Dr. Ben Bikman

That's called hyperplasia.

And when the fat is undergoing hyperplasia, the size of the fat cell is staying very modest.

So the size of each individual fat cell is small.

There are just a lot more of them.

On the other hand, you could have someone who's storing more of their fat through hypertrophy, where the number of fat cells is not changing, but the size is.

The hypertrophic fat cell is a very sick fat cell for two reasons.

And then I'll explain the ethnic predispositions because of it.

So firstly, the fatter the fat cell gets, the more insulin resistant it becomes to prevent further fat growth.

So to say that all another way, a fat cell can undergo more expansion than any other cell in the body that I'm aware of.

It can get 20 times bigger than its original volume.

And as it starts to reach this point of maximum dimension, it has to start limiting its growth.

And so it becomes insulin resistant to stop growing.

But at the same time,

it starts to become hypoxic, where the fat cell has become so big that they've pushed each other too far from capillaries.

And now it can't get the oxygen from the capillaries.

And so it starts releasing a bunch of pro-inflammatory cytokines because some of them will work like a trail of breadcrumbs, resulting in one capillary having a little budding capillary grow off and follow the cytokines to the hypoxic or suffocating fat cell.

So the hypertrophic fat cell becomes insulin resistant to stop growth and it becomes pro-inflammatory to try to correct blood flow.

All of which results in a very insulin resistant on the course to cardiometabolic disease body.

Now back to the various ethnicities.

Some ethnicities like whites and blacks have the ability to make new fat cells.