June 1, 2023

A new study reports that people with insulin resistance and hyperinsulinemia are more likely to lose weight in an unhealthy way. The study shows they are more likely to lose more lean mass and less fat mass compared to those without IR. This has potentially profound implications for for helping people understand the importance of healthy weight loss and how to achieve it.

Weight loss is not all the same if you want to lose weight in a healthy way you want to make sure you’re losing predominantly fat mass and not losing as much or any lean mass if you can so how do we know what we’re doing well you know obviously measuring your body composition can help you determine how you’re going but are there factors that can predict whether

You’re more likely to lose fat or lean mass turns out a new study suggests insulin resistance and hyperinsulinemia may be a major factor in predicting that you’re more likely to lose lean mass and less likely to lose fat mass in your weight loss attempts if this is true this is something you really need to know about because it may change the way you see weight

Loss because if you have insulin resistance or hyperinsulinemia if you are more likely to lose lean mass you need to be very very proactive about not losing that lean mass so you lose mostly fat mass i’m dr brett sher the medical director at dietdoctor.com and the study i’m talking about is from dr david ludwig and colleagues titled stimulated insulin secretion

Predicts changes in body composition following weight loss in adults with high bmi and this was published in the journal of nutrition now what they did for this for this paper was they went through and they looked at two big trials um that were essentially weight loss trials one was called the framingham boston bloomington birmingham and baylor study abbreviated

Fb4 and the other was the framingham state food study now these trials were different and it’s important to note how they were different and how they were similar these trials were similar in that they both involved calorie reduction diet to produce a certain amount of weight loss within a certain amount of time now they were different in that one was a moderate

Carbohydrate intervention and one was a very low carbohydrate intervention and they lasted between 10 and 14 weeks now it’s important to define what moderate and very low carbohydrate are because those aren’t always consistent in the literature so in this fb4 study they were provided food with sixty percent of the calculated energy needs seven and a half percent

From carbohydrates 67.5 percent from fat and 25 from protein with a goal to achieve a 12 to 18 percent reduction in body weight in 14 weeks the other study the fs2 study was also 60 of their energy needs uh with 45 from carbohydrates 30 from fat and 25 from protein with the goal being a 10 to 14 percent weight loss in 10 weeks now why is it important to go through

These differentiations well we’ll talk about that but first let’s see what the the main finding was the main finding quite simply was that the more insulin resistant the subjects were and the higher their insulin level the more likely they were to lose lean mass and less fat mass and in a way that makes sense because when you think of the role of insulin not only

Does it work for moderating glucose in your blood but it also has to do with lipolysis or being able to mobilize your fat stores to burn them for energy and when insulin levels are high your body has a much harder time doing that when insulin levels are low it has an easier time so it makes sense the more insulin you have the more insulin resistance you are the more

Hyperinsulinemia you have that the more the less fat you will be able to burn because you have a harder time um accessing that but the surprise then is that you would then burn more lean mass but that’s what this study suggests it doesn’t tell that that’s the exact mechanism okay this wasn’t a mechanistic study but it makes sense that that could be the mechanism

As this study found people with higher insulin levels and higher insulin resistance burn less fat and more muscle and as we know that’s problem that is a problem because you don’t want to burn lean tissue it’s much easier to gain fat mass than it is to gain lean mass so if you’re burning more lean mass and less fat mass that’s really the opposite of healthy weight

Loss and that’s when you also will see resting metabolic rates start to decrease which makes weight maintenance harder down the road and that’s when you can really get into trouble with sarcopenia and weakness and other functional problems down the road and muscle is metabolically active right lean tissue is metabolically active and helps you become insulin sensitive

So so important to not lose weight in the way that these subjects did so here’s the other interesting part though now even though it showed the more insulin resistant you are the more lean mass you lose the less fat mass you lose there was not a difference between the two studies really and remember one study was a very low carbohydrate study and one was a moderate

Carbohydrate study so you at least i would think that that group in the very low carbohydrate study would have done much better and not have the same amount of lean fat or lean tissue loss and less fat loss because they would be overcoming their insulin resistance and their hyperinsulinemia by eating the low carbohydrate diet so we don’t know exactly why it didn’t

Work dr ludwig and his colleagues have some hypotheses then maybe it was the duration but we don’t know i mean let’s just suffice it to say we don’t know but this child wasn’t designed to study that either so that’s what i think is such the interesting next step to do a study like this people who have hyperinsulinemia who have insulin resistance and then randomize

Them to a very low carbohydrate weight loss diet or a higher carbohydrate weight loss diet see what happens to their hyperinsulinemia their insulin sensitivity and see what happens to their resulting body composition with their weight loss but the take home from all this i think is that one you need to know do you have hyperinsulinemia do you have insulin resistance

And that’s something that really isn’t tested for enough now if your weight to height your waist circumference to height ratio is greater than 0.5 chances are you have insulin resistance and are metabolically unhealthy if you have you know elevated fasting insulin levels that’s a good marker to know if your triglycerides are high your hdl is low all of these things

Are suggestive of insulin resistance certainly if your blood glucose is above 100 or your postprandials are going upright those are all markers you want to know but the key is to somehow work with your doctor with your coach with your clinician with your nutritionist with your healthcare provider to find out if you are insulin resistant because if you are then

You want to make sure you’re taking every step to ensure that you are losing weight in a healthy way again that means trying to lose fat mass and not lean mass that may mean doing resistance training that may mean eating a higher than you otherwise would protein diet to make sure you’re getting enough of the substrate to build and maintain your muscles with your

Resistance training and i would argue that that would mean focusing on a diet that improves your insulin resistance in many cases that is a very low carbohydrate diet i would argue a very low carbohydrate and at least adequate to high protein diet and that you can monitor this by following those markers your waist circumference to height ratio your blood tests

That i mentioned the key is making sure you’re following them don’t just lose weight and assume all is good because the number on the scale is going down but instead pay attention to your body composition and your health healthy weight loss and as this study shows so important for those people who have insulin resistance and hyperinsulinemia and we have guides on

What is insulin resistance how to treat insulin resistance and on body composition and how to measure it i think all those guides really play in well to this message so you might want to check those out we’ll link to those down below so if you think this was helpful please give us the thumbs up and subscribe so get all our updates here on ddnews on youtube thanks

A lot everybody have a great day

Transcribed from video
Insulin resistance impairs fat loss By Diet Doctor