Johns Hopkins Health Alert
Controlling Medication-Related Weight Gain
Some diabetes drugs have an unwanted side effect -- excess pounds.
Diabetes medications that help control blood glucose levels are essential for people with type 2 diabetes. Unfortunately, insulin, sulfonylureas and thiazolidinediones can cause weight gain -- a special concern for many people with type 2 diabetes who are already overweight or obese. Despite the potential for weight gain, these medications are valuable treatments for type 2 diabetes, and when used properly their benefits outweigh their risks. Achieving and maintaining a healthy body weight is an important goal for people with type 2 diabetes. Fortunately, medication-related weight gain can often be remedied with medication and lifestyle changes.
Causes of Weight Gain For People With Diabetes
Weight gain with diabetes medications occurs for a number of reasons:
- Insulin may cause hypoglycemia (low-blood sugar), which stimulates appetite. Intensive insulin therapy may increase episodes of hypoglycemia.
- Sulfonylureas -- such as Diabinese (chlorpropamide), Amaryl (glimepiride), Glucotrol (glipizide), and DiaBeta or Glynase (glyburides) -- may cause hypoglycemia, which in turn stimulates appetite.
- Thiazolidinediones -- such as Actos (pioglitazone) -- cause fat cells to store more fatty acids from the blood, causing the fat cells to enlarge. Thiazolidinediones can cause fluid retention as well, which can increase body weight. (Note: Contact your doctor if you experience fluid retention or sudden weight gain while taking a thiazolidinedione. These side effects may be a sign of heart failure.)
Keeping Your Weight in Check
One option for controlling diabetes medication-related weight gain is to adjust the medication regimen. Studies show that adding the diabetes medication Glucophage (metformin) can help minimize weight gain or even help promote weight loss. Like anyone attempting to lose weight, people with diabetes need to decrease energy intake and increase energy output. Despite all the popular diets and gimmicks that proclaim quick and dramatic results, the only proven way to lose weight and keep it off over the long term is a permanent change in lifestyle that emphasizes healthy calorie restriction and increased exercise.
Starting and Maintaining a Diabetes Weight-Loss Program
If you are ready to begin a diabetes weight-loss program, consult your doctor. He or she can suggest meal plans and physical activities that are appropriate for you. Also, you may need to alter your diabetes medication in response to changes in food intake, exercise and subsequent weight loss.
In general, calorie restriction should be accomplished primarily by reducing fat intake. At the same time, if you have diabetes be sure to keep your carbohydrate intake consistent to maintain good control of blood glucose. Your exercise should include 30 minutes of moderate physical activity (such as brisk walking) on most days of the week. The following suggestions may help you:
- Set realistic goals -- the safest rate of weight loss is 0.5 to 2 lbs. a week.
- Seek moral support and hands-on help from family and friends.
- Make changes gradually so you don’t get overwhelmed.
- Record your progress in a food diary and recall your accomplishments.
- Evaluate your relationship to food to identify the triggers that lead to an inappropriate desire to eat.
- Eat slowly so you’ll feel satisfied with less food.
- Eat three meals a day -- an “all or nothing” approach is difficult to maintain, usually results in overeating, and can interfere with blood glucose control.
- Don’t try to be perfect -- permit yourself an occasional high-fat food day or vacation from your exercise plan.
Posted in Diabetes on September 20, 2006
Reviewed June 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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