6 ms·

Well, yeah. Adipocytes multiply when you get fat. But when you lose weight, they don't apoptose, they just shrink in volume by giving up their lipid stores.

mkoubaa 2y ago
I am pretty sure the only way to reduce the number of cells is liposuction
- rcruzeiro 2y ago
  Worse than that. Subcutaneous fat (which is the one you can trim off with liposuction) usually expands relying more in cell expansion and not in hyperplasia. Visceral fat on the other hand, is way more likely to involve hyperplasia and you cannot use liposuction against this type of fat. This is also the fat that is very hormonally active and increases the risks of diabetes, heart disease, cancers, strokes.
  - gosub100 2y ago
    Is it unremovable because it's inside the core muscles and near internal organs?
    - nradov 2y ago
      Right. A surgeon can't just stick a liposuction tube into the abdominal cavity and poke around. This would be major invasive surgery with a high risk of complications, far worse than leaving the adipose tissue in place.
    - meindnoch 2y ago
      See the second half of this video: https://www.youtube.com/watch?v=Bav_IBsuXEM https://www.youtube.com/watch?v=Bav_IBsuXEM Visceral fat is literally enclosing the intestines, major blood vessels, organs, etc. of the abdomen. Nevertheless, it is possible to surgically remove this sheet of fat that's covering your organs, it's called an omentectomy. But it's a big surgery, and done only in case of cancer, not for weight loss. That is, in humans: https://pubmed.ncbi.nlm.nih.gov/29367725/ https://pubmed.ncbi.nlm.nih.gov/29367725/
- BurningFrog 2y ago
  I've been wondering about that. Like all cosmetic surgery liposuction is looked down upon. But maybe it can also be a useful and healthy weight loss strategy?
  - mapkkk 2y ago
    Liposuction is actually a very risky procedure, at least in relation to its benefits. For example, fat embolisms in liposuction occur in 8-9% of patients that undergo the procedure. There are other risks that are non-trivial as well. If I had to advise a patient on whether they should consider liposuction vs gastric bypass vs GLP1R agonists, I would tell them to not consider liposuction in that equation at all. As with most cosmetic surgery, risks like these are downplayed by practitioners (willfully and otherwise) as well as by people in these social media circles. This doesn't mean liposuction shouldn't ever be used, however. It can have good uses in reconstructive surgery, for example, where fat is sucked up to be used in reconstructing a different area. In this case, the potential reduction in morbidity and restoration of function to the patient, or increasing their autonomy, might make the risks associated with lipo worth it.
  - deleted 2y ago
    [deleted]
  - bognition 2y ago
    Despite being looked down on, it's still very common. I know several people who have had liposuction. The results are only temporary. Everyone I know that has had this procedure has rebounded back to their original body weight within 2 years.
chewbacha 2y ago
Yea, this actually explains the transcriptional expression and weight gain very well. Strong than the methylation evidence imo. I didn’t see any causal analysis only correlated and the cells still being there makes sense.
phkahler 2y ago
>> But when you lose weight, they don't apoptose Googled for "Adipocyte apoptosis" and oh boy... It does happen, but I don't trust the AI summary. This looks like a deep rabbit hole.
- sleepyguy 2y ago
  It seems fasting causes Adipocyte apoptosis. It makes sense, there is cell death. I lost 100 lbs fasting over 1.5 years. I did gain some weight back after stopping, but not much. Strangely, where I saw fat return was not where most of it came off.
  - mapkkk 2y ago
    I'd love to hear more about your experience! How you went about it, what (if anything) did you do to prepare, if it was hard or easy, or if you have any tips or any specific thing about the experience you think would be beneficial to mention. If you have the time, I would really appreciate it if you reached out to me. You can find my contact info on my profile page, there's also a link to an anonymous contact form, if you'd prefer that. Thank you!
  - meindnoch 2y ago
    Yeah, but fasting is extremely unpleasant.
    - sleepyguy 2y ago
      You get to know yourself well after about 5 days of zero food..... :))
      - MrGilbert 2y ago
        I did that, and it helped to kickstart further weightloss. I was surprised how fast my body got rid of stored water, and how quickly I lost fat in the upper body region, primarily around my face, neck and shoulder.
      - 2y ago
raincom 2y ago
How do glp-1 drugs such as semaglutide, terzepatid and retatrutide impact apoptose? "Tirzepatide promotes M1-type macrophage apoptosis and reduces inflammatory factor secretion by inhibiting ERK phosphorylation" [1] [1] https://www.sciencedirect.com/science/article/abs/pii/S1567576924020216 https://www.sciencedirect.com/science/article/abs/pii/S15675...
- cat_plus_plus 2y ago
