Losing weight can be a challenging journey, and many individuals seek effective strategies to achieve their weight loss goals. Stem-Ross Weight Loss Center offers a comprehensive approach to weight management, combining medical supervision, behavior modification, and various tools to support individuals in their pursuit of a healthy weight. This article delves into the science behind adipose tissue, explores the role of stem cells in obesity, and examines the various components of weight loss programs offered, such as those at Stem-Ross Weight Loss Center.
Understanding Adipose Tissue and Its Role in Obesity
Adipose tissue, commonly known as body fat, is not merely an inert storage depot for energy. It is a complex and dynamic tissue that plays a crucial role in metabolism, hormone regulation, and immune function. Recent advances in understanding the secretory capacity of adipose tissue and the role of adipokines in the development of obesity and associated disorders have added a new dimension to the study of adipose tissue biology in normal and diseased states.
White Adipose Tissue: A Complex Endocrine Organ
White adipose tissue, the primary type of adipose tissue in adults, is divided into two main depots: visceral and subcutaneous. Visceral adipose tissue is located around the internal organs, while subcutaneous adipose tissue is found beneath the skin. In humans, a major contribution of visceral adipose tissue to the development of insulin resistance and to the cardio-metabolic complications in obesity was proposed. The differences observed between visceral and subcutaneous adipose tissues are supported by studies showing that visceral and subcutaneous fat depots exhibit differential gene expression profiles.
While both visceral and subcutaneous adipose tissues can alter their mass according to the amount of triglycerides stored in adipocytes, this is more evident in subcutaneous fat tissues. Some authors assume that the visceral fat depot is associated with metabolic syndromes, while subcutaneous fat has a metabolic buffer function, which means that an increase in the subcutaneous fat depot in the presence of a positive caloric balance is protective. However, during the development of obesity, the enormous increase in the subcutaneous fat mass results in a dysfunctional tissue.
Cellular Components of Subcutaneous Adipose Tissue
The cellular content of subcutaneous adipose tissue includes a major population of specialized cells, the adipocytes, and a stromal vascular fraction (SVF) composed of preadipocytes, pericytes or multipotent stem cells, vascular wall and endothelial cells, macrophages, lymphocytes, eosinophils, neutrophils, mast cells and hematopoietic progenitor cells. It was initially proposed that adipocyte hypertrophy is the major mechanism by which subcutaneous adipose tissue expands. However, adipocyte hyperplasia also contributes to tissue expansion through the activation of multipotent stem cells, leading to the generation of new cells to sustain the demand for fat storage.
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Inflammation and Obesity
Lipid accumulation is not the only trigger for the development of obesity. One of the most important discoveries regarding the development of obesity was the description of the establishment of an inflammatory state characterized by an increase in the levels of local and systemic inflammatory cytokines and macrophage infiltration into subcutaneous adipose tissue. Besides, endoplasmic reticulum dysfunction is being given as evidence of adipocyte stress, playing an upregulation role in inflammatory scenario of adipose tissue. The accumulated macrophages contribute to the production of inflammatory mediators, thus amplifying the inflammatory state of the adipose tissue and thereby representing an important factor in promoting insulin resistance. The macrophage population within inflamed obese adipose tissue can switch phenotypes between inflammatory and non-inflammatory states.
It has been suggested that preadipocytes of mouse adipose tissue could be responsible for most of the secretion of MCP-1, which has been classically described regarding the role of this cytokine in monocyte mobilization from the bone marrow and the migration of monocytes through the peripheral circulation. Therefore, it was proposed that the inflammatory process that is established during the development of obesity could be initiated by preadipocytes that were affected by adipose tissue growth. The cellular events that lead to the establishment of this scenario have not been fully elucidated, and the mechanisms by which obesity is associated with other metabolic disorders are not well understood.
The Role of Adipose Stem Cells in Obesity
Because multipotent stem cells are directly involved in subcutaneous adipose tissue homeostasis, it is reasonable to postulate a pleiotropic role for stem cells in the vicious cycle of inflammation. In fact, since 2000, the number of scientific articles in the adipose stem cell field within the context of obesity has been increasing. The term mesenchymal stem cells (MSC) was first used for a multipotent cell population that dwells in adult bone marrow stroma. Based on the concept of bone marrow MSC, this population of perivascular cells has been described in a variety of other adult tissues, including adipose tissue. MSC contribute to tissue homeostasis, repair and regeneration.
Data collected during the last 10 years suggest that MSC represent a specific adult tissue stem cell population, the plasticity of which is essential. It is not clear whether all the MSC populations, derived from different tissues throughout the body, represent a substantially similar cell category. Among the different sources of MSC already described, the adipose stem cells have attracted the attention of many scientists and physicians due to the frequently large amounts of subcutaneous adipose tissue that can be easily harvested using liposuction. In addition to being an important tool for tissue regeneration, due to their secretory capacity, adipose stem cells also represent possible regulators in the development of obesity.
