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Weight loss and diabetes

Weight is a sensitive issue for many people and getting to an ideal, healthy weight is easier said than done. But when you have diabetes, there are huge benefits to losing weight if you're carrying extra weight.

You’ll have more energy and you’ll reduce your risk of serious complications like heart disease and stroke. Losing weight can help with your diabetes control too. And if you have type 2 diabetes, losing weight could even mean going into diabetes remission.

But millions of people with diabetes find keeping to a healthy weight a huge struggle. You're not alone in this, there's support out there to help – a good first step is to ask your healthcare team for help and advice.

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Around 60% of people with type 1 diabetes and around 85% of people with type 2 diabetes are carrying extra weight or are living with obesity.

    Benefits of losing extra weight

    There are so many benefits to losing extra weight – both physically and emotionally. 

    Extra weight around your waist means fat can build up around your organs, like your liver and pancreas. This can cause something called insulin resistance. So losing this weight could help the insulin you produce or the insulin you inject work properly.

    And as you start to lose weight and get more active, you and your healthcare team may need to look at your medication, especially if you treat your diabetes with insulin or sulphonylurea. This might mean reducing the dose or making other adjustments, but talk to your healthcare team about it. For some people, needing fewer diabetes medications is a great motivation for losing weight. 

    Although getting type 1 diabetes has nothing to do with weight, losing any extra weight will help you reduce your risk of complications and could mean injecting less insulin.

    And if you have type 2 diabetes, losing around 5% of your body weight can have real benefits for your health. If you have obesity, you are more likely to put your diabetes into remission if you lose a larger amount of weight,15kg (or 2 stone 5lbs), as quickly and safely as possible following your diagnosis. This could mean coming off your diabetes medication completely – a life-changing possibility. This is even more likely if you lose the weight nearer to your diagnosis and quickly. It's a myth that losing weight slowly is better for you. 

    Most people say they also feel better in their mood, have more energy and sleep better.

    We’ve got lots of information to help you maintain a healthy weight too, to help keep you on track and prevent putting weight back on.

    “We know that losing even 5% of your weight helps improve blood pressure and cholesterol levels. This can have a big impact on your overall health and go a long way to reducing your risk of serious complications, like heart disease and stroke.”

    Douglas Twenefour, our Deputy Head of Care and dietitian

    What’s a healthy weight to aim for?

    Before you get started, you need to know what a healthy weight is and what numbers you’re aiming for. This is about working out your Body Mass Index (BMI) and your waist size. 

    Know your weight

    Research shows that the more weight you lose, the greater the health benefits, but even losing just 5% of extra weight will improve your health. 

    BMI uses your height and weight to work out if you're a healthy weight. It doesn’t look at how much fat you have around the middle, so that’s why you need to measure your waist too. You can work your BMI out for yourself using this NHS tool  – it will show you your target range.

    For many people living with obesity, aiming for a healthy BMI may not be realistic. 

    Know your waist size

    A healthy waist size depends on your gender and ethnicity. It should be:

    • less than 80cm (31.5in) for all women
    • less than 94cm (37in) for most men
    • less than 90cm (35in) for South Asian men.

    Here’s our community champion Rohit to show you how to measure your waist.

     

    Can diabetes cause weight gain?

    If you have type 1 diabetes, when you start taking insulin, you might start to put on weight. There are lots of reasons for this, like how much insulin you take, your diet and the type of insulin you’re taking.

    Insulin is a growth hormone, and any growth hormone you take will mean putting on more weight. When you’re diagnosed with diabetes it’s also likely that you lost a lot of weight in a short space of time, as this is one of the symptoms, and the weight gain is part of the recovery. 

    The type of insulin you take can affect your weight in different ways. We’ve got more information about the different types and how they can affect your weight.

    If you’re worried about putting on weight, or you’d like some help losing weight, then we’re here to help

    Diabetes diet plans to lose weight

    You may have heard that diabetes can be controlled by diet. There is no such thing as a special diet exclusively for people with diabetes. There are a lot of different ways to lose weight – but there’s no one-size-fits-all diet. 

    It starts with finding a way to eat fewer calories than you need.

    A calorie (or kcal) is a unit of energy, which is in the food and drink we consume. Your body uses energy for everything we do – from breathing and sleeping to exercising. When you eat, you’re replacing the energy you’ve used, which helps you to maintain a healthy weight.

    As a general guide, government recommendations are that men need around 2,500kcal a day to maintain a healthy weight, and women need around 2,000kcal a day. But most people need different amounts of calories based on how their bodies work, how active they are and any weight management goals. 

