How to lose weight with insulin resistance

If you are insulin resistant, losing weight may be harder for you than the average person. Why? A body needs insulin—a hormone produced by your pancreas—to move sugar from the bloodstream into the cells to be used for energy. Insulin resistance causes cells to become less responsive to insulin. 

Insulin resistance is very common: It is the hallmark of prediabetes and Type 2 diabetes.  (The American Diabetes Association also describes this as impaired insulin sensitivity.) Here’s what you need to know about losing weight with insulin resistance.

RELATED: Insulin resistance vs. prediabetes

Insulin resistance and weight 

Research shows that adult weight gain is linked with increased insulin resistance. The more weight that you put on, the greater the likelihood of developing insulin resistance—and eventually, Type 2 diabetes. In fact, it’s well established that obesity is a risk factor for Type 2 diabetes.

Conversely, if you lose weight, you may regain some insulin sensitivity. But it does depend in part on where the weight is. Research tells us that not all weight gain (or obesity) is the same. 

“People that naturally gain weight in their belly are more prone to insulin resistance,” notes Brandy Wellmon, PA-C, a physician assistant and certified diabetes educator with Texas Diabetes & Endocrinology.

A big belly, or a potbelly, is a sign of visceral fat, according to the Cleveland Clinic. If you have extra weight in your abdominal area, those excess pounds may be visceral adipose tissue, surrounding your internal organs. Visceral adipose tissue is hormonally active and can interfere with insulin signaling. This is different from the fat that lies just beneath your skin, which is known as subcutaneous fat.

Experts say that those with insulin resistance can still lose weight—though it may be more difficult. “Weight loss can be a challenge for anyone,” says Natasha Agbai, MD, a pediatrician who specializes in obesity medicine and founder of Weight Loss for Kids. “For someone with insulin resistance, it’s an even bigger challenge due to the way their body processes glucose.”

When your cells don’t respond to insulin very well, levels of insulin increase as does glucose in your bloodstream. This makes it harder to burn fat because the extra insulin levels tell the body to store energy instead of using it as fuel. “As a result, you may experience weight gain or difficulty losing weight,” Dr. Agbai says.

RELATED: How to reverse insulin resistance

How to lose weight with insulin resistance

Now for some good news. “Fortunately, people with insulin resistance can still lose weight if they adjust their diet accordingly, through increased physical activity and nutrition changes such as decreasing processed foods and added sugars and flours,” Dr. Agbai explains.

Start by talking to your healthcare provider about your plan. Understanding what constitutes a healthy weight for you can help you set a goal, and then you can work toward that number. Here are some strategies to help you lose weight and improve insulin sensitivity.

1. Incorporate healthy foods into your diet

First, you can work on keeping your blood glucose levels well controlled by eating right, says registered dietitian Amanda Stahl, RD, LDN, co-owner of Simple Start Nutrition. Assess what is missing from your current diet so you’ll know what to add. For example, substitute brown rice for white rice, or opt for whole-grain bread rather than white bread. Research shows that eating a diet rich in whole grains, rather than refined grains, can lower your propensity for putting on visceral adipose tissue, aka belly fat. 

But don’t stop there. “We want to focus on a wide variety of fruits and non-starchy vegetables (i.e., broccoli, mushrooms, and salad greens), whole grain starches (instead of the white, pasty items), nuts and nut butter, and legumes (i.e., beans and lentils),” Stahl says. “We also want to ensure that we are including lean protein sources into our diet, i.e., chicken, turkey, eggs, and fish while including moderate amounts of dairy.”

RELATED: The best diet for insulin resistance

2. Cut back on unhealthy foods

While you’re adding healthier fare to your meal plan, cut back on junk food, refined sugars, carbs, and trans fats. The American Diabetes Association suggests steering clear of sugary cereal, sugary sweetened beverages, cakes, cookies, chips, and candy—instead opting for whole foods. “Ultra-processed foods are often high in flours, sugars, and unhealthy fats—and lack essential nutrients like vitamins and minerals that support a healthy metabolism,” Dr. Agbai says.

3. Eat at the right time

Eating a healthy array of foods and foregoing the less-healthy foods are the first steps. You also establish an eating plan to help you eat at the right times. “These well-balanced meals should be evenly spread out throughout the day to keep our blood sugars within even levels,” Stahl says. “Our bodies don’t appreciate it when we don’t eat all day and then load up at one meal, typically with too many carbohydrate choices, which alter our blood sugars.”

