These conditions are not just about appearance or weight — they represent a deeper imbalance in the body’s metabolic systems and are linked to a wide range of preventable diseases.

Tackling overweight and obesity is a critical step in reducing the burden of chronic conditions such as diabetes, cardiovascular disease and certain cancers.

This page explores the definitions, causes, health impacts and management strategies for overweight and obesity — with a specific lens on how they affect diabetes prevention and care.

What do the terms “overweight” and “obese” mean?

Overweight and obesity both refer to excess body fat that may impair health. The difference lies in the degree of fat accumulation.

In adults, these conditions are typically assessed using the Body Mass Index (BMI) — a calculation based on height and weight:

• Overweight: BMI between 25.0 and 29.9
• Obesity: BMI of 30.0 or higher

BMI is calculated by dividing a person’s weight in kilograms by the square of their height in metres (kg/m²).

While BMI doesn’t directly measure fat, it remains a useful and widely adopted screening tool in clinical and public health settings.

In children and adolescents, weight categories are determined using BMI percentiles, which compare a child’s measurements to national norms for age and sex:

• Overweight: 85th to 94th percentile
• Obesity: 95th percentile or higher

In both adults and children, central (abdominal) fat — measured by waist circumference — is particularly important, as it’s more strongly associated with metabolic diseases.

• Body Mass Index (BMI) Calculator

How do people become overweight or obese?

The causes of overweight and obesity are complex and involve a dynamic mix of biological, behavioural, environmental and social factors.

At the core, weight gain occurs when caloric intake consistently exceeds caloric expenditure. But this simple equation is influenced by a web of interconnected drivers.

• Diet: High intake of energy-dense, nutrient-poor foods (such as processed snacks, sugary drinks and takeaway meals) contributes significantly to weight gain.
• Physical inactivity: Many people do not meet minimum movement guidelines, often due to sedentary jobs, long commutes, or digital lifestyles.
• Genetics and family history: Genetic factors can affect appetite, satiety, fat storage and metabolism.
• Hormonal and metabolic issues: Conditions like hypothyroidism, insulin resistance and polycystic ovary syndrome (PCOS) can increase susceptibility.
• Mental health and emotional eating: Stress, anxiety, depression and trauma can influence eating behaviours and physical activity levels.
• Socioeconomic factors: Lack of access to affordable healthy foods, safe outdoor spaces and health services makes prevention harder in some communities.

Importantly, weight gain doesn’t happen overnight. It often develops over years of small imbalances and gradually ingrained habits.

Consequences of excess weight

Carrying excess weight affects nearly every system in the body and significantly increases the risk of developing type 2 diabetes. This is because excess fat, particularly around the abdominal organs, leads to insulin resistance — the condition where the body’s cells become less responsive to insulin.

Insulin resistance is the key driver of type 2 diabetes and can develop silently over many years.

It’s estimated that around 90% of people with type 2 diabetes are overweight or obese.

The relationship is so strong that managing weight is often the most effective way to prevent or even reverse early-stage type 2 diabetes.

But the consequences of obesity and overweight don’t stop there. People living with excess weight also face increased risk of:

• Heart disease and stroke
• Hypertension (high blood pressure)
• Joint pain and osteoarthritis
• Obstructive sleep apnoea
• Fatty liver disease
• Certain types of cancer (e.g. breast, bowel, womb)
• Reproductive health issues (e.g. PCOS, infertility)
• Mental health conditions, including depression, anxiety and low self-esteem

It’s also important to note that not all people with type 2 diabetes are obese.

So-called “skinny type 2 diabetes” — where individuals appear slim but carry dangerous fat around their organs — is also a recognised form of metabolic disease.

How to reduce the risk of health complications?

Preventing overweight and obesity starts early — ideally in childhood — but it’s never too late to take action. The most effective prevention strategies are sustainable, realistic and address both diet and physical activity alongside emotional and environmental factors.

A balanced, whole-food diet is essential.

This includes a wide variety of vegetables, fruits, whole grains, lean protein and healthy fats, while limiting refined carbohydrates, sugar and ultra-processed foods.

Education about portion sizes and label reading can be powerful tools for change.

Staying active is equally important.

The NHS recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity per week, plus strength-building exercises on two or more days per week.

Beyond diet and exercise, support systems — whether friends, family, community groups or health coaches — can help maintain motivation and accountability.

• Speak to other people in the Diabetes Forum

Behavioural tools like meal tracking, goal setting and digital platforms can also play a valuable role in sustaining change.

Managing overweight and obesity

Management strategies for overweight and obesity can range from self-led lifestyle adjustments to clinical interventions, depending on the individual’s needs and health risks.

Dietary change remains the first line of treatment. Whether following a low-carb approach, a calorie-controlled plan, or intermittent fasting, success depends on consistency and personal fit. Working with a registered dietitian or nutritionist can help tailor the right plan.

Exercise should be safe, achievable and enjoyable. This could mean walking more, joining a structured program, or using fitness apps and trackers to stay engaged.

For those with more significant weight challenges or obesity-related health conditions, medical interventions may be considered.

These include:

• Prescription medications such as GLP-1 agonists (e.g. semaglutide)
• Weight loss surgery (e.g. gastric sleeve, gastric bypass)
• Digital behaviour change programmes that combine coaching, education and tracking

Addressing mental and emotional factors is also crucial.

Behavioural therapy, CBT and group support can be helpful in identifying triggers for overeating and building healthier habits.

Regular check-ins — with a GP, weight management service, or digital programme — help maintain progress, adapt goals and prevent relapse.

Overweight and obesity are major contributors to the rising rates of type 2 diabetes in the UK and globally.

While these conditions are complex and influenced by many factors, they are not irreversible.

With education, support and evidence-based tools, people can take meaningful steps toward a healthier future.

For more information on diet strategies, digital support tools and treatment options, explore our guides on:

• Low Carb Diet: Beginner’s Guide
• Low Calorie Diet and Type 2 Diabetes
• Semaglutide and GLP-1 Medications
• Managing Type 2 Diabetes with Lifestyle Change

Overweight is defined by having a Body Mass Index (BMI) between 25 and 29.9, while obesity is defined by a BMI of 30 or higher.

Both can lead to serious health problems, including type 2 diabetes, heart disease, stroke, and certain types of cancer. For individuals with type 2 diabetes in particular, managing weight is particularly crucial as it can help improve blood sugar control and reduce the risk of complications.

