Sheri Colberg, PhD
A True Story about a Cause of Slow Weight Gain with Diabetes
I recently had a personal experience with slow weight gain that is worth mentioning. It was concerning to me not only because my clothes were fitting tighter than I like, but also because I have generally been weight stable throughout my adult life. While many people have gained weight during COVID, I am lucky to live somewhere with weather conducive to exercising outdoors all year long. And as you know, I am an exercise physiologist and happily practice what I preach about being active.
However, during the past year when I slowly was gaining some weight, the cause was, at first, inexplicable to me. My weight was slowly creeping up about a pound a month over a six-month period. In my head, I went through all the possible reasons someone like me (who has type 1 diabetes) could be gaining weight:
1. Taking too much insulin. This is always the first thing I consider. Needing to take more insulin can happen for a variety of reasons, including eating more, exercising less, going through stressful times (mental or physical), hormonal changes, and changing insulin types or timing. While I had changed my basal insulin from Lantus to Tresiba, that occurred six months before the weight gain started.
2. Gaining muscle mass from exercise training. While gaining muscle from working out can certainly happen, I have been physically active throughout my adult life but since I had actually been exercising more (greater volume) during COVID times, not less, could it be that I was actually gaining some new muscle mass from training? I know from experience that this was highly unlikely for me, no matter how desirable it would have been. If anything, we’re all slowly losing muscle mass with each passing decade.
3. Doing less daily movement. COVID times have also restricted people from doing many of the activities they normally undertake on a daily base, such as commuting to work or school and getting out of the house. Just having less daily movement can lead to slow weight gain, but in my case, I have been working from home for the past five years. My weight gain was not from doing less daily movement than normal.
4. Having to treat too many hypoglycemic episodes. Training more and becoming more insulin sensitive can result in excess calorie intake from treating lows. When I changed my basal insulins, though, I actually started getting fewer nighttime lows and no longer needed a bedtime snack. Again, it did not appear to be a likely cause for me specifically.
5. Hormonal changes and weight gain associated with aging. Everyone goes through hormonal changes with aging—even men—and it is often blamed for the middle-aged spread many people have. However, aging alone is not a cause of weight gain if you’re taking in the right amount of calories daily. I am finally old enough to be going through the menopausal stage of my life, and it certainly has impacted my insulin needs some, but my personal experience has been to need less insulin, not more, without the normal female monthly cycles and cyclic increases in insulin resistance. Again, I was having trouble blaming one year’s weight gain on age-related changes.
6. Consuming empty calories through alcohol intake. My husband and I undeniably have been trying our best to help support our local wineries by buying and drinking more wine than normal, especially since the pandemic started. Nevertheless, we still draw the line at one 5-oz glass of wine daily, which is only about 100 calories, and my wine intake has been more or less consistent for longer than the past year.
7. Taking in too many calories for other reasons. I grew up with diabetes before there were blood glucose meters and many insulin choices, and I have always been careful about what I eat since I have to balance everything with insulin. At my former university, I also taught fitness-related nutrition for almost two decades, so I understand diet, calories, and body weight connections. Taking in too many calories for any reason—even if it’s just 50 a day—can result in weight gain over time. In fact, an excess of just 50 calories a day (whether it’s from eating more or exercising less, or both) can potentially cause you to gain 5 pounds in a year. Still no immediate answers there for me, though.
In my case, the “Eureka!” moment came last fall when I was complaining to my husband about my slow weight gain. He could have looked at me and said, “Honey, you’re beautiful at any weight!” and I would have laughed in his face. Instead, he said, “I think it’s the chocolate.”
Admittedly, I have always had a weakness for dark chocolate. Even with diabetes, I can barely feel the impact of eating any on my blood glucose, and it hardly ever requires extra insulin. What I realized had been happening, though, is that I was simply eating too much of it. A few bites of Bark Thins (bought from Costco in the large economy bags) here or five dark chocolate almonds there really adds up more than you give those (mostly) empty calories credit for!
So, I went cold turkey and cut out all dark chocolate candy that day. Don’t get me wrong—I have a chocolate tooth. I have continued to drink a half packet of sugar-free hot cocoa mix each morning with breakfast (I don’t like coffee—long story there stemming from my childhood), but I started replacing my after-dinner dark chocolate candy (undetermined amount, but clearly too many calories) with a single sugar-free frozen Fudge Pop (40 calories), which takes much longer to eat and satisfies my chocolate tooth. Life is just better with some chocolate in it.
Within three months of dropping dark chocolate—without any other dietary changes—my weight gain had reversed and I was back down to my previous, more comfortable body weight, where I have plateaued and like to be. The amazing thing is that I didn’t give up wine or eating other things I like or make myself try to exercise even more or go on a diet: I just simply gave up some extra, uncounted calories from dark chocolate, my intake of which was hard to pin down.
If you’re unhappy with your body weight or gained some extra during COVID, maybe now is the time to look at your own dietary patterns and/or exercise participation and figure out what may be causing your calorie imbalance. There are so many possibilities, but I will leave it up to you to figure out your own way to rebalance the intake-output calorie scale that may have a big impact on your weight or your health. Happy hunting!