Excess body fat causes or aggravates insulin resistance; losing excess body fat reduces or eliminates insulin resistance. Therefore, most people with Type 2 diabetes need to lose weight. They have a very hard time doing it, though.

Here are some suggestions that may help. Give them a try. Success possible, difficulty guaranteed!


Writing it down

Most of us tend to have an inaccurate impression of what we eat, and how much of it we eat. When you go to bed at night, can you actually remember everything you've eaten all day? Most people can't, and if they try, they tend to leave things out (particularly snacks).

Because we tend to think we're eating less than we actually are, the difficulty we have with losing weight (or even maintaining weight) can seem mysterious and unfair. It's as if nature is playing tricks on us, sneaking pounds of fat onto our bodies that we certainly never put there. The longer we continue to have this feeling, the more ready we are to give up on weight control, on the grounds that we suffer from some strange malady which makes weight control impossible in our case. Because our chronic underestimation of our food intake is such an obstacle for us, it can be very helpful to gain a bit of objectivity on the subject.

The best way to do that is to keep a little notebook with you (paper or electronic, it doesn't matter), and write down everything you eat all day (and everything you drink, if it has any calories in it). You don't need to make any decisions in advance about what you're going to eat -- the crucial thng is to decide that you're only allowed to eat something if you're going to write down that you ate it.

Making that agreement with yourself has some desirable effects:
  • It makes you aware of certain trends in your eating habits which you didn't realize where there. Perhaps you have it in your mind that you eat very little bread, or that you're very close to being a vegetarian. Your notebook may have a different story to tell.
  • It reduces the amount of snacking you will do, because the pleasure to be had from eating one cookie or two olives is outweighed by the annoyance of having to write down that you ate one cookie or two olives.
  • It leads you to decide to skip certain foods that tempt you, simply because you don't like the way the report looks when you yield to temptation.
  • After you've been doing this for a while, you start to get pretty good sense of the relationship between what you eat and what goes on with your weight.


Going to bed hungry

Every popular weight-loss diet that I know of promises that on this plan, unlike others you may have tried, you won't feel hungry. Which, if true, means that you won't lose weight on it.

The search for a diet that will allow us to lose weight without feeling hungry is like the search for a perpetual motion machine; failure is built into the effort from the start, because the basic premise (that nature can be fooled into granting us an exemption from physical law) is silly to begin with.

To lose weight requires a calorie deficit (that is, a prolonged state of burning more calories than you're taking in). As a defense against starvation, the body is programmed to react badly to a calorie deficit; whenever calorie consumption drops below calorie usage, the body tries to stimulate us to eat more through the simple and rather effective means of making us hungry. If you're not feeling hungry, you're not running a calorie deficit, and if you're not running a calorie deficit, your weight is not going to go down. If you are feeling hungry, then you're getting somewhere. Therefore, if you want to lose weight, the first thing you have to do is to drop the magical thinking, and accept that feeling hungry is the price we have to pay for weight loss. Until you achieve the weight goal you're aiming for, I'm afraid you're going to be going to bed hungry for a while.

If you're going to have to be hungry, evening is generally the best time for it. In the daytime, when you're out and about, feeling hungry tends to make you feel weak as well, so that you lose confidence in your ability to do what's necessary to get through your day. It's easier to go to bed hungry than to get through a day at work hungry. Neither is easy, at least at first, but going to bed hungry is the easier of the two, and that's why I recommend making supper the lightest meal of the day.

"Going to bed hungry" sounds awfully grim, I realize, but it becomes a lot easier to cope with once you learn to accept it as necessary. Hunger is most potent when we're afraid of it or are trying to wish it away. If you accept it -- if you seek it out, in fact -- it loses most of its power over us. A huge element of hunger is psychological anyway; it's more an emotional feeling than a physical one.

Next time you're feeling a powerful urge to eat a midnight snack, meditate for a little while and focus entirely on the physical sensations in your stomach; you may be surprised to discover that there really aren't any, and that the "hunger" you thought you were just feeling so intensely was really just an emotional impulse. You're not really starving. You're not even hungry, as a matter of fact. You're just in the mood to eat, which is a very different thing.

Therefore, when you're engaged in losing weight, you should expect to feel hungry when you go to bed at night, and should actively seek out that feeling as a desirable one. If you can go to bed without feeling any urge to have a midnight snack first, then you screwed up somehow, and must try to eat a bit less the next day.

Believe it or not, this sort of thing gets easier as it goes along. The real obstacle is achieving acceptance of what's necessary -- once you get over that, doing what's necessary is comparatively easy.


Vegetarianism

Although it is possible, in principle, to gain just as much weight on a vegetarian diet as on any other, it's a lot less likely. If you want to lose weight, vegetarianism is almost certainly the easiest way to do so -- provided, of course, that you don't adopt a fake definition of vegetarianism.

The number of restaurants that think a cheese omelet qualifies as a "vegetarian" dish makes me think there isn't a lot of clarify out there about where eggs and cheese come from. (I've even heard of chicken being offered as a vegetarian food -- was no one paying attention during biology class?)

Vegetarianism means eating plants -- preferably without a lot of factory processing. Whole grains. Fruits and vegetables. Peas and beans. Potatoes. That sort of thing. A meal that is centered around these foods is usually going to be lower in calories, and richer in vitamins and fiber and other things you actually need, than a meal centered around meat and cheese. The trouble with animal foods (apart from their high calorie-density) is that they tend to crowd plant foods out of your diet; most people don't get enough fruits and vegetables unless fruits and vegetables are what their meals consist of.

Concern about not getting enough protein scares some people away from trying vegetarianism even temporarily, but it's a pretty silly thing to worry about. The amount of protein we actually need is smaller than most people imagine. Vegetarians get enough protein, and meat-eaters tend to get too much. If you're not outright starving, you're unlikely to develop a protein deficiency. And you certainly aren't going to develop it by adopting a vegetarian diet as a temporary weight-losss measure.



Using the calendar

Weighing yourself every day at the same time, and jotting that number down on the calendar, is a good practice. It reveals trends, for one thing;  it shows how different kinds of meals and different levels of exercise affect the daily and weakly fluctuation of your weight. It also helps you focus on your weight-loss goals. Map out how much weight you're trying to lose over the next month, or the next week, and see if your daily results are on track or not (and if not, you know what needs to change).



Sacrificing alcohol

I love wine, and it seems to me that any self-respecting dinner ought to include it. However, the sad truth about alcohol is that it contributes a lot of calories to your diet, and these are among the "emptiest" calories around. Alcohol provides nothing that you can't live without, and what it does provide, your body already has too much of.

Alcohol is neither sugar, fat, nor protein, but your body can obtain energy from it -- about 7 calories per gram, in fact, which makes it considerably more calorie-dense than sugar (though not quite so calorie-dense as fat). Drinking or not drinking alcohol makes a big difference to your calorie intake for the day. A lot of people find that, if they're not willing to give up their beloved wine or beer for an extended period, they simply cannot lose weight.

Over the long haul, drinking wine is a healthy choice if you don't drink too much, but when you're trying to lose weight and having a hard time with it, it's better to give up wine for the time being.