10.1016/b978-0-7295-3951-7.50048-3

Prevention of obesity is the first step in management of diabetes mellitus type 2, but prevention programmes have had poor long-term efficacy. The cornerstones of treatment in obese type 2 diabetic patients are diet, physical activity and behavioural modifications. A small weight loss results in improvement of type 2 diabetic patients. The obese type 2 diabetic patient shows extra impediments to weight loss, such as the adverse effects of diabetic medications. New drugs, as orlistat and sibutramine, can offer some additional help, by providing the benefit associated with weight loss. Bariatric surgery can produce major long-term weight loss in severely obese patients.