The Many Dimensions of Fat

Shedding those extra pounds can be tough—especially if you try too hard
October 1, 2020 Updated: October 1, 2020

Some factors of the American obesity epidemic are obvious. We lead sedentary lives with an abundance of tantalizing calorie-dense foods made from combinations of sugar, fat, and salt.

These factors alone make losing fat hard enough. But the addition of other, more subtle factors can make the job even harder.

We’re bigger than ever, but, at the same time, more image-conscious than ever. And when our image fails to meet our expectations, it can fuel issues of self-worth and make us lose confidence in our ability to exercise self-control.

Plus, we live in a world of instant gratification. This doesn’t give us much practice with activities like fat loss, which take time and patience.

These social and psychological factors don’t contain any calories, but they’re a big reason why so many people with aspirations to slim down simply give up, or turn to drastic measures.

Our feelings about fat change with the times. Throughout history, beauty standards have ranged from stick-thin to generous curves. But the problems associated with fat are much more than an issue of aesthetics.


Health and fat are intimately entwined. Obesity is linked to death via heart disease, cancer, and diabetes, not to mention it puts extra stress on joints having to haul that excess mass around.

Obesity also makes for more complications during surgery. Most hospitals now require three separate consent forms for anyone with a BMI over 40.

Excess fat can also weaken our immune system. Studies from France, China, and the United States have consistently found that heavier patients infected with COVID-19 were more likely to die than their leaner counterparts. And vaccines are generally less effective in people with excess fat.

While such health facts can occasionally help inspire us in the battle to lose fat, many of us are much more motivated to chuck our excess baggage based on how we look.

Efforts in Vain

For New York plastic surgeon Dr. Thomas Sterry, that inspiration came when he turned 40. A friend snapped a photo of him at the beach from behind as Sterry was protecting his toddler from the waves.

“I saw the photo and said, ‘Who’s that fat bald guy with my kid?!’  I spent the next 10 years fighting the good fight,” he said.

Sterry cut out carbs and treats, and went to the gym religiously. But even after all that sacrifice, his image still fell short of expectations.

“Just before my 50th birthday—as I realized I didn’t look substantially better—I called a friend and had him suck my flanks,” he said.

Despite his profession and his own personal frustration, Sterry maintains that diet and exercise is still the best strategy to lose unwanted weight. It may not be the quickest, easiest, or most exciting answer to fat loss, but Sterry says this method can get to places that even the best surgeon can’t touch.

“Plastic surgery is a trick on mother nature. We can get away with little things here and there,” he said. “The fat that we can remove is only a small portion of what people carry inside their belly, in their liver, and in between the spaces.”

There are endless diet and exercise options for losing fat, but the trick is finding a method that you can live with long term. Running five miles a day and starving yourself can certainly take off the pounds, but how long can you keep that up?

Sterry said that his routine got him close to the image he was seeking, but it required an
“unreasonable lifestyle” to maintain.

“I dropped carbohydrates completely, got up at 5:30 AM to hit the gym before my kids got up, never enjoyed an ice cream cone with them, and lived on a lot of rabbit food,” he said. “Sure, I looked better, but it was unsustainable.”

When sustainability is the goal, you might need to lower your expectations. Not everyone has the time, energy, or genetic disposition to look like a superhero in leisurewear.

But we can still maintain a healthier fitness level.

How Much Is Too Much?

Despite our unrealistic beauty standards and cultural hangups about fat, we actually need to carry some. The ultimate goal isn’t a body of pure muscle, but achieving a healthy balance.

Fat plays an important role in our biology. Fat is basically stored energy. In a well-fed society of people who sit most of the day, this feature becomes more of a burden than an asset. But in times of famine, an energy store means survival.

Women typically carry more fat than men. Hormones help drive this pattern—estrogen encourages fat, and testosterone suppresses it. This extra layer of softness gives women the additional energy necessary to grow and feed offspring.

It’s clear we need some fat, but how much should we carry? There are lots of opinions, but Sterry says the answer is elusive.

“When I got my Master’s Degree in Exercise Physiology, there was a lot of debate about people who were technically overweight but were still able to outperform the vast majority of the population in various exercise tests,” Sterry said. “The question became which is more important—to be fit or fat?”

But people don’t usually ponder this question. Instead, we’re all about the numbers. What does the scale say? The U.S. Centers for Disease Control and Prevention (CDC) has a slightly more sophisticated metric called the body mass index (BMI). The figure is calculated by your weight relative to your height. Obesity is classified as a BMI of more than 30. Extreme or severe obesity is classified by a BMI of more than 40.

But Sterry says BMI doesn’t tell the whole story.

“We know that many very muscular people have a high BMI but clearly have very low-fat content (think NFL player types).  So is it the weight that matters?” he said.

Some suggest that a better gauge of health is body fat percentage—the amount of fatty tissue you carry relative to the rest of your body’s mass. You can get an estimate of this figure with skinfold thickness measurements, bioelectrical impedance devices, or underwater weighing. An easier method is just to eyeball it—compare your own naked torso next to a body fat percentage chart and find your closest match. Close the door first.

