How do I lose weight when I live with diabetes? This is a great question, and one that people ask me all the time.
The short answer is: the same way as people without diabetes lose weight. However, all the factors that go along with living with diabetes (I’m looking at you insulin and type 2 drugs like Gliclazide) can make it more difficult. There can also be other diabetes-related tagalongs like Hypothyroidism and frozen body parts, which can make things more complicated.
In this post, I’ll work with the assumption that the tagalongs are handled by your medical team and we only have to deal with weight management and diabetes.
I would like to share my top five rules for how to lose weight with diabetes. These are based on science, from working with men and women living with diabetes from all over the world, and from my personal experiences. But before we dig in, I want to get an important message across and make sure you don’t miss it:
”Weight management with diabetes can be done. It’s not impossible and it’s not out of reach”
1. Have realistic expectations and be patient
The two main reasons I see people living with diabetes not reaching their weight goals are unrealistic expectations and lack of patience. Weight loss takes time and effort and, in my experience, it can take longer for people living with diabetes.
So if you expect to drop 5 lbs. the first week or 20 lbs. in 21 days, I can tell you that you most likely will be very disappointed. That initial disappointment makes many people fall back into old unhealthy habits, concluding that weight loss just isn’t possible for them.
The general rule for healthy weight loss is to aim for max. 1-2 lbs. per week. It’s also quite common for people living with diabetes to take as long as 2-3 weeks before seeing any weight loss at all on a new diet. It seems that our bodies need a little time to kick into weight loss gear as we decrease our insulin (or other diabetes medication) needs and dial in our diets. I know we all want to know how to lose weight and get results yesterday, but just as it took some time to put on those pounds, it will take some time to get rid of them.
On the positive side, a slow and controlled weight loss makes it much more likely that the weight will stay off than if you crash dieted and lost a lot of weight in a short period of time.
2. Carbs and fats are not the enemies
I don’t preach no-carbs or no-fat diets for weight loss. What I suggest is a balanced diet of mainly low glycemic carbs, healthy fats, and lean proteins.
If you want to lose (or gain) weight, start by finding your daily calorie equilibrium. This is the amount of calories necessary per day to maintain your weight at its current level. You can learn how to find your calorie equilibrium by reading this post.
Depending on your goals, you can then aim to eat either fewer or more calories than your equilibrium to lose or gain weight. If you are trying to lose weight, a very good starting point is a 500-calorie deficit per day for the first month. If that doesn’t do the trick, cut out a few more calories. However, I would never suggest that you go below 1,200 calories per day as an absolute minimum.
Now that you have found how many calories to eat, let’s look at carbs, fats, and protein, all important factors in how to lose weight.
A general recommendation is that at least 40% of your calories should come from carbs. In my experience, that’s too much for most diabetics who want to lean out and aren’t lifting super heavily or doing many hours of exercise a day. Generally, I recommend starting at 30% carbs, 30% fat, and 40% protein, and adjusting as needed after the first month.
Let’s say you calculate that you need 1,900 calories to maintain your weight, so you decided on a 1,400 calorie diet. This would mean that 420 calories should come from carbs (30% of 1,400). Since each gram of carbs has about 4 calories, you would eat around 100 grams of carbs per day.
I know that even this may seem like a lot of carbs to some people who are living with diabetes, but if you are trying to lose weight in what I consider the best way (by including both cardio and resistance training), you will need the energy from carbohydrates to power your workouts and gain muscle mass.
Note: There are many different opinions about how many carbs you should eat, and some people achieve good results with very low-carb diets. What I have described here is the approach that works for me and the clients I work with, which is not the only possible way of losing weight with diabetes.
3. Insulin won’t make you gain weight
That insulin in itself will make you gain weight is one of the most common misconceptions surrounding diabetes, most likely because many people experience weight gain right after they start on insulin (I have written about my experience in this post).
The truth is that insulin in itself doesn’t cause weight gain*. Eating more calories than your daily calorie equilibrium causes weight gain. What insulin can do is make it harder to eat only the right amount of calories and no more.
We all know that finding the right balance of food and insulin can be hard, so we sometimes end up over-correcting low blood sugars, correcting them with the “wrong” carbs, or we simply go along all day “feeding the insulin”.
Let me explain those last two phrases a little more in depth.
