Unintentional Weight Loss

[Kim663]

I am a 54-year-old diabetes patient whose blood sugar is not well controlled although we are currently on a new insulin regimen of 35 units at night. I also take metformin 1000 mg BID and Jardiance once daily.  I was at my heaviest in 2008 at 355 lbs.  Over the ensuing years, I have lost very slowly and am now down to 271 lbs as of this morning.  My concern is that approximately a week ago, I weighed in at 287 lbs.  My eating habits have changed some.  I work second shift in a hospital ER so typically only have two meals a day.  I rarely eat "meals", choosing to have Cheez-Its and pepperoni or sometimes mixed fruit, cheese, or something else light on the stomach.  My daughter is a nursing student and she is concerned about malnutrition.  I have no other symptoms such as fatigue, weakness, altered mental status or confusion, etc.  My only physical symptoms are those cause by osteoarthritis of the knees and hips because of the many years from carrying 300+ lbs of weight.  I do not "feel" depressed or anxious although my husband of 26 years did pass in August of 2016 and my sister who has some behavioral health issues, did move in with us in July of 2017.  Could stress cause this type of weight loss?

[TheLightSeeker]

I'm sure you don't need your daughter, or me or anybody else to tell you that you are on a very "slippery slope".

If you don't take time to address your situation, your situation (alarming to my opinion) will sooner or later force you to take time, which may be too late to reverse the damage.
It is a miracle that you don't have any other diagnoses, however, this does not mean that because of that you are in  the clear, barring the ones you mentioned.

As a matter of fact, you have certain undiagnosed imbalances, which have not brought about any symptoms yet.
The onset of disease process, starts long before symptoms  appear.

You are still able to prevent any additional serious unwanted health complications, by making some core
lifestyle changes.

Make time to prepare healthy meals and also to prepare healthy snacks for work from scratch!
LCHF as Red Star mentioned and choose organic, fresh and nutritious SINGLE ingredients!
Cheez-Its and pepperoni??? Really?
I don't even know what that is but it doesn't sound healthy.

Your life outside work should be the opposite of the hospital ER. Calm, peaceful, serene and slow paced.

Your  weight loss is of some concern.
Stress and diabetes are possible factors as Red Star said, but it may have to do more with the effect of  Jardiance, which causes ongoing glucose elimination. Not  designed as a weight loss drug though.
When combined with an optimized nutritional plan and some exercise, it will probably work to your advantage.
Just watch out for any side effects, specially kidney issues and UTIs.

Best wishes,
Niko

[Red_Star]

Stress raises blood sugar so you have that to deal with for a start. Consider trying a LCHF (low carb high fat) diet and also intermittent fasting. Diet Doctor has some great articles to read through. It's possible stress is affecting your weight but so can diabetes (weight gain or loss).