The need many people have for medications to help with weight loss is real, and it highlights the opportunity for physicians to work through their individual weight biases
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10.1038/s41418-019-0480-9 259 YangZ.KlionskyD
In addition, microbial functional profiles characterized by increased representation of LPS biosynthesis and branched-chain amino acid metabolism-pathways previously linked to insulin resistance and low-grade inflammation, have been hypothesized to contribute to reduced metabolic responsiveness
As a result, there is upregulation of genes involved in lipid and glucose uptake, inhibition of lipolysis, and mitochondrial dysfunction, which collectively contribute to fat accumulation and metabolic alterations in the affected areas.15,16 Furthermore, gene expression studies show increased aromatase CYP19A1 the enzyme that converts androgens to estrogen in lipedema subcutaneous fat compared to healthy controls and even to the abdominal fat of the same patient
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