I am a 17 year old male who was diagnosed with diabetes at the age of 13. Although my blood sugar levels are normal, my weight has decreased over the past few months because of switching to a vegetarian diet. I am about 5 feet 11 inches tall and right now weigh about 155-160 pounds. I have lost about 10 pounds since switching to a vegetarian lifestyle. Although I am probably healthier on the inside (as evident by my cholesterol levels), I think I look a little thinner on the outside. How can I gain weight without sacrificing my vegetarian beliefs? Is it okay for people with diabetes to take supplements (creatine, etc.)?

I applaud you for your attention to your health. A weight of 155-160 pounds on a 5 foot 11 inch frame is definitely on the thin side, but I’d look to your energy level to tell me if it’s actually too thin for you. If your weight loss was very rapid, you might have lost muscle as well as extra body fat. You would probably notice the effects of this in a loss of strength or stamina. If the weight is just too low for your natural body type, you might be noticing that your overall energy level is diminished. If you’re feeling great at your new weight, on the other hand, that’s a sign that it’s probably a healthy weight for you.

You don’t mention whether you’re eating dairy products, eggs, or cheese as part of your vegetarian eating style. These are good sources of protein and fairly dense in calories, as compared with veggies, fruit, dried beans and so on. If you’ve gone to a vegan (only plant product) eating style, the volume of food that it takes to get adequate calories and protein can drive weight loss because you feel full before you actually consume the number of calories you need. If this is the case, you might try adding in soy milk and tofu as well as healthy monounsaturated fats such as olive oil, nuts and avocados to increase the calorie load of your meals.

I’m assuming that when you talk about wanting to gain weight, you’re more interested in adding muscle than body fat. Building muscle requires eating a little extra of everything (calories, protein, vitamins, minerals) and doing physical activity that requires the body to build muscle (weight lifting is the classic example). Using supplements to try to speed up this process is unproven. If you’ve decided to try something like creatine, get a good baseline set of blood sugars, both pre- and post-meal readings for several days before starting the supplement. Then you can compare numbers as you add the supplement. This makes it much easier to see if something new calls for a change in food or insulin to keep the blood sugar balance you’ve established.

Anytime you change food and/or activity levels, it is likely to change your insulin needs. If you don’t already know how to make these adjustments yourself, please check with your health care team for guidance. Having good food, blood sugar, insulin dose, and activity records will be the best tool for figuring out any needed changes.

BB