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Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease―and How to Fight It

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A scientist reveals the groundbreaking evidence linking many major diseases, including cancer, diabetes, and Alzheimer's disease, to a common root cause—insulin resistance—and shares an easy, effective plan to reverse and prevent it.

We are sick. Around the world, we struggle with diseases that were once considered rare. Cancer, heart disease, Alzheimer's disease, and diabetes affect millions each year; many people are also struggling with hypertension, weight gain, fatty liver, dementia, low testosterone, menstrual irregularities and infertility, and more. We treat the symptoms, not realizing that all of these diseases and disorders have something in common. 

Each of them is caused or made worse by a condition known as insulin resistance. And you might have it. Odds are you do—over half of all adults in the United States are insulin resistant, with most other countries either worse or not far behind. 

In Why We Get Sick , internationally renowned scientist and pathophysiology professor Benjamin Bikman explores why insulin resistance has become so prevalent and why it matters. Unless we recognize it and take steps to reverse the trend, major chronic diseases will be even more widespread. But reversing insulin resistance is possible, and Bikman offers an evidence-based plan to stop and prevent it, with helpful food lists, meal suggestions, easy exercise principles, and more. Full of surprising research and practical advice, Why We Get Sick will help you to take control of your health.

280 pages, Kindle Edition

First published July 21, 2020

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Benjamin Bikman

2 books46 followers

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5 stars
1,351 (41%)
4 stars
1,188 (36%)
3 stars
597 (18%)
2 stars
117 (3%)
1 star
27 (<1%)
Displaying 1 - 30 of 356 reviews
Profile Image for Flora.
473 reviews8 followers
October 2, 2020
The first important thing to note is that Ben Bikman based his book on a lot of reliable research and studies - not on his own whims and fancies. The second thing is that he is not trying to sell you any supplements or expensive consultation programmes. You can also be fairly sure that he’s not being funded by any of the big industries. What’s more - he is an expert on insulin resistance, being a biomedical professor who had earlier on stumbled upon the fact that insulin seems to be the one common factor in almost every chronic disease that we are facing today.

I am convinced that this book has the potential to change the health and lives of countless people if they would just follow the simple suggestions that he has towards the end of the book,

Why we get sick is immensely well-written and easy to understand. I hope every doctor or doctor-to-be would read it so that they can make real improvements in the health outcomes of their patients instead of endlessly supplying medications that often do not ultimately have a positive impact. Everyone who experience chronic illnesses or want to prevent them should also pick up this life-saving book.

Highly recommended.

Thank you NetGalley and Benbella for the ARC. This is my honest review.
Profile Image for Pap Lőrinc.
111 reviews8 followers
August 1, 2020
Insulin was long regarded as the hormone only diabetics should care about - this book takes a more holistic approach of insulin's effect on the brain, the muscles and the cells in general.

It's a very technical and very theoretical book - recommendations and "solutions" are only at the very end. It presents the problem in great detail before attempting to give advice.

I loved the explanations of why muscle mass is not only an aesthetics consideration (it regulates glucose metabolism without insulin involvement), the practical difference between aerobic cardio vs anaerobic resistance training (the latter is better, but only if you're willing to do it), the timing of meals regarding hormone levels (fast for longer periods for the body to rest and become insulin sensitive again) and the effect of synchronous macro digestions to mimic real food ratios (fats + protein are often found together, but rarely contain high carb levels as well).

He mentions the effects of salt (some people are sensitive, other can consume it freely), that carbs shouldn't be drunk (since the fibers are usually missing, which would dampen the insulin spike) and that blood pressure should go down once insulin levels are in order.

Good general introduction to nutrition, based on evolution and latest researches, ignoring the poor confusing studies done over the past decades that caused all this havoc.
Profile Image for Corey.
209 reviews7 followers
August 19, 2020
The author provides a robust explanation of insulin resistance and how it impacts our health in various ways as you would expect from a researcher in this field. The information paints a morbid picture of many of our leading killers and how they are connected to insulin resistance. There's interesting information on genetics, hormones and reproductive health, but things get weird when you get to the lifestyle area. The author moves into a strange place of kind of pushing keto, but not really. Re-framing it to be low carb. They talk about how eating whole fruits is good for us and has little effect on blood sugar/insulin resistance since the fructose is bound in fibre, but later refers to a glycemic load table that discourages the consumption of bananas, berries and citrus. This raised serious alarm bells for me and as the book went on and more and more information was shared about keto I lost all interest and trust in the author. This jaded the first half of the book for me too.

