Does Prediabetes Cause Weight Gain?

Dr Jedha, Host

Hello wonderful people and welcome to episode 76.

If you have prediabetes and struggle with weight gain, you’re not alone. One of the most common frustrations people experience is feeling like their weight is creeping up, even when they’re not eating any differently than before. And maybe you’ve even tried to lose weight—cutting calories, following all the traditional advice—only to find that nothing seems to work.

So, does prediabetes actually cause weight gain? And if it does, can losing weight reverse prediabetes? More importantly, why do so many diet plans fail people with prediabetes, leaving them feeling stuck and frustrated?

In today’s episode, we’re diving deep into the connection between prediabetes and weight gain, breaking down what’s really going on in your body, and why some of the most popular weight loss strategies—like calorie counting and low-fat diets—often don’t work. We’ll also talk about what actually does work, so you can finally stop battling your metabolism and start working with your body instead.

Let’s get into it.

02:18

When it comes to prediabetes and weight gain, it’s not always clear which comes first. Does gaining weight lead to prediabetes, or does prediabetes cause weight gain? The truth is, both are closely linked, and it all comes down to how the body handles insulin.

Let me explain this. Whenever you eat, especially foods containing carbohydrates, your body breaks them down into glucose, or sugar, which enters the bloodstream. Now, your body doesn’t want too much sugar lingering in the blood for too long because it can be harmful. So, your pancreas steps in and releases insulin, a hormone that helps move glucose from your bloodstream into your cells, where it’s either used for energy or stored for later.

In prediabetes, something goes wrong with this system. Your cells become less responsive to insulin, which is what we call insulin resistance. Think of it like a door that normally opens smoothly when insulin knocks, but now that door is getting stuck. To compensate, your pancreas releases even more insulin, hoping that the extra push will get the job done. The problem is that insulin doesn’t just help with blood sugar—it’s also a fat storage hormone. So, when your insulin levels are high, your body is being signaled to store fat, especially around the abdomen.

This is why many people with prediabetes notice they’re gaining weight, particularly around the midsection, even when they don’t think they’re overeating. And it’s not just the insulin. High blood sugar levels can cause spikes and crashes, which leave you feeling tired and craving sugary, starchy foods. You’re not imagining it when you feel hungrier, even after a meal. Your body is constantly chasing that next hit of energy to stabilize blood sugar, and those extra calories often get stored as fat.

There’s also the role of inflammation, which many people don’t realize is tied to weight gain. In prediabetes, your body experiences a type of low-grade chronic inflammation. This can interfere with how your metabolism works and make it harder to lose weight. When you combine insulin resistance, increased hunger, and inflammation, it creates the perfect environment for weight gain to sneak up on you. Suddenly you’re looking at yourself, weighing yourself or trying on a pair of pants and thinking: geez, I’ve really gained a lot of weight. 

It’s not just about what you’re eating—it’s about how your body is processing that food. Prediabetes changes your metabolism in ways that often promote weight gain. So does prediabetes cause weight gain? Yes, in many cases it does. The underlying metabolic imbalance (the high blood sugar and high insulin) is the core issue. But the good news is that this cycle can be interrupted with the right approach, and we’ll certainly be getting to that later.

05:43

First, let’s talk about one of the biggest questions people have when they find out they have prediabetes, and that is whether losing weight can actually reverse prediabetes. The short answer is yes, weight loss can help to reverse prediabetes, but there’s a little more to the story. It’s not just about the number on the scale—it’s about what’s happening inside your body.  

With prediabetes, what we’re facing here is an altered metabolism, so in order to reverse these effects, reverse the weight-gaining state that your body is in, we need to think differently and focus on overall wellness, focus on overall health from the inside out, because we can certainly re-alter our metabolism. The body is very intelligent, so when we start nurturing it with the right foods and the right things, it brings itself naturally back into balance. 

The key reason weight loss helps reverse prediabetes is that weight loss helps reduce insulin resistance and inflammation. Remember, in prediabetes, your body is struggling to use insulin properly, and your pancreas is pumping out more and more of it to compensate. You’ve got lots of insulin circulating around your body. Since insulin is a fat storage hormone, high levels make it harder to lose weight. It’s a frustrating cycle—insulin resistance promotes weight gain, and weight gain makes insulin resistance worse.  

And then there’s the fat cells themselves. Fat cells produce inflammatory molecules so when there’s more fat cells, there’s more cellular inflammation in the body. That causes another frustrating cycle where insulin resistance becomes worse, then you have higher blood sugar and higher insulin adding to this perpetual cycle. 

