Losing Weight When You Have Diabetes

Losing weight can be an important part of managing diabetes. Diabetes is a condition that affects how your body processes glucose (sugar). Your body either doesn’t produce enough insulin (a hormone that helps your body use glucose for energy) or can’t use insulin effectively. Losing weight may help you better manage your blood sugar levels.

Diabetes can affect metabolism and how the body processes food, making weight loss and weight management challenging. However, many people find that gradual weight loss is achievable with a balanced approach—healthful eating, regular exercise, and sometimes medication.

Weight loss is just one part of diabetes management. You and your healthcare provider can work together to create a safe, realistic plan.

Not everyone with excess weight will develop type 2 diabetes, and not everyone with type 2 diabetes has excess weight. Still, type 2 diabetes and weight are closely linked. For example, gaining weight—especially around your belly—raises your risk of developing diabetes, and having diabetes can lead to weight gain.

How Weight Affects Blood Sugar

Extra weight makes it harder for your body to use insulin, the hormone that moves sugar from your blood into your cells for energy. When your cells don’t respond well to insulin (insulin resistance), blood sugar levels remain high and increase the risk of type 2 diabetes.

How Diabetes Affects Weight

Diabetes itself can lead to weight gain. When your body doesn’t use insulin well, it produces more insulin to stabilize blood sugar. However, high insulin levels can lead to extra fat storage, resulting in weight gain.

The Benefits of Weight Loss

Not everyone with diabetes needs to lose weight. If you and your healthcare provider decide weight loss can be beneficial to your diabetes management, there could be some benefits.

When you lose weight, your body can become more sensitive to insulin, meaning it uses insulin better. This has several potential benefits, including:

Weight loss also helps improve blood pressure and cholesterol, both of which are important for protecting your heart health when diabetes increases the risk of heart disease.

Is It Harder to Lose Weight With Diabetes?

Living with diabetes may make weight loss harder if you’re overweight, some research suggests. Insulin resistance, certain diabetes medications, and changes in blood sugar can slow your metabolism, making weight loss challenging. 

Blood sugar changes can also lower your energy, making it more difficult to keep up with exercise and diet changes. However, with the right plan, people with diabetes can lose weight. 

A balanced diet supports both weight loss and blood sugar control. The general rule of thumb is to reduce daily calories by 500–700 calories, based on your individual needs. Your healthcare provider can help you determine what calorie deficit would be most safe and helpful for you and how to reach it.

It helps to balance each meal with protein, fiber, and low-glycemic carbohydrates to help keep blood sugar stable and prevent hunger. Recommended foods include:

• Non-starchy vegetables: Broccoli, leafy greens, peppers, cauliflower, cucumbers, and carrots are low in calories and high in fiber, which helps you feel full.
• Lean proteins: Lean meats like chicken and fish and plant-based proteins like beans are good choices for feeling satisfied after eating.
• Nutritious carbohydrates: Whole grains, starchy veggies (like sweet potatoes), low-glycemic fruits (such as berries or apples), and low-fat dairy support steady energy levels.
• Healthy fats: Foods like avocado, coconut oil, olive oil, and nuts slow digestion and help control blood sugar.
• Fermented foods: Yogurt, sauerkraut, and kimchi contain probiotics that support gut health, which may benefit blood sugar stability.

An approach dubbed “the diabetes plate method” can help make portion control easy. This method involves filling half a 9-inch plate with non-starchy vegetables, one-quarter with lean protein, and one-quarter with healthy carbs.

Sugary drinks, white bread, pastries, fried foods, and heavily processed snacks can cause sugar spikes and weight gain, so they should be avoided or limited on a weight management plan.

Diet Plans

While many diet plans are available, the Mediterranean diet continually ranks high in terms of health benefits and sustainability. This eating plan emphasizes vegetables, lean proteins, and healthy fats. It’s a good option for blood sugar stability and weight loss. Other diet plans or diet patterns that research suggests may help with diabetes weight loss include:

Combining aerobic exercise with strength training helps your body use insulin better, improving blood sugar levels. 

Aerobic exercises, like brisk walking, cycling, or swimming, increase your heart rate and help your body use energy. Strength training, like lifting weights or using resistance bands, builds muscle, helping you burn more calories at rest.

Aim for at least 150 minutes of moderate aerobic exercise each week, plus two days of strength training.

Diabetes medications and weight loss medications may be helpful options if you are looking to lose weight and have diabetes.

Diabetes Medications

Several medications for type 2 diabetes support weight loss by controlling blood sugar, reducing appetite, and improving insulin sensitivity. 

Glucagon-like peptide-1 (GLP-1) receptor agonists help control blood sugar and support weight loss by reducing appetite and slowing digestion. Examples include:

• Mounjaro (tirzepatide)
• Ozempic, Wegovy (semaglutide) 
• Saxenda (liraglutide)

Sodium-glucose cotransporter-2 (SGLT2) inhibitors aid in weight management by helping the body remove excess sugar through urine. Examples include:

• Farxiga (dapagliflozin)
• Invokana (canagliflozin)
• Jardiance (empagliflozin)

Certain diabetes medications may affect weight differently, with some causing weight gain. Work closely with your healthcare provider to ensure your treatment plan supports blood sugar control and weight management.

