Dr. Ben Bikman

Men have relatively lower levels of estrogens, so we don't have that hyperplasia as much as the females do.

So if we're getting fatter, it's more through hypertrophy relative to the ladies.

Right.

I'm so happy you brought that up.

I deliberately chose not to because I thought I'm already being too long winded.

But here you are slow pitching the ball to me anyway.

So, yeah, the problem with that hypertrophic fat cell is that it's becoming insulin is trying to still force feed it to store more fat.

And insulin's main mechanism of promoting fat storage is by inhibiting lipolysis.

So insulin will promote the growth of the fat cell.

It does enable the feeding to some degree, but its most powerful effect is blocking the breakdown.

And so the fat cell is saying, insulin, I can't keep, you keep telling me to grow.

I can't.

If I continue to grow, I mean, it literally gets to the point where the membrane can start to fray.

It can't hold itself together.

It's like a balloon that's being filled too much.

And so it becomes insulin resistant.

which is manifested as insulin not being able to inhibit lipolysis.

Now we have a metabolic milieu that's quite odd, where you have high insulin and high free fatty acids.

That does not happen unless the fat cells are insulin resistant.

So just to make that clear, in a fasted state or a low carb state, insulin is low, and so you have more lipolysis, so free fatty acids will be higher.