Chapter 10: Insulin Resistance - The Major Player

Aug 23, 2019

 

Click here to watch a replay of the Facebook LIVE discussion. 

You Will Learn  

  • Why the longer you have excess weight, the harder it is to lose.  
  • Why when we eat is just as, if not more important than what we eat for developing insulin resistance. 
  • Common myths about how eating more frequently is better to lose weight.  

 

About Dr. Fung, Author of The Obesity Code and The Diabetes Code

Dr. Jason Fung is a medical doctor, nephrologist by trade, who specializes in kidney disease, type 2 diabetes, and obesity. He acknowledged that traditional medicine wastes time and resources attempting to treat symptoms of disease, rather than the cause of disease.  

You can purchase The Obesity Code book HERE. Most information in this post is direct from this book. 

 

Overview of the Book

Here is an outline of the book. Today I’m covering Chapter 10 in Part 3 of the book. 

  • Part 1: “The Epidemic,” explores the timeline of the obesity epidemic and the contribution of the patient’s family history. It highlights the underlying causes of obesity. 
  • Part 2: “The Calorie Deception,” reviews the current caloric theory in depth and highlights the shortcomings of the current understanding of obesity. 
  • Part 3: “A New Model of Obesity,” describes how hormones are involved in the development of obesity. These chapters explain the central role of insulin in regulating body weight and describe the vitally important role of insulin resistance. 
  • Part 4: “The Social Phenomenon of Obesity,” dives into childhood obesity and why obesity is associated with poverty. 
  • Part 5: “What’s Wrong with Our Diet?,” explores the role of fat, protein, and carbohydrates, the three macronutrients, in weight gain. In addition, it examines one of the main culprits in weight gain - fructose - and the effects of artificial sweeteners. 
  • Part 6: “The Solution,” provides guidelines for lasting treatment of obesity by addressing the hormonal imbalance of high blood insulin through proper nutrition, sleep, and stress management. 

 

What is Insulin Resistance?

Disclaimer: if you want the super scientific answers to all of these questions, just go buy the Obesity Code! I’ll try to keep things as simple as possible.  

Research is finding that insulin resistance is best thought of in terms of central (brain) insulin resistance, and peripheral (body) insulin resistance.  

Essentially there has been too much insulin in your system for too long and your body has accommodated by being less receptive to its effects, thus requiring more of the hormone to achieve the desired outcomes.  

Insulin has many roles in the body and brain. In the body insulin is mainly responsible for maintaining appropriate blood sugar levels, fat creation, and cellular growth. In the brain insulin plays a big role in metabolism, memory, immunity, and mood.  

The concept of insulin resistance becomes easier to understand in the broader context of healthcare. You have probably heard of the following situations:  

  • Antibiotic resistance - when your body has been exposed to too much antibiotic and thus becomes resistance to its effect.
  • Drug resistance - when you need more and more of a substance (alcohol, cocaine, narcotics) to get the same effect.
  • Viral resistance - when you are exposed to a dead or weakened virus through a vaccine so your body becomes resistant to the actual virus.  

Insulin resistance is much the same. Too much insulin for too long renders the body no choice but to adapt, thus making the insulin less effective, and requiring more and more to get the same effect.  

 

What are the Signs of Insulin Resistance? 

Brain Insulin Resistance: Increased body set weight, increased appetite, anxiety, depression, decreased cognitive performance and memory. This leads to obesity, type 2 diabetes, and dementia. 

Body Insulin Resistance: Feel tired and hungry, high blood sugar, high blood cholesterol, high blood pressure. This also leads to obesity, cardiovascular disease, and diabetes. 

 

Insulin Resistance and Obesity are Time Dependent 

Dr. Fung makes a good analogy on page 115 about rust. If you want to study rust, you are going to have to be patient long enough for it to develop. The same goes with insulin resistance. It doesn’t develop instantly but instead happens over time with persistently elevated levels of insulin.  

If you have struggled with weight, you know this is inherently true. The longer you have excess weight, the more you put on and the harder it is to get off. That is because of this underlying insulin resistance that is being developed. 

