How to dance with the devil without losing a leg. Diabetes is not the end of gaining. In fact for some, diabetes marks the beginning of their serious weight gain. Many gainers I know have had diabetes for years or even decades and have continued to gain well past 400 or even 500 pounds. These people are not legless cripples; in fact, many are gainers you all know and follow on Tumblr, YouTube, or other sites. They just haven’t told you since talk of diabetes is the third-rail of gaining. (And anyway it’s really nobody’s business but theirs.) I asked a few of these diabetic gainers for help in writing this article.
Diabetes is a manageable disease. Very manageable. Easily manageable. Despite this, most people with diabetes do not manage it. When you hear about people losing a foot or a leg to diabetes, when you hear about people suffering with burning pain in their hands and feet with no relief in sight, you’re hearing about people who have not managed their diabetes—or more accurately, managed their blood sugar.
Managing diabetes means keeping your blood sugar within a particular range. In normal folks, their pancreas takes care of this automatically by releasing the appropriate amount of insulin, a hormone that unlocks muscle and fat cells and allows the sugar in the blood to enter and power the cell. People with Type 2 diabetes produce insulin, but for some reason, the insulin fails to unlock the cells. (The inferred cause is “insulin resistance,” meaning that the cells become unresponsive or resistant to normal amounts of insulin. However, the reason cells would resist insulin is poorly understood.) The blood sugar from digested food isn’t getting to the cells to power the body, so it builds up in the blood stream.
I should make it clear that you can have Type 2 diabetes and not be fat; you can be fat and not have Type 2 diabetes. Also, you can’t give yourself diabetes by eating the wrong foods. Medical science doesn’t know exactly what causes diabetes, but it seems clear that no single factor is responsible.
Diabetes is the diagnosis, not the problem. A diabetic person produces insufficient insulin to control their blood sugar. However, the actual problem is that when blood sugar gets too high, it starts destroying nerves and tiny blood vessels. Left unchecked, high blood sugar cuts off sensation and circulation, leaving the skin, hands, feet, muscles, organs, even whole bodily systems to rot and die. Really, I can’t understate the toxicity of uncontrolled high blood sugar. But again, the problem is not diabetes per se. The problem is the failure to manage one’s high blood sugar. Diabetes is simply the name for the body’s inability to control it automatically. Losing body fat is the common advice for curing diabetes, but as I said, you can be thin and still have diabetes. Fortunately today, there are many (many!) options for controlling high blood sugar including various oral medications and injectable insulin. Diabetes is not a problem if blood sugar is under control.
Managing your blood sugar is easy, but it does take a bit of commitment. You have to carry your kit with you. You’ve got to prick yourself and measure your blood sugar. Then you have to prick yourself again to administer the correct amount of insulin. While that might sound inconvenient and uncomfortable, it’s certainly not difficult or time consuming. The process takes literally seconds. (I have a gainer friend who shoots his insulin in mid-conversation when we’re at a restaurant.) Your doctor probably also has some pills for you to take a few times a day. That’s it. Follow the protocol that you and your doctor devise, and you should have no problem.
The Shame of Diabetes. I remember I got a phone call for a close gainer friend. He had just received the news from his doctor that he was diabetic, and my friend was in tears. He’d been “pre-diabetic” for many years, but finally his doctor told him that his latest test ranked him as diabetic. The diagnosis represented many things for my friend: shame, failure, loss, guilt, and most of all “what now!?” He’s dealt with all those beautifully, and is now well over 400 pounds five years after his diagnosis. He takes his insulin very seriously and has consistently normal blood sugar levels (a1c = 5.7) He told me to tell you this: “Getting diabetes means facing the shame of the diagnosis. Managing it means growingup and dealing with it like an adult.”
Here are 3 reasons people don’t manage their diabetes.
