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8 Steps to Reversing Diabesity

8 Steps to Reversing Diabesity

Last week I began a discussion about a modern epidemic, a deadly disease that one of every two of you have, a disease that’s making you fat, sick, and will kill you, but 90 percent of you don’t even know you have it.

This disease is diabesity, the continuum of abnormal biology that ranges from mild insulin resistance to full-blown diabetes.

This week I want to explain the real causes of diabesity and provide 8 steps you can take to reverse this disease starting today!

The Real Causes of Diabesity

The entire spectrum of diabesity, including all of its complications–diabetes, elevated blood sugar, blood pressure, and cholesterol–are simply downstream symptoms that result from problems with diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities.

Those are the real causes of diabesity.

And the reason these dietary and lifestyle factors lead to diabesity is because they create a condition known as insulin resistance. Contrary to what most people think, type 2 diabetes is a disease of too much, not too little, insulin. Insulin is the real driver of problems with diabesity.

When your diet is full of empty calories and an abundance of quickly absorbed sugars, liquid calories, and carbohydrates (like bread, pasta, rice, and potatoes), your cells slowly become resistant to the effects of insulin and need more and more to do the same job of keeping your blood sugar even.

Thus, you develop insulin resistance. A high insulin level is the first sign of a problem. The higher your insulin levels are, the worse your insulin resistance. Your body starts to age and deteriorate. In fact, insulin resistance is the single most important phenomenon that leads to rapid and premature aging and all its resultant diseases, including heart disease, stroke, dementia, and cancer.

As your insulin levels increase it leads to an appetite that is out of control, increasing weight gain around the belly, more inflammation and oxidative stress, and myriad downstream effects including high blood pressure, high cholesterol, low HDL, high triglycerides, weight gain around the middle, thickening of the blood, and increased risk of cancer, Alzheimer’s, and depression.

These are all a result of insulin resistance and too much insulin. Elevated blood sugar is not the source of the problem.

And because insulin resistance (and diabesity) are a direct outcome of diet and lifestyle, the condition is 100 percent reversible in the vast majority of cases.

Most people just need to eliminate the things that are sending their biology out of balance and include what’s needed to help the body re-balance itself. For most, the interventions required are extremely simply and extraordinarily effective.

8 Steps to Reversing Diabesity

In my book, The Blood Sugar Solution, I outline a comprehensive 8-week plan for overcoming diabesity in all its forms. Here is a sneak preview of the steps outlined in the book:

  1. Get the right tests. Most doctors focus on fasting blood sugar. This is actually a poor indicator of diabesity. The best test to tease out the condition is an insulin response test where insulin levels are measured fasting and then 1 and 2 hours after a glucose drink. Demand this test from your doctor.
  2. Get smart about nutrition. Despite the media hype and the seeming confusion amongst doctors, the basics of nutrition are extremely simply. Eliminate sugar and processed carbohydrates, include whole real foods like lean protein (chicken or fish), veggies, nuts, seeds, beans, and whole grains.
  3. Get the right supplements. There has recently been a frenzy of negative reports about supplements. Most of them are unfounded. Supplements are an essential part of treating diabesity. A good multivitamin, vitamin D, fish oil, and special blood sugar balancing nutrients like alpha lipoic acid, chromium polynicotinate, biotin, cinnamon, green tea catechins, and glucomannan should also be included.
  4. Get relaxed. Stress is a major unrecognized contributor to insulin resistance and blood sugar imbalance. Push your pause button every day with deep breathing, visualization, yoga, and other relaxation techniques.
  5. Get moving. Aside from changing your diet, exercise is probably the single best medication for diabesity. Walk at least 30 minutes every day. For some, 30-60 minutes of more vigorous aerobic exercise 4-6 times a week may be necessary.
  6. Get clean and green. Environmental toxins also contribute to diabesity. Filter your water, look for green cleaning products, and avoid plastics when you can.
  7. Get personal. While the steps above will address 80 percent of the problems with diabesity, some may need to take additional steps to optimize key areas of their biology. Remember, the medicine of the future is personal medicine. Seek out your own biological imbalances and look for ways to address them.
  8. Get connected. Research is beginning to show that we get better more effectively when we get together. Invite your friends, families, and neighbors to change their diets and lifestyle along with you. Together we can all take back our health.

