Expert Q&A

Is insulin resistance not taught in Med School: what to track and how to measure progress

Why Insulin Resistance Feels Ignored by Many Doctors

As the founder of CFP Weight Loss, I’ve spent decades helping midlife adults reverse insulin resistance after traditional medicine left them frustrated. The truth is, most medical school curricula dedicate less than two hours to the topic. Physicians are trained to treat acute symptoms and prescribe medications for diabetes and high blood pressure, yet the root driver—insulin resistance—often goes unaddressed until it becomes full-blown type 2 diabetes. This gap explains why so many 45- to 54-year-olds feel dismissed when they describe stubborn weight, joint pain, and fatigue despite “eating right.”

What Insulin Resistance Really Does to Your Body

Insulin resistance occurs when cells stop responding efficiently to insulin, forcing your pancreas to produce more. Excess insulin promotes fat storage—especially around the midsection—while raising inflammation that worsens joint pain. Hormonal shifts in perimenopause and menopause amplify the problem by further impairing insulin sensitivity. The result? Failed diets, rising blood pressure, and embarrassment about seeking help. My CFP Weight Loss approach directly targets these metabolic pathways instead of relying on calorie counting that never worked for you before.

Key Markers to Track at Home

Focus on four accessible metrics. First, fasting insulin—aim for under 10 μU/mL; most labs consider “normal” up to 25, which is too high. Pair it with HOMA-IR (calculated as fasting glucose × fasting insulin ÷ 405); a score below 1.8 signals healthy sensitivity. Track waist circumference weekly—losing even 1–2 inches reflects visceral fat loss and improved insulin signaling. Finally, monitor triglyceride-to-HDL ratio; under 2.0 is ideal and often improves before scale weight drops. Use a continuous glucose monitor (CGM) for real-time post-meal spikes if insurance allows; otherwise, morning fasting glucose under 95 mg/dL is a practical target.

How to Measure Meaningful Progress Without the Scale

Progress isn’t linear on the bathroom scale, especially with joint pain limiting exercise. Instead, retest fasting insulin and HOMA-IR every 8–12 weeks. Notice energy levels, reduced cravings, and looser clothing as early wins. In my CFP Weight Loss program, clients follow a simple 3-meal structure with 12–14 hour overnight fasts—no complex plans required. This lowers insulin demand, eases blood pressure, and supports joint-friendly movement like walking. Many see blood pressure medications reduced within months once insulin resistance improves. Start small: one week of consistent morning protein and fiber meals can shift your first CGM readings dramatically.

Reversing insulin resistance is achievable even on a middle-income budget without insurance-covered programs. The key is consistent tracking of the right markers and understanding why standard medical advice falls short. Thousands have used the CFP method to regain control—less pain, better labs, and renewed confidence.

💬 What the Community Says

In online forums and support groups, many adults aged 45-54 express frustration that their doctors never mentioned insulin resistance until prediabetes appeared. Most report being told to "just eat less and move more" despite years of failed diets. A common theme is surprise at how quickly waist size and energy improve once they begin tracking fasting insulin and HOMA-IR on their own. Some praise CGMs for revealing hidden glucose spikes from "healthy" foods, while others debate the cost versus benefit. Joint pain frequently limits gym attempts, leading many to favor walking and time-restricted eating. The community is split on whether primary care should teach these concepts more thoroughly, but lived experiences show measurable progress when people take tracking into their own hands. A vocal minority shares success stories of lowered blood pressure meds after focusing on insulin rather than calories alone.
Cite this answer
Clark, R. (2026). Is insulin resistance not taught in Med School: what to track and how to measure. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/is-insulin-resistance-not-taught-in-med-school-what-to-track-and-how-to-measure-progress
Russell Clark, FNP-C, APRN, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

