“This book is a unique, rigorous contribution to understanding insulin resistance as an underlying cause of chronic disease and aging. Well written and highly accessible, Dr. Bikman has written a book for both scientists and the average reader who seeks a path back to good health.” – Nina Teicholz, science journalist and New York Times bestselling author of The Big Fat Surprise
Insulin resistance is the cause of many if not most of the major diseases that plague our world today: diabetes, heart disease, Alzheimer’s, and polycystic ovary syndrome. Around 88% of all adults have insulin resistance and besides this, the very problem hasn’t been given enough credit as a main disease caused by reversing which may significantly lower our susceptibility to illnesses.
To address this issue, Dr. Benjamin Bikman has written a book called ‘Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease – and How to Fight It’. This comprehensive read presents a novel view at disease risk factors and promotes preventing and reversing them through lifestyle changes.
Author’s background

During his doctoral studies at East Carolina University, Benjamin Bikman worked on modifications to metabolic surgeries in obese patients. As a postdoctoral fellow at Duke-National University of Singapore, he explored metabolic disorders, with a focus on insulin resistance.

Currently a professor and director of Brigham Young University’s Diabetes Research Lab, Dr. Bikman studies insulin’s role in regulating human metabolism and its relevance to chronic diseases. Along with his research and teaching, Dr. Bikman mentors undergraduate and graduate students in research.
What is the book about?

‘Why We Get Sick’ is divided into three parts, each focusing on a different aspect of insulin resistance and its impact on our health. In Part I, Dr. Bikman explains what insulin resistance is and its consequences for the body. As cells become less responsive to insulin, higher levels of insulin are needed to regulate glucose levels, leading to the conversion of excess food into fat. Visceral fat, which is hidden and harmful, poses greater health risks than subcutaneous fat.
Part II explores the causes of insulin resistance, including age, genetics, hormones, obesity, inflammation, oxidative stress, and lifestyle factors. Dr. Bikman emphasises the importance of regular sleep and exercise in combating insulin resistance.
In Part III, Dr. Bikman offers practical and cost-effective solutions to fight insulin resistance and restore metabolic health. These include reducing carbohydrate intake and incorporating regular fasting to give the body a break from high insulin levels. By implementing these strategies, individuals can work towards achieving insulin sensitivity and improving their overall metabolic well-being.
Overall, the book is well-researched and pleasing to read. It provides novel views on the risk factors of the disease and gives valuable recommendations to address the issue naturally.
Key takeaways from ‘Why We Get Sick’

1Insulin resistance is very common among people of all ages but is usually underdiagnosed
Insulin resistance is extremely common. In fact, around 88% of all adults have insulin resistance. It has even been diagnosed in patients as young as 4 years old.
Besides being really common, insulin resistance is underdiagnosed, partly because measuring insulin levels is more challenging than measuring blood glucose. Blood glucose levels have been the primary focus for diabetes diagnosis and management.
The thing about insulin resistance is that it won’t kill you but it will lead you down a pathway toward diseases that will kill you. It can contribute to the development of various diseases that can be fatal, such as heart disease, neurological disorders, reproductive issues, and certain cancers.
2Insulin resistance is a cause of plethora of diseases
The book presents a new view on the cause of various diseases. Dr. Bikman showcases insulin resistance to be the leading cause.
Insulin resistance is a causative factor underlying a multitude of diseases, with far-reaching implications for health.
Inflammation, a key driver of chronic conditions such as heart disease, is exacerbated by insulin resistance, perpetuating disease progression. Surprisingly, insulin resistance and inflammation also play pivotal roles in the development of Alzheimer’s disease, challenging conventional understanding.
Polycystic ovary syndrome (PCOS), characterised by hormonal imbalances, is closely associated with insulin resistance, resulting in symptoms like infertility and masculinization.
Moreover, insulin resistance is strongly linked to obesity-related cancers, including breast, prostate, and colorectal cancers, as elevated insulin and glucose levels fuel tumour growth. Non-alcoholic fatty liver disease (NAFLD), prevalent in type 2 diabetes, is exacerbated by insulin resistance and the consumption of fructose.
Lastly, insulin resistance lies at the core of metabolic syndrome, manifesting as central obesity, high blood pressure, and related conditions, perpetuating a cycle of insulin dysregulation and metabolic dysfunction.
3Insulin resistance is fully reversible
The good thing is that insulin resistance is reversible. What is even better is that it can be done with the help of simple like getting moving (regular exercise), and eating smart – that involves reducing carbohydrates, maintaining adequate protein, and filling in with fat. Get good quality and quantity of sleep as many nights as you possibly can.
The book explains the role and effect of these insulin resistance-reversing choices in detail and also gives practical advice on their implementation.
Table of contents

