Causes of Insulin Resistance: The Personal Fat Threshold

This video discusses the personal fat threshold hypothesis, a key concept in the development of insulin resistance and type 2 diabetes.
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- VIDEO DESCRIPTION -
Being overweight or obese is associated with a substantially increased risk of becoming insulin-resistant and developing type 2 diabetes.
However, not everyone with obesity is insulin resistant, and many people with even morbid obesity never develop diabetes. At the same time, some people develop type 2 diabetes even though they are barely overweight or even have a body mass index in the normal range, while others are obese and never develop diabetes. How can these observations be reconciled?
The cumulative evidence on the topic suggests a model called the personal fat threshold hypothesis. This hypothesis posits that insulin resistance and glucose intolerance are associated with fat accumulation in some tissues, whereas fat accumulation in others is metabolically benign.
In this video, we will thoroughly review the personal fat threshold hypothesis, how fat tissue works, and what happens inside the body when fat can no longer be safely stored.
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- TIMESTAMPS -
0:00 Introduction
04:18 Weight Gain is Associated With an Increase in Insulin Resistance
08:37 How Fat Can Safely Be Stored in the Body
10:53 The Type of Body Fat that Triggers Insulin Resistance
13:15 How Fat Tissue Works
23:49 The Personal Fat Threshold
26:37 What is the Evidence Supporting the Personal Fat Threshold Hypothesis?
30:00 Why is the Personal Fat Threshold Hypothesis Relevant?
32:30 How Do We Know Whether We Have Crossed Our Own Personal Fat Threshold?
35:43 Summary
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The content of this video, this KZbin channel in general, and our blog at www.nourishedbyscience.com is for informational purposes only. Nothing herein shall be construed to be health or medical advice. Although we have made every effort to ensure the accuracy of all information posted to this Website, we can make no guarantees as to how the information and advice provided herein will affect you and your personal situation. If you need or require individual advice or guidance, then you should consult with a professional who can assist you. For our full disclaimer, please refer to nourishedbyscience.com/discla...

[@peterbedford2610]

Fasted work outs in the morning really helped me drop the last few pounds

[@harani4446]

Good

[@sheila7814]

Thank you for sharing is method

[@marcdaniels9079]

I must have watched literally 100s of nutrition and health videos over the last 5 years and this is without doubt the absolute BEST. Clear, well explained with no food tribe drama. I hope as many people as possible can see this so that they are better educated and can steer away from the hype and nonsense being pedalled to them by YT "experts" and "doctors" interested in promoting their books or extreme lifestyles. THANK YOU SO MUCH.

[@nourishedbyscience]

Appreciate you taking the time to provide feedback. Particularly because you spell out some of the reasons that motivated me to start this channel. I am so tired of diet tribalism, and literally sick to my stomach about all of the influencers out there on KZbin and other social media who mostly line their pockets with sponsored posts and affiliate deals that end up promoting some processed crap, or some extreme views that inevitably lead to a supplement. Best, Mario

[@Franklin-pc3xd]

Agreed - this clears up a whole lot and makes sense; including, by inference, the plateauing phenomena we routinely experience in weight loss campaigns. The next thing I'd like to explore is how, and if, resistance training might alleviate the visceral fat problem as it relates to muscle fat build-up.

[@edoardo849]

Probably one of two best nutritional KZbin channel. The other being the weight loss videos of Renaissance Periodisation. Incredible that this is free. This kind of web is amazing.

[@janetmoy6127]

Totally agree! No doctor has been able to explain these valid points to me. Thank you!!

[@Daniele__D9]

AGREE ! Thank You !!

[@johannel8104]

Thanks Dr K. This was very illuminating and seems to explains the weird cases where skinny people have diabetes and very overweight people do not.

[@Carterofmars]

One of the best scientist on YT. Mario is extremely rational in arriving at his determinations. Nothing is taken for granted or at face value and is properly (as far as this layman can tell), analyzed. He sites credible sources of scientific studies and journals. End result: a VERY high level of confidence in his material. I'd love to see Dr. Katz and Dr. Becky Gillaspy, another very credible YT doctor, in a long form discussion. 👍👍👍

[@nourishedbyscience]

Thank you for the praise. Didn't know Dr. Becky; I'll check out her channel. Cheers Mario

[@user-fk8rb8ue5h]

Roy Taylor's work is the benchmark. Professor at Newcastle University.

