Being overweight or obese (especially when the fat is in the abdomen) increases the body's insulin needs, and losing this extra weight can significantly improve diabetes control. Often the weight loss can eliminate the need for medications altogether. You do not have to lose a huge amount of weight—a 5 percent loss in body weight is sufficient.
Here are some basic concepts about weight loss:
• Weight loss occurs when there is a negative energy balance. If you consume fewer kilocalories than you expend, you will lose weight. This is the principle behind all weight-loss diets, and there are no exceptions to this rule. If you reduce the number of calories you eat by about 500 kilocalories per day, you will lose about one pound in weight per week.
• Physiologically, we are designed to avoid eating too little. The mechanisms of the body evolved when there was less food available than we have now, and these mechanisms are designed to avoid weight loss. With environmental changes and the ready availability of highly dense calories (that is, lots of calories in a small portion size), it takes very little excess caloric intake on a daily basis to gain a considerable amount of weight over time. It is estimated that in the United States, over 90 percent of the weight gain seen in adults results from a positive energy balance of less than 100 kcal a day. It is very easy to get into a positive energy balance (more calories consumed than expended)—for example, a two-ounce candy bar such as Snickers has 273 kcals.
• The body's energy requirement goes down when you lose weight and as you age. About 70 percent of your energy requirement is for the basic life processes, and the other 30 percent is for activity related to eating, working, and walking. Your energy requirements go down as you age and as your weight goes down. So as you lose weight, your energy requirements fall, and you will need to reduce the number of calories you consume further for continued weight loss.
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