Doctors have been saying “you need to lose weight” for a very long time, decades at least. Aside from a small sliver of patients this advice is typically ignored. People want a pill for this, not to have to give up that bucket of KFC or the supersized McDonald’s French fries.

Recently, patients raise hell with healthcare workers’ bosses if weight loss is advised because it’s “mean” or is “impacting my mental health” regarding body image. So the suggestion is not made as much in general in the last 5 years.

The problem on this one isn’t often the doctors.

Now, if a patient needs surgery and is too obese for it to happen then there’s a path forward to advise weight loss without repercussions. If cholesterol is high there’s also a path forward for advising diet change, again, without repercussions. Diabetes, again, diet recommendations so you don’t fall into a coma and die, and so you can potentially keep both your feet.

All of that said, you hit diabetes phase you do have it forever, but with type 2 you can manage it by diet if you behave well, reduce weight, and maintain healthy eating. This is great, but it doesn’t mean the type 2 diabetes is gone just that it’s well managed, or “diet managed”. Another way to think of it is that it’s in remission by virtue of your good behavior but not cured. Go on a month long food bender and things can change back again.

To reverse, you need to lose weight and adjust your diet, per your doctors instructions, as soon as your doctor tells you you are pre-diabetic.

Nutrition consults typically come with the diagnosis, but people are notorious for not following up with the next specialist. Diabetic educator is a position as well. Your doctor is booked like an airport by his/her bosses and probably can’t cram that into the 15-20min time slot allowed. Referrals are made for a reason.

Two things that commonly happen to thinking on this topic. Oh, I’m prediabetic, whatever, it’s something we watch, nothing to do here, I’m safe because no insulin required. Or, I no longer need Metformin or insulin or whatever, so I must no longer be diabetic. Both are typically wrong.

Another thing that happens is hardcore denial of even having type 2 diabetes because “I don’t take insulin.”

This isn’t all people, this is simply a piece of the mess involved with diet and exercise advice in health care alongside type 2.

In keeping with the probabilities game that is the human body, here’s a fun fact. There are morbidly obese people in the 500-700lb zone who are not diabetic and still guzzling sugar like none other. Someone has to exist on the tails of the bell curve.

As always, bring your health questions to your doctors, don’t take some random dipshit on the internet seriously.