I was diagnosed with psoriasis in 1972, psoriatic arthritis (PsA) in 1976, and diabetes in 2016. I know that it is not uncommon for people with psoriasis to allow themselves to gain weight, and that obesity can lead to prediabetes. I have a history of diabetes in my family. My father and two brothers all were diagnosed in their 40s. Weight control is one way to try to delay the onset and negative effects of diabetes.
Shortly after I was diagnosed with PSA, initially in my knees, my rheumatologist urged me to lose weight, since the excess pounds would ultimately cause problems with my weight-bearing joints (hips, knees, ankles, and feet). He recommended that I limit my eating of fatty meats, fried foods, sugared sodas, candies, and desserts.
I believe that there are two primary ways to control weight – limit how much food you eat and burn off calories by physical activity and exercise. I understand that weight gain occurs when how much you eat is not offset by calories that you burn, since the excess calories are converted into body fat.
When I was diagnosed with diabetes, my endocrinologist took the dieting one step further. He referred me to a dietitian, who taught me the importance of diabetic patients limiting their carbohydrates. The body converts carbohydrates (e.g., bread, rolls, bagels, pasta, rice, potatoes) into sugar, which can, in turn, increase the blood glucose in your body.
Here are a couple of tips from the dietitian:
- If you must eat pizza, be sure to include some meat as a topping, which will mitigate somewhat against the carbohydrates in the crust.
- If you crave a bagel, scoop out the insides and only eat one-half of the crust, and be sure to include some protein (lox).
While insulin can lower the blood glucose score, it is easier to reduce carbohydrates at the front end at mealtime, and thereby reduce your need for increased dosing of insulin.
I learned that portion control refers to limiting the quantity of meats you eat at any sitting to the equivalent of the size of one fist. She also suggested that, to the maximum extent possible, you should try to fill up with fresh cooked vegetables rather than bread or potatoes, and have fruit for dessert rather than ice cream, cookies, or cake. Over time, my wife and I have limited our dinners to broiled or sautéed chicken, turkey, or fish, (all low-fat alternatives to beef, pork, lamb, etc.). The meat is accompanied by a cooked vegetable and a salad, with a low-calorie ice bar or fruit for dessert.
Over time, I have developed a greatly reduced appetite in general, but also less of a craving for any foods that include more than 8 grams of sugar. Fortunately, FDA requirements for food labeling on cans and bottles have made it easy for everyone to conform to dietary restrictions without guessing. It is easy to use substitute sweeteners (Stevia, Splenda, Equal) to fend off the “sweet tooth” cravings. With my diabetes generally under control, it is OK to have the occasional dessert at a party or otherwise, if you eat a small piece and test yourself shortly thereafter, and then use insulin as necessary.
By doing moderate exercise and physical therapy when necessary, I have been able to maintain muscle tone in and around the weight-bearing joints, while reducing the overall body weight borne by those joints. You will look better and feel better.
A disease like psoriasis, which involves visible areas of plaques on the skin, often leads to self-consciousness and low self-esteem, it is best not to add to those negative feelings about yourself by also being overweight. Controlling your weight also makes the job of the surgeon easier, if you require any surgery.
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