What is BMI?

Body Mass Index (BMI) is a widely used measure to classify underweight, normal weight, overweight, and obesity in adults.

It is calculated by dividing a person’s weight in kilograms by the square of their height in metres (kg/m²). Although BMI does not measure body fat directly, it provides a useful indication of whether a person is underweight, normal weight, overweight, or obese, helping to identify potential health risks.

Some critics argue that waist to hip is a better measure of health.

• Body Mass Index (BMI) Calculator

Calorie counting

Calorie counting is a fundamental aspect of weight loss and weight management which involves keeping track of the number of calories consumed through eating and drinking and the number of calories burned through physical activity.

For weight loss, the goal is to create a calorie deficit, meaning you consume fewer calories than you expend.

This deficit forces the body to use stored fat for energy, leading to weight loss.

For individuals with diabetes, managing calorie intake is essential for maintaining stable blood sugar levels and overall health.

Healthy eating for weight loss

Adopting healthy eating habits can make a huge difference towards achieving your weight loss goals. It’s a good idea to set achievable and realistic weight loss goals to stay motivated and avoid frustration. Small, incremental changes can lead to significant, sustainable weight loss over time.

Real food diet

Aim for a real food diet that includes a variety of foods. Focus on incorporating fruits, vegetables, whole grains, lean proteins, and healthy fats – which provide essential nutrients while helping to control calorie intake.

• Low Carb Diet: Beginner’s Guide
• Low Calorie Diet
• Intermittent Fasting: Guide to Fasting

Reducing carbohydrates and eating more protein can help promote sustainable weight loss.

Portion control

Being mindful of portion sizes is crucial to avoid overeating. Using smaller plates, measuring portions, and being aware of serving sizes can help manage calorie intake effectively.

Portion control can be particularly important for managing blood sugar levels in individuals with diabetes.

Regular meals

Skipping meals can lead to overeating later in the day and can cause blood sugar levels to fluctuate.

Aim to eat regular, balanced meals to maintain energy levels and keep hunger at bay.

Healthy snacking

Choose healthy snacks such as fruits, nuts, or yoghurt over processed snacks that are high in sugar and unhealthy fats.

Healthy snacks can help manage hunger and provide essential nutrients.

• Proccessed and ultra-processed foods: how do they affect your health?

Limit sugary drinks

Sugary drinks, including fizzy drinks and fruit juices, can contribute to excessive calorie intake and spikes in blood sugar levels.

Opt for water, herbal teas, or other low-calorie beverages to stay hydrated without adding extra calories.

Mindful eating

Practicing mindful eating can help you pay attention to what and how much you eat, promoting better food choices and portion control.

Mindful eating involves eating slowly, savouring each bite, and recognising hunger and fullness cues.

Stay hydrated

Drinking plenty of water throughout the day can help control hunger and support overall health.

Sometimes thirst is mistaken for hunger, leading to unnecessary eating.

Maintaining a healthy lifestyle

It’s not just about losing weight but about making sustainable lifestyle changes that promote long-term health and wellbeing.

Get regular exercise

Incorporating aerobic exercises like walking, running, or swimming into your routine can help boost metabolism, maintain muscle mass during weight loss, and improve insulin sensitivity.

• Compound exercises: how they support healthy aging
• 5 easy ways to sneak exercise into your day
• Walking

Prioritise sleep

Poor sleep can disrupt hormones that regulate hunger and appetite, making it harder to lose weight.

It might be easier said than done, but aim for 7-9 hours of quality sleep each night to support your weight loss efforts and overall health.

Support

Weight loss can be challenging, but you don’t have to do it alone.

Seek support from support groups, qualified expert nutrition coaches or connect with friends and family who can provide encouragement and accountability.

Professional support can also help address any specific challenges you may face.

The Body Mass Index (BMI) is a measure of body fat that is used by the medical profession to determine a person’s weight in regard to the height.

BMI applies to adult men and women and assesses whether people are underweight, of a healthy weight, overweight or clinically obese.

Why does BMI matter?

People who are classed as clinically obese possess a greater risk of developing diabetes, as well as cardiovascular diseases,

cancer
and suffering a

stroke

You can use the BMI tool to tell how healthy your weight is for your height, however, BMI has its drawbacks and arguments have been made against it.

Guide to BMI

Explore BMI; from why it’s important to how to take your waist circumference in order to calculate your BMI.

GUIDE TO BMI

Why is BMI Important?

How to Calculate BMI

Measure Your Waist

Is BMI a true measure of my health?

Body fat is not taken into account when compared to muscle content, so a tall athlete in excellent physical condition may have a higher BMI than someone who is overweight.

BMI is also no indication of general fitness or health, with another criticism aimed at BMI readings that age is not taken into consideration.

Type 2 diabetes
is very closely associated with weight, with over 90% of newly
diagnosed type 2 diabetics above their ideal weight.

Being overweight can
hurt your confidence, and getting back to a healthy
weight can seem like a never-ending challenge.

Losing some weight could
both prevent you from developing diabetes,
or help you to better manage your condition if you have already been diagnosed
with diabetes.

First things first – weigh yourself

First off, work out how overweight you actually are. For many people, weighing yourself is the

first step

to weighing less.

Most
people will have an intuitive sense of what a healthy
weight is for them, but understanding how much you have to lose can make
all the difference in having clear goals.

Talking about weight loss can
be tough, particularly if you do not know your doctor or diabetes
specialist very well, but understanding weight loss can make all the difference.

• 
  How overweight am I?

Get ready to lose weight and keep motivated

Getting into the right frame of mind to lose weight can be half the battle for some people. Get your head in good shape and allow the body to follow.

• 
  Weight loss motivation

What can you do?

Read up as much as you can, including topics such as

diabetes
and obesity, and

diabetes
and metabolic syndrome

That way you will understand your risks and
what you have to do.

Diabetes prevention starts with losing weight.

First
things first, discuss weight loss and an individual program with your health
care team.

Take things slowly at first, and take one step at a time.

Which diet will help me to lose weight?

The diet industry is huge, but how do you pick a sensible diet?

Many diets involve reducing or restricting certain foods which makes some diets more or less appropriate for certain types of people.

If you need help choosing which diet to pick, a dietitian will be able to assist you in making a suitable choice.

