Is there a metabolic program in the skeletal muscle of obese individuals?

Severe obesity (bmi ≥ 40 kg/m2) is associated with multiple defects in skeletal muscle which contribute to insulin resistance and a reduction in fatty acid oxidation (fao) in this tissue. these metabolic derangements are retained in human skeletal muscle cells raised in culture. together,these findings are indicative of a dysfunctional global metabolic program with severe obesity which is of an epigenetic or genetic origin. weight loss via gastric bypass surgery can turn off and/or correct components of this metabolic program as insulin sensitivity is restored; however,the impairment in fao in skeletal muscle remains evident. physical activity can improve fao and insulin action,indicating that this patient population is not exercise resistant and that exercise offers a pathway to circumvent the abnormal program. findings presented in this review will hopefully increase the understanding of and aid in preventing and/or treating the severely obese condition. © 2011 joseph a. houmard et al.