Diabetes is a metabolic disease that causes high blood sugar, or glucose. With diabetes, the body either doesn’t make enough of a hormone called insulin or can’t effectively use the insulin it does make. Insulin controls the levels of glucose in the blood after you eat a meal.
People with type 1 diabetes may lose weight unintentionally since they can’t use the sugar they eat for energy. In this case, the pancreas doesn’t make insulin, and sugar is removed from the body during urination.
Being overweight or obese increases a person’s risk for developing type 2 diabetes. People with type 2 diabetes have a condition called insulin resistance. This means that the pancreas can typically still make insulin, but the body can’t use it properly. The pancreas tries to compensate by making more insulin, but it eventually wears out.
Weight loss, which can be achieved through diet changes, exercise, and certain medications, can be an important way to help combat insulin resistance and treat type 2 diabetes, and in some instances type 1.
Unexpected or unintended weight loss is often a symptom of unmanaged diabetes, both type 1 and type 2.
With type 1 diabetes, the immune system attacks cells of the pancreas that make insulin. Since there’s no insulin available to move glucose into the body’s cells, glucose builds up in the bloodstream. The kidneys then work to remove this unused sugar through urination. The sugar isn’t used as energy, so the body starts burning fat and muscle for energy, resulting in weight loss.
Weight loss in type 1 diabetes may be unintentional. If people with type 1 diabetes need to lose weight, this can be done safely by reducing calorie intake. Some people may under-treat their diabetes to lose weight, but this is highly dangerous. Skipping insulin can lead to very high blood sugar levels, a serious complication known as diabetic ketoacidosis, and potentially death.
Under-treating diabetes to lose weight can be a symptom of an eating disorder. If you think you have an eating disorder, reach out to your doctor or a mental health professional to get specialized support and treatment.
Type 2 diabetes occurs when your body becomes resistant to insulin, causing sugar to build up in the blood. Having overweight or obesity puts you at a much higher risk for developing diabetes, and it makes blood sugar levels harder to manage.
In fact, research shows that losing just 5 to 7 percent of body weight may reduce the chance of developing type 2 diabetes by over 50 percent in adults at high risk for the disease.
There are many benefits to losing weight when you have type 2 diabetes. These include:
decreased insulin resistance , which makes it easier to reach target blood sugar levels- improvements in overall energy level and mood
- improvements in mobility
lower total cholesterol, triglycerides, and LDL cholesterol levels- lower chance of developing complications from diabetes, like kidney or heart disease
In some cases, weight loss can even restore blood sugar to a normal level and eliminate the need to take type 2 diabetes medications.
If you have type 1 diabetes, weight gain may occur once you start taking insulin. Losing weight may require fine-tuning your calorie and carbohydrate intake and insulin dose.
People with type 1 diabetes can also develop insulin resistance, and in that situation, would benefit from weight loss to help them need less insulin.
Certain medications used to treat diabetes also help with weight loss, including:
Metformin
Metformin is a commonly prescribed diabetes medication that is used to control blood sugar.
GLP-1 agonists
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are very effective at lowering blood sugar levels. They may also help with
Examples include:
- dulaglutide (Trulicity)
- exenatide extended-release (Bydureon)
- liraglutide (Victoza)
- semaglutide (Ozempic)
SGLT2 inhibitors
Another class of medications associated with
- canagliflozin (Invokana)
- dapagliflozin (Farxiga)
- empagliflozin (Jardiance)
Adjusting medications for weight loss
As you lose weight, your may need less medication to keep your blood sugar in target range. This can cause some people to develop low blood sugars. If you notice this occurring during your weight loss journey, talk with a medical professional to adjust your diabetes medications.
If you have diabetes and wish to lose weight, combining a balanced diet with physical activity is likely the best strategy. Even small changes to your diet can go a long way.
In general, you should aim for a diet high in non-starchy vegetables, lean protein, and whole grains.
Diet
The American Diabetes Association recommends using the Diabetes Plate Method when preparing meals.
For this method, use a plate approximately 9 inches in width and follow these three simple steps:
- Fill half the plate with non-starchy vegetables. Non-starchy vegetables are lower in carbohydrates and high in vitamins, minerals, and fibre. If you don’t have access to fresh vegetables, canned or frozen vegetables work just fine. Examples include leafy salad greens, peppers, broccoli, tomatoes, and Brussel sprouts.
- Fill one quarter of the plate with lean protein, such as chicken, fish, turkey, tofu, tempeh, and beans.
- Fill the other quarter of the plate with complex carbohydrate foods like brown rice, quinoa, oats, whole grain bread or pasta, and dairy products like low fat yogurt.
For drinks, stick with water or unsweetened tea whenever possible.
You should avoid snacking on high sugar, high fat, or heavily processed foods, like:
- candy
- cookies
- cakes
- fast food
- fried foods
Exercise
In addition to diet changes, exercise is also important for weight loss. Always talk with your doctor before starting a new exercise program.
Start by setting modest goals. You can begin by walking either outside or on a treadmill for 10 to 20 minutes each day. After a week or so, increase the time or the speed you’re walking.
Research shows that getting moderate intensity aerobic exercise for at least 150 minutes each week is enough to produce significant improvements in blood sugar control and help you lose weight.
Aerobic exercise includes activities like:
- walking
- running
- swimming
- dancing
- hiking
- playing tennis
To help get you motivated, you can join a gym or a group fitness class or exercise with a friend.
If you’re not sure how best to eat for diabetes, or if you want help with managing your weight, consider meeting with a dietitian or nutritionist.
If you have Medicare, you may be eligible for Intensive Behavioural Therapy for Obesity. This includes up to a year of in-person weight-loss counselling visits with a healthcare professional.
Certified Diabetes Care and Education Specialists (CDCES) are professionals who provide personal one-on-one support to people living with diabetes. They can help with:
- medications
- diet
- exercise
- blood sugar control
The Diabetes Foundation or the Association of Diabetes Care and Education Specialists can help you locate a free or low cost CDCES.
If you or a loved one are restricting insulin to lose weight, it can have very serious consequences. This practice is considered a type of eating disorder, and professional help is available.
Weight loss can be an unintended symptom of untreated type 1 diabetes. If you have type 1 diabetes and you’re losing too much weight, talk with a medical professional.
On the other hand, weight loss is an important part of the treatment program for people with type 2 diabetes and people with type 1 diabetes and overweight. Losing weight can decrease insulin resistance and make blood sugar easier to control.
If you have type 2 diabetes and are trying to lose weight, the best approach is to set realistic weight-loss goals and aim for moderation. Take steps to eat a more balanced diet, include more physical activity in your daily routine, and be sure to take all prescribed medications.
If you’re still concerned with your weight, don’t hesitate to talk with a medical professional or meet with a Certified Diabetes Care and Education Specialist.
https://www.healthline.com/health/diabetes/diabetes-weight-loss
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