Why Am I Struggling to Lose Weight with Type 2 Diabetes?
In short
Losing weight with Type 2 Diabetes is often harder for 4 reasons: strict diets, hunger, some Diabetes medicines and expecting steady weekly losses. A flexible approach built around your routine, your medicines and the foods you enjoy is usually easier to keep up.
If you have Type 2 Diabetes and are trying to lose weight, you may feel that you have tried everything. Perhaps you have reduced your portions, followed different diets or made changes to your lifestyle, but the results have not lasted.
Weight management can be challenging, and it is rarely as simple as eating less and moving more. Understanding what may be getting in your way can help you find a more sustainable approach.
Why is it hard to lose weight with Type 2 Diabetes?
Losing weight with Type 2 Diabetes is harder when your eating plan is too strict, hunger gets in the way, your medicines affect your weight, or you expect the scales to drop every week. It is rarely about willpower.
Is your eating plan too strict to keep up?
Often, yes. Highly restrictive diets can leave you feeling hungry, deprived or frustrated, so you might manage them for a few weeks before returning to your previous habits.
A more flexible approach, built around foods you enjoy and your everyday routine, may be easier to maintain in the long term.
The NHS warns against switching to a very strict, low-calorie diet without talking to a health professional first. It may not suit people taking Insulin or other Diabetes medicines (NHS (opens in a new tab)).
Are hunger and cravings getting in the way?
They may be. Skipping meals, eating too little or choosing meals that do not keep you satisfied can make it harder to manage hunger.
Including sources of protein, fibre-rich foods and appropriate portions of carbohydrate can help you build more satisfying meals. Your individual needs will depend on your health, preferences and medication.
My protein-packed breakfast ideas show what a satisfying start to the day can look like.
Can Diabetes medicines make it harder to lose weight?
Yes, some can. Insulin and sulphonylureas such as Gliclazide can make weight gain more likely, and the NHS lists weight gain as a common side effect of Pioglitazone (NHS (opens in a new tab)).
Other medicines may increase the risk of low blood glucose if food intake changes significantly. If you take Insulin or medicines that can cause hypoglycaemia, seek advice before making substantial dietary changes.
Never stop or change a medicine yourself to lose weight. If you think one is affecting your weight, ask your Diabetes team whether your treatment is still right for you. If you have been prescribed a weight-loss medicine, read what to eat on Mounjaro.
Sleep, stress, other health conditions and your daily routine can also affect your ability to make and maintain changes.
Are you expecting the scales to drop every week?
Weight does not always change steadily. Short-term fluctuations can occur because of changes in fluid levels, digestion and other factors.
Progress can also involve improvements in eating habits, physical activity, blood glucose management and wellbeing, rather than the number on the scales alone.
Your blood sugar can start to improve before your weight does, and your HbA1c will usually show the difference after about 3 months.
What helps you lose weight with Type 2 Diabetes?
An approach you can realistically maintain helps most. Instead of starting another restrictive diet, you might begin by:
- establishing regular meals
- including more vegetables and fibre-rich foods
- planning ahead for busy days
- finding physical activities you enjoy
You do not need to change everything at once. Small, achievable adjustments can provide a starting point.
For activity, the UK Chief Medical Officers recommend at least 150 minutes of moderate activity a week, such as brisk walking, and say that some activity is better than none (UK Chief Medical Officers (opens in a new tab)). You can also check your BMI and read about the foods that help manage blood sugar.
Can losing weight put Type 2 Diabetes into remission?
For some people, yes. In the DiRECT trial, funded by Diabetes UK, 46% of people on a structured weight-loss programme were in remission after 1 year, rising to 86% of those who lost 15 kg or more (The Lancet, 2017 (opens in a new tab)).
In the NHS’s own low-calorie programme, about a third of people who completed it and had their results recorded were in remission after a year (NHS England (opens in a new tab)).
Remission means your HbA1c stays below 48 mmol/mol without Diabetes medication. It is not a cure, so the changes need keeping up. Read more about Type 2 Diabetes remission.
How can a Dietitian help you lose weight with Type 2 Diabetes?
A registered Dietitian can help you understand the factors affecting your weight and develop an approach that considers your Diabetes, medication, food preferences and lifestyle.
Rather than following a generic plan, you can work together to identify realistic goals and review what is or is not working.
Ready for a more personalised approach to weight management? Find out about my weight management support, read why a generic diet plan may not work for you, or book a free discovery call. Consultations are available online or in person.
