This content material initially appeared on diaTribe. Republished with permission.
By Paul Heltzel
Medically Reviewed by Charles M. Alexander
Key takeaways:
- When taking weight reduction drugs, consuming nutritious meals and getting bodily exercise are key to staying properly for individuals with diabetes.
- Transient bouts of train may help construct and keep energy and cardiovascular well being.
- Specialists additionally burdened the significance of psychological well being assist throughout weight reduction, particularly if a change happens in temper or relationships with others.
Weight reduction drugs have produced dramatic well being advantages for a lot of however when utilized by individuals with diabetes there are particular issues. A panel of specialists just lately supplied methods for taking them and staying properly.
The panel was led by Dr. Kelly Brownell, a professor and director emeritus of the World Meals Coverage Heart at Duke College, and was joined by the next specialists:
- Dr. Lisa Neff, govt director of worldwide medical affairs for Eli Lilly and Firm and specialist in endocrinology, weight problems medication, and medical vitamin.
- Lorena Drago, registered dietitian nutritionist and authorized diabetes care and training specialist
- Dr. John Jakicic, train physiologist and weight problems researcher on the College of Kansas Medical Heart
How weight reduction drugs work
Neff defined that these drugs work on the receptors for 2 naturally occurring hormones – glucose-dependent insulinotropic polypeptide (GIP) and glucagon‐like peptide‐1 (GLP-1) – which collectively regulate blood sugar and urge for food.
“We now have numerous understanding of how they work and the way efficient they’re,” she stated.
Lilly’s medicine tirzepatide, higher referred to as Mounjaro when used to deal with kind 2 diabetes and Zepbound for treating weight problems, prompts GIP and GLP-1 receptors, making it a mixture medicine. Semaglutide, referred to as Ozempic when taken by individuals with kind 2 diabetes and Wegovy when taken for weight reduction, then again, prompts solely GLP-1 receptors.
These drugs may help regulate blood sugar in a number of methods. They cut back the quantity of glucose produced by the liver and assist the pancreas launch extra insulin when blood sugar is excessive, bettering insulin sensitivity.
Nutritionist and diabetes educator Drago famous the drugs additionally cut back starvation – the bodily have to eat – in addition to cravings. These drugs additionally gradual the digestion of meals.
“So each starvation and urge for food are lowered, which results in a lower within the consumption of meals,” Drago stated.
Getting satisfactory vitamin on weight reduction drugs
Neff identified that as a result of individuals taking these medicines are consuming smaller quantities, it’s essential to make these energy rely by consuming meals that assist meet dietary wants.
“Concentrate on nutrient-rich meals, like lean proteins, greens, fruits, and entire grain meals,” she stated. “The vitamins we’re speaking about are actually essential for thus many physique processes, together with power manufacturing. They’re additionally essential for issues like immune perform, pores and skin well being, and bone well being.”
Neff and Drago each emphasised the significance of dietary fiber and protein whereas taking these drugs.
The significance of train
The panel defined the necessity for bodily exercise whereas reducing weight to offset any lack of muscle mass, by constructing and sustaining energy and cardiovascular health.
Train researcher Jakicic defined that even temporary quantities of train can have outsized advantages.
“You understand how you walked out of your automobile to your workplace and walked again? Simply perform a little bit extra of that. As soon as within the morning, as soon as within the early afternoon, and as soon as within the night, take a 5 to 10-minute stroll,” he stated.
Jakicic acknowledged the challenges of sustaining bodily exercise for older individuals and people who are coping with fatigue. Listed below are a few of his suggestions for simple strength-building and basic health:
- Resistance or energy coaching may help to enhance muscle high quality and construct energy. At residence, cheap resistance bands are an choice.
- For these with mobility points, there are easy workouts that may be carried out in a chair.
- When watching TV, stroll in place throughout commercials. Or make a recreation of it by strolling in place for one minute when a personality on a present makes use of a well-recognized phrase.
Jakicic acknowledged that folks of all ages may have to change workouts and burdened the necessity for personalization to find pleasurable, sustainable bodily actions.
“If we deal with workouts as one measurement matches all, that’s truly going to translate into one measurement matches none,” he stated. “Everybody will strategy train in a barely completely different approach.”
Managing unintended effects of weight reduction drugs
Some individuals taking weight reduction medicine might expertise unintended effects, which may embody nausea and different gastrointestinal points. Along with consulting with the prescribing physician, the panel supplied some ideas.
“The very first thing that I ask is: How lengthy does it take you to eat?” Drago stated. “Individuals might eat in a short time and need to readjust.”
Along with taking extra time to eat, she really helpful a number of small meals all through the day. Drago supplied a number of different recommendations for many who expertise gastrointestinal points. She really helpful making an attempt meals at room temperature vs. scorching meals and avoiding decisions which are excessive in fats. When nauseous, it’s greatest to attend till after meals to drink liquids as an alternative of getting them collectively. For constipation, she urged high-fiber fruits and greens.
“It’s essential if individuals are experiencing these signs that they speak with a healthcare skilled,” Neff stated. “There could also be a dose or dietary adjustment that’s really helpful to assist enhance these signs.”
The significance of psychological well being
Whereas seeing enhancements in well being on account of weight reduction, some individuals can also face psychological well being challenges. The specialists supplied recommendation for modifications in temper after weight reduction, or a change of their relationships with others.
“When some individuals drop some pounds, they could really feel very uncomfortable by the elevated consideration to their physique in consequence,” Neff stated. “Once more, that is one other alternative to achieve out to a physician or a psychological well being skilled for assist. It’s essential to know you’re not alone.”
Neff stated a necessity exists for larger understanding of the complexities associated to weight problems as a power illness. The American Board of Weight problems Medication could be a useful resource for locating licensed clinicians, she stated.
“There are advanced organic techniques that affect our urge for food, consuming behaviors, and physique weight,” Neff stated. “Sufferers don’t need to really feel the disgrace and blame that they felt for thus lengthy round weight. Weight problems is a troublesome illness, and it has created numerous burdens and obstacles to take care of individuals for a few years. I believe we’re simply beginning to see enhancements in that. Sufferers with weight problems deserve the identical stage of care as these with another power illness.”
The underside line
Incretin-based drugs initially developed to deal with diabetes could be helpful for weight administration, however it’s essential to maintain a deal with weight-reduction plan, vitamin, and train to remain properly, particularly if fewer energy are consumed.
Unwanted effects like fatigue and gastrointestinal issues can generally be an indication {that a} dietary or medicine change is required. For those who’re experiencing unintended effects, seek the advice of together with your prescribing physician. Adjustments in meal decisions, vitamin, or medicine doses might assist.
Specialists stated coupling small quantities of pleasurable train that may be carried out anyplace is vital, in constructing and sustaining muscle and coronary heart well being.
Those that expertise psychological well being challenges associated to weight and weight reduction can profit from the assist of well being professionals. As Neff put it, anybody residing with chubby or weight problems deserves the identical stage of care supplied to anybody with a power illness.
