Smart Strategies for Weight Loss With Type 2 Diabetes

By Denise Maher


If you’re thinking, I’d love to drop a pants size, now is the time to forget the fads, stick to the facts, get serious and do it. Why the urgency? If you’re at risk for developing type 2 diabetes, losing weight—or curbing midlife weight gain—can help you avoid ever getting the disease. (Carrying extra weight, especially in your midsection, is a major risk factor for developing type 2 diabetes). If you’ve already been diagnosed with type 2 diabetes, losing weight can increase your energy, improve your body’s response to glucose, reduce your need for medication and help stave off life-threatening complications. And the kicker? It doesn’t take a major life change to reap the benefits. Reducing your total body weight by as little as 5 to 7 percent can get you there.

If you’ve just been diagnosed with diabetes, there’s no better time to start getting a grip on your weight. A diagnosis is a great opportunity to change course before serious complications such as kidney disease or heart disease develop. In fact, research suggests that the process of learning that you have type 2 diabetes — and the support, education and tools that come with the news — can help spark healthy change. Individuals who lost weight soon after being diagnosed with type 2 diabetes had better blood sugar and blood pressure control and were more likely to retain those benefits, even if they regained weight, according to a study by Kaiser Permanente researchers published in the journal Diabetes Care.


Take the Long Road

By now, you know losing weight is much harder than putting it on. But when you have diabetes, it can be even more challenging. For starters, you have to eat at regularly scheduled times and carefully balance your carb intake. That means no fad juice fasts, protein-only diets, skipping meals or other shortcuts. What’s more, certain diabetes medications can make it difficult to shed pounds. So how can you lose that extra weight and, more important, keep it off? The bottom line: Do it slowly and steadily (read: sustainably) through a combination of changes to your diet, getting regular exercise and finding ways to manage stress.


Choose to Lose

Once you connect with a doctor or a certified diabetes educator (CDE), you can start to understand the role of blood glucose (blood sugar), how to manage it, plan meals and set some realistic short- and long-term goals.

“Certified diabetes educators can help people with diabetes figure out which strategies — such as counting carbohydrates, using the glycemic index or the plate method — to use to keep blood sugar levels steady,” says Academy of Nutrition and Dietetics spokesperson Angela Ginn, RD, CDE. Don’t have a CDE? Call your health insurance company to connect with an educator whose services may be covered by your plan.

As you learn to keep food and/or glucose logs — tools that help you monitor and track blood sugar and the foods you eat — you’ll gain the confidence you need to take charge. Make no mistake, says Ginn, “diabetes is a self-management disease and you are in the driver’s seat.” Your doctor, CDE, nurse and pharmacist will offer support, recommendations and tools, but the goals are your own, and actually reaching them is on you.

To start, Ginn often offers advice about eating less food gradually by cutting down on portion sizes. Her favorite tips: Serve food in the kitchen onto individual plates — not family style on the table or straight out of a to-go container — to better track intake and make it harder to grab seconds. Next, scale down to a 9-inch plate — not the large platters that some use — to keep serving sizes in check. Using smaller plates can help create the illusion of the plate being more full, making it psychologically more satisfying.

Another key focus in the beginning of diabetes education is balance. Meals should deliver an even amount of carbohydrates (30 to 45 grams per meal for women, about 60 for men) and include foods high in healthy monounsaturated fats such as peanut butter or almond butter, almonds and walnuts. Balance makes meals more satisfying and helps tame your appetite. For example, a healthful, balanced snack like whole grain crackers with reduced-fat cheese won’t spike blood sugar levels, but should satisfy. What’s more, whole grains, with their extra fiber, protein and other nutrients, steady sugar levels so that hunger isn’t revved — making it easier for you to stop eating. Balance remains important in your snacks, since grains are still carbohydrates and portion control is still important.

Finally, know this: Understanding good diabetes nutrition will teach you not only what to eat and avoid, but also how to fit in your favorite foods. For example, if you strategize, you can slip in some dessert. Helping people with type 2 diabetes figure out ways to safely eat their old favorites every once in a while is another one of Ginn’s tried-and-true CDE tactics. Ice cream, anyone?


Move It to Lose It

Another great tool for keeping blood sugar in check? Exercise. The simple act of using your muscles improves blood glucose and insulin sensitivity at the same time it burns calories (sugar). Need to see the effects to believe it? Try measuring your blood sugar just before you exercise, when you finish and one hour afterward, suggests exercise physiologist Sheri Colberg-Ochs, Ph.D., professor of exercise science at Old Dominion University, adjunct professor of internal medicine at Eastern Virginia Medical School and American Diabetes Association spokesperson.

Exercise delivers immediate heart and holistic health benefits, too. It boosts energy levels and mood, helps you sleep better, strengthens bones, helps ease joint pain, and improves flexibility, blood pressure and cholesterol levels. Physical activity can also lower blood glucose and weight, so it may help you need less medicine. In fact, some people can control diabetes through diet, exercise and stress management alone.

While any physical activity will get your muscles moving and help burn calories, researchers have found that cardio exercise along with resistance training is the ideal combo for fighting diabetes. In fact, one study published in The Journal of the American Medical Association conducted by Louisiana State University System researchers found that a combination of aerobic exercise and resistance training improves HbA1c levels, reduces the need for diabetes medication and leads to more overall weight loss in people with diabetes than doing just aerobic exercise or resistance training alone.

In 2010, the American Diabetes Association and the American College of Sports Medicine updated their joint exercise guidelines for people with type 2 diabetes after it became evident that aerobic plus strength training is the winning combo. Specifically, the guidelines call for:

  • Moderate-to-vigorous aerobic exercise, such as brisk walking, at least 150 minutes a week, spread out over at least three days.
  • In addition to aerobic exercise, resistance (strength) training at least two to three times a week, on nonconsecutive days. (Resistance training is the use of free weights, resistance bands or your own body weight to build muscle.)
  • Regular and consistent exercise, with no more than two consecutive days between aerobic workouts.


Reviewed by Joseph Sclafani, MD on December 11, 2013
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