Endocrinology-Diabetes Questions Diabetes

Can weight loss help me get rid of my diabetes?

I have diabetes and am trying to lose weight, personally would rather do this than have to be on meds for the rest of life. Will weight loss help me get rid of diabetes?

16 Answers

Absolutely.

Weight loss can help you get rid of diabetes. I have several patients who have done so. It takes a willingness on your part to make lifestyle changes. There are many options for you. If you have the will, you can achieve.

I am not making any recommendations because, I don't know enough about you to make recommendations. Talk to your doctor.
Yes absolutely
Yes
Here’s an article I wrote:

Weight Loss—Why is it so hard to do and what can be done?
Obesity is a disease located in the hypothalamus of the brain. Unfortunately, it’s like treating high blood pressure in the 1960s, we understand the lifestyle changes but only have a few medicines. Many drugs are in the pipeline.

The problem is that 70% of the nation is either overweight or obese. Arthritis, diabetes and sleep apnea are sky-rocketing due to obesity. Obesity is an actual disease as evidenced by inflammation in the hypothalamus of the brain. The brain fails to receive the hormonal input that causes one to feel full.
It is hard to lose weight because metabolism slows and the hunger hormone, ghrelin, increases.

The key to losing weight is taking action by setting up follow-up appointments with your physician, dietician and/or weight loss psychologist. Form the team and stick with it! Portion control works better than exercise but both are important factors.

Weight Watchers remains the most successful weight loss program according to clinical studies. The power of the group is motivating.

Remember to keep a food journal, exercise daily or every other day, weigh each day and wear a pedometer. Aim for 10,000 steps daily, bring the right foods into your house and eat only when you’re hungry. A great snack is air popped popcorn (not microwave or theater popcorn) with a little olive oil. It is a whole grain, gluten free and quite filling and can even be used as a meal substitute (no more than once a day).

The MyPlate approach increases satiety and decreases waist circumference even at 1 year. Essentially, you have a plate of food that is divided into quarters and includes whole grains, vegetables, fruits and proteins.

What is the best lifestyle change to lengthen your life?
It’s the Mediterranean diet which consists of lower carbs, olive oil, fruits, vegetables, fish, whole grains and a little alcohol. Basically, you are reducing white rice pasta, white potatoes, sweets, chips and bread.

Sugar and processed foods increase weight, elevate the risk for cardiovascular disease, double the cancer risk and heighten the risk of dementia.

This approach reduces dementia, cancer and heart disease!
Wow, so the father of medicine, Hipoccrates, was right. The best medicine is at the end of your fork. Ok, maybe they didn’t have forks back in those days but you get the idea.

Losing weight can preserve your memory, reduce arthritis, cure sleep apnea, prevent diabetes, decrease cancer and lessen heart attacks.

Interestingly, a Nov. 17th 2005 NEJM study showed in a 1 year study that a weight loss drug alone resulted in an 11 pound weight loss. An intensive lifestyle modification program consisting of 30 meetings added to a drug yielded nearly a 15 pound weight loss.

The drug plus eight 15 minute counseling sessions done by an MD helped patients to lose 16.5 pounds. Finally, the combo of intensive lifestyle modification plus the drug resulted in over a 26.5 pound weight loss.

If we extrapolate, perhaps Weight Watchers plus a medicine can be an effective strategy.

Another interesting strategy is just add fiber to your diet. Fiber can have many beneficial effects upon the body. In a small 8 week study from Nutrition Journal 201615:86, 10.5 grams of soluble fiber or psyllium reduced HbA1C by 1% (as good as a drug to lower sugar), improved the cholesterol and resulted in nearly a 7 pound weight loss.

So you could take a teaspoon of Metamucil=psyllium 3 times daily and lose weight. At the very least, you’ll likely improve blood sugar and cholesterol. A medicine called Gelesis100 (Plenity, Gelesis) is FDA cleared for weight loss. 25% of patients will lose 10% or more of their weight and it can be used in people who have a BMI of 25-30.

Let’s debunk a myth for just a moment. You must eat breakfast, it is the healthiest meal of the day. Breakfast doesn’t help you lose weight or help you live longer. It is your option if you wish to eat breakfast. See BMJ Jan. 30th 2019.

Newer medications (Belviq, Qsymia, Saxenda and Contrave) and surgical procedures can also be beneficial. All of these weight loss medicines create a sense of fullness and help one lose about 5% of total body weight, but the results can vary. The chart gives a quick overview.

The side effect profiles are low, but these agents can be expensive so utilize the coupons provided by your health provider.

Such medicines are indicated if you are obese (a BMI of 30 or higher) or if you are overweight (a BMI of 27-30) with a cardiovascular risk factor such as diabetes, smoking, high cholesterol or high blood pressure. BMI stands for body mass index and charts are numerous on the internet.

If you have a BMI of 35 or more (morbid obesity), then you may need to consider a procedure.

