This article is not intended to provide medical advice, diagnosis, opinion, treatment or services. This article and the links contained in it provide general information for educational purposes only. The information provided in this article is not a substitute for medical care, and should not be used in place of the advice of your physician or registered dietitian.
Insulin is a necessary treatment for regulating blood sugar levels in people living with type 1 diabetes. Despite being an essential component of diabetes management, there is a lot of speculation and concern that the use of insulin leads to weight gain. This blog post is going to uncover the truth behind these statements, where they originate from, and what you can do about it.
Weight Changes After Diagnosis of Diabetes
People with type 1 diabetes can experience weight changes throughout their diagnosis. Typically, T1Ds experience unintentional weight loss prior to receiving their diagnosis. Since there is little to no insulin production from the pancreas during this time, the body cannot use glucose from food as energy. As a result, the body will begin breaking down body fat, which leads to reduction in weight, in order to provide the body with the necessary energy it needs to perform day-to-day tasks. When left untreated, this can result in a significant amount of weight loss as well as diabetic ketoacidosis (DKA) that can be life-threatening.
Once insulin therapy is started, the body will finally be able to absorb glucose and bring blood glucose levels down to a safe level. Now that the body is able to absorb glucose, it no longer has to rely on breaking down body fat for energy. The body will work to replace the lost fat stores that ultimately results in weight gain. Although it may be alarming at first, it's important to remember that weight gain during this time is a common (and HEALTHY!) response as the body recovers.
Stigma Around Insulin
Within the diabetes community, there is often discussion around trying to take the least amount of insulin possible. These claims are extremely stigmatizing and can be dangerous. There are a variety of factors that influence the amount of insulin someone takes and the majority of these factors are simply out of someone's control- including aging, hormones and menstrual cycles.
Furthermore, these narratives can negatively impact someone’s diabetes self-management. This can look like:
Being reluctant to start insulin therapy
Not wanting to take insulin injections in front of others
Feeling guilty for taking more insulin compared to others
It is important to remember everyone’s journey with T1D is different- everybody will require different amounts of insulin because everyone’s body is different- and that’s OKAY. Different is just different- not bad!
Prevalence of Eating Disorders and Disordered Eating with Diabetes
People with type 1 diabetes are at 2x the risk of developing eating disorders or disordered eating than the general population. The constant conscious decisions surrounding food choices, calculating insulin dosing multiple times a day compounded with the misconceptions with diabetes- the line between healthy and unhealthy habits can easily become blurred. If you believe you are struggling with disordered eating or an eating disorder, there are a few free resources that can support you in getting the help you need:
What to do about weight changes with diabetes
Coping with body changes alongside managing a chronic condition can be challenging. Here are some strategies for coping with weight changes with diabetes:
Look Beyond the Scale
It may seem like watching the number on the scale decrease is the only way to be healthy, but the truth is even when you start implementing healthy habits, you may not always see your hard work reflected on the scale. Instead of using the scale as the key to your success, consider evaluating other areas of your life like how:
Energized you feel throughout the day
Well you are sleeping at night
Stressed or relaxed you feel
Consistent you are with activity
Mindful your eating habits are
Reduce the Frequency of Low Blood Sugars
Determining how much insulin your body needs isn’t easy since there are a number of factors that influence your insulin needs for any given day. When insulin rates are too high, it can lead to frequent low blood sugar episodes that require almost constant intake of fast-acting glucose to get blood sugars back into a safe range. Forcing yourself to consume excess calories when you aren't hungry in order to get your blood sugars back into range can be
mentally and physically exhausting. While goals for blood glucose levels may vary person-to-person, the current recommendations are to spend less than 4% below 70 mg/dL and less than 1% below 54 mg/dL. If you are experiencing higher rates of low blood sugars, you should discuss making adjustments with your care team.
Coping with Weight Gain After Starting Insulin
It is normal to experience a range of emotions when coping with changes to your body, especially when these body changes are the result of a condition that you had no control over. It is important to give yourself time to adjust to these changes, seek out community support, and give yourself permission to cope with these changes in a way that works best for you. It is important to care for yourself and your body- even if you are angry, sad, worried or bothering by the changes to your brought about as a result of your diabetes diagnosis and treatment.
Should you decrease or stop taking insulin to lose weight?
Absolutely, NOT! Under no circumstances should insulin be manipulated in an effort to lose weight. Insulin should be taken as prescribed by your physician to keep blood glucose values within a healthy range. When the body is deprived of insulin, it can lead to persistently elevated blood glucose values that increases the risk for serious diabetes complications or DKA. Remember- the weight you were at diagnosis was not a healthy weight for your body as your body was breaking down fat stores as a result of not having sufficient insulin. Giving your body the insulin that it needs is a basic act of self-care so it can utilize the energy you are supplying it with.
If you are living with type 1 diabetes, you can learn more about how working with a registered dietitian can help you here. We are now accepting insurance!