Well Being: Keeping the Weight OFF for a Long and Healthy Life

Executive summary:

• This essay explores the link between obesity and metabolically altered fat cells, and how those cells influence behavior over time.

  • We discuss how obesity is a significant factor in increased inflammatory processes.

  • We explain how obesity leads to chronic diseases and changes in physiological functions.

  • We then examine options for weight loss and offer tips to improve the chances of long-term success in weight loss programs to maintain the weight loss.

An image is making its way around Facebook, asserting that when you lose fat, it just gets turned into CO2 and we breathe it out, or it gets excreted through the usual pathways. That all sounds great!

Eat less, move more – and lose fat!

Except that this isn’t exactly what happens.

Just ask anyone who has lost a little or a lot of weight, only to gain it back. Again and again and again. Maybe they (or you) have cycled like that their entire adult lives.

Ask anyone who has gone on a GLP-1 inhibitor, lost a bunch of weight, gone off the inhibitor, and gained it all back…

Or gone on a crash diet plan, only to gain it all back after the diet ended.

What happened to all that “willpower”

The reason is simple and not so simple. The complex answer is as follows:

The number of fat cells in the body generally remains constant throughout adulthood. But when we become fat, the fat cells become metabolically altered.

Obesity fundamentally reprograms fat cells metabolically, endocrinologically, and epigenetically, turning them into drivers of metabolic disease rather than passive energy reservoirs.

Fat cells undergo significant metabolic changes when one loses weight, but do not fully revert to their pre-obesity state.

Fat cells retain an epigenetic “memory” of obesity that persists, even when a person loses the weight. These cells react to weight loss, to losing mass, as if they are starving.

To repeat: Weight loss improves some metabolic functions, such as reducing inflammation and enhancing insulin sensitivity. However, fat cells retain an epigenetic “memory” of obesity that persists even after weight loss.

This memory alters gene expression and cellular function, predisposing individuals to weight regain. This is why it becomes tricky to maintain the weight loss once it has been achieved. But it gets worse.

Fat cells are long-lived and only renewed or replaced every ten years. Adults lose approximately 10% of their fat cells each year, while new ones are formed in a process known as adipocyte renewal. Hence, once obese, theoretically, it takes at least ten years for the body to recover its pre-obesity fat cell memory fully.

Therefore, once the goals of returning to a normal weight are achieved, the need for self-control methods beyond what a thin person needs to maintain that lowered body weight is critical. What we know now is that it takes years to heal from obesity.

So, if you are obese or even overweight, the best thing you can do for your body is to lose the weight. But keeping that weight off will not be an easy task.

Not because you lack willpower, but because your fat cells are hungry.

It is as if “Seymour” from the “Little Shop of Horrors” were riding shotgun in your brain:

So, why bother? What’s a little fat?

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