America’s Metabolic Epidemic: Insulin Resistance Is Destroying Our Health One Meal at a Time

By Dr. Greg Fors, Board-certified Chiropractic Neurologist

Clinic Director, Pain and Brain Healing Center
Chief Science Officer, Biospec Nutritionals

Dr. Greg Fors is Clinic Director of Pain and Brain Healing Center and Chief Science Officer of Biospec Nutritionals.

Educational only. This is not personal medical advice.

Key Takeaways

• 93% of American adults are metabolically unhealthy.
• Insulin resistance can build silently for years while blood sugar stays normal.
• Muscle that stops listening to insulin pushes fuel to the liver, which turns it into fat.
• Blood sugar is the smoke. Insulin is the fire.
• Blood-vessel damage and insulin resistance fuel each other.
• Drugs are tools, not replacements for changing the environment that made you sick.

Why this matters now

Insulin resistance can quietly build for years. By the time fasting glucose and A1c become abnormal, that metabolic fire may have been burning for years.

America is sick. Our waistlines are growing. We are tired. We hurt. We have brain fog. Fatty liver is exploding. Diabetes is everywhere. Heart disease remains a major killer.

And underneath much of this is a problem that can quietly build for years:

Insulin resistance and metabolic dysfunction.

The numbers are shocking. A large study of more than 55,000 American adults found that only 6.8% had optimal metabolic health.[1]

That means 93.2% were metabolically unhealthy by those standards. Think about that. More than 9 out of 10 American adults failed to meet all five criteria for optimal cardiometabolic health—healthy blood sugar, blood pressure, blood lipids, body fat and absence of cardiovascular disease.[1]

More than 9 out of 10. Look around. This should not surprise anyone. Something has gone terribly wrong with the way we eat and live. And insulin resistance sits right in the middle of this mess.

Your Body Can Only Handle So Much Carbohydrate

Here is something people need to understand: We do not all handle carbohydrates the same way. Your friend may eat a bowl of oatmeal and handle it fairly well. You may eat the same bowl and send your blood sugar through the roof.

So stop asking: "Is this considered a healthy carbohydrate?"

Start asking:

"Can MY body handle this carbohydrate?"

Your physiology gets the final vote.

When you eat carbohydrate, it is broken down into glucose. Glucose enters your blood. Your pancreas releases insulin. Insulin tells your cells: "Take this glucose out of the blood."

Muscle is one of the biggest places that glucose can go. But after years of metabolic abuse, muscle cells can become less responsive to insulin. The muscle becomes hard of hearing.

Insulin knocks. The muscle does not listen. So your pancreas knocks harder by sending out more insulin. And then more and more.

Your blood sugar may still look "normal" for years because your pancreas is working overtime to keep it there. That is why I tell my patients:

Blood sugar is the smoke. Insulin is the fire.

By the time your fasting glucose and A1c finally become abnormal, that metabolic fire may have been burning for years.

When Your Muscles Stop Taking the Fuel, the Fuel Has to Go Somewhere

This is where things really start going wrong. Your muscles are supposed to take a large amount of glucose after a meal. But insulin-resistant muscle does not do that well. So where does the extra fuel go?

Toward your liver.

And your liver starts turning more of that extra carbohydrate into fat. Researchers have actually measured this in people.

In one important study, insulin-resistant people stored about 60% less carbohydrate in their muscles after high-carbohydrate meals. At the same time, their liver made more than twice as much fat. Their triglycerides went up. Their HDL—the so-called "good cholesterol"—went down.[2]

Read that again.

This is why I always look at the ratio between triglycerides and HDL levels. Optimal is about a 2-to-1 ratio. A ratio greater than that is one of the earliest indirect markers that your body is struggling to process insulin properly, often showing up before fasting blood sugar levels rise.

The muscles rejected the fuel. The liver got the overflow. Then the liver made more fat.

That is insulin resistance in action.

