Weight gain can be a typical side effect of insulin therapy. Insulin helps you manage your blood sugar by assisting your cells in absorbing sugar (glucose).

Without insulin, your body’s cells are unable to use sugar for energy. You’ll eliminate the extra glucose in your bloodstream through your urine or it will stay in the blood causing high blood sugar levels.

You may experience weight loss before you start insulin therapy. The loss of sugar in your urine takes water with it, so some of this weight loss is due to water loss. Weight loss may also be partially by the kidneys increasingly removing glucose via urine.

When you start insulin therapy and begin getting your blood sugar under control, the glucose in your body is absorbed and stored. This causes weight gain if the amount you eat is more than you need for the day.

It’s important not to cut back on your insulin, even if you gain weight. You may lose weight again when you’re not on insulin, but you’re increasing your risk of complications. Also, once you start treatment again, the weight will come back.

This can lead to an unhealthy weight loss pattern and long-term complications such as heart disease or kidney damage. Insulin is the best way to lower your blood glucose for those with type 2 diabetes that is not well managed. And remember, never make any changes to your insulin therapy unless your doctor recommends doing so.

You can manage your weight while taking insulin. It may involve adapting lifestyle behaviors such as changing your eating habits and increasing physical activity to help you maintain a moderate weight.

Learn what steps you can take to manage your weight.

Your healthcare team has a wealth of information, experience, and practical tips for navigating weight management. They can help you make a plan for weight loss and for maintaining a moderate weight. Your team may include one or more of the following healthcare professionals:

  • primary care doctor
  • nurse educator or diabetes nurse educator
  • certified diabetes educator
  • registered dietitian
  • endocrinologist
  • eye doctor
  • podiatrist
  • exercise physiologist
  • therapist, social worker, or psychologist

Your healthcare team will help create your plan by assessing your current status. They’ll start looking at your body mass index (BMI), overall health status, weight circumference, and obstacles you may face when it comes to your eating patterns and physical activity.

They can also provide guidance for setting realistic goals based on their assessment. Numeric goals can help with your weight loss journey. Your goals may be:

  • reaching a healthy BMI
  • maintaining a moderate weight to help manage your glucose levels
  • reaching daily and weekly physical activity goals
  • changing lifestyle habits to help improve your health
  • accomplishing your goals by a certain date

You can also ask your doctor about other diabetes medications to help you reduce your insulin dosage. Some medications such as glyburide-metformin (Glucovance), sitagliptin (Januvia), semaglutide (Ozempic), and Empagliflozin (Jardiance), can help regulate your sugar levels and aid in weight loss.

Your doctor will let you know if these medications are appropriate for your condition.

A dietitian can help you with meal planning that incorporates the dietary changes you need to make. An individualized meal plan is crucial for success because everyone’s eating habits and dietary needs are different.

Your plan will include the types of foods you eat, portion size, and when you eat. It may also include shopping tips and meal preparation.

Calorie intake

Most people with diabetes are familiar with managing their carbohydrate intake, but calorie counting is different. It involves monitoring protein, fat, and alcohol intake as well.

The key to losing weight is buring more calories than you consume. But this does not mean skipping meals. Skipping meals has a larger side effect than losing weight. It can cause low blood sugar levels and even weight gain. Your body uses energy less efficiently when skipping meals.

Instead, some of the most effective ways of reducing calories and decreasing blood sugar are avoiding sugary beverages (e.g., juice and soda), desserts, candy, white bread, pasta, and rice.

Portion control

Portion control can help with managing your calorie intake. In addition to counting carbs, consider using the “plate method” of portion control. Trimming your portion size can help with lowering your calorie count.

