[Afton]

I can't read the study directly (and it's not my field, which makes reading it directly challenging), but this is the abstract conclusion:

` Higher fasting insulin and higher c-reactive protein confound the association between BMI and the risk of all-cause mortality. The increase in mortality that has been attributed to higher BMI is more likely due to hyperinsulinemia and inflammation rather than obesity.`

[oaktrout]

Excess fat -> insulin resistance -> higher fasting insulin.

[danwills]

This is mentioned in the article, I must admit I previously thought it was as you say, but:

"available evidence in humans suggests that hyperinsulinemia precedes weight gain (rather than the other way around)"