Fat Cells and How They Work

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Fat vs Muscle

Did you ever wonder why some people have more fat cells than others?  As much as we wish we didn’t have them, they are essential to our lives. Fat cells are designed to expand and shrink depending on diet and exercise. By reducing the amount of fat your body stores is what causes our fat cells to shrink and this is what we call “losing weight”.

A while ago I lectured on fat cells and how they work.  Many people loved the information, so I thought I would share here. Statistics show that an incredible 65.2 percent of theU.S.population is considered to be “overweight” or “obese.” According to the Centers for Disease Control and Prevention (CDC).  Here is an interesting statistic from the CDC.

Trends by State 1985–2010

During the past 20 years, there has been a dramatic increase in obesity in theUnited Statesand rates remain high. In 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence of 25% or more; 12 of these states (Alabama,Arkansas,Kentucky,Louisiana,Michigan,Mississippi,Missouri,Oklahoma,South Carolina,Tennessee,Texas, andWest Virginia) had a prevalence of 30% or more.

Did you ever wonder how we create fat cells?  Not only can you fill your fat cells to maximum capacity, but also you can actually make more!!!  Believe it or not, there are certain times in our lives and under certain circumstances, when we can create a higher number of fat cells. Here is the bad news, once you create a fat cell by excessive eating, it is yours for good and never goes away. As you can see from the picture above the difference between someone that has never been obese and those that have reduced their fat cells.  It is still an accomplishment when a person that has been overweight or obese loses a ton of weight and they should feel proud and share the information of why they changed their lives!!!

When we are born we are born with a certain number of fat cells.  A typical infant has 5-6 billion fat cells.  If the mothers diet is bad, she can increase the number of fat cells her baby will have in her third trimester.  This is so important when you are pregnant to make sure you are eating healthy and watching how much weight you gain during your pregnancy.  During pregnancy is another time you can increase your fat cells.  Once you have them, they are yours to keep!!!  You want to make sure you are exercising and eating healthy at this time for a lot of reasons.

During late childhood and early puberty is another time when you can actually increase your fat cells.  It is important to teach your children to eat healthy as children and develop healthy eating habits as they approach this time in their lives.  If they go into this part of their lives with unhealthy habits you are setting them on a course for obesity and a life of the health issues associated with it.

A healthy adult who has healthy body fat has 25-30 billion, and an over weight adult has 75 billion, with severe obesity; this number can be as high as 250 to 300 billion!  That is 10 times what a healthy person has. An overweight person’s fat cells can be up to 3 times larger than a person with ideal body composition.

Dr. Samuel Klein of the School of Medicine at Washington University in St. Louis stated, “The more metabolically harmful fat cells in obese people have 50 to 75 per cent more mass than fat cells in lean people”, said lead author of the study.

If you do not get your weight under control, you can make it difficult for you to loose weight in the future. Many people will go have liposuction to remove unwanted fat, but what they don’t understand is if they don’t change their life style their body will just make more fat cells to deal with the amount of excess food they are consuming.  There are no short cuts!!!  You have to burn 3,500 calories to burn just 1 pound of fat!!

Here are some interesting facts.  A child who has normal weight parents has a 7% chance of being over weight or obese. A child who has 1 over weight parent has a 40% chance of being over weight or obese. A child who has 2 overweight parents has a 70% chance of being over weight or obese.  That is scary when you look at how many children today have 2 over weight or obese parents.  As parents we set the example.  Our children need to see us eating healthy and exercising.  What we do speak so much louder than what we say.

It has been interesting as I work with people that have been overweight.  As they strive to get lean, sometimes it can be difficult because they can shrink their fat cells but never truly get rid of them.

The more muscle you have and can build your body can burn anywhere from 50-100 more calories even when they are resting.  Fat takes up 5 times mores space so as you burn fat off and increase muscle you will see major inch loss.  I always explain to people it isn’t what you weigh that is important; it is what your body fat percentage is that defines how healthy you are.

By Michele LeSueur

Find out how Boston Testosterone can help you achieve your weight loss goals.


Part II. Testosterone and the Heart

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Part II. 

Abdominal Obesity, Insulin Resistance

A growing number of studies have linked androgen deficiency to insulin resistance, as well as increased abdominal obesity. These two factors are also common with men suffering from cardiovascular disease, and may directly contribute to (among other things) endothelial cell dysfunction and vascular damage. Androgen substitution has been shown in several studies to reduce midsection fat deposits, increase glucose tolerance, and improve the overall metabolic state. It has additionally been postulated that due to the important role of testosterone in managing insulin sensitivity, androgen deficiency may be a contributing factor to adult-onset (type 2) diabetes. Likewise, the substitution of testosterone in aging men with hypogonadism might reduce the likelihood of developing diabetes.

Endothelial Function

The endothelium is a layer of cells that lines the blood vessels throughout the entire circulatory system. These cells are responsible for managing the passage of some materials in and out of the blood vessels, and supporting the flow of blood through the system. Endothelial cells play a role in vasoconstriction and vasodilation, they regulate certain inflammatory processes, and they’re involved in blood clotting and in supporting the formation of new blood vessels. Endothelial dysfunction is linked to androgen deficiency in men, and may result in elevated blood pressure (hypertension), vascular ‘stiffness,’ and significantly increased risk of cardiovascular disease. Likewise, replacement of testosterone in men with a deficiency has been shown to improve endothelial function, blood vessel dilation, arterial vasoreactivity, and blood flow.