• 
  Diet and weight loss

How does exercise help diabetes and weight loss?

Exercise can help you to lose weight, by building muscle and burning calories. Although this can take time, particularly to physically notice the differences, each activity becomes easier as you become fitter. Always make sure exercise is appropriate to your situation.

• 
  Weight loss and exercise

Could alternative weight loss therapies help?

Alternative weight loss therapies can be beneficial to help support weight loss. They can help with motivation and can also help you to make appropriate health choices. If in any doubt though, check with your healthcare team whether the therapy is suitable for you.

• 
  Alternative weight loss therapies

Should I consider weight loss surgery?

If all else fails, and only if all else fails, weight loss surgery is available as a last resort option.

Weight loss surgery is a serious undertaking but for some people it can be particularly beneficial.

• 
  Weight loss surgery

Support to help you shed the weight

Losing weight using physical exercise and diet control can
be difficult, but if you persevere it will have a hugely positive effect
for the vast majority of diabetics.

• 
  Discuss
  losing weight on the Diabetes Forum

Low-carb diets are very effective for people who want to lose weight.

As well as being satisfying and healthy, a strict low-carb diet is able to switch your body into fat burning mode.

To achieve effective weight loss on a low-carb diet, you’ll need to:

• Keep carbohydrate intake low
• Protein intake moderate
• Fat intake high
• Avoid snacking
• Exercise regularly

The information on this page guides you towards what you need to do to lose weight on a low-carb diet.

Other guides that you will find useful, include:

• 
  How low carb diets work
  
  – for the theory on how the diet helps to reduce weight and blood sugar
• 
  How to follow a healthy low-carb diet
  
  – this will tell you which type of foods to include in your diet
• 
  Common mistakes on a low-carb diet
  
  – see if you’re making any of these mistakes which could be holding back your success
• 
  Why is low-carb not working?
  
  – see if there are any others factors that may be making weight loss harder for you than it is for others

Low carb, moderate protein, high fat

Getting the right balance of carbohydrate, protein and fat should help you lose weight.

Most people can have success on a low carb diet without having to measure how much carbs, protein or fat they’re having.

Avoiding starchy foods like bread, rice, pasta, potatoes and pastry and not having too much protein-based foods including meat, cheese and nuts, is a good basis for most people to lose weight.

However, some of you may want to monitor your energy intake to make sure you’re keeping on the right lines. There are a number of apps that can help with this.

Keep carbohydrate low

It’s up to you how low-carb you want your diet to be but strict ketogenic low-carb diets are particularly good for achieving weight loss.

Carbohydrate

intake usually needs to be below 50g per day to be ketogenic. Some people may find they need to restrict their carb intake further, say to under 30g, to achieve a ketogenic diet.

Ketogenic diets are when the body is being fuelled primarily by ketones rather than by glucose. Ketones are a form of energy produced by the breaking down of body fat.

To achieve a

ketogenic diet

, you will need to eliminate grains, starchy foods and most fruit from your diet.

When keeping to a strict low-carb diet, it’s important to be aware how much carbohydrate is in different foods. To help out, see our guide on

which foods have more carbs than you might expect

Protein should be moderate

Protein should be moderate for weight loss to occur. Too much protein can cause the liver to produce too much glucose (a process called gluconeogenesis) which leads to higher blood sugar levels and can hamper weight loss.

There is no fixed figure for how much ‘moderate’ should be but low-carb diet researchers and doctors recommend upper limits of anywhere between 30g and 120g of protein.

As this is quite a wide spread, it may be best to aim for a more conservative window of around 50g to 60g of protein a day and work from there.


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The following image gives a visual guide to how much protein can be found in typical foods.

High in natural fats

A low-carb ketogenic diet for weight loss has a high fat content with

Fats

coming from natural sources such as meat, oily fish, nuts, avocado, olive oil and dairy.

Fat is the energy providing nutrient (macronutrient) that results in the least impact on blood glucose, insulin levels and weight gain.

Put another way, a high fat diet is more likely to assist weight loss than diets that are high in carbohydrate or protein.

Most people find that if they keep carbohydrate intake low and protein intake sensible, they do not need to monitor how much fat they’re having.

One point to bear in mind is that a number of fatty foods, such as meat, fish, nuts and cheese are sources of protein and yoghurt and nuts are a source of carbohydrate so be wary of having excessive amounts of these foods.

Avoid snacking

A low-carb ketogenic diet is generally fairly self-regulating. Many people will find that it’s actually quite hard to overeat when sticking to a low-carb, moderate-protein, high-fat diet.

However, no diet is totally fool proof and weight loss will be best achieved if you can avoid snacking between meals.

This will help to keep the level of insulin in your body low and therefore help your body to burn fat.

Exercise regularly

Exercise

works the muscles and helps them to take in excess glucose and energy from the blood, which helps lower insulin levels, promote ketosis and therefore stimulate weight loss.

Adding regular exercise to a low-carb diet therefore gives a belt and braces approach to reducing your waistline.

Monitoring fat burning (ketosis)

Measuring your weight is the most obvious way to measure weight loss but some people may wish to also measure their ketone levels.

Ketones

are produced in direct response to the burning of fat and so this is a good way measuring to check if your body is burning fat.

Note that sometimes weight loss can occur as a result of fluid loss and weight can be put on in terms of muscle if you have been exercising, so measuring ketones helps avoid these uncertainties.

Measuring ketones can be useful if your weight loss stalls or if you make a

change to your diet

and want to review whether fat burning is indeed occurring.

In type 1 diabetes, the body doesn’t automatically respond to meals by releasing insulin, this has to be done manually through taking injections or through bolus doses via insulin pump.

If you’re looking to lose weight, this can give an advantage, in a way, as it allows you to review exactly how much insulin you’re taking each day.

By contrast, people without

type 1 diabetes

have no good way of knowing how much insulin they have in their body.

A good rule of thumb is that the more units of insulin you take per day, the more likely you are to put on weight.

• See also more general advice in our guide to
  
  weight loss on a low-carb diet
  

Less insulin intake, improved weight management

Say Jill and Michelle are roughly the same height and both have type 1 diabetes. Jill is taking 50 units per day and Michelle is taking 100 units per day. Generally speaking, it’s more likely that Jill will be finding it easier to manage her weight than Michelle.

