Insulin Causes Insulin Resistance – Hormonal Obesity X

Insulin resistance plays a large role in increasing insulin levels.  Increasing insulin levels tend to drive weight gain and obesity.  Continuing from the previous post, we continue our exploration of the hormonal obesity theory.  To start Hormonal Obesity part I, click here.

The question we need to answer is this.  What causes Insulin Resistance?  From other biological systems, we can guess that a good place to start is with insulin itself.  Does insulin cause insulin resistance?Insulinoma  Let’s look at the evidence.

There are rare tumors called insulinomas that secrete abnormally large amounts of insulin.  In these cases, patients will have very large increases in insulin but very little else wrong with them.  In these cases, would the increase in insulin lead to insulin resistance?

This article “Patients with insulinoma show insulin resistance in the absence of arterial hypertension” answers that question.

Looking at the graph,  it is clear that as the levels of insulin in the body go up and up, the levels of insulin resistance goes up and up. This is a protective mechanism and a very good thing, which is why the body does it.

If the body did not develop resistance to insulin, the high levels of insulin would rapidly lead to very, very low blood sugars.  This severe hypoglycemia would quickly lead to seizures and death.  Since we don’t want to die, the body protects itself by developing insulin resistance.  This is a good thing.

The usual treatment of this condition is surgery to remove the insulinoma.  Doing this reverses the insulin resistance and even the associated conditions such as acanthosis nigricans.  The bottom line is this – high levels of insulin cause insulin resistance.  Taking away the high insulin levels reverses the insulin resistance.Insulin infusion1

The next step is to see if we can give somebody insulin resistance.  That’s what they did in the next paper “Production of insulin resistance by hyperinsulinemia in man” Diabetologia 28:70 –75, 1985 Rizza RA.  12 non-obese participants were given a 40 hour.  One group was given higher and higher dose of insulin, the other was given saline (control group)

The blood sugar was kept stable by infusions of glucose.  At the end of the experiment, subjects were tested to see if insulin resistance had developed.  The subjects that had insulin infusion showed a significant 15% lower ability to use glucose compared to those that did not receive insulin.  Put another way, the insulin group developed 15% greater insulin resistance.

The implication is this – I can make you insulin resistant.  I can make anybody insulin resistant.  All I need to do is give them insulin.  Insulin causes insulin resistance.Insulin infusion2

Another study shows the exact same thing, but with physiologic doses of insulin.  “Effect of sustained physiologic hyperinsulinemia and hyperglycemia on insulin secretion and insulin sensitivity in man”  Diabetologia Oct1994, Vol37, Iss 10, 1025-1035 Del Prato S.  The previous study used doses of insulin that were much higher than seen naturally.  This study uses doses of insulin that are often seen in humans.

The subjects were 15 healthy young men.  They were given 96 hour constant infusions of insulin.  These subjects are neither obese, nor pre-diabetic nor diabetic.  They were normal healthy subjects.  After 96 hours of insulin infusion, their insulin sensitivity dropped by 20-40%.

The implications are staggering.  I can make these healthy lean men insulin resistant.  Since type 2 diabetes is all about insulin resistant, that means that I can start these people on the road to diabetes and obesity withing 3 days.  High levels of insulin causes insulin resistance.  They are as inseparable as a shadow to a body.

We see the exact same pattern in type 2 diabetic patients.  Let’s look at this fascinating study “Intensive ConventiInsulin causes resistance1onal Insulin Therapy for Type II Diabetes” Diabetes Care 1993 16:23-31 Henry  RR.  The conventional (and disastrously incorrect) thinking at that time was that controlling the blood sugar is the most important part of diabetes.

You might think that the better you can control the sugar, the better the diabetes and you will be healthier.  You might also be disastrously wrong and cause yourself irreparable damage.

But, that was the conventional thought.  So they took these type 2 diabetics and intensified their insulin treatment to tightly control the blood sugars.  They started on no insulin and by 6 months were taking 100 units a day.  The sugars were very, very well controlled.

But what happened to their insulin resistance?  The more insulin they took, the more insulin resistance they got.  Since diabetes is a disease of insulin resistance, that means their diabetes was getting worse not better!  High levels of insulin causes insulin resistance.Insulin weight gain

Here’s where things get really interesting.  I’ve also said that insulin causes obesity.  If this were true, you could expect that as we increase the dose of insulin from zero to 100 units/day over 6 months, that the patients would gain weight.  True to form, that is exactly what happened.  Patients gained 8.7 kg (19 lbs) over 6 months.

