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Comment by diabeetusman | Hacker News Reader

I'm not seeing the reasoning behind intermittent fasting in particular as opposed to losing weight in general. Couldn't the title just have equivalently been "losing weight may negate need for [type 2] diabetes drugs"?

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Metabolic syndrome isn't so simple. You can sugary calories in small doses throughout the day, lose weight (through caloric deficit), and still develop insulin resistance because your body is constantly saturated in insulin. The theory behind fasting and T2D reversal is that your body is subjected to insulin (especially high insulin) as minimally as possible.

I have a friend who is a competitive seniors category swimmer, and has been competitive his whole adult (and adolescent) life. At the age of 60, after a lifetime of eating 6 small carb heavy meals a day to fuel his races he developed T2D. At the time he was 165lbs of lean muscle and he started wasting away. He has now eliminated all starchy/sugary carbohydrates and fasts 12 hours a day. He has reversed T2D, as long as he maintains the diet and fasting.

> eating 6 small carb heavy meals a day to fuel his races

That was the theory in 1980s, and has been largely debunked.

IF has an immediate effect on blood glucose levels and so insulin sensitivity quickly improves. Losing weight generally also improves insulin sensitivity but more slowly (blood glucose levels can stay high until significant weight loss has occurred)

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