Insulin is the single and only cause of obesity (local or generalised) because it is the only hormone that builds fat and blocks fat breakdown (lipolysis).
Original statement
الانسولين هو السبب الوحيد الاوحد للسمنه موضعيه كانت او الابديمه متحجره متحشره الانسولين يا باشا الهرمون الوحيد الذي يكون الدهون
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
Insulin is the single and only cause of obesity (local or generalised) because it is the only hormone that builds fat and blocks fat breakdown (lipolysis).
Origin
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- المفاهيم المضللة عن الإنسولين ومغالطات شائعه حول الإنسولين #ضياء_العوضي (Open source)
- Published
- 17 April 2026
- Timestamp
- 0:05:21 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.
- Claimed mechanism
Insulin inhibits lipolysis and promotes fat storage; therefore insulin alone causes obesity.
- Claimed health effect
Obesity; also: insulin treatment makes people fat.
- Population concerned
General population; people with diabetes treated with insulin
- Geographic restriction by Elawady
none found
Diverging source versions
- Source status
- Archive quote (no location given)
- Attribution
- Elawady (archive paraphrase; source video not given)
- Origin
- https://eltayebat.com/rule/insulin-injections/
- Attribution uncertainty
- The archive's 'د. ضياء يقول' box gives no video reference; wording is the archive's paraphrase.
لك السمنه هي اللي ورا السكر السمنه هي اللي ورا السكر طب اذا كان يروح امك الانسولين هو الهرمون الوحيد المسبب للسمنه ها يعني شوف المفاجاه بقى الصادمه الصادمه اللي هي بتقول
Insulin is the only hormone that causes obesity; obesity is not what causes diabetes.
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- بدأت قناة ＂Dr Diaa Al Awady د ضياء العوضي＂ بثًا مباشرًا تصليح مفاهيم (Open source)
- Published
- 31 March 2026
- Timestamp
- 1:05:27 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.
Scientific assessment
Mostly false – Essential parts of the statement are not supported by the evidence or are strongly exaggerated.
Certainty of evidence: moderate – Further research may still affect the assessment.
1. What was claimed?
Insulin is the sole cause of all obesity and the only hormone that forms fat and blocks lipolysis.
2. What is demonstrably correct?
Insulin is the main anabolic hormone of fat tissue: it suppresses lipolysis and promotes fat storage. Starting or intensifying insulin therapy in type 2 diabetes causes weight gain: in UKPDS 33 patients assigned insulin gained 4.0 kg vs 1.7-2.6 kg with sulfonylureas (A-INS-16); weight gain rises with insulin dose and intensity (A-INS-17, A-INS-18).
3. What is wrong or exaggerated?
'Only cause' is not supported. Obesity is multifactorial (energy intake, food environment, ultra-processed foods, genetics, sleep, medications, physical activity). In a metabolic-ward crossover study, cutting dietary fat (which barely changes insulin) produced more body-fat loss (89 g/day) than cutting carbohydrate (53 g/day) even though carbohydrate restriction lowered insulin (I-INS-09). Other hormones (cortisol excess, hypothyroidism, sex hormones, leptin deficiency) and drugs also influence fat mass. People with type 1 diabetes and absent insulin lose weight and fat rapidly, which shows insulin is needed to store fat but does not show it is the only cause of obesity. In a related passage (3j32fjfYRbU) he argues against the view that obesity is behind type 2 diabetes. This is contradicted by randomised evidence: in DiRECT, a weight-management programme led to diabetes remission in 46% vs 4% of controls, and remission rose with the amount of weight lost (86% with >=15 kg) (I-FAST-12).
4. What remains unclear?
The relative weight of insulin-driven mechanisms versus energy intake in long-term human obesity (the 'carbohydrate-insulin model' versus the 'energy balance model') is still debated in the literature; this debate does not support the 'only cause' wording.
5. Which studies support it?
A-INS-16, A-INS-17, A-INS-18 (weight gain with insulin therapy, dose-related); A-INS-19 (metformin reduces insulin dose and weight gain).
6. Which studies contradict it?
I-INS-09 (fat restriction > carbohydrate restriction for fat loss at equal calories).
7. What applies to Germany and Europe?
European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.
8. What is known about Egypt?
Egypt has one of the highest diabetes prevalences in the region; the same drug classes and insulins are used. Access barriers and cost may make advice to stop medication attractive, which increases the practical risk of this claim. No Egypt-specific evidence changes the assessment.
9. What practical conclusion is appropriate?
Weight gain is a real side effect of insulin therapy in type 2 diabetes and is a reason to use the lowest effective dose and to prefer weight-neutral or weight-reducing drugs where appropriate. It is not a reason to see insulin as the cause of all obesity or to stop prescribed insulin.