4. Consume more fiber

If you’re trying to tackle stubborn body fat, try adding more fiber to your diet plan, too. Increasing both your total dietary fiber and insoluble fiber may help you reduce some of that adipose tissue in your abdomen, according to research in Obesity.

5. Drink less alcohol

Alcoholic beverages contain unnecessary calories, thwarting your attempts to lose weight. Additionally, research suggests an association between central adiposity and consuming multiple alcoholic drinks per day. In other words, if you’re trying to shed some belly weight, start by reducing or even eliminating your alcohol consumption.

6. Exercise

While diet matters when it comes to losing weight, so does regular physical activity. “Exercise is also very beneficial for improving insulin sensitivity, as it increases glucose uptake into the cells,” says Dr. Agbai. “Exercise helps not only to reduce fat but also increases the availability of glucose receptors on cell surfaces—making them more sensitive to available glucose or other nutrients needed for energy production.” If you’re not exercising regularly, consider talking to a professional trainer or another expert to get tips on how to get started.

7. Consider weight-loss medication

You might want to discussi a weight-loss medication with your primary healthcare provider or endocrinologist, especially if dietary changes and exercise aren’t working as effectively as you’d like. To qualify for a prescription weight-loss drug, you must have a body mass index (BMI) of 30 or greater or have a BMI of 27 or greater with at least one weight-related disease, such as high blood pressure, high cholesterol, heart disease, or diabetes.

If you already have Type 2 diabetes, your healthcare provider might prescribe a diabetes medication known for suppressing appetite and helping with weight loss. For example, metformin is a commonly used diabetes drug that also suppresses appetite, aiding in weight loss. Another class of medications, called glucagon-like peptide 1 (GLP-1) agonists, is known to be effective in helping people lose weight. For example, Ozempic (semaglutide) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of diabetes in late 2017. Another example is Mounjaro (tirzepatide).

However, if you have insulin resistance but haven’t been diagnosed with Type 2 diabetes, you have options. Semaglutide is now also available specifically as a weight-loss drug for people with obesity or excess weight and a weight-related medical problem. That version is sold under the name Wegovy. Your doctor can also prescribe the above medications off label, but your insurance may not cover it.

8. Reduce your stress levels

When you are stressed out, the body releases hormones such as cortisol and adrenaline. Unfortunately, those hormones contribute to insulin resistance. That can make your blood sugar levels rise, and it may also impede your efforts to lose weight. There are great stress management strategies out there, such as mindfulness, meditation, exercise, making social connections, journaling, and making music. Pick your preferred stress relief activity and embrace it!

9. Get adequate sleep

“We can’t overlook sleep because sleep significantly improves metabolic function for people suffering from obesity/insulin resistance issues,” Dr. Agbai says. “Inadequate rest impairs hormones related to appetite control, such as ghrelin, which reduces your ability to regulate hunger pangs safely without overeating or indulging in unhealthy snacks throughout the day.” Additionally, she notes, if you don’t get enough quality sleep, your body produces extra cortisol, which makes fat loss more difficult.

What is the fastest way to lose weight with insulin resistance?

Everyone wants a quick fix. But patience is necessary for successful weight-loss. “We expect to see results immediately,” says Wellmon. “If you set your expectations to attainable goals, then the first and most important thing to remember is you should stick with your lifestyle improvements for at least three months before you should expect to see a significant amount of weight loss.”

Dr. Agbai agrees that making changes in diet or exercise regimen are best made gradually over time—and in consultation with a healthcare provider or nutritionist who is knowledgeable about insulin resistance. If you’re making positive changes and the weight still won’t come off, your healthcare team can help with other options for weight management.

The bottom line – Insulin resistance and weight loss

If you’re overweight or obese, losing weight significantly reduces your chances of developing health conditions such as cardiovascular disease or metabolic syndrome. It can help you address high blood pressure and high blood sugar levels. Or consider your cholesterol levels: losing just 5%-10% of your body weight can help decrease your triglyceride and low-density lipoprotein (LDL) levels, too.

Don’t lose sight of your reason for losing weight. Keeping the big picture in mind helps you stay on track if the pounds are slow to drop off.

Start by making small, actionable lifestyle changes. Embrace a healthy diet and reduce your stress levels. If those changes aren’t helping you reach your goals, consult your healthcare provider for some additional guidance.

“The most important thing for people with insulin resistance is to think positively, work hard, and be patient,” says Dr. Agbai. “It may take time before you start seeing results, but don’t let this discourage you from striving for your desired outcome.”