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Clinical Diabetes 23:130-136, 2005
© American Diabetes Association ®, Inc., 2005

Position Statement

Weight Management Using Lifestyle Modification in the Prevention and Management of Type 2 Diabetes: Rationale and Strategies

The American Diabetes Association, the North American Association for the Study of Obesity and and the American Society for Clinical Nutrition

Reprinted with permission from Diabetes Care 27:2067 -2073, 2004[Free Full Text]

The first 300 words of the full text of this article appear below.


   Introduction
 
The prevalence of diabetes in the U.S. continues to rise by epidemic proportions. This increase parallels the rising rates of obesity and overweight observed over the past decade.1,2 Indeed, as BMI increases, the risk of developing type 2 diabetes increases in a "dose-dependent" manner.3,4 The prevalence of type 2 diabetes is 3-7 times higher in obese than in normal-weight adults, and those with a BMI > 35 kg/m2 are 20 times more likely to develop diabetes than those with a BMI between 18.5 and 24.9 kg/m2.5,6 In addition, weight gain during adulthood is also directly correlated with an increased risk of type 2 diabetes.3,7-9

Obesity also complicates the management of type 2 diabetes by increasing insulin resistance and blood glucose concentrations.10 It is an independent risk factor for dyslipidemia, hypertension, and cardiovascular disease6,11-14 and, thus, increases the risk of cardiovascular complications and cardiovascular mortality in patients with type 2 diabetes.15

The purpose of this statement is to review the important role of weight management in the prevention and management of type 2 diabetes and to describe strategies for achieving and maintaining a healthy body weight through lifestyle modification. The use of weight loss medications and bariatric surgery in the management of obesity will not be discussed in this document. Pharmacotherapy can be a useful adjunct to lifestyle modification in the long-term management of obesity in selected patients.16 Weight loss medications may be considered for those with a BMI ≥ 30 or those with a BMI ≥ 27 plus obesity-related comorbid conditions. Weight loss surgery may be a therapeutic alternative for patients with a BMI ≥ 40 or a BMI ≥ 35 plus comorbid conditions.16 Comprehensive review articles that discuss the use of weight loss medications and surgery in the management of obesity have recently been published.17-20


   Benefits of weight loss
 
Weight loss is an important goal . . . [Full Text of this Article]


   Indications and goals for weight loss therapy
 

   Diet
 

   Physical activity
 

   Facilitating lifestyle change in an office practice
 

   Maintaining weight loss
 

   Summary
 

   Specific recommendations
 

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Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2005 by the American Diabetes Association.