  They tell your brain you have lots of food in your stomach, which triggers lots of behavioral and metabolic changes. This does not necessarily reverse every effect of obesity, maybe not gene expression changes described in this article. But enough to keep weight off with ongoing treatment.
inverted_flag 2y ago
"An ounce of prevention is worth a pound of cure" continues to be an undefeated aphorism.
Aurornis 2y ago
Similar adaptions occur in muscle. The extent of new muscle fiber development (hyperplasia) is debated, so there are multiples factors influencing how muscle retains some memory of past strength ability. Once you’ve reached a level of physical strength it’s easier to return to that level in the future. This has been a topic of debate in the sports world because past anabolic steroid use could therefore carry benefits into the future long after the athlete has stopped using the steroid. Non-professional athletes shouldn’t get too excited about using steroids, though, because the damage steroids do to the body’s own hormone systems also has lasting effects unless you plan on doing TRT for the rest of your life, which has its own downsides. For average people this does show the importance of getting at least some exercise when you’re young. It’s much easier to get a little bit fit when you’re young which then makes it easier to stay fit in the future. Never too late too start.
- ben7799 2y ago
  I can't remember exactly what I was listening to, maybe some kind of NPR podcast. But the doctor was mentioning that none of the influencers influencing young people to try T and Steroids (which is rampant right now) are ever mentioning that you are on a ticking clock to infertility as soon as you start this stuff. Some people can regain their fertility but it might take years, and some people are going to be permanently infertile even staying on HRT. Plenty of those "alpha male" guys on social media are shooting blanks.
  - deleted 2y ago
    [deleted]
  - joncrane 2y ago
    This is interesting because about 20 or so years ago when I was super into bodybuilding, you couldn't talk about a "cycle" on a bodybuilding forum without talking about a "post cycle protocol." I know that's different than permanent TRT but I feel like you couldn't get very far researching that stuff without understanding that you natural test production (and sperm production) would get "shut down" as soon as you started adding exogenous androgens.
Ifkaluva 2y ago
Is this true? When I looked into this issue it seemed the medical consensus is that fat cells are mostly constant throughout life, and weight gain happens through adipocyte hypertrophy.
- meindnoch 2y ago
  Look up adipogenesis.
darksaints 2y ago
I kinda went down a rabbit hole a while back with certain treatments that can kill adipocytes, as there's actually some significant research backing both heat-generating and cold-generating treatments. They do kill fat cells, and they are flushed out of the body. But people who undergo such treatments do not lose fat. At best, these devices can reshape your fat, pulling it out of one area and distributing it more evenly in other areas. The problem is that when you kill an adipocyte, it releases all of its triglycerides, which are then free to move around the blood stream. But when blood triglyceride levels are high and there isn't significant oxidation, other metabolic processes are triggered to start to store them. So you kill an adipocyte, release the triglycerides, which get reabsorbed into still living adipocytes, which now get engorged and then multiply again, replacing the fat cells that have been killed. After learning quite a bit about these processes, I think these devices might actually be useful, not for losing fat, but by eliminating this sort of fat memory. In other words, they should be used after significant weight loss, because adipocytes are relatively empty and externally triggered apoptosis can kill the cells without releasing significant quantities of triglycerides which can be reabsorbed and trigger adipocyte mitosis. I think this would effectively reset that person to a state as if they had never been fat in the first place. Thoughts?
- meindnoch 2y ago
  Interesting! Why can't we just remove the triglycerids from the blood before they trigger adipogenesis? Basically we need a form of dialysis.
  - mapkkk 2y ago
    Removing triglycerides from blood would technically work, however lipids in blood, including triglycerides typically travel attached to task-specific proteins. So, you'd have to remove the entire protein-lipid complex, and that might have additional ramifications complicating the process. Bear in mind, dialysis does work, however it certainly does not work as well as we hope it should. Dialysis, in all of its different forms, takes a huge toll on the body, and dialysis itself significantly increases mortality; it is also an invasive intervention. All that being said, we certainly should be doing more research on this.
trulyamazing 2y ago
[dead]

