I got rid of insulin

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Life is beautiful if you are healthy and have adequate resources for living. But when there is some problem in the body, life gets out of track and things become dull and unexciting. And when you have to take medicines regularly, it makes things all the more miserable. 33-year-old Khawaja Abdul Basit, a resident of Rawalpindi, faced multiple health problems at a young age. Obesity topped the list. This brought other health problems for him later. Jane Velez-Mitchell, a famous American television host and author says, “obesity affects every aspect of people’s lives, from health to relationships”. And it was true for Khawaja as well. He was not only suffering from medical problems but hurdles in finding a bride.
Weight gain for him did not occur overnight. He was chubby as a child and even during adolescence. But as a teenager he had become aware of his excess weight and made slight efforts to reduce it. “I used to play cricket thinking I would probably become slim. But it did not turn out to be effective. My weight kept fluctuating”. At 32, he weighed 100 kg. Unfortunately, at this time he came to know he was suffering from type2 diabetes. This was such unexpected news. Interestingly, none in his family was diabetic. “People used to tell me that obesity is a root of various diseases but never realized this until now. And it was too late”.
After diagnosis, he was given medicines for controlling his sugar level. They worked but in next four months his weight reached to 124 kg. The doctor advised him to reduce weight but he was not much serious about it. According to Dr Rezzan Khan, a nutritionist at Shifa International Hospital Islamabad, usually diabetics who rely on medicines become carless about their eating habits. “They think they do not need to make any effort because the medicine will take care of their weight issue. But it is not true”.
Meanwhile, he started to have high blood pressure as well. He was prescribed medicines to control this problem too. Medicines however, were not enough to control his diabetes. He needed to switch to insulin. And life just kept going. By the mid of 2014, his weight jumped to 140 kg. “It increased so rapidly that in eight months I put on 40 kg. This depressed me”. He was engulfed in so many problems. On one hand, he was battling with diabetes and on other hand he was making desperate efforts to control his fast-paced weight. Doctors had already warned him that if he did not reduce it, he would complicate his condition further. And their prediction came true in the next few weeks, when he started to experience severe depression. “I was obsessed with the thought that how could I control my weight. It seemed impossible”. His condition was worsening so had to be put on anti-depressants.
Khawaja is a trader and used to work long hours just sitting on his chair. He did not have much time to go out for a walk. “I think my working style was the main reason which caused me all these problems”. Now, he did not have much stamina. He was also suffering from shortness of breath. His doctor told him to lose weight at any cost, even if it meant through surgery. Otherwise he would suffer from kidney failure and heart problems. “I realized I had fallen into a deep pit. And I should visit a qualified doctor for weight reduction”, says Khawaja.
He went to a doctor in Rawalpindi for that purpose who advised him liposuction. But for a second opinion, he went to Shifa International Hospital Islamabad in December last year. Here he met Dr M A Hashmi, a general surgeon who advised him to visit a nutritionist. The doctor wanted to make him reduce weight naturally instead of going for liposuction. He went to the nutritionist half-heartedly. “I had decided that if the nutritionist’s help did not work, I would go for liposuction. I was tired”. He had lost hope to reduce weight through diet and exercise.
“When he came to me, he was lethargic and suffering from severe depression”, says Dr Rezzan. He was simultaneously visiting a psychiatrist and an endocrinologist because his diabetes was fluctuating.
On 31 December 2014, Dr Rezzan put him on a three month weight loss program in which he had to diet, exercise and make behavioral changes. The nutritionist had given him hope that he would definitely lose weight if he followed her instructions. This was not just another weight loss program. He had to go through a complete process starting from taking down his height and weight, his diet and medical history. After calculating his fats, the nutritionist asked about his lifestyle; when he got up, went to bed, meal timings and physical activity. His potential for weight reduction was also assessed and then finally a diet plan was made for the patient.  Next came the major task. “Patients on the weight loss program are given a diary for writing whatever they eat or drink and exercise during the whole day. We also measure their mood patterns”, says the nutritionist. This diary was examined by the nutritionist after a week. And unhealthy things being eaten were told to be excluded and alternatives were given to him. The main purpose of this nutritional plan is that the patient should not feel hungry and deprived of food. If he would not be able to manage these things, he would not be able to accomplish his goal. “Our aim is to change a patient’s behavior”, adds the nutritionist. Khawaja was also asked to monitor his blood sugar level frequently to avoid hypoglycemia; low blood sugar. “Because it is more dangerous than hyperglycemia”, says Dr Rezzan.
Earlier, Khawaja did not have a regular time table for meals. “I used to give large gaps between meals. But the nutritionist informed that this was inappropriate”. She advised him to take two slices of brown bread, a boiled egg and a cup of tea at breakfast. Between breakfast and lunch he could have a fruit like apple, orange or banana etc. At lunch, he would take a small chapatti with pulses or vegetables cooked in only one teaspoon oil. And in evening, some snacks or a handful of nuts. And at dinner, a chapatti with vegetables or pulses.  Salads were also included in his diet plan. “Later in night, if he felt hungry he could take a cup of milk with a teaspoon of husk”, says Dr Rezzan. Last but not the least, he was asked to walk half an hour a day. Such a diet plan however, does not work for all. The nutritionists consider all aspects of a patient and then recommends a diet plan individually.
“Khawaja was anxious to lose weight. I kept checking on his nutritional diary and found he was eating everything according to my recommendations”, informs Dr Rezzan. Two weeks later, he informed the nutritionist that his endocrinologist had taken him off the insulin because he did not need it any more. “After following the program properly, I started to feel a change in my life. I was feeling lighter and my stamina was improving”, says Khawaja. After following the nutritional plan, he not only got rid of insulin but also quitted taking tablets for blood pressure and depression. Nowadays he is taking only a small pill for regulating his blood sugar.
Dr Rezzan does not forget to add, that this plan is not just for three months. “It is for life time and a person should be mentally prepared for permanent lifestyle and food changes”. But how was it possible for him to get off insulin so easily? According to Dr Rezzan, insulin increases fat synthesis. When the production goes up, the requirement for insulin goes up too. It is like a vicious cycle. When the patient reduces the fat, his cells become more sensitive to insulin, and then with a small quantity of insulin they can utilize the glucose properly. Khawaja already had a small amount of insulin in his body. But his body was not able to utilize it properly because of large deposits of fat. After reducing weight, he was able to depend on his own insulin. Now the tablet he is using increases the cell sensitivity to insulin.
In three months he had reduced 20 kg. The nutritionist’s aim is to bring him to 90 kg so that he can eat normally. “I am hopeful that in the next six months I will shed another 30 kg”, says the determined Khawaja.
But for staying healthy, he would have to keep a check on his eating habits and exercise regularly.
When treating obesity, Dr Rezzan says that we need to educate the family as well along with the patient. Obesity is increasing in Pakistan and our eating habits are causing many health problems.
“Juices, soft drinks, sugary and fried foods all should be avoided. Minimize the use of oil. One to two teaspoon of oil is enough for each family member”. Moreover, avoid eating in huge quantities at one time. Instead eat in small quantity in short intervals. Also do not eat in a hurry. Eat a fruit or some healthy snack between the meals. “This is good for regulating the blood glucose level which helps in concentration. When blood sugar level goes down, a person becomes irritable and cannot concentrate on his work”. Food has a direct link with our concentration, work and brain.
Khawaja now feels good and much lighter when he works. He has become a much confident person with a high self-esteem. His determination led to his achievement. And now he has decided that after shedding weight, he will start to search for his life partner. We wish him good luck in this mission too.

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