Dr. Boz [Annette Bosworth, MD] - How To Tell If You Are STILL Insulin Resistant

Short Summary

Main recommendation: Reverse insulin resistance by cutting carbohydrates sharply (to about 20 grams or less a day) so the body makes less insulin and the liver produces ketones, which can enter muscle cells without insulin's help. The speaker presents a sardine-only diet and periodic extended fasting as examples of ways she has seen or used to lower insulin demand.

Key Points

• Insulin resistance is described as muscle cells that stop responding to insulin's signal, so glucose stays in the bloodstream and the pancreas must produce more and more insulin to compensate.
• A low-carbohydrate, high-fat (ketogenic) approach lowers insulin needs, and the liver turns fat into ketones that fuel muscle cells without requiring insulin.
• Over roughly two to three weeks on a low-carb approach, blood sugar falls and some insulin receptors disappear, so fewer insulin signals are needed to move glucose into cells.
• Consistency is the main obstacle: the speaker describes a patient who could hold a very restricted eating window for only five or six days before cravings led to overeating, which primes the pancreas to produce large amounts of insulin again.
• The speaker presents her own weekly extended fasting (at least 48 hours) as the only way she could keep food volume and insulin production low.

Details Worth Noting

• Concrete instructions:
  • Keep daily carbohydrate intake to about 20 grams or less; the speaker says one patient who did well stayed under 20 total carbohydrates, probably under 10.
  • Follow a very low-carb, high-fat diet, which the speaker says results in less insulin being produced.
  • Restrict the eating window to about four hours a day, and hold that pattern consistently rather than in short bursts.
  • Consider a fast of at least 48 hours each week, as the speaker does, with normal eating the other days if that is tolerable.
  • One patient reported success with a sardine-only diet for 30 days; the speaker says she is not promoting this and doubts she could sustain it herself.
  • Expect progress to be gradual: the speaker describes fasting blood sugars improving week after week rather than immediately.
• Ketone production is used as a signal: the speaker says ketone levels staying above 1 indicated the liver kept producing fuel that does not need insulin.
• Other actions the patient mentioned alongside the diet were using a sauna and going for a walk for the first time in years.
• The speaker links to a separate video on the "seven best foods for insulin resistance," which is not covered in this transcript.
• The speaker notes that a patient with type 1 diabetes, who makes no insulin, would need a prescription for insulin rather than diet changes; this is presented as a contrast, not as guidance for insulin-resistant readers.

Bottom Line

Insulin resistance is framed as a problem that carbohydrate restriction and fat-based fuel can ease over weeks, but the speaker stresses that the hardest part is staying consistent without the rebound overeating that keeps insulin high.