Losing weight can be difficult for anyone, and living with type 1 diabetes definitely doesn’t make it easier. However, there ARE people who set out to lose weight and end up so extraordinarily successful that you wonder if they have some inside information you don’t.
That information EXISTS. I’m here to give you the rundown on how to lose weight with type 1 diabetes (actually, most of the advice is relevant for people with any type of diabetes).
Without further ado…let’s GET TO IT!
Temper expectations at the start
Most people have this intense need for instant gratification. They want that 15 lbs gone by yesterday! While I’m all for efficiency, I’m going to be short and sweet and show reality with a pop quiz:
True or false: it took more than a week to gain the weight you are trying to lose.
The answer is undeniably “True”. So if it took you X number of months to gain weight, why would it take you a week or two to lose it?
It doesn’t. It takes time and some concerted effort. Don’t expect to lose all of the weight immediately, but know that with proper habit formation and consistency, you WILL see the results you are after.
The general rule for healthy weight loss is to aim for A MAX of 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.
“Why?” you ask.
Changing caloric intake and workout routines may require a reduction of insulin (or other diabetes medication) as well as diet manipulation, which takes a little trial and error to adjust.
Once the ball is rolling, a slow and controlled weight loss makes it much more likely that the weight will come off and STAY off than if you crash dieted and lost a lot of weight quickly.
To learn more about setting realistic goals, read “How to set Realistic Diabetes and Fitness Goals and Find Your Positive Motivation”.
How many calories should you eat?
Weight loss can be summed up as follows:
Calories in (eating) < Calories out (burning) = weight loss.
From a thermodynamics standpoint, if you are eating fewer calories than you are expending, you should THEORETICALLY lose weight. No system is perfect, but this is the general premise.
However, this whole “eat less than you expend” advice gets blown out of proportion quite often as you see people slashing their diets to nearly nothing or eating just grapefruits all day. This will work in the very short term, but will seriously decrease your metabolism while you mostly lose water weight that will come right back when you finish your diet.
The first step in any weight loss program is, therefore, to calculate how many calories you should eat per day for a healthy weight loss.
Luckily, there is a guide here on Diabetes Strong that explains how to do this in 5 easy steps. So before reading on, please go to “How to Find Your Daily Calorie Need” and calculate your daily calorie need. Then come back here and continue this guide.
How about protein, carbs, and fat?
I’m not going to stand here and tell you that there is only one way to lose weight with type 1 diabetes. I’ve had experience losing weight on a high carb diet, low carb diet, and moderate carb diet.
They’re all predicated on the aforementioned “calories in, calories out” equation.
But, a couple of tips to consider as you plan your diet:
Protein is helpful in satiety AND retaining muscle mass
In other words, protein will help keep you fuller for longer after meals, which is key in a situation where you are eating less than you may be accustomed to normally.
Additionally, when people lose weight, the composition is typically 75% fat and 25% muscle1. However, a higher protein diet has been linked to a reduction in the amount of muscle lost during a caloric deficit.2
I could go on and on all day, but I’ll leave you with this:
Recommendation: Aim to eat 0.5-0.8 grams per pound of bodyweight per day. It will help you keep your hard-earned muscles while losing weight. So if you weight 200 pounds (91 kg), you should aim for 100-160 grams of protein per day.
Note: If you suffer from kidney disease or have any history of kidney problems, increasing your protein intake may not be recommended.3 Always consult your medical team before making major dietary changes.
Carbs and Fat are FRIENDS (and food)
So many people fear fat and carbs. It is too bad people won’t give them a chance and get to know them…
…and recognize that there is NOTHING scary about them, they deliver a great deal of benefits, and they are delicious!
Carbs are great for those quick bursts of energy you need during a workout. They also provide fiber, which is critical for digestive health and increasing satiety.
Fat will come in handy during a long, sustained workout as the primary energy source. Fat also provides omega-3s, which are useful for anti-inflammatory effects as well as visual acuity, and additionally is the building block for hormones, like testosterone and estrogen.
The keys are the sources from which you get them. Try to stick to the whole food, lesser processed varieties of fat and low-glycemic carbs, rather than the Frankenfoods that have been sitting on the shelf at the grocery store for ages.
The other key is HOW MUCH of each to eat.
At the end of the day, it truly comes down to what works best for you and your blood sugar management. Maybe fewer carbs work for you but more carbs work for me.
But, after determining calorie and protein needs, try to partition the remaining calories pretty evenly for fat and carbs.
For example, if your calorie requirement is 2000 per day and your protein needs require 800 calories, try to split the remaining 1200 calories evenly between fat and carbs (600 calories each) and work from there to determine the optimal amount for you and your goals.
Exercise is great, but nutrition is the key
Raise your hand if you’ve heard the saying “you can’t out-train a bad diet.”
Maybe you’ve heard it, maybe not. Either way, it is very true. It’s really difficult to overcome a poor nutritional intake. Really, REALLY difficult.
Don’t get me wrong. Exercise is CRUCIAL for a healthy lifestyle and for a successful weight loss initiative. It provides a ton of benefits that otherwise wouldn’t be attainable. But, in isolation, exercise alone will not result in as much weight loss as dieting will.4
However, what if we…dare I say it…utilize BOTH?
Both anecdotally and in the research, combining diet and exercise will result in the best outcomes while also setting you up for sustained success, as ideally, this weight loss should kick off a lifestyle change.
