In prior research, the investigators induced weight loss and improved glycemic control while decreasing antiglycemic medications. A combination of an intensive weight management program with the diabetes management offered in SMAs has potential to further improve diabetes outcomes, reduce complications, decrease costs and increase health-related quality of life. Such a combined intervention is ideal for patients with diabetes because of their unique dietary considerations, and their need for careful glycemic and medication management during weight loss. Project Objectives: The investigators will examine whether an intensive, group-based weight management program followed by an SMA intervention (WM/SMA arm) is comparably effective (non-inferior) to the SMA intervention alone for improving glycemic control while using less antiglycemic medication and resulting in fewer hypoglycemic events and lower healthcare costs. Project Methods: 308 overweight VA outpatients with uncontrolled (hemoglobin A1c 8.0% or 7.5% or greater for those under 50) type 2 diabetes will participate in this RCT. Similar to prior SMAs, the SMA visits will occur every 4 weeks for 16 weeks and then every 8 weeks for 32 weeks for a total of 9 visits. Sessions will be led by a physician and trained interventionists, and will include educational topics related to diabetes management (including diet and physical activity), self-management training, and medication adjustment. Similar to the investigators' prior weight management trials, the WM/SMA group will meet every 2 weeks for 16 weeks and then every 8 weeks for 32 weeks for a total of 13 visits. The weight management program will focus on a low carbohydrate dietary pattern because of its potential to lower glycemia, leading to reduced antiglycemic medication needs. After 16 weeks, meeting content will shift to the SMA intervention content but weight management will continue to be addressed at the meetings. The primary outcome is glycemic control assessed by hemoglobin A1c assessed at baseline and at 16, 32, and 48 weeks. Secondary outcomes include hypoglycemic events, changes in the antiglycemic medication regimen as assessed by a summary score, weight and healthcare costs. Diabetes-specific health-related quality of life and medication adherence will also be assessed.