Happy Saturday! Or maybe not so happy if you're dealing with the weight struggles that some of our readers are writing in about this week. Got the dieting blues? We hear you. Please take a gander at this week's edition of Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

{Need help navigating life with diabetes? Email us at AskDMine@diabetesmine.com}

 

Debbie from Washington, type 2, writes: I've had diabetes for about 15 years. I maintained my weight fairly well, maybe 15 lbs. over ideal, until I eventually started insulin. I gained 40 lbs. in about 6 weeks and my weight just keeps going up as does my need for more and more insulin. I am 5'3" and weigh 250 lbs. I have bad knees and this extra weight makes it very difficult to walk or exercise. I went to Disneyland last year and had to be pushed around in a wheelchair for much of the time (devastating). I must lose weight!! Can you recommend supplements that may help in my endeavor? Diets, meal plans, anything that might help would greatly be appreciated. Please help me.

Wil@Ask D'Mine answers: Ohmygosh, that Disneyland story almost made me cry. That's awful, and I'm so sorry to hear about your troubles. I've got a couple of ideas that might work, but first some background: Weight matters. Too much weight is hard on the heart, hard on the knees, hard on insulin resistance, and hard on the ego.

The medical types use something called the body mass index, or BMI, to classify the relative health risks of various weight-to-height ratios. It's a far from perfect system, but it least it gives us a vocabulary to use when talking about how serious someone's weight is. So I ran your BMI here and got a score 44.3. Now, anything above 30 is a red light when it comes to living long and prospering. So yeah... Umm... yours is pretty bad. In fact, you fall into the rudely named category of "extreme obesity."

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By the way, as a complete side note, I was stunned to hear how quickly you went from basically OK to disasterville. Weight gain is often seen with insulin starts, and the question of whether insulin causes weight gain, or if weight gain is a side effect of reigning in high blood sugar, or a combination of both, is a controversial hotly contended subject amongst insulinologists (OK, I just made that word up) and waaaaaaaay beyond the scope of today's column. Today we're just gonna focus on how to get the frickin' weight back off of you; and to that end we need to understand how extra weight happens.

But first we need to talk about cars.

I drive a Jeep. I love my Jeep. It can go pretty much anywhere, regardless of whether there is even a road to anywhere or not. But my Jeep uses quite a bit of fuel to do so. Even out on the open pavement at 85 miles per hour... Uh... I mean 75 miles per hour, of course... I only get 22 miles per gallon. So I trade spectacular off-road performance for a hefty dent in the wallet. My tree-hugger friend (I only have one of those) drives a Prius and gets something like twice the gas mileage I do. Of course she can get stuck in a garden-variety mud puddle, too. And then she'll need to be rescued by someone like me, in a Jeep.

Anyway, my point here is that the whole your-mileage-may-vary thing is true not just of cars, but of human bodies, too. In general, the human body gobbles up around 2,000 calories per day. But unlike cars, if you put too much gas in the tank, instead of dribbling out the excess fuel onto your feet, the extra fuel is converted to fat and stored for a rainy day.

So if you eat more than you burn, you put on weight. And it doesn't take much extra, either. Consider this: If you eat 10 lousy calories more per day more than you need, you'll put on one pound by the end of the year. 100 calories more per day buys you ten pounds. And so forth. It doesn't take much more than you need to give you real trouble.

To lose weight you need to take in less than you burn. That forces the body to draw on those rainy-day fat reserves. So, in theory, cutting your calorie intake by 10 less than you need melts a pound in a year; 100 less than you need melts ten pounds in a year, and so forth.

So, how to go about cutting those calories?

Now, I haven't seen any evidence to convince me that any of the "supplements" are really going to help you lose weight, so let's talk diet. Yeah. I know, I know. The word "die" is in diet and it's easier to change your gender than your diet. But, really, diets are just different approaches to reducing calorie intake; and that's what we need to do to get the extra pounds off you.

So here are my favorite diets: the smaller plate diet; the turn-off-the-f*ing-TV diet; the bear-trap-in-front-of-the-fridge-at-night diet; the measure-the-damn-carbs diet; the exploding seconds plate diet; and the refrigerator-ectomy diet.

