Laurie Janavey’s battle of the bulge began decades ago, when she was a teenager. But her weight caught up with her health during pregnancy – when it contributed to gestational diabetes.
Being overweight or obese is one of the risk factors for this form of diabetes. Many women’s blood sugar levels go back to normal after their baby is born. But they have a greater chance of getting type 2 diabetes in the future.
For Janavey, 57, of Shrub Oak, NY, diabetes never went away. She was diagnosed with type 2 in 1999. Her weight-related health problems didn’t stop there. High cholesterol and blood pressure were also part of the package.
But she’s been able to turn her health around with the help of the right weight loss tools as well as her friends, family, and supportive health care providers.
The Weight-Diabetes Link
Excess pounds can lead to many health problems, like heart disease, nonalcoholic fatty liver disease, type 2 diabetes, and more. In fact, it’s estimated that up to half of new type 2 cases in the United States are linked to obesity.
“Excess weight increases insulin resistance,” explains Rachel Goldman, manager and advanced clinical providers senior director of clinical care at the Center for Weight Management and Diabetes Education in Chappaqua, NY.
Insulin is a hormone made in the pancreas that helps turn sugar into energy. “When someone starts to struggle with their weight, sometimes they have difficulty using that insulin as efficiently as they did at a heathier weight,” says Goldman, who treats Janavey. When the pancreas can’t keep up with the insulin demands, blood sugars start to rise to abnormal levels: first, to prediabetes and then for some, type 2 diabetes.
With prediabetes, blood sugar levels are higher than normal, but not as high as those found in type 2. You can reverse it by taking lifestyle management steps that include weight loss. You may even be able to prevent type 2 if you follow your doctor’s orders.
Am I Overweight or Obese?
Janavey knew she was overweight. “I have mirrors in the house,” she says, jokingly.
But when do you cross the line from overweight to obesity? A check of your body mass index (BMI) will let you know where you fall. Your doctor’s office will weigh you every time you have an appointment.
The adult BMI is a calculation that measures body fat and uses your weight divided by your height. It divides people into four categories: underweight, normal, overweight, and obese. A BMI result between 25 and 29.9 (23 to 26.9 if you are of Asian descent) means you are overweight, while 30 and above is classified as obese.
For instance, a 5-foot-9-inch person who is between 169 and 202 pounds is considered overweight. If they’re more than 203 pounds, they’re considered obese. Talk to your doctor about what the numbers mean in your case.
BMI in kids and teens are calculated differently. It takes into account the age and sex of a child as well as their height and weight. It charts the child’s information against others just like them and reports the results in percentiles.
If a child is in the 85th percentile or greater, they’re considered overweight or obese.
Talk to your pediatrician to find out if your child’s weight could set them up for health problems in the future.
Type 2 Diabetes Health Checks
For overweight children, blood sugar should be tested at 10 years old or when puberty begins, whichever comes first. Overweight or obese adults ages 35 and over need to be checked for type 2 diabetes. One of the easiest and most accurate screening tests for most people is a hemoglobin A1c blood test, Goldman says. It measures your average blood sugar levels over the preceding 3 months. A level of 5.7 to 6.4 is prediabetes, while anything over 6.5 is type 2 diabetes.
Your doctor will tell you when you need your A1c rechecked if it’s high and put you on a treatment plan. You may need to do blood sugar tests at home, too.
Diabetes puts you at risk of complications involving your smallest blood vessels. “The disease is the leading cause of blindness, kidney disease, and foot amputations across America,” Goldman says. If diabetes is present, you or your loved one needs these important screenings:
Dilated eye exam. See your eye doctor yearly to check for eye damage, which can lead to a condition called diabetic macular edema.
Urine test. This annual test checks for certain proteins that could signal kidney disease
Nerve testing. This checks for diabetic neuropathy, a type of nerve damage. It most often affects the legs and feet. If positive, you need regular yearly checkups with a podiatrist. You should also check your legs and feet daily yourself to make sure you have no cuts or signs of infection, which you might be unaware of if you lose feeling in your feet.
Type 2 diabetes also can raise levels of artery-clogging “bad” LDL cholesterol and triglycerides. High levels of these raise your risk of cardiovascular disease. You’ll have a cholesterol test at your diabetes diagnosis. Your doctor will go over your results with you and discuss whether you need to take cholesterol-lowering medication. You may need to go in for more frequent cholesterol checks based on your personal risk factors.
