Can I lose weight when my body is insulin resistant?

Carmen Patrick Mohan, MD
Internal Medicine
Studies have demonstrated that insulin resistant individuals can lose weight just as effectively as insulin sensitive individuals. More, a healthy low calorie diet combined with exercise improves insulin resistance dramatically after just a 10% decrease in body weight.
You can lose weight if you have insulin resistance, and the good news is that modest weight loss improves insulin responsiveness and blood sugar control in people with insulin resistance.

Insulin resistance is a precursor of type 2 diabetes. When cells don't respond properly to the insulin that the body produces, sugar cannot move from the bloodstream to the cells. The pancreas produces extra insulin to compensate, but eventually it may be unable to do so.

If you are insulin resistant, it is important that you lose weight and exercise regularly because being overweight and exercising less than three times a week increases your risk of developing diabetes. Even in people with diabetes, structured programs that focus on lifestyle modification, including education, reduced calorie intake, and regular physical activity, can produce sustained, modest (e.g., 5% to 7% of initial body weight) weight loss.

Weight Watchers offers a comprehensive approach to weight loss that can help you reach your goals.
Yes, you absolutely can lose weight when your body is insulin resistant; however, you must modify your nutrition and increase your physical activity. Be sure to consult your physician to make sure it is safe for you to begin an exercise program and to modify your nutrition.

Below are six tips to help you start losing weight and increasing your body's sensitivity to insulin again:

1. Reduce your overall food (calorie intake): Before reducing your food intake log what you're eating into a food journal or online food tracker to determine how many calories you're consuming currently, then try to reduce your daily intake by approximately 500 calories/day. If you find you are eating foods high in sugar, these should be the first ones you decrease or eliminate. Doing this should set you up for at least one pound of weight loss per week. According to the American Dietetic Association (ADA) losing just five to ten pounds will actually increase your body's sensitivity to insulin and lower your blood glucose.

2. Eat smaller meals more frequently throughout the day: This practice will help to minimize fluctuations in your blood sugar and insulin levels. Further, it will help keep you more satisfied and less hungry. Hunger usually leads to us making poorer food choices that are typically high in the types of ingredients and nutrients that promote elevated blood sugar and spikes in insulin, which is what you don't want.

3. Eat more fiber: Focus on getting 25-30 grams per day from various whole grain and vegetable sources. Dietary fiber slows down digestion and may limit increases in blood glucose, which when chronic is what leads to insulin resistance. It also aids in satiety so you don't get hungry as fast.

4. Stay hydrated: Drinking water will help to remove excess sugar (glucose) from the blood, which if chronic as mentioned above, is what leads to insulin resistance.

5. Increase your physical activity: Performing a combination of cardiovascular and strength training exercises for as little as 30 minutes a day 3-5 days a week will lower your blood glucose and increase your sensitivity to insulin.

6. Aim for at least seven hours of sleep per night: A recent study showed that just one night of shortened sleep was enough to induce insulin resistance. If you are chronically sleep-deprived, it may be contributing to your insulin resistance.
Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
First, let me give a quick explanation of insulin resistance. Insulin resistance means that the body is not responding as well to insulin-the insulin made by the body itself, or insulin injected as a treatment for diabetes-as well as it should. Someone with insulin resistance may require two or three times (maybe even more) the amount of insulin to keep blood sugar normal as someone who has normal responsiveness to insulin.
Precisely what causes insulin resistance has been a major focus of research in diabetes for several decades. Insulin resistance is clearly the result of abdominal obesity. Fat cells in and around the internal organs of the abdomen make a variety of chemicals that are associated with insulin resistance, so the greater the abdominal obesity-the greater the waist circumference-the more insulin resistant someone is going to be and the greater his or her likelihood of having diabetes. 
So obesity causes insulin resistance. The question is whether, in turn, insulin resistance also causes obesity, thereby leading to a viscous cycle. To some extent, this is probably the case. One concern here is that insulin is an anabolic hormone, meaning a hormone that promotes energy storage, including fat storage. When you take in calories, some of those calories are going to be stored as fat, and insulin is an important part of this process. Obviously if you don’t take in the calories, you will not store the fat, so those with insulin resistance can still lose weight if they reduce their calorie intake and increase their calorie expenditure through exercise. The weight loss then leads to improved insulin sensitivity, and the problem becomes steadily less severe as someone loses weight. 
If someone who is insulin resistant has difficulty losing weight despite good dietary and lifestyle habits, metformin may be of help. Metformin is a medication used to treat diabetes, and it works, in part, by enhancing the body’s responsiveness to insulin. The drugs tend to suppress appetite somewhat, and those taking metformin have a fall in blood sugar as well as a decline in insulin levels. This medication sometimes helps people lose weight, and it is generally safe to take as long as you do not have kidney problems. It is available generically and is not very expensive.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.