Diabetes & obesity – what you need to know

Type 2 diabetes and obesity are closely related. In this article we explore the correlation between diabetes and excess weight, the common risk factors, as well as providing tips for successful weight management when living with type 2 diabetes.

Obesity is a disease that develops due to an excess amount of body fat – most commonly measured by Body Mass Index (BMI).1 Like other chronic conditions, obesity requires ongoing medical attention and can restrict several daily activities and bodily functions. Obesity is a risk factor for other chronic diseases, including diabetes, as well as heart disease, cancer and many more.²

In fact, obesity and diabetes are mutual comorbidities of one another – meaning that by developing either one, your risk of exacerbating the other increases dramatically.² There is significant overlap in people who develop these conditions, as both diseases are related to diet, metabolism and excess blood sugar.³

More about obesity: Definition, symptoms and diagnosis

Type 2 diabetes management is primarily about regulating blood glucose levels. With diabetes, blood sugar tends to be elevated due to the body being unable to release enough insulin to metabolise it, or being unable to effectively use the insulin it does make (insulin resistance).

But does diabetes cause weight gain? In some cases, yes. Type 2 diabetes can lead to weight gain4, depending on the individual, their medication, and where they are in their diabetes journey. Excess blood glucose that cannot be metabolised or stored elsewhere is invariably converted into fat.⁵

Weight gain can also worsen insulin resistance⁶, causing the body to make even more, potentially unusable insulin. Insulin, whether produced naturally in the body or taken as a treatment, can itself contribute to weight gain.⁴ So, while diabetes management is about balancing blood sugar, weight control is a big part of maintaining that balance.

4 tips for better weight management

To find out if you’re living with diabetes or obesity, it’s important to talk to your doctor for a formal diagnosis. In the meantime, the simplest way of ‘obesity scanning’ is to calculate your BMI.

The Body Mass Index (BMI) classifies underweight, overweight, and obesity in adults based on their height and weight. BMI above 25 is considered overweight, while over 30 is obese.¹

Most diabetes complications are connected to chronically high blood glucose which corrodes the arteries, leading to a build-up of plaque, and increasing the risk of adverse events such as heart attack and stroke.^8,9

Being overweight or obese makes it increasingly difficult to manage blood-sugar levels and is likely to accelerate the progression of type 2 diabetes.¹⁰

But excess weight also puts the body under increased strain with or without diabetes. So, there is a risk of complications related to obesity, such as heart failure, stroke and high blood pressure.¹¹

How to reduce the risk of long-term complications with type 2 diabetes

Diabetes, stroke and cardiovascular disease

While the principles of managing obesity and diabetes seem simple, the formula for success can vary from person to person. Our genetic variations mean we all store and spend energy differently. Our ability to make healthy choices – such as shopping for (and affording) healthy food, or having the time and energy to exercise – can be driven by our economies, but also the environments in which we live.

Diabetes and weight management is about striking a balance between nutrition, exercise, and mindset. More often than not, success requires a combination of different solutions.

Understanding nutrition means understanding how the calories you consume affect your body. It’s not simply about eating less and exercising more, but rather finding the right balance between calorie intake and energy output.

For example, if somebody plays 18 holes of golf on a Sunday, then sits on a plane for 24 hours on a Monday, that represents two totally different energy spends, and our bodies require totally different calorie levels to make it through those days. The energy spend will also vary for people of different weights.¹²

We need to be aware of when our energy spend goes up, and when it goes down, and be prepared to adjust our calorie intake based on that.

To simplify the equation: consuming more calories than you spend = weight gain. Burning more calories than you consume = weight loss.¹²

How to manage diabetes through exercise

How to manage diabetes with diet

Where you live, education, income and occupation can all play a role in your weight and your ability to manage it. When life gets busy, we often reach out for whatever is nearest or cheapest. But that is rarely the best thing for us.

To avoid the temptation of convenience, we must be prepared to develop new routines. That might mean shopping for groceries beyond the local supermarket, aligning the grocery list to a meal plan, or making a packed lunch instead of a high calorie, over-the-counter meal.

The weight of the modern world: How our environment affects our health

Depression, fatigue and sleeping problems can all be linked to weight gain.^13,14 It’s important to try to understand what psychological factors might be working against you. You might be able to remedy some things yourself, but where you can’t, you should seek the advice and support of your doctor. When it comes to mental health, always seek professional help as early as possible.

How to deal with stress when you have diabetes

Sometimes lifestyle changes are not enough. You’ve tried everything but nothing seems to work. That’s because everybody is different. The chance of inheriting obesity via genetics is estimated between 40-70%.¹⁵ However, glucose-lowering diabetes medications such as SGLT2s and GLP-1s have been shown to support weight loss and cardiovascular benefits.^16,17

Note: In extreme cases – when BMI is above 40, or above 35 in patients with comorbidities – bariatric surgery may also be recommended. However, even with surgery, making permanent healthy lifestyle changes is required to maintain your condition.¹⁸

Type 2 diabetes treatments – Finding the right treatment for you

I asked my doctor – Question Guide

The good news is that both diabetes and obesity – if treated well – can be managed while maintaining a good quality of life.19,20 But there are many treatment paths and individual variables to consider, so it’s crucial to seek ongoing advice from your GP and relevant specialists.

It’s also helpful to set realistic goals for yourself. Obviously, diabetes and obesity require discipline and positive changes to your routine. But don’t join a gym if you hate going to the gym. Your first step could simply be regular walks in the park, gradually increasing the distance and intensity over time. By making changes that are accessible and sustainable, you increase the chances of maintaining them. Don’t abstain from things you love – find small ways to ‘earn’ them. If an empty fridge always leads to takeout, try a meal plan and shop for the week ahead.

Most importantly, you don’t need to face these challenges alone. If nothing seems to be working, ask your doctor for help managing your weight. Some people may only need to make small adjustments to their current habits. But everyone’s body, mindset, and circumstances are different, so there’s no one-size-fits-all solution that will work for everybody.

The advice is based on the writer’s experience and may deviate from professional opinion in medicine and science. Consult your doctor before making any changes to your diabetes management routines.