Diabetes Self-Management Blog

Spring is here and many of you are probably looking forward to wearing shorts, bathing suits, and flip-flops. And it’s often this time of year when people somewhat guiltily reflect back on their eating habits over the winter. Did you gain a few pounds? Are your spring pants or skirts feeling a little tight around the waistband?

It’s actually normal to put weight on over the winter. After all, you may not have been as active as you usually are, and maybe you opted for those comfort foods over lower-calorie fare, like salads. But the time is here to shed that winter weight. It’s not always easy. And sometimes people find that despite eating fewer calories, cutting out the snacks, and stepping up the exercise, the weight is stubbornly refusing to come off — or it’s taking its own sweet time.

This week, I’d like to point out some reasons why it might be harder for you to lose weight (or, why you’re gaining weight). Now, most weight gain occurs because of an imbalance between food intake and physical activity (that is to say, calories in exceed calories out). But if you’ve been struggling to drop those pounds, you might consider these possible causes:

Hypothyroidism. It seems all too easy to blame your weight gain on “hormones” that are out of whack. But, as I wrote back in January, thyroid disorders are more common in people with diabetes, especially among people with Type 1 diabetes. Hypothyroidism, or too having too little thyroid hormone, can not only make you feel sluggish and tired, it can cause you to gain weight (or at least, make it hard to lose weight). Have your thyroid hormone (TSH and T4) levels checked every year. If you take thyroid medicine, take it as directed and work with your health-care provider to get your dose regulated, if needed.

Not enough (or too many) ZZZs. Are you short-changing yourself on sleep? At least one third of Americans don’t get enough sleep and up to 70 million people in the United States suffer from some kind of sleep disorder. A lack of sleep does more than just make you feel tired. It’s linked to some very real health problems, including depression, anxiety, high blood pressure, diabetes, and obesity. It also makes it harder to manage diabetes. So you might think twice about burning the midnight oil. In one study, people who got fewer than four hours of sleep at night were 73% more likely to gain excess weight. And people who get six hours of sleep each night? They were 23% more likely to become obese.

There are two possible explanations for why a lack of sleep may pack on the pounds: first, not getting enough sleep affects the hormones leptin and ghrelin, which regulate appetite and satiety. When these hormones are disrupted by lack of sleep, people tend to eat more and also not feel as full when they do eat. Also, research shows that people who have sleep apnea, a condition where a person experiences pauses in their breathing while sleeping, are more likely to be overweight. The more severe the apnea, the higher the risk of obesity.

Aiming for about 7 to 8 hours of sleep each night should do the trick. But don’t sleep much longer than that if you’re male: studies show that men who sleep longer than 9 hours a night are 1.42 times more likely to be overweight than men who sleep 7 to 8 hours a night.

Medicines. It’s not exactly news that certain medicines may cause some weight gain. For example, antidepressants, antipsychotics, antiseizure medicines, and steroids (the legal kind, like prednisone) are known to cause weight gain. If you take pioglitazone (brand name Actos) to manage your diabetes, you may gain weight.

More recently, scientists have discovered that other types of medicines can cause weight gain, too, including antihistamines. Allergy-sufferers who take prescription antihistamines are more likely to be overweight than nonusers. It’s possible that antihistamines affect the appetite control center of the brain, leading to overeating and slower breakdown of fat.

Another possible culprit is beta-blockers. These are a class of medicines used to treat high blood pressure, migraine headaches, and anxiety. Unfortunately, according to the Mayo Clinic, some of the older types of beta-blockers, atenolol (Tenormin) and metoprolol (Lopressor, Toprol-XL), may cause an average weight gain of four pounds (not a lot!). Why? It’s thought that beta-blockers may slow metabolism. However, it’s important not to stop taking any medicines without first talking with your provider. Just because you take any of the above mentioned medicines doesn’t necessarily mean that you’ll gain weight.

Stress. It might sound like a cliché by now, but there’s a real link between stress and weight. We all have stress, although we don’t all respond to it in the same way. Acute stress, such as missing a deadline at work or having to take a loved one to the emergency room, often leads to a loss of appetite. It’s the day-to-day, chronic stress that’s the culprit. Marriage, work or financial difficulties, for example, are the kinds of stressors that can lead to an increase in appetite, thanks in part, to the hormone cortisol.

