Weight Loss Plateaus and Diabetes: Why They Happen and What You Can Do

Not everyone needs to lose weight with type 2 diabetes. But if your doctor recommends it, here are tips to consider when your routine isn’t getting you where you want to be.

For some (though not all) people with type 2 diabetes, weight loss is an important part of their diabetes care strategy. When you lose weight, your pancreas is better able to keep up with your body’s insulin needs, ultimately improving your insulin resistance.

A 2017 study found that participants who maintained successful weight loss had improved insulin sensitivity. Other research has shown that some people are even able to achieve type 2 diabetes remission through weight loss alone.

Of course, that doesn’t mean losing weight is easy — especially in the long term. In fact, sometimes, you may be chugging along, consistently dropping pounds, when suddenly, for no apparent reason, the number on the scale stops budging.

This is known as a weight loss plateau. Experts say it’s pretty common in people with type 2 diabetes.

Here’s a look at why weight loss plateaus happen in diabetes and how to break through them.

Join the free T2D community!

Connect with thousands of members and find support through daily live chats, curated resources, and one-to-one messaging.

Sign up

Why you might experience a weight loss plateau

Though this can happen to anyone, it may be especially likely in people with type 2 diabetes, said Erin Palinski-Wade, RD, CDCES, LDN, CPT, author of “2-Day Diabetes Diet.”

“Insulin resistance can make it harder for the body to lose weight,” Palinski-Wade said. “The more insulin resistant you are, the more you may struggle with an increase in hunger hormones and a decrease in satiety hormones, which can make it hard to create a calorie deficit for weight loss.”

She adds that as cells respond less to insulin, the body makes more of this hormone to compensate. But this works against weight loss by promoting fat storage.

Vandana Sheth, RDN, CDCES, FAND, a plant-based dietitian, says certain type 2 diabetes medications don’t make the situation any easier.

“Some of the medications that you may be taking for your blood sugar management may lead to weight gain or affect your weight loss efforts,” said Sheth.

Medications like insulin, thiazolidinediones, and sulfonylureas are known for weight gain.

Meanwhile, the state of your blood sugar could affect your ability to exercise, Palinski-Wade said.

“Uncontrolled blood sugar levels can directly impact energy levels, mood, and focus,” she said. “If energy levels are low, it can be hard to fit in more daily physical activity.”

Tips to overcome a weight loss plateau

So, what are you to do if you seem to have stalled out on weight loss?

Take heart — a plateau doesn’t have to be permanent. Consider these tactics to break through this stage.

Increase your protein

These days, protein seems to be touted as the go-to macronutrient for all things health-related. Though its reputation may be a bit overblown, protein really can be a tool for busting through a weight loss plateau, Palinski-Wade said.

“Consuming more protein can help preserve lean muscle mass during weight loss, which is crucial for maintaining a healthy metabolism,” she said.

Palinski-Wade adds that protein is the most satiating macronutrient, so getting more of it could keep you fuller between meals. She suggests increasing protein to 20% to 25% of your total daily calories.

Focus on sleep

Could you snooze your way through a lull in weight loss? A 2024 study suggests so.

Researchers found a link between a chronic lack of sleep and increased insulin resistance, especially in postmenopausal participants. When they went from getting under 7 hours of sleep to getting 7 to 9 hours, study participants’ insulin and glucose levels returned to normal.

Though the study didn’t focus on weight loss, researchers suggest its results could affect weight. If you’re stuck in a plateau, try tweaking your sleep habits to get at least 7 hours each night.

Add resistance training

One unsurprising place where weight loss breakthroughs are likely to happen is the gym. Sheth said strength training is a great practice to add.

“Start focusing on strength training to build muscle. This can boost your metabolism and promote weight loss,” she said.

Sheth also suggests mixing up your cardio by varying the intensity to challenge your body.

Consider asking your care team how often you can add strength training to your weekly routine. Your recommendations might look different than the standard or for other people who don’t live with a chronic condition like diabetes.

Track your intake

Sometimes, getting through a weight loss plateau means getting back to basics by tracking your food intake.

Palinski-Wade suggests keeping a food journal of everything (literally everything!) you eat each day.

“Many times, weight loss plateaus occur due to small changes in diet, including growing portion sizes,” she said. “For one week, write down your food, measure your portions, and see if there may be small changes that have been slowing down your progress and need adjustment.”

Manage your stress

It’s well known that there’s a relationship between the stress hormone cortisol and conditions like obesity and type 2 diabetes. It’s possible that dialing down your stress levels could also lower the number on the scale.

“Practice stress management through activities such as yoga, meditation, and visualization to help you control your cortisol levels,” said Sheth.

Plus, reducing your stress can improve your overall mood, which will help you stay active and do the things you love.

Talk with your doctor

If you suspect your prescription medications are contributing to your weight loss plateau, it’s worth talking with your doctor. Other medications might be an option.

Sheth suggests talking with your healthcare team about your weight loss progress. They’re likely to have information or strategies you haven’t considered.

“Build your support team to include a dietitian and diabetes care specialist to get personalized guidance and support,” she said.

Takeaway

Not everyone with type 2 diabetes needs to follow weight management advice. Everybody is different. It can be frustrating for those who feel stuck in a weight loss rut or plateau, but it’s not necessarily the end of your journey.

Stick with healthy habits like tracking your food intake, mixing things up in your workout routine, and getting to bed on time. Any or all of these might provide the breakthrough you need.