Continuing the late Dr Mosley's legacy, we look at how type 2 diabetes can be avoided or put into remission.
Diabetes affects nearly 4.4 million people in the UK alone, and that number is increasing. According to Diabetes UK, it is estimated that 8% of cases are type 1 diabetes – when your body can’t make insulin. Type 1 diabetes cannot be prevented, and its exact cause is unknown.
90% of cases are type 2 diabetes and it's also thought that there are another 1.2 million people living with undiagnosed type 2 diabetes.
A lot of type 2 diabetes cases could be prevented through diet and lifestyle changes, and a recent study of an NHS scheme has proven you can reverse type 2 diabetes through weight loss.
The late Dr Michael Mosley was a pioneer in this area, having successfully reversed his own type 2 diabetes diagnosis. He then went on to create The Fast 800 diet, which has helped so many people with their own lifestyle changes.
Although he is sadly no longer with us, Dr Mosley’s legacy lives on. Below, we delve into the findings of the study as well as looking back at Michael Mosley’s thoughts on type 2 diabetes and how to control it.
What is type 2 diabetes?
According to the NHS, type 2 diabetes is a condition that causes blood sugar to become too high. It causes symptoms like excessive thirst, tiredness and needing the toilet a lot. Many people have no symptoms.
You are more at risk of developing type 2 diabetes if you’re over 40, or over 25 and of a Black African, Black Caribbean or Asian ethnic background.
You are also more at risk if you are overweight, obese, or not very physically active.
The NHS rapid weight loss programme and its results
The NHS offers a lot of support for those who have type 2 diabetes. Medication to control the disease is an option, however, it’s far better to adopt lifestyle changes such as eating a healthier diet and adopting a fitness regime.
A rapid weight loss diet scheme trialled by the NHS now looks set to be rolled out more widely after it found that one in three participants permanently reversed their diabetes.00194-3/fulltext){href='https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00194-3/fulltext' target='_blank' rel='noreferrer noopener nofollow'} The programme uses meal replacement shakes, diet bars and soups, for three months to induce rapid weight loss. Participants then have continued support to gradually reintroduce regular food into their diet, focusing on healthy choices such as lean meat, fish, vegetables and fruit.
The study monitored 1740 participants for a year – the length of the programme- and found that 32% put their type 2 diabetes into remission, with an average weight loss across the group of 15.9kg, or 35lbs.
It’s very important to note that this is an extremely restrictive diet, and it’s aimed at very overweight or obese individuals. It is not suitable for everyone, but the findings are encouraging. At the moment, the scheme is available to around 10,000 people, but given these results, the NHS is thinking of making it an option for more people.
Can you reverse type 2 diabetes permanently?
In short, yes, but while the study results are very encouraging, it is far better to adopt a more preventative approach and change habits before such a strict weight loss regime becomes necessary. If you’ve been told you’re pre-diabetic, or you’re worried about weight gain or inactivity, now is the time to do something your future self will thank you for. Not only will you halt diabetes in its tracks, you’ll also reduce blood pressure, cholesterol and fat around your vital organs (visceral fat) that can lead to many health complications.
However, if you already have a type 2 diabetes diagnosis, you can successfully reverse it and keep it that way by making the changes listed below. It won’t always be easy, but it will always be worth it.
Dr Michael Mosley and The Fast 800
Dr Mosley was always very open about his own type 2 diabetes diagnosis. The revelation caught him off guard and prompted him to make many lifestyle changes including exercising more effectively, adopting intermittent fasting, and eating a Mediterranean style diet, as he explained:
“In 2012, I was diagnosed with type 2 diabetes which came as a major shock. My dad had died at the age of 74 from complications of diabetes, so I went on a mission to see if my type 2 diabetes could be put into remission. Turns out, it can be.
"I studied at Oxford University and trained to be a doctor at the Royal Free Hospital in London (which is where I met my wife, Clare). But it wasn’t until I had a blood test, in 2012, that I got really interested in nutrition. The test revealed that I had type 2 diabetes, and my GP recommended I start on metformin, which was standard protocol. I wasn’t keen because my father had been prescribed the same medication when he was diagnosed with type 2 diabetes but died at the age of 74 from complications of the disease. So, I was keen to try to put my diabetes into remission through diet and lifestyle changes alone, despite doctors telling me it was impossible.
