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By Dr. John Beaney MB, BS; LRCP, MRCS (Retd.)

Hardly a day goes by without at least one program on TV or report on social media about obesity and diabetes. I'm sure you feel the same way as I do - they can't all be right! There is an enormous amount of conflicting advice.

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You’ve all heard it. If you want to lose weight, eat less and move more. It’s another way of saying ‘calories in versus calories out’. That has been the conventional wisdom for at least 50 years. In my 40 years as a doctor in general practice, that is what I too have taught thousands of patients. I really believed it to be true. It certainly makes perfect sense. What’s more, there is lots of evidence from people who have followed these instructions.

So why is it that as a nation, we are getting heavier? Those with excess weight are looking down the barrel of type 2 diabetes, heart attacks, strokes, and a whole range of chronic diseases. Cancer and Alzheimer’s Disease are much more common in overweight people. Bariatric surgery (removing most of a perfectly normal stomach) is now becoming commonplace.

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The idea that gaining or losing weight is a balancing act between intake of calories and burning them up with exercise is a myth.  

The conventional wisdom requires you to work out how many calories you need in a day based on your current height, weight, age, gender and activity level.  Then decrease the calories in and increase the calories out so there is an overall calorie deficit.

For a lucky few it works.  They are the ones who are metabolically fit.  They probably didn’t need to lose weight in the first place. 

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Type 2 diabetes is described by Diabetes Australia and other health organisations as a chronic, progressive disease, the epidemic of the 21st century and the biggest challenge confronting Australia’s healthcare system.

Apart from minor updates, management has remained unchanged for many years: follow a high complex carbohydrate, low fat diet, exercise and take more medications as your condition progresses.

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