23/06/2024

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Should You Get a CGM for Weight Loss?

Should You Get a CGM for Weight Loss?

Continuous glucose monitoring (CGM) technology has revolutionized diabetes management, providing real-time insights into blood sugar levels for individuals with diabetes. While CGMs have immense benefits for this specific population, the idea of using them for weight loss among the general public has become more popular. This blog critically examines the potential risks and limitations of repurposing CGMs for weight loss. 

The foundation of CGMs: Diabetes management

Continuous Glucose Monitoring (CGM) systems are advanced medical devices that monitor glucose levels in real-time.They’re made up of a tiny sensor that is inserted under the skin to measure the amount of glucose in the interstitial fluid. A receiver or smartphone receives data from the sensor, which provides ongoing updates on blood sugar levels. By providing a dynamic view of glucose swings, this technology enables people with diabetes to make educated decisions about their food, insulin dosage, and overall diabetes management.

CGM for weight loss review
CGMs are a huge improvement in blood sugar management

For diabetics, real-time blood sugar monitoring through CGMs offers precise and up-to-the-minute information on glucose levels.This accuracy enables prompt actions to stop potentially harmful spikes or dips, improving glycemic control. Additionally, CGMs offer insight into how certain foods and lifestyle choices affect blood sugar, enabling individualized treatment strategies. Rapid changes that are detected early can help prevent severe hypo- or hyperglycemia, thereby lowering the risk of complications from diabetes.

The connection between blood sugar and weight 

The intricate relationship between blood sugar levels and weight gain reveals a complex interplay that goes beyond simple caloric intake. 

Blood sugar rises after we eat proteins and carbs (and in particular, with carbs). This is a completely normal response, and not one we should aim to avoid. When blood sugar rises, the body releases insulin to facilitate glucose uptake into cells. Again, totally normal response, and most of us, especially those of us without diabetes, don’t have to micromanage or even worry about this bodily process.

What we do generally want to avoid, is having large blood glucose spikes throughout the day. These are thought to lead to an increased risk for cardiovascular disease (although a diet that causes large insulin spikes is likely highly refined, which is also a risk factor for heart disease).

For some people, consumption of large amounts of highly refined carbohydrate foods can lead to weight gain, which is one of the primary risk factors for insulin resistance.

Insulin is not the evil monster that a lot of social media personalities make it seem. The Carbohydrate Insulin Theory – which states that weight loss can not occur when insulin levels are elevated (and therefore we should all be eating a low-carb diet) – is questionable. Both low carb and low calorie diets work for weight loss when they’re sustained over the long-term, leading many reputable researchers to believe that it’s calorie balance, not insulin, that is responsible for weight loss.

In fact, the recent DIETFITS trial concluded that not only do low-carb and low-fat diets produce similar results for weight loss, but insulin levels do not impact weight loss. Some interpretations argue that both groups had a reduction in glycemic load which then led to weight loss.

Interestingly, the DIETFITS study was partially funded by NuSci, which was founded by Dr. Gary Taubes, a low-carb advocate and champion of the carbohydrate-insulin theory of weight loss.

We do know, however, that ultra-processed, refined foods are metabolized quicker and offer more energy aka calories to the body over less processed options. While I’d never recommend cutting ultra-processed foods out altogether, limiting them is something we should all strive towards.

Read about why I want you to eat processed foods.

Both high and low blood sugar levels wield a significant influence over cravings, energy levels, and overall eating habits. When steep blood sugar spikes and crashes occur, particularly after consuming sugary or refined carbohydrate-rich meals, the body experiences a shift in energy. This rollercoaster effect can lead to heightened hunger, cravings, and an increased likelihood of overeating. 

These fluctuations in blood sugar levels  can instigate a vicious cycle of poor eating habits. The quest for quick energy fixes through sugary snacks can lead to further blood sugar spikes and crashes, perpetuating unhealthy patterns. As a result, fostering stable blood sugar levels through balanced meals rich in complex carbohydrates, fiber, protein, and healthy fats becomes pivotal in curbing cravings, sustaining energy, and promoting overall healthier eating habits.

CGM for weight loss review

Using a CGM for weight loss

The future of CGM technology seems to be shifting to prospects in the realm of weight management. Ongoing research is delving into more intricate aspects of glucose fluctuations and their relationship with metabolism and weight. 

Advanced algorithms are being developed to enhance the predictive capabilities of CGMs, offering individuals real-time insights into how different foods and activities impact their blood sugar levels. 

The current IRB study with 50,000 participants is collecting data CGM data over 5 years to determine if the use of CGMs can help people with weight loss, with a 1 year follow up period. Both men and women 18 years and above are eligible for this study along with other specific criteria.

The estimated study completion date is November 2027. This study is considered a clinical trial and it is looking into the use of CGM’s in the non-diabetic population to compliment Signos mobile health platform. 

Primary outcome measures include determining the average fasting glucose and the change in weight in number of pounds. Secondary outcome measures include body composition such as percentage of body fat. Another secondary outcome measure is percentage of time spent in range glucose levels less than 140. 

CGM for weight loss review
Normal blood sugar levels are 70-110 mg/dl or 4.0-7.0 mmol/l

While the primary purpose of CGMs remains diabetes management, their potential applications for weight management are being explored. CGMs can provide data on how specific foods and dietary patterns affect blood sugar levels, offering a personalized approach to weight loss. By understanding how certain foods cause rapid blood sugar spikes or crashes, individuals can make more informed choices to stabilize their energy levels and reduce cravings.

While it can be informative to see what effects different foods have on our blood sugar personally, I honestly don’t think non-diabetics need to use CGMs for weight loss or overall health. Choosing more whole and minimally processed foods, fewer sugary beverages and less alcohol, and being active as much as possible are all basic steps to better health and weight loss that many of us haven’t yet mastered.

