Hormonal
In obese individuals, insulin resistance and hyperinsulinemia are strongly associated with decreased adipose tissue expression of the lipases ATGL and HSL, independent of fat mass.
If you are obese and insulin resistant, your body actively suppresses the enzymes needed to break down fat stores (ATGL and HSL) to protect against fatty acid overload. This is a hormonal defense mechanism, not just a lack of willpower. Addressing insulin sensitivity (e.g., through exercise or specific dietary patterns that lower insulin) may be required to restore these enzymes before significant fat mobilization can occur.
In obese subjects, insulin resistance and hyperinsulinemia are strongly associated with ATGL and HSL mRNA and protein expression, independent of fat mass.
Why this rating
Human clinical study with a reasonable sample size (n=44) and rigorous biochemical analysis, though observational in nature regarding the baseline state.
Source
Adipose Triglyceride Lipase and Hormone-Sensitive Lipase Protein Expression Is Decreased in the Obese Insulin-Resistant State
Johan W. E. Jocken et al. · The Journal of Clinical Endocrinology & Metabolism · 2007
DOI 10.1210/jc.2006-1318
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