What type of diabetes do you get from being overweight

You can prevent or delay type 2 diabetes with proven, achievable lifestyle changes—such as losing a small amount of weight and being more physically active—even if you’re at high risk.

There’s more to why people get type 2 diabetes than you may know. Although lifestyle is a big part, so are family history, age, and race. Learn about what causes type 2 diabetes and how you can help lower your risk.

You’ve probably heard the expression, “you can’t judge a book by its cover.” In the same way we can’t tell what’s inside a book without reading it, we can’t look at a person and know if they’re at risk of type 2 diabetes.

It’s true that being overweight is a risk factor for developing type 2 diabetes, but your family history, age, and race are risk factors too.

Learn about what causes type 2 diabetes, and how you can help lower your risk.

Diabetes Factors

If you have type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. We don’t know exactly why this happens, but we do know factors that may increase a person’s risk of developing type 2 diabetes. You may be at risk if you:

• Have prediabetes.
• Are overweight.
• Are 45 years or older.
• Have a parent, brother, or sister with type 2 diabetes.
• Are physically active for less than 150 minutes a week.
• Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds.
• Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk).

The Fat You Can’t See

Although a person looks thin on the outside, they may have fat on the inside that nobody can see that puts them at risk of type 2 diabetes. How is this possible?

There are two kinds of fat:

• Fat that’s stored just under the skin. This is fat that we may be able to feel on the outside, like on our arms and legs.
• Fat that’s stored in our stomach and surrounds important internal organs. We can’t see this hidden, or “visceral” fat from the outside.

Research shows that visceral fat is an important factor in how our hormones work. It’s also linked to insulin resistance, when cells in your muscles, fat, and liver don’t respond well to insulin.

Having too much visceral fat may increase the risk of heart disease, diabetes, and stroke.

Your Body Mass Index Matters

Body mass index (BMI) is a number calculated from a person’s weight and height. Most health professionals rely on BMI to assess whether their patients are overweight (BMI of 25 or more) or have obesity (BMI of 30 or more). All adults who are overweight should talk to their doctor about getting tested for type 2 diabetes.

People of Asian heritage in the normal weight range may have too much visceral fat and be at risk of type 2 diabetes at a lower BMI. Researchers now suggest that people of Asian heritage get tested if their BMI is 23 or more.

You Can Prevent Type 2 Diabetes

Before developing type 2 diabetes, most people have prediabetes, where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. People who have prediabetes are at increased risk of developing type 2 diabetes.

If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A lifestyle change program offered through the CDC-led National Diabetes Prevention Program can help you make those changes—and make them stick. Through the program, you can lower your risk of developing type 2 diabetes by as much as 58% (71% if you’re aged 60 years or older).

Take the 1-minute test to see if you may be at risk of prediabetes.

Managing Diabetes

If you have diabetes, getting support and education is critical. Diabetes self-management education and support (DSMES) services can help you stay healthy and thrive with diabetes.

Through DSMES, you’ll get to work one-on-one with a diabetes care and education specialist, a certified professional who is specially trained in diabetes care and management. They can:

• Help you learn how to manage your blood sugar.
• Explain how diabetes medicines work.
• Help you figure out the best type of blood sugar monitoring device for you and your situation.
• Suggest tools to help you track your progress.
• Help you reduce your risks for complications.

Learn more about DSMES services.

People often assume that if you’re skinny, you’re healthy — people only get diabetes if they’re overweight. Right?

Not necessarily. 

“Diabetes isn’t related to how you look,” explains Misty Kosak, a dietitian and diabetes educator at Geisinger Community Medical Center. “Diabetes comes from insulin resistance, which raises blood sugar.”

One reason that thin people get diabetes? A condition known as “skinny fat.” 

What does skinny fat mean?

Skinny on the outside doesn’t always mean skinny on the inside. Commonly called “dad bod” or “mom bod,” “skinny fat” refers to someone with a normal BMI and weight but low muscle mass. Skinny fat people tend to have a type of fat called visceral fat. Visceral fat grows around your organs instead of under your skin, so it isn’t visible. 

If you have visceral fat, you may not look overweight, but you may have as much fat as someone who looks heavier. 

“The medical term for skinny fat is MONW, which stands for metabolically obese, normal weight,” says Kosak. “People who are MONW may look healthy but are at risk for conditions like diabetes.”

Understanding your risk factors

Besides visceral fat, some other causes of diabetes in thin people are:

Diet. “You are what you eat.” While it may sound silly, there’s truth to this adage. Your diet is an important factor in your risk for diabetes. “Diets high in sugar and unhealthy fats can increase your risk of developing diabetes,” says Kosak. 

Sedentary lifestyle. Sitting for long periods can change your metabolism. And it can lead to insulin resistance, a contributing factor to diabetes.

Prediabetes. Having higher than normal blood sugar levels causes this condition. Left untreated, it can develop into Type 2 diabetes.

Stress. When we feel stressed, our body releases a chemical called cortisol. Cortisol triggers our fight-or-flight response.

“As part of the fight-or-flight response, cortisol raises your blood sugar level,” explains Kosak. “That can lead to weight gain, insulin resistance and diabetes.” 

Fatty liver disease. Having a condition known as fatty liver disease puts you at risk of developing diabetes. There are two types of fatty liver disease. The primary type is caused by excessive alcohol consumption. The other type, non-alcoholic fatty liver disease (NAFLD), is caused by a buildup of fat in the liver.

If you have fatty liver disease, talk to your healthcare provider. They can work with you to develop a plan to lower your risk of developing diabetes. 

Healthy habits now benefit you later 

With a few minor changes, it’s easy to reduce your diabetes risk. Not sure where to start? Consider these:

• Eat a balanced diet. To feel your best, eat a diet rich in vegetables, fruit, low-fat dairy, whole grains and lean meats or plant-based protein.
• Get moving. There’s hope for couch potatoes everywhere. Being active helps reduce your risk of diabetes. Another bonus? You may even shed a few pounds. How much activity do you need? Aim for 150 minutes of physical activity per week. Think brisk walking, swimming or lifting weights.
• Reduce your stress levels. No one likes feeling stressed out. Besides feeling good, managing stress is good for you. For less stress, start small. Focus on getting more exercise, better rest, staying connected to the people you love and getting a few laughs.
• Get enough rest. It’s important to take time for yourself and make sure you’re getting enough quality sleep. A short afternoon nap or going to bed a few minutes earlier can give you the restful sleep your body needs.

Having trouble making changes? Enlist your healthcare provider’s help. They can recommend resources to help you live your healthiest life.

Next steps:

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