The Obesity Hormone Nobody's Measuring
The EMBER | #8001
What we’re exploring this week…
🕳️🐇 The Rabbit Hole
THE QUESTION:
Why do we ignore the one hormone directly linked to obesity and metabolic dysfunction?
What if I told you that sugar doesn't make us fat—but the hormone our body releases in response to sugar does? And that we've been measuring the wrong thing for decades?
THE STATUS QUO:
We’re told to watch our sugar intake, count our calories, limit carbohydrates. When we get bloodwork, the doctor checks our glucose and hemoglobin A1C. If those numbers look good, we’re told our metabolism is fine.
Then one day—seemingly out of nowhere—we’re told we have prediabetes or type 2 diabetes. As if it just happened.
But it didn’t just happen. The metabolic dysfunction had been building for years. We just weren’t looking at the right number.
Our medical system monitors glucose and hemoglobin A1C, but largely ignores insulin levels, missing years of progressive insulin resistance before diabetes is diagnosed.
These are people whose metabolic machinery is breaking down right now, silently, while their doctors tell them their labs look fine. Because they’re not measuring the right thing.
THE REST OF THE STORY:
I started thinking about this because of a simple observation that hides in plain sight: type 1 diabetics are thin.
People with type 1 diabetes produce little or no insulin. They can eat sugar, carbohydrates, excess calories—and they don’t gain weight. Before insulin therapy existed, type 1 diabetics wasted away despite eating plenty of food.
When they start insulin injections, weight gain is expected. Not because their diet changed. Because insulin changed.
This tells us something fundamental: it’s not the food that causes fat storage. It’s the insulin response to the food.
That distinction matters enormously—and almost nobody talks about it.
Consider this…
As of 2021, 38.4 million Americans have diabetes—but 8.7 million of them don’t know it. Another 97.6 million have pre-diabetes, the precursor state where intervention is most effective. Yet only 19% of people with pre-diabetes have been told by a health professional that they have it.¹
We’re watching a slow-motion epidemic unfold, and we’re diagnosing it at the end rather than the beginning.
Insulin drives fat storage whether you’re eating or not. It’s the metabolic signal that determines what your body does with energy.
WHAT THIS MEANS:
If insulin is the real driver, why don’t we measure it?
It’s not because of cost. As a matter of fact, an insulin test is cheap and readily available through standard labs like Labcorp and Quest. If we are truly concerned with cost, let’s consider the cost of the diabetes epidemic. Unlike an insulin test, it is not cheap.
Total cost of diagnosed diabetes in 2022 was $412.9 billion! This includes $306.6 billion in direct medical costs, and $106.3 billion in reduced productivity.² As staggering as these numbers are, they account only for the economic burden. The numbers don’t account for the human cost—suboptimal quality of life, the stress of managing a chronic disease, and the years of healthspan that were lost.
Your standard primary care panel shows glucose and A1C—but these only become abnormal after your pancreas can no longer compensate for insulin resistance. By then, you’ve been metabolically dysfunctional for years.
Measuring fasting insulin can reveal problems 5–10 years earlier. Time you could use to change course before beta cells burn out.
The consequence: insulin resistance develops silently over 5–10+ years. The pancreas compensates by producing more insulin (hyperinsulinemia), keeping glucose levels normal. The person appears metabolically healthy by standard metrics.
Only when the pancreas can no longer keep up—when beta cells become exhausted—does glucose rise and diabetes get diagnosed. At that point, we act as if diabetes suddenly appeared, when in reality the metabolic dysfunction had been progressing for a decade.
If we measured insulin, we could intervene years earlier.
If you’re truly curious about your metabolic health, get a fasting insulin level. It’s an inexpensive test that tells a story glucose alone cannot.
The Absurdity Summarized
❌ “Sugar causes obesity” → ✅ Insulin—the response to sugar—drives fat storage. The food is the trigger; the hormone is the mechanism.
❌“We monitor glucose and A1C” → ✅ These only become abnormal after years of dysfunction. Insulin levels would show the problem 5–10 years earlier.
❌ “Diabetes appears suddenly” → ✅ It doesn’t. Insulin resistance develops silently for a decade while glucose stays normal—because the pancreas compensates until it can’t.
👉 The tools to detect this earlier exist. They’re inexpensive. We simply don’t use them.
🔬 The Data Point:
🎯 Fasting Insulin Test:
Results: “Normal range”: ~ 2-20 µIU/mL
**Important note: "Normal" lab ranges are based on an average of 95% of the population—which includes many people with early insulin resistance. A fasting insulin of 15 µIU/mL might be flagged as "normal" but is far from optimal!
Here is what the results actually indicate:
👉 < 8: Target range (<5 is optimal)
👉 8-10: Borderline/early resistance
👉 >10-12: Clear indicator of insulin resistance
👉 >20: Abnormal by all standards
Cost: Typically < $50
How to get the test:
🔬Option 1: Ask your doctor:
Request a fasting insulin test at your next physical. If your doctor hesitates, cite family history of diabetes, weight concerns, or desire for a metabolic health baseline. Your insurance may or may not pay for it.
🔬 Option 2: Direct-to-consumer-labs:
Order the test directly from a lab without a doctors order, such as:
Quest Labs Insulin Resistance Test Panel $105
🔬 Option 3 (Our favorite): Order through Ember 8 Visionary Wellness
The fasting insulin test is included in our Comprehensive Foundational Lab Panel
This panel includes several tests to provide an overall picture of health. If you wish to only get the insulin test or other few specific tests to save cost we are flexible and can adjust to your needs.
💡 On My Radar:
📚 Reading: Genome by Matt Ridley Yes this book is a bit older, but still very relevant. Understanding the history and fundamentals of genome mapping as AI gives us new discoveries every day is invaluable.
🎧 Listening:
While Tim is my absolute favorite, in this episode he introduces a new podcast, Drug Story, which I will be listening to a lot more of. This was a great introduction.
Would love to hear your thoughts in the comments. Keep the conversation going!
Exploring and being open-minded is how we learn…not to mention it’s fun.
Until next week….
Stay curious!
Heather | Ember 8
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¹ Centers for Disease Control and Prevention, National Diabetes Statistics Report (2024),
https://www.cdc.gov/diabetes/php/data-research/index.html
² Parker ED, Lin J, Mahoney T, et al. “Economic Costs of Diabetes in the U.S. in 2022.”
Diabetes Care. 2024;47(1):26-43. doi:10.2337/dci23-0085