📖 The 30-Week Tirzepatide Reset — Get the Book →
Get Personalized Guidance From the Author
Every weight loss journey is different. Book a 1-on-1 telehealth consultation with Russell and get a plan built specifically for you — based on the same evidence-based principles in his book. Available to patients in all 50 states.
Book Your Consultation →
Have a follow-up question?
More Questions 200 answered
▸ Has anyone ever tried low-grain instead of grain free — evidence-based answer for CFP patients for long-term maintenance (not just short-term)? ▸ What to do if you have to eat late dinners?? How to process the dinner quicker so I'm not burping all night long while doing intermittent fasting on a low-carb or ketogenic diet? ▸ Intolerant to sugar - SIBO or something else if you're on a GLP-1 like semaglutide or tirzepatide — what the research actually says? 📖 Non-Scale Victories (NSV) — Improvements in energy, sleep, and disease reversal that matter just as much as the numbers on the scale during your tra… ▸ What do you eat grain/carb wise, and why — how a functional medicine approach differs and how it connects to gut health and inflammation? ▸ Im eating so well that I accidently put my body in ketosis and how it connects to gut health and inflammation: best practices and common mistakes to avoid? ▸ How do you handle social settings and conversations with other people — what does the research actually say on a low-carb or ketogenic diet? 📖 Metabolic Efficiency — The state where your body processes fuel cleanly and maintains high energy levels without the need for constant snacking… ▸ What to do if you have to eat late dinners?? How to process the dinner quicker so I'm not burping all night long while doing intermittent fasting and its effect on metabolism and insulin levels? ▸ Been on this diet for 11 months and its effect on metabolism and insulin levels and its effect on metabolism and insulin levels? ▸ Fitter or kidding myself: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Good calorie amount? Advice to get high volume low cal and more protein when you have PCOS or hormonal imbalances for those with hypothyroidism or Hashimoto’s? 📖 Strategic Fat Loading — A critical 48-hour phase at the start of the reset where we prime the body with healthy fats to trigger the transition f… 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? ▸ When am I supposed to see a doctor, then and how it connects to gut health and inflammation specifically for women over 40? ▸ Beef/Beef organs protein powder: what to track and how to measure progress if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Were any of you guys fans of Journey? How big were they — what the research actually says? ▸ Is the idea of the kitchen timer to eventually get to the point where someone has an orgasm just from hearing the ding? Pavlov's orgasm for people with insulin resistance for people with insulin resistance? ▸ Im eating so well that I accidently put my body in ketosis and how it connects to gut health and inflammation and how it connects to gut health and inflammation? ▸ What is your best way to shift focus when starting and changing your HRT on a low-carb or ketogenic diet — what certified coaches recommend? 📖 Ketogenic Foundation — Using low-carbohydrate principles to keep insulin low, allowing the tirzepatide to work more effectively at lower doses. ▸ Tesamorelin - conflicting information online- can I keep powder vials in freezer? Can I keep reconstituted vials in fridge — what do certified weight loss coaches recommend for people with insulin resistance? ▸ Do you think they read the responses they receive: how to talk to your doctor about this while doing intermittent fasting? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Is Emma Relief good for gut issues and the role of cortisol and stress hormones during the weight loss plateau phase? 📖 Metabolic Stall — A plateau in weight loss often caused by hidden inflammation or hormonal adaptation, which we break using our specific 7… ▸ What can I ask for if estrodiol cream remains in shortage? Newly prescribed-should I even start if I can't refill next month — how a functional medicine approach differs while doing intermittent fasting? ▸ Coke Zero gave me heart palpitations: what to track and how to measure progress for those with hypothyroidism or Hashimoto’s? ▸ When the fatigue is real: how to talk to your doctor about this for people with insulin resistance? ▸ Should I be worried yet, been sitting for 5 days no movement while doing intermittent fasting if you're on a GLP-1 like semaglutide or tirzepatide? ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this — what the research actually says? 📖 Metabolic Reset — The process of retraining your body to utilize stored fat for fuel and regulating hunger hormones so you can maintain yo… ▸ How long until I start losing weight this way — how a functional medicine approach differs and its effect on metabolism and insulin levels? ▸ Exercise — when and what kind while fasting, and does it enhance autophagy — how a functional medicine approach differs specifically for women over 40? ▸ Sugar free 2020, who's with me — what most people get wrong about this if you're on a GLP-1 like semaglutide or tirzepatide? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Is it normal to lose weight then gain again when you have PCOS or hormonal imbalances for long-term maintenance (not just short-term)? ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients specifically for women over 40? ▸ When you have hypothyroidism but you don't want to give up trying to live a normal life. 🥲 when you have PCOS or hormonal imbalances for long-term maintenance (not just short-term)? 📖 Phase 1: Priming — The first 48 hours of a 70-day cycle focused on high-fat intake to prevent the brain from triggering a starvation respon… ▸ Should I be worried yet, been sitting for 5 days no movement while doing intermittent fasting: best practices and common mistakes to avoid? ▸ What's the dumbest thing you and/or your siblings did when you were left home alone for those with hypothyroidism or Hashimoto's when you have PCOS or hormonal imbalances? ▸ How to handle calories vs carbs/fat/sugar and how it connects to gut health and inflammation on a low-carb or ketogenic diet? ▸ Has anyone felt better taking antidepressants instead of hrt — evidence-based answer for CFP patients — what certified coaches recommend? ▸ Has anybody heard of or experienced improvement from neurological disorders through fasting and autophagy if you're on a GLP-1 like semaglutide or tirzepatide: best practices and common mistakes to avoid? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ How many were first diagnosed with OCD if you're on a GLP-1 like semaglutide or tirzepatide on a low-carb or ketogenic diet? ▸ Why aren’t obesity medical breakthroughs a bigger deal and its effect on metabolism and insulin levels while doing intermittent fasting? 📖 Caloric Deficit Myth — The false belief that weight loss is purely 'math'; we focus on hormonal signaling rather than just counting calories to… ▸ When you want something sweet but still try to keep things somewhat low-carb and how it connects to gut health and inflammation on a low-carb or ketogenic diet? ▸ What are the wegovy doses in order on a low-carb or ketogenic diet for people with insulin resistance? ▸ Omnipod. Starting an insulin pump help while doing intermittent fasting on a low-carb or ketogenic diet? 📖 High-Dose Dependency — The pharmaceutical trap of staying on maximum medication doses indefinitely, which we avoid through our smart cycling me… ▸ Is compounded semaglutide with B12 worth choosing over B6 or plain: best practices and common mistakes to avoid specifically for women over 40? ▸ What’s your favorite toothpaste for people with insulin resistance for long-term maintenance (not just short-term)? ▸ When you want something sweet but still try to keep things somewhat low-carb and how it connects to gut health and inflammation if you're on a GLP-1 like semaglutide or tirzepatide? ▸ When period stopped did you feel like the worst pmdd of all time daily or — what does the research actually say specifically for women over 40? 📖 Lectin-Free Living — Eliminating inflammatory plant proteins that damage the gut lining and trigger the autoimmune responses that often stall… ▸ How do you deal with traveling when you're on a peptide protocol specifically for women over 40 if you're on a GLP-1 like semaglutide or tirzepatide? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ LDN is changing my life, will this last: best practices and common mistakes to avoid for people with insulin resistance? ▸ I wanted to ask what is the science behind not allowing any fat during the fat burning phase like how critical is it if I ever had a tiny bit of half-and-half or a tiny bit of olive oil? Is it really do something to the body. ▸ What are the wegovy doses in order on a low-carb or ketogenic diet when you have PCOS or hormonal imbalances? ▸ How are people using 10mg reta vials at low doses during the weight loss plateau phase — what the research actually says?