Seriously, referring to the same table on glycemic load, the author recommends 'being careful' in consuming lentils and beans. I've seen a study showing how people eat more beans have lower rates of all cause mortality. Similarly, there's studies showing how consumption of foods rich in antioxidants, such as berries, level out our blood sugars. Really, anyone suggesting we cut carbs and avoid some of the scientifically proven healthiest foods on the planet (whole fruits and vegetables) just seems irresponsible to me. Eat your fruits and vegetables and don't do keto. Seriously, it may have some use as a treatment for epilepsy, but you'd need to way that benefit up with your increased risk of heart disease and other illnesses.

I wouldn't really recommend this book to anyone. Maybe someone with insulin resistance or a chronic metabolic disease could get something out of it. However, I think there are more informative, accurate and effective books addressing these illnesses through lifestyle choices and would recommend those instead. For example, How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease and Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure.

The main message I took from this book is that insulin resistance is incredibly prevalent in society and underpins our leading causes of illness and death.

Some notable points:
- In the 1900s if you asked why we got sick, the answer would be infectious diseases. This is no longer the case and we now get sick from chronic metabolic diseases often underpinned by insulin resistance.

- A recent study suggests that as many as 85% of American adults are insulin resistance. Many other countries have similar or worse rates of insulin resistance.

- We are sick. Worldwide, we are struggling with diseases that were once very rare. Each year, roughly 10 million people die from cancer and almost 20 million people die from heart disease. About 50 million people have Alzheimer's disease and almost a half a billion people have diabetes. Roughly 40% of adults worldwide are considered overweight or obese.

- Not all adaptations are beneficial.

- Insulin resistance doesn't kill you, but it is a vehicle that takes you closer to death.

- Prolonged insulin resistance physically alters the brain. 10 years of insulin resistance ages your brain by two years compared to someone not insulin resistant.

- Insulin, independent of body fat, directly inhibits testosterone.

- The average onset of puberty was around 16 years for girls in the 1800s, 14 in the 1900s, then 13 and 12 in the mid and late 1900s. Now the average is under 10 years old. This is connected to obesity and other health issues.

- Having people with type 2 diabetes take insulin creates an artificially high state of insulin, higher than the pancreas could ever produce. However since insulin increases insulin resistance, a vicious cycle forms where more and more insulin is needed.

- Obesity is also an inflammatory disorder. It is a state of chronic inflammation.

- Tobacco smoke increases insulin resistance in those exposed to it, even through second hand smoke.

- One week of less sleep can make the body 30% more insulin resistance when compared to normal sleep patterns.

- Exercise helps increase insulin sensitivity.

- Glycemic load is a better measure of how much potential glucose is in your diet than glycemic index.

Profile Image for Carol Bakker.
1,165 reviews78 followers
January 24, 2021
I read this book about insulin resistance last summer; I revisited it this week to harvest quotes and main points for my journal. I ended up reading each page again. Ben Bikman is right up there with Dr. Jason Fung as one of my favorites. I will listen to *any* podcast that the winsome Dr. Bikman is on. Curt and I have watched videos on YouTube, which I highly recommend.

Insulin Resistance. The anabolic hormone that has an affect on every cell. Almost every major disease can be traced back to insulin resistance. Maybe not stuttering and hang nails. But heart, cancer, diabetes, migraines, PCOS, ED, psoriasis, fatty liver, tinnitus, Alzheimer's, Parkinson's... you get the idea.

How to lower insulin? Lower stress, get good sleep, ditch processed food, eat less carbs, exercise, and practice some form of time-restricted eating. I appreciate his emphasis on exercise. It may not be that effective for weight loss ("You can't outrun a poor diet" people love to repeat), but movement and contracting muscles are necessary for health. From a video: if you don't have any weight-lifting equipment, start by standing up and sitting down repeatedly.

Dr. Bikman is a (double) Ph.D., not a clinician, but he recommends getting fasting insulin numbers in addition to fasting blood glucose. I've always been nervous about being that "strange" patient, but I'm going to ask for fasting insulin draw at my next doctor's appointment.
Profile Image for Levi Walls.
137 reviews46 followers
December 8, 2022
One of the best non-fiction books I have ever read. It is mind-bogglingly eye opening and could change the life of anyone who reads it. I write this as I go to read it for the second time a mere two months later because it is so good.
1 review
January 28, 2021
As a medical professional, I feel this is an important work and have recommended to my colleagues.

Although there is (somewhat unavoidable) repetition, I am happy to overlook this for the expansive, insightful and practical coverage of such a crucial topic.