So, if you’re looking to lose weight, one way to achieve this is to modify your diet, or eating habits, so that you take less insulin whilst maintaining good blood control.

Warning note:

We need to make an important safety note that reducing your insulin whilst letting glucose levels go high for long periods of time is not a good idea at all. Doing this will lead to a much greater risk of very serious health problems such as retinopathy, neuropathy and kidney disease.

Reducing insulin intake safely

There are a number of ways insulin intake can be reduced in a safe way:

• Lower your carbohydrate intake
• Lower your protein intake -if you eat a lot of protein
• Increase physical activity
• Reduce snacking

Out of these, reducing carbohydrate intake is likely to have the greatest effect.

Lowering insulin doses should only be done if you are confident with adjusting your own insulin. If you are not confident, speak to your doctor about whether and how your insulin doses should be adjusted.

For more information on improving your success on a low carb diet, see our guides on:

• 
  Why your low-carb diet isn’t working
  
• 
  Commonly made mistakes ona low-carb diet
  

Lower your carbohydrate intake

If you can reduce either your carbohydrate intake, you should be able to reduce your doses of insulin, however, be prepared to be patient with this.

If you can reduce the carb for meals, you should find you need less high mealtime/bolus doses.

Note that basal insulin doses may need adjusting when going onto a low-carb diet so involve your health in reviewing your insulin requirements.

Lower your protein intake

Some people may struggle to lose weight on a low-carb diet if they’re having a lot of protein in their diet.

If you are having a large amount of meat, for instance, you may need to substitute some of the meat for foods with more fat and less protein.

See more on

how to follow a healthy low-carb diet

Increase physical activity

Getting into the habit of taking regular physical activity should help towards taking less insulin.

Taking walks after meals is a good way to lower sugar levels. Make sure you put in a lower dose for the meal to account for this.

Basal insulin can be reduced in advance of exercise if you know that you will definitely be carrying out a significant amount of exercise within up to 24 hours.

If you use an

insulin pump

, you can reduce or suspend your basal dose prior to or during exercise to prevent hypos occurring.

One thing to watch out for is if you find yourself having to take carbohydrate prior to or during exercise to prevent exercise.

You can try taking a

10-second sprint

to raise sugar levels prior to exercise instead of having carbohydrate. The 10-second sprint, which can be performed on the spot, will usually trigger the liver to raise sugar levels within about 15 minutes.

Check your sugar levels 15 minutes after the sprint to make sure the effect has worked. Note you will need to use a blood glucose meter rather than a

continuous glucose monitor (CGM)

as they have around a 10-minute delay.

Reduce snacking

Excess snacking is a habit that many of us can all-too-easily fall into. Cutting back on snacking can be achieved with good commitment and being confident that you don’t really need to snack.

Hunger typically comes in waves and often, when feeling in a grazing mood, simply waiting it out for 20 minutes or so can see the snacking impulse pass.

It’s a good idea to get into a task or take some exercise to distract your thoughts away from eating.

Note that a feeling of hunger can sometimes be brought on by low sugar levels. If you are regularly going low after meals, you will need to review your insulin doses.

Reduce basal insulin gradually

The

DAFNE course

advises that most people do not need to be on more than 24 units of basal insulin a day. However, if you have insulin resistance, you may need to be on a higher basal dose than this and try to gradually reduce your basal dose down.

Maintaining a good low-carb diet should help you towards achieving this.

Seeing if you can reduce your basal dose down, whilst keeping good blood glucose control, can be used as motivation to see how you’re progressing.

Remember that this will take time so don’t demotivate yourself by expecting too much too soon.

Also, don’t get put off track by colds or other illnesses which may require you to raise your basal dose temporarily to keep sugar levels under control.

Certain shopping habits can prove detrimental for some people, and actually play a big part in how easy it can be to put on weight.

Special deals advertised by supermarkets can be tempting when larger products are discounted at a much lower price, regardless of how healthy they are.

This can lead to people buying excess food that they don’t really need and  in greater portions than recommended.

Putting on weight
can be easily done from bad shopping habits, so planning your shopping activity in advance is important to avoid certain supermarket pitfalls.

Eat before shopping

If you haven’t eaten before you shop, it is likely that hunger pangs that strike at the supermarket can lead you to make the odd impulse purchase.

Make sure you have eaten, and you are full before you head out to do your grocery shopping. Feelings of hunger will therefore have less of an influence, which will not only prevent you from buying food that may be unhealthy, but also reduce your shopping bill.

Make a grocery list

Making and sticking to a grocery list is important as it gives you a sense of direction when entering a store.

Knowing exactly what you need to buy can prevent you from getting sidetracked and potentially forgetting to buy important items in favour of unplanned purchases.

A grocery list can also save you time when shopping. By crossing off items as you go along, you can work out which aisles to visit next rather than just walking up each one and seeing what things you could buy.

Buy the right foods

Dedicate your shopping list to buying the foods that are best for you when shopping, including fresh fruit and vegetables and

lean cuts of meat
and

fish

Reduce the amount of sugary foods
in your trolley that will result in additional calorie consumption and try to implement whole grain changes into your diet.

Buy brown bread instead of white to gain the most nutrients, while buying whole grain rice and cereal will also be more beneficial for you than white or sugary counterparts.

Buy and try a new fruit or vegetable

The policy of buying and trying a new fruit or vegetable is one element where not sticking specifically to your grocery list can be beneficial.

The nutrients found in most fruit and vegetables make them worth purchasing, especially if you have not had particular ones that you may be interested in trying.

Try one new piece of fruit or

vegetable
each time you go to the supermarket to liven up your meals or snacks for when you get home.

Adopting a healthy diet will enable you to lower your BMI (Body Mass Index), as simply increasing your level of activity might not be enough to lose weight.

Calorie deficit

Reducing how many calories you eat will assist in your weight loss, as the calories in foods people eat can quickly add up.

Entering a calorie deficit, where you eat fewer calories than you burn in a day will prevent you consuming excess fat that serves to increase your BMI.

Starting to cook for yourself more can help you monitor your food portions and subsequent calorie intake.

Check food labels to be sure you are eating the smallest amount of saturated fat possible, and so you can avoid the fats that come from fried and baked foods.

Change your shopping list

Fruit and vegetables

Adding five servings of fruit and vegetables a day can add nutrition to your diet, which will also serve to fill you up.

