Using insulin can lead to extra pounds for several reasons, explains Don McClain, MD, PhD, a professor of internal medicine, endocrinology, and metabolism and director of the Center on Diabetes, Obesity, and Metabolism at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. At first, the insulin may reverse your body’s inability to use glucose from food for energy. As you become rehydrated and regain the ability to build muscle and start to store calories that used to spill out in the urine, you may “bounce back to the weight you were before the illness — or even more,” Dr. McClain says. “Changing long-held eating habits can be hard,” he adds. “You may gain weight if you eat more calories than you burn.” Resist the temptation to stop taking the insulin in order to lose weight, McClain says. The cost to your health can be very high — uncontrolled diabetes can increase your risk of serious health problems like heart disease and stroke. And you’ll likely gain the weight back once you start taking insulin again.
Tips to Manage Your Weight
Avoiding weight gain while taking insulin plays an important role in managing type 2 diabetes. Maintaining a healthy weight can help you control blood sugar levels and reduce your risk of other health conditions. According to a study published in April 2013 in Diabetic Medicine, shedding pounds through healthy living can even help some people reverse type 2 diabetes. The good news: Though managing your weight may seem difficult when you’re taking insulin, there are actually many steps you can take to keep the pounds off. “We’re really in a much better place in terms of things we can do to help our patients avoid gaining weight and still control their blood glucose,” says Michael Jensen, MD, an internist, endocrinologist, and obesity researcher at the Mayo Clinic in Rochester, Minnesota. Try these strategies:
1. Talk to your doctor about your treatment plan.
You should never cut back on your insulin dose or stop taking insulin on your own. Not taking your insulin as prescribed can lead to high blood sugar and increase your risk of complications. If you’re struggling with weight gain, talk to your doctor about adjusting your treatment strategy. Your doctor may also recommend other diabetes drugs. There have been advances in medications over the past five to 10 years that have the side effect of helping people lose weight, says McClain. Ask your doctor if these may be appropriate for you. Also confirm with your doctor that you’re not on medications that can actually cause you to gain weight, Dr. Jensen says.
2. Keep blood sugar levels steady and even.
Big swings in blood sugar can lead to weight gain, so the best approach is to try to keep levels steady, says McClain. “When blood sugar is low, you get a signal that you’re really hungry. In this situation, we teach people to have a snack containing 15 grams of carbohydrate, to bring their sugar level up.” People who tend to have frequent drops in their blood sugar may actually be overeating to treat these dips, which can lead to gaining weight, he adds. Jensen says the goal — to the extent you can manage it — is to live in harmony with your insulin. You don’t have to eat the same exact food every day, or do the exact same activities, but it’s a good idea to aim for some regularity so your levels aren’t swinging around wildly from day to day. “That’s what can get people into trouble,” he says.
3. Count calories.
Eating more calories than you burn? That adds up to weight gain. The number of calories you need each day depends on several factors, such as your size, age, level of activity, and any other health conditions you may have — so talk to your doctor or nutritionist about what’s right for you. Your ticket to weight loss may simply involve eating fewer calories.
4. Exercise regularly.
Exercise helps to burn off extra calories. Two types of physical activity in particular are key, according to the American Diabetes Association: aerobic exercise and strength training. “Exercise not only decreases your resistance to insulin, it also accelerates glucose uptake into muscle,” says McClain. The National Institute of Diabetes and Digestive and Kidney Diseases explains that regular strength training, such as lifting weights or doing push-ups, builds muscle, and maintaining muscle burns more calories.
5. Eat about the same amount of food every day.
Skipping meals may make you feel extra hungry and cause you to overeat later on. Missing meals can also lead to low blood sugar if you don’t adjust your insulin dose. But eating smaller meals throughout the course of your day can help you keep your appetite, blood sugar, and weight under control. With additional reporting by Andrea Peirce
