Weight management is pivotal and complicated in the comprehensive management of type 2 diabetes mellitus (T2DM). In clinical practice, T2DM combined with overweight or obesity is more common. On the basis of controlling overweight or obesity, the quality of weight management should be emphasized. Simply using body mass index as evaluating indicator of obesity is not comprehensive and objective. Therefore, the dynamic changes of body composition especially visceral fat should be evaluated for the purpose of reducing fat and increasing muscle; Other the other hand, for T2DM with underweight, it is necessary to fully evaluate the proportion of muscle and fat, and to adopt reasonable dietary, exercise, and medication interventions. Meanwhile, avoiding the weight fluctuation during weight loss can contribute to long term target of body weight. Sarcopenic obesity should be carried out reasonable dietary and exercise interventions. In summary, weight loss treatment for T2DM with obesity can improve overall metabolism and long-term benefits. At the same time, in the clinical practice of weight management for T2DM, reasonable interventions should be taken for management of weight fluctuation, underweight and sarcopenic obesity, to achieve comprehensive management of T2DM weight.

Diabetes mellitus, Type 2; Body weight fluctuation; Visceral fat; Sarcopenia; Sarcopenic Obesity; Malnutrition