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Jan. 26, 2026

Can prediabetes cause weight gain?

Kristel Fernandez-Lopez, MD

Medically reviewed by:
Kristel Fernandez-Lopez, MD

Prediabetes is silent, but its effects are not. You may feel fine at first, then notice your weight creeping up. The gain may be slow, or it may come on faster than you expect. It can catch you off guard, especially when your habits have not changed. This shift in your weight can be one of the first signs that your blood sugar is no longer in balance.

What is prediabetes?

Prediabetes occurs when your blood sugar is higher than usual but not high enough for a diagnosis of type 2 diabetes.1 It means your body is struggling to use insulin effectively.

Insulin is a hormone that helps your cells use glucose for fuel.2 When your cells resist insulin, your pancreas produces more to overcome that resistance. This extra insulin keeps blood sugar down for a while, but it slowly changes how your body stores and uses energy.

Prediabetes often develops years before symptoms appear. Many adults discover it through routine blood work. The most common risk factors include:

  • Age 45 or older
  • Extra weight, especially around the waist
  • Low physical activity
  • A family history of diabetes
  • Past gestational diabetes
  • Non-alcoholic fatty liver disease
  • Alcohol use of more than 2 drinks per day for males and 3 drinks per day for females

As you get older, your metabolism shifts. This makes it easier for blood sugar to rise and for insulin resistance to develop.3

How prediabetes leads to weight gain

Prediabetes can lead to weight gain because insulin resistance changes how your body handles energy. When your cells stop responding to insulin, your pancreas releases more insulin to try to keep your blood sugar within a normal range. This higher insulin level shifts your body toward storing energy instead of using it.

Much of this stored energy becomes fat, especially around your midsection. Belly fat increases easily when insulin stays high, and it often becomes harder to lose. This can happen even when your overall weight has not changed much over time.

You may also notice your weight increasing even though your habits have stayed the same. Many adults experience this pattern long before they learn their blood sugar is rising.

Why insulin resistance causes weight gain

Insulin resistance affects several systems in your body. These changes work together and make weight gain more likely.

Higher insulin levels

When your body resists insulin, your pancreas releases more of it. A high insulin level promotes fat storage and slows the release of stored fat. This makes it harder to lose weight.4

Changes in hunger

Insulin controls how your blood sugar rises and falls. When the level drops too quickly, you may feel hungry again soon after eating. Many people with prediabetes notice more frequent hunger, cravings for sweets or a stronger desire for starchy foods.

Shifts in energy use

If your cells cannot get enough glucose, your energy may drop. You may move less without meaning to. Lower activity means fewer calories burned, which contributes to weight gain.

Belly fat development

Fat stored around your waist increases when insulin levels stay high. This type of fat is harder to lose and is one of the earliest signs of insulin resistance.

Slow metabolic changes

Prediabetes develops over time. As insulin resistance grows, your metabolism becomes less efficient. As your metabolism changes, your usual eating and activity patterns may start to cause weight gain.

These changes explain why prediabetes and weight gain often appear together.

Does prediabetes weight gain happen slowly or quickly?

Weight changes around prediabetes usually develop slowly. Many adults notice a gradual rise in weight over several years, often before prediabetes is diagnosed. The earliest shift is frequently in the waist. Clothes may feel tighter even when the scale does not move much.

This gradual increase occurs because insulin levels rise well before blood sugar rises. Higher insulin encourages fat storage, and people with elevated insulin tend to gain more weight over time than those with normal insulin levels.5 After prediabetes develops, weight patterns can vary. Some adults continue to gain weight, especially if insulin resistance worsens. Increased hunger, stronger cravings and lower energy can all make weight gain more likely. People who later progress to type 2 diabetes usually gain weight at a faster rate than those who remain prediabetic. Either slow or faster weight changes can be a sign that your body is having trouble using insulin effectively.