Vegetables, especially, are packed with the nutrition our bodies need to feel satisfied and they’re generally low in calories.

Using dressings, herbs and spices can make vegetables more appealing if they do not normally make your shopping list on a regular basis.

Whole grain replacements

High sugar foods such as sweetened cereal, chocolate and pastries should be avoided, as well as sugary soda drinks.

Replace starchy version of foods such as bread, flour and rice with whole grain foods. Whole grain foods are less heavily processed than their white counterparts and contain significantly more fibre and natural nutrition.

Attack snacks

It can be quite tempting to buy snacks when shopping, but snacks such as crisps and chocolate can contain excess calories.
Buy some chewing gum to replace these snacks when hunger strikes, while drinking a large glass of water can also fight off hunger pangs.

Change your diet

Ditch highly processed foods

Processed food should be avoided as part of your diet, with a generally reliable rule being the more processed a choice of food is, the worse it is for your health. Very processed foods tend to include:

• Highly refined carbohydrate – which sharply raise blood sugar levels
• Man made fats
• Added glucose, sugar and salt
• High levels of preservatives
• Very little fibre

Fibre intake

Increasing your fibre intake will not only give you more energy, but it will also help you regulate your body’s systems.

Your

BMR (Basal Metabolic Rate), which is the number of calories required to keep your body functioning at rest, will increase following enhanced fibre. This can also speed up your weight loss in the process.

Whole grain ingredients and products will also assist you in your fibre increase, while whole wheat flour and oatmeal are other good fibre sources.

Make use of protein

Protein has a number of distinct benefits because it provides fewer calories per gram than carbohydrate or fat and keeps you feeling full for long periods of time.

If you need to be strict on calorie content, opt for lean meat such as chicken breast and cuts of red meat with the fat trimmed off.

Eggs are a strong and versatile choice and beans are lentils are a great choice, particularly for people following vegetarian or vegan diets.

Lean meat

Eating lean meat can assist with weight loss as it contains significantly more protein and has less fat and carbohydrate content.

Chicken generally tends to be very lea, with the white of the meat containing less fat than the meat found on the thighs or wings.

Red meats such as beef and pork are also beneficial, with the leanest cuts available containing more beneficial materials such as vitamin B, iron and zinc.

Your BMI may not always be an entirely accurate representation of carrying excess fat, including:

• When pregnant, or having recently given birth, and/or nursing
• Having muscular or athletic build

In these examples body weight and BMI may be higher for reasons other than excess body fat, and therefore BMI would be a less useful indicator of health.

Also, BMI does not distinguish between body fat and muscle mass, which is why muscular athletes may have a high BMI because of increased muscle rather than additional body fat.

Is BMI reliable as an indicator of body fat?

BMI can be useful as a rough guide, and there is a correlation between BMI and body fat, however it is also dependent on sex, race and age.

At the same BMI level, men tend to have less body fat than women, while older people generally have more body fat than younger adults, on average.

Another simple measure to assess body fat and health risk is waist circumference.

Guidelines from the National Heart, Lung and Blood Institute recommended looking at waist circumference – as abdominal fat can lead to obesity-related diseases – and other risk factors associated with

obesity
such as physical inactivity and

high blood pressure

BMI (Body Mass Index) is important as it is widely regarded that your chances of having a longer and healthier life are improved if you have a healthy BMI.

If your BMI is high, you may also have an increased risk of developing

type 2 diabetes, as well as other metabolic diseases such as

hypertension, high cholesterol and heart disease.

Relationship of BMI with diabetes

Research shows strong links between a high BMI and type 2 diabetes, with the risk of the condition rising with each increase in BMI.

Data studies

A review of over 12,000 people in the United States, published in 2014, showed that people with a BMI of 25-29.9 had a 50% increased risk of diabetes compared to people with a BMI of 18.5-24.9.

Obesity was linked with increased rates of diabetes between 2.5 and 5 times higher than people of normal weight, with the highest risk being those with a BMI of 40 or more. The results found:

• 
  BMI 25-29.9 (overweight):
  
  50% higher type 2 diabetes risk
• 
  BMI 30-34.9 (obesity class I):
  
  2.5 times more likely to get diabetes
• 
  BMI 35-39.9 (obesity class II):
  
  3.6 times more likely to get diabetes
• 
  BMI 40+ (obesity class III):
  
  5.1 times more likely to develop diabetes

BMI and other long term health risks

The World Health Organisation (WHO) lists a high BMI as a major risk factor for heart disease, stroke, bone and joint problems including osteoarthritis and a number of cancers, including breast, colon and endometrial cancer.

Large scale surveys, such as SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes), conducted in the USA in 2004, show clear associations between a raised BMI and increased risks of hypertension (high blood pressure) and dyslipidaemia (high cholesterol) in addition to type 2 diabetes.

How health care professionals use BMI Formula

BMI is checked regularly by doctors to assess if people are at a healthy weight, with advice dependent on what your BMI reading is:

• 
  Below 18.5 BMI:
  
  advised to eat more to gain weight within a normal range
• 
  Between 18.5-25:
  
  you are of normal weight
• 
  Between 25-30 BMI:
  
  advised to lose weight and exercise more to reduce risk of obesity
• 
  Over 30 BMI:
  
  specific diets and weight loss programmes suggested, as well as referral to a dietitian.

Diet and weight loss programmes

If you have a BMI over 30, you may be referred to join a weight loss group or given exercise on prescription.

Weight loss groups may be commercial slimming groups or those provided by the NHS. Exercise on prescription involves being referred to receive a number of sessions of physical activity with a health team or a qualified trainer.

Your health team should provide you with guidance on changing eating habits and exercising efficiently to achieve the best possible benefits.

Some people may be considered to go on a very low calorie diet of 800kcal per day. This requires medical supervision and may not be advisable in certain groups of people.

Bariatric surgery

In the UK, you may be considered for bariatric surgery in the following cases:

• Having a BMI over 35
• Having a BMI over 30 and having recently been diagnosed with type 2 diabetes

People of Asian origin may be considered for weight loss surgery if they have been diagnosed with type 2 diabetes within lower BMI brackets than 30.

Follow-up appointments will be carried out to ensure your diet, medication and level of support is appropriate to prevent weight being regained.

When your BMI is calculated, it will translate to being underweight, in the healthy range, overweight or obese.

