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June 1, 2008

Insulin, Weight and Weight Loss

Question from New Zealand:

There is a lot of discussion amongst type 1s about whether or not modern insulins cause weight gain. Can you clarify that for me? I am 54 and have been on insulin for 42 years. Until I was 40, my weight was stable around 98 pounds, which is about right for my slight build. Since then, weight has crept on, especially since I started taking Lantus about three years ago. I am now 133 pounds and I cannot lose weight. I walk an hour a day and have cut back on total food intake. I am eating salad, vegetables and a couple of pieces of fruit and two servings of protein per day, but still cannot loose weight. I am in perfect health otherwise and have had thyroid checks, etc. So, is the insulin the problem?

Answer:

There are several properties of insulin that are known to be weight-promoting. First, it has an anabolic effect. In effect, it lays down fat when energy is available in excess. Second, it has been associated with increases in appetite, possibly due to central nervous system effects. I do not know if the more recently used insulins are more weight-promoting than previous insulins or that we are all exposed to the weight-promoting effects of our society. However, it is important to know how much you eat so as to not exceed limits that will promote weight gain. Second, it is important to avoid hypoglycemia as you will be eating/consuming additional calories to treat the lows. Third, it will be important to make good choices regarding snacks so as to avoid the concentrated calories. I am very quick to point out that help from a dietitian is usually very productive and makes you think about consumer-related changes you can make in your diet. It also important to know that even if you exercise, you still have to restrict calories to lose weight.

JTL