One additional important ‘endpoint’ of improvement to this therapy appears to be an increase in endothelial progenitor cell activity, which helps repair damage to the vascular system.


Traditionally, most physicians are extremely cautious with testosterone drugs. Many family doctors are very willing to prescribe estrogens to their female menopausal patients complaining of symptoms such as sexual dysfunction, but when it comes to their male patients with similar complaints, the response is often different. Many of these same physicians are much more willing to prescribe a drug like Viagra than the basic male androgen testosterone. Some mistakenly consider testosterone to be ‘too dangerous’ to give most of their patients, and reserve its use for extreme cases. And when testosterone is considered, it is given only for a very narrow and specific set of psychological or physical symptoms.

Of course in the era of AndroGel, some physicians are much more enlightened. Still, the troubling common fear of this hormone remains. Perhaps this is changing, and perhaps the accepted set of symptoms and therapies for prescribing this hormone is changing.

It seems clear that we can no longer paint testosterone as simply a ‘bad’ hormone for the cardiovascular system. While excessive high-level elevations of this hormone may indeed damage an individual’s cardiovascular health, we have strong evidence that within a certain physiological range, it may also protect the cardiovascular system from some of the same health issues. As such, its replacement may indeed turn out to be very important medical intervention for millions of men across the country, helping us to not only live better— but also live longer.

After all this time, it appears that this very controversial hormone, the same steroid demonized in the media, might actually help reduce the risk of cardiovascular disease in aging male patients. The study we reviewed this month is, likewise, something all men should take to heart— literally.



1. The Dark Side of Testosterone Deficiency: III. Cardiovascular Disease. Traish AM, Saad F et al. Journal of Andrology, April 2, 2009. ePub, Ahead of Print.

Part I. Testosterone and the Heart – A New Era?

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By William Llewellyn

Testosterone and the Heart— A New Era?

If you are a man, at some point in your life you are likely to be a candidate for hormone replacement therapy. As we age, our testosterone levels decline, and with them often a number of physical and psychological characteristics. It has long been understood that low testosterone levels can be linked to reduced libido, sexual dysfunction, diminished energy, and a reduced overall sense of well-being. For these reasons, replacement therapy with testosterone drugs is a strong and steadily growing area of medicine for aging men.

Beyond these basic facts, testosterone remains a controversial drug. Its abuse is linked to changes in the body that may increase the likelihood of cardiovascular disease, and partly because of this, the potential benefits and risks of testosterone replacement therapy have long been the subject of much debate. Is this therapy actually safe?

In recent years, evidence has been surfacing that testosterone replacement may actually reduce cardiovascular disease risk. Usually isolated in scope, these papers concern many favorable changes in cardiovascular health markers, such as the management of triglycerides and cholesterol. I believe I’ve discussed some of these papers in this column before. Hopefully, a paper published in the Journal of Andrology will further this discussion a great deal.

This 37-page report entitled “The Dark Side of Testosterone Deficiency” is the third in a series of papers covering the potential benefits of hormone replacement therapy in men.1 It specifically reviews the mounting evidence in favor of the use of testosterone for reducing heart disease risk, addressing the most detailed and relevant studies on the subject. This is the most extensive paper on testosterone therapy and heart disease to date, and covers several specific potential benefits.

Growing evidence suggests that testosterone administration may actually reduce the risk of heart disease in older men.

Serum Lipids

One of the first potential benefits of testosterone replacement therapy (TRT) reviewed in this paper is the management of triglyceride and cholesterol levels. As detailed in a growing number of studies, testosterone replacement therapy consistently improves the lipid profile in men with hormone deficiency. The most consistent endpoints of improvement appear to be a reduction in total cholesterol, a reduction in LDL (‘bad’) cholesterol, and a lowering of serum triglycerides. The improvements in lipid profile appear to be more pronounced in older men, although both young and old populations tend to show improvements in serum lipids when testosterone is given to correct a deficient state.

The effect of TRT on HDL (‘good’) cholesterol levels is less consistent. Studies giving testosterone gels, patches, or the longest-acting ester (testosterone undecanoate) tend to show improvement or no consistent effect on HDL. Studies with the more common esters such as cypionate and enanthate tend to show minor decreases in HDL during therapy, likely owing to the brief supraphysiological peaks for several days after administration. Note that HDL is often improved when TRT is combined with exercise and other lifestyle modifications.

Inflammatory Markers

Androgen deficiency is associated with an increase in certain inflammatory markers that can support the progression of atherosclerosis. Testosterone replacement therapy has been shown to reduce some of the same inflammatory mediators, specifically TNF-alpha (tumor necrosis factor-alpha) and IL-1B (interleukin-1beta).

Inflammation in the vascular system is an especially important concern with heart disease. For one, vascular inflammation is associated with the deposition of arterial plaque, a key component of this disease. Inflammation of the blood vessels may also damage the arteries, making them both thicker and weaker. Scarring may be noticed, and blood flow may be reduced. All of this can restrict blood flow and reduce the heart’s blood pumping capacity.

By helping to reduce the production of TNF-alpha and IL-1B, hormone replacement therapy may reduce inflammation, vascular damage, and the chance for atherosclerosis. Again, instead of seeing a neutral or ‘negative’ effect, we find a specific improvement in the cardiovascular disease risk profile with the administration of this drug.