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by maskedinvader 2886 days ago
correlation doesn't mean causation, although I myself think insulin resistance happens to obese people because they are obese and not some underlying mysterious reason, but insulin resistance is not typically the only source of T2D, if it was, thin people would never get T2D, so I guess we still have ways to go before we solve this one.
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Thin people with T2D are probably “TOFI” — thin on the outside, fat on the inside. There is a concept of the “personal fat threshold” which is how much fat you can pack into your fat cells, and how many new ones you can grow. This concept explains why Asia and India have high rates of T2D at a much lower BMI.

An interesting way to show that this is likely the case is people with lipodystophy - they have no subcutaneous fat, and they are almost all diabetic.

I might just be matter of being "skinny fat" - someone is an average weight, but because they opt completely out of physical activity, they have basically no muscle mass, and the majority of their structure is composed of fat tissue.
That's sort of what TOFI is, its the term used in medical literature.