ZocdocAnswersHow can I lose weight?

Question

How can I lose weight?

i have metabolic syndrome, type 2 diabetes and 1500 mgs of metformin daily and a good diet, can't lose weight.

Answer

First of all, congratulations on setting a goal to take control of your weight and work towards a weight loss to improve your health. However, you shouldn't try to do it on your own. It is important that you check with your doctor before starting a diabetes weight loss program, and then consult with a diabetes nutritionist. The reason for doing so is that your blood sugar, insulin, and medications need special attention while you are dieting because it is a delicate balance. Having said all this, the best way to lose weight is to eat fewer calories and burn up more calories than you need. In general, I suggest cutting 500 calories a day across the board- from protein, carbohydrates, and fat. I recommend an ideal diet containing 50% to 55% carbs, 30% fat, 10-15% protein. Special attention with carbs intake is important because they have the biggest effect on your blood sugar because they are broken down into sugar. Eating complex carbs such as whole-grain bread is good because they are absorbed into the blood stream more slowly and thus helps prevent a sugar spike. Most people tend to cut a lot of carbs in their diets which can be dangerous. Lack of carbs can trigger your body to go into ketosis because when there is insufficient supply of glucose and glycogen, your body exclusively uses ketones (acidic substances from at breakdown) for energy and eventually becomes acidemic (acidic blood). Exercise is essential to burn up your calories and you should consult with your doctor to determine which type of exercise is safe for your condition. Generally, water aerobics will probably give you the best work out without being too harsh on your joints. If all fails, bariatric surgery is a possible weight loss solution when combined with other therapies. I would recommend a consultation with first a primary care doctor, then a nutritionist, and possibly a bariatric surgeon.

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