If you don’t have the basics down, a CGM isn’t going to magically help you.

CGM for Weight Loss: Potential Challenges and Considerations

As the concept of repurposing CGMs for weight loss gains traction, it is crucial to address the potential challenges and considerations associated with this approach. While CGMs have proven immensely beneficial in diabetes management, their application to weight loss demands a careful examination of the limitations that can arise. 

1. Overemphasis on Numbers Over Well-Being

One of the primary concerns when using CGMs for weight loss is the risk of fixating solely on blood sugar numbers, potentially overshadowing the broader aspects of health and well-being. Placing excessive importance on data-driven outcomes might lead to a narrow perspective of overall wellness. A focus on glucose levels may divert attention from essential factors such as mental health, emotional well-being, and sustainable lifestyle habits.

2. Unrealistic Expectations and Quick Fixes

While CGMs can provide real-time insights, expecting them to be a complete tool for weight management oversimplifies a complex issue. Weight loss encompasses multifaceted elements, including dietary choices, physical activity, sleep, and stress management. It should also include self-regulation and hunger and fullness cues, as well as satisfaction and satiety from meals.

Relying solely on CGM data might inadvertently promote the notion that weight loss can be achieved through technology alone, neglecting the importance of goal setting and long-term approaches. Increased data and awareness is not enough to change behaviour! CGMs are not the be all end all of weight loss and can be seen as unrealistic. 

3. Disordered Eating and Emotional Impact

The potential for CGMs to trigger or exacerbate disordered eating behaviors is a critical concern. Constant monitoring of blood sugar levels might inadvertently encourage obsessive behaviors around food intake and exercise, contributing to an unhealthy preoccupation with numbers. Moreover, the emotional toll of striving to maintain specific blood sugar levels – especially when not clinically relevant – can lead to heightened stress and anxiety, potentially compromising mental well-being. 

4. Potential for Misinterpretation and Misinformation

Interpreting CGM data accurately requires an understanding of physiology and nutrition. Without proper guidance from healthcare professionals, individuals might misinterpret fluctuations in blood sugar levels, leading to unnecessary dietary restrictions or inadequate responses to genuine health concerns. Misinformation could easily spread through online communities and social media, compounding potential risks. Everyone is not trained on using CGMs, as they were not created for the greater public. 

5. Cost, if not covered by insurance

This can become a very expensive tool to aid in weight loss ranging anywhere from $100-$300 per month.

It’s also important to note that in some instances, using a CGM when you aren’t diabetic may be causing people who actually need one to survive, to lose some access to these tools.

About Nutrisense.io 

Nutrisense is a company that offers a comprehensive app-based tool for tracking and analyzing how various factors such as food, sleep, exercise, and stress affect glucose levels. This tool appears to be particularly aimed at individuals with or without diabetes who want to gain insights into their glucose responses throughout the day in order to lose weight and better their overall health. 

Nutrisense io does work with dietitians. They have actually contacted me to collaborate, but I declined. Some dietitians believe that CGMs are useful for people who don’t have diabetes. Again, while I think it can be interesting to see your personal glucose response to different foods, I don’t think the results are clinically relevant for the majority of non-diabetics.

The app uses Continuous Glucose Monitoring technology to provide real-time data on glucose levels, and it seems that Nutrisense takes care of the CGM prescriptions for its members. However, the service comes with a cost, with subscription plans starting at $299 per month for a 3-month subscription or $225 per month for a 12-month commitment. It’s worth noting that Nutrisense is not covered by insurance.

The Nutrisense app claims to teach users how to eat in a better way and to start making the right food choices that will help to achieve weight loss goals. This can all be done without a CGM, but okay.

This type of service could potentially be valuable for individuals looking to better understand and manage their glucose levels for health purposes, but again, there’s really no need for most of us to drill our health down to this level.

CGM for weight loss: Online Claims 

Online nutrition claims have become increasingly prevalent, often promising quick fixes and results by purchasing some sort of product.

Over on TikTok, for example, some guy named Klint claims he is losing weight from using his CGM. Klint shares that after 2 weeks he has lost 30 pounds due to the CGM. He uses the app to track his glucose levels based on different patterns. When his glucose is not elevated, he claims to be in “weight loss mode” and when he has small spikes it is “healthy eating mode” and then lots of high spikes in glucose is “weight gain”. 

This sort of thinking shows a real misunderstanding of how the body works.

CGM for weight loss review

He mentions staying in storage mode causes weight gain, and that he gained 3 pounds from a meal. Someone needs to tell Klint that that 3 pounds isn’t fat.

When he eats “good,” he loses weight, and when he eats “bad,” he gains weight. He explains that eating more natural foods and less processed foods helped him lose the weight.

Klint is making it seem like the CGM is what is making him lose weight when in reality, it’s probably the lifestyle changes he is making to his diet. 

It is no doubt that CGMs have their purpose in the diabetic world. People looking specifically for weight loss shouldn’t be relying solely on CGM technology. 

Individuals should adopt a multifaceted approach that integrates personalized nutrition, physical activity, mindfulness, and mental well-being. Registered dietitians play a pivotal role in guiding individuals through this journey, providing evidence-based recommendations and fostering realistic expectations that are specific to one’s needs and lifestyle. 

The prospect of using CGMs for weight loss offers a glimpse into a future where technology intersects with wellness. However, navigating this path requires careful consideration of potential challenges and ethical dilemmas. 

While CGMs have revolutionized diabetes management, their application to weight loss demands a cautious and comprehensive approach that values overall health and well-being above mere data points. Stick to the basics and be consistent, instead of leaning to CGMs to guide weight loss.