    We’ve put together some 7-day meal plans to help you lose weight. They're all clinically approved, nutritionally balanced, calorie and carb counted, and can help if you want to lose weight:

    Evidence shows that the best approach is the one that you’re likely to stick to. So the key is to find a plan that you enjoy and fits in with the rest of your life. Everyone’s different and what works for some may not for others.

    Low-calorie and very low-calorie diets

    A low-calorie diet is made up of between 800 to 1200 calories a day – our DiRECT study used a low-calorie diet of around 850 calories a day to see if type 2 diabetes could be put in to remission. But DiRECT is not a diet. It’s a weight-management programme, delivered in GP practices in some areas of the country.

    Then there's a very low-calorie diet, which means having less than 800 calories a day. 

    We haven't created low or very-low calorie meal plans as these could be challenging for most people to make themselves at home. Most people who follow these diets use special meal replacement products, likes soups and shakes, which are nutritionally complete. If you chose to try a low-calorie diet like the one in DiRECT, speak to your GP or nurse first, especially if you use medications like insulin.

    Other diets

    low GI diet can help you manage your blood sugar levels, but the evidence for people with diabetes losing weight is not very strong. 

    There are other popular diets, like intermittent fasting (such as the 5:2 diet) and the Paleo diet. Unfortunately there isn’t enough strong evidence to say these are effective for weight loss in people with diabetes either.  

    Commercial weight-loss programmes

    Some people feel that they need more support and choose to join a commercial weight-loss programme. These usually involve calorie-controlled eating plans or meal replacements, like milkshakes or bars.

    It’s really important to ask lots of questions about these programmes, so you’ve got all the evidence and information you need to make an informed decision. Here are some ideas:

    • Has a healthcare professional been involved?
    • Does the programme offer advice on your diabetes (especially if you’re at risk of hypos)?
    • Are you getting all the nutrition you need from this programme?
    • Does the programme give support and education?

    Whether you choose to try one of our meal plans, or another type of diet, it’s really important that you talk it through with your diabetes team first. Starting a new diet will affect your medication or blood sugar levels, so you need their knowledge and support.

    Weight-loss planner

    "I keep a daily diary and log my weight and activity. It keeps me accountable and focused."

    Edward Morrison

    You can download My weight-loss planner (PDF, 534KB) to set goals and track your progress. By putting a plan in place and noting down your progress, you'll be able to see the positive changes you're making. 

    Your feelings about food

    The emotional part of trying to lose weight is important and can often be overlooked. 

    Do you feel guilty when you eat a treat? Do you eat more when you’re upset? Do you feel dejected if you can’t see progress straight away?
    These are really common feelings and tackling them can help you on the road to a healthier lifestyle and a healthy weight.

    Find out more about your feelings about food and diabetes.

    Connect with others and share tips in our online forum – we’ve made a board especially for people who are looking to lose weight.

    Exercise and being active for weight loss

    Regular exercise or physical activity has many health benefits and will help you in your weight loss journey. We’ve got more information about how much activity you should be doing and different ways to get active

    But before you start any new physical activity, speak to your diabetes team. They can make sure you have all the information you need about how your diabetes might be affected. Especially if you treat your diabetes with insulin  or certain diabetes medications like sulphonylureas, as being more active may increase your risk of hypos.

    Your diabetes team will support you to make the right adjustments to your medications to reduce your risk of hypos. 

    Weight loss surgery

    If you have a lot of weight to lose, ask your healthcare team if weight loss surgery is a possibility. There are different types of weight loss surgery, also called bariatric surgery. They aim to make you feel fuller sooner and eat less. Weight loss surgery can be a very effective way of losing weight, keeping your HbA1c in the target range and putting type 2 diabetes into remission for some people. 

    For people with diabetes, weight loss surgery isn’t just about weight loss. It is now seen as an actual treatment for type 2 diabetes, and the weight loss is a bonus. 

    Weight loss surgery changes the way the digestive system works, in ways that are helpful for people with type 2 diabetes. It can:

    • change how the hormones in your gut work, which in turn affects how your body makes insulin
    • increase the amount of bile acids that your body makes, these make your body more sensitive to insulin
    • improve the way your body uses insulin, leading to lower blood sugar levels.

    Diabetes weight loss medication

    Your healthcare team may be able to prescribe some weight loss medications which can help with weight loss. One of these is Orlistat. Some diabetes medications, such as GLP-1 analogues, can also help with weight loss 

    Your healthcare team can give you advice about whether these medications are right for you. Avoid buying medications online and always get advice from a healthcare professional 

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