Underweight

If your BMI reading is below 18.5 then you would be classed as underweight and advised to eat more to gain weight within a normal range.

Risks of being underweight

You should consult your GP if you need to gain weight, as low body mass can damage your health and decrease your body’s immune system.

When your immune system is not 100 per cent, you are more likely to catch a cold or other infections, as you lack vital nutrients required for your body to grow, fight infections and work properly.

Among the risks that come with being underweight and having a weakened immune system include:

• 
  Loss of periods for women
• Lack of calcium – resulting in failure to maintain strong and healthy bones
• Malnutrition
• Weakened muscles – including your heart

Losing weight without trying

If your BMI reading classes you as underweight, and if you have not being trying to lose weight, you should consult your GP to see if other problems are causing this weight loss.

Emotional issues such as feeling anxious when thinking about food could be stopping you from eating a healthy diet.

Experiencing high levels of stress, or other emotional problems, can result in a change in eating patterns that may be hard to recognise, but could result in you losing weight.

If you are exercising control intentionally to avoid eating food, this could be a sign that you may have an

eating disorder

Alternatively, there may be an underlying medical cause for your low weight, such as an

overactive thyroid

Steps to achieve a normal weight

Adopting a healthy, balanced diet can assist with achieving a normal, healthy weight for your height and age, but it is important to gain weight gradually rather than in a rush.
Increasing weight the right way is crucial.

Avoid foods that increase your body fat rather than your lean body mass such as

chocolate, cakes and other high-calorie foods.

Aiming for three meals and three snacks a day, involving

starchy carbohydrates
– such as pasta, rice or potatoes – as well as fruit and vegetables are good healthy eating principles to base your diet on to achieve a healthy weight.

BMI outcomes in adults – Healthy BMI

Having a BMI reading of between 18.5 and 24.9 means you are of a normal weight and that your body is not at risk of a weight-related disease.

It is important to ensure that you maintain your healthy weight through a balanced diet of vegetables, fresh fruit and limited intake of processed food.

If your calorie intake matches your energy output you will remain a normal weight, but exercise is also important, with 30 minutes a day for five days a week recommended for all adults.

Keeping an eye on your waistline
can also help monitor any excess weight that might put you at risk of developing long term health conditions.

BMI outcomes in adults: Overweight or obese

If you have a BMI reading of over 25 then you would be classed as overweight, while a reading of 30 or above would see you measured as obese.

Being classed in these groups puts individuals at greater risk of potential risks and illnesses. Doctors may advise you to consult with a bariatric surgeon if your BMI falls in the obese category to help you instigate a weight loss regime.

Among the diseases and health problems that can be more likely to affect overweight or obese people include:

• 
  Type 2 diabetes
• Cardiovascular diseases
• 
  Stroke
• 
  Hypertension
• Some cancers (breast, colon and endometrial)

Steps to achieving a healthy weight

Fitness specialists will recommend programs designed to reduce your BMI if you fall into one of these groups.

They will also provide guidance and support over how to change your eating habits and exercise regime to efficiently achieve the best results possible.

Weight loss can improve your health and improve physical ailments such as back and joint pain upon shedding excess weight.

Exercise

Even losing a small amount of weight can benefit adults who are overweight or obese, and commencing with an excise regime can help you become a healthier weight.

Adults are recommended to engage in at least 150 minutes of physical activity a week, but adults who are overweight will likely need to exercise more than this to lose weight. This could be achieved through

cycling
,


running,

swimming

Diet

Eating fewer calories by swapping high-calorie meals and snacks for healthier options is an additional part of losing weight.

Swapping energy intake from fats and sugars for increased consumption of fruits, vegetables and whole grains will also assist with weight loss.

Follow-up appointments will often be recommended if your BMI reading is over 25 to ensure that your weight loss goals are being met.

If you are looking to reduce your BMI reading, or alter your diet to lose weight, there are a number of ways to change your eating habits.

It may be rather than the food you are eating, it is certain habits you have developed which are responsible for your diet not being as healthy as it could be.

Stick to a regular eating schedule

A regular eating schedule can help

regulate blood sugar levels, which is especially important for people with diabetes.

Delayed or irregular meals can commonly cause a stronger sense of hunger which can easily lead to taking in too many calories when you do eat. Skipping meals can have a similar effect.

Eat with others

Setting aside time to eat with others can assist with this schedule, and your body will start to recognise times of the day where it can expect to consume food.

Eating with others, while engaging in conversation, can also help you eat food slower, leaving you fuller after your meal and less inclined to eat soon afterwards.

Eat before you get too hungry

If you feel hunger pangs and you are not eating a main meal for a while, eating a healthy snack such as fruit or raw vegetables is an ideal way of keeping hunger at bay.

Allowing hunger to build can result in your overcompensating during your next meal and absorbing more calories in order to make yourself feel full.

Drink lots of water

Water can be especially filling, so drinking a large glass either before or during meal, or both, can help you feel less hungry during and after your meal.

Replace any soda or sugary drinks that may accompany your meal with water to eradicate excess calories.

Don’t eat late at night

Eating late at night, particularly excess calories that can be found in crisps and

chocolate, is a sure-fire way of putting on weight. Instead, make sure you main evening meal is filling and nutritious enough to fight off the temptation to snack during evening or night.

Green salads

When preparing a meal, make a green salad on the side to fill you up. This can also be done in a restaurant when ordering your food.

Asking for a salad on the side, or to replace a more starchy food that comes with your meal, such as chips, is a healthy way to brighten up your plate.

Bring your own lunch

It can be quite tempting to buy food when you’re on a lunch break at work, especially if a collection of food shops is nearby.

However,

bringing your own lunch
each day will allow you to monitor your calorie content, with many food establishments (even those presenting themselves as healthy) often packing a surprising number of hidden fats into their foods.

Note that to ensure you do lose weight as a result of exercise, you will need to ensure that your diet does not contain excess calories which could prevent your exercise from bringing your body weight down.

Aerobic exercise

It is recommended by the World Health Organisation that adults get at least 30 minutes of moderate aerobic exercise five days a week.

Alternatively, this can be 75 minutes of vigorous-intensity activity through the week.

Children should aim to take part in an hour of physical activity each day.

Swimming, running and cycling are all good examples of aerobic exercise, which serves to increase your heart and breathing rate.

