No matter what type of diabetes a person has, the initiation of insulin therapy is often accompanied by some weight gain. This is because calories from glucose that were once being excreted in the urine are now being stored in the body’s cells. It may also be because a person is feeling better and has more of an appetite. In a person who lost a lot of body weight before his diabetes diagnosis, a certain amount of weight gain when starting insulin therapy may be healthy, but a person who is not underweight may need to cut back on calories to prevent weight gain.
While very high blood glucose can lead to weight loss as glucose is excreted in the urine, it can also cause feelings of tiredness and increased hunger, which can lead to decreased activity, increased eating, and over time (assuming there is not a complete absence of insulin), weight gain. Having an effective plan to manage blood glucose levels—whether with insulin or by other means—is therefore an important part of weight control for people with diabetes.
Environmental challenges. A person who is actively losing weight is often the recipient of praise and compliments from family members, friends, and colleagues. Many people also enjoy the excitement of fitting into smaller clothes sizes as they lose weight. These types of positive reinforcement can help a person who is actively losing weight to stay motivated to continue with the healthful lifestyle changes that enable him to lose more weight.
Once a person’s weight has stabilized, however, the compliments from others may become less frequent, and the person himself may start to take his smaller clothes size and improved blood pressure, blood cholesterol, and blood glucose levels for granted. When this happens, a person must find new positive reinforcements to feel motivated to keep up his good habits and maintain his weight loss year after year. One of the places in which such reinforcement may be found is in a weight-loss support group, where others are facing the same issues and understand how challenging weight maintenance can be.
Some other factors in a person’s environment that can pose a challenge to weight maintenance are food packaging and restaurant serving sizes, both of which influence how much a person eats. Serving sizes of foods and beverages started rising in the 1970’s and have paralleled the obesity epidemic over the past 36 years. Many studies suggest that the larger the portion served or purchased, the more of it a person consumes. In one study, people who were served soup in invisibly self-refilling bowls ate 73% more soup than those eating from normal soup bowls. Interestingly, the people who ate more soup did not believe they had consumed more, nor did they feel more sated than those eating from normal bowls. In another study, participants consumed 30% more macaroni and cheese at lunch when offered a larger portion.
These are important findings to remember when eating out, since restaurants today tend to serve larger portions of food than in years past, as well as foods with greater calorie density. As a result, frequently dining out or buying take-out food from restaurants can make maintaining weight loss more challenging. People who do eat out frequently need to learn strategies to keep their calories in check, such as eating just half of the food served (and saving the other half for a second meal) and limiting higher-calorie menu selections such as deep-fried, creamy, or cheesy items.
Benefits of long-term weight loss
Since losing weight and keeping it off is so difficult for so many people, it’s worth asking whether making the effort has actual benefits. In the short term, weight loss is known to improve sleep apnea (the repeated cessation of breathing during sleep), lower high blood pressure, and improve blood cholesterol and triglyceride levels. But does long-term weight loss have long-term benefits, such as a lowered risk of chronic disease or a longer life?