Why Do Overweight and Obese
People Find Weight Loss So Difficult?
Scientists have discovered why fat people find it so hard to
lose weight, which will lead to many new approaches to weight
loss.
The difference in the number of fat
cells between lean and obese
people is established in childhood and, although fat people
replenish fat cells at the same rate as thin ones, they have around
twice as many.
This remarkable glimpse of what gives us beer
guts, love handle and muffin tops could also lead to new approaches
to fight the flab, by cutting the overall number of fat cells
in the body, as well as providing an insight into why fat people
find it so hard to lose weight, because the number of fat cells
in a person remains the same, even after a successful diet.
The details of how humans regulate their fat mass
is reported in the journal Nature by a team led by scientists
at the Karlolinksa Institute, Stockholm, Sweden, as a second team,
led by Imperial College London, reports in the journal Nature
Genetics the discovery of a gene sequence present in half the
population linked to three quarters of an inch bigger waistline,
four lb gain in weight, and a tendency to become resistant to
insulin, which can lead to type 2 diabetes.
The fundamental new insight into the cause of
obesity comes from an international team lead by Dr Kirsty Spalding,
Prof Jonas Frisén and Prof Peter Arner who found the body
constantly produces new fat cells to replace equally rapid break
down of the already existing fat cells due to cell death.
They also show, that overweight people generate
and replace more fat cells than do lean - and that the total number
of fat cells stays equal after a diet
program.
Until now, it was not clear that adults could
make new fat cells. Some had assumed that they increase their
fat mass by incorporating more fats into already existing fat
cells in order to maintain their body weight (lean, overweight,
obese). However now it seems we constantly produce new fat cells
irrespective of our body weight status, sex or age.
"The total number of fat cells in the body is
stable over time, because the making of new fat cells is counterbalanced
by an equally rapid break down of the already existing fat cells
due to cell death", says Prof Arner.
The study was made possible by a method to use
radioactive isotopes in fat cells from people who had lived through
the brief period of Cold War nuclear bomb testing from 1955 to
1963 to determine the age of the fat cells in the body.
This was combined with methods to carefully measure
the size of the fat cells in relation to the total amount of adipose
tissue in 687 people with a large individual variation in body
weight who had undergone liposuction and abdominal reconstruction
surgery.
Fat cells are replaced at the same rate that they
die - roughly 10 per cent every year. The level of obesity is
determined by a combination of the number and size of fat cells,
which can grow or shrink as fat from food is deposited in them.
Even if obese subjects go on a diet they keep
the total number of fat cells in the body constant, but the size
of individual fat cells is decreased markedly. This effect is
most obvious and well sustained during programs which integrate
diet and exercise for at least 12 weeks or more.
"The results may, at least in part, explain why
it is so difficult to maintain the weight after slimming", adds
Prof Arner.
"Until now it was not clear whether there was
fat cell turnover in adults," adds Dr Spalding. "Now we have established
this does occur, we can target the process.
Other new insights into how to treat obesity could
come from the gene sequence linked to an expanding waist line,
weight gain and a tendency to develop type 2 diabetes in the Imperial
led study.
Professor Jaspal Kooner, the paper's senior author
from the National Heart and Lung Institute at Imperial College
London, says: "Finding such a close association between a genetic
sequence and significant physical effects is very important, especially
when the sequence is found in half the population."
The study shows that the sequence is a third more
common in those with Indian Asian than in those with European
ancestry. This could provide a possible genetic explanation for
the particularly high levels of obesity and insulin resistance
in Indian Asians, who make up 25 per cent of the world's population,
but who are expected to account for 40 per cent of global heart
disease by 2020.
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