Then Your Liver Becomes a Fat Factory

Your liver is supposed to help control your fuel. Insulin resistance messes up that system. Now your liver keeps putting glucose back into your blood when it should stop. At the same time, it can keep making fat.

The result?

• More liver fat—fatty liver, or NAFLD.
• More triglycerides.
• More VLDL particles carrying fat through your blood.
• More small, dense LDL particles.
• Lower HDL.

This is why that ugly cholesterol panel your doctor finds may be about much more than cholesterol. Your body is waving a red flag:

YOUR FUEL SYSTEM IS BREAKING DOWN.

And taking a cholesterol pill alone does not fix the metabolic problem that helped create it.

Your Blood Vessels Are Taking a Beating Too

Now we get to one of the most dangerous parts. Every blood vessel in your body has a delicate living inner lining. It is called the endothelium.

Think of it as the protective lining inside your arteries. It helps control blood flow. It helps your arteries relax. It helps control blood pressure. It helps control inflammation and clotting. It helps move oxygen and nutrients into your tissues.

Healthy blood vessels make nitric oxide, which helps keep them open and flexible. But repeated high blood sugar, high insulin and abnormal blood fats can damage this system.[6-8]

Even a single large rise in blood sugar after a meal can temporarily hurt normal blood-vessel function.[7] Now imagine doing that over and over again.

Breakfast. Spike.
Snack. Spike.
Lunch. Spike.
Another snack. Spike.
Dinner. Spike.

Tomorrow? Do it again. Next week? Again. Next year? Again!

Your body keeps score.

Then the Vicious Cycle Gets Worse

Here is the really ugly part. Insulin resistance can hurt your blood vessels. But unhealthy blood vessels can also make insulin resistance worse.[8]

Why? Because insulin normally helps send more blood into muscle. That helps deliver glucose and insulin to muscle cells. But when blood vessels stop working properly, that delivery system gets worse.

So now we have:

Insulin resistance → blood-vessel damage → poorer blood flow to muscle → worse insulin resistance.

Around and around it goes. And remember: blood vessels go everywhere.

Your heart. Your brain. Your kidneys. Your eyes. Your nerves. Your muscles. Your liver. Your sexual organs.

Every one of them depends on healthy blood flow. So no, insulin resistance is not just a blood sugar problem. It is a whole-body problem.

First Comes the Waistline. Then Comes Something Worse.

Most people first care because they don't like what they see in the mirror. Their belly gets bigger. Their pants get tighter. Weight becomes harder to lose. Then other problems show up:

• Fatigue.
• Brain fog.
• Hunger and cravings.
• Inflammation.
• Pain.
• Poor energy.

Those things matter. But what worries me more is what can come later if nothing changes:

• Type 2 diabetes.
• Fatty liver.
• High blood pressure.
• Heart disease.
• Heart attack.
• Stroke.
• Kidney disease.
• Damage to your blood vessels throughout your body.

Your growing belly may simply be the warning light on the dashboard!

The damage under the hood can be much worse.

And Then We Want a Shot to Fix It

Today millions of people are turning to GLP-1 drugs for weight loss. But let's understand what they are.

They are tools. They are not a replacement for fixing your lifestyle.

These drugs can also cause side effects. Common side effects of semaglutide include:

• nausea,
• vomiting,
• diarrhea,
• constipation,
• stomach pain,
• bloating,
• indigestion,
• reflux,
• fatigue,
• dizziness.[10]

More serious problems can include pancreatitis, gallbladder problems, severe stomach and intestinal problems, and kidney problems related to dehydration.[10]

And here is the bigger issue:

A drug does not erase the lifestyle and metabolic environment that helped create the problem.

In a major semaglutide study, people who stopped the medication regained about two-thirds of the weight they had lost within one year. Many of their metabolic improvements also started moving backward.[11] That should teach us something.

If you lose weight but never change the environment that made you sick, your body will start heading right back where it came from.

