Should I Join a Weight Loss Program for Type 2 Diabetes?

Health Writer
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If you have type 2 diabetes, your doctor may have told you that you’ll be able to improve your health if you lose 5 to 10 percent of your body weight. You may be eager to lose weight but may be unsure how to do it on your own. For some people, joining a formal weight loss program is helpful.

“About 20 percent of patients can do this on their own,” said obesity researcher Donna Ryan, MD, associate executive director for clinical science at Pennington Biomedical Research Center at Louisiana State University, in an e-mail interview. “However, most people struggle for various reasons, but not because of lack of will power. The pitfalls are increasing hunger during the weight loss effort and not knowing the behavioral skills to make weight loss possible.”

If you’re considering joining a formal weight loss plan, consider the following advice:

Know what you're capable of

There are many formal weight loss programs to choose from. Some may require you to count calories, weigh your food or classify what you eat into different categories. For others, you may need to eat the prepared foods that are delivered to your home. Some programs include in-person meetings with others on their weight loss journeys, while others encourage online support groups. Still others may have you interacting in a healthcare setting. Before you choose a plan, be sure to consider your habits and preferences, as well as your schedule, to ensure that you’ll be able to follow through.

“I always ask patients what has worked well for them for weight loss in the past, as this tends to predict their future success as well,” said Jamie Mullally, MD, assistant professor of medicine at Columbia University Medical Center, an endocrinologist specializing in obesity medicine at the Columbia Weight Control Center, in an e-mail interview. “It’s really about finding a program that the patient likes and can adhere to.”

Embrace the group dynamic

When you join a formal weight loss plan, you’ll typically interact with other people who are having similar experiences as you. You’ll also have access to someone who can provide help or advice when you need it. These aspects of the plan may help you lose weight or stick with the program.

“Studies showed that attempting weight loss in a group is much more successful than to do it alone,” said Osama Hamdy, MD, PhD, medical director of the Obesity Clinical Program and director of the Inpatient Diabetes Program at Joslin Diabetes Center, in an e-mail interview. “Group dynamics encourage weight reduction and provide a needed support. Doing it with a health coach is always beneficial, not only for guidance but also for accountability.”

Think beyond commercially available programs

When you’re considering formal weight loss programs, you probably think of programs that advertise on TV or in magazines. But it may be worthwhile to ask your doctor to recommend a program that meets in a healthcare setting and is tailored specifically to the needs of people with type 2 diabetes.

“There are supervised medical weight loss programs where patients actually see a nurse practitioner in the practice on a weekly basis,” said Saleh Aldasouqi, MD, chief of the endocrinology division and professor of medicine at Michigan State University, in a phone interview. “They continue to follow the patient for months and maybe years, and they have documented sustained weight loss.”

Researchers have shown that these programs can be quite successful: Nearly half of the participants in a weight loss program for people with type 2 diabetes that met in doctor’s offices were able to reverse their diabetes and stop taking medication for the condition.

“They just enrolled patients in primary-care clinics and asked the nurses to prescribe a healthy, low-carb diet, and monitor the patients,” Aldasouqi said.

Don’t lose momentum

Being patient is important when you join a formal weight loss program because you won’t see results overnight. Knowing that you’re taking strides to improve your health may help you stick with the plan.

"Losing weight is hard work. There is no magic.” - Donna Ryan, MD

“These programs are the gold standard,” Ryan said. “The down side is that they take time and commitment. Losing weight is hard work. There is no magic.”

Once you’ve been successful, it’s important to continue the same eating habits long-term to maintain your weight loss. Rather than thinking of your weight loss program as a temporary eating plan, it’s better to think of it as having learned new habits that you’ve adopted for life.

“They work in the beginning, but once the patient quits, the weight comes back,” Aldasouqi said. “Nothing sticks unless you stick with it.”

Think small at first

Advertisements for commercial weight loss programs often highlight people who have lost 50 pounds or more, but they may have fine print that says, “results not typical.” You may be eager to become slim, but some diabetes medications make it harder to lose weight, and you may have other diabetes-related setbacks. Instead of aiming to lose all your extra weight when you join a weight loss program, think in manageable chunks. Losing 1 to 2 pounds a week is a good guide.

“There is a lot of individual variability in response to weight loss programs and medications, and it’s difficult to predict how much any one person will lose,” Mullally said. “An initial goal of losing 5 to 10 percent is great because there are many known metabolic benefits, even with this relatively modest amount of weight loss.”

If you’re successful with your initial weight loss, it’s fine to continue.

“Sometimes, I joke with my patients,” Aldasouqi said. “They say, ‘What if I lose 30 pounds?’ I say, ‘You lose the next 30 pounds.’ The 5 to 10 percent weight loss will get us okay with diabetes, but when the A1C and sugars are normal, do we stop there? No – the benefit of weight loss is good for so many other things. [So] losing 5 to 10 percent is fine. Then move to the next 5 to 10 percent.”