Can Weight Loss Reverse Type 2 Diabetes?

Having excess weight or obesity is the leading risk factor for type 2 diabetes. Almost 90% of the 37 million Americans with type 2 diabetes are classified as having excess weight or obesity. If you have excess weight, your risk of developing type 2 diabetes is about 2.4 times higher than those at a healthy weight. For those who have obesity, the risk is about 6 times higher. 

The good news is that losing weight and making other lifestyle changes may help reverse diabetes and prevent long-term health complications. Research shows that substantial weight loss through healthy lifestyle habits or surgery can prevent or reverse type 2 diabetes.

This article explores what it takes to lose weight and how you can potentially reverse type 2 diabetes.

Connection Between Weight and Type 2 Diabetes

Obesity significantly increases the risk of developing serious health conditions, including type 2 diabetes. This type of diabetes is directly linked to excess body weight and lack of physical activity. Nearly half of new diabetes cases in the United States each year are caused by obesity.

Type 2 diabetes is characterized by high blood sugar (glucose) levels. It occurs when the body’s ability to produce or respond to insulin is impaired. After we eat, the pancreas releases insulin, a hormone that helps the body’s cells use glucose for energy. With type 2 diabetes, the cells do not effectively use insulin, known as insulin resistance. 

Research shows that extra fat around the liver and visceral fat (the fat surrounding organs) plays a role in blocking insulin, preventing glucose from entering the cells. The higher a person’s body fat percentage, the harder it is for their cells to respond properly to insulin.

While carrying extra weight anywhere in the body can increase your risk of developing type 2 diabetes, evidence suggests that people who carry excess abdominal (belly) fat are at a greater risk of the disease.

Achieving a Healthy Weight

Weight loss is proven to help prevent or reverse type 2 diabetes. Research shows that losing even as little as 3% to 5% of your body weight through healthy lifestyle changes can help control diabetes. If you have type 2 diabetes, making lifestyle changes to lose extra weight can help control your blood sugar levels, boost your energy levels, and improve your overall health and well-being.

Diet and Exercise

Losing weight is best achieved by making healthy lifestyle choices and sticking with them. While there’s no “one size fits all” solution for losing weight to reverse type 2 diabetes, there are some tried and true strategies for weight loss, including:

• Set a weight loss goal. Set a realistic goal (e.g., lose 2 pounds per week) and celebrate each milestone you reach. The American Diabetes Association recommends a weight loss of at least 5% of body weight for most people with type 2 diabetes.
• Eat smaller portions. To reduce your caloric intake and lose weight, eat smaller portions of foods, especially those that are high in calories, saturated fats, and processed sugars. 
• Focus on nutrient-dense foods. Eat healthy, nutrient-dense foods such as fruits, vegetables, lean proteins, nuts, and whole grains rather than processed, packaged foods. 
• Increase water intake. Opt for water to stay hydrated, and avoid soda, sports drinks, fruit juices, and alcoholic beverages. 
• Regularly exercise. Aim to do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking, swimming, or cycling. Strength-training activities two to three times a week (e.g., weight lifting) can help build muscle, burn fat, and promote weight loss. 

One study found that people who have obesity and type 2 diabetes and followed a six-month diet plan lost an average of 30 pounds, and nearly half achieved remission (reversal) of diabetes.

Bariatric Surgery

Bariatric surgery, also known as weight loss surgery or metabolic surgery, is a procedure that modifies the stomach and intestines to treat obesity and promote weight loss. The procedure is designed to reduce food intake and decrease hunger to help people achieve and maintain a healthy weight.

Bariatric surgery is currently available only for people with a body mass index (BMI) greater than 40 or people with a BMI greater than 35 with a comorbidity (having two or more conditions simultaneously)—such as type 2 diabetes—and an inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.

There are various bariatric surgeries performed, including the following:

• Gastric sleeve
• Gastric bypass
• Adjustable gastric band

One study exploring the impact of bariatric surgery on people with obesity and type 2 diabetes found that 64% of participants achieved remission (reversal) within one year post-procedure. A research review found that bariatric surgery can effectively reverse type 2 diabetes in up to 80% of people—and quickly. For some, blood sugar levels may return to healthy levels within hours or days after the procedure.

What Is Diabetes Reversal?

Diabetes reversal, or remission, is defined as sustaining blood glucose levels within a normal range for three months or more without taking diabetes medication. Weight loss through healthy lifestyle habits and/or bariatric surgery has been proven to help achieve diabetes reversal. 

In a recent clinical trial, people with type 2 diabetes followed a lifestyle intervention program that included eating a low-calorie diet and getting regular exercise. At the end of one year, study participants lost an average of 26 pounds, and about 61% successfully achieved remission of diabetes.

Remission is most likely to occur in the early stages of type 2 diabetes. Studies show that losing just 10% to 15% of body weight within two years of diagnosis is enough to achieve remission. In later stages of diabetes, the body may lose its ability to make insulin, making remission less likely. However, some people with advanced type 2 diabetes may achieve remission by losing 20% to 25% of their body weight.

After Diabetes Reversal

When you achieve diabetes reversal through weight loss, maintaining healthy lifestyle habits can help prevent diabetes relapse (return). Diabetes reversal is not a cure, and weight gain is associated with type 2 diabetes relapse. Maintaining a healthy weight by eating nutritious foods and staying active is key to remission.

Your healthcare provider will regularly monitor your blood sugar levels to check for signs of elevated blood glucose to ensure you are still in remission. Some people may experience diabetes relapse and require diabetes medications in addition to making lifestyle changes to control their blood sugar levels.

Summary

Having excess weight or obesity is the leading risk factor for type 2 diabetes. Studies show that substantial weight loss, either through lifestyle changes or bariatric surgery, may lead to diabetes reversal (remission) in some people with type 2 diabetes.

Lifestyle changes that support weight loss include eating a low-calorie diet, avoiding processed sugars, and getting about 150 minutes of exercise per week. Bariatric surgery is an effective treatment for weight loss that is proven effective at reversing type 2 diabetes in some people with obesity.

Diabetes remission (reversal) is not a cure. To prevent relapse, people who have successfully achieved remission must maintain a healthy lifestyle and weight to keep their blood sugar levels within the normal range.

A Word From Verywell

If you have type 2 diabetes and obesity, making certain lifestyle changes may help you reverse the condition. It's important to remember that losing weight takes time—stick with your healthy habits and know that the work you’re putting into achieving a healthy weight will support your overall health and well-being.