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Obesity and Inflammation: A Vicious Cycle

Does obesity cause inflammation or does inflammation lead to obesity?

With Felicia Stoler CDN, RD

The discovery of systematic inflammation as an important health factor is fairly recent, and researchers are still working to understand the different mechanisms and implications.

Collectively, diseases related to chronic inflammation account for 50% of deaths worldwide. The relation between obesity, inflammation, and metabolic syndrome is an interconnected web that is leading researchers to reevaluate how we approach the question of weight. Being advised to lose weight for health reasons is complicated because it often involves politics, medical bias, social status, body image, stigma, and socioeconomics. As a result, it is also a health issue that often isn’t addressed in the same medically effective and objective manner as other medical conditions. 

Obesity is linked to

Systematic Inflammation (SCI) can lead to several diseases

  • Cardiovascular disease
  • Diabetes
  • Autoimmune conditions
  • Neurodegenerative disorders 

Metaflammation, the metabolic inflammatory state associated with obesity, directly contributes to insulin resistance, metabolic syndrome, and type 2 diabetes. The condition is defined by low-grade chronic inflammation in metabolic tissues, including

  • Adipose (fat) cells
  • Liver
  • Brain
  • Pancreas

Weight loss and calorie restriction have been shown to decrease inflammation and increase insulin sensitivity in people who have been medically advised to lose excess weight.

Systemic inflammation increases your risk for metabolic syndromes

  • Hypertension
  • Hyperglycemia (an excess of sugars in the blood)
  • Dyslipidemia (an excess of fats in the blood)

Systematic inflammation also increases your chances of developing

  • Type 2 diabetes
  • Depression
  • Osteoporosis

You may have noticed that all of these conditions are likely to make losing weight more difficult. Obesity is often part of a difficult cycle, but breaking this cycle is not impossible. Understanding the link between inflammation and obesity can also be a way of arriving at a new approach to health and weight loss.

How obesity drives inflammation

The discovery of systematic inflammation as an important health factor is fairly recent, and researchers are still working to understand the different mechanisms and implications. Exactly how obesity triggers inflammation is uncertain, but the process of inflammation seems to be an immune response.

Inflammation induced by obesity represents a focused and rapid response to a site of injury or infection by the innate immune system, which is responsible for fighting new infections. However, unlike the defensive inflammatory response that fights off an infection, the inflammation marked by obesity does not resolve and, without intervention, can become chronic.

In this case, specialized metabolic cells (adipose or fat cells) maintain the injury and begin the inflammatory process—disrupting metabolic homeostasis:

  • The immune system recognizes the injury and sends an array of inflammatory cytokines.
  • These cytokines travel to adipose cells as well as the liver, pancreas, and sometimes the brain and muscle tissues.
  • Additional immune cells infiltrate metabolic tissues, such as natural killer cells (NT) and macrophages.
  • Changes appear in the T cell population of adipose cells. There appears to be a decrease in regulatory T cells, which favors further immune activation.

There is an association between increased weight gain and increased inflammation. More weight can mean more inflammation. However, reducing excess weight also tends to mean less inflammation.

Gut inflammation may also be a contributing factor and can lead to weight gain. For this reason, many dietary interventions are turning their attention to pre- and probiotics. Eating a balanced diet with lots of fresh vegetables is also important for gut health.

Different lipids may become elevated due to obesity or to diet. These lipids may contribute to the pathology of obesity by driving the cellular infiltration of pro-inflammatory macrophages. On the other hand, other lipids such as omega-3 and omega-6 have anti-inflammatory properties.

Inflammation as a precursor to weight gain

By making you more prone to insulin resistance, type 2 diabetes, and cardiovascular disease, systematic inflammation can make weight gain easier and weight loss more difficult. For this reason, certain populations such as people with rheumatoid arthritis (a chronic condition marked by systematic inflammation) are more susceptible to insulin resistance and metabolic disorder. For people dealing with these conditions, understanding how to manage a balanced diet and active lifestyle can be key to preventing the cycle of inflammation and obesity.

Breaking the cycle of obesity and inflammation is difficult, but not impossible. An excess of weight often equals more inflammation. It also can cause a cascade of hormonal adaptations that disrupt your body’s hunger signaling. Felicia Stoler, a doctor of clinical nutrition and registered dietician, says, “I'm always going to advocate for a balanced diet and exercise. However, I think prevention is best."  

Inflammation knocks the body out of balance. A healthy and balanced lifestyle is key to returning the body back to health and equilibrium.

Whether or not certain foods reduce inflammation can depend on the person and the full dietary approach. We tend to eat in patterns, and an imbalanced and heavily processed diet is often inflammatory. However, certain foods do seem to decrease inflammation. Omega-3 and omega-6 can decrease inflammation by correcting the imbalance of lipids in the body. Certain other foods may also decrease inflammation due to polyphenols.

Foods that fight inflammation

  • Olive oil
  • Green leafy vegetables, such as spinach, kale, and collards
  • Nuts such as almonds and walnuts
  • Fatty fish like salmon, mackerel, tuna, and sardines
  • Fruit such as strawberries, blueberries, cherries, and oranges
  • Coffee

Foods that may increase inflammation 

  • Refined carbohydrates, such as white bread and pastries
  • French fries and other fried foods
  • Soda and other sugar-sweetened beverages

Treating obesity like any other chronic medical condition

When obesity affects health, it can be considered a chronic medical condition, and it can be most effective to treat it that way. Exercise and a balanced diet made of whole, unprocessed foods can be part of the prescription to prevent many diseases. The important thing is that daily behaviors that start small can create lasting positive changes over time.

Medically advised weight loss is difficult, particularly when other endocrine condititions are in play. Here are a few strategies you can do to help yourself succeed: 

  • Get social. Walk with a friend, or join an exercise class. Go for a hike outside.
  • Surround yourself with supporters for your weight loss journey and health goals.
  • Eating more plant-based foods can help decrease inflammation and increase your intake of nutrients, without increasing your caloric intake.
  • Focus on adding color to your plate from fruits and vegetables as a way of getting a variety of nutrients and anti-inflammatory benefits.
  • Make movement part of your daily life. Exercise doesn’t have to only happen at the gym. Park further from the grocery store. Take the stairs. Plant a garden.
  • Sleep. Inadequate sleep quality and quantity can stress your system and have been shown to increase weight gain and inflammation
  • Find your Zen. Excess stress hormones have been linked to both weight gain and inflammation. Having a mindfulness practice, doing yoga, or meditating can help to keep your hormones in check.

If you are having a hard time achieving medically advised weight loss, consider enlisting a professional such as a nutritionist, personal trainer, or health coach to assist you on your journey. We rely on professionals to help maintain things that are much less important for our future health and happiness than our own bodies, such as our cars and taxes. It makes sense to also invest at least as much in taking care of ourselves.

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