The Harm of Calling T2D a Lifestyle Disease
Last updated: August 2023
Don't call type 2 diabetes (T2D) a "lifestyle disease." It's way more complicated than that. Personal lifestyle changes can positively impact diabetes. However, they don't resolve the underlying genetic predisposition or physical and environmental influences on health. Lifestyle changes alone don't cure diabetes.
Harmful impacts of the "lifestyle disease" label
Beyond being inaccurate, calling type 2 diabetes a "lifestyle disease" can cause further harm. Having a "lifestyle disease" falsely implies that the person can change how their body functions simply by changing their behavior and habits.
While nutrition and exercise can improve insulin resistance or manage weight, their impacts aren't reliably predictable, and, ultimately, they cannot make diabetes go away.
Labeling type 2 diabetes as a "lifestyle disease" and insisting that lifestyle changes are the best (or preferred) way to manage diabetes presents a false dichotomy that can lead to many kinds of harm.
The mental harm
The term itself, a "lifestyle disease," is stigmatizing. It suggests that type 2 diabetes is preventable and curable and that all a person needs to do is change what they eat and exercise more.
However, when eating better and exercising more doesn't yield the expected results, the person with diabetes could feel guilt and shame. They blame themselves for developing type 2 diabetes and feel the shame of being imperfect. They tell themselves that if only they were a better person – better at eating well or working out routinely – they would get the desired results.
The fact that a major organ in their body isn't correctly functioning doesn't even enter the thought process.
The physical harm
Delaying medical intervention
Focusing on lifestyle interventions can get in the way of seeking medical attention or starting medical treatment. The approach goes something like this: "I don't need to see a doctor or take medication. All I need to do is lose 20 pounds or exercise 30 minutes daily. A better diet and exercising is all I need."
Despite the time and effort, losing weight alone might not improve how the body processes glucose. If blood sugar levels remain elevated, the risk of damage to other organs is greater. In short, delaying medical treatment for type 2 diabetes boosts the risk of developing complications.
Disordered eating and compulsive behaviors
Conversely, focusing only on lifestyle changes can lead to obsessive and compulsive behaviors. For example, it could lead some people to believe that eating in moderation and exercising is insufficient. Rather, they believe they must be hyper-disciplined and never miss a day.
This kind of approach can lead to disordered eating and over-exercising. Disordered eating is considered common among people with diabetes and is associated with developing complications. Over-exercising can cause repeated hypoglycemic episodes, which is dangerous in itself.1
The social harm
Judgment from others
Labeling type 2 diabetes as a "lifestyle disease" highlights the choices someone with diabetes makes in social situations – especially regarding food and eating.
The inevitable questions, fueled with judgment, are asked of people with T2D. Questions such as, "Can you eat that?" and "Should you be having that?" are personal and feel like bullying.
These questions and comments from others can cause a person with type 2 diabetes to withdraw and socially isolate themselves. This can undermine their social support networks and harm their overall mental health.
The clinical impacts of labeling type 2 diabetes
The assumptions that come along with labeling type 2 diabetes as a "lifestyle disease" can also lead to clinical inertia. Clinical inertia is defined as "the failure to initiate or intensify therapy according to the guidelines."2,3
Assuming that a specific approach (like lifestyle interventions) is always the best one to use or not fully understanding the variety of diabetes treatments currently available can get in the way of prescribing the appropriate and appropriately intense treatment. Clinical inertia can result in high glucose levels for longer than otherwise possible, increasing the risk of additional health complications.2,3
Lifestyle factors are an aspect of T2D
Diabetes is a metabolic disease/disorder. Diabetes is a chronic disease with lifestyle factors. Lifestyle factors are only 1 part of the very complex work of managing type 2 diabetes.
While improving lifestyle factors can improve some health aspects, ultimately, they can't entirely fix the body's ability to process glucose.
Do you find it difficult to "eat right" and stick to a nutrition plan?