For the Reduced Obese it is not a sick fat cell, it is a shruken fat cell.

The main challenge in the Obesity Epidemic is to help the people who have lost weight maintain that weight loss.

I learned a major lesson when I watched:
  
HBO Weight Loss Nation 1 min 40 second video

It is clear to me that fat cells become sick, especially in the apple shaped obese.

However, it is also clear to me that insulin resistance is often reversible when there is weight loss.  Thus the fat cell is not sick it is shrunken. 

It has lost it's fat and subsequently the body has a Leptin deficiency. 

Strange, since the body did not have this Leptin deficiency when it was at this lower weight before. 

The younger body did not have all these billions of extra fat cells that will now never go away. 

These are not sick fat cells, on the contrary, these fat cells are very capable of doing their job.  Storing fat to get ready for the next famine. 

In Always Hungry by Dr. David Ludwig he writes: 

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I don't believe low glycemic diet will change the nature of a shrunken fat cell that is deficient in Leptin. 
Dr Aronne in The Change Your Biology Diet offers this approach:

Then he suggests that intense exercise may be the key:

Diet and Exercise have failed to helped the majority of the reduced obese because of the billions of fats cells that remain after weight loss. 
These Leptin deficient fat cells cause the body and the brain to regain weight at low calorie diet and high exercise.

I call this:

The Sponge Theory


How to treat adaptive thermogenesis in the reduced obese