Type 2 diabetes and obesity occur together so often that the portmanteau word "diabesity" is used as shorthand. Join Amy Berger as she details why carrying excess total body fat cannot be the cause of type 2 diabetes (T2D) because not everyone who is overweight or has obesity develops type 2 diabetes. Furthermore, not everyone with type 2 diabetes is overweight. Changes in diet can drastically reduce the need for T2D medications -- even while someone still carries a substantial amount of excess body fat. The personal fat threshold concept elegantly explains seeming paradoxes and provides a new framework for understanding the etiology of T2D.
Key Points:
- Being overweight does not cause type 2 diabetes.
- Type 2 diabetes develops even in people at a "normal" body weight.
- Some individuals who are overweight or have obesity have reduced risk risk for cardiometabolic complications ("the obesity paradox").
- Glycemic control may improve almost immediately after bariatric surgery, during a fast, or within just days of adopting a low-carb or ketogenic diet -- long before a significant amount of weight is lost.
- Some diabetes medications (e.g., the TZD class) improve glycemic control even while an individual gains body fat.
