It is very often assumed that weight gain “causes” insulin resistance and that insulin resistance leads to diabetes. Weight loss is therefore often recommended to “prevent” diabetes. While an association can make it look like a causal effect, we actually have no evidence of a causal relationship between weight and diabetes. In reality, diabetes is actually a multifactorial disease with a strongly genetic pathogenesis. Less than 5% of people can lose more than 5% of their weight and keep it off. Regardless of weight loss, healthy behavior can benefit insulin resistance and therefore delay the onset of diabetes. Unsuccessful weight loss efforts can lead to increased stress/depression and decrease motivation for healthy behavior. Evidence shows that it is more beneficial to focus on healthy behavior rather than weight. We are gathering more evidence that improving insulin resistance leads to decreased weight rather than decreasing weight leading to improved insulin resistance.