Why is Obesity a Fat Trapping Hormonal Disease?

Hormones are chemical signals secreted by endocrine tissues in the body that control growth and development, metabolism and mood.

Our brain is an endocrine organ and regulates many of the hormones that control functions in the body such as thyroid function and sex hormone control. Furthermore, fat tissue in the body is also an endocrine tissue and it secretes hormones such as leptin which control the amount of fat you hold on your body in concert with the brain.

Therefore, one way to look at obesity is that it's a disease of inappropriate fat trapping as a function of a broken or damaged pathway of hormonal control. In the case of type 2 diabetes, there is high blood glucose levels in the presence of high blood insulin. But insulin's role as a hormone is that it reduces blood glucose. This was discovered in 1921, by Banting and Best and led to their Nobel Prize. Insulin interacts with the insulin receptors on cells and facilitates glucose uptake into the cells, which removes it from the bloodstream thereby decreasing the glucose circulating in the bloodstream. Why would the level of blood insulin (measurable on a standard blood draw) be so high when the blood glucose is so high? (see studies from Dr. Joseph Kraft on hyperinsulinemia)

https://www.sciencedirect.com/science/article/abs/pii/S0168822716301577

The reason is that the cells in the body which are supposed to take up the insulin such as the liver, and the brain, and the fat, and the muscles are insulin resistant. Therefore, the blood glucose is elevated outside the cell and in the bloodstream along with the elevated insulin.

What is insulin resistance?

Insulin and Glucose accumulate outside the cell when Insulin Resistant. How can you tell? You can measure it on a blood test.

Why does this lead to fat trapping? Insulin also inhibits hormone-sensitive lipase (HSL). Hormone-sensitive lipase is an enzyme primarily found in adipose (fat) tissue, where it catalyzes the breakdown of stored triglycerides(the stuff inside the fat cells) into free fatty acids and glycerol. This process, known as lipolysis, is essential for mobilizing energy during periods of fasting or increased energy demand. Therefore, when insulin increases, so does the fat trapping in the body.

TAG= triglyceride; INS=insulin; LPL=lipoprotein lipase; FFA=free fatty acids

What is leptin and leptin resistance?

Leptin similarly is elevated in common obesity. Hyperleptinemia (HL) is seen with the majority of cases of obesity, and leptin's role is to facilitate feeling full and leptin is made by the fat cells in the body. Leptin is another hormone that signals the brain there's plenty of fat here on the body so we can turn off fat storage and start using this up. However, in common obesity it's elevated. Again, this is measureable on a simple blood test and commonly performed by obesity medicine specialists and is a key component of my own research. Leptin is high in obesity when there's plenty of fat around. Yet leptin's role is to get rid of the fat. Insulin is high when the blood glucose is high, yet insulin's role is to get rid of the glucose. See the parallel? The reason for this is leptin resistance. Leptin resistance is characterized by increased hunger, slower metabolism, and fat trapping in the setting of already adequate fat stores.

Hyperleptinemia commonly seen in obesity

What is the goal of weight loss?

Therefore, if your goal is to lose weight and decrease fat trapping. Your goal is to reduce your insulin and reduce your leptin. How can you achieve this? First of all you have to measure these on your lab tests to establish and baseline and a trend. Second, you have to follow the principles of a high nutrient real food diet low in glycemic index and carbohydrates in order to reduce the insulin and leptin in the bloodstream which would in time help the receptors of insulin and leptin to recover. Third, you have to improve your muscle by sprinting, calisthenics, HIIT workouts, and weight lifting to improve insulin and leptin sensitivity. Fourth, you have to live an anti-inflammatory lifestyle and fix your microbiome. Fifth, there are proven insulin reducing effects to medications such as GLP-1 agonists and metformin that might help, and anti-obesity medication such as topiramate has leptin sensitizing effects. This is the benefit of working with an obesity medicine specialist to find the system that will work for you.

Conclusion

Obesity medicine is precise that you cannot say that you have tried everything with diet and exercise and have this disease of fat trapping, but failed to look at the hormones that control body fat storage. You should work with an obesity medicine specialist or metabolic health specialist who understands why the system of fat storage is broken inside your body.