[@vincitquesevincit]

This is the best video I've seen explaining the current understanding of how insulin resistance develops. Thank you for an informative and well-delivered presentation.

[@timber750]

This is the most lucid discussion of the cause for the development of insulin resistance I have yet encountered. Thanks.

[@fractalbeans9513]

I need to watch it again and again; so many questions. This is an eye opener - THANK YOU!

[@trend0000]

I waited almost impatiently for your new video! Great explanation, understandable and very teaching about our conditions who may concerns! On many similar KZbin sites, I always try to redirect people to this channel! Many explain well in general terms, but as you do, is all different level! Thank you!

[@felicecaccamo68]

Fantastic and clear! One of the best resources on KZbin.

[@martin9756]

Watched this video and you have again added another piece of the jig-saw picture showing and giving me the information and knowledge not to be mislead and mis-treated - medically for my T2D condition. Big Thank You.

[@tinybarabo]

Wow, this video is gold worth!! Also it make me really appreciate how the body is trying to keep up with bad diets, stress, etc.

[@adriananis2]

Excellent video Dr Kratz. One of the only few channels that actually asks the right questions and looks at root causes.

[@juliapace2845]

Thank you for this excellent explanation, something that other 'experts' only hint at. Interesting and well done - without dietary dogma. Thank you so much - I have been searching for this kind of information.

[@janegardener1662]

Great video! Thanks for taking the time to explain this "sensitive" topic.

[@rajeshjyotsna1184]

Immediately subscribed and pressed bell icon after watching this video. The most clear way of explanation which everyone can understand. Got confidence that i can improve my health

[@mariomenezes1153]

Brilliant explanation! I have heard a lot about insulin resistance, the high level understanding of what causes it and the negative effects on the metabolic system, but did not understand the mechanics of when and how insulin resistance is caused. Was also aware that there are thin people who are insulin resistant and overweight people who are insulin sensitive, but this explanation of the underlying reason was the best I have heard. Thank you!

[@kirstygreenfield1926]

Fantastic video, clearest and most comprehensive explanation I have come across, and I really appreciate your evidence based approach.

[@thewellnessroom6574]

I am obsessed with IR and have watched hundreds of videos and have gone to conferences explaining this, and this videos in my opinion is one on the best ones. Thank you!!

[@Gianmarco77]

This is a life changing video. Must watch over and over.

[@karolina8367]

Glad to have found your channel, so much valuable knowledge, thank you so much!

[@rmararj]

Wow, this is the best explanation about insulin resistance in YT, congratulations and thanks

[@Overlord1241]

Woahh! The knowledge, the animation, and the tids and bits of information that I had, everything makes so much sense now! Thanks!!!

[@montourigirl]

Wow, best explanation i have listened to! I think I finally understand this complexity.

[@Gamvrelis]

A brilliant and well-paced presentation - thank you!

[@janborkowski9494]

That was a very informative and well prepared materiał. Keep up decoding how the body function and how we can avoid all that mess❤

[@sssoup]

Easily one of the best in explaining complicated material in simple fashion. Thanks ...very very helpful

[@nourishedbyscience]

Thank you!

[@CapucineAbadie]

I thought I already knew quite a lot about this stuff, but this was soooo fascinating! It's actually very inspiring, because once you know how something works, you know what you can do about it.

[@nourishedbyscience]

I'll make one more video about causes of insulin resistance, because not only do we need to understand how the body works, but also what the specific cause of insulin resistance in any one person may be. If someone is insulin resistant because they are chronically stressed and sleep deprived, the lifestyle change needed will be different than in someone who has fatty liver or medication-induced insulin resistance. Thank you for the feedback. Cheers Mario

[@lazarus6983]

Wow... What an amazing video. This is extremely high quality stuff right here. It makes sometimes seemingly contradictory epidemiology very digestible and explainable to the average person. We need more videos like this across more domains which people often get confused in (mainly due to social media)

[@nourishedbyscience]

Glad you enjoyed it!

[@jackgoldman1]

Thank you for your science based approach to nutrition and being our own best doctor for myself. I am lowing my A1C with medication and behavior changes.

