Losing weight can be a struggle for many. Whether it’s five pounds or fifty, staying on a diet, getting enough exercise and having the willpower to go at it long-term, is a challenge.
New research from the University of Exeter in the UK suggests that not all fat is the same, however, and that some people who are overweight have fat that has become scarred, inflamed and distressed and this change can make it even more difficult to lose excess weight. As the pounds pile up, amounts of adipose tissue, or fat as it’s commonly known, cannot function properly and, in a sense, becomes “suffocated” by the increase that comes with weight gain.
Dr. Katarina Kos, a Senior Lecturer at the University of Exeter's Medical School, examined samples of fat and other types of tissue from overweight patients and those who had undergone bariatric surgery. The main issue was oxygen supply. As fat cells enlarge, there isn’t enough oxygen, and the cells struggle to survive. This causes inflammation in the fat cells, and that response carries over to the bloodstream, eventually reaching levels that are measurable in blood assays.
Inflammation isn’t the only problem. These stressed-out cells cannot absorb the energy that is converted from food. Adipose tissue has a job in the body, which is to store energy from food. It’s an evolutionary mechanism that protects the body in case of illness or a drop in the food supply. Since these inflamed cells can't take on the excess energy and store it, that excess is diverted from fat cells to vital organs like the liver and heart. This results in many of the obesity complications like diabetes, cardiovascular disease, and fatty liver. It’s also trapped in muscle tissue, leaving the body weaker.
In the patients in the study who had undergone bariatric surgery, the researchers found that the fat tissue was scarred and more rigid than typical fat. Dr. Kos explained how this impacts weight loss, stating, “Scarring of fat tissue may make weight loss more difficult," Dr. Kos said. "But this does not mean that scarring makes weight loss impossible. Adding some regular activity to a somewhat reduced energy intake for a longer period makes weight loss possible and helps the fat tissue not to become further overworked. We know that doing this improves our blood sugar and is key in the management of diabetes."
Location is important as well. If fat is centered around the torso and abdomen, it’s near organs and can do more damage than fat in the arms and legs. Major arteries are also impacted if there is a build-up of fat around them. It can cause arterial stiffening and lead to blood clots and strokes.
The team at Exeter found that a molecule called lysyl oxidase (LOX) is more prevalent in obese patients and it’s responsible for making fat stiffer and more difficult to manage. It’s also driven by lower oxygen levels and inflammation, making it a key player in the difficult some overweight people have when trying to lose weight and get healthier. The research revealed that even patients who had lost significant amounts of weight from surgery, still had fat tissue that was inflamed, lower in oxygen and scarred. The team acknowledged that more research is needed to find how why LOX is dysregulated in some and how to prevent it. The video below has more information.