In The Blood Sugar SolutionI outline all of the social, economic, biological, and medical underpinnings of this health epidemic and provide an 8-week, step-by-step system that will allow you to dig deep into your own biology and heal even the most severe cases of diabesity.

Also, please take a look at The Blood Sugar Solution Cookbook, where I show you how you can delight your palate and your senses with fabulously tasty food and heal your body at the same time. As I’ve said many times before, the most powerful medicine is at the end of your fork, not at the bottom of your pill bottle. Food is medicine!

Now I’d like to hear from you …

What are the root causes of diabesity in your life?

Have you tried any of the steps in this article? How have they worked for you?

What solutions do you see for our modern health crisis?

Please leave your thoughts by adding a comment below–but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!

To your good health,

Mark Hyman, MD

Mark Hyman MD is the Medical Director at Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.

Comments (41)

  • I am looking forward to the new cookbook that I have already ordered .
    I do have a question to do with diabesity. I am a very slim person and do work at keeping my fasting glucose below 100.
    Most attention is being given to the overweight people . I have the opposite situation -probably need to weight more.
    I hope there will be advise in the new book. I follow most of the eight suggestions listed above and am never sure about the supplements in my case.
    Thank you,
    F. Jaffe

  • Healthy grains do NOT work for me: They shoot my blood glucose through the roof. I have been eating low carb for a year now. Lost 20 but plateaued…am now trying to get ore exercise to boost metabolism.

    • I agree with you, Kristy. I cannot eat any grains. I followed the advanced plan (no bread, grains or dairy; only 1/2 cup berries per day; etc.) perfectly for three months. It lowered my blood sugar, but I gained 4 pounds. I walk 2 miles daily and do weight training 2-3X per week. I am hoping that adding more exercise will help. Seems all I do is exercise and eat the same foods, which gets boring after awhile. I know this is how I will have to eat for the rest of my life, but I can’t help feeling deprived.

      May I suggest another cookbook for those of us who must LIVE on the advanced plan? With super low carbs, please. I cannot eat 33+ carbs at one meal.

      • I noticed the same thing about recipes for the Advanced Plan…when I turned to the recipe section in Blood Sugar Solutions, many of them had legumes and grains. I longed for some recipes I could use to vary the repetitive meat, veggies, nuts and 1/ cup blueberries day after day! A special section, perhaps?

        • Hi BJ,

          We apologize for the confusion re: typos in the back of The Blood Sugar Solution book. It is best to stick with the guidelines for the Advanced Plan when composing your meals. 75% non starchy veggies, 25% protein. No grains, starches, fruits (other than 1/2 cup berries) or sweeteners. Have you seen the new cookbook? This is an excellent source for new, creative and tasty recipes!

          For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: OR call (800) 892-1443 to get started.

      • Vicky

        Try and change the exercise you do. Do walking say two days a week. Try and see if you can find the time, money & space for an Airdyne & do that two times a week & throw in some short distance sprint swimming. Look up Tabata ‘s on Youtube too. Time effective / efficient way of working out. They blast of the fat. I’ve lost 27lbs now looking for another 25 to go. Its very important to mix up the exercise or your body gets to normalize the routine & you plateau.

        Good luck to you..


  • Read Blood Sugar Solution in Nov. 2012 and starting eating healthy on Dec. 1st. Have lost 24lbs Fasting Blood Sugar is dramatically reduced. Stopped taking Diabetic, Cholesterol, and Blood Pressure meds on Jan. 1st. Continue to monitor BS and BP daily. Great results.

    Some family members and friends are excited about your approach too!

    Thanks for this life changing awareness!

  • here is a pneumonic for the “get the right supplement”
    A – ALA
    B – Biotin
    C – cinnamon
    D – vit D
    E – grEEn tEa
    F – fish oil
    G – glucomannan

  • I have bought your book The Sugar Solution and read it and it all makes so much sense. I am trying to adapt the eating right with the exercise. I am 65 years young and I am taking 100 units of Levemir and about 75-100 units of Humalog daily. I bought the supplements you suggested and they do make a difference. I am on a limited income, my job was elimated 2 years ago. I would like to purchase your cookbook. My significate other has no sugar problems and I would like to cook one meal that both of us can enjoy. He likes vegetables so that isnt a problem. I bought a 3 wheel bike last summer and cant wait to use it when the weather breaks. I live in Illinois, in a suburb just outside Chicago. It gets so depressing at this time of the year. My doctor prescribed me 50,000 units of vitamin D every week because I run low. That seems to help. I just dont want to keep pumping so much insulin into my body. I need to get very serious about this very serious disease. I already am experiencing numbness in my feet. I like to read sucess stories to help build my confidence. I need motivation. Its hard when your partner doesnt have problems with sugar and can eat and drink anything they want. He does support me but brings things into the house that tempt me.

