7 Reasons You May Be Struggling to Lose Weight With Type 2 Diabetes

When you have type 2 diabetes, reaching a healthier weight through lifestyle changes like eating well and exercising can help you reduce your risk of diabetes-related complications.

“Body fat is a component of insulin resistance,” says Jennifer Shrodes, RD, CDCES, a diabetes educator at The Ohio State University Wexner Medical Center in Columbus. “You want insulin to work as effectively and efficiently as possible, and when you lose some fat, you can usually see insulin resistance improve,” she says.

But it’s easy to sabotage your own weight loss efforts without even knowing it. Move the needle on the scale with advice from diabetes experts about these common obstacles you may be facing.

1. You’re Overwhelmed

If you’re overweight or have obesity, the prospect of losing weight and maintaining that weight loss can be daunting. To make weight loss feel less intimidating, Margaret Powers, PhD, RD, a clinician and research scientist at the International Diabetes Center at Park Nicollet in Minneapolis, suggests thinking about the commitment as though you’re making it for just today.

“Start by committing to making healthy choices in the morning,” she says. “And then add on.” Commit to making healthy choices at lunch, then at snack time, after work, and at dinner. Repeat this practice each day, and keep working at it even if you slip into old habits at times.

“The hardest thing about losing weight is maintaining it,” says Dr. Powers. “It takes a lot of work, but renewing that commitment sets you up for success every day.”

Additionally, making changes that you can work into your lifestyle for the long term is key. “If you can’t sustain these changes, it will backfire,” says Shrodes.

2. You Don’t Get Enough Quality Sleep

3. You Go for Long Periods Without Eating

It’s particularly common for people newly diagnosed with type 2 diabetes to struggle with eating at regular intervals.

“They’re afraid to eat something and affect their blood sugar,” says Arycelis Segura, CDCES, a training specialist at Mount Sinai Health System in New York City. She says that it’s also a problem among people who’ve been managing diabetes for a while but haven’t been educated on dietary issues, as well as among people who work double shifts and find it difficult to stop for a meal.

4. You Eat Healthy Foods but in Large Quantities

Eating healthy foods is a basic tenet of a diabetes-friendly diet, but serving sizes and portion control are important too.

“Lots of times, people equate ‘healthy’ with ‘unlimited,’” says Segura. “I have patients that are picking really healthy foods like nuts, olive oil, and avocados, but failing to realize that they’re chock-full of calories.”

“If you were overeating before and use this method, you’ll naturally manage your blood sugar, cut calories, and start to lose weight,” says Shrodes.

5. You’re Eating Lean Proteins but Using Unhealthy Cooking Techniques to Prepare Them

Lean proteins like beef and poultry are better for weight loss than fattier meat varieties like sausage, regular ground beef, or a heavily marbled steak, and they’re recommended as part of a healthy type 2 diabetes diet, but how you prepare them matters, says Segura.

6. You Graze Mindlessly

Healthy snacking is encouraged in a diabetes-friendly diet, but mindlessly grazing can lead to the consumption of extra calories and weight gain.

Conversely, if you eat 100 fewer calories a day, you could lose 10 pounds in a year, she says.

If you’re a mindless grazer, try scheduling and preparing diabetes-friendly snacks in advance. “Don’t eat as you’re walking through the kitchen,” says Powers. “Sit down, enjoy, and be mindful of the food.”

She also suggests replacing grazing with another healthy behavior. For example, skip the trip to your pantry during the workday and grab herbal tea with lemon instead.

7. You Justify Eating Dessert With Exercise

Managing diabetes well requires controlling your blood sugar by balancing what you eat and drink with physical activity and taking diabetes medication as prescribed by your healthcare provider. While there are certain trade-offs you can make when it comes to balancing blood sugar, high-sugar treats aren’t necessarily canceled out by calorie-burning movement.

If you want to have a cookie or another sweet for dessert, Segura suggests keeping your prior meal starch-free. “But if your overall goal is to decrease calories and lose weight, then having that dessert isn’t necessarily the best choice,” says Powers, because exercise is unlikely to offset the amount of calories in the dessert. “If you look at how many calories you expend when walking a mile, it’s not a lot of calories,” she says.

In addition to maintaining a consistent exercise routine, refrain from eating treats regularly, and when you do indulge, account for them in your daily calorie and carbohydrate budget. You can also lean into healthier ways to satisfy your sweet tooth that better suit your goals.

The Takeaway

• Struggling to lose weight when you have type 2 diabetes often stems from feeling overwhelmed by your goal, which can be overcome by focusing on small, sustainable, daily commitments, rather than on the entire amount of weight you want to lose.
• Skipping meals and overconsuming even healthy, high-calorie foods, due to a lack of portion control, can undermine both your blood sugar management and weight loss goals.
• Inadequate or poor-quality sleep disrupts appetite-regulating hormones and encourages late-night snacking, which can also impede your weight loss efforts.
• Other setbacks include using unhealthy cooking techniques (like frying lean proteins in excessive oil or butter) and making the mistake of justifying high-calorie desserts with exercise.