I used to think weight loss was pretty simple – calories in vs calories out. No matter what you consume, the total number of calories are what make you gain/lose/maintain weight, right? I was recently diagnosed with PCOS and mild insulin resistance. Everybody’s saying that IR makes losing weight incredibly difficult, which is quite a bummer as I’m currently trying to drop several pounds. What I’m wondering is: How does insulin resistance affect the whole CICO rule (the law of conservation of energy, nonetheless!)? It seems sort of unrealistic for IR to make you an exception to the laws of physics. Is it more related to appetite and increased food intake or does it actually alter the way your body uses energy?
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Biochemist here. I’m not intimately familiar with insulin resistance, but insulin is the signaling molecule your body uses to tell your cells if they should be taking up sugar from the bloodstream, or if they should be using alternate methods of making energy. This is why insulin is so closely tied to blood glucose levels, because it’s essentially telling your cells “its feeding time!”. Type 1 diabetes is characterized by low natural levels of insulin, so even when sugar is available the cells don’t take it up. Also, the same type 1 diabetics don’t respond to low insulin levels by switching over to catabolic energy pathways, and so low blood sugar levels can be very dangerous for them.
This all being said, yes having a disruption to your response pathways to insulin can easily disrupt normal metabolic pathways. It’s not about violating physics; I used to think similarly until I took biochemistry classes. The different energy production pathways in your body all have different relative efficiencies, so the same number of calories can produce different numbers of ATP molecules depending on how they are utilized. To use a poor but adequate analogy, a gallon of gas has a set amount of chemical energy but you’ll get father with a gallon of gas in a Prius than you would with the same gallon of gasoline in a pickup truck
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