Weight Loss and Diabetes: What Really Works for Prediabetes and Type 2 Diabetes

Weight loss is one of the most powerful tools we have for improving blood glucose levels, reducing insulin resistance, and lowering long-term health risks in people with prediabetes and type 2 diabetes.

But it is also one of the most misunderstood. Many people are told to “just lose weight” without being given a clear explanation of why weight matters, how it affects blood sugar, or what approach is actually realistic for long-term success.

This hub brings together the evidence, the physiology, and the practical strategies behind weight loss and diabetes — helping you understand what works, what doesn’t, and how to choose an approach that fits your body, your health, and your life.

Why weight matters in diabetes

Excess body fat — particularly around the abdomen — plays a direct role in worsening insulin resistance, raising blood glucose levels, and increasing the risk of complications.

In people with prediabetes, modest and sustained weight loss can significantly reduce the risk of progressing to type 2 diabetes. In people already living with type 2 diabetes, weight loss often leads to:

• lower fasting and post-meal glucose levels
• reduced medication requirements
• improved blood pressure and cholesterol
• less strain on joints, sleep, and overall wellbeing

Importantly, weight loss does not need to be extreme to be meaningful. Even small, achievable changes can have measurable metabolic benefits — particularly when they are maintained over time.

Weight loss and insulin resistance

At the centre of both prediabetes and type 2 diabetes is insulin resistance — a state where the body’s cells no longer respond effectively to insulin.

Excess weight, especially visceral fat stored around the liver and abdominal organs, worsens insulin resistance by:

• increasing inflammatory signals
• altering hormone balance
• interfering with normal insulin signalling

Weight loss helps reverse these processes. As insulin sensitivity improves, blood glucose levels often fall — sometimes before the number on the scales changes dramatically.

This is why some people notice better glucose readings early in their weight-loss journey, even with modest weight changes.

Diet, behaviour, and sustainability

There is no single “best” diet for weight loss in diabetes. What matters most is choosing an approach that improves blood glucose control while being realistic and sustainable.

Dietary strategies explored in this section include:

• calorie awareness and portion size
• carbohydrate quality and quantity
• low-carbohydrate and moderate-carbohydrate approaches
• protein intake and satiety
• meal timing and consistency

Just as important as food choices are behavioural factors such as stress, sleep, emotional eating, and habits formed over decades. Long-term success usually comes from addressing both the biological and psychological drivers of weight gain — not willpower alone.

Medications and medical support

For some people, lifestyle changes alone are not enough. Medical therapies can play an important role in supporting weight loss and improving glucose control.

These may include:

• metformin, which can reduce insulin resistance and appetite
• GLP-1 receptor agonists, which influence hunger, satiety, and weight regulation
• adjustments to insulin or other glucose-lowering medications

Any medication-based strategy should be personalised and reviewed regularly with a healthcare professional.

Beyond the scales

Weight is only one marker of progress. Improvements in blood glucose, energy levels, sleep quality, confidence, and daily functioning often matter just as much — if not more.

Focusing solely on the number on the scales can be discouraging and misleading. A broader view of health allows for more sustainable motivation and better long-term outcomes.