Losing Weight with Type 2 Diabetes: Things to Consider


Losing weight with type 2 diabetes (T2D) is far more complicated than simply taking regular walks and eating more veggies. On top of the weight loss efforts a non-diabetic needs to mind, living with T2D means you’re also juggling insulin resistance, medication side effects, managing low and high blood sugar levels and complications that can interfere with exercising safely.

Here are a few important details to keep in mind while working on your weight-loss goals as a person with T2D.

Remember, your diet doesn’t need to be perfect.

It can be easy to hit “diet burnout” if you set the standards much too high. Who could possibly go 365 days without chocolate? Or a glass of wine? Or a plate of pasta? You don’t need to eat the perfect diet in order to lose weight despite what mainstream media and your Instagram feed might be telling you.

Instead, aim for the 80/20 rule. This means that for 80 percent of the day, you’re striving to make very healthy choices around food and drinks, but you leave room (the 20 percent) for something more indulgent that keeps you from feeling deprived.

For some, it might mean nixing juice or soda from the daytime but enjoying one tall glass of soda at night. Yes, you’re still consuming a lot of sugar in that glass of soda, but if it’s 200 grams less sugar than your previous daily soda routine, that’s a huge reduction! And a huge improvement in your overall sugar consumption for the day.

Another example might be bread and pasta. Eating bread or pasta several times a day could make weight loss difficult, but if you love it, you don’t have to nix it forever. Strive to eat non-starchy carbohydrates from fruits and veggies in your daytime meals and enjoy your starchier bread at dinner.

It’s about creating a balance. But the balance needs to be something that doesn’t drive you crazy with deprivation. Deprivation leads to binge eating. Create personal guidelines (perhaps around carbs or calories or food types) and goals you can manage long-term!

Certain medications can support your weight-loss goals.

Asking for help is never easy, but there are several diabetes medications available today that have shown to help people lose weight on top of improving blood sugar levels. That being said, there are also some diabetes medications that can make weight loss more challenging.

This means it’s really important to communicate with your healthcare team. Let them know you’re working to lose weight and discuss how your current medications might help or hinder your efforts.

Diabetes medications that tend to help people lose weight include:

  • Metformin
  • SGLT-2 inhibitors (Farxiga, Invokana, Jardiance, etc.)
  • GLP-1 agonists (Ozempic, Rybelsus, Trulicity, etc.)
  • Dual GIP-GLP agonists (Mounjaro)

Learn more about which diabetes medications can support your weight loss goals.

Check-in (for real) on your current relationship with food.

While it would be nice to pretend the past several years or decades of food habits don’t matter, it’s really important to address what drives your decisions around food. Putting in the hard work and energy to lose weight will only work long-term if you take the time to look at any persistent habits you have around that food that call for a deeper dive.

Are you struggling with emotional eating? When your day gets overwhelming and stressful, do you turn to food? Does it work? Does it help? What are the consequences? How do you feel? How often have you been using food to manage that emotion?

Do you have a habit of trying to do the “all-or-nothing” diets that completely eliminate an entire food group? After a few days or weeks, do you find yourself binge eating that food group? How many times have you found yourself in that cycle?

How often are you telling yourself you are “bad” for eating a certain type of food? How does that impact your relationship with that food? Does it make you want it more? Does it make you reach for it when you’re feeling out of control in another area of your life? Look deeper! This “guilt” mindset around food can drive you to abuse that food instead of enjoying it thoughtfully.

Take a moment and really think about your habits around food and what is driving those habits. They won’t go away overnight—especially if they are part of a deeper emotional coping mechanism or self-destructive core beliefs you have about yourself or your life.

Big changes in your lifestyle could mean you’ll need big changes in medication dosages.

If you suddenly go from no regular exercise to walking twice a day for 30 minutes, you may need to talk to your doctor about reducing certain types of diabetes medications (especially insulin) within a few days or weeks to prevent low blood sugars!

Regular exercise not only increases how quickly your body burns up glucose during the exercise—it also increases your overall sensitivity to insulin when you keep at it day after day.

This means your body may need less help from your diabetes medications to maintain safe blood sugar levels as you become more sensitive to the insulin your body produces.

This is an awesome benefit of exercise! But it could lead to low blood sugars if you don’t gradually reduce your medication dosages, too.

Know which types of exercise are safe for you depending on complications and health concerns.

If exercise is part of your weight-loss plan, it’s crucial that you talk to your doctor before getting started. In fact, diabetes complications are only one of the many factors that affect how much and what types of exercise you can do safely.

Blood pressure, heart disease status, retinopathy—just to name a few. In fact, it’s also a good time to get screened for certain complications, including your eyes, if you haven’t been to your doctor or ophthalmologist in a while!

If you’ve been diagnosed with any type of diabetes-related eye condition, it’s important to avoid activities that increase blood pressure which can strain the blood vessels in your eyes.

Activities like sprinting, lifting weights and any contact sports are not recommended unless your eye care team has said it’s safe. By increasing your blood pressure, these kinds of exercise could worsen existing eye conditions involving leaking blood vessels or swelling.

You might also consider wearing eye protection if you’re playing basketball or soccer, for instance, to protect yourself from the potential of someone’s finger in your eye!

Make adjustments for diabetes complications—and experiment with new options.

Something as simple as walking can also be downright dangerous if you’re dealing with certain diabetes complications. Neuropathy in your feet and legs can make balancing and walking difficult if you’ve lost a lot of sensation or you’re in constant pain. Retinopathy in your eyes can mean you’re unable to see as well, making it difficult to navigate a path while walking or riding your bicycle.

Here are a few adjustments you could make to make exercising a little easier:

  • Walking with a friend
  • Following YouTube exercise videos at home (with neuropathy/retinopathy)
  • Dance classes on YouTube
  • Using a hand-bike or spin-bike
  • Using a rowing machine
  • Swimming laps in a pool
  • Chair yoga

You have options! Don’t let the limitations of neuropathy or retinopathy keep you from exploring and experimenting with different types of exercise and different environments. A little bit of exercise goes a long way.

The bottom line…

Losing weight doesn’t happen overnight. It happens slowly with consistent persistence, bit by bit. You may not see the results of your hard work show up on the scale or in your jeans for several weeks after you get started!

Don’t be discouraged! Focus on those daily little habits and keep at it. In fact, perhaps forget about the scale altogether! There are so many other signs of success and progress in your blood pressure, your blood sugars, how your jeans feel, your cholesterol—the list goes on and on!

Losing weight is a long-term project. Each day counts.

Educational content related to type 2 diabetes is made possible with support from Lilly Diabetes. Beyond Type 2 maintains full editorial control of all content published on our platforms.

WRITTEN BY Ginger Vieira, POSTED 01/24/22, UPDATED 11/15/23

Ginger Vieira the senior content manager at Beyond Type 1. She is also an author and writer living with type 1 diabetes, celiac disease, fibromyalgia and hypothyroidism. She’s authored a variety of books, including “When I Go Low” (for kids), “Pregnancy with Type 1 Diabetes,” and “Dealing with Diabetes Burnout.” Before joining Beyond Type 1, Ginger spent the last 15 years writing for Diabetes Mine, Healthline, T1D Exchange, Diabetes Strong and more! In her free time, she is jumping rope, scootering with her daughters, or walking with her handsome fella and their dog.