Adipose Tissue-Derived Stem Cells (ASC)
The in vitro-amplified stem cell population derived from adipose tissue is now termed adipose tissue-derived stem cells (ASC). ASC share common features with MSC derived from other tissues, which are primarily based on the paracrine activity of these cells. ASC are similar to MSC derived from bone marrow, including the capacity to sustain hematopoiesis and immunomodulatory activities, but most importantly, ASC display specific features, among which are higher angiogenic and adipogenic potentials. In fact, results from in vitro assays and animal models have supported a beneficial role for ASC in tissue regeneration and immunomodulation via paracrine activity. However, ASC are responsive to inflammatory stimulus. Hoogduijn et al showed in C57BL/6 mice that intravenously infused ASC home to the lung where they first induce an inflammatory response that in turn leads to immunomodulatory effects. Furthermore, after lipopolysaccharide stimulation ASC increases their inflammatory cytokines secretion with clones exhibiting varying degrees of paracrine activity.
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Stressful conditions on tissue homeostasis can lead to extreme cell behavior changes, and specifically in subcutaneous adipose tissue it has been reported that some diseases can alter ASC function. For example, autologous ASC therapy treatment in a mouse model of multiple sclerosis showed no positive results on the disease progression. There is a positive correlation between high body-mass index (BMI) and some types of malignant tumors. MSC may favor tumor development through the release of soluble factors and by direct cell contact, promoting proliferation, survival, and drug resistance. It is postulated that the inflammatory tumor microenvironment could change the phenotype of infiltrating MSC to a pro-inflammatory state.
ASC and Obesity Development
In addition to producing new adipocytes and to participation in the growth of the vascular tree, ASC could contribute in other ways to the development of obesity. First, these cells could generate macrophages by direct differentiation or indirectly, by supporting their generation from resident hematopoietic progenitor cells. Murine ASC have a phagocytic activity, both in vitro and in vivo. Human ASC also have this capacity. Recently, a macrophage population that expresses CD34 and is plastic-adherent and multipotent, similar to ASC, was identified in human white adipose tissue. Therefore, the idea that a significant proportion of the inflammatory macrophages present in the adipose tissue of obese patients may be generate in situ cannot be ignored.
Second, ASC could also participate in obesity via cytokine secretion function. The endocrine function of adipose tissue depends upon the activity of the adipocytes and the cells from the SVF. Adipocytes are the main source of leptin and adiponectin, while inflammatory cytokines such as IL-6 and TNF-α, are mostly secreted by the stromal-vascular cells, among which are ASC and preadipocytes. Oñate et al showed a low capacity for adipogenic and angiogenic differentiation and an upregulation on inflammatory genes in the ASC from obese patients. Once ASC and preadipocytes are exposed to inflammatory adipose tissue microenvironment, they may react in several possible ways including cytokines secretion, dedifferentiation and migration, aiming to reduce tissue damage. In this microenvironment, inflammatory cytokines secretion by non-healthy ASC could represent a failure to evade stress. Indeed, the cellular and molecular events in obesity may alter ASC producing a non-healthy and even inflammatory phenotype that in turn impairs the normal cellular physiology of the subcutaneous adipose tissue
Multipotent Stem Cells as Key Players in Tissue Homeostasis Disruption in Obesity
The enormous increase in subcutaneous fat mass leads to an increase in secreted molecules such as monocyte chemotactic protein 1 (MCP-1), which causes monocyte infiltration and subsequent macrophage differentiation. Inflammatory cytokines may change multipotent stem cells to a non-healthy phenotype that in turn impairs the normal adipogenesis of subcutaneous adipose tissue. This opens a new and fascinating pathway for modulating obesity through the possibility of manipulating the functional capacity of ASC.
ASC are now considered to be regenerative cells that promote tissue repair and regeneration in vivo, which may occur via different mechanisms, including indirectly by the production of soluble factors or directly by the differentiation of the ASC themselves. The first clinical trial that used expanded ASC involved the treatment of fistulas in Crohnâs auto-immune disease. More than a decadeâs worth of animal model studies and clinical trials using ASC suggest that cell therapy approaches lead to the reestablishment of function and the remodeling of tissue after injury, mostly via a paracrine mechanism.
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The Impact of Weight Loss on ASC
Obesity is an inflammatory disease, and relevant changes in the cytokine release profile are expected when comparing obese and non-obese patients and even after massive weight loss (ex-obese patients). In fact, it is known that epigenetic modifications could play a role in chronic diseases. The alterations in cellular behavior caused by the inflammatory microenvironment in obese subcutaneous adipose tissue could be partially maintained even after the decrease of inflammation because of the accumulation of epigenetic modifications. Therefore, it is critical to investigate the biology of ASC to understand their potential use in particular therapeutic approaches.
