Reversing Diabetes Through Weight Loss: How Much Should You Lose?

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Losing weight can increase insulin sensitivity in people with type 2 diabetes, potentially putting the disease in remission if the loss is sustained.

Here’s how.

Your doctor probably preaches healthy eating habits and exercise to manage type 2 diabetes, and while both of those things work to help keep your blood sugar in check, they can also help you lose weight. And weight loss may be the key to reversing type 2 diabetes, according to an analysis published in September 2017 in the journal BMJ.

The authors noted that losing 33 pounds (lbs) often helps put diabetes into remission. Yes, that sounds pretty specific, but it makes more sense if you consider that the data is based on losing 15 kilograms, which equals 33 lbs. It's a bold statement, considering many people think type 2 diabetes is a chronic, lifelong condition.

The specific figure is taken from previous research: A study published in May 2016 in the journal Diabetes Care found that 40 percent of people who lost about 33 lbs and kept it off for six months through a low-calorie diet were able to send diabetes into remission.

In that study, the authors concluded that type 2 diabetes “is a potentially reversible condition.” That said, it doesn’t mean that you should aim to lose 33 lbs specifically. “Further work on this is ongoing, regarding the actual weight loss needed,” says study co-author Louise McCombie, RD, a research associate at the University of Glasgow in Scotland.

Indeed, this is part of a larger body of research that will be presented at the International Diabetes Federation in December 2017. And while 40 percent of people sending diabetes into remission is an impressive figure, it also suggests that this is possible for some people but not everyone.

The Connection Between Diabetes and Weight Loss

It’s well established that losing weight if you have prediabetes can prevent the condition from developing into full-blown diabetes. According to the Centers for Disease Control and Prevention (CDC), losing a modest 5 to 7 percent of your body weight is the magic range. That would be 10 to 14 lbs if you are a 200-lb person.

So why does weight loss make such a difference? “The key mechanism for the reversal of type 2 diabetes has to do with the loss of fat from the pancreas and liver,” says McCombie. She references a study published in October 2011 in the journal Diabetologia that found that losing weight by reducing caloric intake for eight weeks improved the function of beta cells, which are located in the pancreas and whose function it is to store and release insulin. The researchers said that insulin resistance and problems with insulin secretion all come down to excess fat in the pancreas and liver.

One problem? Many people with type 2 diabetes aren’t aware of how important it is to lose weight, which can have a big impact on your future health. “The consequences are severe, particularly as people are developing the disease much younger, and the [problems] have time to manifest,” says McCombie. Rather than solely relying on medication to manage blood sugar, weight loss has the added benefit of addressing the root cause of the disease, she notes.

Why Reversing Diabetes Depends on Sustained Loss of Weight

So here’s the rub: Weight loss may be easy initially — but what’s hard is keeping it off. “Weight loss maintenance is vital, and you need to have appropriate strategies in place,” says McCombie.

That’s the key. Otherwise, you’re at risk of slipping back into your old habits. If that happens, your numbers can go right back into the diabetes range, says Martha McKittrick, RD, CDE, based in New York City. “When people are first diagnosed with type 2 diabetes, they become really strict and start exercising and controlling their diet.

They may even see their blood sugar numbers come down to normal levels. They lose weight and are happy and relieved. But after a couple of months, the motivation goes away; most people return to their old habits, and diabetes comes right back,” she says.

There’s also something called the weight set point, in which losing weight gets increasingly challenging as you drop pounds due to a loss of metabolism.

McKittrick agrees that many people aren’t aware of just how important losing weight is when you have type 2 diabetes.

“I think that if they really understand — that if you shrink your fat cells, you will be able to use the insulin more effectively, therefore you can produce less insulin, so in a way you are ‘saving’ your pancreas from overworking and eventually not being able to make enough insulin — they may be more willing to make permanent changes,” she says.

8 Tips to Help You Reverse Diabetes by Losing Weight

To increase your chances of weight loss success, consider the following:

1. What’s your motivation? Make sure it’s positive. Phrases like “I can increase my life expectancy,” “enjoy a better life as I get older,” and “take less medication” will show you the bigger picture to help keep you on track, says McKittrick.

2. Change habits gradually. It’s a lot to ask yourself to start going to the gym six days a week if you don’t exercise now. A better option may be first building activity into your day, says McKittrick. “Exercise is such an important component to prevent type 2 diabetes or put it into remission. It encourages muscle cells to suck in sugar for energy, which helps lower blood glucose,” she explains. If you haven’t developed a full-blown exercise regimen, make part of your commute a walking commute, commit to taking your dog out for two short walks per day, or get out during lunch and walk.

3. Think about your diet. An eating plan that works for one person might not for another. For instance, you may thrive on a very low-carb diet, while someone else needs some healthy carbs, like quinoa, at their meals to feel satisfied, points out McKittrick. “Working with a registered dietitian specializing in diabetes can help you fine-tune your diet,” she says.

4. Know that your diabetes medication may affect body weight. For instance, while Glucophage (metformin) can lead to weight loss in some individuals, insulin may pack on extra pounds. If you’re having trouble losing weight, consider talking to your doctor to find out how your drugs for diabetes might be affecting your waistline.

5. Talk to your doctor about weight loss surgery options. If you meet certain criteria, you may be a good candidate for bariatric surgery, which studies suggest may help lead to better glycemic control. For example, an article published in February 2017 in the New England Journal of Medicine, from the randomized controlled Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial, found that bariatric surgery may be more effective than diabetes medication alone for helping people with type 2 diabetes achieve blood sugar control.

6. Monitor yourself. It’s crucial to keep your blood sugar in check. Monitoring can give you important feedback on how your actions affect your levels, McKittrick says.

7. Ask for help. Don’t be afraid to call in the reinforcements — and tell people about your weight loss goals. Having a spouse, family, or coworkers to lend their support is invaluable. “A team behind you can keep you on track,” says McKittrick.

8. Think bigger. If you have a bump in the road where you’re not sticking to your eating plan, and potentially not seeing weight loss results, think of the bigger picture. “Commit to getting back on track as soon as possible,” says McKittrick. “This is a long-term thing, not a quick fix. Following radical diets will send you straight back to your old habits. It’s important to be patient and think about the positive outcomes, like getting your blood sugar lower and possibly putting diabetes into remission,” she says.