According to the American Council on Exercise, an acceptable body fat range for men is between 18 and 24 percent fat, and women between 25 and 31 percent. Any more than this is considered obese.

Techniques for Losing Fat

There’s no solid consensus marking the difference between healthy and unhealthy when it comes to fat, but there are some facts that everybody generally agrees with. One is that belly fat poses more of a health risk than fat found on other parts of the body. Another is that hormones play a fundamental role in how much fat we carry.

Avoiding Insulin Resistance

The hormone best associated with fat is insulin. This hormone unlocks the cells of our body so they can take in glucose from the food we consume.

Insulin resistance happens when our cells will no longer accept the glucose, despite insulin knocking at their door. In this case, excess calories are just stored as fat.

According to biochemist and author of the Zone Diet, Dr. Barry Sears, even people with higher body fat percentages can still be healthy as long as they don’t have insulin resistance. But it doesn’t mean they’re out of the woods.

“As long as you don’t have insulin resistance, you can be considered to have metabolically healthy obesity (MHO). However, it’s just a matter of time before inflammation increases in your fat stores. Now that excess fat becomes a breeding ground for the development of chronic disease and acceleration of aging.”

Sears says that what makes obesity such a major health concern is the excess inflammation it can generate. Inflammation is at the heart of nearly all chronic disease, and it creates a vicious cycle with excess fat. As systemic inflammation increases, the body accumulates fat more easily and makes losing fat that much harder.

So how do we safely and reliably get rid of fat?  According to Sears, the basic strategy is to reduce calories without malnutrition and hunger. You need to balance insulin to cut fat, but you also don’t want to eat too little and disrupt your glucagon hormone and throw your blood sugar off.

“This balance is controlled by the protein-to-carbohydrate ratio at every meal, Sears said. “You need a calorie-restricted diet with adequate protein, moderate carbohydrate, and low fat, but rich in fiber.”

Intermittent Fasting

The Zone Diet isn’t the only method to address insulin resistance. Naturopathic doctor Christian Gonzalez recommends intermittent fasting (IF). This diet is less about specific foods, and more of a timed approach to eating.

Think of IF as a daily mini-fast. Instead of a typical fast where you go days or even weeks without eating, in IF you restrict all your meals to an eight-hour block of time. The remaining 16 hours you fast, except for water.

Sugar and carbohydrates trigger the biggest spikes in insulin, but the body secretes this hormone with every snack, meal, or nibble of food we take. The idea behind IF’s fat-loss power is that an extended period without insulin in the system helps make cells more sensitive to it.

“You’re not eating, so you’re not giving your body that sugar or glucose that goes into your cells. When there’s no more glucose for the body, then we start breaking it down from our liver,” Gonzalez said. “Our bodies are so smart that they recognize you’re not giving me this fuel, so let me go get fuel from somewhere else.”

Another advantage of a 12- to 16-hour daily fast is that it has been shown to trigger human growth hormone, which helps the body build muscle and burn fat.

“We also see burning of visceral fat, the disease-promoting fat around the organs. Another beautiful thing that happens is the reduction of inflammation,” Gonzalez said. “Lowering that inflammation is one of the number one indicators for long-term health.”


Besides food, the other tool you control in the quest to trim fat is exercise. And, just like your diet, it has to be something that works for you so you can sustain it long term. Fitness is a lifelong process, so be kind with yourself. Try to make the journey enjoyable, even if the results are slow.

To burn off our stored energy, fat loss typically calls for cardio (exercises that get your blood pumping and make you breathe harder), but fitness experts emphasize that a complementary weight training/resistance program is a must for long term success. It may not make the numbers on the scale fall as fast, but having more muscle makes the body more sensitive to insulin, and burns more calories at rest.

Unlike muscle, fat accumulates with ease and age, so keeping it off takes sustained effort. And you’re more likely to keep the effort up if you don’t feel abused or deprived in the process. Although some individuals are able to take a punishing approach to slimming down, they may be hurting their health rather than helping it.


Yoga teacher Jess Penesso, who designs workouts to help women lose fat, spent 15 years thinking she would be happier if she could just shed 10 pounds. Her goal was the grail of fat loss—visible abdominal muscles—anatomy that only begins to reveal itself once you fall below 15 percent body fat.

But chasing after the highly coveted “six-pack” only left Penesso miserable.

“I told myself that ‘I’d love my body when…’ This was from years of consuming media and stories from friends and family that I believed.  It led to disordered eating, drinking too much, and low self-esteem,” Penesso said.

Penesso says her life changed when she dropped the expectations, and simply fell in love with what her body could do.

“The less I obsessed about fat, the more my body seemed to change,” she said. “I’ve made peace with the body I have and love it right now (even with some fat) while having goals to feel the best I can.”

Follow Conan on Twitter: @ConanMilner