hello, thank you for asking the question.
I can understand losing weight is a difficult task.
I can’t advise you until I know your age, medical history, drugs you have tried already and your BMI.
kindly provide the required information in the comment.

According to additional information that you have provided, it seems you are diabetic and now on insulin for its management. In addition, you are overweight and your BMI is around 28, which is slightly over the healthy range.

You should understand that the management of diabetes and keeping blood sugar within a goal is the primary target in a diabetic patient. For this reason, you have been started on insulin. As you have stated you have insulin resistance, it means you are using a high dose of it.

Insulin is an anabolic hormone. It promotes the utilization of glucose and its conversion into fats if there is an excess of it. So if you are on insulin, particularly a high dose, weight loss is a side effect and it is usually difficult to control.

Now what we can do to limit this weight gain?

I would recommend the following strategies.

1. limit your calorie intake. Do not go over 1400 to 1500 calories per day. I found myfitnesspal, a very good android app which helps to calculate calorie intake.
2. Once you control diet, you would need a lower dose of insulin to control your blood sugar, that will help. follow a strict dietary regimen.
3. Search on internet and find out what type of foods are best for a diabetic patient.
4. Exercise is the key. I wouldn’t recommend intense exercise, and i am more inclined towards duration than the intensity. Therefore, try to do exercise for a longer time. my recommended duration is 60 minutes per day for at least 5 days a week. It doesn’t mean you should start walking for 60 minutes right from the start. Start slow but gradually increase the duration to 60 minutes per day.
5. Then lastly, the pharmacological aid. I can see you have tried various medication. All are found to be helpful. Discuss with your doctor if you could use “Topiramate” as a weight loss aid, another drug which is found to be helpful in losing weight. Remember, this drug is not suitable for all patients, therefore, you must first discuss with your doctor. If your doctor agrees this can also be tried.

Losing weight in a diabetic patient, who is insulin-dependent need a substantial amount of patience. therefore, be patient. I am very hopeful the above measures will work but it will need time.

Moreover, while losing weight is very important and helpful, our primary goal still is to keep blood sugars within the normal range and avoid hyper or hypoglycemic episodes and keep HbA1c level below 7%. Therefore, do not think of decreasing the dose of insulin because it has the side-effect of weight gain. Try to limit your calorie intake, modify your diet and exercise, so we could use a lesser dose of insulin while keeping your blood sugar within normal range.

I hope the above information will be helpful.

Regards.
Dr Adil Ramzan.
MD Internal Medicine.