According to the CDC, 41.9% of Americans are obese.[*] Many of these folks also have type 2 diabetes.
The term for this unfortunate combo? Diabesity.
Diabesity is a modern epidemic, but it’s not a hopeless one. Since metabolic health hinges on diet and lifestyle, it can be improved by diet and lifestyle.
Stick around to learn how obesity and diabetes interrelate, lifestyle factors influencing risk, and which dietary strategies can help. Let’s dive in.
What Is Diabesity?
Diabesity isn’t an official diagnosis. It’s a mash-up term for the dual presentation of two related conditions: type 2 diabetes and obesity.[*]
Researchers have long noticed that obese people develop diabetes at higher rates. By one estimate, a person’s risk for diabetes increases by 4.5% for every extra kilogram of bodyweight.[*]
To qualify as obese, a person’s body mass index (BMI) must exceed 30. BMI isn’t a perfect measure (bodybuilders have high BMIs and certainly aren’t obese), but it usually tracks the real problem.
The real problem with obesity isn’t a high BMI but the runaway accumulation of fat mass.[*] You’ll learn how this “fat-storage mode” relates to diabetes in a moment.
Type 2 diabetes, by the way, is a metabolic disorder marked by high blood sugar levels. It’s typically diagnosed by elevated HbA1c (average blood glucose), fasting blood glucose, or both.[*]
Folks with type 2 diabetes also tend to have high insulin levels, high blood pressure, high cholesterol, high triglycerides, and high waist circumference. (Waist circumference is another way of measuring obesity.) All are bad news for heart health.
Heart disease is the number one killer of those with type 2 diabetes (and humans at large), but it’s not the only concern. Diabesity also increases one’s risk of:
- Cancer[*]
- Alzheimer’s disease[*]
- Kidney disease[*]
- Blood vessel damage[*]
- Neuropathy[*]
- And many other conditions
So, why do obesity and diabetes come together? Keep reading.
The Link Between Obesity and Diabetes
Pondering obesity and diabetes is like pondering the chicken and the egg. Which one comes first? Good luck with that riddle.
Diabetes and obesity come together. That’s why “diabesity” is such an apt term.
Let’s look at diabesity from both sides. First, how might diabetes promote obesity?
When a person has type 2 diabetes, they suffer from a problem called insulin resistance.[*] (Their cells don’t listen to insulin’s commands to store blood sugar as glycogen.) Consequently, blood sugar stays high, and the pancreas churns out bushels of insulin to keep up.
High insulin, unfortunately, equals fat-storage mode.[*] Not ideal if you’re trying to lose weight.
It works the other way too. When someone gains weight, their metabolic health suffers.
Why? That’s not entirely clear, but inflammation appears to play a role.[*] Excess fat stimulates excess immune activity, which drives high blood sugar and insulin resistance. It’s a nasty cycle that culminates in diabesity.
What Leads to Diabesity?
To understand the roots of diabesity, we need to answer some basic questions.
Why have US diabetes rates increased sevenfold in the past fifty years?[*] Why are people becoming fatter, sicker, and more metabolically deranged with each passing decade?
Because diets and lifestyles are changing. Consider the following:
- People are consuming more sugar than ever. As sugar intakes rise, obesity rates rise along with them.[*]
- Screen-fueled sedentary lifestyles are now the norm. If you want to increase your diabetes risk, sit on your butt all day.[*]
- Modern life is stressful. Unfortunately, the stress hormone cortisol elevates blood sugar and promotes fat storage.[*]
- Most people don’t get enough sleep. Unfortunately, short sleep leads to insulin resistance, sluggishness, and an appetite like a starving hyena.[*]
The good news? Commonsense measures can help. Let’s start with diet.
Dietary Considerations for Diabesity
If we reduce our collective sugar consumption, we’ll reduce our collective diabesity risk. Some explanation will help.
A high-sugar diet keeps blood sugar levels chronically elevated.[*] insulin never gets to rest, insulin resistance develops, and soon you’re looking at obesity plus diabetes.
The smart move is to replace sugary processed foods with fiber-rich whole foods. (Fruits, nuts, and vegetables.) Fiber not only stabilizes blood sugar but also promotes satiety.[*]
Whole foods also supply nutrients and antioxidants that can improve metabolic health. Micronutrients matter, folks.
And when it comes to diabesity risk, macros matter too. According to one review paper, carbohydrate reduction is the most promising dietary therapy for type 2 diabetes.[*]
By reducing carbs, you reduce the macro that raises blood sugar the most. Blood sugar goes down, insulin can chill out, and you start burning (not storing) fat.
It’s a snazzy theory, but does it work in practice?
Evidence for Keto Improving Diabesity
When you eat a Keto diet, you consume under 10% of your calories from carbohydrates. Restricting carbs keeps blood sugar and insulin low, stimulating a fat-burning state called ketosis.
These are desirable metabolic changes in the fight against diabesity. Let’s look at three studies to illustrate:
- The Virta Health study. Researchers put 267 people with type 2 diabetes on a two-year supervised Keto diet. By the end, over 50% had reversed their diabetes (assessed by HbA1c)—and the group (on average) had lost 10% of their body weight.[*]
- The Nutrition & Metabolism study. Compared to a higher-carb diet, a six-month Keto diet significantly improved insulin, blood sugar, and body weight in people with type 2 diabetes.[*]
- The Experimental and Clinical Cardiology Study. Twenty-four weeks of Keto dieting stimulated weight loss and improved blood lipids in obese people.[*]
To learn more, read this blog on Keto for type 2 diabetes.
A Holistic Approach to Diabesity
Diet is just one lever for reducing diabesity risk. Other levers include:
- Sleep
- Stress management
- Exercise
- Supplements and medications
- Continually educating yourself on the topic
This article can help with the last bullet, but the rest of the program is up to you and your medical professional. Take a holistic approach—address as many bullets as possible—and you’ll be in good shape to live a long and metabolically healthy life.
