Insulin resistance is a condition associated with many metabolic conditions including obesity, type 2 diabetes, and fatty liver disease. While underlying mechanisms of insulin resistance are not fully understood, it does appear to be closely related to weight. Relating to both causing weight gain and as a result of weight gain. This article will explore the association between insulin resistance and weight gain as well as strategies for losing weight when you have been diagnosed as insulin resistant.

What is insulin resistance?

It's first important to understand the role of insulin. Insulin is a hormone produced by the pancreas that tells our liver, muscle, and fat cells to take up sugars from the bloodstream. Think of it like insulin knocking on the cell's door and the door opening to let the sugar inside. When we eat, carbohydrates are broken down into sugar molecules, and we make insulin. Insulin helps our cells to take in those sugar molecules and use them for energy. These are important physiological processes that give our bodies the fuel we need for activities of daily living while keeping our blood sugar levels in a normal range. And to be clear, the sugars that come from digestion of food are not a bad thing. They are an essential fuel that our cells run on. But sugars can only be used as fuel when inside of cells. When floating around in the bloodstream, sugars can do damage.

As someone diagnosed with insulin resistance, cells are less responsive to insulin. You can think about it like the insulin is knocking, but the door isn't opening as easily. As a result, sugars do not get inside of cells to be used for fuel, but remain circulating in our bloodstream. Then the pancreas has to produce greater amounts of insulin to get the cells to take up excess sugars and keep blood levels normal. Eventually, the cells of the pancreas struggle to keep up with increasing demands. Insulin production is insufficient to overcome the resistance, and blood sugar levels stay high. Over time this may lead to the development of type 2 diabetes, as well as increasing the risk of cardiovascular disease or other chronic diseases. 

Blood tests can be used to determine if you have insulin resistance. Tests include a fasting blood glucose level, fasting insulin level, and a hemoglobin A1c. Fasting blood glucose and insulin levels tell us what the blood glucose and levels of insulin are at the moment the test is done, whereas the hemoglobin A1c gives us an idea of what the average blood sugar levels were for the last 3 months. A glucose tolerance test is also used, but less commonly.

How does weight gain cause insulin resistance?

While we don't have a full understanding of how it happens, research consistently supports that the development of insulin resistance is common in the setting of weight gain and obesity. Many studies suggest that it has to do with fat accumulation in the liver and skeletal muscles. Muscle and liver cells are important consumers of the sugars we break down from food. When fat accumulates around these tissues, it causes insulin signals to be less effective at getting blood inside of those cells. Inflammation has also been proposed to play a key role in insulin resistance. Numerous studies link obesity as well as high-fat, high-refined sugar diets to chronic, low-grade inflammation. Inflammation also decreases the ability of insulin to efficiently get sugars inside of cells.

How does insulin resistance cause weight gain?

We have learned that insulin regulates our blood sugar levels. In addition, insulin plays other important roles as a hormone: it promotes the storage of fat, and it can increase feelings of hunger. As we reviewed, in individuals with insulin resistance, the pancreas is producing higher levels of insulin than average. This means the body is primed for fat storage. At the same time, insulin's effect on hunger can lead to increased food intake. It's through these effects that insulin resistance can make it more challenging to maintain a healthy weight.

Can you lose weight with insulin resistance?

You can! Losing excess weight is the best way to improve insulin sensitivity and reduce the risk of developing type 2 diabetes. In fact, research shows that weight loss can even reverse insulin resistance. While having high insulin levels can make weight loss more challenging for the reasons discussed, it is possible to lose weight with insulin resistance. Here are some effective strategies:

1) Reduce your calorie intake

2) Choose carbohydrates that are high in fiber and low in added or refined sugars

Choosing more complex carbohydrates that are high in fiber like vegetables and whole grains in place of refined carbohydrates like white bread, white pasta, cookies, and chips is helpful for controlling your blood sugar and insulin levels.

3) Avoid sugar-sweetened beverages

Beverages that are high in added sugar cause a spike in your blood sugar and levels of insulin, and may increase the likelihood for insulin resistance over time. One of the best things you can do to lose weight and prevent diabetes is to limit the sugar in your drinks. Try flavored sparkling water instead of soda and limit the amount of sugar you're putting in your morning coffee as just a few strategies that can help you to reduce the amount of sugar you're drinking.

4) Increase physical activity

Physical activity has been shown to reduce blood sugar and insulin levels as well as help with weight loss. If you're not currently engaging in regular exercise, start with a small amount of movement – park farther away, take the stairs, or walk the dog – all of it adds up!

5) Talk to your doctor about medication

If you're adopting healthier habits, but still not losing excess weight or seeing improvements in your blood sugar, you may be a candidate for medication to assist your efforts. There are FDA-approved medications that can help with both weight loss and improving insulin resistance. Talk to your health care provider to see if one of these might be appropriate for you.

How Form Health can help with weight gain and insulin resistance

At Form Health, we consider biological factors like insulin-related weight gain that may be affecting a person's weight when developing personalized weight loss plans. Our Board Certified Doctors and Registered Dietitians have expertise in creating treatment plans that treat obesity and reduce the risk of diabetes or cardiovascular disease from insulin resistance. If you're interested in seeking medical care for weight management, give Form Health a try! We can help by developing a personalized path aimed to improve your health and help you lose weight. Take our quiz to see if Form Health is right for you!