If ASC are isolated from ex-obese patients, the regenerative potential of these cells may be modified, and distinct from that observed in the cell populations present in and derived from non-obese patients. Although massive weight loss has been associated with reduced inflammatory markers in plasma, bariatric procedures could produce metabolic abnormalities, including the increase of bone resorption. It has been reported that after massive weight loss, subcutaneous adipose tissue returns to a non-inflamatory state with a significant decrease in inflammatory cytokines and immune cells infiltration.
Comprehensive Weight Loss Programs: A Multifaceted Approach
Stem-Ross Weight Loss Center, following the footsteps of its founder Dr. Emil Kfoury, offers a comprehensive weight loss program that focuses on behavior modification, medication, and counseling. This approach recognizes that weight loss is not simply about reducing calories but also about addressing the underlying factors that contribute to weight gain and making sustainable lifestyle changes.
Key Components of the Program
- Medical Supervision: The program is medically supervised from start to finish, ensuring that individuals receive personalized care and guidance from healthcare professionals.
- Behavior Modification: A crucial aspect of long-lasting weight loss is behavior modification. The program helps individuals identify and change unhealthy eating habits and develop a sustainable approach to nutrition.
- Medication: Phentermine is a prescription medication that may be used as an appetite suppressant to aid in weight loss. It is considered safe when used as directed by a medical professional and has been in use since 1959. Phentermine works by suppressing your appetite and increasing metabolism, which can help the body burn calories more efficiently. Phendimetrazine, like phentermine, is a stimulant that works by suppressing appetite and increasing metabolism. By helping individuals lose weight, phentermine and phendimetrazine may also help to improve their overall health and quality of life, reducing risk of chronic diseases such as heart disease and diabetes. The length of time that you will need to take phentermine will vary depending on your individual weight loss goals.
- Counseling: Counseling provides individuals with support and guidance to address emotional and psychological factors that may be contributing to their weight.
- Vitamins and Supplements: The program may include vitamins and supplements such as B12 and chromium to support overall health and weight loss efforts.
- Vitamin B12: B12 helps with increasing your energy, which boosts your metabolism. Because Vitamin B12 is water-soluble, you cannot store it in your body, so you must get it from outside sources. Stem-Ross Weight Loss Center uses hydroxocobalamin, which is more effective than cyanocobalamin.
- Chromium: Some studies suggest that chromium supplementation may help reduce appetite and cravings for carbohydrates, which may help with weight loss efforts. It helps overcome sugar cravings.
- Lipo Shots: The Lipo Shots at Stem-Ross Weight Loss Center can help you reach your weight loss goals.
- Semaglutide: This weekly injectable medication operates by leveraging the bodyâs natural mechanisms to curb appetite, increase the sensation of fullness, and slow down digestion. By mimicking the actions of the glucagon-like peptide-1 hormone, semaglutide enhances insulin release while reducing the production of glucagon, resulting in more controlled blood sugar levels. This dual action not only aids in weight loss but also presents an innovative way to address obesity-related health concerns. With its proven efficacy, semaglutide marks a promising advancement in the field of weight management, providing individuals with a potent tool to achieve and sustain their weight loss goals.
Program Structure and Follow-Up
After your initial consultation at Stem-Ross Weight Loss Center, follow-up appointments are essential for maintaining a focus on your health and achieving long-term goals. After your initial visit, you return every 2 weeks for the next 2-4 visits. If everything is going well with the medication, the medical professional may recommend switching to monthly visits.
Setting Attainable Goals
Everyoneâs ideal weight goal is different. The team at Stem-Ross Weight Loss Center works with you to set goals that are attainable and realistic, depending on your lifestyle and goals.
The Importance of a Balanced Approach
One of the most important parts of building a long-lasting weight loss routine is to not feel deprived. Eating similar things to your family and friends so you donât feel left out in social situations is recommended. The system is based on practical solutions that are both healthy and long-lasting, providing guidance, appetite medication, vitamins, chromium, B12 injections, and proper guidance.
Potential Benefits and Considerations
Losing weight can have numerous health benefits, including reduced risk of chronic diseases such as heart disease and diabetes. By helping individuals lose weight, programs like those offered at Stem-Ross Weight Loss Center may also help to improve their overall health and quality of life.
However, it is important to note that phentermine, phendimetrazine and other medications are not a magic solution for weight loss. They should be used as part of a comprehensive weight loss program that includes a reduced-calorie diet and increased physical activity.
Like all medications, phentermine may cause side effects in some individuals. The most common side effects of phentermine include dry mouth, constipation, insomnia, and increased heart rate. It is essential to discuss any potential risks and benefits with a healthcare professional before starting any weight loss medication.