Michael Collins relied on mainstream medicine to manage his type 2 diabetes for nearly 20 years — during which time he became morbidly obese as the illness became severe and increasingly uncontrolled. “My doctor would tell me to lose weight. I tried every diet and nothing worked.”

The drugs he was prescribed to control his blood sugar were no longer working and he was told he would need daily insulin shots. “I had severe heart and leg problems and couldn’t get my breath,” he recalls.  

The 52-year-old mental health services manager lives in Boaz, Alabama — a state with a 39 per cent adult obesity rate in 2020, the third highest in the US. Indeed, across the US diabetes affects one in 10 (or 37mn) people, with the vast majority (95 per cent) of these cases being type two, according to the Centers for Disease Control and Prevention (CDC). Genetic factors raise the risk of developing the disease along with being overweight and inactivity.