• fat cells

    Asked by Schu on Monday, May 6, 2019

    fat cells

    We know that estrogen and breast cancer go hand in hand. Estrogen is found mainly in fat cells. Most women on aromatase inhibitors gain about 30 pounds. This weight increase results in more fat cells filled with more estrogen. This doesn’t make sense to me. Thoughts, please? Thank you

    10 Answers from the Community

    10 answers
    • GregP_WN's Avatar
      GregP_WN

      I'm no expert on that matter, but your theory makes sense to me.

      about 1 month ago
    • addysmum's Avatar
      addysmum

      I have been on them for 3 months and no weight gain, weight has stayed the same. My oncologist advised me to watch my diet and exercise and i should not gain weight. So far that has been my experience

      about 1 month ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      There's a difference between weight gain in general and fat gain specifically. There is also a misconception that fat in general makes the androgen that gets converted to estrogen unless thwarted by an aromatase inhibitor. It's adipose tissue--and the fat cells, not the fat within the cells--that cranks out the androgen which aromatase (made by the liver) acts as the catalyst for conversion to estrogen.

      Weight gain on AIs is caused by depriving the body--or at least drastically reducing the production--of estrogen. That, in turn, results in a slowed metabolism and without caloric restriction and increased exercise, weight gain (some of it water, a tiny bit muscle, mostly fat).

      Here's the process: when one gains fat, it fills up the fat cells until they're full. Some people are born with more fat cells than are other. There is no way to lose fat cells themselves without surgical or quasi-surgical intervention (e.g., liposuction, tissue removal such as tummy tuck, or targeted cryotherapy, aka CoolSculpting). Diet and exercise causes the fat in the cells to be released and burned, but the cells are still there, albeit somewhat deflated; which causes one to lose circumferential (horizontal, not height) inches as well. When fat cells contain too much fat, that is called "hypertrophic obesity."

      Normally, one cannot make more fat cells. Men almost never do. But women can if their fat cells get too full--it's called "hyperplastic obesity." Our fat cells are smaller than men's. It's another disadvantage that Mother Nature throws our way in order to protect us from famine and preserve fertility and the survival of the species, albeit to the detriment of the individual. (Evolution is very, very slow, and the body still doesn't know that in most parts of the world there's plenty of food and population; nor that most women now live well past their childbearing years).

      Morbid obesity in men causes the adipose tissue to behave exactly as it does in women: secrete androgen, which aromatase converts to estrogen, which can signal the body to make more fat cells if the larger male fat cells get filled to capacity. (Estrogen doesn't know or care whether it's in a man or woman). It isn't fair, but men can lose weight faster with less effort and keep it off better than we can.

      So why do some women not seem to gain weight (fat) even when deprived of estrogen? Either they have fewer fat cells to begin with, have a high enough basal metabolism before going on an AI so that they still adequately burn fat (and perhaps their muscles burn glycogen, which is the preferred fuel in anyone not insulin-resistant, especially active athletes), or find it not burdensome to eat less (or eat foods that are burned better--a very complex concept not addressed here) and move more because they've instinctively maintained an active lifestyle and view food practically rather than esthetically (i.e., fuel vs. source of pleasure). Most of us, unfortunately, prioritize the taste, texture, and even emotional impact of food.

      Would surgical or quasi-surgical removal of fat cells also reduce the (end) production of estrogen? Maybe--but there may come a point when the body (which has an innate need to maintain the status quo and revert to it if necessary) senses the shortage of fat cells and decides to send hormones that signal us to fill up the remaining ones and then make new ones.

      about 1 month ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Tamoxifen also usually causes weight gain, but that process is not yet well understood because Tamox. works differently from AIs in that Tamox. does not reduce the amount of estrogen in the body but rather blocks tumor cells' estrogen receptors from accessing it.

      My MO told me to try and maintain my pre-treatment weight if I could. Best to start off with the advantage of a lower body mass before an AI lowers the metabolism. Easier said than done, especially since we don't yet have time travel.

      about 1 month ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Oh, and it took over a year for me to gain 10 lbs. and 3 yrs. to gain 20. AIs' effect on metabolism doesn't show up immediately (because it takes awhile for the effects of estrogen deprivation to accumulate). So nobody should be complacent about the lack of weight gain after only 3 months--nor should they judge us who've gained the weight.

      At my MO's urging, I am starting at my hospital system's non-surgical bariatric program in just about a month (earliest appt. I could get). But in the meantime, I recently started wearing an Invisalign tooth straightener: which must be removed for eating & drinking anything other than water; not reinserted w/o first brushing & flossing; and worn for at least 20--preferably 22--hrs/day. As a result, I find snacking to be a pain in the butt and because my time for eating is rationed, I'm eating more mindfully. In 2-1/2 weeks I've lost 2 lbs., so who knows? (Patients' blogs refer to this as the Invisalign Diet).

      about 1 month ago
    • addysmum's Avatar
      addysmum

      I was simply sharing my experience so far, and by no means am I complacent.

      I will take my oncologist advise and eat as much non processed food as i can and exercise like i always have. That is all I can do and this is MY experience so far.

      about 1 month ago
    • gpgirl70's Avatar
      gpgirl70

      I think there is more to weight gain than AIs. I gained weight during treatment and have been struggling to lose weight since then. I’ve actually lost some weight during my 4 years on AIs. Having cancer is very stressful and I think that plays a big role in weight gain. I have not noticed that my metabolism is noticeably slower. Once I was able to return to my former activity level, the weight I gained during treatment has slowly come off. I hate dieting so I try to control weight with exercise. I do feel my ability to control my weight is the same on or off AIs. It’s always a struggle either way.

      about 1 month ago
    • Maryflier's Avatar
      Maryflier

      I believe the struggle with fighting cancer effects everything in your life. I gained a few pounds when I was taking Anastrozole ( probably not exercising due to the muscle aches). I’ve been on Exemestane since September, weight stayed the same. Decided, in March, to forget about what AI I was taking, got back to exercising, went on Atkins for 2 months and I lost 10 lbs. Just trying to maintain now. Off Atkins stuff as it is all HIGHLY processed , but it taught me to watch my carbohydrates and sugar intake. Try to find something that works for you. Best of luck to you, stay strong!

      about 1 month ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      My MO says not to eat anything white except fish, cauliflower and full-fat dairy. That cuts out a lot of the sugary, starchy carbs. (She says low-or-non-fat dairy is too carby). Will let you know what the bariatric doc says when I see him next month. Meanwhile, I am now only 10 lbs. heavier than at diagnosis. (Was 23)!

      about 1 month ago
    • Lorie's Avatar
      Lorie

      I was severely limiting dairy due to my C being hormone receptive and there are added hormones in dairy. Some dairy products say no artificial hormones. Does that mean there's natural hormones in them? Lorie

      about 1 month ago

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