I was first introduced to and became intrigued with the subject of insulin resistance about a year ago after watching a TED Talk speech by Dr. Peter Attia.

Attia discussed how some individuals prejudge overweight and obese people and assume that they eat too much junk food and don’t exercise enough and that is the reason they are the way they are. It wasn’t until Attia was diagnosed with insulin resistance (also called metabolic syndrome) himself that he began to think differently and started to research what was going on.

Did we have it all backwards, and was it insulin resistance that caused weight gain and not weight gain that causes insulin resistance? How could a person, like Attia, who worked out hours per day and ate well, develop something that he thought only overweight and obese people developed?

What is insulin resistance, you might ask? Insulin resistance is a condition in which the body makes insulin but the body’s cells get increasingly resistant to letting insulin do its job.

Let’s back up here for a bit and talk about what insulin is first. Insulin is a hormone made in the pancreas and plays a major role in the way the body uses digested food for energy. When people have insulin resistance, glucose accumulates in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes. Some people don’t even realize they have insulin resistance until it has gone on too long.

How does someone know they have insulin resistance? What are some signs, and how does one develop insulin resistance? The exact cause of insulin resistance is not known. Scientists are still researching this condition. But what scientists do know is that there are a couple factors contributing to insulin resistance:

» 1) Physical inactivity

» 2) Poor diet

Some signs of having insulin resistance are:

» 1) Waist size of 40″ or over in men; 35″ or over in women

» 2) High levels of triglycerides, greater than 150mg/decilimeter

» 3) Low levels of good HDL — less than 40mg/DL

» 4) High blood pressure — over 130/85

» 5) Blood sugar levels above normal —- fasting 100mg/dl or above.

In extreme cases of insulin resistance, one might find that people have dark patches of skin, many times in the back of the neck. Also, people have a dark ring around their neck. These dark patches can also be seen on elbows, knees, knuckles and armpits. This condition is called acanthosis nigricans.

Risk factors for insulin resistance are:

Genetic factors:

» 1) Family history with type 2 diabetes

» 2) Family decent of black, Hispanic, American Indian or Asian

» 3) Age 40 to 45 or older

According to the U.S. Centers for Disease Control and Prevention, 100 million Americans are considered obese, with a Body Mass Index (BMI) of 30 or higher. Also, the CDC reports that as many as 80 million Americans were insulin-resistant, and since many people with insulin resistance develop diabetes, the two numbers seem to go hand-in-hand.

There are a number of health conditions that people can develop as a result of being insulin resistant including high blood pressure, high cholesterol, heart disease, and polycystic ovarian syndrome (PCOS), which can affect families trying to have babies.

To find out if someone has insulin resistance, health care providers use blood tests to see if a person has prediabetes, but they do not always test specifically for insulin resistance. Insulin resistance can be diagnosed by measuring the level of insulin in the bloodstream.

Overweight and obese people are not the only ones who can develop insulin resistance. A person can be thin and have insulin resistance — in fact, over 4 million thin people have insulin resistance. Big or small people can be born with a defect in their insulin-producing beta cells that stops the pancreas from producing insulin over a certain level of demand, in fact, 40 percent of people with insulin resistance have this defect.

Here are five tips to help prevent insulin resistance and prediabetes and diabetes:

» 1) Exercise

» 2) Eat a healthy diet

» 3) Lose extra pounds (especially around the belly)

» 4) Stop smoking

» 5) Get more sleep


Body fat, especially belly fat plays a large part in creating chronic, or long-lasting inflammation. Chronic inflammation can cause havoc all over the body over time without any warnings or symptoms. Studies indicate that shedding excess weight can reduce insulin resistance and prevent or delay type 2 diabetes.

Eat a Healthy Diet

Eating a healthy diet of clean, non-processed foods and grains, a low level of sugar, high levels of vegetables and foods that are known to be anti-inflammatory can be helpful in sustaining a healthy body weight and reduced fat. One should try to reduce their saturated fats and sugars, particularly fructose. Focus on non-processed foods and choose more low glycemic index sources of carbohydrate (those that raise blood sugar levels slowly). Also, look for carbohydrates with higher contents of fiber.

Physical Inactivity

If someone typically does not regularly exercise, they should start an exercise routine of at least 30 minutes per day five days per week with two of those days involving more intense exercise (HIIT, or high intensity interval training). Studies indicate that after exercising, muscles become more sensitive to insulin, helping insulin resistance and lowering blood glucose levels. Exercise also is great for helping muscles absorb more glucose with less need for insulin. Think weight lifting — the more muscle a body has, the more glucose it can burn to control blood glucose levels.

Quit Smoking

Smoking can increase someone’s chances of developing insulin resistance. Past studies have shown that smokers are likely to become insulin resistant, and to make up for it, their blood sugar levels rise to levels higher than normal. Other studies have also shown that nicotine and cigarette smoking cause the levels of the stress hormone, cortisol, to increase.

Get More Sleep

Studies indicate that sleep problems that are not treated, especially sleep apnea, can increase the risk of obesity, insulin resistance and type 2 diabetes. Night shift workers may need to be aware of the signs of insulin resistance also.

I hope that this blog will help people become more aware of what insulin resistance is and what the signs for it are. Please consult with your doctor if you feel that you are doing everything right — you are eating healthy and in correct proportions and you are exercising daily but you find that you are not able to lose weight or you feel lethargic. You may need to have your doctor run some tests to see what is really going on.

Sue McDonald is a health coach who leads online support groups to help people improve their eating habits and fitness levels to lead healthy and fulfilling lives. She also teaches PiYo strength group fitness classes in Santa Barbara. The opinions expressed are her own.