Diabetes patients who participate in group medical visits (GMVs) have successfully improved their glycemia using intensifying medications, which in infrequent cases also resulted in weight loss. This study evaluated the use of GMV alone versus GMV in combination with intensive weight management (WM) and compared the two for their effects on change in glycated hemoglobin (HbA1c) level at 48 weeks, hypoglycemic events, diabetes medication intensity, and weight loss. Patients with type 2 diabetes, uncontrolled HbA1c, and body mass index (BMI) ≥27 kg/m2 were recruited from Veterans Affairs Medical Center clinics in North Carolina were randomized to one of two groups: The GMV group (n = 136) received diabetes-related counseling pertaining to medication optimization every four weeks for 16 weeks, then every eight weeks; the WM/GMV group (n = 127) was given low-carbohydrate diet counseling with baseline medication reduction and subsequent medication optimization every two weeks for 16 weeks, followed by an abbreviated GMV intervention every eight weeks. The mean age of the total study group was 60.7 years; baseline HbA1c level was 9.1%, and BMI was 35.3 kg/m2. After 48 weeks, both groups presented improved HbA1c levels, at the same time, the WM/GMV group had a lower rate of diabetes medication use and greater weight loss, as well as fewer hypoglycemic events.