Cortisol sticks around when you’re stressed and not only does it trigger you to eat more, it signals the body to store glucose as fat (often around your midsection). Plus, you may be less likely to get up and exercise when you’re stressed out (although that’s exactly what you SHOULD do!). Stress may not go away, but you can learn to deal with it, through exercise, relaxation or meditation, or counseling.


  1. i have loss some weaght .was 200.but iam 180.and still there at 180 i work out .eat small meals. on pop.no meats. no breads. like to be 160. iam 53 years old .

    Posted by donna tillberry |
  2. I am a 48 years old Type-2 diabetic male. Agree that stress is causing weight gain and prevent the weight loss significantly. Since I got married about 10 years ago, I put on a good 50 lbs. And the stress leading up to the divorce in the past 5, did not help me at all. Got my thyroid hormones checked but turned out to be no concern, even though I get teary eyed while watching TV or a movie easily (which is what I was told another indicative of thyroid hormone imbalance).

    Now, I am seriously considering the Lap-Band option. Even though I eat sensibly and trying to limit my calorie intake below 1500 per day, desk job, long commute, does not leave much time for exercise. I am hoping the lapband will be my silver bullet.

    Posted by M. B. |
  3. I have type 2 Diabetes. Recently my endocrinologist has put me on a nighttime injection of insulin to help lower my morning reading. I kept ratcheting the number up on the pen until I reached 42 and that number seems to lower my blood sugar below 120 in the morning.

    The problem seems to be that my weight is either at a standstill or slightly creeping up. I am 68″ tall and I weigh 190. My ideal weight should be around 160…I would even accept 170 to 175.

    I am an accountant so I am putting in long days and averaging about 6 hours of sleep a night. Until the last 2 weeks I was averaging about 12 to 16 miles of fast walking 3 to 4 days a week. Even then, with this insulin, I wasn’t losing weight. Now it is “crunch” time for me so my walking has suffered.

    I keep my carbs below 100 and sime days it may be only 50. I try to measure my calories as I seem to intaking around 1500 per day.

    I know I am a perfect “Syndrome X” with all my fat around my abdomen. I have really cut back on red meat and eat plenty of fish, chicken, vegetables, salads, whole grains when I have any starches and low glycemic fruits.


    Posted by GARY COHEN |
  4. I got off actos about 18months ago and have lost about 40# after going to
    weight watchers..and excercise..feel great..

    Posted by mary niblock |
  5. Thank you for this article. It would be interesting to see another that addresses “plateaus” - how to figure out/regulate nutrition vs. exercise when you stop losing weight. It has been very frustrating lately.

    Posted by Cathy R |
  6. To Gary: I too had the same problem. The endocrinologist put me on Lantus, which helped the a.m. blood sugars, but made the weight pack on. One time I saw the nurse practioner in his office when he was out. She told me Lantus does add the pounds and she changed me to Levemir. The results were even better for the blood sugar and helped with weight management. Also, ask your endocrinologist if Byetta is right for you. It works! I went from 225 to 131. Good luck - hope this helps.

    Posted by Cathy A. |
  7. I am for the early use of insulin but it should be pointed out that for many diabetic, in particular if you are insulin resistant, it is a weight gain drug. So it is important to be aware of this and to take extreme corrective measures.

    Adding metformin and minimizing insulin requirements are a good idea.

    Posted by calgarydiabetic |
  8. What about weight problems with us who are older (61) and have type 1 diabetes for many many years. Weight is becomming a “growing” problem in my life and being insulin dependent I need to eat etc.

    Posted by Don Irvin |
  9. i am type 2 diabetes i went on a cruise and i put on about 15lbs.,my work started a biggest loser contest and i joined.when i went on the scale i weigh 280lbs from jan.24th to 20th of april i am now 238lbs. and i still have two more weeks to go. my goal is to get to230lbs. i feel great.i am doing so good my doc. even took me off januvia (diabetic pills)and asked me to come back to the lab for bloodwork in three months,i did what he wanted me to do.my results came out with a great showing,so he told me to keep up the good work and come back within the next four months for bloodwork.my height 6ft 3′ i feel a little skinny but it’s for my health.i am saying this to let you know that what-ever you set your mind to do,you can have great success.be mind strong

    Posted by joseph |
  10. After reading this article, I may as well give up.

    I’m on numerous pain meds (including anti-seizure) due to degenerative disk disease and a great deal of poly neuropathy in the extremities, I take Actos, beta-blockers, I have sleep apnea, am obese (6′3″, 295 lbs) and am under a huge amount of stress constantly. My BP averages 190/110 even with other BP meds.

