People who are overweight or obese are perceivably at a higher risk of developing type 2 diabetes; however, not everyone who gains weight is also diagnosed with the condition. So what is the real relationship between weight and diabetes? A study out of the Steno Diabetes Center in Gentofte, Denmark, has revealed that weight gain and diabetes development have less to do with each other than once thought.

According to the American Diabetes Association, approximately 26 million children and adults in the United States have been diagnosed with diabetes. People who lose seven percent of their body weight and add 30 minutes of moderate exercise to each day of their week can lower their risk of developing type 2 diabetes by 58 percent. Following a dramatic increase in overweight Americans between 1990 and 2010, over one-third of adults in the U.S. are considered obese.

"Type 2 diabetes is a not a single disease entity, but rather a heterogeneous disease with different pathophysiological pathways depending on the level and development of obesity," lead researchers Dorte Vistisen and Kristine Faerch said in a statement. "Strategies focusing on small weight reductions for the entire population may be more beneficial than predominantly focusing on weight loss for high-risk individuals."

Researchers involved in the Whitehall II study recruited 6,705 civil servants from London who had not been diagnosed with diabetes at the start of the study. Participants were followed over the span of 10 years and were tested for diabetes every five years. After calculating each participant’s body mass index (BMI) by way of their height and weight, the research team was able to identify patterns of change in BMI among people who ended up developing diabetes. Out of 6,705 civil servants participating in this study, 645 were eventually diagnosed with diabetes at least five years after its start.

Diabetes patients were grouped into three distinct patterns of obesity development marked by different changes in insulin resistance and other risk factors for heart disease and diabetes. The “stably overweight” group of individuals, who experienced little to no change in their BMI before they were diagnosed with diabetes, included 606 participants. Twenty-six participants were persistently obese over the course of the study, including some who were obese for 18 years before developing diabetes. The third and final group included 15 participants who had gained weight continuously leading up to their diagnosis.

“Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role,” states the American Diabetes Association’s website. “Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.”

Source: Vistisen D, Witte D, Taba’k A, Herder C, Brunner E. Patterns of Obesity Development before the Diagnosis of Type 2 Diabetes: The Whitehall II Cohort Study. PLoS Med. 2014.