I’m banging my head against a brick wall here but trying to get help for a diabetic is really hard. I’m working with the local rep frm Diabetes NZ to try and find out what my family can do.
The standard info, though, seems to be look only at exercise, nutrition and medication.
That’s all well and good but lets look at the dieting industry as a whole. The reason it exists is because we find it really hard to put that balance in place when we are young, fit and relatively more able to make the choices. As you age (although unfortunately in NZ we now have adolescants with Type 2 diabetes) and your metabolism slows it gets harder and harder. What was hard before must seem impossible now.
But it’s not so hard, surely. We know what to do. It’s all spelt out to us, we see people doing it all the time. But still, the vast majority of us fail to actually make the necessary changes and to stick to them.
Consequently we have a new generation of books like Dr Phil’s The 7 Keys to Weight Loss Freedom and Paul McKenna’s I can make you thin which focus on the habits and lifestyle choices of being overweight rather than the mechanics of how to change it.
Yet the official line from the Government seems to focus on education. This may be important and it seems to be invaluable in some of the news items I’ve seen. But for many others education isn’t the problem. They know how to eat well but their western, affluent lifestyle requires them to eat large, rich meals – otherwise aren’t you mocking the western, affluent lifestyle? I doubt any of them would consider they think that way but going without the vast array of goodies paraded in front of you whenever you step outside, go shopping, watch TV or read a magazine is impossible.
Buried deep within the National Guideline Clearinghouse is an article on Management of type 2 diabetes. Here is one of the “Good Practice Points”:
GPP Consider referral to weight management health care practitioners for motivational counselling or specific energy balance assessment and advice when general lifestyle advice does not achieve a sustained weight loss.
Should this be a GPP? Or should it be a compulsary first step? Counselling is an anathema to many, too touchy feely. But if it helps a patient to accept that turning down the goodies is essential then maybe it’s a really good thing! If it helps them to accept the changes they need to make then it must be good. And if it helps them to understand just why they used to overeat then surely that’s good too!