I am definitely not begrudging using these highly effective medications.
I do though think the attention to hitting “normal range” BMI is misplaced.
Right off the so-called “overweight” category is a mixed bag. If you are BMI 26 carrying your fat intra abdominally that’s one thing. If you are BMI 26 and exercising regularly then including a modest amount of strength training, some muscle and not a huge gut, it’s another.
More importantly how is your diabetes going? If it is well controlled then why chase?
And to the pertinence of this hijack to the thread: is the medicine something you are doing instead of trying to keep up with good nutrition and regular exercise? Or something you are doing as well as those things?
I’m exercising regularly with a Pilates trainer twice a week, I eat a mostly vegetarian diet, my A1C is at a steady 5.4, and cholesterol normal. In fact I’m sticking to the lowest maintenance dose of Ozempic in consultation with my GP as to not chase the normal BMI, he’s very happy with all my labs.
My point is that in spite of pharmaceutical intervention, chasing the ideal is still not easy.
Can you please tell that to the medical professionals who display clear fat-bias? Or just clear weight bias? The skinny-worshipping media? Fat-shaming society in general?
Yes, just losing some weight can result in health improvement for most people. If all a person can lose is 10 pounds that’s still a worthy goal and to be applauded. Yet too often it’s treated as a failure because it’s not seen as enough weight loss.
Your comment about the mis-match between our wiring and our recent environment is spot-on. I can’t change the greater environment I live in, I’m still tempted by the candy at the store check-out. I’m still urged to eat more than I want by friends when we gather together. I love calorie-dense foods, just like everyone else. I’m fortunate not to have the weight problems some people do, but our environment really is conductive to over eating and eating things that aren’t really good for us.
The ideal is to be healthy. Well controlled T2D and normal cholesterol ARE healthy. There’s something to be said for not fixing what isn’t broke. Stay where you are for awhile. If later on you want to do more, fine, but it seems to me you’re way away of the crowd right now.
Piling on to @Broomstick ’s congratulations. You don’t get much more ideal than that. And your actions are the counterpoint to the position that it is just about the calories.
Interesting article today in the NYT that illustrates that the quality of the food and the habits matter, not only the weight loss achieved. Gift link.
… who simply followed a Mediterranean diet were 30 percent less likely to develop diabetes than those who followed only a low-fat diet. (In that trial participants did not restrict calories, increase physical activity or experience weight loss.)
No weight loss.
Now a big study demonstrates that adding modest calorie restriction and a balanced exercise program dials that impact up to eleven, even with extremely small resultant weight loss, only 3.7% of body weight on average. It
followed nearly 5,000 adults ages 55 to 75 years who were overweight or obese and had metabolic syndrome but no history of cardiovascular disease or diabetes at base line. (Metabolic syndrome is a cluster of conditions — like high abdominal fat, high blood sugar and high blood pressure — that increase one’s risk for developing diabetes and other chronic diseases.)
Those in the intervention group met with a dietitian regularly for six years and were counseled on how to follow the Mediterranean diet and reduce calories. They were also advised on adopting an exercise program of 45 minutes per day, six days a week, of brisk walking or an equivalent aerobic activity, plus additional strength and balance training two to three times per week. Those in the control group received only education on the Mediterranean diet, and they met with dietitians less frequently. All participants received olive oil, an expensive component of the diet.
The intervention group lost more than seven pounds after six years, on average, and reduced waist circumference by 1.4 inches, on average, compared with just over one pound and 0.1 inch in the control group. The amount of weight lost in the intervention group represented 3.7 percent of body weight — less than doctors often think is needed to reduce the incidence of diabetes.
Returning the focus to statins, mostly - good lipid numbers are important. But they are important because they correlate with the real prize we need to keep our eyes on: a long highly functional healthspan. Using a statin to achieve the lipid numbers part of it is great. Losing weight with a GLP-1 is great. But combining those single things as needed with healthier habits, as @FinsToTheLeft is doing, is going to give better outcomes even at less weight loss.