08:18

When you start losing weight, even a little, insulin sensitivity improves and inflammation reduces, you start to break those frustrating metabolic cycles that your body’s cells become stuck in. With some weight loss, your cells start responding better, which means your body doesn’t have to produce as much insulin to do its job. With lower insulin levels, your body can start tapping into stored fat for energy instead of constantly storing it. That’s why you need to switch the focus. If you need to lose weight, focus on getting blood sugar under control, then weight loss actually becomes a whole lot easier.  

But here’s the important part—how you lose the weight matters. A lot of people go straight to calorie-cutting, thinking that simply eating less will fix the problem. And while reducing calories can lead to some weight loss, it doesn’t necessarily fix insulin resistance. If you’re just eating smaller portions of the same high-carb, blood sugar-spiking foods, your body is still dealing with the same metabolic dysfunction. That’s why some people try low-calorie diets and find they lose a little at first, but then hit a wall fairly fast, and then they start gaining it back.  

Think about it for a minute. A lot of people with prediabetes turn to programs like Weight Watchers, thinking it will help them lose weight and lower their blood sugar. After all, it’s one of the most well-known diet programs out there, and plenty of people have lost weight using it, haven’t they? Well perhaps…but… when it comes to prediabetes, the Weight Watchers approach—and other low-calorie, point-based systems—can actually work against you.

The reason goes back to what we’ve already talked about: prediabetes is driven by insulin resistance. And insulin resistance isn’t just about weight—it’s about how your body processes food, particularly carbohydrates. Weight Watchers, like most mainstream diet plans, is based on calories in, calories out. It operates on the idea that if you eat fewer calories than you burn, you’ll lose weight. One of the biggest problems with Weight Watchers and similar mainstream dieting programs is that they often encourage foods that are low in fat but high in carbohydrates. Many of the “zero-point” foods on the plan—things like whole grains, fruit, and starchy vegetables—can cause major blood sugar spikes. If you’re insulin resistant, those spikes mean your body is still producing too much insulin, which means your body is primed to store fat, even if you’re eating fewer calories overall.

Calorie-counting diets are the type of diets people usually fall to for weight loss, as we’ve all been led to believe we need to eat less and do more to lose weight. This is known as the the Energy Balance Model, but it’s flawed because you’re not working with your body. Instead, we need to focus on the Carbohydrate-Insulin Model, which shifts to reducing carbohydrates rather than just calories, then something magical happens — blood sugar naturally stabilizes, it reduces the insulin spikes that drive fat storage, which allows your body to start using fat for fuel instead of being locked in fat-storing mode. When insulin levels drop, the body isn’t holding on to excess water and fat the way it does when insulin is high. Along with that, inflammation reduces, which also improves insulin sensitivity and blood sugar control. Your altered metabolism starts rebalancing, bringing everything back into harmony. We talked about the Energy Balance Model versus the Carbohydrate-Insulin Model for smarter weight loss back in episode 12, so I’d encourage you to listen back to that. But just know that if you focus on the right nutrition plan you will be working with your body so that weight loss is easier, rather than working against your body where weight loss is a major struggle. 

You also don’t want to be hungry all the time, that’s counterproductive. You also need stable energy, that’s important. You also want to ensure you actually lose fat not muscle. So many people go on these weight loss diets and think it’s their willpower, they’ve failed once again. That’s not it. The problem isn’t your willpower or effort—the problem is the plan itself. A quality nutrition plan focuses on fixing what’s driving the issue in the first place. And that’s why certain diet programs, like Weight Watchers, often fail people with prediabetes. They’re designed around calorie restriction rather than metabolic health.

In fact, I just want to say that one of the most frustrating things I see people experience with prediabetes all the time, is eating what they believe is a healthy diet but still struggling to lose weight. People often say things like, “I’ve cut back on sweets, I’m eating more whole grains, I’m following all the guidelines, but the scale won’t budge!” And this often relates back to the same problem we just discussed with Weight Watchers—focusing on low-calorie or low-fat eating rather than blood sugar control and improving how your metabolism functions. 

Look, we get told a lot of things about what healthy eating is. And out there on the wild west web we frequently see conventional advice telling people with prediabetes to eat whole grains, fruits, low-fat dairy, and lean proteins while cutting back on calories and fat. That’s the common narrative. 

But here’s the thing and let’s use whole grain foods as an example here: Foods like whole grain bread, oatmeal, brown rice, these are some of the highest carbohydrate foods. And when you eat carbohydrate foods they all break down to sugar or glucose, meaning they cause your blood sugar to still rise. 

Even though these are considered “healthy” foods, they still require insulin to help process that sugar. And if you’re already insulin resistant, your body responds by pumping out even more insulin. High insulin levels mean your body is constantly in fat-storage mode, making it really difficult to lose weight, no matter how few calories you’re eating. So there we are back at that frustrating cycle once again, even though you thought you were eating healthy whole grains. What you didn’t know is that those healthy whole grains are keeping your blood sugar and insulin levels high. 