Aerobic exercise does not lead to putting on muscle mass to the extent that anaerobic exercise does. For this reason, when you perform aerobic exercise, you burn off fat without putting much weight back on as muscle mass.

Note that there is nothing unhealthy on putting on muscle mass, it is just that those who need to see their weight dropping for motivation purposes may prefer to concentrate more on aerobic exercises, at least initially.

Anaerobic exercise

Anaerobic exercise includes lifting weights and other resistance exercises such as push ups or stomach crunches.

Anaerobic exercise is effective in lowering your BMI, but you may find that you don’t experience a drop in your weight in the short-term as an increase in muscle mass may see the scales showing the same weight even though you are actually burning body fat.

In the longer-term, however, as your muscles increase, you should start to notice that your weight, and therefore your BMI, begins to drop.

When working a muscle group, make sure you have a day’s rest before exercising those muscles again as this will allow your muscles time to recover and grow.

Research shows that combining both aerobic and anaerobic exercise to be successful towards weight loss as well as in improving insulin sensitivity in people with diabetes.

Portion sizes have increased dramatically over the last 20 years, which can lead to

portion distortion
when meals are being served.

Keeping an eye on your portion size is important as you can avoid excess calories that would qualify as more than one food serving.

To limit your portion intake, especially with bigger meals, deploy some tips which can help reduce your portion size, and subsequently any additional calories which could increase your BMI reading.

Share your food

If you are out for a meal and wary that the portion of food you have ordered contains more than one food serving, either remove some of the food from your plate before you start or stop as soon as you feel full.

Offer to share your food, if dining with company, or ask to have the food wrapped up for you to take home.

You can maintain a healthy weight by choosing the right number of servings from your chosen food group by not finishing your plate if it exceeds this number.

Eat sweets in small amounts

Sweets can be eaten as part of diets, but smaller amounts are the way to go if you are consuming high sugar or high calorie products.

Restrict your portions, especially in times of festivities such as

Halloween, as this will keep your

blood sugar levels
from increasing as well as keep you from putting on excess body fat.

Don’t have seconds

Seconds can often be tempting if you still feel hungry after a meal, especially if you are dining out at a restaurant such as a buffet.

However, this can lead to you consuming portions that could feed between two or three people, a sure way to increase your recommended calorie content.

Note that having high sugar levels can itself be a cause of hunger and so if you’re hungry despite having recently eaten, it’s best to allow the insulin to catch up before eating any more.

Restricting yourself from having seconds, especially if you are already full, will keep your BMI reading and body fat level down.

The plate method is a technique of dividing up your plate to enable you to measure out appropriate portion sizes of different foods.

The plate method can be used to aid

weight management

and can also be helpful for people with diabetes in managing

carbohydrate intake

The plate method is simple to apply and is therefore an easy way to manage your energy intake and ensure a healthy balance of

nutrients

in your diet.

Does plate size matter?

For the plate method to work well, it helps to begin with a suitably sized plate. Many dinner plates in the UK are up to 12 inches in diameter.

Replacing a larger plate with one that has a 10 inch diameter can you help to reduce your meal size by up to a quarter.

Dividing your plate

The American Diabetes Association recommends, at main meals, dividing your plate into quarters as follows:

• 2 quarters made up of non-starchy vegetables
• 1 quarter of starchy foods
• 1 quarter of protein based foods

Non-starchy vegetables

include vegetables that have less impact on blood sugar levels, such as broccoli, mushrooms, swede and most salad vegetables.

Starchy foods include

whole grain foods

, such as bread and rice, and

starchy vegetables

include vegetables such as potatoes, cassava and beetroot.

Protein based foods may include any of the following:

• 
  Fish
  
• 
  Lean meat
  
• 
  Red meat
  
• 
  Eggs, beans and pulses
  

Portion size plates

There are options available to make dividing your plate up even easier.

The Diet Plate has easy to follow divisions on the plate which are tailored for men and women depending on which plate you choose.

The

Low-Carb Program

– a structured education programme for people interested in following a low-carb diet – makes extensive use of the plate method.

Sign up today »

If you exercise to lose weight, it can be annoying for those on insulin as it can mean having to take in as many calories, in the form of carbohydrate to keep your sugar levels up, as you can hope to lose by doing the exercise.

We review two methods that can reduce the need to take in carbohydrate prior to exercise.

Intense sprinting raises blood sugar levels

Taking part in an intense 10 second sprint has been found to raise blood glucose levels in people with

type 1 diabetes

When the body takes part in sprinting, it needs a ready source of glucose and the liver is naturally set up to do this by releasing stored glucose into our bloodstream.

This is well worth trying for people who are looking to manage their weight as it means you can raise your blood sugar levels for exercise without needing to take so much carbohydrate on board.

Test your blood glucose levels 15 minutes after the sprint to see if it has raised your sugar levels sufficiently.

The rise in blood sugar levels from a short sprint should sustain your blood sugar levels for the initial part of your exercise.

If you’re taking part in exercise for more than 20 or 30 minutes, you may find you need to take in glucose or another form of carbohydrate to prevent your blood glucose levels from going low.

If you are experiencing

low blood glucose levels

, it is important to take a source of quick acting carbohydrate such as glucose tablets.

• Read more on
  
  sport and blood sugar levels
  

Reduce insulin intake for exercise

An effective way of reducing carbohydrate intake for exercise is to reduce your insulin.

This is a relatively easy option for people on

insulin pumps

Some people will decide to remove their pump for exercise, allowing the exercise itself to prevent blood glucose levels rising.

Bear in mind that it is not recommended to be disconnected from your pump for more than hour to prevent ketone levels from rising.

If you make changes to your insulin, or disconnect from your pump for a period of time, monitor your blood glucose levels regularly to help prevent high or low blood sugar levels.

For those on injections, reducing insulin intake is more difficult to achieve and the sprinting method above is likely to be a better option.

Whilst weight gain on

diabetes medication
is not a foregone conclusio, it is a relatively common problem that can occur.

With commitment, and the support of your doctor, it is possible to prevent weight gain and to

start losing weight

Reasons for gaining weight

Before looking at what can be done to prevent weight gain, it’s important to understand in what ways medication can lead to weight gain.