"I came across some novel research into intermittent fasting and based on that, I invented something I called the 5:2™ diet, where I cut my calories for two days a week and ate normally on the other days. Within a couple of months, I shed nearly 20lb and reversed both my fatty liver disease and type 2 diabetes.”
What is intermittent fasting?
There are many different type of intermittent fasting, but all work on the idea that by restricting your eating window, you consume fewer calories. Some people adopt time restricted eating (TRE) where they might eat for ten hours and fast for 14, or other equations. Other people, like Michael Mosley, prefer restricting calories for 2 days a week and eating a healthy diet for 5. You might even like to alternate days.
What is the secret to reverse type 2 diabetes?
Michael Mosley offered the following advice, which has helped many people change their habits: “Intermittent fasting has the potential to improve brain function, prevent or reverse prediabetes and put type 2 diabetes into remission, as well as improve stress resilience and reduce inflammation.
“There is also a big body of scientific evidence to support the belief that a Mediterranean-style diet is great for your physical health and your waistline. It will cut your risk of heart attack or stroke by around 30%, reduce your risk of developing type 2 diabetes by 50%, and slash your risk of breast cancer by 70%. It is also a great way to lose weight."
“Recent research shows it is great for your mental health and well-being too, having a positive effect on mood and helping to ease depression. That’s because the foods that make up the traditional Mediterranean diet (plenty of olive oil, nuts, oily fish, fruit, veg and whole grains, a reasonable amounts of full-fat yogurt and cheese, and perhaps even a glass of red wine with the evening meal) are packed with the nutrients your body needs.
“Incorporating exercise into your daily routine is another crucial component of weight loss and better health. Not only does it help you to manage weight and build muscle, it also improves mood, reduces anxiety and enhances cognitive function. That said, don’t expect to massively increase the amount of exercise you do at the start of the programme, because lots of exercise can make you hungry. Which is why exercise alone rarely leads to weight loss.”
What foods should type 2 diabetics avoid?
“Diets rich in sugar and refined carbs have been linked to a host of health problems, from high blood pressure, to type 2 diabetes, obesity, heart disease and tooth decay,” Dr Mosley pointed out. “One of the problems with eating lots of sugary food is it leads to constant blood sugar spikes, forcing your body to respond by pumping out the hormone insulin. This in turn can cause blood sugar crashes, which leaves you feeling starving. Over time your body becomes resistant to the impact of insulin, which can then tip you into prediabetes and then diabetes.”
For recommended foods to include in a healthy diet, we'd recommend looking at a type 2 diabetes food list.
Should I take diabetes medication for weight loss?
While medication may have its place, Dr Mosley was a big advocate for lifestyle changes rather than reliance on pills, as he explained:
“There’s been a lot in the press about diabetes medication, and I think people appreciate that alone, they’re not always the answer. Once people finish the medication, the weight tends to come back on, so that’s why they need to make positive changes to their lifestyle whilst using the medication.”
How much weight do you need to lose to reverse type 2 diabetes?
Diabetes UK offers the following advice: “If you have type 2 diabetes, losing around 5% of your body weight can have real benefits for your health. If you have obesity, you are more likely to put your diabetes into remission if you lose a larger amount of weight,15kg (or 2 stone 5lbs), as quickly and safely as possible following your diagnosis."
Meet the expert
Dr Michael Mosley was the co-founder of The Fast 800. He was also a distinguished journalist, presenter and writer who worked for the BBC. He sadly died in 2024 while on holiday with his family in Greece. We are grateful to be able to share his legacy quotes around diabetes, intermittent fasting, healthy eating and exercise, and hope that his words continue to inspire and help many of you.
Becky Fuller is a senior digital writer for Yours.co.uk. She is also a fully qualified personal trainer and strength coach, specialising in fitness and wellbeing for over 50s. Prior to joining Yours, Becky was a fitness writer for Saga, and a freelance entertainment and theatre journalist. Becky is passionate about helping people to move well and discover the many benefits of strength training.