We have all heard that the number of fat cells, in a person's body, are pretty much determined by genetics. This number appears to stabilize, during years of growth, and then remain constant throughout the person's adult life. Fat cells expand and contract with fat gain or loss, while maintaining their numbers intact. But, fat cells turnover like every other cell in the body. This means that they do eventually die, and are replaced with new fat cells, at the same rate, causing for their numbers to appear invariable. This isn't all that fat cells do, though, and they are far from being static, even when they are usually described that way.
Your fat cells are very much active and an integral part of your metabolism. They aren't just little bags that do nothing, but sit there and wait to get filled or emptied, at the person's whim, like calories in/calories out (CICO) advocates ignorantly describe. Fat cells are in constant communication with your neuroendocrine system, secreting proteins and hormones into surrounding tissues, and which cross the blood/brain barrier, that affect metabolism in multiple ways and ultimately dictate where calories go. Because of this, they are usually referred to as 'the largest endocrine organ in the body'.
But, is that all there is to fat cells? It turns out no. This adult onset stability of fat cells is only true under normal circumstances and not under severe endocrine distress like seen in metabolic syndrome, a starvation adaptation. Fat cells under this condition, behave quite differently. They begin to adapt to this environment in multiple ways.
Not only do obese people have more fat cells, than those who are not, their fat cells have a turnover rate that is twice as fast as the lean. Even when obese people lose weight, their fat cell count remains the same as when they were obese. This means they have a much higher fat cell count than an equivalently lean counterpart, who was never obese. The situation becomes worse, as several studies have found that fat cell count can actually change, but only by increasing, never decreasing. Obese people who lose weight, end up with an increased number of fat cells, if they regain the weight. This can explain why weight loss is usually followed by even higher weight regain. With each subsequent regain, the person only gets fatter. They never end up where they started.
This means that fat people get fatter, not leaner, and once you are fat, you are perfecting your ability to get fatter. Obesity increases your risk for further obesity. The body becomes resistant to being lean, because it adapts and evolves to be fat.
The once obese have much smaller, and a greater number, of fat cells than their lean counterparts, with a similar body mass index (BMI), but who were never obese. These smaller fat cells are primed and ready to fill up with fat. They are much more insulin sensitive, they send out more hunger signals and they are more enhanced for fat storage. Though the once obese might now look lean, they are very much still obese. They can become fat, much quicker than a lean person, who was never fat before. This technically means that the "cure" created more of the "disease".
Obese people's fat cells have adapted to an environment that promotes fat storage and sparing and they are acting accordingly. Remaining obese, further enhances this, but reversing obesity does too. Obesity is not a condition of just the present. It is a condition that has far reaching implications for the future, whether the person loses the fat or not. It also reaches in from the past.
This is why it's so important to prevent obesity rather than "cure" it, as obesity is a condition with no known cure. This is also why it is very naïve to say "They are thin, so they can eat whatever they want". Not if they don't want a lifetime of trouble. Long gone are the days when we believed that obesity was simply addressed by "just losing weight". We all know that doesn't work. If it did, then simple dieting would be the long term solution for obesity, but it's not.
The good news, to all of this bad news, is that we know that there are people who lose weight and can keep it off. It's rare, it's unusual, but it does occur. The longer the person can sustain their weight loss, the lower the risk of regaining the weight. This can mean that long term fat cell turnover might be replacing the "sick" fat cells, with new healthy fat cells. Sustained weight loss requires a change in the set weight point.
This is why we take a complete approach for addressing obesity/metabolic syndrome, on this blog. Our focus is on educating, in as simple terms as possible, so you become aware of what you're truly up against and have a better chance of choosing the correct treatment. On this blog, you will be learning real lifestyle strategies for addressing metabolic dysfunction, rather than the latest tabloid gimmicks, commonly used failed tactics or complicated dead ends.
The approach you choose to tackle metabolic dysfunction must be long term, because addressing obesity is much more complex than just losing some weight. If you lose some weight, you better keep it off. If you don't, your fat cells will just keep coming back to life, like zombies, stronger than before. (What doesn't kill them, only makes them stronger.) There is nothing more difficult than fighting the undead. The only way to ensure they are truly dead is by cutting off their heads (insulin/leptin dysregulation), because it's not enough to knock them down and bury them, out of sight, as they have the tendency of digging themselves back out.
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