May 7, 2018
If you are carrying excess weight and have been told you are at risk of or have type 2 diabetes, you’ve probably been told to lose weight. Of course, nearly everyone whose weight has been a problem for some time already knows they should lose weight, but few ask why. What is it about being overweight or obese leads to type 2 diabetes?
Ever since a pair of studies appeared in the New England Journal of Medicine showing that weight loss could prevent and even reverse newly diagnosed type 2 diabetes, doctors have recommended weight loss along with physical exercise as one of the first things to do to treat the disease. 
Researchers Show How Obesity Triggers Type 2 Diabetes
More recently, Harvard researchers have figured out how excess weight ends up causing the disease. In their study published in the journal Science, they found that obesity stresses a system of cell membranes called endoplasmic reticulum (ER), which is responsible for processing proteins and fats.
When subjected to excess lipids, or blood fats, the ER becomes overworked and sends an SOS signal that causes the cell to shut down its receptors for insulin. Insulin is a hormone that converts blood sugar to energy for the body’s cells.
This process is designed to be a temporary response to too many nutrients, but when it’s performed time and time again, can create insulin resistance and a reduced ability of the body to clear excess blood sugar or glucose from the body.
Obesity-driven Insulin Resistance May Cause Metabolic Syndrome
In addition to a higher risk of type 2 diabetes, carrying excess weight can also lead to what is called metabolic syndrome, a group of conditions that raise your risk of heart disease and diabetes.
According to MedlinePlus, metabolic syndrome includes high blood pressure, high blood sugar, high triglycerides (fat in your blood), low levels of HDL (the “good” cholesterol), and too much fat around the waist. It is unknown how excess weight and metabolic syndrome are linked, but some doctors think the cause is insulin resistance.
Weight Loss Offers Highest Return in Overall Health
In short, losing weight can give you one of the best returns on your investment of time and effort for your overall health. By losing weight, you reduce the workload on the ER, turn off the SOS signal, and allow cells to take in insulin again, thus breaking the vicious cycle of weight gain, insulin resistance, and higher glucose.
But it is not enough to just lose a few pounds if your goal is to reverse type 2 diabetes. Several studies have found that losing in excess of 30 pounds, or more than 10 percent of one’s body weight, is needed to reverse type 2 diabetes.
Weight Loss Takes a Plan to Reverse Type 2 Diabetes
Losing that much weight is not easy; it takes a plan, commitment, and often a coach or someone you trust to help you. The American Diabetes Association offers a complete resource guide for weight loss from goal-setting to making a plan and good food choices.
In terms of exercise, any type of physical exercise can help. The more you move, the more energy you burn, which will cause your body to use blood sugar and remove it from your blood. The ADA recommends aerobic exercise and strength training, but also recommends just increasing your activity level each day. Park further away from the entrance of wherever you are going will increase the number of steps you take each day. Get off the elevator one floor from your destination and walk up the final flight.
In addition to ridding yourself of a life of diabetes medication and potential complications, losing weight will also reduce your risk of metabolic syndrome and related cardiovascular disease, heart attack, and stroke.
At Healthcare Associates of Texas, we specialize in finding the optimal treatment for you. Our diabetes specialists work with you to help you manage your type 2 diabetes and reach your weight-loss and blood sugar goals. Book an appointment today.
 N Engl J Med. 2002 Feb 7;346(6):393-403.
 N Engl J Med. 2001 May 3; 344(18):1343-50
 Science. 2015 Jul 31;349(6247):500-6
 BMJ 2017;358:j4030
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