And yes. Of course. I'm writing a book on each of these diets in hopes of creating the next big fad, cashing in on it, and retiring to Aruba on my royalties. (Actually, I've never been to Aruba, and I don't know if I'd even like it. But I digress...)

Bottom line: You need to eat less, and you gotta trick your mind into being happy eating less. So... Look at your portion sizes. You need to keep them smallish, and smaller plates can help you do that... Don't let your mind be distracted while eating. It's a proven fact that folks who eat in front of the TV eat more than folks eating at tables with the TV off... If you snack at night, make sure it is very low calorie. Think rice cakes or fresh veggies... Use the proper portions of high-carb sides. Did you know a "proper" portion of rice is only a third of a cup? Measure it... Wait at least 15 minutes before having seconds. And it would be better if you never had seconds at all. Ever. Oh, and no cheating and putting two servings on your plate in the first place!

It's hard, especially at first. But to lose weight, you need to put less fuel in the tank. Just keep your eye on the prize. Think how much better you'll feel when you are back down to 15 pounds over ideal!

Oh and one last thing: If you fall off the wagon, just get up, dust off your jeans, and jump back on again. Failure happens. Just don't stay in a state of failure.

PS: of course there's something in the medicine cabinet that has been shown to keep blood sugar in check and help you lose weight: The GLP-1 meds Byetta and Victoza. Neither of these popular injectables are magic bullets. They don't melt excess fat. They simply reduce most people's appetite, which causes them to eat less without being hungry, which causes them to reduce their calorie intake, which PRESTO! causes them to lose weight. Yep. They're just a diet in a syringe. (OK, well, in a pen, actually. But you know what I mean.) You might want ask your doctor if a diet in a syringe is right for you.

 

Meanwhile, on the other side of the coin:

Mendell from Washington, type 2, writes: I have an unusual problem — I need to gain weight. I've had type 2 since 2005 and lost weight as soon as I began my medications (Metformin & Glipizide), and then kept losing more weight over the next few years. I am now down to about 130 lbs. and am 5'9" tall. Not Good. Do you know of any products that are good nutrition that can help? It has to be sugar free, of course. And please do not respond by telling me, "You're so lucky to be thin . . ." I hear it all the time. (Sorry and my prayers go out to those who are trying to lose weight.)

Wil@Ask D'Mine answers: OK. I won't tell you that you are lucky to be thin, 'cause I'm not actually sure that you are. Well, more correctly, I'm not sure that you're too thin, anyway. Like I did with our first reader, I ran your BMI and got 19.2, which is towards the bottom end of the "normal" weight range, and thus not medically underweight.

But that said, if you think you're too thin, I guess that's good enough for me. And I'm here to help you fatten up. But first some myth busting: Your diet does not need to be sugar-free. Anyone with diabetes can have sugar, that whole "no sugar" thing is an urban myth like alligators in the sewer and spontaneous human combustion. Of course, some kinds of sugar are worse than others. You should avoid drinking sugar, for instance. Liquid sugars tend to out-pace even our best meds. But you absolutely can eat some sugar or stuff with sugar in it.

Still, don't get me wrong, I'm not advocating the Entenmann's Doughnut Diet to fatten you up....

As a side note, both your meds together are technically weight neutral, so I'd be willing to bet that your weight loss was due to changes in eating habits after you were diagnosed. It's got me wondering if fear of high blood sugar has you half-starving yourself to death. But that aside, you need to do the opposite of what our earlier reader has to do. You need to put more calories in the tank every day than you burn, so that you can gain weight. And you're 100% right, this is not as fun, or as easy, as it sounds for this simple reason: most really high calorie foods are hard on the blood sugar.

So to eat more, we need to look at how you eat now. If you eat three small meals a day, maybe we could add a fourth, or some snacks. Or maybe we can increase your portion sizes a little bit. We also need to look at high-calorie foods that are low on the glycemic index — foods that turn to sugar slowly in your body. Nuts and sunflower seeds come to mind as an example.

Of course, everything has a cost. Most foods that are high in calories and low in sugar tend to be high in fat. That'll be OK, unless your cholesterol is high. But check out this list here for more ideas (50 to be exact) for foods to fatten you up.

You know, what we really need is some sort of Star Trek technology to move extra fat from those who don't need it to those who do. But in the meantime, my prescription for you is to eat, drink, and be merry. In less moderation than you are doing now.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.