I really feel for you cdpm - weight gain is a formidable enemy, and I fight it all the time too. Being on insulin must make it so much harder. I don't really know what to say except that I find it helps me to talk about it.
Most of us know how hard weight loss is to achieve, let alone maintain. The statistics are horrifying, but we can only fight and hope we will be in the tiny percentage that succeed.
I sometimes slip into conspiracy theory mode and wonder how it is that we still have so little in the way of genuinely helpful treatments for weight loss and regain. Could it be immensely powerful vested interests in protecting economies based on the sale of harmful food types, and I'm talking about overbred grains, fruits and vegetables that no longer resemble those our bodies evolved to eat, not just the highly processed stuff that addicts us. Could be, I guess.