The Insulin & Glucose Doctor: This Will Strip Your Fat Faster Than Anything!

Here are the top 10 key takeaways from Dr. Benjamin Bickman's discussion on insulin resistance, ketosis, and metabolic health that could transform how you think about your diet and long-term wellbeing.

1. Insulin resistance is at the core of many chronic diseases

Insulin resistance is a condition that has two components: insulin not working as well as it should, and insulin levels being chronically elevated. Dr. Bickman explains that insulin resistance affects almost every cell in the body and contributes to numerous diseases that we often think of as separate conditions.

When insulin resistance occurs, cells become "deaf" to insulin's signals, requiring more insulin to achieve the same effect. This is similar to how a mother might become selectively deaf to her children constantly calling for her, while a father who spends less time with them remains more responsive. The combination of cells not responding properly to insulin and chronically elevated insulin levels creates a perfect storm for health problems.

Many conditions we treat as separate diseases—including hypertension, Alzheimer's (sometimes called "type 3 diabetes"), erectile dysfunction, and PCOS—share insulin resistance as a common metabolic core. Rather than just treating symptoms with medications that "prune the branches," addressing the root cause of insulin resistance can improve multiple conditions simultaneously.

2. There are fast and slow pathways to insulin resistance

Dr. Bickman describes two distinct pathways to insulin resistance: the fast lane and the slow lane. The fast lane has three primary drivers: stress, inflammation, and too much insulin itself. These can make someone insulin resistant within hours, but the effect can also disappear quickly when the triggers are removed.

Stress hormones like cortisol and adrenaline work to increase blood glucose, putting them in direct opposition to insulin, which tries to lower blood glucose. When stress hormones remain elevated (due to poor sleep, excessive caffeine, etc.), insulin must work harder, leading to resistance. Similarly, inflammation from illness or autoimmune conditions can rapidly cause insulin resistance.

The slow lane of insulin resistance involves fat cell size. As fat cells grow too large, they become inflamed and resistant to insulin's signals. This type of insulin resistance takes longer to develop but is also harder to reverse. The size of fat cells matters more than the total amount of fat, which is why different ethnicities with varying fat cell distributions show different susceptibilities to metabolic disorders despite similar body fat percentages.

3. Different ethnicities store fat differently, affecting metabolic health

Ethnicity plays a significant role in how people store fat and their susceptibility to insulin resistance. Dr. Bickman explains that East Asians typically have fewer fat cells compared to Caucasians or those of African descent, making them more vulnerable to metabolic issues with less weight gain.

When someone with fewer fat cells gains weight, those cells become larger more quickly. As fat cells grow in size, they become more inflammatory and insulin resistant. This is why an East Asian person might develop diabetes, hypertension, and other metabolic issues at a much lower body weight than someone of European ancestry with more fat cells that can each store a little fat without becoming too large.

This concept is described as the "personal fat threshold" - each person has a limit to how much fat they can store healthily before metabolic problems emerge. The location of fat storage also matters significantly. Visceral fat (around organs) is more metabolically harmful than subcutaneous fat (under the skin). Some ethnicities are more prone to storing fat viscerally, increasing their risk of insulin resistance even at lower body weights.

4. Modern eating patterns keep insulin chronically elevated

The typical modern eating pattern keeps insulin levels perpetually elevated, promoting insulin resistance and fat storage. Dr. Bickman points out that about 70% of global calories come from carbohydrates, and dietary guidelines recommending frequent meals throughout the day prevent insulin levels from ever returning to baseline.

When we eat breakfast (often carbohydrate-heavy foods like cereal or toast), insulin rises to manage blood glucose. Before insulin can return to normal levels (which takes 3-4 hours), we're having a mid-morning snack, then lunch, then an afternoon snack, then dinner, and sometimes an evening snack. This keeps insulin elevated throughout all waking hours.

Chronically elevated insulin not only directly promotes insulin resistance but also continuously signals fat cells to store energy. This makes weight management nearly impossible for many people. The body never gets the opportunity to access stored fat because the constant presence of insulin locks fat in storage and prevents the body from switching to fat-burning mode.

5. Alzheimer's disease has strong connections to insulin resistance

Alzheimer's disease is increasingly recognized as having strong connections to insulin resistance, sometimes being called "type 3 diabetes" or "insulin resistance of the brain." Dr. Bickman explains that studies showing plaque-reducing drugs having no effect on cognitive function have challenged the traditional amyloid plaque theory of Alzheimer's.

The brain has a very high energy demand but can primarily use only two fuels: glucose and ketones. In parts of the brain affected by Alzheimer's, glucose uptake requires insulin signaling. As the brain becomes insulin resistant, these areas can't get enough glucose despite adequate blood levels. This creates an energy gap that impairs brain function.

