Many of us know that obesity can lead to having type 2 diabetes and it is not coincidence that most patients suffering from type 2 diabetes are overweight or obese.

Have you ever thought about how obesity causes diabetes?

First, it is important to know that in type 2 diabetes mellitus the cause of the disease is not that the body does not have enough insulin. The opposite is true. In early cases of type 2 diabetes, the patients have up to 5 times higher fasting insulin level than the non-diabetics. The root cause of type 2 diabetes is your cells become resistant to the insulin it produces. The body subsequently attempts to compensate for this by making the pancreas produce more insulin.

Back to our original question. How does obesity cause type 2 diabetes?

The fat cells in our body are not just storage sites. They are actually an endocrine organ. 1 They are involved in the secretion of hormones, cytokines, inflammatory signals, and other metabolically active substances in the body.

The fat cells secrete multiple pro-inflammatory substances such as TNF-alpha and IL-6 which cause a state of low-grade chronic inflammation in the body. Both TNF-alpha and IL-6 can alter insulin sensitivity by affecting different key steps in the insulin signaling pathway which causes insulin resistance leading to type 2 diabetes mellitus. 2

It becomes even more complicated. The insulin resistance causes the pancreas to secrete more insulin by trying to overcome the resistance. The higher level of insulin causes further fat accumulation in the adipose tissue by activation the fat synthesis in the liver and activating the enzyme lipoprotein lipase in the adipose tissue promoting more fat storage causing more obesity. Please review our article The Obesity Hormone.

More fat means leads to more active chronic inflammation causing more insulin resistance which causes type 2 diabetes and also causes a high insulin level that in turn causes more fat at the same time. This places the patient in a vicious cycle that only can be treated by correcting the insulin resistance and the obesity and not solely focusing on the blood sugar level.


The Metabolism Clinic is established as the destination for weight loss and reversal of diabetes. Based in Charlotte, North Carolina.