 [ Symptoms ] why is it that obesity does not always cause type 2 diabetes [ Disease ] it is true that the more severe the degree of obesity the greater the odds of type 2 diabetes that is because the excess body fat fuels insulin resistance in the muscles and organs there may be adverse hormonal effects on the beta cells as well after years of insulin resistance the beta cells wear down to the point where prediabetes or full type 2 diabetes occurs but only in a certain fraction of indiviiduals with obesity we do not fully understand why some people with obesity are at risk for diabetes while others can be obese their whole lives without getting it the answer is likely in the genetics but we do not know which genes confer protection or susceptibility similarly some thin people develop type 2 diabetes despite minimal insulin resistance again the answer is in the genes but we do not know which genes