The first steps to stop being obese - part 3

Adipose tissue is not just made up of fat cells. It is not a passive store of fat. It is made up of different cells that are active and react to what is happening in the body (like the vast majority of cells, in fact). Along with adipocytes (the fat cells themselves), the largest component of adipose tissue are immune cells, such as macrophages or mast cells.

Obesity is not just a condition characterised by excessive fat accumulation. It is also admittedly an inflammatory condition, which means that there is an active role of immune cells.

This is relatively obvious, given that there are so many of these cells in fat ...

In an apparent example of the classic chicken and egg question, it is not clear whether the inflammatory state is only a consequence or also the initial cause of obesity. What is known is that

1. these cells produce and release inflammatory mediators, such as IL6, IL1 and TNFa, both locally, to the adipose tissue, and into the blood circulation, having a global systemic effect.

2. these same mediators increase the size, number and even activity of these cells in the fat, promoting their increase.

3. when they decrease, so do the immune cells.

You will rightly ask, "how can the fat distinguish if these were produced in the fat or if they came from somewhere else in the body?".

Youdon't know!

Regardless of whether they are mediators originating in the fat or somewhere else, they do not have the same effect on those cells! Once they get into circulation, the same particles will have the same effect. It's the same as with glucose, for example: whether it's in the blood coming directly from intestinal absorption or whether it was produced in the liver, it's going to be used to produce energy.

So, if:

• Immune cells make up over 40% of all cells in fat,
  They are affected by the amount of mediators in circulation

• Both their size and even their number decrease when we reduce the concentration of these same mediators
  

Isn't the logical step to reduce the inflammation in the body? It seems "elementary, my dear Watson".

When you reduce inflammation, weight goes down quickly, significantly and dramatically. Much of it is caused by water loss associated with that process, no doubt. But that's no reason to diminish the importance of that loss.

Infact, the reason for the loss is the important part!

Reducing the amount of water means there is no longer the stimulus to accumulate it, and one of the stimuli is systemic inflammation, the same one that increases the number and size of immune cells in fat. There is a very direct relationship between increased levels of inflammation and increased fluid retention. When inflammation increases, we retain water. When it decreases, we eliminate water.

The first goal of an obesity plan should be to control and decrease inflammatory levels in the body. Not only will this have a marked impact on the actual weight lost, but there is a smaller impact on endocrine, neurological and mental balance. We can therefore start the plan with weight loss, reinforcing motivation, without upsetting this unstable balance.

The quickest route to achieving this step is not in fat but elsewhere in our body: the intestine.

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