Commonly, gastric sleeves are being performed. By simply making the stomach smaller with this laparoscopic, surgical procedure, significant weight loss can be realized. This surgery carries the same or less risk than a gall bladder operation. It is indicated for individuals who are obese, especially if there are additional cardiac risk factors.

You can lose up to 50% of your excess body weight. So if you should weigh 200 pounds but you actually weigh 300, then a gastric sleeve procedure can help you lose an additional 50 pounds. According to Ann Intern Med. 2018;169(11):741-750, here are the percent weight loss for gastric bypass, gastric banding and gastric sleeve procedures:

1 yr. 31% 25% 14%

5 yrs. 25% 20% 10%

Gastric bypass has more side effects, but results in more weight loss. Also, gastric surgery likely reduces cardiovascular death in half according to JAMA 2018 Oct 16; 320:1545. Additionally, according to JAMA 2018 319 (3) 279-290, the overall mortality is significantly lower in each surgical group compared to no surgery.

Best,

Dr. Lipkis
No, but it would help tremendously.
Yes, especially if you have DM type 2. Obesity is a risk factor no only for diabetes but also for cardiovascular disease including Heart attack, Stroke, and Peripheral Vascular Disease. In Obesity, the fat tissue tends to block the receptors for insulin. Insulin is needed to open some canals in all cells of your body so that the glucose (sugar) can enter the cells and be utilize as source of energy. So, when fat tissue block insulin receptors, the insulin can not open the canals and the blood sugar stay high in your bloodstream. Here is the importance of losing weight.
It is possible to put type 2 diabetes "in remission" with weight loss. In fact, there was a trial in the UK that showed that this is indeed possible.
However, to be realistic, it is also important to note that most people who lose 5-10% of their body weight do regain it rather quickly. This is not due to a lack of willpower, rather it is due to the body's reaction to the weight loss. The body tries to protect a "biological set point" of weight, and has many dirty tricks in store for you (such as pumping out hunger hormones) when you lose weight.
Often times, people need to remain on weight loss drugs long term to maintain the lower weight. It is a conundrum. You must think in terms of resetting your body's weight set point.
I encourage you to exercise as much as possible, and to limit carbs as much as possible. Also, I would suggest avoiding "weight gaining" diabetic medications such as sulfonureas (like glyburide) and insulins. The newer medications such as ozempic might be a good choice for weight loss. I would also stay on the metformin.
If you are able to simply use diet and exercise, that would be wonderful, though you would be in the minority of people who are actually able to do that. Best of luck.
Yes, if it is early diabetes, which we call pre-diabetes, weight loss sometimes helps to prevent going forward to frank diabetes. Also, it will help the medications work better.
Thanks.
Yes it can absolutely help you control your blood sugar and improve your body’s own insulin sensitivity.
If you developed diabetes as an adult any weight loss and especially watching your carbohydrate intake will improve your blood sugars. There is a blood test called HGA1c which is a measure of your blood sugar control over the past 3 months. If that number is super high then chances are you will need medications in addition to weight loss and careful dietary intake. If the number is not high or borderline chances are that weight loss and strict low carbs diet will treat your high blood sugar.
Good nutrition and weight control is the first and most important step in diabetes prevention and management. Losing weight on a balanced diet with appropriate mealtimes frequently permits people to control their diabetes without medication. Appetite suppressants, used under medical supervision, may assist in lifestyle change..
YESSSSS!!!!!! Go for it!!!!!!


5% weight loss had been shown to improve blood pressure, blood sugar, and cholesterol.
As a matter of fact weight loss and exercise are essential to control diabetes. Maintaining an adequate weight for your age, height and gender is one of the best actions to defeat diabetes. Diabetes can be cured by implementing decisively these actions:

- 30 minutes of cardiovascular exercise at least 3 times a week
- Drinking only water and nothing but water
- A balanced diet. Avoid unhealthy snacking
- Maintenance of weight weight within target
Patients with Type 2 diabetes typically have insulin resistance, which leads to high sugar levels but also contributes to weight gain. Weight loss, by way of aerobic exercise, is a proven lifestyle modification to reduce insulin resistance, and aid control sugar levels better. It is not expected thought to get rid of diabetes as a disease since, by definition, diabetes is a chronic degenerative disease; however, weight loss and aerobic exercise can definitely help reduce sugar levels to completely normal values, just like a person without diabetes.
Hi
We offer customized plans for patient to lose weight. Modification of diet is the first step. Try to count your intake calorie.
No & Yes. No because diabetes is an inherited disease & we can't change our genes. Yes because diabetes is precipitated and continued by some environmental factors such as body fat, inactivity, overeating, etc. You can't change your genes but you can change the environmental factors that interact with your genes to both contribute to the development & progression of diabetes. Wt. loss will certainly help & you should be about it if you are overwt. It will improve your diabetes control even if it doesn't "cure". You'll always have the inheritance so always control the things you can control-the environmental factors.