I got a note from my boss at the Y today. He scheduled a consult for me on Thursday with a 16 year old girl who has a "hormonal imbalance that creates blood sugar intolerance, creating fat production." She wants to build muscle. She's always been a small

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I got a note from my boss at the Y today. He scheduled a consult for me on Thursday with a 16 year old girl who has a “hormonal imbalance that creates blood sugar intolerance, creating fat production.” She wants to build muscle. She’s always been a small girl, but has started gaining a lot of fat due to this imbalance. It’s not diabetes or PCOS. I’d like to go into this consult with an idea of what this may be…so that I can taylor her workout to it, as well as suggest some food ideas (I have to do this by the books.) Any ideas on what this may likely be?
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Yep. Insulin resistance. Which is the precursor to type 2 diabetes and PCOS. Building muscle provides a bigger glucose sink, more muscle fibres with more insulin receptors. Loss of adipose tissue reduces systemic inflammation which goes some way to reverse insulin resistance too.
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The research has shown excellent results from a lower CHO diet. Even dropping it to the lower end of the “recommended” %age of calories, around 40-45% has been shown to reduce insulin levels. Although I’d recommend fewer carbs and definitely cut out all processed foods and added sugars. I work with IR clients in my nutrition practise and they get nowhere until the processed carbs are gone because you’re treating the root cause, the production of insulin. Good luck!
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It sounds like IR, but given she is 16, would avoid rushing to this diagnosis. Presumably there is blood work, so first look there. Given her age, I would also suggest sex hormones + exogenous ie. contraception Can you do metabolic assessments, RQ, REP etc? It may well be IR and you can evaluate this from pathology, but many other factors can influence this.
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