    Carol Bowman

    • Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet. However, we can suggest that you join one of the groups in the Ultrawellness Community which can be located on

      Wishing You the Best of Health!

      Dr. Hyman Staff

  • I am on Weight Watchers 360 online program and have lost 9 pounds. I have 9 more to go and then I think my belly will be flat. I am 4′ 11″ and now weigh 109. I am not diabetic but my overweight sister is and I do not want that to happen to me. I am fairly active but could be more so. I enjoyed hearing about your program on Dr. Oz show today about diabesity. I definitely eat more sugar than I should. The thing is that I do eat a lot of vegetables, fruits and berries, whole grains. I also eat 1 egg per day for breakfast with an orange. I enjoy goat cheese on my salad occasionally. My husband has a cow dairy allergy so we do not have any products that contain those items. We use rice milk for cereal and soy products for butter. I’m thinking about buying the book.

  • Dr. Hyman suggested a certain supplement that should be taken before meals…It sounded like PG? and I didn’t get the rest of it…I would love to know exactly what it was…

  • I saw you on Dr. Oz and immediately ordered your book. (not here yet). I want to start the supplements. However, I have been told in the past to take Flax Oil instead of fish oil due to me taking Tricor.
    Can I take flax instead of fish oil? I take Metformin as well. Looking forward to my new improved life thanks to you.

  • I was diagnosed with Type 1 Diabetes last May. 47 y/o male – no health issues and no diabetes in the family. I have generally been “skinny” my whole life. I did gain weight around my waste – and just wasn’t eating a good diet. A1C was 11.3 – resting blood sugar at 242 on diagnosis.

    By Sept – I was off Levemir completely – three months! I have lost approx 30 lbs (6-2; 175 now – but had lost most of that weight by the time I was diagnosed). Totally changed my diet – lower carbs, higher protein diet worked for me. Cannot tell you how much better I feel! I agree that our diet has so much to do with the issues. I ate out a lot – and didn’t eat good stuff. I eat a lot more veggies – salads, etc, along with more chicken and fish. I know I am lucky and hope that my trend continues. I am hopeful my body can continue to produce enough insulin to keep my OK. My doc wants my resting level between 70 and 110 – I hit that 98% of the time. I haven’t seen my level above 140 (usually within 1.5 hours of a meal to get that number) in 6 months!

    I just wanted to encourage everyone to keep at it – it’s very hard – especially giving up the junk food! My family is amazed i could do it – the good Lord is blessing me with a second chance – I just don’t want to die – simple!

    • Hi Ross,

      Dr Hyman would suggest working with a lab to get an OGTT with insulin (fasting) for optimal results. For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: OR call (800) 892-1443 to get started.

  • How do I stop eating sugar? I crave it and seem to need more and more and feel miserable. Help!

  • Like Ferne, I am very slim and tend to be underweight. I do get frustrated with the focus on losing weight that is always present with diabetes. With a husband who insists on eating and drinking very unhealthy and children with their own food challenges, mealtimes are a massive struggle. I recently bought the cookbook, but not sure how useful it will be to me as I don’t have the energy to make separate meals for us all and many of the ingredients the children simply will not eat, they would rather leave the table hungry. My diabetes is caused by A3243g Mitochondrial Mutation, so not even type 1 or 2. It does get very depressing.

  • I have started taking Syntra-5 before meals and am very surprised by the results. My blood sugar levels have halfed and I have also lowered my insulin doses.
    I also have issues with grains and they too cause my blood sugar levels to rise dramatically. I had a nutrigenomic DNA test and that showed that I need a very low – nil carbohydrate diet.

  • Ok, I am SOLD. I want to be a purist “Dr. Hyman” devotee.