Other signs of prediabetes you may notice

Prediabetes often has no apparent symptoms. Still, some changes are common:

  • Increased hunger
  • Fatigue
  • A rise in belly fat
  • Blurred vision
  • More frequent urination
  • Increased thirst
  • Slowly healing cuts
  • Hyperpigmented (darker color) skin on back of neck

Many adults assume these changes are part of aging. That is why regular checkups matter. Your doctor can check your blood sugar through tests such as A1C, fasting glucose or glucose tolerance tests.

With prediabetes, your doctor may schedule labs every six months to watch for progression to diabetes. Medicare Part B covers two diabetes screenings per year for eligible adults when medically necessary.6

What to do if you think prediabetes is causing weight gain

If you suspect your weight changes are linked to prediabetes, talk with your doctor. Early care can prevent type 2 diabetes.

Ask your doctor:

  • Should you be tested for prediabetes?
  • What changes can help right now?
  • Should you meet with a dietitian?
  • How often should your blood sugar be checked?

If you do not have a provider, you can find one at WellMed Healthcare. Getting answers early helps you take control of your health.

How to lose weight with prediabetes

You can lose weight with prediabetes. Your plan should focus on improving insulin sensitivity. Small, steady changes work best.

Change your plate

Choose foods that support steady blood sugar. Try to build meals with:

  • Lean protein
  • Vegetables
  • Whole grains
  • High-fiber foods
  • Healthy fats

Fiber slows digestion and helps prevent sharp swings in blood sugar. It keeps you full longer and reduces cravings.

Limit sugary snacks and refined carbs. Drink water instead of sweetened drinks.

If you need help with meal planning, ask your doctor about nutrition counseling.

Move more

Physical activity helps your body use glucose better. Even light movement improves insulin sensitivity.

Simple options:

  • A short walk after each meal
  • Chair exercises
  • Stretching routines
  • Water exercises
  • Light strength training

Choose activities that fit your mobility and comfort.

Improve your sleep

Poor sleep affects insulin levels and hunger signals. Aim for steady sleep habits each night.

Address stress

Stress raises cortisol, and cortisol can increase blood sugar. Small habits like breathing exercises or quiet breaks during the day can help manage stress.

Ask about medication

Some adults benefit from medications that improve insulin sensitivity. Metformin is the most common option.7 Your doctor will help decide if medication is proper for you.

Consider your meal timing

Steady meal timing can help keep your blood sugar stable. Long gaps between meals may lead to stronger cravings and make it harder to manage your weight. Try to eat at regular times throughout the day, and avoid late-night meals when possible.

Can you reverse prediabetes and lose weight?

Yes. Many adults reverse prediabetes and lose weight with consistent changes. Weight loss improves insulin sensitivity. Better insulin sensitivity helps control hunger and energy use.

Losing even a small amount of weight, such as 5 to 7 percent of your body weight, can lower your risk of type 2 diabetes.8

Work with your doctor to track progress. Routine blood work helps you understand how your body responds to lifestyle changes.

Prediabetes in older adults

Prediabetes is common in older adults because metabolism slows with age. Muscle mass decreases, and the body becomes less efficient at using glucose. These changes make it easier for insulin resistance to develop.

Weight gain may also be more noticeable as mobility changes. Even minor adjustments to routine can help you maintain your health.

Caretakers can support loved ones by watching for early signs, encouraging steady habits and helping them prepare balanced meals or stay active.

When to call your doctor

Call your doctor if you notice:

  • Weight gain without a clear cause
  • A rise in hunger or cravings
  • New or worsening fatigue
  • Blurred vision
  • Increased thirst or urination
  • Slow-healing wounds

These may indicate progressing insulin resistance.

Understanding your next steps

Prediabetes can cause weight gain. Insulin resistance, hunger shifts, energy changes and fat storage patterns all lead to gradual weight gain. Many adults notice this change before any other sign of prediabetes.

With support from your doctor, you can improve your blood sugar and manage your weight. You can lower your risk for type 2 diabetes and protect your long-term health.

If you are seeing new weight changes or think you may have prediabetes, talk with your doctor. If you need a provider, you can find one through WellMed Healthcare. Getting care early can help you stay healthy and feel more in control of your health.

References

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