Mechanisms of obesity-associated insulin resistance

The prevalence of chronic illnesses has become rampant in the past decade. The effects of these are being seen in the newer generations worldwide. Some of the most common chronic diseases that have increased tenfold have been obesity and diabetes, affecting millions of people around the world. Various studies have closely linked obesity and insulin resistance, so let’s understand these two in more detail, how they are connected and what are the ways of overcoming them for a healthier life. ‍

What Is Insulin Resistance?

Insulin is a crucial hormone produced by the pancreas which enables the cells in our body to convert the glucose from our blood into energy. Glucose is released by the food we eat into the bloodstream and is also more commonly known as blood sugar. Insulin resistance occurs when cells in your muscles, fat, and liver don’t react properly to insulin and can’t utilize it optimally to convert glucose from your blood into energy. Due to the lack of utilization of insulin, your body tries to compensate and your pancreas ends up producing a greater quantity of insulin. Even despite releasing more insulin your cells fail to respond to it and become resistant to the insulin production which then causes elevated blood sugar levels at all times, also known as insulin resistance. Obesity, high blood pressure, high cholesterol, and type 2 diabetes are all a product of insulin resistance syndrome. 

Symptoms of insulin resistance

Insulin resistance is one of the biggest causes of type 2 diabetes and it is a gradual process that develops over time. Symptoms of insulin resistance are rarely seen unless specifically checking for it or conducting a blood test but here are a few common symptoms that are associated with the onset of type 2 diabetes which may help in determining if you have insulin resistance as well. 

• Constantly feeling thirsty
• Feeling unsatiated even after a meal
• Urinating more often than normal
• Tingling sensation in the hands or feet
• Feeling fatigued even after resting 
• Being more susceptible to infections or flu
• Developing dark velvety skin on various parts of the body

With a simple lab test you and your healthcare provider can determine the existence of insulin resistance or prediabetes. ‍

Causes of Insulin resistance

There are various factors that can cause insulin resistance in people. Every body operates differently and while insulin resistance does not have one specific cause that triggers it, there are certain conditions that can cause different levels of insulin resistance in the body. 

• Having excess body fat, being overweight or being obese are some of the major causes of insulin resistance. 
• Having fat centered around the waist or belly causes visceral fat which leads to insulin resistance.
• Leading a sedentary lifestyle and not getting enough physical activity is another factor that can cause insulin resistance.
• Eating a non nutritious diet that contains more processed foods and carbohydrates rather than consuming a balanced and healthy diet. 
• Medications that contain certain steroids can trigger insulin resistance in the body. 
• Being genetically predisposed to diabetes or having a diabetic family history.

There are certain hormonal disorders that can cause insulin resistance as well and these include: 

• Cursing syndrome where there is an excess of cortisol in the body.
• Acromegaly or high levels of growth hormone in the body.
• Hypothyroidism is when the thyroid gland is inactive causing unregulated metabolism. 

Other than these, there are some genetic conditions that can also trigger insulin resistance in the body but they are relatively rare. 

How is Insulin resistance diagnosed?

Due to the fact that insulin resistance is a health condition that develops gradually over time, it is difficult to actually diagnose it unless specifically checking or testing for it. The symptoms for insulin resistance are also negligible which makes it that much harder to actually diagnose insulin resistance unless it transitions into full fledged type 2 diabetes. 

People usually only get checked for insulin resistance upon experiencing symptoms of type 2 diabetes or prediabetes. However, there are some factors that are considered while diagnosing insulin resistance. 

• A patient’s medical history and background 
• Their family’s medical history 
• Signs and symptoms of insulin resistance or prediabetes
• Test results 

The tests that are conducted in order to check for insulin resistance are usually:

• Fasting glucose or glucose tolerance
• glycated hemoglobin or HBA1C
• Lipid profile
• Fasting insulin
• HOMA IR

Generally, doctors also recommend conducting tests for metabolic syndrome, cardiovascular diseases, PCOS or other chronic health issues related to obesity and insulin resistance. 

Do all obese people have insulin resistance?

One of the main causes of developing insulin resistance is having excess fat. Being overweight or obese is a process that occurs gradually which is similar to the process of becoming insulin resistant. Obesity and insulin resistance often function in a loop, meaning one can cause the other and vice versa. 

