How do body weight and insulin sensitivity relate?

Increased body weight is indeed associated with decreased insulin sensitivity. This relationship is primarily due to the accumulation of excess adipose (fat) tissue, which can contribute to a state of inflammation and alter the functioning of insulin receptors. When body weight increases, especially with visceral fat accumulation, it leads to changes in the secretion of adipokines, hormones produced by fat cells. These hormones can impair insulin signaling pathways, making it more difficult for the body’s cells to effectively respond to insulin.

As insulin sensitivity decreases, the body's ability to clear glucose from the bloodstream diminishes, which can lead to higher blood glucose levels and ultimately may contribute to the development of insulin resistance and type 2 diabetes over time. This is why maintaining a healthy body weight is often emphasized in diabetes prevention and management strategies.

The other options suggest that increased body weight does not affect insulin sensitivity or is associated with increased sensitivity, which contradicts numerous studies and clinical observations that clearly demonstrate the negative impact of excessive body weight on insulin function. Additionally, focusing solely on diet disregards the crucial role that body composition plays in metabolic health.