Insulin resistance is at the root of many chronic health conditions, including type 2 diabetes, cardiovascular disease, and obesity. While there’s no shortage of diet advice online, most people are overwhelmed by conflicting recommendations. In this article, I’ll walk you through the exact approach I use with my patients to reverse insulin resistance and reduce visceral fat — all backed by human clinical studies. You'll discover the most effective dietary strategies, the science behind them, and practical tips to make lasting change.
Table of Contents
- Why Insulin Resistance Matters
- The Power of Weight Loss on Insulin Sensitivity
- Subcutaneous Fat vs. Visceral Fat
- What’s the Best Diet for Visceral Fat?
- The Role of Calories, Not Just Carbs or Fat
- Long-Term Diet Success: What Works and Why
- Three Principles for Effective Dieting
- Sleep, Exercise, and Medications
- Final Thoughts
- References
Why Insulin Resistance Matters
At the clinic, my patients often ask me what the best diet is to treat their insulin resistance and diabetes. My answer usually surprises them because it’s a lot simpler than they expect, especially in light of some new research.
Insulin is a hormone that helps move sugar from our bloodstream into our cells for energy. Think of it like a key that unlocks the cell to let glucose (sugar in the blood) in.
After we eat, food gets broken down into glucose, which causes blood sugar levels to rise. In response, the pancreas releases insulin, which helps cells absorb the glucose and brings blood sugar levels back to normal.
But when we develop insulin resistance, this system begins to break down. It’s like the lock gets rusty and the key no longer fits. Blood sugar stays elevated, and the pancreas is forced to release more insulin.
This creates serious problems. Elevated blood sugar is toxic to cells, tissues, and organs. It encourages cancer growth, inflammation, cardiovascular disease, and infections [1].
Over time, the pancreas can’t keep up, and this can lead to type 2 diabetes — a condition that dramatically increases the risk of heart disease, stroke, and heart failure [2].
In other words, insulin resistance is something we urgently want to address.
The Power of Weight Loss on Insulin Sensitivity
One of the most powerful ways to address insulin resistance is through diet — because insulin resistance is linked to weight. About 80% of people with obesity will develop insulin resistance [3].
Losing weight can significantly improve insulin sensitivity. One meta-analysis found that for every 1 kg of weight lost, there was a 0.1 percentage point drop in HbA1c — a key measure of blood sugar control [4][5].
To put that into perspective: if someone loses 10 kg, that could drop their HbA1c by 1%. Since a level above 6.5% is considered diabetic, a reduction of 1% could take someone from the diabetic range to normal. That’s huge.
Subcutaneous Fat vs. Visceral Fat
Here’s a nuance many people overlook: not all fat is equal.
The fat stored under your skin is called subcutaneous fat. It’s the kind you can pinch. But there’s another kind called visceral fat, which is stored deep inside your abdomen around your organs.
And while subcutaneous fat doesn’t appear to cause insulin resistance [3], visceral fat is strongly linked to it. In fact, a standard deviation increase in visceral fat increases the odds of insulin resistance by 80% [6].
So when we lose weight, it’s not just the number on the scale that matters — it’s the reduction in visceral fat that really helps restore insulin sensitivity.
What’s the Best Diet for Visceral Fat?
This is where the common patient question comes in: What diet works best for losing visceral fat?
Instead of guessing or relying on internet opinions, we can turn to clinical research.
A 2022 study tested this directly. It put participants on one of three calorie-matched diets:
1. Whole-grain flour-based carbs (e.g., whole-grain bread/pasta)
2. Minimally processed “cellular” carbs (fruits, potatoes, rice)
3. Low-carb, high-fat (LCHF)
All groups were told to minimize added sugars and sugary drinks.
Over 6 months, the low-carb group lost 17% of their visceral fat — a substantial amount [7]. However, all three groups lost a significant amount of visceral fat, and the differences between them weren’t statistically significant [7].
This tells us something important: a variety of dietary patterns can work, as long as they lead to weight loss.
The Role of Calories, Not Just Carbs or Fat
Participants across all diet types stuck closely to their calorie and macronutrient targets. Despite only modest reductions in energy intake from baseline, all three diets led to reductions in visceral fat and body weight [7].
The researchers believe that the quality of carbohydrates might matter more than the quantity. Higher fiber intake and lower sugar intake have both been associated with better fat loss and metabolic health [7].
