How to Gain Weight With Diabetes
Most diabetes advice is about losing weight, so it can be hard to find help when you need the opposite. Gaining weight with type 1 or type 2 diabetes is possible, but the order matters. First find out why the weight came off, because losing weight without trying can be a sign that blood sugar is running high. Then add calories in ways that are easier on blood sugar: more healthy fats and protein, carbohydrates kept steady and planned, and any change to insulin or other medicine made with your care team.
- Losing weight without trying is a symptom of diabetes, so get blood sugar checked before anything else.
- Add calories mostly from healthy fats and protein: nuts, nut butters, olive or canola oil, avocado, eggs, fish and yogurt.
- Keep carbohydrate amounts steady and planned, since carbs have a big impact on blood sugar.
- Never skip insulin to control weight, and change doses only with your care team.
Why people with diabetes lose weight
High blood sugar. The CDC lists losing weight without trying among the symptoms of diabetes, along with frequent urination and increased thirst and hunger. NIDDK adds that people with type 1 diabetes may have unexplained weight loss, and it lists eating more but losing weight among the common symptoms in children. In type 1 diabetes the body does not have enough insulin to use blood glucose for energy, so it starts using fat instead, which produces ketones. High ketone levels can cause diabetic ketoacidosis (DKA), which NIDDK calls a medical emergency that needs treatment right away.
Medicines. Some diabetes medicines help people lose weight. NIDDK notes that metformin may help you lose a small amount of weight, and that GLP-1 receptor agonists may make you feel less hungry and help you lose some weight. If you are already lean, that effect may not be what you want, but the answer is a conversation with your doctor, not stopping a medicine. NIDDK advises taking diabetes medicines as your doctor instructs.
Other causes. Weight loss can also come from causes that have nothing to do with diabetes. The National Institute on Aging notes that sudden, unintended weight loss can be a sign of problems such as cancer, digestive disorders or some neurological diseases, so a doctor should look at the whole picture before you start a weight gain plan.
Related reading: does metformin cause weight gain and Ozempic and weight.
Never skip insulin to manage weight
Insulin lets the body use food for energy, so cutting back on it can make weight drop for the wrong reason. NIDDK explains that when the body does not have enough insulin, it cannot use glucose for energy and burns fat instead, producing ketones that can lead to DKA. If you take insulin, NIDDK says to match the dose with your food, physical activity and current blood glucose level, because a mismatch can send blood glucose too low.
Weight worries and diabetes can overlap. NIDDK lists eating disorders such as anorexia, bulimia and binge eating disorder among the health problems people with type 1 diabetes may have a higher risk of. If you have been skipping or cutting insulin to control your weight, tell your care team. NIDDK also suggests speaking with a counselor or your primary care professional about mental health. Weight can also move the other way: NIDDK suggests asking your doctor whether your diabetes medicine can cause side effects such as weight gain, and our page on insulin and weight gain covers that side.
Add calories from healthy fats and protein
The CDC explains that carbohydrates raise blood sugar, and that eating carbs with foods that have protein, fat or fiber slows down how quickly blood sugar rises. That makes fats and proteins useful when you need more calories. The American Diabetes Association (ADA) recommends including more monounsaturated and polyunsaturated fats than saturated or trans fats, and it notes that fats are higher in calories per gram, so small portions add up. The ADA's own suggestions include using olive or canola oil in place of butter and sprinkling a few nuts on a salad, yogurt or cereal.
The planner below shows what common add-ins are worth. Tap + for each serving you could add in a day to see the extra calories, protein and carbohydrate. Values come from USDA FoodData Central.
Values: USDA FoodData Central, SR Legacy (per 100 g, scaled to each portion). Carb servings use the CDC rule of thumb of about 15 g of carbs per serving. Count any added carbs in your meal plan, and ask your care team how to fit them in if you use mealtime insulin.
Reading the numbers
- Calories: oils, nuts, seeds and nut butters pack the most calories into the smallest amount of food.
- Carbs and fiber: the CDC notes that sugars and starches raise blood sugar but fiber does not. Hummus, chia seeds and yogurt carry more carbohydrate than oils, eggs or fish, so count them.
- Saturated fat: the ADA's goal is less than 10% of calories from saturated fat, which is why the planner shows it. Cheese adds calories and protein but also more saturated fat than nuts or oils.
- Protein: the ADA points out that some protein foods are higher in fat, while plant proteins may also contain carbohydrates, so read labels.
For more protein ideas, see our list of high-protein foods for weight gain.
Keep carbohydrates steady and planned
The ADA says carbs can have a big impact on blood glucose, and that it is the balance of insulin in your body and the carbs you eat that determines your blood glucose. So adding weight is not a reason to pile on extra carbohydrate without a plan.