Assessment details
- Rationale for certainty of evidence
Physiology (insulin is anti-lipolytic and lipogenic) and weight gain under insulin therapy are well established in RCTs and meta-analyses (high certainty). The claim that insulin is the only cause of obesity is contradicted by controlled feeding studies showing that body-fat loss depends on energy balance more than on insulin lowering (moderate certainty; few, short metabolic-ward studies).
- Source quality
Own words in a machine transcript (verbatim); archive paraphrase consistent.
- Regional transferability
Physiology is universal.
- Individual exceptions
Some people gain more weight on insulin than others; weight gain depends on dose and regimen (A-INS-17).
- Regional scope of the claim
- general (biological/medical)
- Last reviewed
- 25 October 2026 provisional
In plain language
Insulin is a storage hormone and it does help the body store fat. People who start insulin for type 2 diabetes often gain a few kilograms. But obesity has many causes, and studies show that eating fewer calories reduces body fat even when insulin hardly changes. So insulin is one factor among many, not the only cause.
Studies on this claim
Studies supporting the claim (4)
-
UKPDS: tablets or insulin for new type 2 diabetes
UKPDS Group. Lancet 1998 · PMID 9742976Randomised controlled trialcited by the Tayebat archiveabstract only checked★ key studyBetter sugar control with tablets or insulin cut eye/kidney complications by a quarter; insulin caused more weight gain and low-sugar episodes.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Intensive control with sulfonylurea or insulin vs diet on complications
- How was the study done?
Multicentre RCT (UKPDS 33)
- How many people, animals or samples were studied?
3,867; Newly diagnosed type 2 diabetes, median age 54
- What was actually found?
Microvascular -25%; more hypoglycaemia and weight gain with insulin.
- How large was the observed effect?
RR reduction 25% microvascular
- What do the results mean in everyday life?
Insulin helps prevent complications but has side effects.
- What are the study's limitations?
Open-label; Older drug regimens
- What does it say about Elawady's specific claim?
Supports weight/hypoglycaemia (C-INS-01); contradicts C-INS-03, C-INS-05, C-DIAB-01.
- Do the results apply to Germany and Europe?
UK; directly relevant.
- What can explicitly not be concluded from this study?
That insulin is harmful overall.
-
Weight gain with insulin
Pontiroli AE et al.. Diabetes Obes Metab 2011 · PMID 21645195 · DOI 10.1111/j.1463-1326.2011.01433.xMeta-analysiscited by the Tayebat archiveabstract only checkedThe more intensive the insulin treatment, the more weight people gain in the first year.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Weight increase in first year of insulin treatment and predictors
- How was the study done?
Systematic review and meta-analysis of 46 RCTs
- How many people, animals or samples were studied?
46 RCTs; Type 2 diabetes starting/intensifying insulin
- What was actually found?
Weight gain related to intensity and regimen.
- How large was the observed effect?
not reported in abstract
- What do the results mean in everyday life?
Weight gain is a real insulin side effect.
- What are the study's limitations?
Effect sizes not in abstract; Heterogeneous trials
- What does it say about Elawady's specific claim?
Supports weight-gain kernel of C-INS-01.
- Do the results apply to Germany and Europe?
International.
- What can explicitly not be concluded from this study?
That insulin causes obesity in general.
-
Intensive insulin in 14 patients
Henry RR et al.. Diabetes Care 1993 · PMID 8422777 · DOI 10.2337/diacare.16.1.21Case series / case reportcited by the Tayebat archiveabstract only checkedBlood sugar normalised but patients gained almost 9 kg in six months.
Does the study support the specific claim? Partly · Methodological quality: very low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Metabolic effects of intensive conventional insulin in type 2 diabetes
- How was the study done?
Uncontrolled 6-month clinical study
- How many people, animals or samples were studied?
14; Type 2 diabetes outpatients
- What was actually found?
Glucose improved; +8.7 kg.
- How large was the observed effect?
+8.7 kg
- What do the results mean in everyday life?
Insulin works but can cause substantial weight gain.
- What are the study's limitations?
n=14; No control; 1993 regimen
- What does it say about Elawady's specific claim?
Kernel of C-INS-01.
- Do the results apply to Germany and Europe?
Old US regimen.
- What can explicitly not be concluded from this study?
General conclusions.
-
Adding metformin to insulin
Wulffelé MG et al.. Diabetes Care 2002 · PMID 12453950 · DOI 10.2337/diacare.25.12.2133Randomised controlled trialcited by the Tayebat archiveabstract only checkedMetformin improved sugar control and reduced insulin need and weight gain.
Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Metformin added to intensive insulin in type 2 diabetes
- How was the study done?