How much should you exercise, and what type of exercise?
If you are just starting out, you don’t want to go from 0 to 100 real quick, because you may burn out or get discouraged. I recommend a combination of resistance training and cardiovascular training for optimal results.
People overlook resistance training in the context of weight loss. This is what is going to help you KEEP your hard-earned muscle mass during the calorie reduction.
That muscle mass will keep your metabolism firing. Your metabolism firing means you’ll burn more calories ALL the time, working out or not!
Recommendation: Make resistance training a STAPLE in your exercise program. For help in designing your first routine, check out my post about how to design a resistance training program.
Combine this with some form of cardiovascular training multiple times a week for 20 minutes – get creative here and find something you enjoy – and you’ve got a recipe for success on the exercise front.
I love insulin…and you should too
When people first are diagnosed with type 1 diabetes, they typically start taking insulin. When they start insulin, they typically gain weight. Therefore, insulin is often associated with weight gain.
Insulin is necessary for people with type 1 diabetes to live. You already know this.
What you probably don’t realize, however, is that insulin is not what is causing weight gain. What causes weight gain is a hamster wheel of blood sugar control issues:
Low blood sugar → correct with carbs (aka calories) → overcorrecting leading to a high blood sugar and a correction bolus → too much insulin → low blood sugar…
The cycle is like a roller coaster that you just can’t get off, seemingly forever. You’re eating more calories than expected for your goals, and suddenly, BAM! There are a few pounds you did not plan to gain, or your weight loss goals derailed.
Yes, insulin is a part of the equation, but not THE WHOLE equation.
I get it: low blood sugars can be tough, and some of them you make you want to eat the whole fridge. But, for lows and weight loss, consider the following idea:
- Keep a “carb/calorie reserve” for lows. If your calorie goal is 2000 per day, consider eating 1900 and leaving those last 100 calories for treating lows. If you end up low, you’ve already built it into your goal as opposed to exceeding it.
- See your blood sugar trending downwards? Consider a decreased temporary basal insulin (if you use an insulin pump). The exact amount for basal decrease is determined through trial and error, but it could ultimately lead to fewer calories consumed to treat your low.
All in all, don’t worry about how much insulin you’re using – worry about keeping your blood sugars in great control and preventing lows, and the insulin amount will take care of itself.
To learn more about the best ways to treat lows, read “How to Treat a Low Blood Sugar (Without Eating Everything in Sight)”.
This journey may seem daunting, but just remember, slow and steady wins the race. Develop good, healthy habits with diet and exercise, focus on optimal blood sugar control, and stick to your calorie goal – the rest will all fall into place.
To lose weight with type 1 diabetes:
- Set realistic goals
- Calculate your daily calorie need and create a calorie deficit
- Consume enough protein and split remaining calories between carbs and fat
- Perform a combination of resistance and cardiovascular training
- Don’t be afraid of insulin. It doesn’t cause weight gain
- Strive to maintain good glycemic levels and have a plan for dealing with lows without over-eating
- Be patient! Healthy and sustainable weight loss takes time
You got this!
Suggested next posts:
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Hi! I’m type 1 (almost 20 years), 51, and in menopause. I’m dealing with the standard weight gain and it’s driving me crazy. I appreciate your post though I tend to eat mostly vegan – a lot of fruits & vegetables as opposed to simple carbs of pasta. Any advice? It’s brutal.
Christel Oerum says
Hormonal changes are challenging. Unfortunately, we don’t have much to add regarding menopause, weight management, and diabetes. But if I find any good scientific-based research on it I will add it
Kathy Rolland says
Love your articles. I have been T1 since 1970, and always struggled with weight until about ten years ago when I lost to a healthy weight and have been able to stay at that weight. I achieved my ideal weight by eating the same calories each day – if I didn’t lose weight, I’d lower the calories until I found a good caloric intake that would allow me to lose about 1/2-1 pound per week. I also walk about six miles per day, which allows for a stable BG. ALSO, I do interim fasting. This helps a lot. Twice per week, I only eat 600 calories in a 24-hour period. This helped me to lose weight on a consistent basis, and I have been following this plan for a few years now to maintain weight.
I hate seeing post that say “ you didn’t gain the weight in x amount of months so you can’t expect to lose it in x amount of months”. The truth is YES I did gain the weight in 4 months therefore I want to lose it just as quick. I was diagnosed at 47 with type 1. When I went on insulin I gained 40 lbs in 4 months. I have been trying for a year to lose and I can only maintain.
I feel mostly the same. Diagnosed with Type 1 and Celiac in Fall 2021 at 49 years old and have gained 40 pounds in the last 6 months also. I gave myself some grace but then got so frustrated at such a rapid weight gain and now struggling to lose even a pound every two weeks. I can’t quit though. I just keep trying. I need to be fit to live a long life. Hope you find something that works for you.
J mazumdar says
As a physiotherapist I noticed people want to reduce the weight very rapidly and finally they just don’t follow any diet plan and walking, cycling or resistance exercises.
I don’t know much about food part, learnt here a lot.
But I can tell you by doing proper walking, cycling, swimming, and resistance exercises with 1kg /2 kg doubles and resistance or loop bands can help them a lot.
But exercises should not be very fast or too much.
Should do daily and within your capacity.
Start first day or first week just two to three minutes, increase gradually. So it will become a habit of doing exercises.
You have to bypass your brain your comfort zone.
J Mazumdar physiotherapist