Hormonal
Obesity-induced adipose tissue dysfunction, characterized by hypertrophy and macrophage infiltration, drives systemic insulin resistance and metabolic disease through the dysregulated secretion of pro-inflammatory adipokines (e.g., TNF-α, IL-6, MCP-1) and elevated free fatty acids, rather than fat mass alone.
Focus on improving metabolic health through actions that reduce adipose tissue inflammation, not just weight loss. Strategies that improve adipose tissue function (like exercise which can alter macrophage polarization) may be more effective for insulin sensitivity than caloric restriction alone, especially if you have 'dysfunctional' obesity.
Obesity results from an imbalance between food intake and energy expenditure, which leads to an excessive accumulation of adipose tissue... The expansion of adipose tissue produces a number of bioactive substances, known as adipocytokines or adipokines, which trigger chronic low-grade inflammation and interact with a range of processes in many different organs... dysregulated production or secretion of these adipokines caused by excess adipose tissue and adipose tissue dysfunction can contribute to the development of obesity-related metabolic diseases.
Why this rating
The paper is a comprehensive review citing numerous human and animal studies, though it notes controversies and discrepancies in specific adipokine roles.
Source
Obesity and Its Metabolic Complications: The Role of Adipokines and the Relationship between Obesity, Inflammation, Insulin Resistance, Dyslipidemia and Nonalcoholic Fatty Liver Disease
Un Ju Jung et al. · International Journal of Molecular Sciences · 2014
DOI 10.3390/ijms15046184
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