When you have type 2 diabetes, losing just 5% of your weight can improve blood sugar, blood pressure, and cholesterol. However, as if dropping pounds isn’t tough enough, diabetes can make it even more difficult. Many people who begin taking insulin to control their blood sugar see the scale tick up, and other diabetes drugs, including sulfonylureas, thiazolidinediones, and meglitinides, have also been associated with weight gain. (Although some, like metformin, may help you lose weight.) What’s more, hormonal changes that occur in your late 30s and early 40s add to insulin resistance, which is when your body fails to use insulin efficiently, says Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic. “Metabolism slows down and the risk of gaining weight increases, especially around the midsection,” she says. Here, top experts give their best advice to make losing weight with diabetes a little easier.
Complex carbs like vegetables, fruits, and whole grains speed up weight loss, while a diet high in processed simple carbs such as white bread, pasta, rice, and sweets will do the opposite, says Dr. Hatipoglu. Since people with diabetes have twice the risk of heart disease and stroke as those without, your best road to weight loss may be a Mediterranean-style diet, which has been linked to better heart health in numerous studies (and fits with American Diabetes Association recommendations). Try to eat more veggies, omega-3 rich foods (salmon, oatmeal, nuts) and healthy fats (olive oil, avocado), but keep in mind that even healthy fats can be high in calories; keep saturated fat and simple carbs to a minimum.
All that said, there is no one-size-fits-all diet for diabetes, so talk to your doc or diabetes educator about what may be the best plan for you.
The best way to overcome insulin resistance is with exercise, says Dr. Hatipoglu. “Exercise improves the body’s insulin resistance and helps get rid of the fat,” she says. In fact, exercise can be as powerful as medication at lowering your blood sugar. Take every opportunity to get up and walk around during the day and avoid sitting for long periods of time. Some simple lifestyle tweaks: take the stairs instead of the elevator; get off one stop early if you use public transportation or park at the back of the lot if you drive; and walk over to your coworker’s desk to ask a question instead of shooting an email or instant message. Aim for a total of 30 minutes of moderate-intensity activity a day.
Cardio is just one piece of the exercise puzzle when you have diabetes. Resistance training—using dumbbells, exercise bands, or even your own body weight—lowers blood sugar by making your body more sensitive to insulin. Plus, strength training helps build muscle, which helps you burn more calories all day long even when you’re at rest. Include some form of resistance training two to three times a week in addition to aerobic exercise. Plan your own customized five-move workout or check out our workout library.
If you have type 2 diabetes, you need to watch all calories, but especially carbohydrates and sugar, says Etie Moghissi, MD, associate clinical professor of medicine at the University of California, Los Angeles. A study from Kaiser Permanente showed people who kept a daily food journal lost twice as much weight as those who did not. In addition to recording what you eat, track how you feel. This helps uncover emotional triggers such as boredom or anger that bring on unconscious eating patterns. Record your intake in a simple notebook or use an app like MyFitnessPal. By cutting back on refined grains and added sugars, you can lose weight and better manage your hemoglobin A1C (a blood sugar average over two to three months), says Dr. Moghissi.