I must admit to feeling somewhat frustrated to read reviews that attempt to pigeonhole the text as ‘just another keto book’ and trot out ‘blue zones’ to discredit the themes being addressed. Unfortunately, this belies an ignorance of scientific method and the very reasons we have reached this point as a society due to misinterpretation and/or misrepresentation of epidemiological data.
Profile Image for Alicia McCalla.
Author 8 books88 followers
April 10, 2021
This book was eye-opening. I learned a lot about insulin resistance, glucose and the power intermittent fasting. Game changer for those who need help losing weight, have autoimmune diseases or other health conditions.
Profile Image for Keith Swenson.
Author 15 books50 followers
November 5, 2022
Bikman writes about an important topic: insulin resistance (IR). Everyone should become familiar with this topic, and I learned a lot from this book.

Bikman is a good writer. He presents things in an organized way that flows easily. Relevance and connections are made with the appropriate amount of cross referencing and repetition when needed. I found the book easy to read, even though the topic is potentially quite dry.

The author should be heavily criticized for hyping the topic beyond what is reasonable. He sets out to establish that this is the single most important health issue ever. He repeatedly claims that 85% of Americans have this problem. Well, it turns out that this is a cherry picked statistic from one study done in Latin America. The real figure is 25% to 33% according to main research institutions best estimates. That is still very significant, but Bikman is taken on occasion to select only the most supportive studies and findings, and does not present a balanced and accepted view. Is he claiming that there is a conspiracy trying to hide this disease? Not directly, but he uses persuasive language that might easily support a conspiracy theory.

He spends the entire first half of the book making the claim that ALL modern diseases are caused by insulin resistance. Hypertension (high blood pressure) is caused by insulin resistance. Well, I checked some of the references. He makes this particular statement on page 14 without a reference, and the first cited reference on that does not actually contain the subject of the sentence that contains the citation. My research pointed out many papers covering that hypertension and IR tend to occur together, but there is no consensus on whether one causes the other. They both could simply be the result of poor diet and lack of exercise. In fact IR is correlated with many diseases that are associated with being overweight and out of shape. He boldly however insists that all hypertension is caused by insulin resistance, implying unrealistically that if IR was solved, there would be no more hypertension.

He presents many other diseases are caused by IR. Cancer? Well, he does not say that cancer is caused by IR, but he does say that cancer with IR is worse than cancer without IR. Well, yes, of course, cancer with ANY disease is worse than cancer without that disease. Duh!

How about heart disease? He lists a number of factors that correlate to heart disease, and IR is mentioned several times. The significance of this correlation is never reported. Then, on page 23 he simply jumps to stating "I hope it is clear . . . no single variable is more relevant to heard disease than IR." This actually was never shown, nor was there any research cited to support this, he is instead appealing the intuition of the reader based simply on the number of times he has mentioned IR. This is a logical fallacy.

If your IR gets bad enough, we call it diabetes. In fact IR has been called (or heavily overlaps with) pre-diabetes. Some of the figures he uses includes both IR and diabetes, or blurs the distinction, giving once again inflated figures for the non-diabetic IR.

Once you get past the heavy self-promotion of his subject, he moves on to a decent description of the disease itself, why it exists, and what to do about it. This is all quite science and evidence based, and I learned a lot. This is where the real value of the book lies.

He explains how insulin is a hormone that does a lot of things. One thing is to turn sugar into fat, which is the primary effect, but it is important to remember that there are other things it does: like promote cell growth. If you have a lot of sugar going though your blood, you need a lot more insulin. But once you have a lot of fat, those cells stop taking in more fat. Insulin stops working as well. Hence, insulin resistance. So the pancreas creates more of it, causing more of the other things that insulin does happen as a side effect.

His recommendation is sound as well. Watch your diet, avoid piling on the carbs, and get exercise. Again, this fully rational and supported by science.

Overall, this is a book that I learned from, but I can't say it is in excellent book because of the way he cherry picks evidence in order to promote this as the one main cause of all disease, and the associated implication that if we could solve IR, we would thereby solve all disease. This is a simplistic reductionist theory akin to a fad believed to the exclusion of other theories. Sorry, Bikman, it is just not that simple. There are 70,000 proteins floating around in humans, and the complex interactions have still be mapped out. Insulin resistance is an important problem that we need to be aware of, but it is not the cure-all for all disease.
Profile Image for Donna.
3,901 reviews18 followers
March 22, 2023
I read this one a while ago and I have since binge watched this author on most of the podcasts he was a guest on. I think I like him more now, as well as his message. I'm not a fan of keto but that is because I don't do well on that type of diet but I loved the breakdown of being insulin resistant. Definitely educational. So I've added a star...it's now at 4.


