Weight loss should be your focus to reverse Type 2 diabetes

Q: I’ve been diagnosed with Type 2 diabetes. What’s more important, losing weight (I’m 40 pounds overweight) or getting my blood sugar level down to normal? -- Chaz R., Fort Worth, Texas

A: Great question and one that researchers have been focusing on recently. That’s because the emphasis on getting blood sugar levels down, which has been the guiding principle of treatment for Type 2 diabetes since the 1980s, turns out not to be an effective way to reverse the disease -- and it is reversible!

Physician-researchers now recommend that you focus on obesity first and glucose control second so you can send Type 2 diabetes into sustained remission, not just lessen its damage to your heart, nerves, digestion, eyesight, mental health and more. That’s the message in a new study in The Lancet that shows dropping 15% or more of your body weight can have a profound disease-modifying effect -- easing obesity-triggered insulin resistance and beta-cell dysfunction (they make insulin).

The researchers do acknowledge that it’s hard to lose weight and keep it off. The best approaches are:

-- Reshaping your diet to reduce your calorie intake while you eliminate inflammatory foods (red meat, added sugars, ultra-processed foods) that change how your body stores fat.

-- Bariatric surgery, such as gastric bypass. It’s highly effective in causing weight loss that puts diabetes into remission -for 70% of patients according to one Danish study.

-- New weight-loss medications (they may also lower glucose levels) -- some are available, some coming down the pike. One example: A study found that 12 weeks of treatment with Fda-approved sema glutide leads to around 11 pounds of weight loss, mostly fat. Other meds, such as AM833, still in clinical trials, helped study participants lose 11% of their body weight, in part by slowing movement of food through the intestines.

So talk to your diabetes doc about the best way to start a weight-loss program, and discuss whether bariatric surgery or weight-loss medications are a good idea. Glucose control will follow.