I Have Seen People Change Their Lives

I have treated patients with these problems for decades. I have watched people change the way they eat. They start walking. They build muscle. Their insulin comes down. Their glucose improves. Their triglycerides improve. Their waist gets smaller. Their energy comes back.

I have watched patients lose 30, 40 and 50 pounds. I have watched people turn diabetes around and completely change the direction of their health. They did not do it with magic.

They changed what they were putting into their bodies and how they were living.

Unfortunately, I have also watched people reverse course. They feel better. They lose weight. Their blood tests improve. Then the old foods slowly return.

Someone says: "Come on, one piece of bread won't hurt." "It's only dessert." "It's the weekend." "You deserve it."

Then one exception becomes five. Five become fifty.

And months later they are heading right back toward the disease they fought so hard to escape. It is heartbreaking. Because they had already proved something enormously important:

Their body COULD get better!

Stop Asking Whether a Food Is Supposed to Be Healthy

Ask something much more important:

CAN MY BODY HANDLE IT?

Bread may be a problem. Pasta may be a problem. Rice may be a problem. Potatoes may be a problem. Breakfast cereal may be a problem. Oatmeal may be a problem. Even something labeled "whole grain" can be a problem. These foods are all rich in carbohydrates.

Watch what happens to your blood sugar and insulin. Your metabolism does not read the package. It does not care about advertising. It does not care that somebody called the product "heart healthy."

Your body responds to what actually hits your bloodstream.

Want to See Part of the Problem? Look in the Shopping Cart.

Walk through almost any American grocery store. Look into the carts.

Boxes. Bags. Bread. Cereal. Crackers. Cookies. Chips. Sweetened drinks. Frozen processed food. Desserts. Sugar. Refined starch. Ultra-processed food everywhere.

Then look at America.

Look at our waistlines. Look at diabetes. Look at fatty liver. Look at heart disease. Look at how many medications people are taking. Look at how exhausted people are.

Do we really think these things are unrelated?

The food industry has built an environment filled with cheap, addictive, easy-to-eat processed food. But you still have to decide whether you are going to eat it.

Because your pancreas does not care how pretty the package is. Your liver does not care what the commercial promised. And your muscles do not care that the bread says "whole grain."

We Are Paying Trillions for This

America spent about $5.3 trillion on healthcare in 2024.[12] That is more than $15,000 for every man, woman and child in the country.

Poor nutrition alone has been estimated to cost roughly $1.1 trillion every year in medical costs and lost productivity.[13]

We are spending a fortune treating diseases that are deeply tied to how we live. We have built an amazing system for treating heart attacks, diabetes, kidney disease and other chronic illnesses after people get sick.

We need to get much better at preventing people from getting sick in the first place.

Stop Feeding the Disease

There is no injection that replaces a healthy life. There is no supplement that replaces a healthy life. There is no prescription that gives you permission to ignore your biology.

The correct supplements can help. But the foundation is still the foundation:

• Eat real food.
• Stop drinking sugary drinks.
• Get ultra-processed food out of your daily life.
• Cut out the refined and ground carbohydrates your body cannot handle.
• Eat enough protein.
• Eat non-starchy vegetables.
• Eat healthy fats.
• Walk—especially after meals.
• Build muscle.
• Sleep.
• Stay consistent.

And stop feeding metabolic disease all day long and then asking your doctor to rescue you from it.

Measure It Before It Becomes Diabetes

Don't wait until somebody tells you that you have diabetes. Check your metabolism.

Have your doctor look at:

• Fasting insulin: around 5 is optimal.
• Fasting glucose.
• HOMA-IR: under 1 is optimal.
• Hemoglobin A1c.
• Triglycerides.
• HDL.
• Blood pressure.
• Your waistline.

And when appropriate, find out what happens to your glucose after you eat. You can do this by going to the drugstore and getting a glucose monitor.

Remember:

Blood sugar is the smoke. Insulin is the fire.

Find the fire before the house burns down.

This Is Your Choice

You do not have to be perfect. But you do have to make a choice. Every meal is a choice. Every walk is a choice. Every workout is a choice. Every trip through the grocery store is a choice.

