Everything You Know About Fat Is Still Wrong


Or maybe it isn’t. What is known today may be superseded by fresh discoveries tomorrow. Sometimes, new knowledge rolls out slowly, while, at other times, entire areas of specialization are thrown into confusion overnight. The subject of body fat has been slowly revealing its secrets, and causing some astonishment along the way.

A terrible irony is that the subcutaneous fat so often liposuctioned out of people is considered to be “good fat,” with protective and cosmetic functions. It also produces the hormone adiponectin, which appears to counteract breast cancer. Visceral fat, on the other hand, can not be sucked out, which is a shame because it “infiltrates our vital organs, bathing them in a nasty chemical stew that wreaks havoc in the body.”

Writer Bill Gifford explains:

On a strictly mechanical level, more fat means less muscle, which means fewer mitochondria, the cellular power plants that are most plentiful in muscle tissue. The majority of fat contains almost no mitochondria. This explains one of the nagging problems with obesity: the more fat you accumulate, the harder it becomes for your body to burn off that stored energy.

Gifford interviewed Dr. Gerald Shulman, whose expertise is in diabetes, and who points out that while the total amount of fat a person carries is important, the placement of it can make a fatal difference. You don’t want it in amongst muscle fiber (see illustration) where it “infiltrates individual muscle cells in the form of lipid droplets that make the cells sluggish.” Fat is particularly not wanted in the liver.

Be neither an apple nor a pear

In 2013, researchers from UC Davis debunked a long-held belief about body fat. The announcement says:

People who are “apple-shaped” — with fat more concentrated around the abdomen — have long been considered more at risk for conditions such as heart disease and diabetes than those who are “pear-shaped” and carry weight more in the buttocks, hips and thighs.

But no. As it turns out, junk in the trunk (gluteal adipose tissue) produces chemicals that provoke inflammation and maybe even insulin resistance. In other words, abdominal fat has one way of attacking, and fat stored in the rear end has another. The only upside is a possibility that the substance chemerin could serve as a useful biomarker for the early diagnosis of metabolic syndrome gone bad.

The fat inside us

The average human body, according to Brent Rose, contains from 10 to 30 billion fat cells, and an obese person might end up with as many as 100 billion of them. It gets worse. While a seemingly infinite number of fat cells can be added, none can be subtracted. Many people believe that losing weight means the disappearance of fat cells, but this is not true.

When a person makes a life-changing decision and loses several hundred pounds, each individual fat cell gets skinnier. But every single one of them hangs around, with the anticipation of being re-inflated at some future time, and the only way to truly banish them is by liposuction.

When weight is lost through non-invasive means, this happens:

The mitochondria (cellular energy centers) in your muscle or liver cells pull some of the fat (stored as triglycerides) from within your fat cells and put it through a metabolic process. This converts the fat into heat, carbon dioxide, water, and ATP (adenosine triphosphate)…

ATP carries fuel to the muscles; water exits the body as urine. The carbon dioxide is exhaled, to join the earth’s atmosphere and contribute to global warming. But the prospect of increasing one’s carbon footprint is not a good enough reason to remain overweight, if a person can possibly help it.

Your responses and feedback are welcome!

Source: “Your Fat Has a Brain. Seriously. And It’s Trying to Kill You,” OutsideOnline.com, 03/05/13
Source: “UC Davis study deflates notion that pear-shaped bodies more healthy than apples,” UCDavis.edu, 01/10/13
Source: “The Science of Fat,” Gizmodo.com, 02/17/14
Photo credit: Paul Keller via VisualHunt/CC BY

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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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