The precise mechanisms of leptin resistance are not yet understood, with possibilities including fewer leptin receptors, impaired intracellular signaling, or altered cell-to-cell communication.

“but we don't really know how it works yet so you know that's just a general term for requiring more leptin to avert the starvation response but we don't know whether that is something where there's fewer leptin receptors on a certain kind of cell whether there's a downstream signaling impairment in interior cellular signaling cascades whether there is a change in cell to cell communication maybe the cell that's receiving a leptin is getting the message just fine but there's some kind of downstream change in neural processing where the signal gets gets clouded or modified we don't know the answer to that question”