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.
BE PATIENT.
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.
Guess what?
That muscle mass will keep your metabolism firing. Your metabolism firing means you’ll burn more calories ALL the time, working out or not!
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 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)”.
Summary
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!
Mom wanting to help
My 17 year old daughter has had T1D since age 4, and Hypothyroid since age 13. She is struggling with rapid weight gain (25 lbs this year), lethargy and not wanting to exercise, severe acne and her worst A1c on record. Thyroid blood work seems in range. She has always been so diligent, and now seems to have lost her will in this. How can I help motivate her?
Christel Oerum
Oh, I’m so sorry to hear that she’s struggling. Have your medical team talked to you about burnout (https://diabetesstrong.com/diabetes-burnout-why-it-might-not-be-what-you-think-it-is-and-how-to-work-through-it/). Could be that she struggling with that. Maybe meeting others with type 1 her age can give her a push in the right direction.
As for managing her weight. You probably know this, and I’m sure you’re already doing everything you can to make sure she has a healthy relationship with food, but an alarmingly high percentage of people with diabetes develops a disorted relationship with food. If you are interested in working with a registered dietitian who also lives with type 1, I recommend reaching out to our Fitness editor Ben Tzeel (ben@diabetesstrong.com)
Filipa Montano
Hi all I have been a diabetic for over 19 years had three kids and find a very hard to lose weight also very hard to manage my sugars I would love to know what’s the best diet while on let’s not call it a diet what is the best thing to do to eat healthy and to lose weight? I find myself struggling in different diets and all it does is raise my sugars because maybe I’m not doing things right I need some kind of guidance like a meal plans that I can follow off every single day or just really need help it with some guidance.
Christel Oerum
Ultimately, what you need to do to lose weight is to manage your blood sugars fairly tightly and be in a calorie deficit for a long enough time. You can use any of the meal plans here or create your own consisting of the foods you like.
To know if you’re truly in a deficit I’d suggest tracking all your food and calorie drinks (I like MyFitnessPal) and if you don’t lose on that amount of calories, then you reduce it (e.g. 200 calories) and try that out for a while.
The thing to note though is that weight loss takes time, and I find that to be even more true for us living with diabetes
Maria John
My mother is suffering from type 1 diabetes. And it is very difficult for her to manage her regular diet. Drinking a lot of water is very helpful in maintaining the insulin value. Thank you for sharing the wonderful article.
Rhonda
I’m a type 1 for 36 years. I’ve been trying for a year to lose weight. According to the calorie calculator I “need” 3200 calories. I only eat between 1200-1400 a day. I’ve been doing low carb high protein (in addition to anything I can find that might make a difference). I’ve not lost 1 single pound. I’m extremely frustrated and don’t know what else to do!! Any suggestions?
Christel Oerum
That’s frustrating! Remember the calculator is a way to assess your starting point, and if you’re already eating much less I’d start there.
A few things to consider:
– How long have you been dieting? Some people (especially when living with diabetes) don’t start to see results until the 4-week mark. We need time to adjust our insulin and generally injecting insulin just means that it will take longer
– If you’ve been in a calorie deficit for 4 weeks with no results; make sure that you’re actually only eating that amount of calories consistently. I suggest measuring and weighing everything including the liquid calories
– If you’ve been in a calorie deficit for 4 weeks with no results; Have your thyroid checked, if your hormones are off you might need them corrected before you’ll see any weight loss
– If you’ve been in a calorie deficit for 4 weeks with no results; consider increasing your calories slightly. When we diet really hard we put a lot of stress on our bodies and stress is very counterproductive when it comes to weight loss. I’ve seen people start to drop weight when they went up 100 calories
– If you’ve been in a calorie deficit for 4 weeks with no results; Try changing up the way you eat and exercise
These are just a few tips. Since I don’t know your whole journey it’s hard for me to pinpoint what to change but these are good places to start. Hang in there, I know it’s hard, but it can be done
Jess
Hi,
Just found this website. I’m a type 1, I’ve been diebetic for a year, but ever since then I’ve been gaining weight, I’m only 17 however gaining weight is so fustrating. And all the weight I get is on the lower part of my stomach. Could this be because of by insulin injections because I do them on my stomach ? Do you have any tips ? I’m also a full time student and I hardly have the time to exercise at the moment ! Thank you
Christel Oerum
Weight gain can be really frustrating, I get it! First thing I’d recommend you do is figuring out why you are in a calorie surplus. Ultimately you’re eating more than your body needs to maintain your weight which is why you’re gaining weight. I’d suggest you track your food and calorie drinks for 5-7 days (only track if that doesn’t trigger any unwanted eating behaviour), in an app like MyFitnessPal or LoseIt. Then review what you’ve eaten, you’ll most likely be surprised and find where you can cut back.
