Childhood Obesity and the Mysteries of Fat

Ahm under ur skinz...

It used to be fat was thought of as pretty much inert. Then scientific research brought about an “Everything you know is wrong” moment, and fat was declared to be a metabolically active organ. As Deepak Chopra puts it:

Fat tissue produces literally dozens of hormones, including leptin, which controls appetite, and adiponectin, which affects insulin sensitivity and blood sugar levels. The hormones and messenger chemicals fat tissue produces travel through the bloodstream and affect organs all over the body.

So, fat doesn’t just sit there. Every fat cell is a little factory that produces more than 30 different chemicals that get up to all kinds of mischief when we’re not looking. What is more, in an obese individual, fat can make up 50% of the total body mass. That’s a lot of cells.

Erin E. Kershaw, M.D., and Jeffrey S. Flier, M.D., endocrinologists from Boston’s Beth Israel Deaconess Medical Center, wrote one of many papers on this subject, explaining that while adipose tissue responds to signals from the hormone system and the central nervous system, it also does so much more.

A lot is going on. Adipose tissue “expresses and secretes factors with important endocrine functions,” and the study authors say:

These factors include leptin, other cytokines, adiponectin, complement components, plasminogen activator inhibitor-1, proteins of the renin-angiotensin system, and resistin. Adipose tissue is also a major site for metabolism of sex steroids and glucocorticoids.

But then, along came others, to uphold the old belief and insist that we were wrong to think we were wrong, because actually, fat does just sit there. For instance, Stephen Guyenet of the University of Washington says:

According to literally thousands of publications spanning nearly two centuries, the brain is the only organ that is known to regulate body fat mass in humans and other animals — neither fat tissue itself, nor the insulin-secreting pancreas have the ability to regulate body fat mass as far as we currently know.

Or maybe there are a few things that fat can do, such as produce cytokines that cause inflammation, as mentioned by H. Yang et al.:

The chronic ‘sterile’ inflammation during obesity, in the absence of any overt infection, leads to several ancillary disease states, which include type 2 diabetes, defective immunity, and several cancers. Excessive production of proinflammatory cytokines by expanded macrophage populations within the adipose tissue is an important contributor toward insulin resistance…

Diabetes and cancer are not the only potential problems. An organ transplant can fail because of obesity-induced inflammation. A bone marrow transplant can be rejected, or a skin graft refuse to “take,” for the very same reason. Inflammation started up by cytokines can get into the brain, too, and is associated with depressive disorder. Dr. James M. Greenblatt says:

It appears that inflammation and the complicated collection of immune system chemical messengers called cytokines play an important role in brain function and may cause psychological symptoms. When the brain is aggravated by any source — stress, infections, trauma, stroke, poisons, or nutritional deficiencies — inflammation spurs the release of pro-inflammatory cytokines, which may affect mood.

Dave Asprey, author of The Bulletproof Executive, says:

Inflammation decreases your cognitive performance by causing a release of inflammatory cytokines that basically ‘cloud’ your brain. This is one of the reasons people don’t perform well when they’re stressed. Stress causes inflammation, which releases inflammatory cytokines like TNF-alpha, which decreases your brain function.

What helps, according to Asprey? Astonishingly, an array of substances that we have been taught to avoid — coffee, butter, and chocolate — along with vanilla. All, of course, have to be grown, produced, harvested, processed, and stored correctly to avoid mycotoxins and other noxious growths that could negate the good effects of these foodstuffs.

NOTE: The picture is of a toy adipocyte found by photographer E. D. Truitt in a museum gift shop. But don’t worry, the plush-covered fat cell is also available online.

Your responses and feedback are welcome!

Source: “No More Laughing at Fat Kids,” The Huffington Post, 10/ 26/11
Source: “Adipose Tissue as an Endocrine Organ,”, 06/04
Source: “The Carbohydrate Hypothesis of Obesity: a Critical Examination,” Whole Health Source, 08/11/11
Source: “Obesity Increases the Production of Proinflammatory Mediators…,”, 06/10
Source: “The Brain on Fire: Inflammation and Depression,” Psychology Today, 11/23/11
Source: “Real Superfoods That Destroy Inflammation in Your Brain…,” The Bulletproof Executive, 01/30/13
Image by Etee.

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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