Weight loss and diabetes: exploring the connection
Written on May 23, 2023 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
- Benefits of losing weight for diabetics
- Strategies for achieving diabetic remission through weight loss
- Weight loss tips
- Conclusion
- Everlywell can help with weight management
- Related content
The worldwide dual epidemic of obesity and type 2 diabetes is an important public health issue. The connection between obesity and diabetes is so strong there is a name for it—“diabesity.”[1]
Obesity is linked to 30% to 53% of new diabetes cases in the United States yearly.[2]
Almost 80% to 90% of type 2 diabetes patients are overweight or obese. This is alarming as type 2 diabetes is a disabling, progressive disease that imposes considerable burdens on individuals, families, communities, and the health system. The total direct medical and indirect expenditures attributable to diabetes in the United States amounted to about $245 billion in 2012.[3]
Benefits of losing weight for diabetics
There are so many benefits to losing extra weight if you’re diabetic—both physically and emotionally.
Extra weight around your waist means it can build up around your organs, like your liver and pancreas. This can cause something called insulin resistance. Losing this weight could help the insulin you produce or the insulin you inject work properly.
And as you start to lose weight and get more active, you and your healthcare team may need to look at your medication, especially if you treat your diabetes with insulin or sulfonylurea. This might mean reducing the dose or making other adjustments, so discuss it with your healthcare team.
For some people, needing fewer diabetes medications is a great motivation for losing weight.
And if you have type 2 diabetes, losing around 5% of your body weight can have real benefits for your health. If you have obesity, you are more likely to put your diabetes into remission if you lose a larger amount of weight, 15 kg, as quickly and safely as possible following your diagnosis.
This could mean coming off your diabetes medication completely—a life-changing possibility. This is even more likely if you lose the weight nearer to your diagnosis and quickly. It’s a myth that losing weight slowly is better for you.[4]
Strategies for achieving diabetic remission through weight loss
The most important factor in achieving remission from diabetes is weight loss, and two techniques—metabolic or bariatric surgery and lifestyle changes that restrict calories on a daily basis to achieve weight loss—have been shown to induce remission.
Studies of weight loss through restricting calories or metabolic surgery have found that people with type 2 diabetes who start with greater pancreatic function at baseline prior to the intervention are more likely to undergo remission. People who have had shorter diabetes duration are also more likely to undergo remission.
Type 2 diabetes is a progressive disease, and after a long time with diabetes, pancreatic function may decline over time. Thus, observations suggest that after having diabetes for a long period of time, significantly improving pancreatic function and achieving remission may prove to be more difficult compared to achieving remission early in the natural history of the disease.
For example, consider the Diabetes Remission Clinical Trial (DiRECT) conducted in primary care practices in the United Kingdom, where researchers examined type 2 diabetes remission rates in participants who lost weight, starting with a very low-calorie diet and sustaining the weight loss over time. DiRECT found high rates of type 2 diabetes remission among people who lost a significant amount of weight—more than 10 kg (about 22 pounds)—and sustained the weight loss over 12 to 24 months.
Both healthcare professionals and people who have type 2 diabetes should realize that significant weight loss either from lifestyle intervention (i.e., diet and exercise) or from certain procedures can result in blood glucose levels decreasing into the nondiabetic range and that achieving remission can minimize or prevent future complications.[5]
Weight loss tips
The American Diabetes Association offers the following to lose weight for good.
Break the cycle
By losing just a few pounds with healthy eating and exercise, you’ll start to feel better. You’ll have more energy. And it will get easier to manage your diabetes, all while reducing your risk of developing other related problems.
Get back to basics
The key to weight loss for most people is simply finding the right combination of exercise, healthy foods, and portion control. No fad diet required.
Know why you’re eating
Emotional eating can quickly sabotage weight loss efforts. If you can pinpoint the emotions that cause you to reach for food, you can stay on track.
Stay positive
The way we frame our weight loss journey can have a big impact on progress—good or bad. Learn some positive self-talk strategies that will keep you in the right frame of mind.[6]
Conclusion
Overall, with significant weight loss through calorie restriction or bariatric procedures, you have a high likelihood of achieving diabetic remission, particularly if you have a greater baseline pancreatic function and have had diabetes for a shorter time.
Everlywell can help with weight management
Everlywell offers the opportunity for you to partner with a clinician through virtual visits for weight loss online. This will allow you and the clinician to discuss your weight goals and determine if GLP-1, an anti-obesity medication, is right for you.
We also offer the home-collection hemoglobin A1c test (HbA1c test), which is an easy way to measure how well you have been maintaining your blood sugar levels for the past 90 days.
Related content
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Managing weight loss drug side effects: how it works
References
- Ng ACT, Delgado V, Borlaug BA, Bax JJ. Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging. Nat Rev Cardiol. 2021 Apr;18(4):291-304. doi: 10.1038/s41569-020-00465-5. https://pubmed.ncbi.nlm.nih.gov/33188304/.
- Obesity contributes to up to half of new diabetes cases annually in the United States. Journal of American Heart Association. https://newsroom.heart.org/news/obesity-contributes-to-up-to-half-of-new-diabetes-cases-annually-in-the-united-states. Published February 10, 2021. Accessed on May 11, 2023.
- Nianogo RA, Arab O. Front. Public Health, 05 April 2022Sec. Public Health and Nutrition Volume 10 - 2022. https://doi.org/10.3389/fpubh.2022.818816
- Weight loss and diabetes. Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/whats-your-healthy-weight/lose-weight#:~:text=Although%20getting%20type%201%20diabetes,real%20benefits%20for%20your%20health. Accessed on May 13, 2023.
- Achieving Type 2 Diabetes Remission through Weight Loss. NIDDK. https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/achieving-type-2-diabetes-remission-through-weight-loss. Published September 20, 2020.Accessed on May 11, 2023.
- Lose weight for good. American Diabetes Association. https://diabetes.org/healthy-living/weight-loss. Accessed on May 13, 2023.