Why am I not losing body fat?
For any regular exerciser, the balance of exercise and diet required to support weight loss is generally well understood – eat fewer carbs and calories, get enough movement and cardio and add in some weights to change body composition and increase metabolic rate. An interesting scenario arises when it seems that no matter how many workouts you do, nor how few carbs or calories you consume, nothing seems to budge. And we are not talking about a couple of kilos here. We are talking about 10 or more kilos which could clearly be lost but which do not seem to budge. Whenever I see a client who is carrying 10-20 extra kilos, despite eating relatively well and exercising regularly, I question whether their insulin levels may be out of whack. Insulin is the hormone that controls both glucose and fat metabolism in the body, and high levels of insulin over time can make weight loss very difficult.
Insulin resistance (IR) is a clinical condition in which insulin, the hormone secreted by the pancreas to control blood glucose levels in the body is no longer working as efficiently as it should. Over time, numerous factors including a diet high in processed carbohydrates, a relatively inactive lifestyle and often genetics insulin becomes less and less efficient at processing the glucose we consume in carbohydrate based foods such as bread, cereals, fruit and sugars. When insulin is not working properly, the body is forced to produce more and more insulin to process the same amount of glucose that we consume in food to fuel the muscles and the brain. The unfortunate thing when it comes to weight control is that the higher the amount of insulin that you have circulating in the body, the harder it becomes to burn body fat. This means that if you have insulin resistance, you can be eating an extremely healthy diet, exercising as recommended and actually physically unable to lose weight. In fact, as insulin is the central regulator of both glucose and fat metabolism in the body, when it is not working, the basic energy balance equation when it comes to weight loss, calories in versus calories out simply does not hold true.
The body may show signs of insulin resistance in a number of ways. As resistance builds up over many months if not years, these signs and symptoms can be subtle before become more noticeable over time. Fatigue is common as glucose is not being taken to the cells as efficiently as it should be. Sugar cravings are too common, as insulin and glucose levels fluctuate widely during the day. Perhaps the most powerful sign that a degree of insulin resistance may be present is in the way that fat is deposited on the body. Insulin likes to deposit fat around the abdominal area, which is why women (and men) with severe insulin resistance have a large belly, and the reason that a waist measurement greater than 80cm for a female too may be a sign that insulin resistance is present.
What about the diet?
From a lifestyle perspective, the irony of insulin resistance is that the standard low fat, high carbohydrate diet filled with wholegrains, fruit and low fat snacks may actually exacerbate insulin resistance and may even act to prevent weight loss. While a high carb diet is ‘healthy’, highly processed carbohydrate rich foods result in a relatively high release of insulin. The more insulin we have circulating at any one time, the less likely it is we will burn body fat. For this reason, those with insulin resistance require a high protein, moderate carbohydrate diet which eliminates as much processed carbohydrate from the diet as possible. This does not mean eliminating all carbs, rather working to combine both small amounts of carbohydrates with protein rich foods such as eggs, fish, meat, dairy or nuts at each meal and snack. This ensures that the body has small amounts of carbohydrate at any one time, which in turn helps to regulate the release of insulin, while the proteins help to, keep you full and provide essential nutrients including the good fats, calcium and iron.
Getting the right mix of movement and high intensity training is a crucial component of managing IR long term, as the right types of exercise can actually teach the muscle to burn carbohydrates efficiently again. Ideally a mix of plenty of movement via 10,000 or more steps a day, coupled with 4-5, 30-40 minute high intensity cardio training sessions such as running, aerobics classes or even Zumba are ideal. While weights training is often prescribed, as insulin resistant individuals tend to have plenty of muscle mass (up to 25% more than a non-insulin resistant person), focusing on cardio training and plenty of movement at least initially is a better option that embarking on heavy weights training, as while insulin levels are high, the body will remain in store and build mode, often working to prevent weight loss. This is often seen when individuals who are insulin resistance start with a weights program and lose body size but not weight on the scales.
What to do if you think you may have IR
If you are experiencing any of the symptoms of insulin resistance and find that you are constantly struggling with your weight, the best thing you can do is visit your GP or endocrinologist and have a glucose tolerance test to identify if IR is present. IR is a clinical condition and does need to be managed accordingly, with good dietary and exercise advice and often medication. Once though you do have IR under control not only are your likely to prevent getting diabetes, but you are also likely to be able to get your weight under control, and nothing is more empowering than that.
Signs you may have IR
- Family history of Type 2 diabetes or gestational diabetes
- Distinct abdominal obesity
- Inability to lose weight
- Sugar cravings