What Is Why We Get Sick About? Insulin Resistance and Hyperinsulinemia
Why We Get Sick by Benjamin Bikman: how hyperinsulinemia and insulin resistance drive chronic disease, plus fasting insulin, HOMA-IR, and low-glycemic protocols.
Insulin resistance as the common root — labs, food, and how it sits next to Fung and Means
Why We Get Sick (2020) is the mechanism book under a lot of metabolic Twitter. Bikman argues insulin resistance links diabetes, fatty liver, hypertension, and more. This guide extracts the labs and the boring plan — and tells you when to stay on the drugs you already have.
Frequency
Daily food pattern plus walking
Duration
Months to reverse labs; lifelong maintenance
Level
Beginner
Key Takeaways
- 1Start with waist, triglycerides, HDL, blood pressure, and fasting insulin if you can get it
- 2Cut liquid sugar and ultra-processed snacks before you buy a CGM membership
- 3Fung is the fasting layer; Means is the kitchen layer; Bikman is the why
- 4Do not stop diabetes medication because a hardcover explained insulin
Who this is for
- ·Readers comparing Bikman vs Fung vs Means vs Inchauspé
- ·Anyone whose last metabolic panel is five years old
- ·People tempted to treat every symptom as mitochondria
The Common-Root Claim
Moderate EvidenceHyperinsulinemia as upstream of many ‘separate’ diagnoses is a useful organizing story. It is not a complete map of cancer or psychiatry.
The practical move is to treat refined carbohydrate load and inactivity as first-order, and boutique supplements as later.
Labs Before Capsules
Strong EvidenceTriglycerides, HDL, waist, home BP (Omron), fasting glucose. Fasting insulin or HOMA-IR if your clinician will order them. ApoB still belongs on the list if you are playing Attia’s game.
A CGM is optional curiosity. It is not required to follow the book.
Keep vs Skip
Moderate EvidenceKeep: protein and plants, walking after meals, sleep, and actual labs. Skip: stopping prescribed drugs, and assuming every fatigue is insulin.
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Sources
Key references cited in this guide. Links open the original publication or abstract.
- Why We Get SickBenBella, 2020
- Insulin resistance and chronic disease — review contextPhysiol Rev, 2016
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Read guideLast updated: 2026-09-22 · For informational purposes only. Not medical advice. Consult a healthcare provider before starting any new health protocol. Health disclaimer.