- What I’m referring to when I say correcting with the “wrong” carbs is correcting with foods such as chocolate and peanut butter every time your blood sugars drop. There’s no need for those fat calories. You need fast acting carbs for lows, not fat calories that will slow down carb absorption. Reach for juice or glucose tabs. These foods are way less calorie dense and will raise your blood sugars faster
- Feeding your insulin means that you constantly have too much insulin in your system and have to “feed it” (i.e. eat) throughout the day to keep your sugars at an acceptable level. The solution is to reduce your insulin, not increase your carbs. If you’re dealing with low blood sugars on a daily basis, I would say that you most likely are injecting too much insulin
The takeaway here is that good diabetes management is key to good weight management. The better you are at keeping you blood sugar stable, the easier it is to lose weight or maintain your weight. Don’t be afraid of insulin. Adjust your diet based on weight goals and try to take the right amount of insulin to adjust for the food you eat.
4. Proper nutrition is 80% of the equation
The saying that you can’t outrun a bad diet is very true. Exercise is an important part of both how to lose weight and general diabetes management, but it can’t compensate for a bad diet.
The best way to lose weight is, therefore, to focus on your nutrition. Calculate your daily calorie need as described above and start concentrating on eating mainly fresh, minimally processed ingredients until eating a well-balanced, nutritious diet has become a habit.
If you are looking for how to lose weight a little faster, I suggest that you design a weight loss meal plan (or get a professional to help you out), and follow it as closely as you can in the beginning. That would mean no “cheat days” unless they are a part of the plan. While I agree that weight management should be about living a healthy lifestyle and that nobody wants to “diet” forever, incorporating cheat days initially won’t do your waistline any favors. So if you really want to see significant weight loss results in the first month or two, I recommend that you buckle down and stick to your plan.
After the first 1-2 months, you can start to slowly loosen up your diet a bit and work towards a more sustainable long-term healthy lifestyle, but first, you need to give your body a chance to get into fat loss mode.
5. Include both cardio and resistance training workouts
Getting your diet on point is 80% of the equation for how to lose weight successfully, but exercise is still extremely important. The improved insulin sensitivity that comes along with exercise can really help the weight loss process along.
Resistance training especially is something that is often overlooked when it comes to weight loss. When you gain a little muscle mass, your metabolism will increase, meaning you burn more calories ALL THE TIME! Even when you aren’t working out. This makes resistance training excellent for long-term weight management.
When it comes to weight loss, I’ve found that fasting steady-state cardio in the morning is extremely effective. I’m not talking about all-out “I think I’m going to die” cardio, but a smooth and steady ride with a heart rate in the 140-150 BPM range for up to 40 min.
The benefit of fasting morning cardio is that morning is the time when you are the least likely to experience cardio-induced hypoglycemia since you have the least insulin in your system. You have also depleted a lot of your stored glycogen overnight, meaning that your body is more likely to use fat for energy.
However, if fasting cardio isn’t you cup of tea (or doesn’t fit in your schedule), don’t worry about it. Do your cardio when it works for you and you’ll still benefit from it.
I typically recommend 2-3 full-body resistance training sessions and 2-3 cardio sessions per week. To save time, you can do resistance and cardio sessions right after each other, or you can do cardio in the morning and resistance later in the day. In this way, you really only have to work out 3 days per week to get 6 sessions in.
If you’re just starting out, ease into it and take it slow in the beginning. If you been exercising for years, go for the 6 sessions per week. I suggest exercising at least every 3 days to ensure that you continually see the benefits of improved insulin sensitivity, which can last up to 72 hours after a workout.
When you’re trying to figure out how to lose weight, remember these five guidelines:
- Have realistic goals. Accept that weight loss takes time and that you might not see results the first 2-3 weeks. Hang in there
- Carbs and fats are not making you fat, too many calories are. Calculate your calorie need and design a meal plan based on that
- Insulin in and of itself won’t mess with your waistline. Get your nutrition right and take the insulin needed to manage your blood sugar
- Nutrition is 80% of the weight loss equation
- Add resistance training and cardio to your weight loss plan for optimal results
I hope you found this post useful. I know that there are a lot of different opinions on how to lose weight, eat and train when you have diabetes, but this is what works for me!
Suggested next post: How to Create a Weekly Meal Plan
*Sources: Gary Scheiner MS, CDE “Insulin & Weight Gain: Does Tighter Control Make You Loosen Your Belt?” and Rebecca J. Brown, M.D., etc.: ”Uncoupling Intensive Insulin Therapy from Weight Gain and Hypoglycemia in Type 1 Diabetes”
Medical Disclaimer: All information provided on TheFitBlog is based on my own and our expert’s personal experience. We are not medical professionals and no adjustments to care should be made without consulting your medical team. If you are new to exercise, haven’t exercised in a while and/or haven’t seen your medical team in the last 3 months, it is advised to do so before engaging in any kind of physical activities. You must not rely on the information on TheFitBlog as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.
Join the Newsletter
Never miss a post! Subscribe to my newsletter.