mkoubaa 2y ago

I am pretty sure the only way to reduce the number of cells is liposuction

rcruzeiro 2y ago
Worse than that. Subcutaneous fat (which is the one you can trim off with liposuction) usually expands relying more in cell expansion and not in hyperplasia. Visceral fat on the other hand, is way more likely to involve hyperplasia and you cannot use liposuction against this type of fat. This is also the fat that is very hormonally active and increases the risks of diabetes, heart disease, cancers, strokes.
- gosub100 2y ago
  Is it unremovable because it's inside the core muscles and near internal organs?
  - nradov 2y ago
    Right. A surgeon can't just stick a liposuction tube into the abdominal cavity and poke around. This would be major invasive surgery with a high risk of complications, far worse than leaving the adipose tissue in place.
  - meindnoch 2y ago
    See the second half of this video: https://www.youtube.com/watch?v=Bav_IBsuXEM https://www.youtube.com/watch?v=Bav_IBsuXEM Visceral fat is literally enclosing the intestines, major blood vessels, organs, etc. of the abdomen. Nevertheless, it is possible to surgically remove this sheet of fat that's covering your organs, it's called an omentectomy. But it's a big surgery, and done only in case of cancer, not for weight loss. That is, in humans: https://pubmed.ncbi.nlm.nih.gov/29367725/ https://pubmed.ncbi.nlm.nih.gov/29367725/
BurningFrog 2y ago
I've been wondering about that. Like all cosmetic surgery liposuction is looked down upon. But maybe it can also be a useful and healthy weight loss strategy?
- mapkkk 2y ago
  Liposuction is actually a very risky procedure, at least in relation to its benefits. For example, fat embolisms in liposuction occur in 8-9% of patients that undergo the procedure. There are other risks that are non-trivial as well. If I had to advise a patient on whether they should consider liposuction vs gastric bypass vs GLP1R agonists, I would tell them to not consider liposuction in that equation at all. As with most cosmetic surgery, risks like these are downplayed by practitioners (willfully and otherwise) as well as by people in these social media circles. This doesn't mean liposuction shouldn't ever be used, however. It can have good uses in reconstructive surgery, for example, where fat is sucked up to be used in reconstructing a different area. In this case, the potential reduction in morbidity and restoration of function to the patient, or increasing their autonomy, might make the risks associated with lipo worth it.
- deleted 2y ago
  [deleted]
- bognition 2y ago
  Despite being looked down on, it's still very common. I know several people who have had liposuction. The results are only temporary. Everyone I know that has had this procedure has rebounded back to their original body weight within 2 years.

chewbacha 2y ago

Yea, this actually explains the transcriptional expression and weight gain very well. Strong than the methylation evidence imo. I didn’t see any causal analysis only correlated and the cells still being there makes sense.

phkahler 2y ago

>> But when you lose weight, they don't apoptose Googled for "Adipocyte apoptosis" and oh boy... It does happen, but I don't trust the AI summary. This looks like a deep rabbit hole.

sleepyguy 2y ago
It seems fasting causes Adipocyte apoptosis. It makes sense, there is cell death. I lost 100 lbs fasting over 1.5 years. I did gain some weight back after stopping, but not much. Strangely, where I saw fat return was not where most of it came off.
- mapkkk 2y ago
  I'd love to hear more about your experience! How you went about it, what (if anything) did you do to prepare, if it was hard or easy, or if you have any tips or any specific thing about the experience you think would be beneficial to mention. If you have the time, I would really appreciate it if you reached out to me. You can find my contact info on my profile page, there's also a link to an anonymous contact form, if you'd prefer that. Thank you!
- meindnoch 2y ago
  Yeah, but fasting is extremely unpleasant.
  - sleepyguy 2y ago
    You get to know yourself well after about 5 days of zero food..... :))
    - MrGilbert 2y ago
      I did that, and it helped to kickstart further weightloss. I was surprised how fast my body got rid of stored water, and how quickly I lost fat in the upper body region, primarily around my face, neck and shoulder.
    - 2y ago

raincom 2y ago

How do glp-1 drugs such as semaglutide, terzepatid and retatrutide impact apoptose? "Tirzepatide promotes M1-type macrophage apoptosis and reduces inflammatory factor secretion by inhibiting ERK phosphorylation" [1] [1] https://www.sciencedirect.com/science/article/abs/pii/S1567576924020216 https://www.sciencedirect.com/science/article/abs/pii/S15675...

cat_plus_plus 2y ago
They tell your brain you have lots of food in your stomach, which triggers lots of behavioral and metabolic changes. This does not necessarily reverse every effect of obesity, maybe not gene expression changes described in this article. But enough to keep weight off with ongoing treatment.

inverted_flag 2y ago

"An ounce of prevention is worth a pound of cure" continues to be an undefeated aphorism.

