How losing weight affects type 2 diabetes

Managing diabetes and losing weight often get tossed around in the same sentence, and it’s for a good reason: Losing weight kicks off a chain reaction in your body, often improving how your body uses insulin and reducing your blood sugar. In fact, lose enough weight and you may even get your blood sugar closer to target ranges. Here’s more about how the two are linked, how much you need to lose to see a difference, and the right way to go about it.

How can losing weight help with type 2 diabetes?

It’s actually pretty direct: “Weight loss can improve insulin resistance,” says registered dietitian Angela Goscilo, R.D. Insulin is the hormone released by the pancreas that helps move glucose from the blood to cells, where it’s used for energy. “One of the actions of insulin is to open up every cell in your body so that they can be fed by the glucose,” says David Marrero, Ph.D., former president for health care and education with the American Diabetes Association and former director of the Diabetes Translational Research Center at Indiana University School of Medicine.

When you have more fat, fat deposits in the muscle and liver — along with fatty acids released in the blood stream — increase inflammation and lead to insulin resistance. This ultimately leads to diabetes.

Losing weight kicks that whole process into reverse. “When you lose weight, you lose fat," says Marrero. And losing fat results in less fat in muscles and liver, and subsequently less resistance.

That can help reduce your blood sugar highs, which can bring on other benefits. “Losing weight and having better glucose control has a real effect on how you feel throughout the course of the day, by giving you more energy and improving your sleep,” says Elizabeth Venditti, Ph.D., director of the Diabetes Prevention Support Center at University of Pittsburgh School of Medicine in Pennsylvania.

Can losing weight help reduce the risk of diabetes complications?

Losing weight doesn’t just make blood sugar easier to control, end of story. It creates a ripple effect of health benefits, which may ultimately reduce your risk of developing a whole host of diabetes-related complications, including:

• Vision problems: Diabetes is one of the top causes of vision loss and blindness in the United States. “Going blind is often the largest fear for those with diabetes, more than any other disability, and the more overweight you have, the higher your risk,” says Dr. Michael Abramoff, M.D., Ph.D., professor of ophthalmology and visual sciences at the University of Iowa in Iowa City. “When your blood sugar stays elevated, it causes damage to the retina, in the back of the eye. Over time, there may be too much scar tissue for proper vision.” By losing weight and staying on top of regular eye exams to catch problems early, you can significantly reduce your risk of blindness and may even eliminate the chances of serious vision issues, Abramoff says.
  
  
• Cardiovascular diseases: Cardiovascular disease affects about a third of all people with type 2 diabetes and is a major cause of death. “Weight loss tends to improve blood pressure as well as cholesterol and triglycerides, which all have a major impact on heart health,” says Dr. David Baidal, M.D., assistant professor in the division of endocrinology, diabetes and metabolism at University of Miami Miller School of Medicine in Florida. The lower inflammation levels prompted by weight loss can also help prevent the buildup of plaque in your arteries, providing another heart health advantage, he adds.
  
  
• Kidney disease: Research estimates that up to half of all people with type 2 diabetes in the U.S. could develop chronic kidney disease, particularly older adults. Weight loss can make a big difference in whether that happens. “Excess weight causes the kidneys to work harder,” says Baidal. “Over time, this can affect kidney function in a negative way, potentially leading to kidney disease. Reducing your weight can lower your risk because your kidneys will operate more efficiently.”

Could losing weight help people with type 1 diabetes?

Since overweight and obesity aren’t significant risk factors for type 1 diabetes, weight loss hasn’t traditionally been part of the protocol for treating it. That thinking has now changed, though, as rates of overweight and obesity have increased faster for people with type 1 diabetes compared with the general population.

That, combined with the discovery that weight loss improves glucose control and lower weight decreases insulin needs, has led to the recommendation that people with type 1 diabetes with overweight or obesity lose weight to improve overall blood sugar management. “If you have type 1 diabetes and carry excess weight, it still impacts your glucose control,” says Venditti. “Weight loss will improve your insulin sensitivity the same way it would if you had type 2 diabetes.”

