How Metabolism Affects Obesity, Type 2 Diabetes Risks

by Amy Hendel, P.A. Health Writer

Have you ever known someone who could sit in class and ace the surprise quiz, even if they didn’t seem to study or take the class seriously, while you studied and took copious notes and got a B minus? Or do you work with someone who seems to be able to throw a power point together overnight, while you slaved over a similar project for the better part of a week? I’ll bet you also know someone who seems to be able to eat whatever they want and never seems to gain a pound, while you’ve tried countless diets and come up with minimal weight loss despite your efforts. In fact, you may be a poor fat metabolizer, which means you may have to be more rigid with your diet and make greater efforts when you exercise. Welcome to my reality.

A study published in the June 2018 issue of Cell Metabolism found that some individuals seem to need more intensive lifestyle changes if they want to avoid gaining excess weight and developing type 2 diabetes. Researchers have known for some time that some people have a tendency to gain weight more easily, and also have a higher risk of developing obesity which can eventually lead to diabetes. Lifestyle factors can contribute to this weight gain risk, but researchers have always suspected a physiologic difference that would account for easier fat gain.

The researchers analyzed tissue obtained from the subcutaneous stomach fat of women before and after a ten year follow up. They found that in some women, the ability of fat cells to free up fatty acids, (lipolysis), from the first samples taken, could predict the likelihood of some of the women developing type 2 diabetes by the ten-year end point of the study. Those at-risk women had low levels of hormone-stimulated lipolysis which meant they were poor fat metabolizers. They were at higher risk of weight gain and diabetes.

I am such a person. There was generational obesity in my family, on my mother’s side. From a young age, I was allowed to eat whatever I wanted, but I noticed that my friends were eating similar amounts (or more) and not gaining weight at the rate that I was. We were all similarly active, playing during recess and after school. By age 12, I was overweight. By age 15, I was obese. The dating scene motivated me to join Weight Watchers and I lost about 50 pounds within a year.

Once I hit goal weight, I realized quickly that if I veered off 'tight control' of my diet, or abandoned exercise for even a short period, the weight would start to creep on. Pregnancies were incredibly difficult – my body turned traitor and despite best efforts, I gained 55 pounds with both pregnancies. It took more than a year each time to lose the weight – but I did. Recently, when menopause hit, I had to tweak a pretty disciplined diet and exercise program yet again, in order to stop the weight creep.

I am a health coach and have helped numerous individuals with what I assume is inefficient subcutaneous fat lipolysis, to lose weight. I’ve been unable to help others, because they simply did not want to deal with the unfairness of their physiologic lot in life. Yes, there are those of us who have to study harder or work harder when it comes to achieving the goals that others seem to come by quite easily. It’s a bummer – but it’s a reality. And a good number of us may have this unfortunate impaired fat burning physiologic reality from birth, or it may develop during life. Others may just eat too much or move too little, even with normal fat burning.

Whatever the reason for excessive weight gain, obesity puts us at risk of type 2 diabetes, heart disease, and many cancers.

I can easily identify individuals who have a normal or super metabolism based on a week’s food journal entries. Good for them I think, except, if they are choosing poor quality foods they may also end up with lifestyle-related disease, despite being slim. Or when mid-life hits and hormones shift, they may find that weight gain happens pretty brutally. At that point, changing lifestyle can be really hard because they are so accustomed to eating wheat they want and never exercising.

I actually think I was lucky to have been forced, in a sense, to learn diet and exercise habits that support weight maintenance and health early on in life. When I was thrown curve balls during pregnancy and menopause, I knew that I could figure out a food plan and exercise re-vamp that would get me back to baseline. I know I have other gifts, but my weight destiny forced me to deal with a reality that could only be solved by a very disciplined approach to my lifestyle. I need to eat less than the average person, and I need to do hard core exercise most days of the week – aerobic training daily and weight training at least three times a week.

My insights have allowed me to be honest with clients and patients who have to hear this truth – you may have to work harder in order to avoid weight gain. But there are effective and manageable strategies that can be followed and yield the results you’re looking for. Surrender to your physiologic reality and be willing to work just a bit harder. Set realistic, sustainable weight goals, and make it about your health too. Create a home and work environment that supports your efforts. The truth is that when you have to work harder, the end goal when achieved, is so much sweeter.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”