- I shouldn’t have to. Many people resent the fact that they can’t just do as they like, and they see managing their diabetes as an unreasonable burden. They may even see their doctor as a bully or a nag. Have you ever had a roommate who refused to put things away after he used them? Do you know someone who leaves clothes on the floor exactly where they took them off even though the hamper is six feet away? You’ve told them a thousand times, but it makes no difference. They have some excuse, or roll their eyes, or just nod in seeming agreement but nothing changes. Those responses are the adult equivalents of “you can’t make me!” or “I don’t have to if I don’t wanna!” These are often the people who find it too much trouble to manage their blood sugar even though their lives depend on it.
- I’m ashamed to. Some gainers I’ve talked to tell me about dealing with the shame of a diabetes diagnosis. They feel as though they’ve done it to themselves, and the wages of the sin of gluttony must now be paid. For those who already feel ashamed about being or getting fat, diabetes seems a fitting punishment—their just comeuppance. Doctors too almost seem to gloat when they can deliver the diagnosis of diabetes to a patient who’s been getting unrepentantly fatter. Gainers dealing with the shame of diabetes are the first to retreat from getting fatter, but those who continue to gain often avoid their shame by avoiding their treatment. They don’t want to be seen taking insulin. They don’t want to carry it and have to explain it. They don’t want to succumb to the double shame of obesity and diabetes. They don’t want to tell Mom.
- I’m not worth it. Many gainers and encouragers are all too familiar with the self-loathing fat person. We’ve seen those online profiles of guys who seem to have chosen to look their worst on their profile pics. It’s unfortunate, but many fat people have given up on their appearance or their health because they believe it’s a hopeless effort. The guy who doesn’t think it’s worth putting on a clean shirt or who believes that a bad picture of himself is a fitting representation might also be the person who doesn’t think it’s worth managing his blood sugar protocol either.
Your doctor, your diabetes. Your doctor wants what’s best for you, but the two of you may not agree on what “best” is. A gainer friend of mine in Europe was heart broken when he got his diabetes diagnosis. He worried that he’d never feel sexual again, and the idea of losing the weight he’d worked so hard to gain filled him with despair. We talked about what he might do, and in the end, he decided to bring the issue to his doctor. He was quite frank. He told his doctor that given he was unwilling to lose weight, and in fact likely to gain even more, what were the medications or treatment options to keep his blood sugar under control? While his doctor was not happy about my friend’s choice not to lose weight, he did comply with the request. Today my friend is nearing 500 pounds and keeps his blood sugar in check.
Diabetes as a gainer’s best friend. I know that’s a provocative idea, but I’ve heard it from more than one diabetic gainer. One told me, “I couldn’t have put on these last 200 pounds without diabetes.” Remember when I said that insulin is the key that unlocks the cells to accept nourishment? Well, in fat people, it mostly unlocks fat cells. In fact, it’s pretty accurate to say that insulin is like steroids for gainers: It’s a hormone that piles on fat. So having diabetes will get you a legal prescription for a hormone that will make you fatter. That’s one reason physicians are so reluctant to prescribe insulin and do so only after other more conservative measures have been exhausted. Diabetics on insulin almost always end up even fatter. Now, make no mistake: Insulin is a very powerful hormone that will kill you if you don’t take it seriously. On the other hand, so will water if you’re in the deep end of the pool and don’t know how to swim.
By the way, many of the gainers I talked for this article are over 40. One was over 60. I mention this in case you’re wondering whether this is fine for a young guy in his 20s who might be able to bounce back but a death sentence later on. It’s very common to think of gluttony as a sin that must one day be atoned for. (In fact, this is a common erotic fantasy for many gainers.) However, a more useful idea is simply to manage your body and your life to their greatest fulfillment rather than put oneself in a position of rewards and punishments, sins and virtues.
Why go through all this just to be fat? Well, I can’t answer that for you. I think the best I can do is pass on some advice from one particular diabetic gainer friend of mine. He’s been managing is diabetes for over 20 years now, and has put on most of his 470 pounds in that time. He said, “It’s a lot easier to get the medication you need and change how your body processes sugar than to try to change who you are.”