Why Is My Mother Gaining Weight Despite Diabetes Management?

Q: Why Is My Mother Gaining Weight Despite Diabetes Management?

Hello, in response to your question： <br>1. <br>The reasons for weight gain include dietary habits, patterns of physical activity, and differences in energy metabolism. <br>It is essential to first consider and evaluate the impact of diet, exercise, lifestyle, and environmental f

Why do I keep gaining weight?

Hello: My mother has been a diabetic for over ten years.
In the past year, her weight has increased significantly (currently weighing 60.5 kg; height approximately 150 cm).
Are there any other health issues that could be causing this? By the way, my mother was hospitalized earlier this year for thyroiditis but has fully recovered.
Could the corticosteroid medication she received at that time be affecting her? During her regular check-ups every three months, her average blood glucose level was 9.1, which is relatively high, but all other values are within the normal range.
However, her appetite has not increased, yet her weight continues to rise.
Could there be other underlying conditions contributing to this?

c188, 30~39 year old female. Ask Date: 2005/09/09

Dr. Xiao Yongxun reply Internal Medicine

Hello, in response to your question:
1.
The reasons for weight gain include dietary habits, patterns of physical activity, and differences in energy metabolism.
It is essential to first consider and evaluate the impact of diet, exercise, lifestyle, and environmental factors before considering genetic factors (such as Prader-Willi syndrome), medications (such as steroids, antiepileptic drugs, tricyclic antidepressants, and antipsychotics), and endocrine disorders, among others.
2.
The weight gain of your mother is related to the various factors mentioned above, particularly thyroiditis and the use of steroid medications, and it also involves the management of diabetes.
Therefore, it is advisable to take her to a metabolic specialist or a family physician for a differential diagnosis of the underlying causes.
It is not appropriate to jump to conclusions.
3.
Additionally, an HbA1c of 9.1% indicates an average blood glucose level of approximately 210 mg/dL, which is still far from the ideal target of 7% (or even 6.5%).
Efforts are needed to improve this, and it is recommended to discuss this with her family physician first.

Reply Date: 2005/09/09

More Info

Weight gain in individuals with diabetes can be a perplexing issue, especially when one might expect that managing diabetes would lead to weight loss or stabilization. In your mother's case, several factors could be contributing to her weight gain, despite her diabetes management.

Firstly, it is essential to consider the role of insulin in diabetes management. Insulin is a hormone that helps regulate blood sugar levels, but it also promotes fat storage. If your mother is on insulin therapy or other medications that increase insulin levels, this could lead to weight gain. Additionally, if her blood sugar levels have been consistently high (as indicated by the HbA1c of 9.1), her body may be in a state of insulin resistance, which can also contribute to weight gain.

Moreover, the use of corticosteroids, which your mother received during her treatment for thyroiditis, is known to cause weight gain. Corticosteroids can lead to increased appetite, fluid retention, and changes in fat distribution, often resulting in weight gain. Even after the treatment for thyroiditis, the effects of corticosteroids can linger, and it may take time for her body to return to its baseline state.

Another factor to consider is the potential impact of thyroid function on weight. Although your mother has reportedly recovered from thyroiditis, thyroid hormone levels should be monitored regularly. Hypothyroidism (underactive thyroid) can lead to weight gain, fatigue, and other metabolic issues. If her thyroid levels are not optimal, this could contribute to her weight gain despite her efforts to manage diabetes.

Lifestyle factors also play a crucial role in weight management. While you mentioned that her food intake has not increased, it is essential to evaluate the quality of her diet. High-calorie, low-nutrient foods can lead to weight gain, even if portion sizes remain the same. Encouraging a balanced diet rich in whole foods, vegetables, lean proteins, and healthy fats can help manage weight better. Additionally, physical activity is vital for weight management, but if your mother has knee issues, this may limit her ability to exercise. It would be beneficial to consult with a physical therapist or a healthcare provider to develop a safe and effective exercise plan tailored to her needs.

Lastly, psychological factors such as stress and emotional eating can also contribute to weight gain. If your mother is experiencing stress related to her health or other life circumstances, this could lead to changes in eating habits that promote weight gain. Addressing mental health and emotional well-being is just as important as physical health in managing diabetes and weight.

In conclusion, your mother's weight gain could be attributed to a combination of factors, including medication effects (especially corticosteroids), potential thyroid dysfunction, dietary habits, physical activity levels, and psychological factors. It would be advisable to consult with her healthcare provider to conduct a thorough evaluation, including blood tests to check her thyroid function and a review of her diabetes management plan. A registered dietitian can also provide personalized dietary advice to help her achieve a healthier weight while managing her diabetes effectively.

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