ANSWERS TO DIET FAILS
As scientists discover overweight people struggle to shift kilograms because their fat cells are damaged, Maria Lally finds out how we can heal them.
As we are now into the back-to-business month of February, we’re looking back at the real reasons your January diet didn’t work.
There are few things more frustrating than a dry-and-detoxed January resulting in barely a kilo or two of weight loss.
Or, worse, you actually manage to lose a few kilos, only to gain it all quickly back by February.
Now scientists have discovered many of us may have been swimming against the weight-loss tide all along.
Researchers from the University of Exeter have found the fat cells of overweight people become distressed, inflamed and scarred, meaning they don’t respond and work in the same way as healthy fat cells. So people who are already overweight or obese may struggle to lose weight, no matter how much they diet.
“We now know that overweight and obese people can suffer scarring of their fat tissue,” says Dr Katarina Kos of Exeter University, an expert in obesity-related disorders.
“These fat cells are less able to store excess calories, and so may cause fat to move into and wrap around organs such as the liver.”
This can lead to people storing fat within the deep layers of the stomach and around important organs so they have disproportionately large tummies, which can lead to obesity-related conditions such as fatty liver disease, diabetes and heart disease.
“It appears the fat cells in overweight people can’t do their job properly,” says Dr Kos.
“We’ve known this for a while,” says Dr Robert Lustig, an obesity expert at the University of California and author of book Fat Chance: The Hidden Truth About Sugar, Obesity and Disease.
“Researchers have demonstrated that at a certain point, fat tissues lose their ability to be able to be regulated by insulin.
“And when this happens, the enzymes creating fat keep working, and gain of energy inside fat cells appears to become independent.
“There very well may be a point of no return.”
Dr Lustig says when fat cells become huge — in other words, a person becomes overweight or obese — inflammation in the fat tissues becomes so severe the cells become unresponsive to attempts to shrink the fatty elements.
“The enzyme responsible for lifting energy out of fat cells appears not to be stimulated in the same way, so you reach a point where you can’t get the fat out,” he says.
“The fat basically takes on a life of its own.”
Dr Lustig says these findings give hope, and some reassurance, to those people who struggle to lose weight, despite trying to diet.
“For a long time, it’s been thought that overweight people can’t lose weight because they’re lazy, or greedy or not really trying,” he says. “But we scientists know the real story: it really is much harder for them to do so.
“And while overweight people used to be in the minority, they’re now becoming the majority.
“And it’s not simply because the whole world is slowly turning into a lot of sloths and gluttons.
“It’s not simply a case of calories in and calories out. Saying ‘it’s all their fault they’re fat’ is a ruse and a diversion promulgated by the food industry to assuage their culpability in all of this.”
“All of this” being the world’s obesity rate, which has doubled since 1980.
The US, where Dr Lustig is based, has the highest rate of obesity of high-income countries, with 33 per cent of the population considered obese.
The Australian Institute of Health and Welfare reports almost two in three Australian adults are overweight or obese and one quarter of Australian children fall into the same alarming category.
Research from Harvard University recently found more than half of American children growing up today may be obese by middle age.
Nearly 30 per cent of UK women and almost 27 per cent of British men are overweight, with experts warning it has become normal to be vastly overweight.
In October, the World Health Organisation said “widespread” action was needed to tackle the planet’s weight problem.
Of course, overweight people can and do lose weight, but the Exeter research may go some way to explain the countless studies that show around 95 per cent of dieters regain most, if not all or more, of the weight they lose.
Often, this is because they go back to old eating habits, but could this damage to fat cells also be to blame? And if so, what can you do?
“There may be the potential for a drug to be developed to heal scarred fat cells,” Dr Kos says. “Until then, stick to controlling your calories where possible.
“Research has also shown a walk after meals may help prevent fat cells from scarring further, along with burning extra calories.”
Dr Lustig, a vocal and early opponent of sugar who, in the past, has called for laws to restrict its use in food and the way it is advertised, in much the same way as alcohol and tobacco, says there are three ways to help heal your fat cells.
“There’s medicine, diet and exercise. Scientists are working on a drug for the obese that was approved for use for asthma in Japan back in the 80s,” he says.
After a 12-week trial involving Type 2 diabetics taking the repurposed asthma drug Amlexanox, researchers from the University of California San Diego School of Medicine and the University of Michigan found a significant reduction in blood glucose.
“However, that’s for the severely obese,” Dr Lustig says.
“So next comes diet. Currently, food manufacturers can put whatever they want in their products and say, of growing obesity: ‘Hey, it’s not our problem. It’s yours’.
“The more overweight you are, the harder it is to lift the fat out of your fat cells because they’re insulin-resistant.
“So the first thing is to get your insulin down. How? Don’t let it go up. What makes it go up? Refined carbohydrates and white food.
“That means white bread, rice, pasta, sugar you put in your tea, and so on. A field of wheat is, as the patriotic American song goes, ‘amber waves of grain’. When it’s turned into bread, this amber colour and the fibre is stripped out, which affects how your blood insulin rises. A low-sugar, high-fibre diet reduces insulin. So what helps heal damaged fat cells and lowers insulin? Getting people off white, processed food and on to real food. “And lastly, exercise.” However, we’re moving less than ever. The Heart Foundation Australia reports in 2014-15, 65.3 per cent of Australians aged 15 and over were sedentary or had low levels of exercise — that is 12 million Australians not exercising nearly enough.
Again, being overweight in the first place may already put you at a disadvantage.
“High insulin changes your energy levels, which makes you feel less like exercising,” Dr Lustig says. “But rather than being lazy, it’s your body’s biochemistry driving your behaviour. But if you get your insulin down and exercise, being active also improves your insulin sensitivity and is absolutely essential in the fight against obesity.
“So if you’re struggling to lose weight, it may not be your fault. But there’s still plenty you can do.”