[@luccalus]

I have seen a lot of videos on this subject and this one by Dr Kratz is by far the clearest in its explanation.

[@nourishedbyscience]

Thank you for your kind feedback! Cheers Mario

[@bikeman9899]

Excellent. Really good. I especially like the nuance Mario delivers. Also , when introducing a technical term, he displays it on the bottom of the screen. That's helpful. Mario, a suggestion. There is so much info in your videos, I think it would help to number your chapters or sections. It helps to follow along. Congratulations on superb lectures.

[@amarug]

this was a truly amazing video. excellently researched and presented. thank you so much for your efforts!

[@donbrown7694]

This is great to know!!! I switched to a ketogenic diet due to type 1 diabetes. I had the typical hyper responder values (low triglycerides) but after a while I gained 5 kg (to just 75 kg!) and since then my triglycerides are always above 100 no matter what I do. I notice my insulin resistance due to my insulin shots. I’ll also try to get the CRP measured and reduce my fat. Thank you for sharing this!

[@anuraghere4997]

Brilliant is the only word that comes to my mind . I am a lean but belly fat person with hba1c of 11. I was always been a lean person. But chronically stressed and sleep deprived. I vouch for every thing this gentleman had said.

[@katashley1031]

Aha, stress and sleep deprivation! I look forward to hearing him dive into that element as it is a huge contributor to all sorts of health issues, esp metabolically.

[@Frazec_Atsjenkov]

Very well-structured and researched video. I also really like how carefully you worded your comments. A+

[@SaSPonchICo]

After changing my diet, my blood sugar is now normal, but insulin resistance is still high. Since doctors generally recommend to "just" lose weight (which almost ended in an eating disorder) and don't give much insight into the other possible reasons of me having high insulin resistance, I appreciate the insight you provide.

[@alisonbamford6723]

If you are eating a low carb diet, the fats in the diet will drive insulin resistance. I followed LCHF for over. Years & my body became so fat-saturated I couldn’t get my blood sugar down even with loads of insulin. As my ability to digest animal protein had also collapsed, I had no option but to go plant based. I just juiced initially for the first month to give my poor digestion a break, & although my BG stayed high, probably as my body cleared some of the ectopic fat, suddenly, around the end of the month my BG started to drop, my insulin sensitivity returned & I had to cut the insulin intake by more than half. I also lost some of the extra weight I’d gained on Keto. Fats definitely drive my insulin resistance. The more fat I consume, the more resistant I become.

[@laylapersia]

This video is the best single resource on this topic I've seen, and will be useful to share with loved ones as a primer on the often quiet path to pre-diabetes via insulin resistance. ❤ Thank you for being one of the very best channels I've ever seen on KZbin! This is a rare glimpse of humanity and the internet at its best! ❤

[@nourishedbyscience]

Thanks so much, both for the support and the kind feedback. Best, Mario

[@tam8479]

Excellent video! Thank you so much for sharing your knowledge. It makes sense that im underweight and have diabetes eventhough i eat much healthier while my friends who are so unhealthy yet have no major health consequences. Liked, subscribed, shared!

[@vixdivum]

Aaawwwesoooome video!!!!!! Thank you very much! I loved it - as all the other videos! You truely have a unique way and talent to make complex topics easy digestable eve to people with no scientific background! Well done! 👏👏👏

[@eatanelkberger6416]

This is the best explanation I've seen for insulin resistance!

[@catherinewilson1079]

Fantastic video! Thank you. You have a very good method of organizing and presenting your material, making it easy to understand.

[@renhermsen8062]

Many thanks for sharing! Very well explained and well done!

[@NicoMatthijs]

This was a very good video. Thank you for this and for the large amount of effort that was clearly put into this. I learned a lot from this. Subscribed 😊

[@nourishedbyscience]

Glad it was helpful!

[@Flytoohi]

Really well done! The best explanation I've heard, yet. Thank you!

[@littlebitmckee8234]

I am a recently retired nursing professor. I wish I would have known about you to share with my students. Blessings to you and prayers for your continuing work

[@KoiRun50]

Awesome animated graphics. I find this is the best way for me to learn.

[@nourishedbyscience]

Thank you. I am still learning how to make these (and mostly need to learn how to make these quickly; these here took way too long ...;-) Cheers Mario

[@reneejones7807]

This makes so much sense!! Thank you for explaining this in a way a non medical person could understand.

