What does Adiposopathy aka ‘Sick Fat’ mean?

Adiposopathy is a term that refers to ‘sick fat’. But even with this clarification, what does that even mean?!

First, adipose tissue, commonly just called ‘body fat’, refers to the fat cell depots throughout our body, which include subcutaneous adipose tissue and visceral adipose tissue. Adipose tissue is an endocrine organ, which means it makes hormones that circulate in the blood and travel to different organs, where it exerts an effect on that organ.

One example?

Leptin - this is a hormone made in fat tissue and can travel into our brain, specifically, the hypothalamus, where it triggers the feeling of satiety, or feeling full.

In addition to secreting hormones, adipose tissue can insulate and protect organs and other structures in our body, which is an essential and important function of fat.

Adipose tissue is an important part of our health and having a sufficient amount is necessary for our well-being. But if adipose depots become too large or stressed it becomes dysfunctional and can compress organs and impact their function, causing adverse effects, or the stressed adipose tissue can secrete inflammatory chemicals which can also cause serious adverse health outcomes. This dysfunctional adipose tissue, or ‘sick fat’, is what adiposopathy refers to.

Let me provide some examples.

Mechanical

Excess adipose tissue can have adverse mechanical sequelae such as:

*Osteoarthritis of the hips and/or knees

*Obstructive sleep apnea

*Gastrointestinal esophageal reflux disease

Inflammatory

Sick fat secretes pro-inflammatory cytokines and chemokines, such as IL-6 and TNF-a.Various cardiometabolic and other medical conditions have been associated with chronic inflammation directly linked to adiposopathy, such as:

*Insulin resistance

*Type 2 diabetes

*Heart disease

*High cholesterol

*Non-alcoholic fatty liver disease

*Cancers

So when medical professionals discuss weight loss, what we are truly interested in is not a random number on a scale, but rather, determining whether or not a person has excess dysfunctional fat mass that is compromising or at risk of compromising health. We are assessing the risk of adiposopathy on a person's health and this is what we are targeting for treatment.

In fact, the Obesity Medical Association’s definition of obesity defines obesity as, “a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”

How do you know if you have excess adipose tissue?

Body composition measures such as using accurate bioimpedance analysis scales, air displacement plethysmography, or DXA and MRI are able to provide fat mass distribution details. There are standards obesity medicine specialists, like myself, use, to determine objective measures of adipose tissue.

Remember, what obesity medicine specialists are interested in targeting is specifically treating adiposopathy and its impact on health.