Some ~tangential points on metabolic syndrome / metabolically healthy obesity:
people with metabolic syndrome—i.e., some level of insulin resistance
That is straightforwardly not what metabolic syndrome means. Someone with metabolic syndrome is likely to have insulin resistance but it is not guaranteed, and it’s not part of the definition of metabolic syndrome.
Relatedly,
two types of obesity are recognized among those who study fat cells: “metabolically healthy” obesity, in which fat cells are overproduced and fat is stored normally, and “metabolically unhealthy” obesity, in which the number of fat cells is unaltered, but the individual fat cells hypertrophy from the body’s pathological attempts to store more fat.
Your provided citation does not support the definition you give (see “Defining MHO” in the full text). The authors give several different but related definitions involving metabolic syndrome or variants thereof; none of the paper’s definitions match yours. I am not very familiar with this area but I don’t know of any reason to believe that metabolically healthy obesity (MHO) has anything to do with the number of fat cells. Some evidence against your definition is that people with MHO are much more likely to develop metabolic syndrome in the near future than healthy-weight people (source), which seems mechanistically implausible if your definition is correct (it would require people with MHO to lose fat cells despite not losing weight). Also the fact that (to my understanding) doctors routinely diagnose metabolic syndrome or metabolically unhealthy obesity without ever measuring the contents of patients’ fat cells.
I got this info about MHO from Red Pen Reviews’ Everything Fat Loss expert review. Red Pen Reviews is a website where nutrition scientists review nutrition books for scientific accuracy, and I consider it a good and trustworthy source to learn about nutrition science.
That is straightforwardly not what metabolic syndrome means.
On your model—not an absent third party’s—what does metabolic syndrome mean? We can even taboo it. I’m talking about the thing that happens when people get abdominal obesity and have sugar and fat backed up in their blood and tend to be insulin resistant. The post gestures at “some level of insulin resistance” because it’s the most frequently present facet that common medical tests can reliably identify.
Your provided citation does not support the definition you give
They don’t say what they have identified as the mechanism of “metabolically unhealthy obesity” in the definition section.
If you read on to “Fat Distribution and Adipose Tissue (Dys)Function”, you will see:
It is now generally accepted that central body fat distribution and an impaired adipose tissue function are better predictors of obesity-related metabolic abnormalities than total fat mass per se. VAT and ectopic fat accumulation, inflammation, impaired adipose tissue expandability and adipogenesis, as well as hypertrophy and altered lipid metabolism of fat cells, are anatomic and functional derangement of adipose tissue contributing to metabolic diseases and increased CVD risk.
.
Some evidence against your definition is that people with MHO are much more likely to develop metabolic syndrome in the near future than healthy-weight people (source), which seems mechanistically implausible if your definition is correct (it would require people with MHO to lose fat cells despite not losing weight)
The fat deposition mechanism and rate of lipogenesis, not the number of fat cells.
Some ~tangential points on metabolic syndrome / metabolically healthy obesity:
That is straightforwardly not what metabolic syndrome means. Someone with metabolic syndrome is likely to have insulin resistance but it is not guaranteed, and it’s not part of the definition of metabolic syndrome.
Relatedly,
Your provided citation does not support the definition you give (see “Defining MHO” in the full text). The authors give several different but related definitions involving metabolic syndrome or variants thereof; none of the paper’s definitions match yours. I am not very familiar with this area but I don’t know of any reason to believe that metabolically healthy obesity (MHO) has anything to do with the number of fat cells. Some evidence against your definition is that people with MHO are much more likely to develop metabolic syndrome in the near future than healthy-weight people (source), which seems mechanistically implausible if your definition is correct (it would require people with MHO to lose fat cells despite not losing weight). Also the fact that (to my understanding) doctors routinely diagnose metabolic syndrome or metabolically unhealthy obesity without ever measuring the contents of patients’ fat cells.
I got this info about MHO from Red Pen Reviews’ Everything Fat Loss expert review. Red Pen Reviews is a website where nutrition scientists review nutrition books for scientific accuracy, and I consider it a good and trustworthy source to learn about nutrition science.
On your model—not an absent third party’s—what does metabolic syndrome mean? We can even taboo it. I’m talking about the thing that happens when people get abdominal obesity and have sugar and fat backed up in their blood and tend to be insulin resistant. The post gestures at “some level of insulin resistance” because it’s the most frequently present facet that common medical tests can reliably identify.
They don’t say what they have identified as the mechanism of “metabolically unhealthy obesity” in the definition section.
If you read on to “Fat Distribution and Adipose Tissue (Dys)Function”, you will see:
.
The fat deposition mechanism and rate of lipogenesis, not the number of fat cells.
Are you aware of the “Adipose Tissue Expandability Hypothesis”?