But look closely at their caloric intake.  They were eating 300 less calories than at the beginning of the study.  If you believe the Caloric Reduction as Primary (CRaP) theory – that it is all about reducing calories – you would be scratching you head wondering how you could reduce 300 calories per day and still gain almost 20 pounds.

But we know that calories are rather insignificant.  The major question in obesity is this:  What is driving up my insulin? Since insulin levels are way up, the body gains weight.  Reducing calorie intake doesn’t matter.  The body will only further reduce caloric expenditure to match and make the body gain weight.  Insulin drives weight gain.

That brings us back to the question of weight gain.  Insulin drives weight gain.  But what drives insulin?  The Carbohydrate-Insulin Hypothesis assumes that carbohydrate intake drives insulin, but that is incomplete.  Insulin itself will drive insulin resistance which will increase insulin in a self-reinforcing cycle.Hormonal Obesity theory step 2

The longer and higher the insulin levels, the higher the insulin resistance.  The higher the resistance, the higher the insulin.  This is what sets into motion the time dependent effects of obesity.  The fat get fatter.  The longer you have obesity, the harder it is to eradicate.  Insulin Causes Obesity.

Everybody knows about these time dependent effects.  However, most current thinking about obesity completely ignores these effects even though they are plainly obvious to anybody and everybody.  Since type 2 Diabetes is all about insulin resistance – this also leads us to the inescapable conclusion that Insulin Causes Diabetes.

Insulin causes both obesity and diabetes.  This is the new science of Diabesity.  With this new understanding, we are led to entirely new possibilities for the cure of diabesity.  If high insulin levels are the cause, then the cure is to lower insulin levels.  Cure type 2 diabetes?  Can it be true? Yes, but we still have some work before we get there.

Continue to Hormonal Obesity XI

Begin here with Calories I

See the entire lecture – The Aetiology of Obesity 2/6 – The New Science of Diabesity

18 Responses

  1. […] high insulin secretion may lead to the development of insulin resistance.  This can explain the findings of this paper “High intakes of milk, but not meat, increase […]

    • I feel like this is missing the forest for the trees. Artificially increasing NEFA in healthy subjects will also increase insulin resistance. We need energy from somewhere, either glucose or fat, whether it’s from our food or our own energy stores. Obesity and insulin resistance are results, not causes. What caused the insulin resistance in the first place? Is there too much ROS? Inflammation? Lack of micronutrients? Mitochondrial dysfunction? NAFLD? Hormonal imbalance? It’s not purely from eating too many carbohydrates. Evidence simply doesn’t support that, and in fact high carbohydrate, low fat diets were successfully used to treat obesity and hyperglycemia in the past. Generally speaking, losing weight, whether it’s through a low carb, or low fat diet, will help, and both can be efficacious, despite the many debates about which is better, but insulin sensitivity can improve substantially without weight loss if appropriate measures are taken.

      Trying to place the majority of the blame on insulin, or cortisol, or glucose, or fructose, or dietary fat, is myopic, yet nearly every “diabetes” or “obesity” cure does just that, despite there being ample evidence the humans can live healthy lives across a variety of different diets with differing macronutrient ratios.

  2. Jason

    Is there any data showing the relationship between HbA1c and BMI?

    I can find data showing relationships between a whole pile of other metabolic health markers such as insulin and BMI, HbA1c and cancer, HbA1c and heart disease, HbA1c and brain shrinkage, HbA1c and stroke.

    I would have thought that if we follow the logic we could say that reducing the insulin load of the diet we would reduce reduce insulin bodily secretion and normalise blood sugars. Normalised blood sugars would then lead to ketosis or optimal body fat utilisation which would lead to normalised weight.

    Am I on the right track here? I thought someone would have plotted HbA1c versus BMI as the data would be easy to obtain in bulk.

    If you can demonstrate that normalising blood sugars leads to weight loss you can then, rather than promoting LCHF or ketosis or Paleo or some other “religious” dietary framework, you can just tell people to “reduce the insulin load of your diet to a point where your blood sugars normalise, ketosis will ensue, and you’ll lose body fat without hunger as well as lots of your other metabolic markers moving in the right direction.”



  3. […] Insulin causes insulin resistance – hormonal obesity :: Intensive Dietary Management […]

  4. If I understand the insulin resistance theory right, then it is that under the heavy doses of insulin (caused by food) the insulin receptors stop responding to insulin and doesnt react as they should. Hence the body increases production of insulin and cells are becoming even more resistant. So far so good.

