I had this theory that obese people underneath are in good muscular shape. After all every moving moment was a weight lifting exercise wasn't it? How terribly wrong I was. Below are excerpts from an article by Doug McGuff, MD who is the co-author of the book Body by Science (12 minute per week workout).
These elevated insulin levels cause a 30-fold increased rate of transport of glucose into the fat cells where it is converted to triacylglycerol (fat). Also, in the presence of high insulin the liver also coverts glucose to fat but attaches it to a protein-coated package for transport to the fat cells (VLDL or very low density lipoprotein). In the chronically overfed state, the body protects itself by decreasing the sensitivity of insulin receptors on the muscle cells and preserving (actually increasing) insulin sensitivity on the fat cells.....
I began to notice things about my obese ER patients that I had failed to notice in my 19 years of practice. I began to pay attention to CT scans of patients. The images of CT scans represent transverse slices through the body, much like the slices of a spiral-cut ham. On abdominal CT scans I could really notice the consequences of the metabolic processes described above. The most readily obvious finding is the bizarre appearance of a normal size person entrapped in a fatty prison. In many cases, the cumulative width of the pannus of fat on either side, exceeded the width of the normal person trapped inside. The fat was not just on the surface, though. There was fat in the intra-abdominal cavity, layered on the mesentery between the intestines, and it was marbled throughout the liver, and it was packed around the kidneys. This layering of intra-abdominal fat made CT interpretation easier, as it spread out the organs of interest, and inflammation in the surrounding fat was easy to visualize. Even more astounding than the abundance of fat, was the lack of muscle. The atrophy was truly profound. The rectus abdominus, the internal and external obliques, and transversus abdominus muscles, which are normally 1-2 cm thick were only millimeters in thickness. The lumbar extensor muscles, were so atrophied that open spaces were evident between the cord-like bundles and the muscle did not extend above the spinous processes, or beyond the transverse processes of the vertebra. What, in the well-developed state was as thick as the barrel of a baseball bat, was now smaller than a paper towel tube.....
These hernias were occurring because the very thin abdominal muscles were being stretched beyond their capacity by the accumulation of intra-abdominal fat....
Makes me want to fast all day and go out and do some high intensity interval training right now! The fat is not just stuck to the outside people, its on the inside pushing out and squashing all the organs.
