# Type 2 diabetes: Does weight loss really send it into remission?
Type 2 diabetes is linked to obesity, and it can go into remission in people who lose weight. However, a recent study suggests that achieving and maintaining this remission in real-world settings may be challenging. According to the World Health Organization, the number of people with type 2 diabetes has nearly quadrupled between 1980 and 2014.
Obesity and lack of exercise are known risk factors for type 2 diabetes, as they can lead to insulin resistance in cells. Insulin is a hormone that facilitates the uptake of glucose by cells for energy, but some individuals’ cells become less responsive to insulin, causing their glucose levels to rise. Obesity can further increase the risk of insulin resistance and may make it difficult to treat diabetes, as some treatments for type 2 diabetes symptoms can cause weight gain, worsening glucose control.
Various studies have shown that weight loss, whether through lifestyle changes or weight loss surgery, can lead to the remission of type 2 diabetes. For instance, a trial in the United Kingdom revealed that 50% of people with type 2 diabetes achieved remission a year after receiving support for weight loss through dietary changes. However, while clinical trials have demonstrated the efficacy of weight loss for achieving remission, there is limited real-world data available about the likelihood and sustainability of this remission.
To address this gap, a research team from the Chinese University of Hong Kong conducted an analysis of data for over 35,000 people with type 2 diabetes enrolled in the Risk Assessment and Management Programme for Diabetes Mellitus (RAMP-DM) in Hong Kong. The findings revealed that only 6.1% of individuals remained in remission from type 2 diabetes at the 8-year mark.
The study showed that individuals who had lost 10% or more of their total body weight in the year following diagnosis were over three times as likely to be in remission at the end of their follow-up compared to those who had gained weight. Those who had lost between 5–9.9% of their body weight were over twice as likely to achieve remission, while individuals who had lost up to 4.9% of their body weight had a slightly better chance of being in remission compared to those who gained weight.
Although early weight loss was found to increase the likelihood of remission, achieving and maintaining remission in a real-world setting presented challenges. Dan Gallagher, a registered dietitian at Aegle Nutrition, noted that many studies provide a dietary intervention specifically for the study without considering the sustainability of the diet. He emphasized the importance of continual lifestyle changes in managing type 2 diabetes. Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center, highlighted the success rate of bariatric surgery for weight loss and long-term remission of various medical conditions.
