I see the internet. I know you're getting some pretty conflicting advice. So let's put insulin on the table and hash things out once and for all, today.
One camp says insulin resistance makes fat loss pretty much impossible until you fix your insulin. The other says insulin doesn't matter because fat loss is just calories in, calories out.
And the one who is right is ....
NEITHER. Neither is giving you the full picture.
If you're in your 40s or 50s, noticing more belly fat, struggling with hunger, or finding that your old fat-loss strategies aren't working quite as well, this is worth a few minutes of your time.
First, what the heck is insulin resistance?
Insulin helps move glucose from your bloodstream into your cells. When those cells become less responsive, your pancreas often compensates by producing MORE insulin. It's a boy who cried wolf kinda situation. Your blood sugar can look perfectly normal for years because your pancreas is working overtime to keep it there. This is why standard blood tests don't let you know if you're becoming insulin resistant -- even if you have a normal HgbA1c or fasting glucose.
Insulin also temporarily suppresses fat breakdown, which has led to a whole lot of confusion.
Insulin resistance does NOT make fat loss impossible. You can definitely lose fat while insulin resistant. An energy deficit still matters. Howeverrrr, insulin resistance can coexist with increased hunger, abdominal fat accumulation, and other metabolic issues that make the process more challenging. Improving insulin sensitivity and losing excess body fat can also help each other along. Also, being insulin resistant can mean a greater percentage of the WEIGHT you lose will come from lean tissue instead of fat. Meaning, if you lose 5 lbs and 4.5 were gonna come from fat, if you're insulin resistance, maybe only 3 of those lbs came from fat and the rest from muscle. So it can change the ratio of WHAT you lose.
If you're insulin resistant with a fat lose goal, I'd work on BOTH simultaneously. In fact, those 2 goals complement each other very well!
Why does this become more relevant around menopause?
Estrogen influences insulin sensitivity, muscle metabolism, and fat distribution. But of course it does, huh? As estrogen declines, women become more prone to accumulating visceral fat (the deeper abdominal fat surrounding our organs), which is strongly associated with insulin resistance.
Throw in age-related muscle loss, disrupted sleep, and reduced activity, and we've got lots of factors working against us.
Menopause doesn't automatically cause insulin resistance or weight gain. BUT, we do have some extra reasons to be proactive here.
So how do you know if you're insulin resistant?
Here's what I'd discuss with your healthcare provider, along with the numbers I'd pay attention to...
1. Fasting glucose: Below 100 mg/dL is normal, 100–125 is prediabetes, and 126+ is in the diabetes range if confirmed. I like seeing glucose comfortably within a more optimal range though, often in the 70s–80s.
2. Fasting insulin: This is the one I wish more women knew to ask about. Your glucose could be 90, but how much insulin is your pancreas producing to KEEP it at 90? I generally like seeing lower-single-digit fasting insulin when glucose and overall metabolic health are good. Under 6 is often a good sign.
3. HOMA-IR: A calculation using fasting glucose and fasting insulin. The formula is (glucose × insulin) ÷ 405 when glucose is in mg/dL. For example, glucose of 90 and insulin of 5 gives you 1.1. Lower generally suggests better insulin sensitivity. For myself and most of my clients, I love to see this below 1.0. Once it's 1.5-2.5 or higher, we're really starting to need to pay more attention.
4. Hemoglobin A1c: Below 5.7% is normal, 5.7–6.4% is prediabetes, and 6.5%+ is in the diabetes range if confirmed. A normal A1c doesn't rule out early insulin resistance, and things like iron deficiency or altered red blood cell turnover can skew results. Most of the time, something around 4.8 - 5.3 would be comforting to see.
5. Other clues: Triglycerides, HDL, blood pressure, waist circumference, PCOS (PMOS) history, and previous gestational diabetes all help complete the picture. Dark, velvety skin around the neck or armpits can also be a clue. Skin tags are another. An oral glucose tolerance test may be helpful when other results don't tell the whole story.
Like pretty much everything, I don't like looking at these numbers individually in isolation. We're looking for patterns, not trying to win an award for the lowest insulin.
Now, what would I actually DO to improve insulin sensitivity AND lose fat at the same time?
1. Make breakfast protein-forward. Aim for roughly 30-40 grams of protein, adjusted for your needs. Skyr with berries and chia, eggs and egg whites with cottage cheese, or a smoothie with protein and ground flaxseed. Protein helps with fullness and muscle preservation while losing fat. Muscle helps combat insulin resistance.
2. Walk for 10 minutes after a meal. After dinner, around the block, around the kitchen, while your kid tells you a story that's on the 3rd plot twist. Contracting muscles can take up glucose through pathways that don't depend entirely on insulin. It's like a little cheat code! Even 20 bodyweight squats or calf raises is better than nothing.
3. Lift weights 2–4 times weekly. Muscle is one of our biggest sites for glucose disposal. Squats, rows, hinges, step-ups, presses. Choose exercises appropriate for your abilities and equipment access. Strength training improves insulin sensitivity and helps preserve the muscle we REALLY don't want to lose during menopause or fat loss.
4. Keep the carbs. Get smarter about them. Add edamame to your rice bowl, Greek yogurt to your fruit snack, bell peppers alongside your bean salad, and protein and vegetables alongside your potatoes. Fiber-rich carbohydrates get to stay!
5. Get 30+ grams of fiber daily. Chia in oats, ground flax in yogurt, raspberries, lupini beans, lentil pasta, roasted edamame in your bag, psyllium if appropriate. It's been at least a day since I've told you about basil seeds, right? They're overachievers with their FIFTEEN grams of fiber per 2 T serving. Increase gradually and stay hydrated. Fiber supports fullness, glucose regulation, and gut health.
6. Create a slight calorie deficit. Fat loss still requires an energy deficit. I'd look at portions, liquid calories, snacking, cooking oils, small bites, and overall activity before making dramatic changes. Maybe you need a more satisfying afternoon snack, a slightly smaller dessert portion, more consistent movement, or a few less glasses of wine per week. You don't need to slash a bunch of calories and add 6 workouts.
7. Take sleep seriously. Even short periods of sleep restriction can impair insulin sensitivity. If you're waking at 3:17 AM contemplating every decision you've made since Saved by the Bell went off air, let's figure out WHY. Night sweats? Sleep apnea? Caffeine? Poor circadian rhythm? Menopause symptoms? Fix the underlying issue rather than assuming another supplement will do it. But there are some supplements that can help here -- talk with your healthcare provider about magnesium glycinate and / or l-theonine
8. Collect the little metabolic gold stars. Take walking meetings when you can. Keep resistance bands where you'll see them. Get outside for morning sunlight. Consider creatine for muscle performance alongside training, not as an insulin-resistance cure. Stock frozen vegetables, a jar of red sauce, and lupini bean protein pasta for crazy evenings. Watch alcohol intake. Eat enough during the day to avoid the 9:45 PM pantry tour. Stop piling on endless exercise when you're already underslept and under-recovered.
I'd pick THREE things to start with. Get consistent, then add more.
We have a LOT of influence over our metabolic health as we age. I find that way more useful than telling women their metabolism has packed up and left town.
Stay wild + well,
Tara
P.S. If you're tired of sorting through a million conflicting health recommendations and just want to know what's worth your time, what’s B.S., and how to actually make the good stuff work in your life, that's exactly why I created The Metabolic Edge, my women's health club. Join the waitlist to hear when doors open again.