Generally, the most common reason is that stronger diabetes medication can cause

low blood sugar levels (hypoglycemia)
In turn, this can cause an individual to eat more than they might otherwise need to in order to prevent or treat low blood glucose levels.

Stronger diabetes medication can therefore lead to weight gain for the following reasons:

• Needing to ‘feed’ the insulin to prevent low blood sugar levels
• Response to strong hunger as a result of hypos
• Decreased willingness to exercise to avoid risk of hypos

Stop feeding the insulin

Diabetes

drugs such as insulin,

sulphonylureas
and

prandial glucose regulators
all increase the amount of insulin in your body. Whilst these drugs are usually prescribed to people who have blood glucose levels that have been above the target values, they can still sometimes lead to lower-than-normal blood sugars.

If you find that you have to eat more often than you would like, or have larger quantities of starchy foods, in order to prevent lows occurring, you may be at risk of putting on weight as a result.

If you eating more to prevent lows, you may need to speak to your doctor about whether your medication dose can be reduced.

Note that if your dose is reduced, you will need to maintain a healthy and relatively

low calorie diet
and may need to take additional physical activity to

ensure your blood glucose results do not rise too high
Your doctor should be able to help you to strike the right balance.

Beating the hunger of hypos

One of the common symptoms of low blood sugar is a

strong sense of hunger
and it can be challenging not to overeat as a result of such hunger.

If hypo hunger is causing you to overeat, there is a way to beat the binges. The key to treating hypos with least calorie intake is to use the fastest and purest form of glucose –

glucose tablets or a glucose drink

Glucose has the advantage over sugar in that it is a monosacharride,

whereas sugar is a disacharride
What this means is that glucose is measurably quicker at raising blood glucose levels, meaning you spend less time feeling anxious and craving food.

Generally speaking, the strong food cravings subside as soon as your blood glucose returns to healthy levels.

• Read more on
  
  treating hypos and the accompanying hunger

Defeating aversion to exercise

Physical activity is advisable
for people with diabetes. However, because it can lead to lowering of blood sugar levels, this may put off people on stronger diabetes medications if they have experienced low blood sugar levels as a result previously.

If this is the case, you should speak to your doctor about how you can address the problem. Options that may be possible include reducing your medication dose, or even suspending your dose on any day you take exercise. Whilst these are possible options,

your doctor will know best which options are most appropriate

A number of widely

prescribed diabetes medications
have been linked with increased weight gain.

It can be hugely frustrating when medicines which we take to improve our blood glucose levels and

diabetes control
make it harder for us to manage our weight.

However, it’s important to remember that even if your diabetes medication is contributing to increases in weight, it’s not an inescapable trap and there are actions you can take, with your doctor’s help, to combat and reverse weight gain.

Insulin

Insulin allows glucose to move from out of the bloodstream and into the cells of the body, thereby helping to lower levels of blood glucose. However,

insulin is also known as a fat storage hormone

Excess glucose in the blood, if not being used as energy by the muscles, is stored as fat and insulin is the hormone that allows this to happen.

A problem that can happen for many people who take insulin is that the benchmark of how much needs to be eaten is set by the insulin dose. So, invariably, taking insulin is going to require you, at some point, to eat more than you would otherwise to prevent blood glucose levels going too low.

The key to minimising this problem is to ensure you are not taking too much insulin. There is a balance to strike, of course, as taking too little insulin for what you’ eat will result in

too high blood sugar levels

If you are putting on weight on insulin, it will help to speak to your doctor about gradually reducing both your insulin and your dietary intake, particularly with regard to carbohydrate.

Hypos, hunger and weight gain

Insulin has additional problems for weight management. If insulin causes blood glucose levels to go too low (hypoglycemia), it can leave with you a

strong feeling of hunger

The best response to strong hunger or increased appetite is to raise blood glucose levels as quickly and efficiently as possible as once sugar levels are back to normal, the cravings should cease.

If you tend to overeat in response to low blood sugar, it’s advisable to stick strictly to having only glucose tablets or another fast acting form of sugar to treat hypos and not give in to temptation to eat other foods, such as those containing protein or fat, when or following

treatment for a hypo

• Read more on
  
  hypos and controlling hunger

Sulphonylureas

Sulphonylureas are medications for type 2 diabetes that work by stimulating the pancreas to produce more insulin.

Examples of

sulphonylureas
include glimepiride, gilbenclamide and gilclazide. In doing so, the body has more insulin available to transport glucose out of the blood and into cells where it can either be used for fuel or to be stored as fat.

Similar to the problems associated with taking insulin, if you are putting on weight with sulphonylureas, you will need to work with your doctor whereby you can either reduce your calorie or carbohydrate intake or increasing the amount of exercise you do without increasing the risk of going hypo.

Note that if a reduction in carbohydrate intake or a

significant increase in physical activity
results in too low blood glucose levels, your doctor may need to decrease your dose of your sulphonylurea medication.

Thiazolidinediones (Glitazones)

Thiazolidinediones, also known as glitazones or simply TZDs, work very differently to taking either sulphonylureas or insulin. Whereas taking sulphonylureas or insulin increases the amount of insulin in the bloodstream, TZDs help to improve insulin sensitivity and reduce the amount of insulin in the blood.

Any benefits of lower insulin levels must be supported by diet and regular exercise, however. If you are consuming too many calories and not taking enough exercise, excess calories will accumulate as body fat.

So, if weight gain is an issue when taking TZDs, a review of calorie intake and level of physical activity should be undertaken to assess whether or how your lifestyle can be improved.

Switching medication

If you have type 2 diabetes, there is another option available if you are struggling with weight gain despite having made significant improvements to your lifestyle.

A number of newer

type 2 diabetes
medications have been developed in recent years with a particular focus towards supporting weight loss.

Examples of medications which shown clear benefits for losing weight include:

• 
  GLP-1 receptor agonists
  (such as Victoza, Byetta and Bydureon)
• 
  SGLT-2 inhibitors
  (such as Forxiga and Invokana)

Other medications

In some cases, weight gain may result from the use of other medications.

Non-diabetes drugs which have been more strongly linked with weight gain include

corticosteroids
and certain medications for treating epilepsy and depression.

It should also be noted that there are also certain medical conditions that can directly influence weight gain regardless of which diabetes medication is taken.

Cushing’s syndrome
and

hypothyroidism (an underactive thyroid)
are two medical known to directly increase the risk of weight gain.