Energy balance
A caloric deficit of 500–750 kcal/day is the primary driver of weight loss in patients with diabetes, whereas exercise alone is insufficient for initial loss but critical for maintenance.
To lose weight, you must eat less. Focus on creating a daily calorie deficit of 500-750 calories. Do not rely on exercise alone to drop the weight initially, as diet is far more effective for that. Once you have lost the weight, use exercise (150 minutes of moderate activity and resistance training twice a week) to keep it off. If you take insulin, check your blood sugar often when you start eating less to avoid dangerous lows.
It is important to understand that reducing caloric intake is more effective at achieving initial weight loss than only increasing exercise (48,49). Patients who made dietary changes alone lost 7 kg more at the 6-month follow-up than patients who added physical activity alone (49). Physical activity remains important for maintaining weight loss but should not be the primary focus of behavioral change for weight loss.
Why this rating
Supported by RCTs (Dansinger, Wing) and large cohort studies (Look AHEAD), though the paper is a review of guidelines.
Source
Treatment of Obesity in Patients With Diabetes
Carolyn T. Bramante et al. · Diabetes Spectrum · 2017
DOI 10.2337/ds17-0030
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Related findings · Energy balance
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