You don’t need to exercise to lose weight but it will speed up the process and ensure that you maintain muscle mass. It can also help you with improving insulin resistance which could be one of the reasons you’re holding more fat in your belly.
BUT the first step is to figure out your calorie intake and to make sure that you’re keeping your blood sugars in range. Then adjust calories, make sure to get enough sleep and add a little exercise
Rosa Mut Monfort
I’m 27 and diabetic for the last 16 years. I’m now currently strugling to keep my weight and my BG under control. Every time I hit the gym I get an hypo even when I have a snack beforehand and stop my pump a while before starting the activity. The more I exercise the fatter I get and the worse my glucose control. I feel like I have no control over my body/life. What would you recommend?
Christel Oerum
Hi Rose, that’s a frustrating pattern to be caught in. First I’d recommend you spend some time figuring out how much to reduce your insulin before exercise. You might need to do a reduction up to 4 hours before. I recommend sticking with the same type of activity for a while (and the same time a day) and taking structured notes. And remember some types of exercise are less likely to induce low blood sugar, doing resistance training might be a good option for you (and highly recommended when it comes to weight loss especially for us living with diabetes).
But most important for weight loss is that you have to be in a calorie deficit. To know if you are, I recommend tracking your food and drinks and make adjustments when you understand your baseline
ian
I am 20 years old and have had type 1 diabetes since 5th grade i have always been a very athletic kid, 3 sport varsity athlete and i am no stranger to the gym but for some reason the only notable fat i have on my body is the lower part of my abs i cant get rid of it. what can i do to change my 4 pack to a 6 pack.
Christel Oerum
Only, non-procedure way is to reduce your overall body fat. That means being in a calorie deficit for a while and keeping your BGs in range as much as possible
Susan
Found your website and have been reading …. my daughter is an athletic type 1. Loves lifting weights, and all things athletic. She’s been a diabetic for 17 years now (she’s 28). The frustrations she’s always had with the roller coaster BS #’s and exercise. She’s trying hard… she writes her own little blog, and with writing stuff down, that helps her.
I noticed a photo (gray pants, green top…. you’re lifting weights) that you are in — the exercise pants have a side pocket… just what she’s looking for. Wondering if you could tell me the brand of pants these are and if they’re of thick material or thin (see thru.. not good). She’s not wanting to spend an arm and leg to purchase either.
Thanks, from her mom
Christel Oerum
Those pants are from Athleta. It’s an old pair so you can’t get that exact style anymore. But I have several of their pants with side pockets and they’re all really good quality (which is why they last me for years). The ones I have are a little thicker material than most workout pants, so they’re not seethrough as some other brands
Rebecca
As a T1D of 20 years this site is a gift. Thank you for developing this and making it all so accessible/
Christel Oerum
Thank you Rebecca – a comment like yours makes all the work we put into the site worth it
Michael
I have type 1 diabetes for 50 years. I grew up playing sports as well as doing different kinds of exercises. Some people with type 1 diabetes complain that they gain weight since of insulin. They gain weight since they do not exercise at all. Your article is very interesting to read.
Christel Oerum
Hi Michael,
When it comes down to it, it’s what you eat and your activity level that will determine your waistline. However, genetics of course also play a role. Glad you found the article interesting
Rebecca
wow Michael that is a harsh assessment of weight gain with insulin/ Perhaps you should understand some of us have hormonal issues that cause nothing but daily battles with weight gain, even with daily exercise and a super healthy eating plan. Perhaps instead of persecuting your fellow T1D.s you could share you r success and how you manage to be so active and maintain good BSL;s/
Maryann Friesen
I am gaining weight and it’s sooooo frustrating.
It’s all on my tummy
Peanut butter sandwiches for night
Help