Another common issue is frequent eating. People eat way too often, many people eating from the time they wake up until the time they go to bed, grazing and picking all throughout the day. Many people are still following outdated advice that tells them to eat every few hours to “keep their metabolism going.” But every time you eat—especially if that meal or snack contains carbohydrates—your insulin levels rise. If insulin is high all day long, your body never gets the chance to burn stored fat for energy. This is why so many people feel like they’re eating small portions, choosing the right foods, and doing all the right things but still struggling to see results.

And then there’s the issue of low-fat eating. A lot of people still believe that fat is bad, so they avoid it as much as possible. They opt for fat-free yogurt, skim milk, or low-fat snacks and meals, thinking they’re making the healthier choice. But the problem is, fat is one of the most important macronutrients for blood sugar balance and satiety, your feeling of fullness and satisfaction. When you cut back on fat, you often end up eating more carbs to feel full. It’s no surprise that a breakfast of low-fat yogurt with granola, or whole wheat toast with jam, can leave you hungry just a couple of hours later. The blood sugar spike from those foods leads to a crash, making you feel tired, sluggish, and craving more food. You reach for a low fat snack and then, the cycle continues throughout the day. 

So, if you’ve ever found yourself eating what’s considered a “healthy” diet but still struggling with weight loss, it’s not that you’re doing something wrong—it’s that the standard definition of healthy doesn’t really apply to prediabetes. Focusing on the right foods—ones that keep blood sugar stable—is what makes the difference.

18:36

Once you shift the focus from calorie restriction to blood sugar control, weight loss becomes much easier—and more sustainable. For real. Many of our members can’t believe how easy weight loss becomes once they’re just eating the right foods that work with their bodies to rebalance metabolism and not against it. Of course that makes sense logically right? But it’s just that most advice doesn’t help you do that, but works against your body and your willpower. 

So, what actually works to stop gaining weight and to lose weight in prediabetes? The first and most important step is lowering carbohydrates, not just overall calories. Carbs break down into sugar in the bloodstream, and the more sugar in your blood, the more insulin your body releases. The goal is to keep insulin levels lower and stable, so the body can actually tap into stored fat for energy instead of constantly storing it. When insulin is high, the body holds onto fat, no matter how few calories you eat. But when insulin levels drop, the body naturally shifts into fat-burning mode.  

This doesn’t mean you have to cut carbs completely, but the focus should be on choosing lower-carb, nutrient-dense foods. Non-starchy vegetables are amazing sources of quality carbohydrates, nuts and seeds provide protein, fat and quality carbohydrates, small amounts of beans and legumes provide slow carbohydrates and huge amounts of beneficial fiber. Quality carbohydrates alongside quality proteins and healthy fats all help stabilize blood sugar and insulin while keeping you full. Compare that to a typical low-fat, high-carb diet, where you might feel hungry every few hours because your blood sugar is constantly crashing. Nope, you’ll be feeling full and satisfied until your next meal. That’s another thing members often tell us, is they no longer feel hungry all the time. That’s because you’re feeding your body the quality nutrients it needs. 

21:03

The key takeaway is that weight loss with prediabetes isn’t just about eating less—it’s about eating the right foods that support blood sugar balance and support your metabolism to rebalance itself. When you reduce carbs, include enough protein and healthy fats, and allow blood sugar and insulin levels to stabilize, your body starts working with you instead of against you. The result? Not just weight loss, but better energy, fewer cravings, and real improvements in blood sugar control. That’s how many people reverse their prediabetes. 

So, does prediabetes cause weight gain? Yes, for many people it does—because of insulin resistance, high blood sugar, and the way these metabolic changes affect fat storage. But the great news is, you don’t have to stay stuck in that cycle. By focusing on blood sugar balance instead of just calorie restriction, you can start to lose weight more easily, reduce insulin resistance, and even reverse prediabetes altogether.

That means shifting away from the outdated advice that tells you to eat low-fat, count calories, or graze throughout the day. Instead, it’s about focusing on lowering carbohydrates, eating enough protein and healthy fats, and making sure your body has the right conditions to burn fat, not store it.

If you’ve been seeing the weight pack on with prediabetes but also struggled to lose weight, the key isn’t just to eat less—it’s to eat smarter. Work with your body, not against it.

If you don’t know how to do that, head over to our website to check out our great programs at Type2DiabetesTalk.com/programs. For our members, head to the members site to access all the great resources we have and we’ll leave some extra tips for you if you’re stuck on a weight loss plateau and need to kickstart your metabolism to optimize weight loss. 

That’s all for today. 

Dr Jedha over and out.