Weight Loss Interventions and Outcomes: Type 2 Diabetes

Background: Benefits of moderate weight loss for the prevention of prediabetes and diabetes are well documented; however, the benefits of weight loss interventions in overt type 2 diabetes are controversial. Objective: To summarize the role of weight loss interventions for the prevention of prediabetes and diabetes and to report the association between weight loss interventions in adults with type 2 diabetes resulting in weight loss greater or less than 5% on metabolic outcomes. Results: Weight loss interventions of 5% to 10% decrease risk factors for prediabetes and diabetes. However, in a systematic review and meta-analysis of weight loss interventions in persons with type 2 diabetes, the majority of the weight loss interventions resulted in weight losses less than 5% and had nonsignificant beneficial effects on A1C and other metabolic outcomes. In another systematic review, reduced-energy eating plans implemented by registered dietitian/nutritionists in persons with type 2 diabetes, regardless of weight loss, resulted in improved A1C levels. Conclusion: Nutrition therapy for persons with type 2 diabetes should encourage a reduced-energy healthful eating plan, regular physical activity, education, and continued support as primary treatment strategies.