Insulin Resistance in Women, Explained Simply

By Tina Chagoury, Clinical Dietitian · 7 min read · 2026-08-21

Insulin resistance is one of the most talked about and least understood terms in women's health. Here is what is actually happening in your body.

Insulin resistance is everywhere online right now, and most of what is said about it is either oversimplified or wrong. So let me explain what is genuinely happening inside your body.

What insulin resistance actually is

When you eat carbohydrate, your pancreas releases insulin. Insulin's job is to help glucose, the smallest unit of carbohydrate, move out of the bloodstream and into your cells: your brain, your muscles, your organs. That is the whole point.

Insulin resistance means your body has stopped responding to that signal properly. The glucose cannot get where it needs to go, so it stays in the blood. Blood sugar rises. Cravings rise. Hunger rises. And weight gain becomes much easier and much faster.

That is it, in two sentences. The complexity comes from why it happens.

What causes it, and why it is not only sugar

There are three drivers I look for, and they usually appear together.

Too much carbohydrate, too often. Not one dessert. A pattern of it, every day, for years.

Inflammatory food. Processed food, refined oils and constant grazing all raise the inflammatory load in the body, and inflammation interferes with insulin signalling.

Not enough muscle. This is the one almost nobody talks about, and it may be the most important. Muscle is where glucose goes. When you contract a muscle, it pulls glucose out of the blood and holds it there. A woman with very little muscle mass has very little capacity to handle carbohydrate, no matter how carefully she eats.

Put those three together and you get what I call the perfect storm: insulin resistance, excess carbohydrate, and not enough movement or muscle.

What happens next: the liver

Here is something most people do not know. Your liver can make fat.

The liver stores glucose in a form called glycogen, but that storage has a ceiling. Once you exceed it, and you are not using your muscles to draw glucose out of the blood, the liver takes the excess glucose and does something called de novo lipogenesis. It manufactures new fatty acids out of sugar.

Those fatty acids either get packaged out into the blood or stay where they are. When they stay, that is fatty liver.

So when someone tells you that eating too much sugar turns into fat, they are, in this specific sense, correct.

The symptoms women notice first

You do not need a blood test to suspect this. These are the signs I hear most:

• Feeling lightheaded, shaky or noticing a racing heartbeat after a meal high in carbohydrate
• Constant hunger, never really feeling full after meals or after snacks
• Daily cravings, especially for something sweet, especially in the afternoon
• Mood swings, and noticeably worse premenstrual symptoms
• Water retention, waking up feeling puffy and full of fluid
• Brain fog, a short attention span, and losing the ability to multitask

None of these on their own prove anything. Together, they are a strong pattern.

How it is properly tested

A continuous glucose monitor. Worn for one to four weeks, it shows you in real time how your own body responds to your own food, your sleep, your stress and your training. Every woman responds differently. This is the fastest way to learn your pattern.

Bloodwork. Fasting blood glucose tells you about that one day only. HbA1c shows your longer term average. Fasting insulin is the one most often left off, and it is essential. With fasting glucose and fasting insulin together, we can calculate HOMA-IR, which tells us whether insulin resistance is present.

Ask for fasting insulin specifically. It is frequently omitted from a standard panel.

An important caveat

Not every blood sugar problem is insulin resistance. Sometimes the diet is simply wrong. Sometimes movement is too low. Sometimes stress is high and cortisol is disordered, which affects blood sugar directly. This is exactly why we investigate before we intervene.

And not everyone with insulin resistance needs metformin or a GLP-1 injection. There are many factors that improve insulin sensitivity, and most of them are things you can change.

Where to start

Stabilise blood sugar first. Protein within the first hour of waking. Protein at every meal. Stop the all day grazing. Walk for ten minutes after eating. Add resistance training, because muscle is your most powerful tool here.

These are not small interventions. In practice they change everything downstream.

This article is nutrition education, not medical advice. Always work with your own doctor for diagnosis and treatment.

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About the author. Tina Chagoury is a licensed clinical dietitian with over twenty years of practice, specialising in women's hormonal health, metabolism, inflammation and gut health. She is the creator of the Hormone Reset Method™, a structured six month programme built around blood sugar regulation, anti inflammatory nutrition, gut support and muscle. Learn more about the Hormone Reset Method.