Double-blind placebo-controlled RCT
- How many people, animals or samples were studied?
390; Insulin-treated type 2 diabetes
- What was actually found?
Better control, less insulin, less weight gain.
- How large was the observed effect?
GHb -0.7%
- What do the results mean in everyday life?
Combination lowers insulin needs.
- What are the study's limitations?
Short duration; Dropouts higher with metformin
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
Dutch data.
- What can explicitly not be concluded from this study?
That insulin can be stopped.
No study in this group is marked as key.
Studies contradicting or limiting the claim (2)
-
Low-fat vs low-carb in a metabolic ward
Hall KD et al.. Cell Metab 2015 · PMID 26278052 · DOI 10.1016/j.cmet.2015.07.021Randomised controlled trialindependent cross-checkfull text checkedCutting fat led to more fat loss than cutting carbs, even though cutting carbs lowered insulin more.
Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Does carbohydrate restriction (lower insulin) cause more fat loss than fat restriction at equal calories?
- How was the study done?
Randomised crossover metabolic-ward study
- How many people, animals or samples were studied?
19 adults with obesity randomised (17 completed both diets)
- What was actually found?
Fat loss 89 g/day on reduced-fat vs 53 g/day on reduced-carbohydrate (463 g vs 245 g over 6 days), although only the low-carb diet lowered insulin (by 22%).
- How large was the observed effect?
+36 g/day with fat restriction
- What do the results mean in everyday life?
Calories matter; insulin is not the only driver.
- What are the study's limitations?
Only 6 days per diet; small sample; fat loss was a secondary outcome; long-term predictions come from a computer model; moderate (not very-low) carbohydrate restriction.
- What does it say about Elawady's specific claim?
Contradicts C-INS-01 ('insulin the only cause of fat').
- Do the results apply to Germany and Europe?
Physiology transferable.
- What can explicitly not be concluded from this study?
Long-term weight outcomes.
-
DiRECT: weight loss to put type 2 diabetes into remission
Lean ME et al.. Lancet 2018 · PMID 29221645 · DOI 10.1016/S0140-6736(17)33102-1Randomised controlled trialindependent cross-checkabstract only checked★ key study46% of people in the programme were free of diabetes and medication after one year.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Can intensive weight management in primary care achieve T2D remission?
- How was the study done?
Open-label cluster-randomised trial (DiRECT)
- How many people, animals or samples were studied?
306 (149 per group ITT); 49 practices; Age 20-65, T2D <6 years, BMI 27-45, not on insulin
- What was actually found?
Remission 46% vs 4%.
- How large was the observed effect?
OR 19.7
- What do the results mean in everyday life?
Losing 10-15 kg can reverse early type 2 diabetes.
- What are the study's limitations?
Open-label; Selected population; Formula diet
- What does it say about Elawady's specific claim?
Supports C-DIAB-03 (with conditions); limited relevance to C-INS-10 (insulin users excluded).
- Do the results apply to Germany and Europe?
UK; directly relevant.
- What can explicitly not be concluded from this study?
Effect of the Tayebat diet; effect in type 1 or insulin-treated diabetes.
No study in this group is marked as key.
Studies with mixed or unclear results (0)
No studies in this group.
Regional context
Germany / EU
European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.
Egypt
Egypt has one of the highest diabetes prevalences in the region; the same drug classes and insulins are used. Access barriers and cost may make advice to stop medication attractive, which increases the practical risk of this claim. No Egypt-specific evidence changes the assessment.
What applies in my country?
General scientific assessment
Mostly false Insulin promotes fat storage and insulin therapy causes weight gain, but it is not the only cause of obesity.
This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.
References
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.. UKPDS Group. Lancet 1998 · PMID 9742976
- Increase of body weight during the first year of intensive insulin treatment in type 2 diabetes: systematic review and meta-analysis.. Pontiroli AE et al.. Diabetes Obes Metab 2011 · PMID 21645195 · DOI 10.1111/j.1463-1326.2011.01433.x
- Intensive conventional insulin therapy for type II diabetes. Metabolic effects during a 6-mo outpatient trial.. Henry RR et al.. Diabetes Care 1993 · PMID 8422777 · DOI 10.2337/diacare.16.1.21
- Combination of insulin and metformin in the treatment of type 2 diabetes.. Wulffelé MG et al.. Diabetes Care 2002 · PMID 12453950 · DOI 10.2337/diacare.25.12.2133
- Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity.. Hall KD et al.. Cell Metab 2015 · PMID 26278052 · DOI 10.1016/j.cmet.2015.07.021
- Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.. Lean ME et al.. Lancet 2018 · PMID 29221645 · DOI 10.1016/S0140-6736(17)33102-1