Insulin resistance can develop first in muscle tissue from inactivity, but fat tissue may become insulin resistant systemically first in many cases.

“so the first thing that happens I think in most people you can probably become insulin resistant in your muscle tissue first if you just like sit all day and do not move that muscle at all but in January I think the fat becomes in-service system first”

“this is not subcutaneous fat if you guys are seeing these images you can see that they've colored the subcutaneous fat yellow and the visceral fat pink and these fats are very different they're very different indicators in humans if you have lots of visceral fat that is essentially pathonomic is what we would call it in medical school that is essentially a pure direct indicator of underlying metabolic unhealth metabolic dysfunction and or insulin resistance is another word”

“it seems that you get to this point where you've accumulated so much adipose tissue and this starts in the subcutaneous adipose that after that the subcutaneous outer position becomes insulin resistant and then you get this knock-on effect um of other of Adipose being or fat being deposited in other tissues”

“where when you're when you're accumulating excess energy when you're getting fatter if you start spilling that fat outside of the subcutaneous fat cells into the muscle into the liver into the pancreas all those things are exacerbating”