Researchers tested whether two types of strict eating plans could help people with type 2 diabetes feel less stressed and worried about their weight. Over 24 weeks, 120 adults tried either a low-calorie diet, a low-calorie diet with time-restricted eating (only eating during an 8-hour window), or continued their normal habits. Both diet groups felt significantly less stressed about their diabetes and worried less about their weight and appearance. Interestingly, the improvements in stress seemed to come mainly from losing weight and better blood sugar control, rather than from the diets themselves. This suggests that structured eating plans combined with exercise and support can help improve both physical and mental health in people managing type 2 diabetes.

The Quick Take

  • What they studied: Whether two different strict eating plans could reduce stress and worry about weight in people with type 2 diabetes
  • Who participated: 120 adults with type 2 diabetes were divided into three groups: one group followed a low-calorie diet (40 people), another group did the same diet but only ate during an 8-hour window each day (40 people), and a control group continued normal eating (40 people)
  • Key finding: Both diet groups experienced significant reductions in diabetes-related stress and worry about their weight and shape. The group with time-restricted eating showed slightly better improvements, though the difference wasn’t large enough to be certain it was real
  • What it means for you: If you have type 2 diabetes and struggle with stress about your condition or worry about your weight, a structured eating plan combined with exercise and behavioral support may help improve your mental health. However, this is most effective when combined with actual weight loss and better blood sugar control

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of research studies. Researchers randomly assigned 120 adults with type 2 diabetes into three groups to ensure fair comparison. Two groups followed intensive lifestyle programs that included strict calorie and carbohydrate restriction (eating only 1000-1200 calories per day), at least 150 minutes of weekly exercise, and behavioral counseling. One of these groups added time-restricted eating, meaning they could only eat during an 8-hour window each day. The third group served as a control, continuing their normal routines. All participants were followed for 24 weeks (about 6 months), and researchers measured their stress levels, worry about weight and appearance, and metabolic improvements using validated psychological scales.

Using a randomized controlled trial design is important because it helps researchers determine whether the eating plans actually caused the improvements, rather than other factors. By randomly assigning people to different groups and having a control group that didn’t change their habits, researchers could see the true effects of the interventions. The 24-week timeframe is long enough to see meaningful changes in both mental health and physical health markers.

This study has several strengths: it used a control group for comparison, randomly assigned participants, measured validated psychological outcomes using established scales (EDE-Q and PAID), and tracked both mental and physical health changes. The study was registered in a clinical trial database before starting, which increases transparency. However, the sample size of 120 is moderate, and the study was conducted in one location, which may limit how well results apply to other populations. The study also adjusted for weight and blood sugar changes to understand what was really causing the mental health improvements.

What the Results Show

Both the standard calorie-restricted diet group and the time-restricted eating group showed significant improvements in eating disorder-related thoughts and behaviors compared to the control group. Specifically, participants in both intervention groups worried less about their weight and shape, and these improvements were real and measurable. The time-restricted eating group showed slightly larger improvements than the standard diet group, though this difference was small enough that it could have been due to chance.

When researchers looked at diabetes-related stress (worry and frustration about having diabetes), both intervention groups improved significantly compared to the control group. However, when researchers adjusted their analysis to account for weight loss and improved blood sugar control, the stress improvements became less clear. This suggests that the reduction in diabetes stress was mainly due to people losing weight and getting better blood sugar control, rather than the eating plans themselves having a direct calming effect.

The improvements in eating disorder-related thoughts remained significant even after accounting for weight and blood sugar changes, suggesting these mental health benefits came from the structured approach itself, not just from the physical changes.

The control group, which continued normal eating habits, showed minimal changes in either psychological measures or metabolic health over the 24 weeks. This reinforces that the improvements seen in the intervention groups were due to the structured programs, not just from the passage of time. Both intervention groups successfully lost weight and improved their blood sugar control (HbA1c), which are important health outcomes for people with type 2 diabetes.

This research builds on existing evidence that lifestyle changes help people with type 2 diabetes. Previous studies have shown that weight loss and exercise improve blood sugar control, but this study adds important information about mental health benefits. The finding that structured eating plans reduce worry about weight and appearance is consistent with other research showing that clear, structured approaches to eating can reduce anxiety around food. The discovery that time-restricted eating may offer additional benefits over standard calorie restriction is newer and suggests this approach might be worth exploring further.

This study has several important limitations to consider. First, it only included 120 people, so results may not apply to everyone with type 2 diabetes. Second, the study was conducted in one location, possibly with a specific population, so results might differ in other communities or countries. Third, the study only lasted 24 weeks, so we don’t know if benefits continue long-term or if people can stick with these strict eating plans. Fourth, the very low calorie diet (1000-1200 calories per day) is quite restrictive and may not be safe or sustainable for everyone. Finally, the study didn’t measure whether people actually stuck with the eating plans after the study ended, which is important for real-world effectiveness.

The Bottom Line

If you have type 2 diabetes and experience stress or anxiety about your condition, a structured program combining calorie restriction, regular exercise (at least 150 minutes per week), and behavioral support appears to help reduce these feelings. Time-restricted eating (eating only during an 8-hour window) may offer additional benefits, though evidence is still developing. These recommendations have moderate confidence because they come from a well-designed study, but more research is needed. Important note: The very low calorie diet used in this study (1000-1200 calories) should only be attempted under medical supervision, as it’s quite restrictive.

Adults with type 2 diabetes who experience stress, anxiety, or worry about their weight and appearance should consider these findings. People who struggle with eating behaviors or have a history of eating disorders should be especially careful and work closely with healthcare providers before starting very restrictive diets. This approach may be less suitable for people with certain medical conditions, pregnant or breastfeeding women, or those taking specific medications. Anyone considering these changes should discuss them with their doctor first.

Based on this study, you might expect to notice improvements in stress and worry about weight within 6-8 weeks of starting a structured program, with more noticeable changes by 12 weeks. However, individual results vary. The mental health benefits appear to develop alongside physical changes like weight loss and improved blood sugar control, so patience is important. Long-term success depends on being able to maintain the eating plan and exercise routine beyond the initial 24 weeks.

Want to Apply This Research?

  • Track daily calorie intake and eating window times (if using time-restricted eating), along with weekly stress levels about diabetes using a simple 1-10 scale. Also monitor weekly weight and note any changes in worry about appearance or eating behaviors
  • Set a specific eating window (for example, noon to 8 PM) and log each meal within that window. Use the app to receive reminders for exercise sessions and daily stress check-ins. Create a simple mood tracker to record how you feel about your diabetes management each day
  • Weekly review of calorie intake consistency, exercise completion, weight trends, and stress scores. Monthly assessment of changes in worry about weight and appearance. Quarterly check-ins with healthcare provider to discuss progress and adjust the plan if needed. Use the app’s trend analysis to identify patterns between eating consistency, exercise, weight changes, and stress levels

This research describes a structured eating and exercise program that produced benefits for study participants with type 2 diabetes. However, the very low calorie diet used (1000-1200 calories per day) is quite restrictive and should only be attempted under direct medical supervision. This study is not a substitute for personalized medical advice. Before starting any new diet, exercise program, or lifestyle change, especially if you have type 2 diabetes or other health conditions, consult with your healthcare provider or a registered dietitian. Results may vary based on individual health status, medications, and ability to maintain the program. If you have a history of eating disorders or disordered eating patterns, discuss these findings with your healthcare provider before making changes. This research was published in 2026 and represents current evidence, but medical recommendations may evolve as new research emerges.