[@anhha7354]

Wow awesome explanation and illustrations! Very easy to understand. Thank you!

[@dee9692]

This is a brilliant exposition of insulin resistance in itself. And, as I've found after watching very many talks/videos about metabolic syndrome/diseases, this description is absolutely necessary not only for understanding the part that IR plays in the progression towards T2D but, more broadly, the role of uric acid, fructose, nitric oxide, etc. when describing the various processes resulting in metabolic distress. The complexity of these relationships often means that presenters gloss over and short circuit explanations of the meaning of insulin resistance. Here, however, Dr Kratz has squared the circle for me and provided all the missing relationships for a pretty good understanding of the broader aspects of metabolic health. Bravo!

[@nourishedbyscience]

Thank you. Glad you found it helpful. Best, Mario

[@eclampsium]

First time i land on a video from this channel and instantly subscribed and sepparated this video to share with my group of friends that I’m trying to improove they’re health! Fascinating content on fat phisiology. Thank you for takong your time to help others with that. There is so much crap on YT, but this is Gold… i’ve seen hundreds of videos about health and weight loss on YT that helped me to improove my otherwise bad health condition i carried over for the last 2 decades and now i see clearly what happened! I crossed my personal fat treshold and I’m starting to even figure out when and wich is my weight thet causes it to cross and make me inflamed. I’ve done muscle biopsy in the past during my chronic inflammation investigation and this is the second and moat accurate hint of what a strange corpuscle was in my muscle: globs of accumulated energy off course!

[@nourishedbyscience]

Thank you, Humberto, for the kind feedback. One reason I started this channel is that I felt there was way too much diet tribalism and misinformation on KZbin (and other social media). I have about 30 years of clinical research experience, running my own lab for 14 years, all in the area of nutrition as it relates to obesity, type 2 diabetes, fatty liver disease, and cardiovascular disease. So I do know this field well, and I can read and interpret the literature, but the biggest asset I hope to bring to KZbin is that I have learned to appreciate the complexities of human nutrition and biology, and don't easily subscribe to oversimplified solutions (lectins cause all chronic diseases, carbs cause obesity and type 2 diabetes, fat causes heart disease etc etc) and the diet tribalism that comes with that. We need to pay a lot more attention to nuance, and evaluate the scientific findings with all of their pros and cons, because very often, the most plausible mechanistic insights don't pan out like that when we test them in human randomized trials. What this leads to is that in many cases, I am not all that certain myself, and I want to communicate that as well if I see that we still have specific gaps in our knowledge. That's not for everyone, as I have learned that many people prefer quick and simple, and a clear message rather than the sometimes inconclusive reality of actual science. Glad you are on board, and hope you will continue to find this content valuable. Best wishes, Mario

[@luvelyjay]

Wow!! This was fantastic and easy to understand! Thank you! Subscribed 👏🏾

[@write2anishs]

Best video ever . Glad to hear your findings . Amazing it is !!

[@matlepak9694]

Excellent information. Very thought provoking

[@javadivawithdog]

Excellent review of key concepts. Thanks!

[@shauna996]

Excellent presentation! I’ll be reviewing this one several times.

[@isabellelee2658]

Great video. Lots of clarity, thanks.

[@wigglywrigglydoo]

I would love to know more about diabetes type 1. It's under researched. Thank you for this video!

[@stephennickles7389]

Thank you, info meshes somewhat with Roy Taylor's outlook. Inspirational!

[@bunberrier]

Had to watch a couple times to get to the point where I THINK i fully understand. Thanks for the education.

[@richardpackard590]

Agreed, This is the BEST review of the literature and explanation of cause of IR!!

[@alisonjane5364]

Absolutely brilliant video!! These videos should be shown in schools.

[@nravishankar2]

I am a physician and am this is the best explanation I have heard regarding Insulin resistance. Thank you.

[@nourishedbyscience]

Thank you!

[@nanhc9118]

Love the content! Thanks for sharing your knowledge! I came across your channel when looking for information to prevent glucose peaks. That video on GI and GL is excelent, I have since watched all your other videos. If I may suggest a topic, I'd say gestacional diabetes :)

[@nourishedbyscience]

Thank you for the feedback. And: good suggestion. Noted! Cheers Mario

[@julczka]

This is super informative! Thank You! I think on the journey to getting healtier such knowlege is absolutely crucial for success.

