Prediabetes in Gay Men: The Hidden Health Risk in Gay Culture No One Talks About
Introduction
Usually when people think of prediabetes they think of someone who is older or overweight. But when I initially started training gay men, I was shocked to learn about a third of them had been told by their doctor that they were pre-diabetic or on the path to becoming so if they didn’t make changes.
On the surface, many perfectly looked perfectly healthy, but they were what we call "skinny-fat" in the fitness world- an all too common body type in gay-culture. The area many men find themselves in between the ages of 20 and 30. They don't see their abs as clearly anymore, some have slight pudge, and some even celebrate the extra pounds since it makes them more confident now that they are "thick" in gay culture.
Many of these men went in for routine checkups only to be surprised with news that they are pre-diabetic. Some blame genetics, others blame "bad choices". Here's a truth I've found that no one talks about: there is a cultural layer of unique pressures and habits pushing many gay men to prediabetes without them realizing it.
Peter Pan Twinks & The Skinny-Fat Trap
For both 2023 and 2024 "twink" was the most searched word on PornHub. In gay culture, youth and a lean look are highly valued, and many men cling to that younger, softer physique. I call this the “Peter Pan Twink trap.”
In fitness terms, this is known as the skinny-fat body type. It's defined by a low muscle mass combined with higher body fat. On the outside, you look slim, younger, and healthy in clothes. But under the surface, your body is storing fat in dangerous places like around the liver, pancreas, and other organs.
The scary part? Men who fall into this skinny-fat trap often pass as “fit” until their blood work shows they’re on the road to prediabetes.
Yo-Yo Dieting : The Hidden Risk of Rushing "Beach Ready"
One thing I love about gay men is we are always preparing for something- vacation, Pride, birthdays, hookups, the next pool party, Halloween, or really any opportunity where there will be other shirtless men. This leads to an endless cycle of juice cleanses, green drinks, and brutal cardio sessions designed to drop weight fast.
It works. The weight comes off in the short term, but most rebound and regain the weight within a few weeks only to repeat the cycle for the next event.
This yo-yo dieting pattern does more damage than most realize. Rapid weight gain doesn’t give your body time to safely expand fat stores under the skin (subcutaneous fat). Instead, the fat gets forced around the organs (visceral fat) or even into them (ectopic fat).
Both visceral and ectopic fat is far more dangerous than the fat you can pinch on your stomach. It's directly linked to insulin resistance and are the first steps toward prediabetes and type 2 diabetes.
Why Insulin Resistance Matters
Think of your body like an airport. Every time you eat, your food is broken down into sugar (glucose). These are the passengers arriving at the airport. To get those passengers where they need to go (into your muscles and cells for energy), your body uses insulin. Insulin works like the TSA agents directing traffic in this analogy.
When your airport (body) is healthy, everything runs smoothly. The passengers move through security quickly, the TSA keeps order, and flights (your energy) leave on time.
But when there is visceral fat around your organs, things change. The visceral fat releases fatty acids that inflame the organs and slow them down. In our analogy, imagine all of the airports systems having a virus that makes them slower.
Scanners (your body’s systems) get bogged down, the lines at security get longer, and the TSA agents (insulin) can’t keep up. To compensate, the body produces more TSA agents (more insulin) to try and keep up, but the systems being bogged down by visceral fat is the issue.
This is what it looks like when you are becoming pre-diabetic- an abundance of insulin trying to work with less efficient systems due to visceral fat. This is why blood sugar raises even though there is a lot of insulin present. This metabolic traffic jam is what leads to prediabetes and is what it means to be insulin resistant.
Skinny-fat men have airports that look fine on the outside but run less efficiently inside. Their system is more likely to send incoming passengers to the overflow lot (fat stores) instead of the main gates (muscles).
How Gay Culture Fuels The Problem
Insulin resistance doesn’t come out of nowhere. It’s often the result of lifestyle patterns over long periods of time. Many gay men fall into them without realizing it.
Body Image Pressure - Constant comparisons on apps, social media, and in gyms create intense desires for unrealistic body types.
Party Lifestyle - Alcohol, stimulants, depressants, sleepless weekends, and other forms of escapism disrupt recovery and blood sugar regulation. You're almost viewed as weird if you don't want to celebrate everything with drinking, drugs, and tons of "friends".
Quick Fix Solutions - The solutions in mainstream gay culture are short-term quick fixes rather than long-term solutions. Juice cleanses, detox teas, and endless cardio make it easy to “look good” for an event while quietly making your metabolism worse. Most gay men are more comfortable doing cardio and avoiding the parts of the gym that are for strength training.
On their own, these habits might not cause prediabetes. But stacked together, repeated over years, and socially reinforced, they create the perfect storm.
Breaking The Cycle
The good news is that prediabetes isn't permanent and you can avoid this problem altogether by doing the steps below:
Build Muscle - Muscle does more than help turn heads. It acts like a sponge for glucose, soaking up sugar and making you more insulin-sensitive.
Eat Consistently - Eating well-balanced meals with protein, carbs, and fiber throughout the day prevents sugar spikes and crashes, while helping you maintain a more defined physique.
Skip The Extremes - Let go of cleanses and starving yourself. Slow, gradual changes are of the ones more likely to be permanent and are better for your metabolism.
Prioritize Recovery - Sleep, hydration, and stress management are just as important to staying healthy as training.
Check Your Numbers - Get checked routinely for early warning signs, especially if you know you have been more sedentary over the years. Catching these signs early can prevent serious complications.
Want To Learn More?
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