lack of evidence

[firecat]

This post in JunkFoodScience examines whether there is good evidence to support the widespread belief that people with type 2 diabetes should attempt to lose weight and/or eat according to a particular food plan (low-carb or modified fat or what have you). It concludes that there is no good evidence to support weight loss or any particular food plan as a treatment for type 2 diabetes—not many studies have been done, and the studies that have been done are flawed.

http://junkfoodscience.blogspot.com/2008/08/evidence-behind-dietary-and-lifestyle.html

Comments

[dreamalynn.livejournal.com]

This makes me wonder about the Conventional Wisdom about insulin resistance, which I believe is part and parcel of the PCOS I have. (Though I've never had this confirmed.) IR/PCOSers are constantly told to follow the low glycemic index thing, and are constantly told to lose weight (no matter how out of whack their hormones may be, and of course failure to lose weight is a personal willpower issue) and many doctors refuse to offer any sort of medication unless a patient is having difficulties trying to conceive, especially if they're deemed "noncompliant" in terms of diet. I don't get it. It seems like many with PCOS have to progress to full T2 diabetes before anyone is willing to treat the insulin related portion of the disease.

[firecat]

Some doctors prescribe metformin for PCOS. Metformin is supposed to help with insulin resistance.

I think (and vaguely recall reading about some studies, but don't know how good they were or even if they were on humans or mice) that the underlying disorders leading to PCOS and T2 diabetes also sometimes cause weight gain. I think that "treating" them by prescribing weight loss is kind of like trying to reverse aging with minoxidil.

[dreamalynn.livejournal.com]

Oh there's no question that PCOS, generic IR, metabolic syndrome and the other related ailments all have factors which cause weight gain. It's why it's particularly galling to have something which is obviously being caused/aided by a goofed metabolic system being blamed on lack of willpower/poor choices/personal failure.

And yes, Metformin and Glucophage are very successful in helping women with PCOS feel better, have fewer symptoms, reduce unreasonable carb cravings (a friend has described waking up from sleep feeling like she needed mashed potatoes) and (sometimes in conjunction with birth control pills) regulate menstrual cycles. But many women are denied the drugs until they're actively trying to concieve or until they've proven that they're good little girls by losing a significant amount of weight first. It's frustrating that there's no set standard of care, but it's an interdisciplinary ailment and most women are under the care of a doctor that only focuses on one part of the equation.

[firecat]

But many women are denied the drugs until they're actively trying to concieve or until they've proven that they're good little girls by losing a significant amount of weight

You probably know about this, but for the benefit of anyone reading who might not:

The blog First, Do No Harm documents stuff like this. It started as a result of a post on one of the fat activist blogs by a woman whose mother died because she was told by a doctor "Don't come back until you lose 50 pounds." So she never went to the doctor again, for decades.