Obesity is a major risk factor for type 2 diabetes but does not directly cause it. Physical activity, a nutritious diet, and weight loss may lower your risk for type 2 diabetes. GLP-1 medications may help with weight loss.

According to a report from the Centers for Disease Control and Prevention (CDC), 42.5% of adults in the United States in 2018 had obesity and about 31% had overweight.

Overweight and obesity are major risk factors for developing type 2 diabetes or prediabetes, which 1 in 3 adults in the United States may already have. Weight can also factor into diabetes management overall, making it more difficult to keep your blood sugar in the target range.

However, while obesity may play a role in the development of type 2 diabetes in some people, it does not directly cause type 2 diabetes.

This article will explain more about the relationship between obesity and type 2 diabetes and what researchers currently know about the causes of diabetes in general. We’ll also offer you some tips to consider for reducing your weight and managing your health, whether you have type 2 diabetes or are at risk of developing it.

Obesity is related to type 2 diabetes in several ways.

Type 2 diabetes often develops after years of insulin resistance, in which your body does not properly process insulin — a hormone that regulates your blood sugar (blood glucose) levels. Prediabetes often develops first from that insulin resistance. More than 80% of people with prediabetes do not even know they have it.

Obesity is one of the most important risk factors in the development of metabolic diseases, including prediabetes and type 2 diabetes. This is because obesity desensitizes your body to the action of insulin, making it more difficult for your body to naturally use insulin to regulate your blood sugar.

That does not mean that all cases of obesity directly cause type 2 diabetes or that type 2 diabetes increases your chances of developing obesity.

However, obesity raises your risk of developing type 2 diabetes. Research suggests that 80–90% of adults who have type 2 diabetes also have overweight or obesity.

Obesity is not related to the development of type 1 diabetes.

Unlike type 2, type 1 diabetes is an autoimmune disease that causes your immune system to attack and destroy its own beta cells, resulting in an inability to produce insulin.

People with type 1 diabetes can develop insulin resistance over time, especially if they also have overweight or obesity. In fact, the rates of type 1 diabetes in adults with overweight and obesity are the same as in the general population.

While food is an important part of managing type 1 diabetes, a person’s food choices do not cause or contribute to the development of the disease. However, food and lifestyle habits may increase the risk of developing type 2 diabetes.

The three most important ways to reduce your risk for obesity involve changing or maintaining certain lifestyle habits:

  • maintaining a healthy eating pattern
  • getting regular physical activity
  • limiting the time you spend sitting

By reducing your risk for obesity, you will naturally reduce your risk of developing type 2 diabetes.

The CDC recommends the National Diabetes Prevention Program (NDPP) as the best way to help reverse prediabetes and prevent type 2 diabetes. The program was created to help people make dietary changes and increase physical activity in a supportive environment, with the aim of losing 5–7% of their total body weight.

Research analyzing the effects of the NDPP found that participants reduced their risk of developing type 2 diabetes by 58% after 3 years on the program. People ages 60 years and older experienced an even greater decrease: 71% in the same time period.

The study participants were divided into three groups: One group made lifestyle changes, one took the medication metformin, and one was a control group. The lifestyle change group changed their habits and aimed for 150 minutes of activity per week and a diet with fewer calories and less fat, with the goal of losing 7% of their body weight.

About 5% of people in the lifestyle change group developed diabetes each year during the study, while about 11% of people in the placebo group did.

This study suggests that long-term diet and exercise are effective at preventing type 2 diabetes, even more so than pharmaceutical drugs such as metformin.

There are CDC-certified NDPP programs in every U.S. state. Most health insurance plans, including many Medicare and Medicaid programs, will cover most of the program’s costs.

Glucagon-like peptide-1 (GLP-1) agonist medications were designed to help manage blood sugar levels in people with type 2 diabetes. These medications help lower blood sugar and A1C levels.

However, many people are prescribed these medications “off-label,” for uses that the Food and Drug Administration (FDA) has not approved. Instead of using GLP-1 medications for type 2 diabetes management, they use them to promote weight loss and increase insulin sensitivity.

You can take these medications orally or via an injection (either once per day or once per week). Common GLP-1 medications include:

  • Bydureon
  • Byetta
  • Ozempic
  • Rybelsus
  • Trulicity
  • Victoza

The FDA has approved two GLP-1 medications specifically for weight loss: Wegovy and Saxenda.

Studies show that GLP-1 drugs can lead to a total weight loss of 10.5–15.8 pounds. However, not all doctors will write off-label prescriptions, and it can be difficult to get these medications if you do not have a type 2 diabetes diagnosis.

Obesity doesn’t necessarily cause type 2 diabetes, but it is a risk factor for developing this metabolic disease. This is because people with obesity or overweight often develop chronic low level inflammation, which can lead to insulin resistance.

Increasing your daily physical activity; maintaining a nutritious, balanced diet; and losing weight are the best ways to prevent obesity and type 2 diabetes. GLP-1 receptor agonist medications may also be an option to help manage your blood sugar levels and weight.