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September 23, 2001

Weight and Weight Loss

Question from Perth, Australia:

I have had diabetes some 37 years, I have always been on insulin, and I live a very healthy active life which I have tried to continue. I am actually very healthy, and my specialist is pleased with the way I handle myself, but I am overweight by three sizes and cannot seem to rid my self of the extra weight. I swim and walk (not every day), definitely do not overeat, and rarely eat what I should not. My specialist says tells me not to worry as it is better to be healthy than slim. Am I kidding myself about my diet? Is the problem something to do with how my body handles insulin?

Answer:

At first glance, I agree with your physician. Intensive control of blood sugars generally involves some gain in weight. It is better to have the good blood sugar than to forfeit good health for the sake of your weight. That being said, I empathize with your feelings over this issue. As a diabetes provider, I have this conversation with many of my patients who wonder the same thing.

I think weight management requires both a healthy diet and exercise. Don’t give up, there are continued benefits from what you are doing. Other, more aggressive approaches have been tried. However, I would speak with your physician before attempting any new therapies or activities. You might want to increase your physical activity, consider weight loss medications if your weight is great enough, analyze your current insulin regimen to make sure you are not taking too much and eating to stay in the normal glucose range, and seek counsel with a dietitian about your current calorie intake to determine if it is correct for you and your lifestyle.

JTL