[@justsaying7065]

Thank you for the video! Please do videos on insulin resistance in the liver and muscle.

[@manamsana3786]

Your videos are great! Very easy to understand!

[@yorkiepit]

Thanks for sharing the very important information in this video!

[@benfromaustria]

SOOO great explanations…👏🏻👏🏻👏🏻

[@jenniferchapman9645]

Thankyou your videos are so informative you explain so ordinary people can understand much appreciated 😊

[@vincerountree3132]

Outstanding video! Thank you for your research and for such a thorough explanation!

[@lisaatkins4650]

Please make more of these videos that are so VISUAL in nature. It was extremely helpful for a layperson to understand this science. Thank you.

[@nourishedbyscience]

Thank you for the feedback. I will. The downside to making such videos is that they take forever to make ...

[@stevewhalen6973]

Great and best explanation of fat metabolism into body fuel I've seen, and what allows this process.

[@brynnguidry7330]

Kudos for an outstanding presentation. I finally have an understanding of the personal fat threshold. Thank you.

[@techeteri]

Great video, best explanation on KZbin!

[@nourishedbyscience]

Thank you!

[@nastiacooksplants]

Such a great channel. Thank you for your work!

[@cathyellington7599]

Thank you Mario. I always look forward to your videos. You do such a great job teaching. The way you explain things and the teaching aides you use sure do help to make this subject easier to understand. Thank you

[@nourishedbyscience]

Thank you. Appreciate your feedback! Best, Mario

[@maqsoodkhokhar3864]

Mario you have changed our lives, thank you

[@nourishedbyscience]

Thank you. Can you share which specific content was particularly helpful to you, and which additional questions or challenges you still have? Warm wishes, Mario

[@jamescurtis6217]

Masterclass!!!! Thank you Mario for your detailed explanation, I finally feel that I have a grasp of my condition. I am an ancient Brit but live in Czech Rep. and was diagnosed with T2D about 9 years ago and unfortunately my doctor speaks almost no English so your postings are invaluable to me. Thanks again, superb work and very good luck with the channel.

[@aao449]

You live in Czech Rep., should he be talking to you in English or should you be speaking to him in the local language there?😅

[@chremis]

Just stumbled upon your channel, so good, personal story, 6 months keto/low carb, all blood work markers good except elevated ldl/total cholesterol, ideal weight, blood pressure ok...biggest remaining challenge getting that visceral fat from warning level into standard level, difficult to achieve, just entered retirement/male, great content

[@r-type4945]

Finally a new video, was eagerly waiting for this. 👍 Interesignly the channel 'what i've learned' covered the same topic recently. Thanks, Mario. Pls keep up making these videos, you're surely helping a lot of people with this.

[@gloriaharbridge4986]

Prof Ben Bikman is one of the best I have heard. He has done 10 years of studying and teaching Insulin.

[@sw6118]

Finally an explanation that makes sense.

[@wann9333]

Thanks for the good information doc. Appreciate your hard work on this content. 👍

[@nourishedbyscience]

My pleasure!

[@almanchan7936]

Best IR explaination! Thanks!!!

[@debmurray2734]

100% agree with this concept ... i am small person, yet my fat storing threshold is very low. i am not obese but i am highly insulin resistant. Doesnt take many carbs or calories of any type to cause my body to pack on the fat. In other words i have to manage carb intake AND overall calorie intake.

[@h.4727]

Muscles can consume + store a lot excess calories! Build muscle!

[@sheila7814]

I am in the exact same boat. I workout several times a day and walk 5-8 miles a day. Seems to be working now for me…. One benefit, I am getting quite strong!

[@jameshunt7884]

Top effort it dose explain alot keep the top results and research coming foward.from new Zealand

[@omkarmavlankar6611]

Seeing that body fat graph change made all the difference!

[@corrado542]

Very clear, thank you so much Dr. for the your effort. Indeed it can save people.

[@romanftt]

Amazingly explained.

