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I'm sure they were quite obese before insulin resistance kicked in.

• AstralStorm 7y ago
  That depends, in some people it's resistance first (essentially prediabetes), in others it's obesity first. Some others develop insulin resistance when even moderately obese, there are a few who never develop it despite being extremely overweight. The lower insulin resistance, the better the effect of diet, usually.
  • scarface74 7y ago
    If that were true, weight loss surgery wouldn’t help. It takes away their ability to eat too much at once by reducing the size of their stomach. - it doesn’t change their insulin levels. If you watch the show, most of them overeat as a coping mechanism and part of the treatment is psychological help.