People with type 2 diabetes are more likely to be overweight and are likely to benefit from weight loss. If you are overweight, losing weight is one of the single greatest steps you can take to lower your blood glucose levels. Often people with type 2 diabetes who initially take insulin or oral medications find that once they lose weight, they can manage their blood glucose through diet alone. But anyone can, from time to time, need to lose weight-even people with type 1 diabetes. The exception to this is women during pregnancy, a time when losing weight is probably not safe for the growing baby.

If you are beginning to use a healthy eating plan, you are probably already on your way to losing weight. Talk to your dietitian about your weight loss goals and set up a realistic plan for achieving those goals. But don’t try to lose too much weight too quickly. You want to develop a new way of eating that you can continue with throughout your life.

Are You Obese? More than 75 percent of all people with type 2 diabetes either are or were obese at one time or another. But what is obesity? In medical terms, obesity refers to anyone with a body mass index (BMI) of 30 or above. Anyone with a BMI of 25–29 is considered overweight. But what is a healthy weight for you? A BMI chart can help you determine what weight is healthy for you.  BMI takes your height into account and is a good estimate of percent body fat.

Because muscle weighs more than fat, someone who has a lot of muscle can have a high BMI but be at a healthy weight.

And the same weight of muscle and fat can have very different health consequences. Muscle earns its keep by burning calories, but fat is stored energy. It accumulates when your food intake exceeds the amount of energy your body uses for growth, repair, and physical activity. Older adults can have a healthy weight on a BMI chart but not have adequate muscle for good health. The BMI chart does not apply to children, adolescents, or pregnant women.

The Body Fat–Insulin Resistance Connection. Extra food that your body doesn’t need is stored in fat cells as triglycerides. The size and number of fat cells increases with increased body fat.

Having too much fat, especially on the upper body, decreases your body’s ability to use insulin. This is called insulin resistance. Being overweight and overfat also strains your pancreas, and it has a harder time making the insulin your body needs.

So, by getting rid of excess body fat, you can improve your sensitivity to insulin. This will help you lower your blood glucose level.

Managing Your Weight. The best approach to weight is a combination of exercise and a healthy diet. No one plan works for everyone. Some people find it easier to restrict their calories.

Some find it easier to exercise harder. Whatever your approach, a cornerstone will be to develop a lifetime plan of healthy eating and regular exercise. It helps to have some people to cheer you on: your family and friends, your dietitian, and your health care provider. A steady loss of 1 pound per week or less is a safe and effective means to reach your goal. Talk to your dietitian about possible approaches. These can include one or more of the following:

•   a nutritionally sound, calorie-restricted, low-fat meal plan designed to achieve gradual weight loss over several months
•   decreasing portion sizes or eliminating certain foods
•   setting behavioral goals

The most important thing you can do to lose weight is to choose weekly or monthly goals and short-term strategies to reach those goals. You will be more likely to succeed if you take one step and one day at a time.

If you use insulin or an oral diabetes medication to manage your diabetes, you need to monitor your blood glucose levels as you lose weight. You may be able to reduce the dose of your medication as weight loss lowers your glucose levels. If you have episodes of hypoglycemia, you will need to treat them with food,  and this adds calories and can slow down your weight loss. Call a member of your health care team if you start to have more frequent low blood glucose reactions so they can advise you on decreasing your insulin or oral diabetes medication dose.