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The most common myth about diabetes? That it’s exclusively linked to obesity and weight gain. While it’s clear that downing as much chocolate as Augustus Gloop is bad news for your health, the relationship between diabetes and weight is a little more complicated.

In fact, many people living with diabetes lose weight or struggle to gain weight, says Leigh Tracy, RD, LDN, CDE, a dietitian and diabetes educator at The Center for Endocrinology. (Just when we thought we had it all figured out.)

According to Tracy, this unintentional weight loss can be a result of losing fluid and sugar (aka glucose) during bathroom breaks. (Reminder: Diabetes typically makes you have to pee a lot.)

Meds could also be the culprit. Sometimes a new prescription can make you gain weight, and then you lose it again once your body adjusts.

Whatever the cause of your weight loss, your doctor may ask you to work on getting your weight back up. Instead of swan-diving into a pile of french fries, we recommend the following doc-approved methods:

Gaining weight can come with risks, especially if you treat it like a Vegas buffet.

To keep your blood sugar in check, it’s essential to follow a healthy diet full of nutrient-dense food that’s also higher in calories and includes carbs that are lower on the glycemic index.

Make sure to talk with your doctor or a dietitian before you change your diet and exercise plan to gain weight.

1. Find your number

In some ways, gaining weight is similar to losing weight: You need to know what your ideal number is and how much you need to gain to get there.

Start by comparing your current weight and BMI to this calculator from the CDC. Based on the results, set one overall goal that states the total amount of weight you want to gain. Then, set several mini-goals that involve gains each week and month.

2. Make a date with a dietitian

Whether you’ve tried to gain weight on your own and failed or you just want to start off on the right foot, making an appointment to see a registered dietitian who specializes in diabetes might be exactly what you need.

When choosing an RD, look for credentials that point to a specialization in diabetes education, such as CDE (certified diabetes educator).

3. Crank up the calories

Determine the number of calories you need to eat each day for weight maintenance, and then add 500. The Dietary Guidelines for Americans outline estimated calorie needs per day by age, sex, and physical activity level.

4. Fill your plate with nutrient-dense foods

Getting the green light to up your calorie intake doesn’t mean you have permission to eat everything in sight. Sure, loading up on sugary and fatty foods will help you pack on the pounds, but eating a few pints of ice cream every day is not the way to go.

So, what should you focus on? When planning your shopping list, make sure it’s full of nutrient-dense whole foods that are also high in calories.

5. Eat like a hobbit

Instead of eating breakfast, lunch, and dinner, make like the Shirelings and throw in an elevensies, afternoon tea, and supper.

Build your diet around four substantial meals, with two snacks — one midmorning and one before bed. Each meal should be nutrient- and calorie-dense, with the final meal being enough to hold you until the morning.

6. Get swole

If you haven’t already, it’s time to get familiar with the weight room (or at least a couple of machines). For optimal health, the weight you gain should include muscle, not just fat, which means hitting the weight room at least 3 days a week.

Aim for exercises that target all your major muscle groups, and focus on a resistance level that is challenging but doesn’t leave you gasping for air.

7. Swipe right on low-GI carbs

If you’re trying to increase the number on the scale, there’s nothing wrong with slipping a few extra sources of complex carbohydrates into your meal plan.

But if you do carb up, make sure the majority of your choices are lower-glycemic-index carbs, which won’t spike your blood glucose levels.

Oatmeal, yams, beans, legumes, whole-grain bread, whole-grain pasta, and brown rice are just a few top picks from the American Diabetes Association.

8. Go pro(tein)

If you’ve dialed it up in the weight room, make sure your diet is rich in lean sources of protein to help support muscle growth. For active adults, the American College of Sports Medicine recommends a range of 0.5 to 0.8 grams of protein per pound of body weight.

That’s quite a bit more than the recommended dietary allowance for the average adult, which is 0.37 grams per pound of body weight. To hit this number, opt for around 7 ounces of meat, poultry, or fish at mealtimes.

BUT — this is a big ol’ but — consult with your doc before going HAM on protein.

Since people with diabetes have an increased risk of developing kidney problems, you need to be mindful of how much protein you’re actually consuming. A healthcare professional can help you figure out exactly how much to eat each day.

9. Make friends with fats

When it comes to increasing calories, you can’t argue with math. Gram for gram, you’ll get the most bang for your buck by eating healthy sources of fat. That’s because, unlike carbs and protein, which have only 4 calories per gram, fat has 9 calories per gram.

Stick to healthy fats like monounsaturated and polyunsaturated fats. Tracy recommends adding nuts, seeds, avocado, and oils such as olive oil to meals and snacks to increase your caloric intake.

10. Remember, there’s an app for that

Rather than play the nutrition guessing game each day, why not try an app designed to help you track your macros and calories? Even though some of these food trackers are designed for weight loss, anyone can use them.

And the best part? Most of them are free. Some of the top trackers include MyFitnessPal, Calorie Counter by FatSecret, Lose It!, SparkPeople, and MyNetDiary.

11. Ditch the diet food

…at least for now. Diet soda, low calorie drinks, and even coffee and tea can temporarily fill your belly without providing any real calories. To avoid filling up on fillers, eliminate (or at least limit) low and no-calorie foods and drinks.

12. Take snack time seriously

You did in kindergarten, and you def should now.

Make snack time count by choosing nutrient-dense foods like whole grain avocado toast, apple slices with nut butter, full fat Greek yogurt, or nuts and seeds (try a mix of walnuts, almonds, cashews, macadamia nuts, pumpkin seeds, sunflower seeds, and chia seeds).

Fun fact: One small serving of nuts can net you 180 calories. Win!

13. Shake it up

Whenever possible, opt for whole foods. But on those days when squeezing in one more meal doesn’t seem likely, you can always blend up your calories.

You can make any of these delish recipes at home or reach for a store-bought supplement shake, says Tracy.

Before you hit up the grocery store for some extra sources of fat and calories, make sure to talk with your doctor about any changes to your diet.

Since they manage your diabetes treatment plan, getting the green light from them can help you avoid any dangerous dietary mistakes. Plus, they’ll likely have suggestions for healthy ways to gain weight.

Tracy says you should also check in with your doctor if you’re experiencing any of the following red flags:

  • losing weight without trying
  • excessive thirst
  • frequent urination (more than usual — for some people, urinating eight times per day is normal, so anything more than that is unusual)
  • excessive hunger (you’re constantly eating but are still very hungry)
  • blurry vision
  • cuts and sores that are slow to heal
  • extreme fatigue

Bottom line

  • Gaining weight while managing diabetes is not impossible, but it may require an extra dose of patience and some serious planning skills.
  • Consider working with a registered dietitian, who can help you create a diet that aligns with your diabetes treatment and fits your lifestyle.
  • Remember to always consult your doctor before making any dietary modifications.