[@maebellinekang]

I'm so happy I came across your channel. I have been doing intermittent fasting and low carb and this clinical explanation makes so much sense to my journey. Thank you so much, definitely have subscribed. Also the amount of script and research and diagrams in your videos are commendable 💯👍🏻

[@TheMaui2020]

Terrific video. Very enlightening.

[@32starsandsugar]

I am not even on the bmi scale you showed. I’m bmi 19 and A1C 5.8 :(

[@livvielov]

Once you learn about this you can't forget it. So invaluable to living well

[@bipindeshpande2043]

This is an excellent podcast, Dr. Mario. You have explained perfectly with the examples in real life. In my practice, I have seen many diabetics having a good amount of subcutaneous fat compared to the visceral fat. They have less muscle mass. There are also some patients with a huge percentage of visceral fat, yet remain nondiabetic. Anyway, your way of narration is very good. Thanks once again. Dr. Bipin Deshpande, India.

[@nourishedbyscience]

Thank you, Dr. Deshpande! I don't doubt you are correct. However, remember the role of the pancreatic beta cell, i.e., the ability of the patient to make enough insulin for their level of insulin sensitivity. Therefore, the relationship that is strongest for visceral and ectopic fat is with insulin resistance, not glucose tolerance, based on several high-quality clinical studies. Sure someone could have a lot of visceral and ectopic fat and be very insulin resistant as a result, and still not have diabetes if their beta-cells can make enough insulin to compensate for the insulin resistance. Similarly, someone may have quite little or even no visceral fat and still develop diabetes, if their beta-cells are unable to produce much insulin at all. Hope this makes sense!? Warm wishes to India! Cheers Mario

[@bipindeshpande2043]

@@nourishedbyscience Dr. Mario, I appreciate your prompt and rational response. I agree with you totally. Cheers, Dr. Bipin

[@sam2wmc]

Dr. Kratz - Thanks for another great video! I love your evidence-based approach, and the fact that you don’t push anything - but rather - you just state scientifically grounded opinions, as your lifetime of experience has informed you, and then let the viewer decide for themselves. After watching this video highlighting the dangers of excessive fat, I am wondering if you have looked at research to see whether any of today’s “miracle” weight loss drugs can help to reverse a lifetime of neglect - not as a substitute for good nutrition, but to turn back the clock a bit, and then follow a healthy lifestyle? This information could be particularly helpful to older viewers.

[@nourishedbyscience]

That's a great question. Once someone has accumulated a lot of excess visceral and ectopic fat, the data are clear that we can reverse it by diet and lifestyle change, but it can be hard to maintain that reduced body weight in the long term. It's clear that the new class of obesity medications can offer tremendous help to many people with obesity, and I am therefore not against considering them. However, I also do feel strongly that these drugs should be paired with dietary and lifestyle changes, specifically resistance training (to prevent loss of muscle mass) and an adoption of a very micronutrient-dense diet (because the lower overall food intake makes vitamin and mineral deficiencies more likely). I'll make a video about these medications at some point soon. Best, Mario P.S.: Thank you for your generous support! Much appreciated!

[@cassieoz1702]

Excellent graphics and animations

[@zg4472]

Excellent job, scientific video with language that most people understand it.

[@Ronlawhouston]

I am a big believer in the personal fat threshold hypothesis. It is the only thing that explains my situation. I do low carb, so for me, it is not intake. My sugars are great at 165 lbs but not so good at 180. When I see thin diabetics, usually you see a bit of a pooch if abdominal fat.

[@Jay-kk3dv]

You should look more into this. New studies are showing the low-carb insulin resistance association

[@vincent21212]

yep - Im in a similar boat. Im 6'8, 245lbs with a lot of muscle mass and a little fat. Im not the healthiest eater and I just hit the pre-diabetes mark. I know my body would totally give out before I could hit 280. Im not genetically fit to be morbidly obese. the only place Im able to store a bit of subcutaneous fat is in my lower back and gut, but by then my belly is filled with fat beneath the abdominals. I'd die a long time before Id hit 300

[@bugabutu]

​@@Jay-kk3dvusually related to high fat diets too

[@MightyElemental]

The adbominal "pooch" of fat could be caused by insulin injections.

[@keylanoslokj1806]

​@@bugabutuyou plant chompers must stop coping so hard. Low carb high fat diets do none of what you say

[@nicid2]

So well explained, thank you!