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November 19, 2006

Weight and Weight Loss

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Question from Prescott, Arizona, USA:

At 6 feet, 3 inches, I weigh around 145 pounds. I’m 26 years old and would really like to gain some weight in order to look healthier and feel better about myself. I’ve read a lot of plans about gaining weight and, while they do differ, they are similar in the fact that I’m told to eat regularly throughout the day, three meals (breakfast, lunch, and dinner) and three snacks mid-morning, mid-afternoon, and night time). I try to keep a strict routine of when I eat and how many carbohydrates I eat during each meal. Currently, I have a muffin for breakfast, a hamburger (or some fast food) for lunch, and a small dinner. I know I need to increase the protein and carbohydrate intake in these meals, as well as work in some snacks, but I’m afraid of pushing my blood sugar too high and feeling poor all day. Also, since I’ve kept such a strict routine, I don’t feel like my appetite is enough to handle all that eating, yet I really want to gain weight. Do I just start by eating a good amount of protein and carbohydrates and work in my snacks? Then, do I just adjust my insulin levels to account for the high blood sugar? Or, should I start out slow and see if I can stomach the meals and monitor my blood sugar more conservatively? How do most diabetics gain weight?

Answer:

From: DTeam Staff

I would recommend you see a dietitian who is familiar with patients with type 1 diabetes. The simple answer is to increase calories. The calories as carbohydrates will increase your blood sugars and you want to minimize any effect on your blood sugar control. The best change is a gradual change. The dietitian can figure out the content of your meals. I would anticipate that you would increase meal size and add in carbohydrates with the assurance that you will adjust insulin dosing based on carbohydrate content of meals and snacks. Care should be made to minimize the increase in bad fats that are common with fast foods. If you do not already dose your insulin based on a ratio of units of insulin per carbohydrate servings with meals, you may want to learn how to do that so that you can make daily adjustments more easily. The dietitian and/or your diabetes education team can help you more with that. You may also want to add some exercise training with the diet to ensure that the weight you gain is muscle and not all fat. Some resistance training with weights two to three times per week would be helpful. It shouldn’t be overly aggressive, as this minimizes the ability to gain weight. However, muscle that is regularly exercised is more insulin sensitive.

JTL