OBESITY AND INSULIN RESISTANCE

In our offices, many of the topics we talk about and issues that patients have will frequently tie in with concerns about their weight. And while we are not here to function as a weight loss clinic, we do seek to help the majority of our patients attain a healthy weight due to the many negative ramifications that excess body fat will have on a patient’s overall health. In fact, it is more than just a major concern right here in San Antonio; it remains a global epidemic. Nearly ONE THIRD of the world’s population are either overweight or obese! That’s more than 2 billion people who are living their lives with an increased risk for (or already have) type 2 diabetes, hypertension, heart disease, non-alcoholic fatty liver disease, dementia, cancer and numerous other chronic degenerative diseases due to an excess of body fat.

And where does the process begin that leads people down those most undesirable health pathways? That’s right – with the foods they eat! The overabundance of processed foods and foods that have added sugars to them are the highest offenders on the list. Not only are they usually cheaper and readily available, but they are also heavily promoted by manufacturers and advertisers who definitely do not have our best health interests in mind. Once you start down the path of making poor food choices a regular staple of your diet, the quicker you will start to see the changes manifest in your body both internally and externally. But what is really going on that drives the accumulation of all those unwanted excess pounds? The answer is simple: insulin resistance.

Many people incorrectly believe that diabetes is due to the pancreas not being able to produce enough insulin, and while this is actually the case in type 1 diabetes (an autoimmune condition) and does occur later in the diabetic process, it isn’t the starting point for developing the disease. In reality, just the opposite is true. The process begins by asking the pancreas to produce TOO MUCH insulin in response to the foods that we eat. When we eat carbohydrates, whether it is fruits, vegetables, pasta, tortillas, cookies or soda, the body breaks those down into simple sugars, the 2 most common being glucose and fructose. Think of those as your body’s “energy currency” with glucose being the primary source. Every cell in your body needs glucose in order to perform all of its functions that are critical to maintaining life. In order to get that energy into the cells so that they can perform all of those functions they need insulin to facilitate that process. Insulin is like the nozzle on the pump at the gas station. Your car needs gas to run and the gas is there at the gas station, it just needs the nozzle to get it into the tank so that it can be used.

Insulin resistance is like trying to pump too much gas into your tank over and over again. It will only hold so much. The cells in our body are the same when it comes to glucose. When we consistently overeat more than our cells need (yes, even with healthy foods) or eat foods that have too much sugar/carbohydrates in them, the cells will start to signal that they don’t need any more and will decrease their sensitivity to insulin, their way of limiting the amount of glucose that gets into the cells. This would be like your car (your body) altering the shape of your gas tank inlet (insulin receptors on your cells) so that the pump nozzle (insulin) wouldn’t fit in it correctly anymore. Some of the gas (glucose) would still get in the tank (the cells), but the rest would spill out onto the ground (stay in your bloodstream). So what is the first thing we see in the blood work that you get? Elevated glucose levels, the first step towards diabetes.

If we force the body to go through this process time and time again, the insulin resistance continues to increase. This in turn causes the reaction by the body to THEN begin secreting more insulin to try and get the excess sugar out of the bloodstream. But this would be like trying to stick more nozzles into the gas tank; it isn’t going to help.

Now the body is smart and it’s not going to let all that excess sugar stay in the bloodstream because that will promote inflammation in the vessels and disrupt the liver’s ability to prevent cholesterol overproduction (the 2 REAL contributors to coronary artery disease – NOT dietary cholesterol intake*). So what does it do? It will take that excess glucose and convert it to triglycerides, which you will see elevated on your labs. These triglycerides will then be stored as excess fat on your body and here begins the process down the path to obesity, diabetes, heart disease, stroke and so on and so forth.

At the end of the day, we have a choice as to what we put into our bodies and whether or not we develop insulin resistance in our cells. Learning to adopt a healthy diet (with diet simply meaning all the foods that you eat) is your key to success in avoiding this condition. That should be your primary goal, but if you have already developed insulin resistance (and our doctors can help you determine if this is the case), the good news is that you can reverse the process and start regaining sensitivity to insulin and regulating your blood sugars. All you need is the proper plan.

*If you would like to learn more about the REAL causes of heart disease in our blogs, leave us a comment in the section below.