Every day you choose real food instead of processed food, you are changing the chemistry inside your body.

The food industry will keep selling to you. The pharmaceutical industry will keep selling to you. The advertisements will keep coming. The excuses will always be available!

But they do not get the final vote.

You do.

Don't wait for diabetes. Don't wait for fatty liver. Don't wait for the heart attack. Don't wait for the stroke. Don't wait until another blood test changes from "borderline" to "disease."

Your expanding waistline may be the problem you notice today.

Your heart, brain, liver, kidneys and blood vessels are what you are fighting for tomorrow.

Your body can change. I have watched it happen again and again. But there is one thing you cannot escape:

You have to stop asking your body to handle more than it can handle.

Things to Remember

1. Insulin resistance can begin years before diabetes. Your pancreas may simply make more and more insulin to keep blood sugar under control.
2. Your muscles matter. When insulin-resistant muscles stop taking glucose normally, more fuel gets pushed toward your liver.
3. Your liver turns that extra fuel into fat. Triglycerides rise. Fatty liver develops. Your cholesterol pattern can get worse.
4. Your blood vessels take a beating. Repeated glucose, insulin and fat spikes damage the healthy function of the lining inside your arteries.
5. Your carbohydrate tolerance is personal. Stop asking what somebody else can eat. Find out what YOUR body can handle.
6. Drugs can help, but they cannot live your life for you.
7. You can change the direction of this. But you have to make the change.

Scientific References

1. O'Hearn M, et al. Trends and disparities in cardiometabolic health among U.S. adults, 1999–2018. J Am Coll Cardiol. 2022;80:138–151.
2. Petersen KF, et al. The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome. Proc Natl Acad Sci USA. 2007.
3. Flannery C, et al. Skeletal muscle insulin resistance promotes increased hepatic de novo lipogenesis, hyperlipidemia, and hepatic steatosis in the elderly. Diabetes. 2012;61:2711–2717.
4. Petersen MC, Shulman GI. Mechanisms of insulin action and insulin resistance. Physiol Rev. 2018.
5. Sparks JD, Sparks CE, Adeli K. Selective hepatic insulin resistance, VLDL overproduction, and hypertriglyceridemia. Arterioscler Thromb Vasc Biol. 2012.
6. Ceriello A, et al. Postprandial endothelial dysfunction: role of glucose, lipids and insulin. Diabetes Metab Res Rev. 2008.
7. Mah E, Bruno RS. Postprandial hyperglycemia on vascular endothelial function: mechanisms and consequences. Nutr Res. 2012.
8. Cersosimo E, DeFronzo RA. Insulin resistance and endothelial dysfunction: the road map to cardiovascular diseases. Diabetes Metab Res Rev. 2006.
9. Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989–1002.
10. U.S. Food and Drug Administration. Wegovy (semaglutide) prescribing information.
11. Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: STEP 1 trial extension. Diabetes Obes Metab. 2022;24:1553–1564.
12. Centers for Medicare & Medicaid Services. National Health Expenditure Data: 2024 national health expenditures.
13. Ridberg R, et al. Food Is Medicine in the US. Health Affairs. 2025.

Related Reading

• Subclinical Insulin Resistance: The Hidden “Metabolic Drain” Destroying Human Health and Driving Chronic Pain
• The Belly That Steals Your Brain: Why Abdominal Fat May Be Putting Your Memory at Risk
• Treating Brain Fog, Anxiety & Insomnia Naturally
• Your Brain Isn’t Crazy… It May Just Be Hungry
• Is Your Brain Wired and Tired? Magnesium May Be the Missing Link
• Plastic Has Entered the Human Brain

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Call (763) 862-7100 or visit https://painandbrainhealingcenter.com/free-consultation-intake/ to explore a root-cause, functional medicine evaluation.

This article is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment. Do not change medications or begin a new treatment program without speaking with a qualified healthcare professional.