You’re trying hard to lose weight. You’ve changed your eating habits, and you’ve been doing more physical activity than you used to. But a few weeks — or even a few months — have gone by, and the scale isn’t budging. “Why?!” you ask in frustration. “What am I doing wrong?!”
Body weight is regulated mainly by the number of calories consumed and the number of calories burned off. But there are a number of other things that influence weight, and some of them can make it difficult to lose weight. This article explores what some of these are and how to overcome them.
As you make the effort to lose weight, be sure you are aiming for a realistic body weight for you. A starting point for determining this is body-mass index (BMI), a measure of body fat based on height and weight. You can calculate your BMI easily with an online tool such as the one at www.cdc.gov/healthyweight/assessing/bmi. (Note that there’s a separate BMI calculator for children and teens.) Generally, a BMI between 18.5 and 24.9 is considered normal, between 25 and 29.9 is considered overweight, and 30 and higher is considered obese. However, BMI tends to overestimate body fat in athletes and other muscular people and to underestimate it in older people who have lost muscle mass. There is also some evidence that the negative health effects of overweight start at a lower BMI for Asian people.
Keep in mind, too, that people come in different shapes and sizes. You don’t necessarily have to be “thin” to be healthy, but losing some excess fat can improve your health in a number of ways. Talk to your health-care team about your weight-loss goals and about what a healthy weight is for you.
Frequent episodes of hypoglycemia, or low blood glucose, contribute to overweight because of the calories needed to treat hypoglycemia. The general recommendation for treating hypoglycemia is to eat or drink something containing 15 grams of carbohydrate, wait 15 minutes, then check your blood glucose level again with a meter to see if it has risen. Sometimes another 15 grams of carbohydrate is needed, particularly if the blood glucose level was very low when hypoglycemia was detected.
Ideally, foods and drinks used to treat hypoglycemia should contain no fat, because fat slows the rate of stomach emptying and hence the entry of glucose into the bloodstream. Some examples of food and drink that contain 15 grams of carbohydrate and no fat include the following:
- 1/2 cup (4 ounces) fruit juice
- 1/2 cup regular soft drink (not sugar-free)
- 1 dose glucose gel or liquid
- 3–4 glucose tablets
- 1 cup (8 ounces) skim milk
Fifteen grams of carbohydrate contains about 60 calories. If you need 30 grams, that’s 120 calories. And if you consume more than 30 grams of carbohydrate or treat your hypoglycemia with foods such as chocolate bars that also contain fat, it’s easy to take in 200–300 calories. If hypoglycemia occurs and is treated frequently, therefore, the calories — and pounds — can gradually add up.
To prevent weight gain, therefore, it’s important to try to prevent hypoglycemia from occurring in the first place, to refrain from eating or drinking more carbohydrate than necessary when it occurs, and to treat hypoglycemia with foods or drinks that contain only or primarily carbohydrate.
Some common causes of hypoglycemia include taking too much insulin (of any type), taking too high a dose of an oral diabetes medicine, skipping or delaying a meal, increasing the amount of exercise done without decreasing the amount of diabetes medicine taken or increasing the number of calories consumed, and “insulin stacking,” or taking a second dose of insulin before the previous one has finished working.