Small Steps Matter

There is a global epidemic of diabetes and obesity. The World Health Organisation (WHO) declared a global obesity epidemic back in 1997 and it is getting worse. It exists in both developed and developing nations. An estimated 300 million people globally are classified as obese (Body Mass Index (BMI) of 30 or above). There has been a doubling of rates in the past decade in most developed countries. Two-thirds of Australia’s adults and a quarter of its children are either overweight or suffer from obesity.

Obesity increases the risk of illnesses such as type 2 diabetes, cardiovascular disease, stroke, sleep apnoea, knee problems, infertility, non-alcoholic fatty liver disease, high blood pressure and high cholesterol. Obesity also increases the risk of various cancers including kidney, colon and breast, as well as anxiety and depression.

Diabetes similarly causes chronic complications such as heart disease, peripheral artery disease (narrowed blood vessels which reduce blood flow to the limbs and can cause pain), stroke, eye disease that can lead to blindness, kidney damage that can lead to kidney failure requiring dialysis, nerve damage usually in the hands and feet, foot ulcers and amputations and erectile dysfunction in males. There are also disorders that may co-occur with diabetes including obstructive sleep apnoea, polycystic ovary syndrome, non-alcoholic fatty liver disease, gout, certain cancers and some autoimmune diseases (e.g. celiac disease, thyroid disease). Some possible complications due to diabetes treatment include hypoglycaemia, lactic acidosis and weight gain.

In addition, psycho-social complications of diabetes can include depression, anxiety, lack of motivation, significant diabetes distress, grief/loss, eating disorders (e.g. anorexia or bulimia nervosa), inability to drive a vehicle (as a result of hypoglycaemic unawareness or severe hypoglycaemic events), disordered eating (abnormal eating behaviours that reflect many but not all symptoms of eating disorders) and negative impact on relationships.

Research suggests a bidirectional (two-way) relationship between depression and diabetes. That is, depression increases in patients with diabetes (patients burdened with self-care challenges may find their psychological stress leads to depression) and the incidence of diabetes (specifically, type 2 diabetes) increases in patients with depression (depression is often associated with poor behavioural choices like physical inactivity and unhealthy dietary habits).

The principal psychologist (Ana Guinea) of Small Steps Matter has completed a Master of Science in Medicine (Metabolic Health), with a focus on these two areas (diabetes and obesity), in the Faculty of Medicine at the University of Sydney.

Small Steps Matter (SMALL STEPS, BIG CHANGES) was founded with the philosophy that taking small steps can make a huge difference. There are many such examples in life, for example, literally taking many small steps that result in achieving something that seems impossible, like climbing a mountain. This also applies to many physical health problems, including type 2 diabetes and obesity.

Ana Guinea has developed the evidence based Small Steps Matter Program to manage and reverse obesity and type 2 diabetes by promoting small healthy lifestyle changes. It is not like other programs where you must follow a fad diet, count calories, go hungry, have expensive meals delivered to you or attend an exercise boot camp.

The Program provides dietary and physical activity guidelines and explores psychological drivers (such as comfort eating and/or drinking) as well as the motivation to change. Up to date information will be provided on the metabolic effects of different types of food and drinks on your body so that you can make informed choices. Ultimately, realistic goals and strategies will be discussed and agreed upon across the 6 to 10 session program.

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