+
Is Insulin Effecting Your Weight Loss and Your Health?
Teressa Alexander, M.D., FACOG Women’s Healthcare Associates
www.rushcopley.com/whca 630-978-6886
+ Obesity is Epidemic in the US
2/3rds of U.S. adults are overweight or obese
Height Weight Range BMI Considered
5' 9"
124 lbs or less Below 18.5 Underweight 125 lbs to 168 lbs 18.5 to 24.9 Healthy weight 169 lbs to 202 lbs 25.0 to 29.9 Overweight 203 lbs or more 30 or higher Obese
+
1999
Alarmingly, The Obesity Trend is Worsening
2009 1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
+ Over 50 Million Americans Have
Metabolic Syndrome
Defined as the presence of any three of the following conditions:
waist measurement of 35 inches or more for women
triglyceride levels of 150 or above, or taking medication for elevated triglyceride levels
HDL, or “good,” cholesterol level below 50 for women, or taking medication for low HDL levels
blood pressure levels of 130/85 or above, or taking medication for elevated blood pressure levels
fasting blood glucose levels of 100 or above, or taking medication for elevated blood glucose levels
It places your risk of developing disease as EXTREMELY HIGH
+ The Bad News - Obesity Increases
Your Likelihood of Disease
People who are overweight or obese have a greater chance of developing:
High blood pressure
High cholesterol or other lipid disorders
Type 2 diabetes
Heart disease
Stroke
Certain cancers
+
BMI Obesity Class
Waist <35/
to Disease risk
Waist >35/
to Disease risk
Underweight <18.5 - -
Normal 18.5 – 24.9 - -
Overweight 25 – 29.9 Increased High
Obesity 30 – 34.9 I High Very High
35 – 39.9 II Very High Very High Extreme
Obesity
40 III Extremely
High
Extremely High
Disease Risk Increases By Weight
+ There is Good News
A small weight loss (just 10% of your current weight) will
help to lower your risk of developing those diseases
+ So How Does Insulin and Insulin
Resistance Fit In?
A hormone made by the pancreas
Helps the body use glucose for energy
Glucose in the blood is called blood glucose, also known as blood sugar
As the blood glucose level rises after a meal, the pancreas releases insulin to help cells take in and use the glucose.
+ What is Insulin Resistance?
A condition in which the body produces insulin but does not use it properly - muscle, fat, and liver cells do not “receive” this insulin.
+ A Vicious Cycle
With resistance, more insulin is needed to help glucose enter cells
The pancreas tries to keep up with this increased demand for insulin by producing more
Eventually, the pancreas fails to keep up with the body’s need for insulin
Excess glucose builds up in the bloodstream, setting the stage for diabetes
Many people with insulin resistance have high levels of both glucose and insulin circulating in their blood
Many people with insulin resistance have high levels of both glucose and insulin circulating in their blood
+ What Causes Insulin Resistance?
Specific genes have been isolated that make people more likely to develop insulin resistance and diabetes
Poor diet, excess weight and lack of physical activity also contribute
+ The Fat-Burning Impact of Insulin
Resistance
Once your body releases insulin it immediately starts to inhibit your fat-burning hormone called hormone-sensitive lipase
This hormone is responsible for releasing fat into your bloodstream to be utilized as fuel
Once this enzyme is inhibited, your body is unable to burn fat and will then begin utilizing amino acids from your muscle and
carbohydrates as fuel
This will cause you to become hungry, which further feeds this vicious cycle.
The key is to have LOW levels of insulin so your body can produce large amounts of hormone-sensitive lipase and burn fat
The key is to have LOW levels of insulin so your body can produce large amounts of hormone-sensitive lipase and burn fat
+ Other Effects of Insulin Resistance
Insulin resistance increases the chance of developing:
Type 2 diabetes
Hormone abnormalities - PCOS
Cardiovascular disease
Abdominal Obesity
High blood pressure
Abnormal levels of cholesterol and triglycerides
Metabolic Syndrome
+ Diabetes
Type 1 - Where the pancreas makes little or no insulin because the body’s immune system has attacked and destroyed the cells of the pancreas. Formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults.
Type 2 - Begins with insulin resistance, in time, however, the pancreas loses its ability to secrete enough insulin in response to meals. Formerly called adult-onset diabetes, is the most common form. People can develop type 2 diabetes at any age, even during childhood.
Gestational Diabetes - Diabetes that first occurs during pregnancy and resolves with delivery but increases a woman chance of developing type 2 diabetes later in life.