    But how does that makes us fat? If the body becomes resistant to insulin, why insulin makes us fat? Is it that the only “normal cells” develop the resistance, but fat cells doesnt? So, another question should be, why only normal cells develop that type of resistance, while fat cells doesnt? To me it seems like high production of insulin makes normal cells resistant to it, so they need more. While fat cells still respond the same, so they are prone to higher fat storage driven by high levels of insulin. Maybe I got it wrong. If that is the case, then correct me please.

    Thanks very much

    • Think of it this way. Our cells become resistant to insulin because there’s too much there and too much driven into them. So we’re making our cells fatter, they are saying please lighten up on this, much like if you overate you’d be stuffed and your stomach would say, no more, and is resisting more food, but it’s stuffed 🙂

  5. […] is required to deal with the higher blood sugars (the dietary strategy of carb up and shoot up). This excessive insulin intake over years (persistent high levels) actually leads to insulin resistan…, just as what happens in T2D in the normal […]

  6. Thanks so much for your work in this area Jason, and there are some huge implications here as far as how we seek to manage this disease. We are blinded by concerns of hyperglycemia to the point that we neglect the fact that hyperglycemia among type 2 diabetics is merely a symptom of the underlying disease, which is actually hyperinsulinemia. No one wants to talk about high insulin levels and especially those who are being medicated to these high levels on purpose. We are living a fairly tale here, insulin therapy for type 2’s is both benign and extremely beneficial, but this fairly tale has an ugly ending, called progression.

  7. Sorry I meant blinded by concerns of hyperglycemia, typo 🙂 So in other words, how’s your blood sugar doing, let’s not worry about the effects of our treatments to lower it, it’s all about that. Let’s also just manage the disease in the very short term and never mind about the long term effects, live for today, for tomorrow you shall die, and you’ll get there even sooner this way actually 🙂

  8. […] seems to make thing worse, not better. That’s what we argued in a previous post – insulin causes insulin resistance. Therefore, treatment with insulin would be expected to make blood sugars (symptom) better, but […]

  9. Jason, it seems that you have solved or prepared for the solution of diabetes-2 through this article. A great collection of studies proving that insulin itself worsens insulin resistance. In mathematical terms the relation is an exponential function meaning that change is dependent on the magnitude of the function itself. But that is also good news, as such relation goes both ways, providing also key to reverse the phenomenon. By eating foods with low insulin response instead of high response, a worsening situation can therefore be changed to an improving one, quickly! And it is not only fast carbs that then must be excluded, but also some proteins like milk. A famous lady, madam Jeanne Calment, always drenched her meals in olive oil. The immediate result ( with good original olive oil) was dual: 1/The replacement of some calories with zero insulin index calories 2/ Reduction of total calorie requirement by replacing “average” calories with calories of higher satiety/calorie, like fats. The lady was more active and alert than most 80-year old when she was 110 years old and she lived to 122. Nice tricks, now with sound explanations thanks to Dr Jason Fung ! Where can I find good food list listed by low insulin index?

    • Cheryl Durham

      Insulin index equation is carbs minus fiber plus (0.56x protein) slice of white bread is 100

  10. […] פוסט זה מוגש כשירות לציבור. הזכויות על התוכן שייכות לכותב של הפוסט המקורי. את הפוסט המקורי ניתן למצוא בכתובת הזאת. […]

  11. […] It’s protecting us from the excessive insulin. In other words, as we’ve written before, Insulin causes Insulin Resistance. But the root cause here is the Insulin, not the Insulin Resistance. The tissues (heart, nerves, […]

  12. […] insulin. It’s protecting us from the excessive insulin. In other words, as we’ve written before, Insulin causes Insulin Resistance. But the root cause here is the Insulin, not the Insulin Resistance. The tissues (heart, nerves, […]

  13. […] haimasta tulee edes pihaus insuliinia, kannattaa yrittää ensisijaisesti muuta kuin lääkehoitoa. Tässä J.Fungin kirjoituksessaan viittaamansa tutkimuksen ensisijainen tavoite oli mahdollisimman tiukka veren sokerin kontrolli. […]

  14. […] in excess.  One of my favorite articles on this that are directed toward the general public is this one from Dr. Jason Fung, who is one of the few medical doctors who has actually read the science of all this and gets […]

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