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Weight & Waist

A waistline of over 40” for men or 34” for women indicates central obesity.  It is more often recognised that a condition called metabolic syndrome can have a detrimental effect on longevity and health in general, and the hallmarks of this condition are:-

• BMI of more than 25.  (This is your weight in kg divided by your height in meter squared).
• Central obesity.
• Elevated levels of triglycerides.
• Raised levels of insulin.
• Occasionally, there is dark pigmentation affecting areas such as the armpits, called acanthosis Nigerians.

The main mechanism operating in this condition is resistance to insulin and trials have documented that losing weight would increase sensitivity to insulin, which would improve glycaemic control, reduce heart disease risk factors and allow a reduction in the dosage of insulin, which in itself is a weight promoting treatment.

The same mechanism operates with insulin, whether it is endogenously produced or exogenously introduced through injections.  Your doctor might need to introduce what is called an insulin sensitiser, such as Metformin or a glitazone.  The latter is not licensed to be used in patients who inject insulin in the UK at the moment, although it is licensed elsewhere.