The Surprising Truth About Whether Insulin Make You Gain Weight

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Contents

Insulin and diabetes Insulin and weight gain Managing your weight on insulin

Insulin is a crucial hormone you need to survive. When you eat, your body breaks down food—specifically, carbohydrates—into glucose. And insulin helps that glucose move from your bloodstream into your cells, where it then gets used as energy. Without enough insulin, glucose can build up in your bloodstream, spiking your blood sugar and potentially leading to life-threatening complications, per the Cleveland Clinic.

If you have diabetes, you may need to take insulin because your body doesn’t make any, it doesn’t make enough, or your cells have become resistant to it. Blood sugar can then build up in your body, causing symptoms like increased thirst, extreme hunger, fatigue, and unintended weight loss. Obviously, getting your diabetes under control is priority number one. But it’s natural to have questions: What does this mean for my health and life going forward? And is it true that insulin makes you gain weight?

Your doctor can help you navigate that first question, but the answer to the second is a little bit complicated. We asked experts to explain whether insulin really causes weight gain—and when and why it does.

Insulin and diabetes

If you have type 1 diabetes, your body makes little to no insulin, per the Mayo Clinic. So you need to take insulin to regulate your blood sugar, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). That usually translates to taking insulin several times a day, including with meals. Some people will use an insulin pump, which delivers small, steady doses of insulin throughout the day, while others prefer to give themselves injections.

If you have type 2 diabetes, your body doesn’t make enough insulin to regulate your blood sugar or your cells have become insulin-resistant, per the Mayo Clinic. Some people with type 2 diabetes can manage the condition through lifestyle changes, like diet and exercise. But others may need to take certain medications—or insulin—to keep their blood sugar under control, per the NIDDK.

There are many different kinds of insulin, per the American Diabetes Association (ADA). And your doctor will consider factors like your age, diet, and lifestyle when deciding which type—or combination of types—to prescribe, per the Centers for Disease Control and Prevention (CDC). These include:

Rapid-acting: This form of insulin starts working about 15 minutes after you inject it, peaks an hour later, and lasts anywhere from 2 to 4 hours.
Short-acting: This insulin goes to work within 30 minutes, peaks 2 to 3 hours later, and lasts between 3 and 6 hours.
Intermediate-acting: This type of insulin starts working 2 to 4 hours after injection, peaks after 4 to 12 hours, and lasts for 12 to 18 hours.
Long-acting: Long-acting insulin goes to work several hours after you inject it, does not peak, and lasts 24 hours or more.

Insulin and weight gain

So does insulin actually make you gain weight? It depends on what your health was like before you started taking it, says Rachael Oxman, M.D., M.P.H., endocrinologist at The Center for Endocrinology at Mercy Medical Center.

When your diabetes is untreated and uncontrolled, you may rapidly lose weight—even if you’re eating normally, she explains. “This is really unhealthy,” Dr. Oxman says. “When [people] start insulin, they are finally able to make proper use of the calories and carbohydrates in their food, and with this comes weight regain.”

Mark Schutta, M.D., medical director of the Penn Rodebaugh Diabetes Center, agrees. When your blood sugar is chronically high, “you are in a relative starvation state,” he explains. And this keeps your body from properly absorbing nutrients. In fact, people who experience high blood sugar levels for a (very) prolonged period of time may lose as much as 20 pounds over a few months, he says.

“When you give them insulin, you’re getting their blood sugars under reasonable control,” Dr. Schutta says. “And [they’re] generally going to regain the weight, often within a matter of weeks.” So it may seem like insulin made someone gain weight, when it really just restored them to their normal weight, he explains.

Plus, it can take a little trial and error to strike the right balance between your diet and the amount of insulin you need, says Ronald Tamler, M.D., Ph.D,, endocrinologist at the Mount Sinai Diabetes Center. “If one matches the amount of carbs one is eating to one’s daily needs, weight should stay the same,” he says.

And the amount of insulin you need can also play a role. “Some patients on insulin treatment may still experience weight gain, especially if they have to take larger amounts of insulin to keep up with their body’s needs,” Dr. Tamler explains.

The verdict? Weight gain depends on a range of factors, including how much insulin you need and what your health was like before you started taking it.

Managing your weight on insulin

What’s most important is your body getting what it needs to thrive. And for diabetics on insulin therapy, that means taking insulin as prescribed—not taking less than recommended or stopping it altogether in an effort to lose weight.

“Stopping insulin use in order to lose weight is a dangerous strategy that may lead to an emergency called diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome,” says Disha Narang, M.D., endocrinologist at Endeavor Health Medical Group. Diabetic ketoacidosis (DKA) is a serious condition that can lead to diabetic coma or even death, per the ADA. Hyperosmolar hyperglycemic syndrome (HHS) can also cause a coma, per the National Library of Medicine (NLM).

Instead, experts suggest keeping tabs on what you’re eating. “If you are aiming to lose weight, you can try decreasing the number of carbohydrates in your meals and increasing vegetables and lean proteins,” Dr. Oxman says. That should naturally lower your insulin doses and help with weight loss over time.

If you notice you’re gaining weight and it bothers you, Dr. Schutta suggests checking in with your doctor about the type of insulin you’re using and how you’re timing it. “You can try to anticipate how much short-acting insulin you’ll need before your meal and take it 15 minutes before you eat,” he says. “If you’re able to time it right, you have a better chance of making it peak at the time your blood sugar is peaking—that’s what you want it to do. If you time it that way, you’re ultimately going to need less insulin.”

It’s also a good idea to talk to a dietician who specializes in diabetes management to learn how to optimize your insulin demand, Dr. Tamler says. That can help you “identify high-carb foods” and learn how to adjust your lifestyle to lower your insulin needs, he explains. And Dr. Narang agrees, noting that diets lower in carbohydrates—and higher in fiber and protein—can help you manage your weight.

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