Empowered Health Course · Lesson 10 · 3:55
We talked about storing fat safely under the skin, using the example of Paul and his expandable suitcase. In this case it's Omar, and his suitcase is only semi-expandable. What happens is that a group of fat cells stop replicating and staying small. Instead, the immune system — the system that fights infection — interacts with those fat cells and inflames them. The cells get overfilled and can't take in more fat.
So that fat energy is released elsewhere: into the viscera inside the abdomen and into organs like the liver and pancreas. As Omar's suitcase overfills, it's like the socks starting to hang out — the overflow of energy goes somewhere it shouldn't. That's when we see high blood pressure, gout, pre-diabetes, and type 2 diabetes. Omar can't control what his fat cells do or whether they become inflamed.
I met someone who went to the emergency room with a BMI of 27 and type 2 diabetes, and the comment was, "Why do you have type 2 diabetes? Your weight is pretty normal." What I hear there is that, if their BMI were 33, many would think, "Oh, they brought this on themselves" — which we now know isn't true, because of the appetite center and genetics. We blame people with obesity, and we also blame people with type 2 diabetes, as if it's their fault. But we don't control what happens with our fat cells. Some people develop diabetes at a BMI of 27, others at 40 — it has to do with the expandability of the suitcase, something beyond personal control.
So for Omar, whose suitcase is overstuffed and spilling out, metabolic complications of obesity will follow — and clinically we should try to address them, and help those of you in a similar situation, with all the tools and interventions we have that fit within your wishes.
This transcript has been lightly edited from the video for readability. For the complete experience, please watch the video above.