Here are the basics of the plate method for portion control:

  1. Visualize a line down the center of your dinner plate. Add a second line across one of the halves. You should have three sections.
  2. Put nonstarchy vegetables that appeal to you in the largest section. Vegetables add bulk and size to your meals without adding many calories. Plus, they’re often high in fiber, which is good for managing blood sugar and weight.
  3. Grains and starches fill one of the smaller sections based on your carb-counting guidelines.
  4. Place lean protein in the other small section.
  5. Add a serving of fruit or a low fat dairy product as your meal plan allows.
  6. Add healthy fats but limit the amount as these can add a lot of calories in a small amount.
  7. Add a noncaloric beverage such as water or unsweetened coffee or tea.

The food portions you eat are important.

For example, in America, food is supersized.

Research indicates that Americans consume significantly more calories because larger food portions are increasingly made available to them. Creating a plan to routinely select moderate portions and sticking to it at home and when dining out can be helpful.

Certain foods can support your weight loss journey. Choosing high quality and minimally processed foods is more filling (satiating) and effective than relying on calorie counting. High quality foods also help with consuming fewer calories.

On the other hand, an older Harvard School of Public Health study conducted over a 20-year period showed that weight gain is associated with highly processed foods and red meats.

Foods that can support weight loss

  • vegetables
  • whole grains
  • fruits
  • nuts
  • yogurt

Foods that can contribute to weight gain

  • potato chips and potatoes
  • starchy foods
  • sugar-sweetened beverages
  • highly processed and unprocessed red meats
  • refined grains, fats, and sugars
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Talk with your doctor if you’re interested in a particular dietary plan. Not all eating plans work for everyone. And some may cause unintended side effects, especially if you have other health conditions.

The best way to burn calories and unused energy is staying physically active, such as regularly exercising. The American Heart Association (AHA) recommends at least 150 minutes of moderate physical activity each week for adults. This is the equivalent of 30 minutes of physical activity 5 days a week.

Exercise can also help with insulin sensitivity by making your cells more sensitive to insulin. Research suggests that just one session of physical activity can help improve your insulin sensitivity.

A combination of aerobic and resistance exercises can help improve your weight loss journey. Aerobic activities help burn calories and glucose, while resistance training builds muscle.

Your muscles’ primary fuel is glucose. Having more muscle mass provides more health-promoting benefits. Strength training can also preserve lean body mass as you age.

Aerobic activities can be anything that raises your heartbeat, such as:

  • running or walking
  • cycling
  • swimming
  • dancing
  • using stair steppers or elliptical machines

Resistance or strength training includes:

  • doing bodyweight exercises
  • lifting free weights
  • using weight machines

You can get a trainer, take classes, or use a fitness app like 30 Day Fitness Challenges to help jump-start your routine.

Increasing insulin sensitivity

You may find it more beneficial to do interval training, which is when you exercise with periods of slow and moderate or intense activity.

According to a consensus statement the American College of Sports Medicine published, research indicates that people with type 2 diabetes can improve their insulin sensitivity with moderate intensity resistance training.

A study published in 2005 found that older men with type 2 diabetes increased their insulin sensitivity, gained muscle, and lost weight with twice-weekly strength training — even though they ate 15% more calories on average. The study authors noted that there were limitations to their research model.

Though promising and insightful research has been conducted, experts note that more research is still needed.

Other ways to increase insulin sensitivity are:

Exercise can also help with these steps.

Before you start

Be sure to consult your doctor before you begin an exercise regimen. Exercise lowers blood sugar. Depending on the type of insulin you use, you may need to adjust the intensity or timing of your exercise or adjust your insulin or food intake.

Your doctor can advise you on when to test your blood glucose levels and when to eat relative to the time you’ve set aside for exercise.

Exercise can also worsen some diabetes-related complications. It’s important to check with your doctor before starting an exercise routine if you have:

Be mindful that reducing your insulin is never a solution for weight loss. The side effects that you can experience by limiting your insulin dose are serious and can be long lasting.

Remember to discuss any weight-loss programs with your healthcare team. They’ll be able to put you on the right path to maintaining a healthy weight while taking insulin.