How much weight do you need to lose to improve type 2 diabetes?

It’s probably less than you think. The American Diabetes Association recommends states that adults with type 2 diabetes and overweight or obesity lose at least 5% of their weight and keep it off. If you’re 200 pounds, that means losing just 10 pounds can significantly improve insulin sensitivity — a.k.a. the body’s ability to use insulin efficiently. This should be done through healthier eating and regular physical activity, guided by a behavior change program like WeightWatchers for Diabetes (individual results may vary).

While 5% is a great goal, benefits like improved blood sugar, blood pressure, cardiovascular health, and cholesterol can start to be seen even before you reach that mark. “All weight loss is good,” says Marrero. “You don’t need to get back into your prom dress or lose 50 or 100 pounds — that’s not what we’re talking about. The insulin and glucose system is exquisitely sensitive, so the health benefits come from a much more modest weight loss. A little change is good; a little more change is better.”

Dropping 5% of your weight might even be able to help you pare down the number of medications you have to take or lower the dosage, adds Marrero. (Just make sure you talk with your doctor before making any medication adjustments.)

Does where you carry your weight matter?

It might. To understand why, you need to know about the two types of fat in the body: subcutaneous and visceral. The first sits between your skin and muscles — this is the kind you can pinch. The second kind, visceral, is stored deep in the belly and is considered more problematic. Visceral fat can cause fat to enter the bloodstream, the liver, and collect on the walls of your arteries, which can lead to chronic inflammation and increased triglycerides (a type of fat found in blood that increases your risk of heart attack or stroke). That link between visceral fat and inflammation is also why it contributes to insulin resistance, meaning that carrying excess weight in your belly can make it hard to keep your glucose levels where they should be.

Now for the good news: As you start to lose weight, you’ll start to lose visceral fat. And that will then help you lower blood pressure, improve cholesterol, and make insulin regulation more efficient. But there are also some specific ways you can encourage visceral fat loss (and weight loss in general):

• Move it. Any kind of exercise is beneficial here: Both aerobic activity and resistance training has been shown to help you lose visceral fat, although aerobic activity has a greater impact.
• Reach for protein. Fill up on lean sources of protein such as fish, poultry, and beans. In one study, people who focused on eating more protein had significantly less visceral fat than those who ate the recommended daily allowance.
• Sip mindfully. Drinking a daily soda is linked to higher levels of visceral fat (and it also makes it more difficult to control blood sugar). For beverages, reach for water or unsweetened iced tea more than sugary drinks.
• Tuck in early. Getting six or fewer hours of sleep nightly has been associated with larger waist measurements.
• Manage stress. The stress hormone cortisol is linked to larger waists, and stress can also affect your eating patterns, spurring weight gain. This is a good opportunity to turn to other people with diabetes for emotional support, like through diabetes-specific Workshops: Researchers have found that people with diabetes who engage in ongoing peer support have improved self-care as well as better glycemic control over a four-year period.

What’s the best weight-loss plan if you have diabetes?

Pick a weight-loss plan you can live with long-term — one that’ll make healthy habits stick. “A well-structured program with close monitoring and follow-ups is essential," says Baidal..

The WeightWatchers Diabetes Program helps you shift toward better-for-you behaviors when it comes to eating, moving, and even mindset. And research shows that it can help you lose 5.7% of your weight and reduce your A1C by 0.75% in six months.*

Remember to look for positive signs wherever you can find them. “You’re already testing your blood sugar regularly, so you’re going to start to see that your glucose is more in control and that you are in a target range more often,” says Venditti. “That feedback can be so motivating.”

Just make sure you connect with your doctor. Weight loss is often a key piece of the diabetes treatment puzzle, so they should be looped into your plan. They can also be instrumental in helping you set a weight-loss goal that’s meaningful and attainable — and celebrating your health wins along the way.