Everything you should know about

Metabolic Diseases

Everything you should know about

Metabolic Diseases & Insulin Resistance

Insulin resistance drives all metabolic diseases. Excess body fat drives insulin resistance. There are more than 50 reasons why people accumulate excess body fat.

Some people can carry a lot of body fat and still remain healthy (FOFI: Fat outside, fit inside).

Some become metabolically sick even at low body fat percentage. It all depends on someone's
personal fat threshold (PFT).

Insulin resistance leads to the following metabolic diseases

All of type-2 diabetes and PCOD

Almost all of hypertensions and high-cholesterol

Most of the atherosclerosis (blocks in the heart)

Most of the cancers Obesity is a special casea.

Obesity causes insulin resistance and insulin resistance leads to further obesity.

It is all about Insulin

What is Glucose?

Carbohydrates are the starchy stuff in our food. Inside the body, most of the carbohydrates are broken down into glucose. Sometimes, the body can also break down the protein from the muscle tissue and convert it into glucose. Glucose is a major source of fuel for almost all the cells in the body. The body can produce all the glucose it needs, even when we do not eat any carbohydrate. So, eating carbohydrates is not essential. Interestingly, even though carbohydrates are not essential, most of our food items are made up of carbohydrates. This is because carbohydrates are cheaper than the other sources of energy, namely protein and fat.

Carbohydrates have a dirty trick up their sleeve: Carbs switch off our satiation signal.

What is Insulin?

Hormones are messenger chemicals produced by the body. A hormone called testosterone tells the body to grow facial hairs. Another hormone called estrogen tells the body to develop breasts. A hormone called insulin tells the cells in the body to open their gate and take the glucose in.

What is Insulin Resistance?

When cells in the body become partially deaf to insulin's call to open up their gate and accept more glucose, they are said to have become insulin resistant. To compensate for the deafness of the cells, body shouts harder by producing even more insulin.

Three things happen in an insulin resistant body:

  1. Body works harder to produce more insulin.
  2. Too much of insulin is floating around in the body.
  3. Because the cells are resistant to insulin action, some glucose may not get into the cells and in the blood.

They are all bad news:

  1. If body continues to work harder to produce more insulin, it eventually gives up and the insulin production drops precipitously.
  2. Too much of insulin floating around in the body can lead to hypertension, atherosclerosis and even cancer.
  3. Too much of glucose in the body can stick to the protein in the body and damage them.

Fat: How much is too much?

Three places to store the fat

Body stores surplus energy inside fat cells.

First, it starts filling up the fat cells under the skin, this is called the subcutaneous fat. Filling up the subcutaneous fat doesn't lead to metabolic diseases (but  there are other complications like surplus estrogen, too much load on the joint joints, etc.)

After the subcutaneous fat cells are filled up, body starts to till up fat tissue in the abdomen, called the visceral fat.

After the visceral fat is filled up, body starts to store the excess energy in the form of fat in the organs (liver, pancreas, muscle), etc. Some excess energy may also be left stranded in the blood.

When the body starts to store fat in the organs, people become metabolically sick.

PFT: Personal Fat Threshold

PFT (Personal Fat Threshold) is the amount of fat everyone gets to store before they become metabolically sick. PFT levels varies from person to person. Some people have lots of fat cells to fill. They have high PFT. Some people have very few fat cells in their body. They have very low PFT.

Most South Indians carry very low fat cells. Most of them have string-bean like arms and legs. Their fat storage starts overflowing very quickly.  The moment they start growing a paunch, you should expect them to also have fat deposit in the organs. They have low PFT. Typically at around 19% percentage body fat (PBF).

Some people, like sumo wrestlers, have large amount of fat cells. They can store large amounts of fat in their body before their fat cells start to over-flow. Even though they are fat, they do not become metabolically sick. We have had a patient who was 5' 3", 116 kg, with one of the healthiest blood markers we have ever seen. People like her have high a PFT.

Not everyone who carries a lot fat will become metabolically sick. But everyone who fills up their fat cells will.

When it comes to reversing metabolic diseases, the first thing you should work towards is to reduce your body fat to below your personal fat threshold.

Metabolic Diseases Line Up

Here is the list of most common metabolic diseases. They are all diseases caused by insulin resistance:


Obesity is a disease and it is one of the most complex metabolic diseases. More than 50 things can lead to accumulation of excess body fat. But once the amount of fat accumulated exceeds one's personal fat threshold, they become insulin resistant. Once someone become insulin resistant, the excess insulin makes them even more obese. More...


When excess insulin acts upon the ovaries, it produces multiple cysts (bags) in the ovaries. This is called PCOD, or Polycystic Ovarian Disease. Polycystic ovaries produce excess amount of the male hormone testosterone. Reducing excess insulin present in the body and providing nutritional building blocks to the body will help reverse PCOD, usually within a month or so. More...

Type-2 Diabetes

Remember, that when people cross their personal fat threshold the body starts to deposit incoming excess energy in all kind of places. So, some of the excess energy, in the form of carbohydrate, is left stranded in the blood. We call this type-2 diabetes. More...

High Cholesterol

You read in the above section that type-2 diabetes is excess energy stranded in the blood, in the form of carbohydrate. High cholesterol is usually excess energy stranded in the blood in the form of fat. To reduce your cholesterol, empty the fat cells so that excess fuel from the fat cells do not spill in the blood. More...

Hypertension (high BP)

You already know that insulin resistance increases the amount of insulin floating in the blood. This excess insulin damages the inner surface of the blood vessels called endothelium. Endothelium regulates the blood pressure. Once the endothelium is damaged, people lose their ability to regulate their blood pressure and end up with hypertension. More...

Atherosclerosis (blocks)

Once the endothelium is damaged, body tries to putty over the cracks using cholesterol. This becomes the beginning of the plaque formation. Eventually, in order to stop the plaque form breaking away, body adds some calcium matrix. We call it atherosclerosis. More...


As we age, most of us carry cancer cells due to mutations and cell damages. As long as they do not have an environment that encourages their growth, everything is fine. However, insulin resistance increases the amount of insulin in the body. Insulin is anabolic, meaning, it encourages all kind of growth. Including growth of cancver cells.

So, having insulin resistance increases the chances of one eventually getting a cancer. More...


Insulin resistance starts with fat getting deposited into the liver (fatty liver). For these people, the liver doesn't work as efficiently as it must. They get conditions like skin rashes, allergies, etc.

Metabolic diseases (listed here) also lead to many other complications, most of them serious ones.

More on Metabolic Diseases

Metabolic Diseases

Common causes


Metabolic diseases are caused by insulin resistance

Insulin resistance is caused by excess body fat.

More on Gastrointestinal Disorders

Metabolic Diseases 101

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