The high levels of insulin were caused initially by things like eating a lot of refined carbs and sugar, not getting enough sleep, being too stressed, and not being physically active. Genetics also plays a role in your appetite and fat storage. Now the high levels of insulin are caused by the insulin resistance that has developed, as you can see it is a really vicious cycle.  

“The longer the cycle continues, the worse it becomes, that is why obesity is so time dependent.” - The Obesity Code page 115  

We not only have to focus on how to lower your insulin levels, but how to reduce your insulin resistance to get to help you lose weight and actually KEEP it off. 

 

When You Eat is Important

Dr. Fung argues that to reduce insulin resistance, we must focus not only on what we eat, but when we eat, both are equally important but we put so much emphasis on what we are eating. Side note: We are also way overestimating the utility of exercise and weight loss. Exercise is great but if you have to pick only one to focus on first, choose food.  

Our body is designed for bursts of insulin after we eat a meal, not for insulin to be released all day (because we are in the habit of snacking every couple of hours).  

We used to just eat three times per day and we used to not have a huge problem with obesity. For some reason health experts started advocating for more frequent meals and voila, now we have an obesity epidemic. Food quality and quantity has certainly changed, but we can’t ignore that so has our meal timing.  

We spend much more of the day in the fed versus fasting state. When you just eat three times a day, your insulin levels have the chance to go back down, especially overnight. But if you are eating frequently throughout the day (especially on snacks that are often high in carbohydrates that raise insulin levels more than protein or fat), that will raise your fasting insulin levels and lead to insulin resistance. 

 

Myths About Eating More Frequently

Myth #1: Eating More Frequently Will Increase Your Metabolism

Let’s review what makes up for “metabolism” or total energy expenditure for a day. Total energy expenditure (TEE) = basal metabolic rate + thermogenic effect of food + non-exercise activity thermogenesis + excess post-exercise oxygen consumption + exercise.  

The basal metabolic rate takes up about 95% of that, and can go up or down by 40-50% based on what you eat. 

Myth #1 is solely speaking of a tiny proportion of your total energy expenditure, the thermogenic effect of food (or the energy cost associated with breaking down and using the food). You could eat six small meals a day and have six small thermogenic effects of food, or three large meals a day and have three large thermogenic effects of food, it’s pretty much a wash.

 

Myth #2: Eating More Frequently Helps Control Hunger  

When I first read this I thought..duh, you eat and you aren’t hungry. But guess what happens to you when you are just a little hungry? Your insulin levels drop and your body has the chance to use the energy already available. Dr. Fung states there is not evidence to support this myth.  

 

Myth #3: Eating More Frequently Helps Keep Your Blood Sugar From Becoming Too Low

Unless you have diabetes, your body automatically works to keep your blood sugar at an optimal level whether or not you eat. If you don’t have energy readily available from food, your body just breaks down stores of glycogen in your liver and muscles for fuel. When the glycogen runs out, it turns to your fat stores. If you are not diabetic, your blood sugars will remain in a normal range even with prolonged fasting periods.  

I want to put in a disclaimer here, especially for athletes and type 1 diabetics. This post covers the effects of meal timing on weight loss. You may have completely different goals and if you are very active or have type 1 diabetes you may need to follow different advice than that listed above :).

 

Bottom Line 

  • Insulin resistance develops over time and is a huge underlying risk factor for obesity, type 2 diabetes, dementia, high cholesterol, and heart disease. 
  • What we eat and when we eat equally important in developing and treating insulin resistance. 
  • If you have excess weight and want to lose it, pay no attention to the myths that you need to eat more frequently throughout the day. I love food just as much as the next person, but I also want to prevent obesity, dementia, and type 2 diabetes. While I know habits can be hard to break, much of the snacking you are doing is probably because you are bored, tired, and haven’t put enough thought and effort into your three main meals. This can be a great place to start when trying to lose weight. 

  

References  

1. Chapter 10. (2016). In J. Fung, The Obesity Code: Unlocking the Secrets of Weight Loss. Vancouver: Greystone Books. 

2. Arnold SE, Arvanitakis Z, Macauley-Rambach SL, et al. Brain insulin resistance in type 2 diabetes and Alzheimer disease: concepts and conundrums. Nat Rev Neurol. 2018;14(3):168–181. doi:10.1038/nrneurol.2017.185.

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