    I take at a brisk paced walk three to four times a week (3.2 miles in an hour)… And my diet is balanced - lots of fiber, very little processed meat, no sugary sodas/snacks/goodies, lots of water, veggies, etc. (O.K., I could probably do with a few less carbs - healthy cereals/crackers & such - and completely stop imbibing - weekends only…)

    And I was wondering why I couldn’t lose weight.

    But hey, my glucose numbers are GREAT.

    At least I’ll die of a stroke or heart attack with a blood sugar reading of less than 140…

    BTW, the only way I’ve been able to lose weight since being diagnosed Type 2 was to completely get off all my diabetic meds & supplements and let the glucose numbers fly into the 300 - 500 range for a couple of months. But the last time I did that, my eyesight suffered so badly that didn’t want to do it again.

    Oh well… Good luck to everyone else.

    Posted by Jack |
  11. I ate crap and was very fat. As of today I’ve lost 67.1 pounds.

    This is honestly the truth… you have to eat less and exercise. I was a big crybaby like everyone else. Booohooo I’m fat and have every disease in the world. Now I don’t.

    I cut the blood supply with the couch and cut my calories, carbs and fat intake and now I walk.

    Every test is now normal. Monday I go back to the doctors and think she will take me off all my meds.

    I had every excuse in the world just like everyone else and quite frankly I used them to keep from doing anything.

    This is the bottom line… if you keep doing what you’re doing, you’ll keep getting what you’re getting.

    Posted by Tia |
  12. I have been on lantus (and novorapid) for nearly 3 years. I have not gained one ounce of weight and remain slim (5′ 10″ and 165lbs.

    It is NOT lantus that caused weight gain. It is the continued over consumption of carbohydrates.

    Cut down carbs to less than 30 gms per day for a coupe of months and you will see the changes. Insulin should not be blamed for weight gain. Poor nutrition is generally the culprit.

    Posted by Joel |
  13. Hi Gary,

    Cathy had two great suggestions for you. Another suggestion for you is to incorporate some weight-training exercises into your routine. I know you’re busy right now, and the walking that you usually do is excellent. But think about using weights, stretch bands, kettle bells, or other types of muscle toning/strengthening exercises, as well to help increase muscle mass, tone your muscles and increase your metabolic rate.

    Posted by acampbell |
  14. Hi M.B.,

    Having a lot of stress in one’s life can definitely make it harder to lose weight. Having a lap-band procedure can and has helped many people. Just keep in mind that it’s not necessarily a “silver bullet” in and of itself unless you’re prepared and able to follow the diet and do regular exercise afterwards. Otherwise, it’s possible to regain weight. Also, consider looking into ways to help you with your stress, such as counseling, relaxation, meditation, etc.

    Posted by acampbell |
  15. I’ve been doing reduced-carb (about 60g a day) for the last 6 months, and have lost 27 lb. which has brought me down to BMI 24.3. I’d like to lose a little more, but am in no great hurry. I have never in my life been able to lose weight before I started reducing carb intake. I am on insulin, and find that it REDUCES my hunger, and lost weight when I first went on it. I know that some people can tolerate carbs, but I’m not one of them. Not even whole grains, which are so highly touted. Some of us still have the metabolism of the hunter-gatherer, and so we need to eat that way.

    Posted by Natalie Sera |
  16. I am a type 2 diabetic and I weigh 250 and I’m 5′4″. I have no chance in losing weight after this article. I have hypothyroidism, on antihistamines(allergic to everything outside) and I don’t sleep well and have a stressful job. I guess I’m a lost cause. Yeah for me:(

    Posted by Janice |
  17. Amy is right, walking and cardio is great, but add weights and you will see a difference. I also do flex exercises and yoga - wow, I feel great and it clears my mind of the stress. It doesn’t happen overnight, but pretty soon you realize your pants are too big.

    Someone once told me, “Nothing tastes as good as THIN feels.” Ir can be done, people. Don’t have a heart attack like I did before you get up and move.

    Hugs to all. We’re in this together.

