Rec­om­men­da­tions

8.2 Diet, phys­i­cal ac­tiv­i­ty, and be­hav­ioral ther­a­py de­signed to achieve and main­tain >5% weight loss should be pre­scribed for pa­tients with type 2 di­a­betes who are over­weight or obese and ready to achieve weight loss. A

8.3 Such in­ter­ven­tions should be high in­ten­si­ty (≥16 ses­sions in 6 months) and focus on diet, phys­i­cal ac­tiv­i­ty, and be­hav­ioral strate­gies to achieve a 500–750 kcal/‍day en­er­gy deficit. A

8.4 Diets should be in­di­vid­u­al­ized, as those that pro­vide the same caloric re­stric­tion but dif­fer in pro­tein, car­bo­hy­drate, and fat con­tent are equal­ly ef­fec­tive in achiev­ing weight loss. A

8.5 For pa­tients who achieve short-‍term weight-‍loss goals, long-‍term (≥1 year) com­pre­hen­sive weight-‍main­te­nance pro­grams should be pre­scribed. Such pro­grams should pro­vide at least month­ly con­tact and en­cour­age on­go­ing mon­i­tor­ing of body weight (week­ly or more fre­quent­ly) and/‍or other self-‍mon­i­tor­ing strate­gies, such as track­ing in­take, steps, etc.; con­tin­ued con­sump­tion of a re­duced-calorie diet; and par­tic­i­pa­tion in high lev­els of phys­i­cal ac­tiv­i­ty (200– 300 min/‍week). A

8.6 To achieve weight loss of >5%, short-‍term (3-‍month) in­ter­ven­tions that use very low-‍calo­rie diets (≤800 kcal/‍day) and total meal re­place­ments may be pre­scribed for care­ful­ly se­lect­ed pa­tients by trained prac­ti­tion­ers in med­i­cal care set­tings with close med­i­cal mon­i­tor­ing. To main­tain weight loss, such pro­grams must in­cor­po­rate long-‍term com­pre­hen­sive weight-‍main­te­nance coun­sel­ing. B