    I cannot afford to come to your clinic, and there is really no other option for me.
    I love your food and creative reciepes, but I will not be able and cannot cook them. The book is doing nothing for me. It is not possible to find restaurants in Raleigh, NC that has black rice! There are some places with Tofu mixed with cheap veggies fried in cheap oil with MSG. Mostly we are a BBQ state. Hog farms have replaced tobacco for raising pigs and chickens assembly line style.

    1. Can you franchise restaurants in Raleigh, NC that will cook 2 meals a day for take out? I will sign a contract to eat all my meals there.
    2. Or, can you (I hate to ask this) make freeze dried meal plans. Not like Nutri-system- which is nothing but
    cardboard food, but real frozen food.
    3. Saw your recipe for burgers on Dr. Oz. Beans and smashed yams made into a burger- love that! Love black beans and black rice. I can eat any vegetable dish that you put in front of me.
    4. My problem is that on my own I cannot put vegetable meals on the table.
    5. At least make a morning cereal that does not have sugar in it! To avoid sugar – I make my own cereal- a mix of All-Bran, mixed unsalted nuts, chuck coconut from Whole Foods,
    ground Flax seeds, and whole oatmeal-eaten with coconut milk. I do not like sugar in cereal, but even the All-Bran has sugar in it!!!

    Bottom line is that I watch you on National public TV and Dr. Oz -you have already converted me- I really want to take part in your eating program, but I cannot do it on my own. I need someone locally to find fresh and correct foods for me!!!!!!!!!

    hugs and love to you for all that you do.
    Barbara Cappadony 919 265-3999 I am retired and am willing to devote time to this endeavor

    • Hi Barb,

      Thanks for writing in and for all of your comments. You and your community have to make the changes locally, Grow your own food, raise your own livestock if possible. And if you don’t have certain types of foods in your area you can often order them online.

      Wishing You the Best of Health!

      Dr. Hyman Staff

  • I am a 71 year old woman. Weight is 210. Heavy in the middle. Diabetic meds Metforman 2x’s/day. Travel nearly all the time. Eat with people very often. Not much exercise at this time. Know I need to do things differently but not a self motivator. rather stressful life in general. Have too much will power and hardly any “won’t power”. BS runs about 150 but has been lower.

  • Dear Dr Mark & Staff,
    I’ve purchased both the Cookbook & the Blood Sugar Solution books and have had results from your book, Ultra-Metabolism. Since I began my lifestyle change last November (2012), I know my blood pressure has lowered dramatically. I’ve been unemployed for over a year and have not been able to afford the tests that I would like to have, on the other hand, I’m committed to beating the diabesity symptoms that are genetic in my family history. I’ve lost 20 lbs. and continue to drop. One of my friends decided to do this lifestyle change after seeing what it’s done for me. It’s such a chain reaction! Just wanted to share this with you. Also, I consider you, Dr Mark, my nutrition Guru 😀
    Thank you so much for your wisdom!!

  • I have diabesity because of my poor eating habits and the lack of exercise over the last year to year and a half. I left life run me instead of running my own life. When I got upset, I ate. When I got depressed, I ate. When I felt overwhelmed, I ate. Can you see a trend here. I was using food as a way of feeling better but here I am, now obese and been told by my physician that I have diabetes. I just purchased The Blood Sugar Solution and The Blood Sugar Solution Cookbook to hopefully change my eating habits through understanding of what I have done to my body. I also look forward to recipes that will help me get the desired goal I am looking for, feeling better and healthier.

  • Hi, I have just been diagnosed as a diabetic. The doctor has informed me that I must give up soft, apple turnovers and the like. At the moment jumping off a bridge maybe an easier option then to give up these treats of life. I have lived a fairly responsible life except for eating and drinking sugary things. How come our taste buds have fooled us for all these years. People tell me to eat fruit wow that’s going to replace the shear joy of biting into a Big Mac.
    Life without coke a cola, sweet cakes and And all those others pleasantries will make for a very dull. 🙁 such is life.

  • Article
    “When your diet is full of empty calories and an abundance of quickly absorbed sugars, liquid calories, and carbohydrates (like bread, pasta, rice, and potatoes), your cells slowly become resistant to the effects of insulin and need more and more to do the same job of keeping your blood sugar even”.

