Adult who can't gain weight

Hey all,

I’m an adult guy (51 years old) who struggles with maintaining weight - I’m 6’2 and weigh 140. Until 6 weeks ago, I was on a keto diet, which i loved for relative simplicity and fairly stable BG, but have to work hard to stay even at 140 lbs. I’d been on keto for maybe almost 10 years, so figured I’d go off it, take a hit on my A1C to try to eat carbs to put on some weight. Just to compare.

So far, in 6 weeks, i’ve managed to put on ~2 lbs, while enduring much worse BG swings. I’m pretty much thinking it’s not worth it and am about ready to go back to keto.

I have non-celiac-gluten-sensitivity, so I don’t eat gluten. I do eat dairy in the form of cheese, though that’s about my only dairy in my diet. When I’ve tracked calories, i can eat 2500 / day without actually gaining weight. OK, the obvious answer is to eat more. I’m just saying, I don’t put on weight easily.

I “came down with” type-1 at age 37. At that time, i weighed 170 lbs, then dropped 30 lbs and have never been able to put it back.

Any ideas that might help me put back some weight, without destroying my A1C? Generally, my A1C is around 6.0, although xdrip tells me that the average over the last month puts me around 6.6. I’d rather it not go higher - my goal here was maybe 6 months to put on weight, then go back to keto. With no success so far really, i’m thinking of going back much earlier.

Thanks for listening! Any suggestions would be welcome!

So just a thought- have you had your thyroid checked? I’m assuming you get it done with your labs but wondering if maybe you have hyperthyroidism? I have the opposite, but do know thyroid things in general are more common in type 1.

Yep, i’ve had my thyroid checked in the past and it’s always been fine. I just had blood work done today and we’re checking again - T3, T4, TSH. Will know probably early next week the results, but in the past it’s been fine, so let’s go with “probably OK” for now. Anything else anybody can think of?

(If we find that my thryoid’s off now, i’ll report back to close the loop.)


Jason @jlecount , I’m also a 140 pound guy who has now shrunk from 6 feet to about 5’ 10"; I’ve lived with diabetes for 65 years and I’m now in my 80s. Several years ago when I was concerned by my low rate I was put on a 4,000 calorie diet which didn’t help much so I gave it up because all that eating “tired me out”. I don’t have any dietary restrictions governed by any condition other than diabetes.

My thought, is that your keto diet, by its very nature may be a cause of your problem. What is “keto”? Think acidosis, which comes about when we don’t produce or inject sufficient insulin for the body to utilize sugar/glucose passing through our body and the body turns to devouring itself for fuel - the first food the body cannibalizes is stored fats and then muscle. That is your weight disappearing and it can be calculated by simple blood or urine testing. It is strongly recommended that anyone eating keto, with or without diabetes, test frequently foe ketone.

Unfortunately, given your dietary restrictions, I’m at a loss for suggesting what you might try.

Thanks, @Dennis – one thing, ketoacidosis and a ketogenic diet are totally different, and my ketones were never over 3.0 or so, and usually around 1.0 or so. My understanding has been that a ketogenic diet is generally muscle-sparing (Very-low-carbohydrate diets and preservation of muscle mass has some detail here, for example.) Given that I eat a “reasonable” amount of meat (some with most meals, eggs in the mornings for breakfast, etc.) I’d be surprised if my body were catabolizing muscle, but honestly, it doesn’t seem impossible.

Granted, however, that I was thinking that the ketogenic diet could have been related - due to gut bacteria changes, or hormone changes, or…anything. So in going off it for the last 6 weeks, I was hopeful i’d be able to put on weight. However, I’ve seen virtually no change in 6 weeks. Too soon to judge? I was thinking it was possible that gut bacteria changes would maybe play a role and maybe take (even much) longer to straighten out.

I don’t currently have a carb / calorie count available (as far as how much i’ve been eating daily) but I should track it for a week or so to at least have that estimate…Maybe it’s just a calorie deficit, regardless of keto vs conventional diet…?

anyway, thanks for the input.


Hi @jlecount . Just wondering if you’ve seen a dietitian for guidance? Another idea would be to consult a gastroenterologist to see if there are any digestive issues.

Thanks! That’s a good idea. That being said, I don’t have any obvious GI issues - from…eh, input to output, everything seems to move well and all. Maybe there’s something subtle however? Worth investigating more for sure. Thanks again.


Hi Jason,
Not an expert here, my son is T1D. If you want to gain weight, I guess you can either add fat or muscle, and most would probably think that muscle might be better. Combined with your diet, have you tried exercising to increase your muscle mass? I have long had issues to keep my weight up, and find that I need to do exercise with the intention of building muscle mass. Your legs and glutes are your biggest muscles, so it might make sense to try to add some muscle there. Of course, you should consult your physician and maybe a trainer to see what you are fit to do. Simple squats using your own weight will help build muscle in your quads as well as lower legs. Situps and pushups will build your upper body, and don’t require any equipment. If you like to walk, that is another way to help build muscle, but it is slower. Stretching is important so you don’t tighten up, and it is usually healthy to do. Again, ask you doctor and maybe consider to hire a trainer for a couple of weeks to get you started.

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