This is Nonfiction/Health. The author shows how being insulin resistance is the root of many diseases even if you are not diabetic. He also mentions how determining insulin levels more accurately gages the quality of health than glucose levels are. Then this author eventually gets around to how a Keto Diet can benefit such problematic health situations.

I liked the information but I'm always left with the feeling (when reading books like this) of all that there is yet to be discovered and how little the medical community actually knows. I love though that huge strides are being made in this area as more and more studies are being done.

The keto books cite all the studies and sources on why this type of diet is the best. Then there are those that promote the plant based diet that do the same. Then there are the IF diets, and on and on.

This one wasn't quite 3 stars, but I rounded up.
8 reviews
March 17, 2022
Awesome Book! Got insulin resistance(over 80% of all american adults do)? Want to reverse it? You should definitely read this book! IR causes or contributes to every chronic disease.
Profile Image for Cristie Underwood.
2,275 reviews56 followers
July 27, 2020
This book was fascinating, as I hadn't realized insulin resistance could have such an impact on the health of people. The author focused his point on peer-reviewed research and his own experience as a leading expert in his field. This read well, as it didn't feel like I was reading a medical journal and the message the author was writing about is one people need to know more about.
Profile Image for Jenae Lovercamp Hulsey.
35 reviews3 followers
January 22, 2021
Not what I was expecting, but incredibly fascinating. I was expecting to learn about germs and viruses and how they get into the body, but instead learned all about insulin! This books used many credible research studies to show the relationship between your bodies ability to use insulin (either being resistant or sensitive to it) and MANY common illnesses and diseases.
Profile Image for Ula.
177 reviews18 followers
April 23, 2022
It wasn’t a total eye-opener for me since most of the stuff from the book I’ve already knew but I loved that everything was based on studies and how author demythologized some of the biggest dietary BS.
Profile Image for Bejinha.
86 reviews12 followers
July 4, 2021
...because we eat sugar, refined carbs, and we don't exercise.
Profile Image for Ben Denison.
482 reviews22 followers
January 22, 2023
Very eye opening book for me. I personally tap dance right on the edge of being classified as diabetic, so this really woke me up to the issue of insulin, weight, and body metabolism and the impacts they all have on your health. (I knew, just didn’t want to address).

The author does a good job walking you through the chemical reactions, effects on the body, impacting fat, impacting metabolism, impacting health.

I thought maybe it got a little too technical, but I thought it was needed AND I was listening to the audiobook while walking, I think some of this would have been better with his charts and indexes.

I did learn a bit. Less fruit juice (I was juicing), less diet drinks (I thought that was a win for me, but nope). More dairy fat. Obviously less carbs (I count calories). On working out, more resistance training than aerobics, but like he said do something that YOU WILL DO! (I walk).

Overall a good book. Really got me focused on my health and the impacts of bad choices.
Profile Image for MicheleStitches.
175 reviews1 follower
December 31, 2021
This book provides a boatload of really good reasons to change my wicked ways (especially with carbs and sugars) and make better decisions to improve my health. It is packed with information, and the research to back it! Bikman gives published studies for every claim he makes —with over 35 pages of references (in small print!) at the end of the book. I come from a family of diabetics and I KNOW how much better I feel when I take steps to discourage insulin resistance. But sometimes I am weak and I allow the social factors surrounding food as well as the pleasure of eating high-carb to lead me into a downward spiral of cravings and bad food choices. The consequences include inflammation and pain, sleep issues, feeling less sharp mentally, increased anxiety, and stomach issues. “Why We Get Sick” is a good kick in the pants to remind me WHY the long-term health benefits of avoiding carb-heavy foods far outweigh the momentary pleasure of indulging in them.
Profile Image for Annie.
823 reviews835 followers
November 25, 2021
This book should be read slowly to understand the medical terms and how the body functions. Some simple steps to fight insulin resistance are reducing sweet drinks (including fruit juices and diet sodas), doing resistance training (exercises using weights), reducing carbohydrates, eating more vegetables, and eating meals about five hours apart (no constant snacking).
Profile Image for Tracy Challis.
404 reviews15 followers
December 26, 2021
Practical. Easy to understand but scientific and supported by research. Some of it was repetitive from other sources I have read before, but I still found it useful. Insulin resistance is prevalent and dangerous.
Profile Image for Tim.
49 reviews
March 2, 2021
3.5 stars. Good book on insulin, insulin resistance and why it matters so much.