    Posted by Cathy A. |
  18. I too am a Type 2 diabetic. Follow Dr. Bernstein’s protocol: 6 carbs for breakfast, 12 for lunch and 12 for dinner. Don’t believe the lies about eating all those grains - it doesn’t work. Veggies have fiber. Don’t eat potatoes Don’t skip meals, especially breakfast! That meals starts your metabolism for the day. Drink plenty of water and keep active. Watch your portion size, just because chicken has no carbs, that doesn’t mean you can eat as much as you want. Your palm is your portion size - without the fingers. Stay away from polyunsaturated fats - they make your cells resistant to insulin. For your fats, use olive oil and get Omega 3’s. When you eat fatty foods and you have to clear your throat - it shows that you can’t assimilate fats very well, so reduce saturated fats but not all. Do not use MSG - it is used to make mice diabetic for their experiments…and we wonder why there is so much diabetes -just look at your salad dressing label. Eat real food. No sugar alcohols - they raise BS. Drink water and herbal teas. read up about your body’s pH and keep it balanced. If you are too acid, it burns out the beta cells of the pancreas. You will lose weight.
    For those of you that think this is too hard to follow. I think just the opposite…losing my eyes or legs is what is too hard for me. We all have too choose. Doing it only half the time doesn’t work either - it takes about 3 days to get back where you were. The key to making it work is to find the way to substitute recipes for what you want to make. Almond and coconut flour is a great sub. for white flour. Good luck all!

    Posted by Marge B |
  19. Hi Janice,

    I certainly didn’t intend for my posting to be discouraging to anyone, and I’m sorry if you took it that way. I agree that it’s harder for some people to lose weight than others. One way to approach the issue is to focus on what you might be able to change, such as dealing with the stress from your job or addressing your sleep issues (which could be tied in to your stress). And sometimes it helps to take the focus off of your weight and instead, find other ways to take care of yourself (eating well, getting in physical activity, treating yourself to a massage, etc.). It’s not easy, but it’s doable!

    Posted by acampbell |
  20. I’m type 2 diabetic.because I am disabled and can’t walk very far,exercise has been difficult. I went to a nutritionist and she designed a diet around my food likes. It uses exchanges which are divided into 3meals and2 snacks. It’s easy to follow I’m on lantus insulin and junuvia. With the diet so balanced I’ve been able to reduce my insulin intake by 20units so far. I have a goal to lose 100lbs. And to get off insulin. I did once on vegetarian diet,but coudn’t maintain a vegetarian diet due to my husband’s preference for meat. He does all the meal preparation so I can’t push him to follow a vegetarian diet. I’ve lost a small amount of weight I do not blame my weight gain on insulin but on my preference for carbs. My blood sugar is mostly below 100. My doctor is happy with that but encourages me to lose weight. Right now I am waiting to have knee surgery for a torn muscle. my doctor wants me to wait until after surgery to do exercise.i feel like I’m spinning my wheels trying to lose weight. As long as I follow my diet i’mmaintaining my small weight loss.

    Posted by Sally mettler |
  21. Hi Sally,

    Congratulations on the weight loss! What’s more important than the rate at which you lose weight is a) that you have a meal plan that is realistic for you to follow and b) that you aren’t gaining weight and are actually losing weight. While walking may be difficult for you, consider other ways to be more active and burn calories. Can you use a stationary bike? Is swimming a possibility? Also, there are exercise DVDs available that focus on “armchair exercises”, meaning, you can sit down and do them. Joslin Diabetes Center has one available on their Web site (https://www.joslin.org/jstore/keep_moving_keep_healthy_with_diabetes_dvd.html). Or try using some small hand weights, kettle bells, or stretch bands to help tone your upper body and boost your metabolism.

    Posted by acampbell |
  22. You missed one!

    Liver shooting up BG in am and Liver dumps buts and keeps the weight on like mad.

    This only stopped by getting liver shut off. Diet before and after was 1200 calories.

    I was up to 330 and now down to 275 and dropping.

    When I say liver dump I am talking BG shooting up to 238/240 and 311.

