Obesity, particularly central or abdominal obesity, significantly contributes to the onset of type 2 diabetes mellitus (T2DM). Excess adipose tissue, particularly visceral fat, plays a pivotal role in the development of T2DM.

Genetic predispositions, including variations in the FTO gene, heighten the risk for obesity and T2DM. Epigenetic modifications, shaped by environmental factors like diet and physical activity, can be passed to subsequent generations.

Preventive Strategies & Lifestyle Modifications

Preventing T2DM in people with obesity involves a multi-faceted approach:

› Weight Management: Even modest weight loss significantly lowers T2DM risk.

› Physical Activity: Regular exercise, including 150 minutes of moderate-intensity aerobic activity and two to three resistance training sessions weekly.

› Dietary Interventions: A balanced diet with whole grains, fruits, vegetables, lean proteins, and healthy fats is key.

› Behavioral Support: Structured programs focusing on behavior modification, self-monitoring, and goal setting improve adherence to lifestyle changes.

The Role of Early Screening & Intervention

Screening high-risk patients for T2DM in highrisk patients, particularly those aged 35 to 70 with obesity, is crucial. Clinicians should adopt a holistic and individualized strategy in managing patients with obesity and T2DM:

1. Comprehensive Assessment: Evaluate risk factors beyond BMI, including waist circumference and body composition.

2. Tailored Interventions: Address genetic, epigenetic, and lifestyle contributors through individualized care plans.

3. Patient Education: Highlight the connection between obesity and T2DM, emphasizing the benefits of adherence to interventions.

4. Pharmacological Considerations: Choose medications with minimal weight gain potential.

5. Ongoing Support: Patients need regular follow-ups, counseling, and specialist referrals. The Obesity Medicine Association (OMA) offers resources to deepen clinicians’ understanding of the obesity-diabetes connection:

› Clinical Practice Guidelines: The 2024 Obesity Algorithm® provides evidence-based strategies for managing obesity and related comorbidities, including T2DM.

› Obesity Pillars® Journal: Access peer-reviewed research and reviews, such as the 2023 Clinical Practice Statement on obesity, diabetes, and cardiometabolic risk.