The Hidden Fire Within: How Chronic Inflammation Fuels Obesity—and What You Can Do About It

Obesity is not just about excess weight—it's about what that weight is doing inside your body. Beyond what is going on physically that is visible to the eye, there is a silent yet destructive process happening within the body: chronic, low-grade inflammation.

Unlike inflammation you can feel, such as when you sprain an ankle, this kind of inflammation disrupts an individual’s metabolism, hormones, and more. Inflammation due to obesity occurs as a result of excess fat. This is because fat tissue stimulates the release of inflammatory substances throughout the body, causing an array of negative downstream effects.

The best way to minimize chronic inflammation is to get to the root cause, which means losing excess weight. Let’s delve further into what chronic inflammation is and how you can prevent it.

What Is Chronic Inflammation?

There are two types of inflammation: acute inflammation and chronic inflammation. Most people are familiar with acute inflammation. This type of inflammation is associated with swelling, redness, pain, and warmth within the affected joints and tissues. It happens due to an acute injury, such as when you sprain an ankle or when you cut yourself. When the body experiences this injury, the immune system sends out white blood cells to the affected area. Acute inflammation, though uncomfortable, is a positive thing because it is a short-term healing response that protects the body.

Chronic inflammation is different – it is silent and systemic. It occurs when there is too much inflammation for an extended period of time. Although it doesn’t cause physical pain, it does do damage. With chronic inflammation, the immune system continuously releases chemical messengers and white blood cells. This happens because the body thinks it’s under continuous attack, so the immune system remains active. As a result, white blood cells can attack healthy organs and tissues. Studies have indicated that chronic inflammation is linked to heart disease, cancer, diabetes, arthritis, and bowel disease.

Chronic inflammation can occur due to a number of reasons, the main ones being poor diet, stress, toxins, and inactivity. Obesity in particular can be a major cause (1).

The Link Between Obesity and Inflammation

So, why does obesity cause inflammation? This is because adipose tissue, or fat tissue, is metabolically active. Adipose tissue is responsible for controlling appetite, energy expenditure, reproduction, endocrine functions, immunity, and inflammation. Visceral adiposity in particular is linked to an increased risk of cardiovascular diseases and diabetes. This is likely because visceral fat directly affects the release of inflammatory cytokines and free fatty acids into the circulation.

With regards to inflammatory cytokines, adipose tissue in individuals with a healthy weight will release anti-inflammatory adipokines like IL-10, IL-4, IL-13, IL-1, and transforming growth factor-beta (TGFB). In contrast, the adipose tissue in obese individuals tends to release pro-inflammatory cytokines like IL-6, TNF-a leptin, angiotensin II, visfatin, and plasminogen activator inhibitor. Experts haven’t fully characterized the reasons for this difference; however, this cytokine release perpetuates inflammation throughout the body (2).

Unfortunately, inflammation and fat storage are strongly interconnected, causing a self-perpetuating cycle. When the body experiences inflammation, it causes insulin resistance and fat storage around the abdomen. Meanwhile, excess fat tissue secretes inflammatory cytokines, causing constant low-grade inflammation. As a result, inflammation fuels more fat storage, and fat fuels more inflammation – leading to a vicious cycle.

Health Risks of Inflammatory Obesity

Obesity transcends just a cosmetic concern. It is a serious, chronic condition that can lead to widespread, systemic effects that are driven largely by chronic inflammation. This low-grade, chronic inflammation isn’t restricted to just fat tissue, it extends far beyond to other tissues and organs. As such, it can disrupt normal functioning, causing disease. For example, the following are linked to chronic inflammation:

• Type 2 diabetes. Inflammation can lead to insulin resistance, which causes the body to either not make enough insulin or not respond to insulin appropriately. When these processes are disrupted, blood sugars become elevated, causing type 2 diabetes. Diabetes is associated with long-term damage and other serious health conditions.
• Cardiovascular disease. Chronic inflammation can also lead to plaque buildup within the arteries. Over time, this buildup can increase one’s risk of stroke and heart attack.
• Non-alcoholic fatty liver disease (NAFLD). Believe it or not, chronic inflammation can even reach the liver, causing NAFLD. This disease is characterized by the accumulation of fat in the liver, specifically in individuals that drink little to no alcohol.
• Cancer. Inflammation due to obesity is also associated with certain types of cancer, including colon, breast, and pancreatic cancer. This is because inflammation creates a “pro-growth” environment for cancer to develop.
• Brain health. Inflammation can also contribute to the development of Alzheimer’s disease, depression, and mood disorders.