- Consistent carbs: the CDC suggests eating about the same amount of carbs at each meal to keep blood sugar steady. It adds that this is not necessary if you use an insulin pump or multiple daily injections, because mealtime insulin is matched to the carbs you eat.
- Carb counting with insulin: if you take mealtime insulin, the CDC says you count carbs to match your insulin dose to the carbs in your food and drinks. Work out any change in carbs with your team.
- How many carbs: the CDC advises working with your doctor or a registered dietitian to find out how many carbs to aim for.
- Choose carbs well: the ADA suggests eating less of refined, highly processed carbs and foods with added sugar, including sugary drinks such as soda, sweet tea and juice. The CDC notes that fruit juice raises blood sugar faster than whole fruit. Check the label of any shake or weight gainer too, since its carbs and sugar count toward your plan.
Meals, snacks and medicines
Eating more often is a common way to fit in more calories, and with diabetes it has to line up with your medicines. NIDDK warns that not eating enough carbohydrate, or skipping or delaying meals, can drop blood glucose too low for people on insulin or certain other medicines such as sulfonylureas. If you add snacks, ask your team how to count them and whether any dose needs to change. The CDC suggests the plate method for balancing vegetables, protein and carb foods at meals, and a registered dietitian can tailor it to your goals.
Build muscle safely
Strength training helps some of the weight you gain come from muscle. NIDDK notes that strength or resistance training may make muscles and bones stronger and suggests doing it two times a week. It also advises checking blood glucose before, during and right after physical activity, because activity often lowers glucose and low levels can last for hours or even days afterward. Ask your health care professional whether you should take less insulin or eat carbs before, during or after exercise. If you are new to lifting, our weight gain workout plan shows a basic weekly routine to review with your team.
Get a dietitian on your team
A plan for gaining weight with diabetes has to fit your medicines, blood sugar targets and food preferences, which is exactly what medical nutrition therapy is for. NIDDK explains that a registered dietitian can provide medical nutrition therapy, including counseling to help you create and follow a meal plan, and suggests asking your health care team or insurance company whether your benefits cover it. The CDC also recommends asking your doctor for a referral to diabetes self-management education and support (DSMES) services, where a diabetes educator helps build a meal plan for you.
The bottom line
With diabetes, gaining weight starts with a check of why it was lost, especially if blood sugar may be high or insulin has been skipped. After that, the safest calories come mainly from healthy fats and protein, with carbohydrates kept steady and counted, snacks timed around your medicines, and strength training for muscle. Keep your care team in the loop for every change that touches insulin or medicine.
Frequently asked questions
- Why am I losing weight with diabetes?
- Losing weight without trying is one of the symptoms of diabetes, often from high blood sugar, and in type 1 diabetes a lack of insulin makes the body burn fat for energy. Some diabetes medicines, such as metformin and GLP-1 receptor agonists, can also lead to weight loss. See your doctor to find the cause.
- How can a diabetic gain weight safely?
- Find the cause of the weight loss first. Then add calories mainly from healthy fats and protein, keep carbohydrates steady and counted as your plan requires, time extra snacks around your medicines, add strength training, and make any change to insulin or medicine with your care team.
- What can diabetics eat to gain weight?
- Good add-ins include nuts and seeds, peanut butter and other nut butters, olive or canola oil, avocado, eggs, fish such as salmon, plain Greek yogurt, cottage cheese and tofu. Most of them add calories and protein with little carbohydrate, and the planner above shows the numbers for each.
- Is peanut butter good for gaining weight with diabetes?
- It can be. Two tablespoons of smooth peanut butter provide about 191 calories, 7 grams of protein and 7 grams of carbohydrate, according to USDA FoodData Central. The ADA lists nut butters among plant-based protein foods and advises reading labels, since products vary.
- Should I eat more carbs to gain weight if I have diabetes?
- Not without a plan. Carbs have a big impact on blood sugar, so it usually makes sense to get more of the extra calories from healthy fats and protein. If you take mealtime insulin, any change in carbs needs a matching plan from your care team.
- Can diabetes medicine cause weight loss?
- Yes, some can. NIDDK notes that metformin may help people lose a small amount of weight and that GLP-1 receptor agonists may reduce hunger and help people lose some weight. Talk with your doctor if weight loss is unwanted rather than stopping or changing a medicine yourself.
Keep reading
References
Sources: CDC: Diabetes Symptoms · CDC: Carb Counting · CDC: Diabetes Meal Planning · NIDDK: Symptoms and Causes of Diabetes · NIDDK: Type 1 Diabetes · NIDDK: Insulin, Medicines, and Other Diabetes Treatments · NIDDK: Low Blood Glucose · NIDDK: Diabetes Diet, Eating, and Physical Activity · ADA: Fats · ADA: Protein Foods · ADA: Understanding Carbs · ADA: Food and Blood Sugar · NIA: Maintaining a Healthy Weight · USDA FoodData Central.