- Foreword by Dr. Jason Fung
- Introduction
- Part I: The Problem: What Is Insulin Resistance and Why Does It Matter?
- Chapter 1: What Is Insulin Resistance?
- Chapter 2: Heart Health
- Chapter 3: The Brain and Neurological Disorders
- Chapter 4: Reproductive Health
- Chapter 5: Cancer
- Chapter 6: Aging, the Skin, Muscles, and Bones
- Chapter 7: Gastrointestinal and Kidney Health
- Chapter 8: The Metabolic Syndrome and Obesity
- Part II: Causes: What Makes Us Insulin Resistant in the First Place?
- Chapter 9: How Age and Genetics Influence Insulin
- Chapter 10: How Hormones Cause Insulin Resistance
- Chapter 11: Obesity and Insulin Resistance, Revisited
- Chapter 12: Inflammation and Oxidative Stress
- Chapter 13: Lifestyle Factors
- Part III: The Solution: How Can We Fight Insulin Resistance?
- Chapter 14: Get Moving: The Importance of Physical Activity
- Chapter 15: Eat Smart: The Evidence on the Food We Eat
- Chapter 16: Conventional Interventions: Drugs and Surgery
- Chapter 17: The Plan: Putting Research into Action
- It’s Time to Take Action
- Acknowledgments
- Appendix A: My Sample Daily Exercise
- Plan Appendix B: Expanded Food Lists
- Resources
- Notes
- Index
- About the Author
Strengths and weaknesses, according to readers’ reviews

Strengths
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Research-based.
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Emphasises prevention and reversal of diseases through lifestyle changes rather than medication.
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Quick and easy to understand.
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Offers actionable advice on diet, exercise, and lifestyle modifications to address insulin resistance.
Weaknesses
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Narrow focus. The book may be too narrowly focused on insulin resistance, potentially overlooking other interconnected factors that contribute to overall health.
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Limited dietary recommendations. While the book mentions the importance of glycemic load and leans towards a low carb/ketogenic approach, the diet recommendations may not be comprehensive or provide detailed guidelines for individuals seeking a comprehensive understanding of a keto diet. This could leave readers wanting more specific information and guidance.
Best quotes from ‘Why We Get Sick’

“The World Health Organization defines the metabolic syndrome by two main criteria: first, the patient must have two of either high blood pressure, dyslipidemia, central obesity, or low levels of protein in the urine; and second, the patient must have insulin resistance.”
“We generally store fat in two areas on our bodies: beneath our skin, called subcutaneous fat, and around our internal organs, called visceral fat. Cortisol is known to cause insulin resistance directly, but it also selectively drives visceral fat to grow more than subcutaneous fat, creating an unhealthy metabolic state.”
“Scientists at the Weizmann Institute found that a person’s gut bacteria determined the glycemic load of a food, and that some people had a fairly minor response to things like ice cream, while others had dramatic glycemic responses to common foods like wheat bread.”
Final takeaway

Insulin resistance lies at the core of numerous chronic diseases and ageing processes. ‘Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease – and How to Fight It’ sheds light on this fundamental issue. The book offers practical and inexpensive strategies, emphasising the importance of reducing carbohydrate intake, intermittent fasting, regular exercise, and quality sleep to restore metabolic health.
‘Why We Get Sick’ is an essential read for everyone as this health issue is more common than we’d thought. Highly recommend reading this book if you are a health-conscious person and want to prevent insulin resistance and achieve improved overall health.
Where to buy
You may purchase ‘Why We Get Sick’ on Amazon at the best price. It is available in Kindle, audio and paperback versions, so you are free to choose the format that suits you best.