Knowing the widespread impacts of excess weight and associated inflammation, one thing is clear: obesity is not benign —it has deep systemic consequences.

How to Know If You’re Inflamed

So, how do you know if you are inflamed? The easiest indicator would be whether or not you are considered overweight or obese. In particular, body shape can be particularly insightful. Belly fat, specifically visceral fat (which is the fat surrounding your abdominal organs) is associated with systemic inflammation. Thus, your waist circumference and associated measurements (e.g., waist-to-height ratio) can indicate your likelihood of inflammation.

If you are experiencing inflammation, you may also experience common symptoms like fatigue, brain fog, poor recovery, joint pain, and low energy. Of course, these symptoms are pretty nonspecific, meaning that they could be indicative of a wide array of conditions or disease. Thus, it is important to consult a healthcare provider if you are worried about inflammation and are overweight or obese.

A healthcare provider will be able to do a full assessment of your health history, while also gathering labs that can indicate what is going on internally. Some common lab markers they may collect at a visit include:

• CRP (C-reactive protein)
• Fasting insulin
• Ferritin
• Triglycerides

Lifestyle Changes to Reduce Inflammation

While you may be concerned about chronic inflammation, the good news is that there is a lot you can do to minimize inflammation and its negative consequences. As obesity and chronic inflammation are interrelated, your main focus will be on achieving sustainable weight loss. As you lose weight, inflammation will go down. Even losing small amounts of weight can lower inflammation markers, and you will be less susceptible to the health consequences of inflammation.

There are many ways to navigate a weight loss journey, but individuals that are most successful focus on realistic, sustainable changes. This will involve a holistic approach of addressing diet, exercise, sleep, and more.

Diet

The most effective way to lose weight is by being in a caloric deficit. Calorie deficits involve burning more calories that you are consuming through food. This usually means adjusting your diet so that you are eating less calories while in a weight loss phase.

Whether you are in a calorie deficit or not, incorporating anti-inflammatory foods can greatly benefit your overall health and minimize inflammation. At the grocery store, look for anti-inflammatory foods such as fruits, vegetables, fatty fish, olive oil, nuts, whole foods.

Exercise

Exercise has a wide array of benefits, and it is a cornerstone of healthy weight management. However, exercise can also help to minimize inflammation. In fact, routine physical activity decreases levels of pro-inflammatory cytokines like IL-6 and TNF-a, while also increasing anti-inflammatory substances like IL-10. Additionally, exercise can improve insulin sensitivity. Regular movement promotes effective insulin use by the body, helping to lower blood sugar levels and inflammation associated with insulin resistance.

Sleep and stress

Cortisol is a stress hormone that plays a major role in inflammation. Thus, prolonged periods of stress can chronically elevate cortisol, thus contributing to chronic inflammation. Additionally, poor sleep can increase cortisol levels and thus inflammation.

Advanced Medical Interventions

Although holistic lifestyle changes like proper diet, exercise, adequate sleep, and managing stress levels can all promote weight loss and decrease inflammation, sometimes we need some extra support. Thankfully, there are a number of weight loss medications available on the market that are both safe and effective in supporting weight loss.

Glucagon-like peptide-1 (GLP-1) agonist medications are some of the most popular drugs currently available because they offer great results. Medications like semaglutide and tirzepatide can help to augment weight loss alongside lifestyle changes to reduce inflammation long-term.

Conclusion

Many of us want to lose weight because of aesthetic reasons, but there are widespread health implications to being overweight or obese. Abdominal and visceral fat in particular can be an indicator of widespread, systemic inflammation. This chronic, low-grade inflammation can injure the body over time, contributing to conditions like type 2 diabetes, cancer, and cardiovascular disease.

The best way to manage chronic inflammation is to lose weight, which can be done through a combination of diet, exercise, and medication. In addition, these interventions can also help to lower inflammation in the process.

References

1. https://www.health.harvard.edu/staying-healthy/understanding-acute-and-chronic-inflammation
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC8967417/

Author

David J. Bauder, PA-C David Bauder, PA-C, is a certified physician assistant and the assistant medical director at Weight Loss and Vitality in Manassas and Alexandria, Virginia, Washington, DC; and Gaithersburg, MD. He enjoys helping patients optimize their physical and mental health to improve their overall well-being. He earned his physician assistant degree from the University of Texas Health Science Center at San Antonio. Afterward, he gained admission into the reputable graduate program for physician assistant studies at the University of Nebraska Health Science Center in Omaha. David has over 26 years of experience working as a physician assistant. He’s practiced in podiatry, family medicine, emergency medicine, general surgery, urgent care, and functional medicine.