How Does Weight Loss Benefit Type 2 Diabetes? (And Tips for Success)
Key takeaways:
Carrying excess weight increases the risk of developing type 2 diabetes and contributes to worse health outcomes in those diagnosed with the condition.
In individuals with type 2 diabetes, weight loss could improve glycemic control and other health markers, plus potentially lead to diabetes remission.
Insulin resistance and medication-related weight gain can make weight loss challenging for those with type 2 diabetes.
Thankfully, SGLT2i and GLP-1 RA medications, like semaglutide, could be beneficial in helping individuals with type 2 diabetes achieve blood glucose control and weight loss.
But semaglutide should be used alongside — instead of replacing — healthy lifestyle changes.
When you have type 2 diabetes and carry excess weight, a common medical advice you’d receive from your healthcare team is: “Try to lose weight.”
Why? Other questions that may also pop up in your head include:
What’s the link between weight and type 2 diabetes?
Just how beneficial can weight loss truly be for the condition?
Wouldn’t insulin resistance prevent me from losing weight? How can we break this vicious cycle?
Find answers in this article.
The relationship between weight and type 2 diabetes
Put simply, the risk of type 2 diabetes increases linearly with an increase in body mass index (BMI). More than 90% of individuals with type 2 diabetes have obesity or are overweight.
Researchers have yet to fully untangle the (complex) cellular and physiological mechanisms responsible for the link between excess adiposity and type 2 diabetes. But, as of now, a widely accepted theory is that enlarged adipose tissues release:
Excess free fatty acids (FFAs)
Reactive oxygen species (ROS)
Pro-inflammatory cytokines
These together, cause long-term, low-grade systemic inflammation in the body — disrupting the insulin signaling pathway, paving the road for insulin resistance and type 2 diabetes.
Carrying too much fat tissue isn’t simply an independent risk factor for type 2 diabetes.
It could also lead to worse health outcomes for those already diagnosed with the condition, including:
Poorer blood glucose control
A higher risk of developing heart disease, stroke, and microvascular complications
Overall increased risk of mortality
Does weight loss improve type 2 diabetes outcomes in overweight individuals?
OK. So, excess weight contributes to and worsens type 2 diabetes.
But does that necessarily mean weight loss is beneficial? Research says yes. Weight loss has been found to exert profound beneficial effects on type 2 diabetes control and diabetes comorbidities.
And because you must be wondering … no, it doesn’t need to be anything drastic.
Moderate 5-10% weight loss in individuals with type 2 diabetes is enough to improve:
Glycemic control
Plasma triglyceride and HDL-cholesterol concentrations
Blood pressure
That said, greater weight loss can achieve diabetes remission — although the remission rate depends on several factors, including the duration of diabetes and the criteria used to define remission.
But just how much greater are we talking about?
The DiRECT trial, a structured weight management program involving a combination of dieting and lifestyle interventions, incorporated into a medical care setting offers insights.
The researchers found that type 2 diabetes remission occurred in:
7% of participants who lost 0 to 5 kg
34% of participants who lost 5 to 10 kg
57% of participants who lost 10 to 15 kg
86% of participants who lost 15 kg or more
Want to reap those weight loss benefits for yourself?
Check out NOVI Magnum, our personalized diabetes treatment program to help you control your blood glucose levels and work toward your weight goals.
Weight loss with type 2 diabetes isn’t always easy
Yes, weight loss is beneficial for type 2 diabetes management and treatment.
But let’s not forget the elephant in the room: when you have type 2 diabetes, you’ll face a much bumpier road to achieving successful weight loss than the average person.
The usual healthier lifestyle changes — e.g., being mindful of your calorie intake and physical activity levels — may not suffice because of:
Insulin resistance: When your cells and tissues don't respond to insulin (i.e., insulin resistance), the body will try to compensate by making more insulin to maintain blood sugar levels in the normal range. Here’s the thing, though. Insulin promotes fat storage or, in other words, weight gain. And what does that (ironically enough) encourage? That's right: insulin resistance. I.e., you're stuck in a vicious cycle of higher insulin levels/weight gain.
Medication-related weight gain: Some types of diabetes medication — primarily ones that work by affecting insulin, which promotes fat storage, in the body — can cause weight gain. Examples include insulin, sulfonylureas (e.g., gliclazide), thiazolidinediones (e.g., rosiglitazone), and meglitinides (e.g., repaglinide).
Enter, GLP-1 RAs
What’s another option?
A viable option appears to be semaglutide, which belongs to a class of medications known as glucagon-like-peptide-1 receptor agonists or GLP-1 RAs. GLP-1 is a hormone naturally released in your gastrointestinal tract in response to nutrient intake.
And by imitating its effects on the body, semaglutide could help with blood glucose control and weight loss through:
Triggering insulin release from the pancreas
Blocking glucagon secretion (note: glucagon stimulates the conversion of stored glycogen to glucose)
Slowing gastric emptying (promotes fullness and limits the rate of glucose absorption into the bloodstream)
“Rewiring” brain areas regulating appetite and reward, decreasing food intake
While GLP-1 RAs may seem like “breakthrough drugs”, their history date back to the 1970s.
That said, researchers only began to realize what this class of medication could do for type 2 diabetes in 1993, when a study published in Diabetologia found that infusing GLP-1 into individuals with type 2 diabetes normalized their blood glucose levels in 4 hours.
And as for semaglutide’s weight loss benefits?
It’d probably be 2021, when The New England Journal of Medicine published a study showing that weekly semaglutide injections led to an average of 14.9% weight loss in people with BMI ≥ 25.0 (i.e., overweight or obese).
Since then, plenty of other studies have also supported semaglutide’s weight loss benefits.
According to a 2023 trial published in The Lancet, for example, the researchers found that the estimated mean bodyweight change from baseline to week 68 in participants (randomly) assigned to the following groups were:
Oral semaglutide: -15.1%
Placebo: -2.4%
Of course, the use of semaglutide isn’t without side effects. People taking semaglutide for weight loss may experience:
Dizziness
Fatigue
Headache
Gastrointestinal issues (e.g., nausea, vomiting, diarrhea, constipation, and gassiness)
Semaglutide also isn’t recommended for those with:
A history of medullary thyroid cancer, gallbladder disease, and pancreatitis
Multiple endocrine neoplasia syndrome
Semaglutide shouldn’t replace healthy lifestyle changes
Ultimately, semaglutide can put successful weight loss in closer reach if you have type 2 diabetes. But it’s worth remembering that GLP-1 RAs are most effective when used:
Alongside healthy lifestyle changes (e.g., increased physical activity levels and a well-balanced diet)
Under proper and continuous medical supervision (to adjust the treatment plan, e.g., medication dosage, whenever necessary)
On that note, semaglutide — as with other GLP-1 RAs — isn’t available over the counter in Singapore. You must consult a doctor for a prescription.
And if you’d like to find out whether you’re a good candidate for semaglutide, why not check out NOVI Optimum Plus? Our personalized medical weight management plan offers a consultation that considers your age, gender, and complete medical history (e.g., comorbidities) to co-create the best treatment plan for you.