The Obesity Paradox and Diabetes

In Brief The obesity paradox (survival advantage in overweight/obese patients with type 2 diabetes) has called into question the importance of weight loss in overweight people with diabetes. A systematic review of weight loss studies with a minimum of 1-year outcomes in people with diabetes reported inconsistent beneficial effects of weight loss on A1C, lipids, and blood pressure. To lower the risk of cardiovascular disease, a better nutrition therapy intervention may be reducing energy intake, which may or may not lead to weight loss, and selecting cardioprotective foods in appropriate portion sizes. However, any nutrition therapy intervention must be based on lifestyle changes the person with diabetes is willing and able to make.