For those taking diabetes medications, following a consistent routine can help stabilize blood sugar, reduce cravings, and improve energy. These results can make it easier to follow a balanced diet and stay active.

Weight Loss Medications

Healthcare providers may sometimes recommend weight loss medications if diet and exercise aren’t effective on their own. In the United States, the Food and Drug Administration (FDA) approved several weight loss medications to support weight loss by reducing appetite, increasing satiety (fullness), or blocking fat absorption. These medications include:

• Xenical (orlistat)
• Contrave (bupropion/naltrexone)
• Didrex (benzphetamine)
• Qsymia (phentermine/topiramate)
• Tenuate (diethylpropion)

Weight-loss surgeries like gastric bypass or sleeve gastrectomy can support long-term weight loss and improved blood sugar control. Both can reduce hunger and limit food intake.

Gastric bypass changes the way your stomach and small intestine handle food. First, the surgeon will staple your stomach into different sections to make it smaller. The smaller top section, called the pouch, is where food will go. Because your stomach is smaller, you will get fuller faster. Second, the surgeon will connect your small intestines to an opening of the pouch. This way, food will bypass some of the small intestines so that your body doesn’t absorb as many calories.

A sleeve gastrectomy involves removing a large portion of your stomach. With a smaller stomach, you will feel full more quickly.

These surgeries are typically for people with a body mass index (BMI) of 30-35 or higher. However, they can quickly improve blood sugar. That’s why some healthcare providers recommend them as a way to manage diabetes, even for people without severe obesity.

Results aren’t always permanent, and some people may regain weight over time. A healthcare provider can discuss the risks and benefits with you.

Strategies besides what you eat, how often you exercise, and what medication you take can help support weight loss. These include:

• Take time to think about why you’re eating, especially when it comes to emotional eating
• Keep a food log
• Limit how much you sit during the day by increasing your steps or standing time
• Exercise on an empty stomach, which helps your body burn more body fat for fuel
• Set goals, and start small
• Ask for help from your support system to keep you accountable
• Speak to yourself positively, believing in and encouraging your own success

The main thing you’ll want to know when setting a weight loss goal is what the goal should even be. Talk with your healthcare provider about how much weight you should lose and how quickly you can expect results based on the changes you make.

When managing diabetes, setting small, achievable goals can build momentum and increase your chances of lasting success. Gradual changes are easier to stick with and can lead to lasting results. Start with one or two small changes, such as:

• Add a 30-minute walk most days.
• Reduce your intake of simple carbs or sugars.
• Swap soda for water or unsweetened drinks.
• Aim for 5,000 steps a day, gradually increasing to 10,000.

After you master a couple of these changes, you can add or increase your goals to help build and maintain your weight loss. Maintaining weight loss over time provides additional benefits, including:

• Improved blood pressure
• Decreased need for medications
• Fewer diabetes symptoms
• Improved fitness and mobility
• Better sexual health

How To Stay Motivated

It’s easy to feel discouraged if you don’t experience weight loss right away. However, small, steady lifestyle changes add up in powerful ways. Even gradual weight loss can lead to lasting health benefits. The goal isn’t necessarily quick results—it’s building sustainable habits that bring lasting improvement.

Tracking your progress can help you see just how far you’ve come. Consider keeping track of measurable outcomes such as your blood sugar and hemoglobin A1C (HbA1c), a blood test that measures your average blood sugar levels over the past two to three months. You can also keep track of how you feel, writing down and comparing your changes in energy and mood.

Keeping records of your sleep quality, fitness, strength, meals, and how your clothes fit can also help you see changes over time and inspire you to keep going.

Looking back, you’ll notice positive changes that may not appear on the scale but still add up to a healthier you. Each victory—like increased energy, increased strength, or more stable blood sugar—matters. Celebrate these non-scale victories as meaningful milestones. They’re signs of progress toward better health that can keep you moving forward, one step at a time.

If you’re trying to lose weight and have diabetes, it’s important to work closely with your healthcare provider. Seek support if you:

• Experience high or low blood sugar more frequently
• Are interested in medication or surgical options to support weight loss
• Struggle to lose weight despite making appropriate lifestyle changes
• Are unsure where to start with weight loss

Regular check-ins with your healthcare provider can help you adjust your approach and stay on track. It’s recommended that you see your healthcare provider for a check-in every three months if you’re having trouble meeting your treatment goal or every six months if you are hitting your goals.

Losing weight when you have diabetes can benefit your health and help you manage blood sugar levels more effectively. Ask your healthcare provider if weight loss is needed for your diabetes management and, if so, how much.

Although weight loss may be challenging, combining a balanced diet, regular physical activity, medications if needed, and other lifestyle adjustments can make a significant difference over time.