Weight Control for Type 2 Diabetes
The American Diabetes Association recommends that patients aim for a small but consistent weight loss of ½ - 1 pound per week. Most patients should follow a diet that supplies at least 1,000 - 1,200 kcal/day for women and 1,200 - 1,600 kcal/day for men.
Even modest weight loss can reduce the risk factors for heart disease and diabetes. There are many approaches to dieting and many claims for great success with various fad diets. They include calorie restriction, low-fat/high-fiber, or high protein and fat/low carbohydrates.
Here are some general weight-loss suggestions that may be helpful:
- Start with realistic goals. When overweight people achieve even modest weight loss they reduce risk factors in the heart. Ideally, overweight patients should strive for 7% weight loss or better, particularly people with type 2 diabetes.
- A regular exercise program is essential for maintaining weight loss. If there are no health prohibitions, choose one that is enjoyable. Check with a doctor about any health consideration. [For more information, see In-Depth Report #29: Exercise.]
- For patients who cannot lose weight with diet alone, weight-loss medications such as orlistat (Alli, Xenical) may be considered. Unfortunately, orlistat produces only modest weight loss and may cause diarrhea.
- For severely obese patients (a body mass index greater than 35), weight loss through bariatric surgery can help in produce rapid weight loss and improve insulin and glucose levels in people with diabetes.
Even repeated weight loss failure is no reason to give up. [For more information, see In-Depth Report #53: Weight control and diet.]
Review Date: 05/05/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.