Weight Loss Medications and Diabetes: When Medical Support Can Help

For many people living with prediabetes or type 2 diabetes, weight loss can feel far harder than it “should” be.

This is not a lack of effort or willpower. It reflects real biological changes — including insulin resistance, altered hunger signals, and the body’s natural tendency to defend weight.

In this context, weight-loss medications are not shortcuts. They are tools — sometimes necessary — to help correct underlying physiology, support behaviour change, and improve long-term metabolic health.

This page explains when weight-loss medications may be appropriate in diabetes, how they work alongside lifestyle changes, and how they fit into safe, evidence-based care.

Why lifestyle changes are sometimes not enough

Diet, physical activity, sleep, and stress management are always the foundation of weight management in diabetes. But for many people, these alone do not lead to meaningful or sustained weight loss.

This is because insulin resistance changes how the body stores fat, how hungry you feel, and how strongly the brain resists weight loss. The body may respond to calorie reduction by:

• increasing hunger hormones
• reducing metabolic rate
• prioritising fat storage

Weight-loss medications work by addressing these biological barriers — making it possible for lifestyle strategies to actually succeed, rather than constantly fighting against physiology.

Types of weight-loss medications used in diabetes

Several medication classes are used to support weight loss in people with prediabetes and type 2 diabetes. Each works in a different way and suits different clinical situations.

Metformin

Metformin improves insulin sensitivity, reduces the amount of glucose released by the liver, and can modestly reduce appetite.

It is often the first medication used in type 2 diabetes and is sometimes used in prediabetes when insulin resistance is significant.

GLP-1 receptor agonists

GLP-1 medications work through gut–brain pathways to:

• reduce hunger
• increase feelings of fullness
• slow stomach emptying

These medications can lead to substantial and sustained weight loss when used appropriately and monitored carefully.

Insulin and other glucose-lowering medications

In people already using insulin or other diabetes medications, treatment plans may need adjustment during weight loss to avoid hypoglycaemia and unintended weight gain.

Who may benefit from weight-loss medications

Weight-loss medications are not for everyone. They are most useful when excess weight is clearly contributing to:

• worsening insulin resistance
• rising HbA1c levels
• increasing medication burden
• difficulty sustaining lifestyle changes

They are often considered when:

• structured lifestyle strategies have not achieved adequate results
• there is high cardiometabolic risk
• weight regain has occurred repeatedly

All medication-based weight-loss strategies should be individualised, medically supervised, and reviewed regularly.

Using medications as part of a long-term plan

Medications work best when they support — not replace — dietary, behavioural, and psychological strategies.

The goal is not rapid weight loss, but sustainable metabolic improvement:

• better glucose control
• reduced insulin resistance
• lower cardiovascular risk
• improved quality of life

Over time, some people may reduce or stop medications. Others may benefit from longer-term use. Success is measured by health outcomes — not the number on the scales alone.