    Posted by jim snell |
  23. hi i have type 2 diabetes,and have had it now 4 a long time,this past yr,i have really put the lbs on,cause i eat stuff like turkey but i also put hellmans mayo on it,ya i eat a lot of sandwiches thru the week but i put mayo on so i guess its making me fatter,i also like cinnamin grahm crackers with peanut butter and honey on it,depriveing myself from some kind of desert was killing me,im almost 60 yrs old,i have dejenerative disk disease,diabetes,heart disease,copd,bad back,goes with the dissk disease i guess,its terrible and now i ache so bad i cant hardly get up anymore let alone exersize,i take 70 units of novalog b-4 eating when i get up,70 units b-4 supper,and 110 units of lactose b-4 settleing down for the night,and i am on so many meds its driving me insane,but i guess i just wanted to vent cause i have no one to vent to,been thru 2 divorces,won’t do that again,and i got a son that lives with his grandparents and dont even check on me to see if im dead or alive,it sucks,i take symbacort,cymbalta,metropolo,a water pill40mg,fish oil,generic pepcid 40mg,alapurinal for gout,b 12 for severe arthritus severe carpol tunnel and severe nerve damage in my hands,lower tabs for pain,my pain has been real severe for yrs,320mg coated aspirin,allergy pill 4got the name,i think there might be a couple more cant remember now,oh ya i 4 get everything,omgggg,lol well just wanted to vent with ya’s,lol.

    Posted by clarence |
  24. This article is a great pep talk for me. I have been in a bind with losing weight and I know that is all I need to do to become healthy again. I have done it before. Weight Watchers has been a life saver for me 3 times. I lost 75 pounds each time but gained it back. I believe that is why I am not on insulin yet, my glucose levels have been good when i had the weight off those three times, didn’t get off all of the meds but lowered some of the dosages. It is time for me to get it off. I do not want to be 60-80 years old and have to live with the ailments that come with diabetes.

    I am a little upset at the two or three persons that claim they give up after this article. Yes I do not have the additional ailments that you have that would get in the way of losing weight. Ithink it is absolutely ridiculous that the very meds used to keep us alive while having diabetes cause us to gain weight which is a life or death issue for diabetics. Please keep trying. Your Glucose levels being at a good level is very important. I do not have any good advise for you, maybe you can find it through your doctor etc. Please do not give up!!

    You just have to get to the point that you realize you just have to do it, and I think this article has pushed me that point.

    I am type 2 diabetic for at leat 10 years. I have sleep Apnea and GERD. All of which I know should go away once I lose my weight.

    Posted by Kelly |
  25. i have been diabetic for 40 years, had it as a child, i have had so many problems, with stomach, shoulders feet hands, and i cannot lose weight i eat 6 little meals aday i walk a mile or two 3 days aweek, i’m 55 years old, and never had such a weight problem in my life, 5/9 and 236 pounds thats bad. so i really dont know what to do next anyone have any ideals? menifee ca

    Posted by jackie |
  26. Hi jackie,

    I suggest that you contact your local hospital or clinic and inquire about any weight management programs that they may offer. Often, these programs are medically-managed, too, in that a physician is part of the team. It sounds like you need more of a structured approach to help you lose weight and manage your health issues at the same time. Plus, regular support from the health-care team as well as fellow participants is extremely important. Doing it on your own can be hard. A program like this will also likely offer guidance on physical activity as well. If not, you might look into meeting with an exercise physiologist or personal trainer for a more structured exercise program, too.

    Posted by acampbell |
  27. While neither encouraged or discouraged by this article, it has answered my question of “why am I not losing weight?”

    I was diagnosed Type II in late 2011/early 2012. Only in April of 2013 did I finally dedicate myself to losing the weight and being vigilant about my meds. My glucose has dropped from the 300’s to being in the 120’s and only spiking around 20 points after meals…though the doc did up my metformin dose to try and get the fasting rate lower. I exercise moderate to vigorously 6 days a week for an hour and work with a trainer for 2 30 minute sessions of strength training on top of that. Yet my weight loss after such a huge change in lifestyle has been small…maybe 6 pounds a month.

    This article has opened my eyes to the upward climb I’m facing, and though my health has increased (lower lipids, excellent blood pressure), I’m both relieved (b/c of a definite answer) and disheartened (at the ramifications of that answer) to have read about the challenges I face.

    Posted by Sandy |
  28. Stress & weight gain are connected in other ways: Emotional eating, Fast Food, Too busy to exercise.Chronic step & cortisol can contribute to weight gain in the following ways: Metabolism, Cravings, Blood sugar, Fat storage.

    Posted by simmy singh |
  29. Good to hear that I am not the only one…

    i will check with my dr as to my medicine and i like others am on Actos so i want to see what this can be replaced with.

    I am disheartened cause after going from 24/7 eating to a sensible breakfast of bran and skimmed milk, lunch of grilled fish or chicken and veg and a salad for dinner - i have lost the grand total of 3 kgs in a month .. and it has now stopped

    Thanks for the info - will sort this out hopefully

    Posted by Andrea |

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