Losing Weight With Insulin Resistance, Prediabetes or Type 2 Diabetes

Last updated October 27, 2026

Short answer: If you have insulin resistance or prediabetes, even modest weight loss counts. In the Diabetes Prevention Program, a lifestyle program that aimed for 7% weight loss cut the risk of developing type 2 diabetes by 58%, and the NIDDK says losing 5% to 7% of starting weight helped. People who already have type 2 diabetes tend to lose less on weight loss medicines than people without it, so expectations should be adjusted.

Insulin resistance and prediabetes in one paragraph

The NIDDK defines insulin resistance as a condition in which your body does not respond to insulin the way it should, and says people have prediabetes if their blood glucose levels are higher than normal. This page covers what the evidence says about weight loss for both, and for type 2 diabetes. It is general information, not a diagnosis.

What modest weight loss achieved

In the Diabetes Prevention Program, 3,234 adults without diabetes but at high risk were randomly assigned. The lifestyle group aimed for at least 7% weight loss and 150 minutes of activity a week, and its risk of developing type 2 diabetes was 58% lower than with placebo. The NIDDK summarizes this as losing 5% to 7% of starting weight helping to reduce the chance of developing the disease. Metformin lowered the risk by 31%.

With type 2 diabetes, expect less on the scale

In the same weight management programs, people with type 2 diabetes lost less on average than people without it:

For comparison, the same Wegovy and Zepbound programs in people without diabetes averaged 14.9% and up to 20.9%. Ozempic and Mounjaro are approved for type 2 diabetes and contain the same active drugs. See Ozempic for weight loss.

What to do with this

• Aim for a realistic first target, such as 5% to 7% of starting weight, which is the range tied to better outcomes in the Diabetes Prevention Program.
• Do not stop or change diabetes medicines without talking to your prescriber.
• Ask your prescriber whether your weight and blood sugar plan should include a weight management medicine.
• Use the percentage calculator to turn 5% or 7% into pounds for your weight.

Related: weight loss percentage calculator, metformin and weight loss and lifestyle vs. GLP-1 weight loss.