+ PCOS – Polycystic Ovarian Syndrome
Most commonly related to
ovulatory dysfunction as a result of adverse effects of elevated insulin levels on ovarian function
Cause unknown – may be some genetic component
Seen across all races
Affects 10% of all women
Treatment addresses symptoms
Symptoms
Infertility
Increased risk miscarriage
4-7x increase risk of heart disease
Unwanted hair growth - face, chest, abdomen and feet
Acne
Elevated Blood Pressure
Increased risk of Uterine Cancer
Obesity
+ So What Are the Symptoms of Insulin
Resistance?
Usually have no symptoms
Acanthosis nigricans - dark patches of skin, usually on the back of the neck, elbows, knees, knuckles, and armpits
Abnormal periods
Infertility
Obesity
+ Diagnoses of Insulin Resistance
Routine blood tests to determine whether a person is diabetic but do not usually test for insulin resistance
Insulin resistance can be assessed by measuring the level of insulin in the blood
Diabetes and pre-diabetes can be detected with one of the following tests:
Fasting glucose test
Glucose tolerance test
+ Treatment for Insulin Resistance
Learning about insulin resistance is the first step toward making lifestyle changes that can help prevent diabetes and other health problems
The first therapy should always be an intensive lifestyle modification program
Weight loss and physical activity are much more effective than any medication at reducing diabetes risk.
The American Diabetes Association recommends that Metformin is the only drug that should be considered for use in diabetes prevention.
Metformin use was recommended only for very high-risk individuals who have BMI >35, Pre-diabetes, and < 60 years old.
+ Losing Weight Also Helps PCOS
By losing weight, through diet and exercise, women affected by PCOS are more likely to have:
Regular periods
More ovulatory cycles
Reduced hair growth
Stabilized hormone levels
Reduced risk of heart disease
Weight loss will contribute to lowering insulin levels. Because high insulin levels has been found to contribute significantly to the many PCOS
symptoms, reducing your insulin levels will have a direct improvement.
Weight loss and regular exercise are now recommended as a first line treatment for PCOS.
However, in some cases, drugs like Metformin may still be prescribed.
+
Is Insulin Effecting Your Weight Loss and Your Health?
Rondi Stickney C.P.T, Master Trainer
Founder of Ditch the Diet …it’s a Lifestyle
Rondistickney@comcast.net 630-742-9332
+ Diets Don’t Work
Individuals with the best results only lose 5 – 10% of their weight
Over 2/3 gain ALL their weight back within 1 year
99% gain ALL their weight back within 2 years
Going on a diet? Means eventually going OFF a diet – a DIET IS NOT THE ANSWER
+
Low Carbohydrate vs. Conventional Diet
The difference in weight loss was no longer significant at one year.
+ Glycemic Index
How quickly a carbohydrate is absorbed by the body and raises our blood sugar
(compared to controlled carbohydrate that is known, such as glucose)
Bread, rice, cereal, white potatoes, spike sugar faster than as if eating table sugar
Most critical time is immediately after a meal/snack – when blood sugar rises too quickly, it can cause damage of the arteries, too much inflammation, and stimulates the production of too much insulin
+ Behavior Modification
First Bad Behavior: Portion Size. Large or too small. Typically palm size is a good measurement. Have a protein, vegetable, and a
carbohydrate with meals. Try to eat 5-6 small meals. Drink Water!
Second Bad Behavior: Bad choices of what we eat. Sweets, fried, processed or high-glycemic foods, etc.
Third Bad Behavior: Late night snacking or having our last meal to late or that meal being too large. Eat at least 3 hrs before bed.
3 Bad Behaviors – It’s a Lifestyle Change.
+ The Blood Sugar Roller Coaster
Blood sugar control is necessary for the body to operate properly.
If blood sugar is too high, as seen in diabetics, vision may be disturbed and we can’t think as clearly as we should.
If the blood sugar gets too low, we might actually get confused, have a seizure, or even go into a coma.
The extreme rise and fall of one’s blood sugar several times
throughout the day, and the resultant over-stimulation of insulin, leads to the core of acquired insulin resistance.
Control of Blood Sugar is the key to success.
+
+ Reversing Insulin Resistance
Eat a healthy low glycemic diet that does not spike your blood sugar
Develop modest exercise program
Provide cells with cellular nutrition
Employ relaxation (meditation or yoga)
+ Workouts help Reverse Insulin Resistance
& Lower your risk of…
Depression By
28%
Heart Disease By
50%
Hip Fractures By
41%
Breast Cancer By
28%
Colon Cancer By