Yet, I don't agree with some of his conclusions and food recommendations, pushing keto a bit too much vs what is known in the scientific literature, up to a point where he suggests that mayonnaise might be good for you.
Profile Image for Ella Duce.
66 reviews1 follower
June 2, 2022
I took pathophysiology by Dr. Bikman a couple years ago and learned so much! A lot of this was review and I wonder how well I’d have understood if I didn’t already have some of this knowledge. All in all, I think it’s cool to feel like we have control over our own health and a lot of diseases in America. I feel more motivated to prioritize my health and do what I can to extend my healthy, happy years of life.
Profile Image for Anna.
982 reviews
February 9, 2021
Benjamin Bikman makes a convincing case about insulin resistance and the need to be aware of the long term health effects.

Very-research driven, and focused on insulin.

He also presented at a forum about this topic and is a great way to get a 30 minute summary.

Profile Image for Chrisanne.
2,343 reviews63 followers
March 6, 2022
Several years ago my then-boyfriend told me about a group of scientists who were calling Alzheimer's "Type 3 Diabetes." And I was fascinated. Especially because I had been diagnosed as pre-diabetic several years earlier and was managing it via diet so well that, when I switched doctors, the new one didn't believe me (I've fallen off the wagon several times. Nobody's perfect. And my rant about mindful eating can go on a different review).

I'm not sure where I heard about this book but I thought it might be interesting, given my history.

It's not a bad book. In fact, it's quite a good one. The section on gallbladder blew my mind. And I appreciated his take on fasting--- so many people say it's the answer to everything I appreciated his moderated opinion. But, if you follow him on social media(which he does REALLY well), there's not that much that is new. So pick one or the other. And get empowered.
Profile Image for Lael Walters.
205 reviews3 followers
July 28, 2020
This book was chock full of science. I loved that! It is definitely a book I will want to read again to process. You can definitely tell the author is a scientist -- which brings me to my one con - the book is also typical of those written by a scientist in that the recommendations are too loosy goosy. Books written by medical doctors tend to be very specific -- do this, not that. Books written by a scientist tend to try to cover all the possibilities -- some people will react like this, others like that -- which is great, I completely agree with it -- but I think would be hard to implement if I hadn't already read other books with similar (but more specific) advice. But if you're looking for science, this is the book for you.
Profile Image for Nate.
302 reviews7 followers
April 9, 2022
If you’re reading this you’re probably insulin resistant. Don’t argue with me, put that donut down and listen! Insulin resistance leads to obesity and a litany of chronic diseases that you’re probably dying from right now. Stop worrying about fat and worry about sugar instead, unless it’s fat and sugar together then worry about it and if it’s polyunsaturated fat then worry, look, the food pyramid is a lie perpetrated by corporations that want you fat and sick annnnd…your mom dresses you funny.

Honestly, I agree with most of this book but it has no new information and it’s a bit of a boring read.
Profile Image for Linda.
376 reviews5 followers
November 20, 2021
Despite its title, this book does not detail every reason a person could get sick, but rather focuses on insulin resistance as the cause of most major contemporary health problems. While the author is convincing; he provides a lot of peer-reviewed, valid and reliable scientific backing, the book still seems simplistic to me. Health is not as simple as managing healthy insulin levels. Regardless, my awareness of how insulin, and my own choices about diet, exercise and lifestyle influence my health will guide some positive changes for me, and for that I am thankful.
Profile Image for Jude.
375 reviews6 followers
January 24, 2022
This book is gold. Not only does the author explain insulin resistance in detail, but he gives actionable, research-backed advice for how to improve insulin sensitivity and avoid insulin resistance. Many people will dismiss this book because it recommends low carbohydrate eating since the ketogenic way of eating has been repeatedly attacked in the mainstream media for decades, however, that is a small piece of the author's advice for staying healthy. If you've dismissed the low carb eating pattern in the past, consider reading this book with an open mind.
Profile Image for Ashley Knight.
69 reviews
January 29, 2022
I’ve read many health books and I felt that this one brought them all together for me, insulin being a root cause issue for many just makes sense given the state our our modern diets. The data that the author/dr. Gives us is also magnificent.

I’ve never felt great eating a lot of carbohydrates and now I really understand why. Insulin resistance runs rampant through my family and I know see that some of the issues I’ve experienced since a child has stemmed from it. If you want to get motivated to make a change in your life, this book is a great read.
Profile Image for Esben Kranc.
95 reviews10 followers
January 11, 2022
"Why We Get Sick" is a bit misleading since he mostly talks about lifestyle diseases and not viral sickness or bacterial infections. But for lifestyle, the main takeaway is: Most people have insulin resistance which is bad. Don't eat processed foods. Don't eat sugar. Maybe fast. Maybe keto a bit but not because of fat burning but because the keto principles are correlated quite well with insulin resistance resistance.
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