Obesity and type 2 diabetes are closely linked. Excess body fat can alter your body’s metabolic system, promote insulin resistance, and trigger inflammatory responses that affect how well your body regulates blood sugar.

Type 2 diabetes occurs when your body doesn’t respond effectively to the hormone insulin due to what’s known as insulin resistance.

Insulin allows glucose (blood sugar) to enter your body’s cells, where it’s used for energy. When insulin resistance occurs, the pancreas produces more insulin to make up the difference. In type 2 diabetes, your body can’t meet its insulin needs, and hyperglycemia, or elevated blood sugar levels, develop.

Anyone can develop type 2 diabetes. Obesity is one risk factor, as excess body fat contributes to insulin resistance in various ways.

Obesity increases the likelihood of developing type 2 diabetes and is considered a significant risk factor for the condition. Genetics, lifestyle, and environmental factors also affect your risk.

Obesity changes your body composition, resulting in more fatty tissue called adipose tissue. This tissue is more than just energy storage; it’s an endocrine organ that secretes hormones and other compounds used by your body.

When you have too much adipose tissue, particularly around the abdomen, it promotes insulin resistance through several mechanisms:

  • increasing free fatty acids in the bloodstream that interfere with insulin signaling
  • triggering the release of inflammatory cytokines that reduce the effectiveness of insulin receptors on cells
  • creating a state of chronic inflammation that can damage the cells of the pancreas that produce insulin
  • altering the production of adipokines, hormones, and proteins that affect how sensitive cells are to insulin
  • promoting a state of inactivity, which creates less demand from muscle tissue for glucose

But just because you have obesity doesn’t mean you will develop type 2 diabetes. You can have obesity without insulin resistance or type 2 diabetes, and you can have insulin resistance or type 2 diabetes without obesity.

The underlying processes between obesity, insulin, and glucose exist on a spectrum of severity. Type 2 diabetes is diagnosed when your body reaches a point when it cannot compensate for insulin resistance anymore, and your blood sugar levels rise to potentially harmful levels.

Key statistics

Type 2 diabetes and obesity are co-occurring conditions affecting millions of people. Some key statistics include:

  • Approximately 90% of people living with type 2 diabetes have overweight or obesity.
  • Obesity is linked to 30% to 53% of new type 2 diabetes diagnoses in the United States.
  • Childhood obesity and type 2 diabetes is a growing concern. Research suggests around 75% of children with type 2 diabetes have obesity, and around 77% of those children had obesity at the time of their diabetes diagnosis.

Insulin resistance in type 2 diabetes can make weight loss challenging for some people.

When the body is resistant to insulin and your cells aren’t responding effectively, insulin production can increase as the body’s way of meeting the unfulfilled need.

In addition to regulating blood sugar, insulin is involved in fat storage. Elevated insulin levels in the blood from insulin resistance in type 2 diabetes can cause the body to store fat, making weight loss more challenging.

Insulin resistance can also slow weight loss by affecting blood glucose levels. Increased blood sugar from insulin resistance can lead to cravings and hunger because the body can’t fully utilize glucose and believes it is in an energy deficit.

In addition to the challenges of insulin resistance, certain type 2 diabetes medications may also contribute to weight gain or make weight difficult to lose.

Weight loss can reverse the effects of insulin resistance and put type 2 diabetes into remission for some people.

When addressed in the early stages, weight loss can improve insulin sensitivity, reduce the substances interfering with insulin signaling, and improve inflammation levels.

Not everyone with type 2 diabetes who loses weight will experience remission. For some, type 2 diabetes is tied to factors beyond weight, like genetics. In addition, people who have lived with type 2 diabetes for many years may experience irreversible cellular damage that prevents remission.

Because losing weight with type 2 diabetes can be challenging, building a professional team to support your goals can make a big difference.

Your doctor or primary healthcare professional is your frontline resource for weight loss in diabetes. A diabetes nutritionist and a diabetes specialist can also offer invaluable insights into the specific relationship between diabetes and obesity.

To start your weight loss journey, the American Diabetes Association recommends:

  • tracking and reducing your daily calorie intake
  • getting at least 30 minutes of physical activity 5 days per week
  • avoiding sitting or lying down for long periods during the day

Other tips that may help include:

  • focusing on small, maintainable adjustments, like eliminating one high calorie item at a time
  • keeping a journal to help you see patterns in your food intake and circumstances behind your food choices
  • finding an exercise buddy
  • engaging in physical activities you find enjoyable
  • exploring stress management techniques
  • reducing refined carb intake
  • adding more protein to your diet
  • prioritizing quality sleep

Type 2 diabetes and obesity are closely related. If you have obesity, you have a higher risk of developing type 2 diabetes due to obesity’s effects on insulin sensitivity and glucose utilization.

For some people, weight loss can reverse the effects of insulin resistance and put type 2 diabetes into remission. How much weight loss affects your diabetes diagnosis depends on your risk factors and how long you’ve been living with type 2 diabetes.