How to lose weight if you have diabetes (or insulin resistance)
Losing weight with diabetes is possible, but it doesn't work the same as for everyone else: medication, meal timing and the risk of low blood sugar change the rules. As a physician, I work by reaching agreements with you rather than banning foods, and by doing it safely.
Why is losing weight different with diabetes?
With type 2 diabetes and insulin resistance, the body handles sugar less well, which makes it easier to store fat, especially around the belly. Some medications, such as insulin, can also make weight gain easier, and if you eat much less without adjusting them, your blood sugar can drop too far.
The good news is that weight and blood sugar improve together: as you lose weight, your body responds better to insulin. Losing about 5% of your weight can already show in your lab results, and larger losses bring more benefit. In some people with type 2 diabetes, especially in the first years, substantial weight loss can lead to remission, meaning normal blood sugar without medication, always with medical follow-up.
This article is mainly about type 2 diabetes, prediabetes and insulin resistance. If you have type 1 diabetes, changes to how you eat are coordinated with your endocrinologist.
What to change on your plate, without impossible diets
A simple guide is the plate method: half the plate vegetables, a quarter protein (eggs, chicken, fish, lean meat, legumes, dairy) and a quarter good-quality carbohydrates (brown rice, potato, arepa, plantain or fruit, in moderate portions).
- Eat at regular times and avoid skipping meals: it helps keep blood sugar from swinging up and down.
- Include protein at every meal: it keeps you full for longer and protects your muscle while you lose weight.
- Choose fiber: vegetables, legumes, whole fruit and whole grains make blood sugar rise more slowly.
- Cut back on sugary drinks, juices and refined flours. It's not about banning them, but about them no longer being the base of your day.
- Read labels: many "light" or "sugar-free" products still raise blood sugar. I explain it in 5 foods that spike your blood sugar without you noticing.
Watch out for these risks
- Low blood sugar (hypoglycemia): if you use insulin or medications such as glibenclamide (glyburide) or glimepiride, eating less without adjusting the dose can drop your blood sugar. Signs: shakiness, cold sweat, palpitations, intense hunger or confusion.
- Very strict diets or fasting without supervision: they can be risky with diabetes medication. If you want to try them, do it with your doctor.
- Never stop or change your medication on your own, even if your blood sugar improves. Your doctor makes that adjustment.
Movement counts too
For most people with diabetes the recommendation is at least 150 minutes of physical activity a week, such as brisk walking, plus strength exercises 2 or 3 days a week. If you use insulin, check your blood sugar before exercising and carry something to eat in case it drops.
What about medications like Ozempic?
Some diabetes medications also help with weight loss and can be a good tool if your doctor prescribes them. But they don't replace changes in how you eat: without those, the weight usually comes back when they are stopped. More in Does Ozempic work for weight loss?
How I work on this in consultation
As a physician, I review your lab results (such as glucose and HbA1c), your medications and your schedule before proposing a plan, and I coordinate with your treating doctor when needed. We agree on changes you can keep up in real life, with follow-up to adjust along the way. I see patients in person in El Poblado, Medellín, and online, in English and Spanish.
Do you have diabetes or insulin resistance and want to lose weight safely? Let's talk.
💬 Book via WhatsAppFrequently asked questions
How much weight do I need to lose to improve diabetes?
Losing about 5% of your weight can already improve blood sugar control, and larger losses bring more benefit. The exact goal depends on your case and is set in consultation.
Can I lose weight if I take insulin?
Yes. It is possible, but the dose needs to be adjusted with your doctor as you change how you eat, to avoid low blood sugar.
What is the best diet for losing weight with diabetes?
There is no single ideal diet for everyone. The plans that work best cut back on sugars and refined flours, prioritize vegetables, protein and fiber, and are ones you can keep up over time.
Can type 2 diabetes be reversed by losing weight?
In some people, especially in the first years of the disease, substantial weight loss can lead to remission, meaning normal blood sugar without medication. It does not happen in every case and needs medical follow-up.
Do you see patients online?
Yes. I see patients in person in El Poblado, Medellín, and online for patients across Colombia and abroad, in English and Spanish.
This article is informational and does not replace a consultation. Don't stop or change your medication without talking to your doctor. To assess your case, book a clinical nutrition consultation.
