It’s no secret that being overweight is a risk factor for type 2 diabetes. And losing weight can make a big difference in addressing both prediabetes and type 2 diabetes.
So it may surprise you to know that one of the warning signs of type 2 diabetes is weight loss.
The relationship between weight, prediabetes, and type 2 diabetes is complex. Let’s get into it.
Why are overweight people at increased risk of type 2 diabetes?
When a person is overweight, they have increased levels of adipose (fatty) tissue. When you think of fat, your mind probably goes straight to your hips or thighs. And yes, fatty — or adipose — tissue can deposit under the skin and affect your outward appearance. This is called subcutaneous fat.
But that isn’t the only place fat accumulates. Fat can also attach to places inside the body. This is known as visceral fat. Visceral fat is stored deep in the belly where it’s mostly hidden from view. But it can wrap around the organs and contribute to health problems, including type 2 diabetes.
Visceral fat is the fat that makes people appear apple-shaped. But even thin people can have visceral fat. It’s also capable of producing hormones, chemicals, and other molecules that can cause problems in the body, including insulin resistance — a precursor to type 2 diabetes.
Let’s break down what happens with insulin resistance:
Insulin is a hormone involved in energy production and storage. It’s created in your pancreas.
When you eat, your body releases insulin. This hormone’s job is to shuttle the glucose from your bloodstream into your cells so they can produce energy.
When you have insulin resistance, the insulin isn’t the problem. Your body’s response to it is.
It’s like the insulin is the postal carrier with a certified package knocking on the door to the cell. They want to deliver the package, but they can only leave it if someone opens the door.
When your cells become insulin resistant, they no longer respond to insulin. So the door to the cell stays shut and the fuel to make energy can’t get in.
This starts a cascade reaction. The body detects that the fuel (blood glucose) is too high. So it releases more insulin. But extra insulin doesn’t solve the problem. It only makes it worse. The cells still don’t answer the door. In fact, the more insulin you have in your bloodstream, the more resistant the cells become.
If this process continues, you develop prediabetes and eventually type 2 diabetes.
Does type 2 diabetes cause weight gain?
Here’s where things get tricky. Being overweight is a contributing factor to insulin resistance. So it is also a risk factor for type 2 diabetes.
But prediabetes and type 2 diabetes can actually cause unexpected weight loss.
Think of it this way…
When you have insulin resistance, the glucose can’t get into your cells. The postal carrier is knocking, but no one’s letting them in.
But if your cells aren’t getting the glucose they need, they can’t go through the process of creating energy. Your body interprets this as lack of food, even when you’ve been eating.
If your cells aren’t getting the fuel they need to create energy, your body will respond by tapping into existing fat stores and muscle tissue to supply your cells with energy.
If this keeps happening, your body will continue to use stored fat, resulting in weight loss. And this weight loss can happen quickly — over a period of weeks. Remember, your body thinks it’s starving. And it’s #1 job is to keep you alive. So it will take the drastic action of releasing fat stores and breaking down muscle tissue to accomplish this goal.
And while you might be tempted to think this quick weight loss is a good thing, it’s not. Healthy weight loss can go a long way to improving insulin resistance and blood sugar balance. But this rapid, unexplained weight loss is a big red flag. Your body is trying to tell you something is wrong. And if it continues you can see damage to your kidneys, along with other issues.
People do gain weight with type 2 diabetes. Here’s why:
We’ve talked about the cycle that happens when you have blood sugar dysregulation:
Your food is converted into glucose.
Your blood carries the glucose throughout your body.
Your body releases insulin so the glucose can be moved from your blood into your cells.
Your cells become resistant to insulin and don’t let insulin bring in the glucose.
Your body stores the excess glucose as fat.
Your cells lack energy and your blood glucose stays high.
So your body releases more insulin to try to fix the problem.
Your cells become more resistant to insulin and your body goes on starvation alert.
Your body releases fat and breaks down muscle for cellular energy.
If this pattern continues, your body will start to make less insulin than you need.
And if this happens, your doctor may prescribe supplemental insulin or other medications like glipizide and pioglitazone, which can cause weight gain.
In fact, most people who are on insulin therapy gain weight.
Insulin resistance can also cause weight gain. In the stages before your body declares a starvation emergency, it has to do something with the excess blood glucose. So it will store it as fat.
So, while insulin resistance can cause weight gain when the body stores the unused glucose as fat, much of the weight gain seen with type 2 diabetes is primarily the result of the medications people take to treat it.
How do I stop this cycle?
I know this article didn’t paint a pretty picture. But that doesn’t mean that the news is grim. Yes, insulin resistance, prediabetes, and diabetes are scary and complicated. But, they are not out of your control.
With dietary and lifestyle changes, it is totally possible to help your cells become sensitive to insulin again.
And countless people have reversed their prediabetes diagnosis. You have a lot of control over this area of your health.
If you’re ready to do something about your insulin resistance, I’m here to help! I work with clients every day on improving their insulin sensitivity and reversing their prediabetes diagnosis. Let’s chat!