Aurornis 2y ago

Similar adaptions occur in muscle. The extent of new muscle fiber development (hyperplasia) is debated, so there are multiples factors influencing how muscle retains some memory of past strength ability. Once you’ve reached a level of physical strength it’s easier to return to that level in the future. This has been a topic of debate in the sports world because past anabolic steroid use could therefore carry benefits into the future long after the athlete has stopped using the steroid. Non-professional athletes shouldn’t get too excited about using steroids, though, because the damage steroids do to the body’s own hormone systems also has lasting effects unless you plan on doing TRT for the rest of your life, which has its own downsides. For average people this does show the importance of getting at least some exercise when you’re young. It’s much easier to get a little bit fit when you’re young which then makes it easier to stay fit in the future. Never too late too start.

ben7799 2y ago
I can't remember exactly what I was listening to, maybe some kind of NPR podcast. But the doctor was mentioning that none of the influencers influencing young people to try T and Steroids (which is rampant right now) are ever mentioning that you are on a ticking clock to infertility as soon as you start this stuff. Some people can regain their fertility but it might take years, and some people are going to be permanently infertile even staying on HRT. Plenty of those "alpha male" guys on social media are shooting blanks.
- deleted 2y ago
  [deleted]
- joncrane 2y ago
  This is interesting because about 20 or so years ago when I was super into bodybuilding, you couldn't talk about a "cycle" on a bodybuilding forum without talking about a "post cycle protocol." I know that's different than permanent TRT but I feel like you couldn't get very far researching that stuff without understanding that you natural test production (and sperm production) would get "shut down" as soon as you started adding exogenous androgens.

Ifkaluva 2y ago

Is this true? When I looked into this issue it seemed the medical consensus is that fat cells are mostly constant throughout life, and weight gain happens through adipocyte hypertrophy.

meindnoch 2y ago
Look up adipogenesis.

darksaints 2y ago

I kinda went down a rabbit hole a while back with certain treatments that can kill adipocytes, as there's actually some significant research backing both heat-generating and cold-generating treatments. They do kill fat cells, and they are flushed out of the body. But people who undergo such treatments do not lose fat. At best, these devices can reshape your fat, pulling it out of one area and distributing it more evenly in other areas. The problem is that when you kill an adipocyte, it releases all of its triglycerides, which are then free to move around the blood stream. But when blood triglyceride levels are high and there isn't significant oxidation, other metabolic processes are triggered to start to store them. So you kill an adipocyte, release the triglycerides, which get reabsorbed into still living adipocytes, which now get engorged and then multiply again, replacing the fat cells that have been killed. After learning quite a bit about these processes, I think these devices might actually be useful, not for losing fat, but by eliminating this sort of fat memory. In other words, they should be used after significant weight loss, because adipocytes are relatively empty and externally triggered apoptosis can kill the cells without releasing significant quantities of triglycerides which can be reabsorbed and trigger adipocyte mitosis. I think this would effectively reset that person to a state as if they had never been fat in the first place. Thoughts?

meindnoch 2y ago
Interesting! Why can't we just remove the triglycerids from the blood before they trigger adipogenesis? Basically we need a form of dialysis.
- mapkkk 2y ago
  Removing triglycerides from blood would technically work, however lipids in blood, including triglycerides typically travel attached to task-specific proteins. So, you'd have to remove the entire protein-lipid complex, and that might have additional ramifications complicating the process. Bear in mind, dialysis does work, however it certainly does not work as well as we hope it should. Dialysis, in all of its different forms, takes a huge toll on the body, and dialysis itself significantly increases mortality; it is also an invasive intervention. All that being said, we certainly should be doing more research on this.

trulyamazing 2y ago

[dead]