This phenomenon, called "brain glucose hypometabolism," appears in many neurological conditions beyond Alzheimer's, including depression, migraines, epilepsy, and Parkinson's disease. Providing alternative fuel through ketones can dramatically improve cognitive function in Alzheimer's patients, allowing them to perform tasks they previously couldn't manage, supporting the metabolic theory of these brain disorders.

6. Ketones are a superior fuel source for the brain

Ketones emerge as an exceptional alternative fuel source for the brain, especially when glucose metabolism is compromised. Dr. Bickman explains that ketones are produced when insulin levels are low enough to allow extensive fat burning, typically after about 16 hours of fasting or when following a very low-carbohydrate diet.

The brain shows a remarkable preference for ketones when they're available. Even when blood glucose concentration is five times higher than ketone concentration, the brain will derive more than half its energy from ketones. This challenges the conventional belief that glucose is the brain's preferred fuel. In Alzheimer's patients, providing ketones can dramatically improve cognitive function, allowing them to perform tasks they previously couldn't manage.

Ketones offer benefits beyond just providing energy. They have anti-inflammatory properties, improve antioxidant defenses, and protect muscle tissue from breakdown. Elite athletes are increasingly using ketone supplements before training and competition to enhance performance and recovery. The brain particularly thrives on ketones, which may explain the mental clarity many people report when following ketogenic diets.

7. The ketogenic diet promotes fat loss by increasing metabolic rate

The ketogenic diet is particularly effective for fat loss because it increases metabolic rate and changes how the body uses energy. When comparing isocaloric meals (same number of calories) with different macronutrient compositions, the lower-carb option results in less fat storage and a higher metabolic rate—by as much as 300 calories per day.

When insulin levels are low, the body becomes inefficient with energy in beneficial ways. Metabolic rate increases, meaning more calories are burned at rest. The body also begins excreting ketones through breath and urine, essentially "wasting" calories. Fat cells themselves become more metabolically active when exposed to ketones, burning three times more energy compared to their usual sluggish state.

Dr. Bickman's personal experience, like the host's, confirms the remarkable effect on body composition. The diet strips away fat faster than other approaches while providing consistent energy levels without crashes. Many people also report improved mental clarity and cognitive function, which aligns with research showing the brain's preference for ketones as fuel.

8. The best approach to weight loss focuses on controlling insulin first

Traditional weight loss advice of "eat less, exercise more" fails because it increases hunger without addressing insulin. Dr. Bickman explains that when someone cuts calories while insulin remains high, they become extremely hungry as insulin continues signaling the body to store fat rather than burn it.

This explains why contestants from shows like "The Biggest Loser" almost always regain their weight. Their approach creates a perfect recipe for hunger, which eventually wins. More concerning, their metabolic rate often remains depressed even after regaining weight, making further weight management even more difficult.

The better approach starts with lowering insulin by controlling carbohydrates, prioritizing protein, and including healthy fats. This naturally reduces hunger, allowing calorie reduction without willpower battles. As insulin levels drop, the body can access its fat stores for energy. Many people find they're no longer hungry all the time and can comfortably eat less without feeling deprived, leading to sustainable weight loss without the rebound effect.

9. Ozempic and GLP-1 agonists cause significant lean mass loss

Weight loss drugs like Ozempic (GLP-1 receptor agonists) come with concerning side effects that aren't widely discussed. Dr. Bickman cites research showing that 40% of weight lost on these medications comes from lean mass—including muscle and bone—rather than fat tissue. This is particularly problematic for older adults who struggle to rebuild this tissue once lost.

With 69% of users discontinuing these drugs within two years, many regain the fat but not the lost muscle and bone. This can lead to serious long-term health consequences, including osteoporosis, as shared in viral social media testimonials. The drugs also double the risk of suicidal thoughts and triple the risk of major depression, suggesting they may reduce cravings not just for food but for all pleasurable activities.

Dr. Bickman believes these medications have appropriate uses but should be combined with proper nutrition (emphasizing protein and healthy fats) and resistance training to preserve lean mass. He recommends finding the lowest effective dose that helps manage cravings while learning healthier eating habits, with the goal of eventually discontinuing the medication rather than relying on it indefinitely.

10. The four pillars for managing insulin resistance

Dr. Bickman outlines four essential pillars for managing insulin resistance and improving metabolic health. The first pillar is controlling carbohydrates—focusing on whole fruits and vegetables rather than processed foods from "bags and boxes with barcodes," which spike insulin levels dramatically.

The second and third pillars are prioritizing protein (especially animal-source proteins that contain all essential amino acids) and not fearing fat. Fat and protein together create satiety, improve digestion, and enhance muscle growth. In nature, these macronutrients always appear together, and our bodies are designed to process them in combination.

The fourth pillar—frequent fasting—should be implemented only after establishing healthy eating patterns with the first three pillars. Fasting allows insulin levels to drop completely, promoting autophagy (cellular cleanup) and enhancing fat burning. While there are many approaches to fasting, the key is finding a sustainable pattern that works individually. These pillars together create a powerful strategy for improving insulin sensitivity and overall health.