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Chronic (long-term), low-grade inflammation is a key factor that can disrupt normal body functions and contribute to disease. Recent studies have found that obesity can trigger this type of long-term inflammation. This may help to explain the link between obesity and serious health problems like heart disease and diabetes. Understanding how obesity fuels inflammation may provide important clues to preventing and managing obesity-related conditions.
Inflammation is an important part of maintaining your body’s health and protecting it from harm. We often think of inflammation as a bad thing. However, inflammation is a normal part of homeostasis (your body’s ability to remain stable).
There are two main types of inflammation: acute and chronic. In acute inflammation, the immune system has a short-term response to an injury or illness. Chronic inflammation is long-term inflammation that occurs even when there isn’t a need for it. Instead of being helpful, chronic inflammation can cause damage to your body and is linked to several health problems, including:
Obesity is associated with chronic inflammation. In chronic inflammation, there are higher levels of inflammatory signals in the blood. Researchers have found elevated inflammatory marker levels in people with obesity, which may affect the risk of developing other health conditions, including diabetes and hypertension (high blood pressure).
Researchers don’t fully understand how obesity causes an inflammatory response. However, there are several theories about different pathways that may lead to chronic inflammation in obesity.
People with more visceral fat (belly fat that surrounds your organs) may have a higher risk of health problems. Researchers think visceral fat may be more strongly associated with health problems because it’s more likely to cause systemic (whole-body) inflammation. That’s because visceral fat can release fatty acids and active substances to the liver, and these substances can circulate through to the whole body.
Below, we’ll review some of the ways obesity and excess body fat may contribute to systemic inflammation.
Hormones are chemical messengers that help regulate many different body functions. Adipose tissue (fat tissue) is a part of the endocrine system that releases hormones. Researchers have discovered that adipocytes (fat cells) can release more than 50 different hormones — known as adipokines.
In people with obesity, fat tissue tends to release hormones that encourage inflammation. For example, leptin is an inflammatory hormone that helps regulate appetite and energy balance. Leptin is released in proportion to the amount of fat in the body. That means that more body fat is associated with higher levels of leptin.
Obesity is also associated with lower levels of anti-inflammatory hormones normally released by fat tissue, including adiponectin. This hormone helps regulate energy balance and insulin sensitivity.
Obesity is associated with changes in immune cells and a decreased immune function. Increased body fat leads to more immune cells, such as macrophages and T cells, in the fat tissue. These immune cells can add to inflammation. Adipose tissue and immune cells also encourage inflammatory processes by releasing proinflammatory cytokines and other substances, such as tumor necrosis factor, interleukins, and C-reactive protein (CRP).
Another way that excess fat can cause inflammation is by reducing oxygen levels in fat cells. Weight gain can make fat cells grow larger. This increases the distance between individual fat cells and blood vessels that supply nutrients and oxygen, causing stress to these cells. The stressed fat cells release inflammatory markers that activate an immune response. Increased inflammation associated with excess body fat can encourage the immune system to cause inflammation in other parts of the body.
Obesity can alter how the body metabolizes (breaks down) lipids (fat). People with obesity often have higher levels of nonesterified fatty acids (NEFAs). NEFAs can be harmful to other tissues and are associated with stimulating inflammation and insulin resistance. Additionally, NEFAs may also influence the release of adipokines.
Obesity is associated with metabolic inflammation — a chronic, low-grade inflammation all over the body. This inflammatory state is involved in the development of many different health conditions. Below, we’ll review how inflammation plays a role in some common health problems.
Insulin resistance happens when the body becomes less sensitive to insulin. Insulin is a hormone that helps the body use glucose (sugar). With insulin resistance, the body can’t effectively use glucose, and your blood sugar increases. Over time, insulin resistance can lead to type 2 diabetes and metabolic syndrome.
Many studies have found that obesity-related inflammation is a key part of developing insulin resistance. It’s estimated that about 80 percent of people with obesity will develop insulin resistance at some point in their lives. Once insulin resistance begins, it can also worsen inflammation in a vicious cycle that’s difficult to break.
One of the ways obesity may cause insulin resistance is through the release of specific hormones. For example, the hormone adiponectin is known to increase insulin sensitivity. However, obesity is associated with low adiponectin levels. Leptin can also influence insulin sensitivity.
Heart disease is the leading cause of death around the world. Recent studies have found that inflammation associated with obesity can lead to heart disease. Obesity also plays a role in atherosclerosis, one of the most common causes of heart disease. Atherosclerosis happens when plaque (a sticky substance made of fat and other substances) builds up in blood vessels. Eventually, atherosclerosis can cause heart disease by narrowing and blocking the arteries that supply blood to the heart.
Several hormones, including leptin, can increase atherosclerosis in people with obesity. Adiponectin has been shown to decrease atherosclerosis. As previously mentioned, adiponectin is usually lower in people with obesity. Lower adiponectin levels may reduce the body’s ability to protect blood vessels from inflammation and plaque buildup.
Obesity is associated with an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD) — previously known as fatty liver disease. In MASLD, too much fat is stored in the liver, leading to more serious liver problems in some people. Obesity-related inflammation is linked to the development and progression of MASLD.
Autoimmune diseases happen when the immune system mistakenly attacks healthy tissues. Obesity is associated with an increased risk of several autoimmune diseases, including:
Researchers are still learning how obesity and autoimmune diseases are connected. Several studies have found that hormones, especially leptin, can activate the immune system and may trigger an autoimmune condition.
As researchers learn more about how inflammation and obesity are connected, new treatments may target inflammation. Some studies have already investigated using anti-inflammatory medications for high blood sugar and insulin resistance. Many medications already used to treat diabetes also have anti-inflammatory properties. However, more research is needed to learn how anti-inflammatory treatments may affect the risk of other health problems. So far, researchers haven’t found that anti-inflammatory medications can lower the risk of heart disease from inflammation.
Although there aren’t any medications that specifically target obesity-related inflammation, there are some lifestyle habits that may help lower your risk of inflammation, including:
Weight loss may also help reduce inflammation. Some research has found that calorie restriction and intermittent fasting may help improve metabolism and reduce inflammation. Talk to your healthcare provider about dietary or lifestyle changes that may help you reduce inflammation.
MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 57,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.
Have you discussed inflammation with your healthcare provider? What steps have you taken to reduce inflammation? Share your experience in the comments below or on your Activities page.
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