    This diabetes or “diabesity” pandemic is a very recent development. The number of diabetics and obese people were vastly lower in the 80’s. If it is diet which has been the main factor, then it will be the changes in what we consume. Now the ingredients of bread might have changed since the 80’s. But not potatoes. The most likely culprit is surely the increase in the consumption of processed foods.

  • Hi Dr Hyman,
    I recently had elevated blood sugar results from a fasting blood test done while i was on a very low carb diet for over six months. This did not make any sense to me because of my diet and no history of diabetes. My doctor wants me to do the glucose test you recommend but I read from another functional medical person that a better test is the 1 and 2 hours after meal self blood test. I am afraid that the glucose test will make me sick but I do have a lot of faith in your protocols. Can you explain to me why you think the glucose test is a superior indicator when it is so unusual that a person would consume such concentrations of sugar in any normal circumstance.
    Thank you,

    • Hi Lesley,
      The test that Dr. Hyman recommends is a two-hour glucose tolerance test, with measurements of insulin and blood sugar checked after taking a 75-gm load of sugar (the equivalent of two sodas). You first measure fasting glucose and fasting insulin levels. Then you take the sugar drink and measure glucose AND insulin 30 minutes, one hour, and two hours later. The insulin response test is the most sensitive test available to identify insulin resistance and diabesity very early on and highlights the need for more aggressive approaches to treatment and care. It can also be useful to see if you are still capable of producing insulin.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Thank you for your valuable information. I want better schedule my meals and excercise. I take my fast at 7:00am, breakfast, wait 15min walk for 20min wait an hour and measure my after meal. Lunch is at noon, wait 15min, walk for 20min, wait an hour and test. Dinner at 5:30, waith 15min, walk 20min, test an hour after. In bed by 9:30. I’m trying to find the best pattern for testing. Before I’ve found if I take 30min to eat,walk and test it comes out high? Any advice on schedules?

  • My results have been good. But I know the diabetic is still in me. Will my cells ever be able to accept the insulin again?

  • hiya! I have just discovered Dr Hyman – and his stuff is fascinating!!!! I have diabetes type 1 , recently diagnosed. I don’t want to go on insulin and am ready to change my lifestyle. Which of the books would you recommend me buying? The 8 step one or the 10 day detox or another?
    Thank you!

    • Hi Nisha,
      We recommend the 10-Day Detox Diet Program to jump start your results. This program transitions into the Blood Sugar Solution Program to help you customize your diet for lifetime health and optimal blood sugar control.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Dear Dr Hyman,

    I wondered what your opinion is about the starch based vegan diet recommended by Dr John McDougall (and Dr Esselstyn, Dr Neal Barnard, Dr Colin Campbell)?
    He sais the cause of insulin resistance is the fact that your cells are clogged and/or the walls are coated with dietary fat and therefore the insulin receptors dont ‘see’ the insulin anymore. When you remove the dietary fats from your diet, the insulin resistance will be cured. What do you think about this?

    It would mean a lot if you answert.


    Frederique Geubbels (16) from The Netherlands

  • I was on the diet for 5 days following it exactly, exercising 50 min to 1.15 hours a day and gained 4 pounds. Can you help me understand why? I chose this program because I want to balance my blood sugar, detox and get healthier, ( I’ve followed Dr. Hyman for years and know he is the RAL deal and committed to helping people regain their health and detox) I didn’t engage the diet to necessarily lose weight as I haven’t been overweight.

    I assume the fat content of the morning shake and the nuts in between meals is simply too much fat for my body to digest, so my body held onto the weight.

    Could you help me understand and modify the diet to accommodate my body’s response? thank you so much!

  • I am 75. Years ago I read about a medical doctor in the early 1900’s who cured his diabetes by visualizing the Islet of Langerhans increasing. I went to your website because it included in the description visualization. I never have been much of one eat sugar and I eat small amounts of only whole foods no meals frying or processed foods or canned. I meditate, excercise and yet I think I might be diabetic and my ankles swell in the evening but are fine by next morning. I have a lot of medical background and am aware of nutrition and detox and minerals and vitamins. So why should I be having trouble? I believe as a hypnotist I can visualze taking care of these pancreas problems but I don’t know what these langerhans look like exactly. I do live alone so maybe lack of physical intimatcy could play a part.
    Janie Martin, C.Ht