loss. Fat is a flavor carrier, and healthy fats (e.g., in olive or rapeseed oil) reduce the risk of heart attack and stroke – so they should not be completely avoided. The right balance is key.
Weight loss is best achieved by reducing total energy intake. Therefore, in addition to fat and alcohol, carbohydrates and proteins should also be reduced.
Don’t Starve – Eat Until You’re Full
Not feeling hungry is the basic requirement for successful, long-term weight loss.
Hunger arises from an empty stomach. A feeling of fullness must occur to feel “happy.” A meal also needs enough time (eat slowly, chew thoroughly – digestion begins in the mouth!) so that the stomach and messenger substances can signal satiety to the brain (“slow food” rather than “fast food”).
Being full is not a contradiction to wanting to lose weight.
For example, a small piece of chocolate has little volume but many calories — the stomach remains empty, and you’ll still feel hungry.
Salad or vegetables with the same number of calories, however, fill the stomach and create a long-lasting feeling of fullness.
Whether you feel full or not depends on energy density — the number of calories per gram of food.
“To prevent overweight and obesity, it is recommended to reduce the consumption of foods with high energy density and increase those with low energy density.”
(Interdisciplinary Guideline S3 on the Prevention and Therapy of Obesity, http://www.adipositas-gesellschaft.de)
The diet should be low in energy but high in volume to fill the stomach. Vegetables and salads are low in energy and can be eaten almost without restriction (see recommended reading by Erdmann J., Hausmann M., Bayer J**).
This does not mean you should only eat salad and vegetables or completely change your diet overnight. Instead, start by making small changes. Write down what you eat, check how many kilocalories per gram it has. Every packaged food lists the energy density (kcal/100 g).
Then consider: How can I save some calories by replacing a high-energy food with another that has fewer calories but the same or greater volume?
The same or greater volume ensures that you stay full while still losing weight.
Liquid calories cause no feeling of fullness! They pass through the stomach without filling it.
The intake of fast carbohydrates from juices, sodas, colas, and iced teas (with a high glycemic index) triggers a rapid and strong insulin release, causing cravings.
Therefore, liquid calories should be avoided!
For example: 200 ml of apple spritzer has 50–100 kcal. Many believe it is low in calories, but mineral water has 0 kcal.
Did you know that consuming an extra 100 kcal per day can lead to a 6 kg weight gain in one year?
Alcohol also contains many calories. Its intake should be limited, especially high-proof spirits.
Wine also contains liquid calories, but due to its positive effect on the cardiovascular system, an occasional small glass (⅛ L for women, ¼ L for men) can even be beneficial.
Carbohydrates with a high glycemic index should generally be limited throughout the day because large portions cause high insulin release.
These carbohydrates are quickly broken down, but insulin levels in the blood and brain remain high, leading to cravings and snacking — which triggers even more insulin release.
Therefore, sugar should be replaced with sweeteners, and portions of pasta, rice, potatoes, baked goods, and fruit should be reduced to normal sizes.
In particular, after 6 p.m., it is beneficial to avoid carbohydrates entirely.
Fat burning occurs primarily at night — but only when insulin levels are low.
Insulin not only lowers blood glucose but also inhibits fat breakdown.
Lots of carbohydrates mean lots of insulin, which means little or no fat burning, and excess energy is stored as fat.
The evening meal should be high in protein, low in fat, and include plenty of vegetables and/or salad.
These guidelines are meant to provide initial help on your journey toward a sustainable dietary change with the goal of long-term weight reduction.