Diabetes type 2: The crucial role of weight management in regaining health

Although a lifelong condition, recent research reveals that it’s possible to reverse type 2 diabetes through targeted lifestyle changes. At the heart of this approach is weight management - a key factor for insulin sensitivity, blood sugar levels, and potentially diabetes reversal.

Dr Dipesh Patel, leading Endocrinology and Diabetes Consultant Physician, explores the crucial role of weight management in reversing type 2 diabetes, discussing how diet, exercise, and other lifestyle adjustments can support long-term health.

How does weight management affect diabetes type 2?

In type 2 diabetes, cells in the body become less responsive to insulin, a condition referred to as insulin resistance. Over time, this leads to high blood sugar levels, damaging organs and blood vessels.

Excess fat is closely linked to insulin resistance. Reducing body weight directly impacts type 2 diabetes by lowering insulin resistance, helping the body use insulin more effectively and better regulate blood sugar levels.

What are some safe and effective strategies for weight management?

For sustainable weight management in diabetes type 2, a combination of diet, physical activity, behavioural adjustments, and medical intervention is key. Some safe and effective strategies include:

Diet and nutrition

Diets that are high in refined carbohydrates, sugars, and processed foods can cause sharp increases in blood sugar, leading to insulin spikes and fat storage. Instead, it’s important to focus on balanced diets that are rich in vegetables, lean proteins, whole grains, and healthy fats like olive oil. Additionally, eating small meals throughout the day can also prevent blood sugar spikes and reduce cravings.

Regular physical activity

A mix of aerobic exercises (like walking, swimming, cycling) and resistance training (like weightlifting or bodyweight exercises) is recommended. Exercise improves muscle mass, which in turn helps insulin sensitivity and promotes weight loss. Start with 30 minutes of moderate activity five days a week, and gradually increase the intensity as you feel comfortable.

Behavioural therapy

Adopting new, healthier habits can be challenging, and working with a therapist can provide guidance. Behavioural therapy, including cognitive behavioural therapy (CBT) helps in recognising and changing behaviours that may interfere with weight loss and diabetes type 2 management, such as overeating. Behavioural strategies like mindful eating and keeping a food diary can also help in creating healthier habits.

Medical intervention

In some cases, medical intervention may be appropriate for people who struggle with weight loss despite lifestyle changes. These may include medication options like GLP-1 receptor agonists that help regulate blood sugar. Additionally, bariatric surgery may also be an option for people with severe obesity and related health issues, but this should always be considered under the guidance of a physician.

What psychological factors should also be considered in managing weight for type 2 diabetes?

Weight management isn’t only about physical changes. Many people with diabetes type 2 face psychological barriers to weight loss, including mental health conditions like stress, anxiety, and depression, which directly impact eating behaviours, often leading to emotional eating. Addressing these factors can support healthier eating habits.

Stress is particularly important because elevated stress levels can trigger the release of cortisol, a hormone that encourages fat storage and increases cravings for high-calorie foods. Learning stress management techniques such as mindfulness, yoga, or deep breathing exercises can help reduce cortisol levels and be highly beneficial. Seeing a therapist can also provide additional mental health support as well as motivation to continue making progress.

How much weight should I aim to lose to improve my diabetes type 2 management?

Research shows that even losing 5-10% of total body weight can lead to significant improvements in blood sugar levels, reducing the need for medication and lowering the risk of diabetes-related complications. For example, if a person weighs 90 kg, a goal of losing 4.5 to 9 kilograms is a good starting point.

When setting weight-loss goals, it’s essential to focus on gradual, sustainable weight loss rather than rapid results, which can lead to muscle loss and nutritional deficiencies. Aiming to lose around 0.5 to 1 kilogram per week is ideal. Consulting a physician can also help ensure that your weight loss plan is safe, effective, and tailored to meet your individual needs.

Throughout your weight management journey, regular follow-up appointments with your physician are crucial for monitoring progress, adjusting treatment, and monitoring key health markers such as blood sugar levels, blood pressure, and cholesterol. For most people, these appointments will typically take place every three to six months, though your physician may recommend more frequent visits initially.

If you would like to book an appointment with Dr Dipesh Patel, head on over to his Top Doctors profile today.