Fat Cells in the Body: Issues of Loyalty

Sometimes a dreaded thing occurs in the body—a mutiny—resulting in a tumor or a runaway clogging of the system.

At the central railway station in Madras, India, lay one beggar woman more pitiful than the others I saw there. She had positioned herself alongside the stream of passengers hurrying to catch their trains. Businessmen with briefcases passed by her, as did wealthy tourists and government officials.

Like many Indian beggars, the woman was emaciated, with sunken cheeks and eyes and bony limbs. But, paradoxically, a huge mass of plump skin, round and sleek like a sausage, was growing from her side. It lay beside her like a formless baby, connected to her by a broad bridge of skin. The woman had exposed her flank with its grotesque deformity to give her an advantage in the rivalry for pity. Though I saw her only briefly, I felt sure that the growth was a lipoma, a tumor of fat cells. It was a part of her and yet not, as if some doctor had carved a hunk of fat out of a 300-pound person, wrapped it in live skin, and deftly sewed it on this woman. She was starving; she feebly held up a spidery hand for alms. But her tumor was thriving, nearly equaling the weight of the rest of her body. It gleamed in the sun, exuding health, sucking life from her.

Fat cells: the Madras beggar’s tumor was composed entirely of an orgiastic community of them. In our figure-conscious Western culture, the word “fat” connotes a lack of discipline, an unnecessary aggregation of cells that should be reduced.

From the surgeon’s vantage point, however, as he draws a knife across the skin exposing oleaginous layers of fat cells, the evil connotation is balanced by a sense of the value of fat. It insulates against cold, and for that reason billions of fat cells congregate just below the skin. (Because of this, fat people can survive cold air and water better than slim people.) Fat cells pitch their tents wherever they find space around internal organs and muscles and between layers in the body. Their presence helps cushion those vital parts against jarring shocks.

Nothing influences appearance as much as fat. Why are young women so pleasing to the eye? An abundance of fat cells fills in the irregularities of bone and muscle, giving their skin a sleek, smooth contour.

But there is more to fat’s function than insulation and contouring. Each fat cell is a storehouse containing a yellow globule of oil which crowds out the cell nucleus. Most of the time the cell lies dormant, while the body eats enough food to fuel its needs. Come famine, people with plenteous fat cells will be able to sit by while others starve. And that is the most strategic function of fat.

When all is going well, the body takes in just enough food to maintain itself, grow, and replace worn cells. But when the supply diminishes, as when a person mowing the lawn delays supper in order to utilize the summer light, a signal sounds in the body’s fat cells. To the liver short of glycogen and the blood short on glucose, the fat cells freely yield their oily treasure. By being the body’s storehouse, the fat cells free other cells to do their job more efficiently. For example, if every muscle cell had to include a pouch-like reservoir of energy, our bodies would be deformed lumps and nodules.

Some fat is readily expendable: it goes first when a person starts a diet. Other fat, such as that around the kidney and in the palm of the hand, holds out because of its important secondary functions. When the body is starving, however, even these high priority fat cells must relinquish their important contents.

I like to think of fat cells as the banker cells of the body. In times of plenty they bulge with excess, as the body deposits more than it withdraws. In times of want they channel their chemical wealth back into the bloodstream.

But sometimes a dreaded thing occurs in the body—a mutiny—resulting in a tumor lipoma such as the one attached to the Madras beggar. A lipoma is a low-grade, benign tumor. It derives from a single fat cell, skilled in its lazy role of storing fat, that rebels against the leadership of the body and refuses to give up its reserve. It accepts deposits but ignores withdrawal slips. As that cell multiplies, daughter cells follow its lead and a tumor grows like a fungus, filling its crevices, squeezing against muscle and organs. Occasionally a lipoma crowds a vital organ like the eye, pushing it out of alignment or pinching a sensitive nerve, and surgery is required.

I have removed such lipoma tumors. Under a microscope they seem composed of healthy fat cells, bulging with shiny oils. The cells function beautifully except for one flaw—they have become disloyal. In their activity they disregard the body’s needs. And so the beggar woman in Madras gradually starved while a lipoma that was part of her engorged itself.

A tumor is called benign if its effect is fairly localized and it stays within membrane boundaries. But the most traumatizing condition in the body occurs when these disloyal cells defy inhibition. They multiply without any checks on growth, spreading rapidly throughout the body, choking out normal cells. White cells, armed against foreign invaders, will not attack the body’s own mutinous cells. Physicians fear no other malfunction more deeply: it is called cancer. For still mysterious reasons, these cells—and they may be cells from the brain, liver, kidney, bone, blood, skin, or other tissues—grow wild, out of control. Each is a healthy, functioning cell, but disloyal, no longer acting in regard for the rest of the body.

Even the white cells, the dependable palace guard, can destroy the body through rebellion. Sometimes they recklessly reproduce, clogging the bloodstream, overloading the lymph system, strangling the body’s normal function—such is leukemia.

Because I am a surgeon and not a prophet, I tremble to make the analogy between cancer in the physical body and mutiny in the spiritual body of Christ. But I must. In his warnings to the church, Jesus Christ showed no concern about the shocks and bruises his body would meet from external forces. “The gates of hell shall not prevail against my church,” he said flatly (Matt. 16:18). He moved easily, unthreatened, among sinners and criminals. But he cried out against the kind of disloyalty that comes from within.

I must concentrate on how I, as an individual cell, should respond to the crying needs of the body of Christ in other parts of the world. Beyond that, I cannot and should not make sweeping judgments about what the response of other Christians should be.

But I must say, from the perspective of a missionary who spent 18 years in one of the poorest countries on earth, the contrasts in resources are astonishingly large. At Vellore we treated leprosy patients on three dollars per patient per year; yet we turned many away for lack of funds. Then we came to America where churches were heatedly discussing their million-dollar gymnasiums and the cost of landscaping and fertilizer and a new steeple … and sponsoring seminars on tax shelters for members to conserve their accumulated wealth. As I saw those churches’ budgets for foreign missions and for inner-city work, I could not force a telling image from my mind: the memory of the Madras woman slowly starving to death while her lipoma grew plump and round.

The problem is not just an American problem, or even a Western problem. I could easily point to examples of hoarding in every society I’ve seen: in the cruel Iks of Africa, in Soviet Russia, in the disparity within the Christian community in India. The warning applies to all of us. My only message is the caution of a doctor: Remember, the body will have health only if each cell regards the needs of the whole body.

I wonder if perhaps we in the West get caught up in a competitive spiral with “cells” around us, and become oblivious to the stark needs of the rest of the world. In the body of Christ ownership of property and money is no sin; it is an important function of certain members. And when I liken wealthy people to fat cells, I use the image positively, as an admiring doctor who appreciates the role of fat. Hospitality and generosity are made easier by wealth. Reserves can help the body care for itself and fuel its muscular activity in a hurting world. However, the control of fat is a difficult problem, both in biology and in religion.

I realize these issues have complex economic and cultural factors behind them. But I am impressed with how decisively that early church responded to pressing needs: the apostle Paul took months out of his schedule to collect money from Greek Christians to aid improverished Jewish Christians in Jerusalem.

We need to pause and look carefully at ourselves. God needs all types of cells in his body: fat and thin, rich and poor, simple and complex. But he only needs loyal cells. And in the area of using resources, Jesus, our Head, had many unsettling things to say. God save us from being a cancer within his body.

Carl F. H. Henry, first editor of Christianity Today, is lecturer at large for World Vision International. An author of many books, he lives in Arlington, Virginia.

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