Generally, most obese people are insulin resistant but this is not always the case. Since insulin resistance has other underlying causes that can be genetic, it is not necessary that if a person is obese they will have insulin resistance. Insulin resistance also occurs in people that have a normal weight and BMI and are overall lean. It is also possible that people with obesity might be insulin sensitive and don’t develop it over the course of their life. 

What comes first, insulin resistance or obesity?

Trying to determine what comes first among obesity and insulin resistance is a lot like the chicken and egg paradox. Obesity and insulin resistance are so closely linked that it is impossible to determine which of the two conditions begins to take form in the body before the other. Obesity is caused due to a variety of reasons such as not eating a healthy diet, not exercising enough, leading a sedentary lifestyle and genetics. Insulin resistance is when your pancreas releases an over abundance of insulin and your cells are not able to utilize it properly in order to convert glucose into energy. This causes the cells to become resistant to the abundance of insulin already present in the blood which makes obesity and insulin resistance an interlinked condition.

However, to determine which condition comes first in an individual, a person’s history has to be considered. Generally, gaining weight leads to a development of insulin resistance in people who have a genetic inclination towards that. Other conditions such as hormonal disorders like PCOS, family history and overall genetics play a huge role in the development of insulin resistance. ‍

How to treat insulin resistance with obesity?

The main remedy for insulin resistance is lifestyle changes since some of the causes of insulin resistance, such genetics and age, cannot be changed. Changes in lifestyle include:

1. Eating a nutritious diet

Your doctor or dietitian may advise against consuming large quantities of carbs since they cause the body to produce too much insulin. They may also advise against consuming too much unhealthy fat, sugar, red meat, and processed carbohydrates. Instead, they'll probably advise consuming a diet rich in whole foods, which includes more fruits, vegetables, whole grains, fish, and lean meat.

2. Exercise

Engaging in regular, moderate-intensity exercises helps to boost glucose energy consumption and enhance muscle insulin sensitivity. Exercise of a moderate intensity may boost glucose uptake by at least 40% in a single session and it is imperative that people with insulin resistance follow some sort of workout routine. This is the best way to ensure long term results.

3. Reducing extra weight

Your doctor could advise you to attempt to reduce weight in order to try to address insulin resistance. Making these changes will have several beneficial long term impacts such as:

• enhance the sensitivity of insulin (reduce insulin resistance).
• Reduce your blood sugar levels.
• Bring down blood pressure.
• Lower the levels of LDL ("bad") cholesterol and triglycerides.
• elevating HDL ("good") cholesterol levels

With the help of your doctor and a certified nutritionist, you can formulate a diet plan and workout routine that will enable you to achieve these goals. Other than these lifestyle modifications, medication is also used to treat insulin resistance. 

Bottomline

Insulin resistance is a complicated illness that may harm your health in a variety of ways. Because there are no indications of insulin resistance until it progresses to prediabetes or Type 2 diabetes, the best thing you can do is attempt to avoid and control it by keeping a healthy weight, exercising frequently, and eating a balanced diet. Obesity and insulin resistance are closely related conditions and might be the cause of each other and it is best to manage them together by leading a healthy lifestyle. 

FAQs

Does a high fat diet cause insulin resistance?

Yes, a high fat diet, especially one that is high in saturated fats is detrimental to the condition known as insulin resistance. A high fat diet can cause weight gain which further leads to insulin resistance and high cholesterol. Consuming moderate amounts of monounsaturated fats however, can be beneficial for managing weight and cholesterol.

Can losing weight improve insulin resistance?

Yes, losing weight can significantly improve insulin resistance. Losing weight automatically helps the cells to become more insulin sensitive and weight loss further aids in the management of blood sugar levels. 

How do I get rid of insulin resistant fat?

By eating a healthy diet that is low in carbohydrates and rich in fiber, one can get rid of insulin resistant weight. Insulin resistance is caused by having too much visceral or belly fat which is difficult to lose and eating a proportionate and healthy diet is crucial along with working out regularly. 

What is the fastest way to recover from insulin resistance?

Making lifestyle changes and eating a healthy diet is the fastest way to recover from insulin resistance and even reverse it. Regularly exercising and losing weight along with being active and eating healthy is a sure shot way of dealing with insulin resistance. 

What is the best diet to reverse insulin resistance?

In order to deal with insulin resistance and reverse it, it is important that you follow a healthy diet which is rich in protein and fiber and low in carbohydrates. Carbohydrates immediately cause the body to release insulin so any diet with a low carb content can help with the management of insulin resistance.