However, one important limitation: the dropout rate was high. Out of 193 people who started the study, only 57 completed the 12-month trial. Only 14 remained in the group that ate whole-grain flour-based foods [7]. That dropout could skew results, since those who didn’t lose weight might have been more likely to quit.
Long-Term Diet Success: What Works and Why
The reality is that many types of diets can work in the short term. An extensive meta-analysis looked at 14 different diets — including Atkins, DASH, and Mediterranean — and found that most led to modest weight loss and improved cardiovascular risk markers after 6 months [8].
However, by 12 months, much of that weight was regained [8]. Another study found that about 80% of lost weight is regained within 5 years [9].
So the challenge isn’t which diet, but rather sticking to it long-term.
Three Principles for Effective Dieting
Since sustainability is the biggest challenge, I encourage my patients to follow three simple principles that help make calorie reduction easier:
1. Boost Fiber Intake
(Unless you have IBD or IBS)
Fiber helps us feel full and reduces calorie intake naturally. One study found that eating an extra 14 grams of fiber per day was linked to a 10% drop in calorie consumption and a 1.9 kg weight loss over 3.8 months [10].
Fiber also improves digestive health and reduces the risk of heart disease, diabetes, and even mortality [11].
Sources of fiber include fruits, vegetables, beans, seeds, and whole grains.
2. Increase Lean Protein Intake
Protein boosts satiety, making it easier to reduce calories. It also increases the thermic effect of food, meaning our bodies burn more calories digesting it [12].
Crucially, protein helps preserve muscle mass during weight loss. One review found that protein intake above 1.3 g/kg/day could help maintain or even increase muscle mass, while intake below 1.0 g/kg/day was linked to muscle loss [13].
I typically recommend 1.2 g/kg of ideal body weight per day.
3. Cut Back on Processed Foods and Sugar
This helps regulate appetite, reduce inflammation, and prevent insulin spikes.
Sleep, Exercise, and Medications
Diet isn’t the only piece of the puzzle. Exercise is incredibly effective at improving insulin sensitivity.
One meta-analysis found that exercise led to significant improvements in fasting insulin, HOMA-IR, and HbA1c — with an average HbA1c reduction of 0.28% [14].
Exercise also improves sleep — another critical factor. A recent trial found that insufficient sleep impaired insulin sensitivity in women, even without weight gain [15]. And chronic sleep deprivation is linked to weight gain and obesity [16].
Personally, I take a supplement blend of melatonin, magnesium, and glycine to improve sleep. That’s just what works for me — you don’t need to take any supplements unless you want to.
And if you're doing everything right but still struggling, medications can help.
GLP-1 medications like Ozempic have been a game-changer for many. Newer drugs like Tirzepatide, which combines GLP-1 and GIP agonists, appear even more effective for weight and blood sugar control [17][18].
Final Thoughts
To reduce insulin resistance, the key isn’t some specific magic diet — it’s finding a way to sustainably reduce calorie intake.
The best way to do that is by:
- Increasing lean protein
- Increasing fiber (for most people)
-
Avoiding processed food and sugar
Add regular exercise and quality sleep to the mix, and you’ll be on a powerful path toward improved insulin sensitivity and long-term health.
References
1. https://www.sciencedirect.com/science/article/abs/pii/S0753332218322406
2. https://www.atherosclerosis-journal.com/article/S0021-9150(24)00167-9/abstract
3. https://www.uptodate.com/contents/insulin-resistance-definition-and-clinical-spectrum
4. https://pubmed.ncbi.nlm.nih.gov/28417575/
5. https://diabetes.org/about-diabetes/a1c
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC4038351/
7. https://www.clinicalnutritionjournal.com/article/S0261-5614(22)00322-3/fulltext
8. https://pmc.ncbi.nlm.nih.gov/articles/PMC7190064/
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC5764193/
10. https://pubmed.ncbi.nlm.nih.gov/11396693
11. https://pubmed.ncbi.nlm.nih.gov/30638909/
12. https://pmc.ncbi.nlm.nih.gov/articles/PMC8017325/
13. https://www.sciencedirect.com/science/article/abs/pii/S2405457724001761
14. https://pmc.ncbi.nlm.nih.gov/articles/PMC4608087/
16. https://pmc.ncbi.nlm.nih.gov/articles/PMC9031614/
