The Benefits of Weight Loss for Type 2 Diabetes: Prevent or Delay Complications and Other Health Risks
Need motivation to lose weight? These important facts and figures may tip the scale in your favor when preventing diabetes complications and other health problems.

Why Weight Matters

For people who carry extra pounds, weight loss promises a host of health improvements. Trimming just 10-20 pounds can pay huge dividends in managing type 2 diabetes and other ailments — and save you money on health care expenses.

Obesity causes a long list of problems — type 2 diabetes is only one of them. “Excess weight is at the root of more than 50 medical problems,” says Louis Aronne, M.D., clinical professor of metabolic research at Weill-Cornell Medical College in New York City.

Fat in the Fire

Central obesity — the accumulation of fat, or adipose tissue, around the abdomen and liver — is the master switch that sets off many obesity-related health problems, Aronne says. This fat buildup can give some peoples’ bodies an apple-shape appearance.

Excess weight activates white blood cells that trigger inflammation throughout the body. Inflammation in turn causes fat cells to expand and put out larger-than-normal amounts of some hormones, such as insulin. This overflow of insulin turns off the spigot of other hormones involved in blood sugar control. There’s also declining output of adiponectin, a hormone made in the adipose tissue that prevents type 2 diabetes and heart disease.

The changes that occur with inflammation and insulin resistance are at the core of the many weight-related problems. “These changes don’t show up overnight; they’re years in the making and surprisingly also are involved with infertility, depression, and generally decreased energy,” says Ronald Tamler, M.D., Ph.D., director of the Mount Sinai Diabetes Center in New York City.

Modest is Mighty

When excess weight is lost, many conditions show improvement. “The benefits — from lower glucose to having healthier skin — seem endless,” says Beth DeLauder, 46, of Stafford, Virginia, who has type 2 diabetes.

“I didn’t know I felt so bad. I was clueless about the many ways my extra baggage (pounds) was impacting my health.”

Weight loss need not be drastic. “Modest weight loss, 5-7 percent from starting weight, has what’s called ‘curious power’ to lower glucose, because it’s powerful beyond what would be expected,” says Donna Ryan, M.D., professor emeritus at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, and past president of The Obesity Society.

Best Time for Weight Loss

The sooner you trim down after learning you have type 2 diabetes, the better. You’ll salvage more of your existing insulin-making beta cells. Losing weight can rack up even more health benefits for people who have prediabetes or risk factors for developing type 2 because they may have less insulin resistance and more beta cells.

Weight loss soon after type 2 diagnosis may minimize the need for blood glucose-lowering medicines for a few years.

If you’ve lived with type 2 diabetes for a while and haven’t lost weight, move forward now. Most people will experience at least a few benefits regardless of the number of pounds lost or how long they’ve had diabetes, Aronne says.

The Biggest Wins

“From the standpoint of glucose control, shedding a few pounds by reducing calories and burning more with exercise gives you the biggest bang for your efforts,” Ryan says. Even people working to maintain their weight often experience continued improvement in glucose control, she says.

When it comes to lowering blood pressure and triglycerides and increasing HDL (good) cholesterol, modest weight loss provides a big assist, especially when achieved with regular physical activity. Shedding a few pounds can also improve depression, sleep apnea, and arthritis in the knees and hips.

Some conditions require greater weight loss to improve. Correcting LDL (bad) cholesterol requires shedding more pounds and typically a statin medication. “When it comes to the infertility issues in men and women, more than modest weight loss is needed — particularly in men — but any little bit helps,” Tamler says.

Try and Try Again

Even if you don’t lose weight or you regain some, preventing further weight gain is a plus. “The common trajectory of weight gain today is 2-4 pounds a year from a mere 50-100 extra calories a day,” Ryan says. “People and their providers need to be aware that weight regain, at least a few pounds, will happen, but renewed attempts at weight loss can succeed.”

Type 2 diabetes is progressive. Over time the ability to make insulin dwindles. Weight loss several years into having diabetes might help you improve blood sugar control or eliminate a blood glucose-lowering medicine. No matter when weight loss occurs, Aronne says, it’s always easier to manage your diabetes at a lower weight.

3 Ways to Start on the Road to Weight Loss

Ready to start losing weight now? Dr. Ryan suggests these action steps:

• Talk to your health care provider about whether losing a few pounds will improve your glucose control and offer other health benefits.

• Review your blood glucose-lowering medications with your provider: Are they foiling your efforts to lose pounds because they are making you hungry and/or causing hypoglycemia? Other glucose-lowering medicines may help you with weight loss while also lowering your blood sugar.

• Ask for a referral to a reliable and successful weight management program. Support and education are crucial for weight loss and maintenance.