Due to the rise in childhood obesity, doctors now recommend a first cholesterol test between 9 and 11 years old if your child’s weight is normal. For overweight children, blood sugar should be tested at 10 years old or when puberty begins, whichever comes first.
Janavey’s Journey Back to Health
At 231 pounds and 4 feet, 11 inches tall, Janavey’s BMI was 46.7. Her A1c was 11.4. She knew she had to do something to prevent complications. She has a family history of obesity, diabetes, heart problems, and cancer.
With the support of her husband and family, she had gastric bypass surgery in 2006. Her weight started to drop, and she got down to about 190 pounds. But Janavey’s health took a backseat when her mother was diagnosed with cancer.
Her weight loss stalled. “I wasn’t using the tool I was given,” she says.
Janavey admits her overeating was part habit and part emotion. “When I was happy, I ate, sad I ate, or bored, I ate.”
“If I woke up at night, I’d grab six Oreos … walk in the door from work and grab a snack.”
Stress and depression added fuel to the fire. “I packed a lot of weight after my father passed. I knew I was overeating, but I really didn’t care.”
Janavey’s health made a big turnaround after she started weight loss injectable diabetes drugs. She’s now down to 132 pounds. She no longer takes other diabetes medications or insulin shots. Her diabetes is under control, and her high cholesterol and blood pressure are managed well with medication.
“These shots are tools … not magic.” And type 2 diabetes doesn’t disappear, Janavey says. You still need to live a healthy lifestyle. With the help of medical professionals and support from family and friends, she’s been able to do it.
The Importance of Social Support
Old habits die hard. But Janavey’s husband and two grown sons support healthier food choices, which often begin at the grocery store.
Knowing that her weak spot is sweets, they urge her to not bring “junk” into the house. “They know if it’s here, I’ll eat it,” she says.
Extended family helped hold her accountable too, especially early on. “My brother and sister would ask, ‘Did you go to the heart doctor? Did you go this year?’ If I said, no, they’d say, ‘Why not?’ ”
She says finding a supportive, nonjudgmental team of health care providers that really listen to your particular issues is vital. “I tell Rachel [Goldman] all the time that she’s like my therapist!”
If you don’t have strong social network, talk to your health care team. They may be able to point you to the right support groups. Community centers or church groups often provide practical help like meal planning or rides to doctor appointments.
Start a Conversation About Weight
It can be tricky to bring up weight loss to someone you’re concerned about. Start by approaching them with words that come from the heart. You can say something like:
- “I want you to be around for a long time. But your weight can cause health problems.”
- “You’ll have more energy if you drop some pounds. Let me help you do it.”
Once you talk, walk the walk.
- Schedule regular walks or other physical activity that you can do together.
- Celebrate even small weight losses or better blood sugar numbers – but not with food.
As you start to develop new eating habits, set the table for success.
- Stock your pantry with healthy options.
- Use portion control plates, and fill the biggest compartment with veggies.
- Limit dessert to one night a week instead of most nights.
Janavey says it’s important to model good habits to your kids, especially if they struggle with weight themselves.
“If I could do it over again, I’d get in shape younger and not pass on my eating habits to my kids. What you teach them is what they’re going to do.”
Words of praise and encouragement from family and friends go a long way, too.
“It’s nice to hear your son say, ‘Mom, you look so good … you’re so small you could blow away in the wind!’ ”
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Laurie Janavey, type 2 diabetes patient, Shrub Oak, NY.
Rachel L. Goldman FNP-BC, CDCES, advanced clinical providers senior director, clinical care, Center for Weight Management and Diabetes Education Program, Northwell Health Physician Partners, Northern Westchester Hospital, Chappaqua, NY.
American Academy of Pediatrics: “Cholesterol Levels in Children and Adolescents.”
American Heart Association: “Up to half of new diabetes cases in the U.S. linked to obesity.”
CDC: “Diabetes Risk Factors,” “How to Help a Loved One With Diabetes When You Live Far Apart,” “Prevent Type 2 Diabetes in Kids, ” “All About Your A1C.”
U.S. Department of Health and Human Services: “Losing Weight: Conversation Starters.”
National Heart, Lung, and Blood Institute: “Aim for a Healthy Weight.”
Mayo Clinic: “Diabetic Neuropathy.”
