Obesity, Hypertension, Metabolic Syndrome, and More

Insulin resistance is most well known as a cause of type 2 diabetes, but experts today recognize that it creates widespread issues throughout the body.

“When cells become insulin resistant, the body compensates by producing more insulin,” says Rita Rastogi Kalyani, MD, chief scientific and medical officer at the American Diabetes Association and professor of medicine at Johns Hopkins University School of Medicine in Baltimore.

Over time, this overload can cause or exacerbate several chronic diseases, including:

• Obesity “Insulin resistance and obesity often reinforce one another,” says Kuruvadi. Elevated insulin levels prompt the body to store more fat while preventing it from burning fat efficiently. It also drives hunger and cravings. “This makes people feel hungrier and more likely to choose foods that further raise blood sugar and insulin,” says Kuruvadi, which leads to weight gain over time, particularly around the midsection.
• High Blood Pressure People with high blood pressure have reduced insulin sensitivity compared with people with normal blood pressure. Experts suggest that because insulin causes sodium and water retention, an overproduction of the hormone due to reduced sensitivity increases blood volume and pressure on blood vessel walls, forcing the heart to work harder and elevating blood pressure.
• High Cholesterol People with higher levels of LDL (“bad”) cholesterol tend to produce more insulin. The pancreas, where insulin is produced, has specialized proteins known as hormone receptors that respond to LDL cholesterol, so when you have more LDL cholesterol, your pancreas responds by making more insulin. Too much LDL cholesterol also increases your risk of heart disease and stroke.
• Diabetes Insulin resistance is a direct cause of type 2 diabetes. When the body is consistently exposed to high amounts of sugar in the blood, the pancreas has to continue pumping out larger amounts of insulin to move all the sugar out of the bloodstream and into the cells. Eventually, cells stop responding well to insulin, triggering the pancreas to release more insulin. Meanwhile, blood sugar levels remain elevated.
• Liver Disease Insulin resistance helps cause the chronic liver diseases MASLD and MASH by provoking fat accumulation within the liver.
• Cardiovascular Disease Aside from its effects on blood pressure and cholesterol, insulin resistance can also contribute to cardiovascular disease by causing inflammation and dysfunction within the blood vessels.

Insulin resistance is “a vicious cycle where the body increases insulin levels to lower blood sugar, leading to weight gain, which, in turn, worsens insulin resistance,” says Marissa Toussaint, MD, MPH, a family physician in private practice in Brooklyn, New York, who specializes in weight loss and chronic disease management.