Handbook of Eating Disorders: Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia

By Kelly D. Brownell; John P. Foreyt | Go to book overview

4
Fat Cells and Obesity

Per Björntorp

The fat cell, the adipocyte, is the cellular unit that accumulates and stores excess energy in the form of triglycerides, which are a characteristic of obesity. The adipocyte is the main functional entity of the enlarged adipose tissue in obesity. This tissue also contains other cellular and structural units that serve the adipocytes with nutrients, transport fat to and from the fat cells, and furnish a stroma to support the tissue and keep its structure. These parts of adipose tissue are also enlarged in obesity.

Topographical differences in adipose tissue distribution in obesity are well known. Some of these can be recognized as exaggerations or even caricatures of the normal difference in fat distribution between men and women. Vague35 started to systematize such differences in adipose tissue distribution by first describing the differences between nonobese men and women and then finding the same kind of adipose tissue distribution in obese subjects. Obese men typically had enlarged fat depots, located mainly on the upper part of the body, while most obese women had accumulated their excess fat in the lower part of the body, where nonobese women have a typical female fat depot. There were exceptions, some obese men having the female type and some obese women the male type of fat distribution. Vague called obesity with the male type of fat distribution android obesity, and gynoid obesity when the female type of fat distribution was found, irrespective of the sex of the patient. In further extensive studies it was found that obesity complications of a metabolic type were mainly associated with the android type of obesity. Although Vague is the pioneer in this field, several reports have more recently verified and extended his original findings, often by including other more easily applicable measurements of the fat distribution. *

Although the fat distribution characteristics have been long known, only recently has the functional significance of regional differences in fat

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*
See references 1, 8, 13, 16, and 24.

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