- Obesity isn't just about numbers on a scale or your BMI. It's a hidden epidemic silently fueling a range of diseases that we see every day. From heart failure and diabetes to Alzheimer's and even cancer, excess weight is a key player in about 70% of chronic diseases. Today, we expose the shocking truth about how obesity is hijacking our health and just how wide reaching this problem really is. Welcome back everybody to the Building Life-Going Ethics podcast. Thanks so much for stopping by. My name is Jordan Renneken, we have MAET. I'm a dual board physician in sports and family medicine. And the goal of this podcast is to keep you active and healthy for life through actionable evidence and form of education. Today, we're covering an article from Hildenbrand and Pfeiffer from the European Journal of Physiology published in February of 2025. And we're talking all about the wide reaching effects of obesity. So, we know obesity is very prevalent. Today, we're gonna talk all about that. So let's dive in here. So obesity, obesity is a major threat to public health and economic development due to its link with non-communicable diseases. They talk about non-communicable diseases here or NCDs. Those are essentially things that aren't passed on. So we're not talking about like the common cold or things that you can pass or things that are infectious. Non-communicable means, hey, they're caused by some other cause. And obesity is a big one, a really big part of it. And obesity is projected to be the number one preventable risk factor for non-communicable diseases by 2035. And over 70% of non-communicable diseases have a document association with obesity. So there's a good chance that about 70%, so the vast majority of issues that are not infectious have some tie to obesity. That's pretty strong. And these NCDs, they're the largest contributors to excess death globally, accounting for about 74% of all global deaths. So let's just stop that for a second. 74% of all global deaths are related to these non-communicable diseases, right? So non-infectious diseases. And of that 70% are related to obesity. So by my math, a whole lot of deaths can be prevented if we can tackle the obesity epidemic. Obviously, much easier said than done. But the main classes of these NCDs regarding mortality are such a cardiovascular disease, cancer, chronic respiratory diseases, diabetes and kidney diseases, digestive issues and neurological diseases. And these non-communicable diseases, they lead to a significant reduction in quality of life, including mental and musculoskeletal disorder. So lots of associations as well. And there's no definitive cure for most NCDs and long-term treatment is often required. And that's a big thing, right? These chronic diseases, we call them chronic 'cause chronic means they last for a long time. These NCDs, they are not something you just reverse, right? And even if you take a medication for it, it's not reversing it, it's just kind of holding the symptoms at bay. So lots and lots of money to be had, very, very important topic we're talking about today. So overall, the incidence, so there's a high incidence and treatment costs of these NCDs resulting in a tremendous financial burden on our health system and economic development worldwide, right? It's kind of a crushing amount of money. And almost half or about 40% of global death can be attributed to risk factors associated with an obesogenic lifestyle or predisposition. And when I mean predisposition, that means we do know that there's a strong genetic component to that. It's not as easy as you have this gene, you will have obesity. We know it's polygenic, meaning multiple genes are affected, but there is a pretty strong tie to that. And almost half of these deaths, global deaths, can be attributed to risk factors leading to these obesogenic lifestyle. So it's not just necessarily obesity, but lifestyle, meaning sedentary behavior, the things we eat, all that stuff. And it's a lot and it's a huge burden, right? And a huge economic burden. We are spending an enormous amount of money on that and so that is one really important thing that we have to consider, like, what is the cost of obesity? And obesity does steal years away from a healthy life. You know, overweight is defined as a BMI greater than 25 and obesity is above 30 typically. And overweight does still incur a significant risk of death and disease. And overweight and obesity are the fourth most common risk factors for these non-communicable diseases in Europe. And overweight affects about 43% of the global population and obesity about 16%. Specifically high income countries, these are more affected with about, you know, the overweight and obesity rates are in America, 73.6 and 42.5. So overweight, 73% of people overweight and obese, 42.5%. So that is pretty big. And increasing obesity rates are evident in low and middle income countries as well, which is crazy. They just have not quite as high as us, but the world's catching up. All right, great. So we're seeing the spread everywhere. Obesity is no longer just a Western world problem or a first world country. It is becoming prevalent everywhere unless we do something about it. And a lot of times what can happen is we have a measure that we look at called disability adjusted life years or DALYS or DALYS. And this is a way to measure the overall disease burden. And what's happening here, it's measuring this disease burden expressed as the number of years lost due to ill health, disability or early death. Meaning, hey, based off of where you were born and you know, what time and era and demographics and zip code stuff, you should expect to live here. But if you have some sort of disease that's limiting your health or you die early or early in disability, these DALYS or D-A-L-Y-S, they are essentially showing what's the difference there. Like what could have you had and what did you actually have? So it's kind of big. And these NCDs are a major contribute to global disease and burden. And there's about an estimated 1.62 billion disability adjusted life years contributed annually from NCDs, this is just in 2019 alone. And cardiovascular diseases accounted for 400 million DALYS alone. So think of these DALYS or DALYS as a way to measure the total impact of disease on people's lives. So it accounts for both years of life lost because of dying early and years of life lived with disability due to being ill. And overall, the article we're talking about says that non-communicable diseases caused about 1.62 billion DALYS once again, like I said, in 2019, that was just 2019. So that's a while back there. And that's a huge burden, right? So that's 1.62 billion years of healthy life that we're taking from people worldwide. And that's just crazy, it's a huge number. And it just highlights the massive burden of these diseases that they place on society. So once again, just crazy, crazy numbers. We're talking about the 400 million from cardiovascular disease alone. So roughly a quarter of all healthy years lost to these non-communicable diseases can be attributed to heart and blood vessel related issues. That's huge, it's devastating and it's a really big thing. And so that's these disability, I like thinking about it that way. The reason I like thinking about this, 'cause cool, like Jordan, you're giving these stats on obesity is bad, but like, this is a tangible thing. Like you could have lived healthy and this long, but because of non-communicable diseases, obesity, lifestyle, things like that, you've lost not only years, but quality years. And that's a really big thing. 'Cause most people are like, okay, what's a year, what's two, but like quality, everyone seems to click with like, yeah, I wanna live a quality life. And so really big deal. That's why I wanted to mention that and the article did as well. Moving on, chronic overnutrition does fuel a toxic fire. So overweight and obesity, once again, obesity being greater than a 30 BMI results from an imbalance in energy intake and expenditure. There's some controversy, and I would say controversy loosely on the internet saying, it's not calories, it's hormones. And let's just put that to bed saying, your calories affect your hormones, your hormones affect your calories. So there is a definitive role in that. So, but either way I say energy imbalance. So imbalance in energy intake, that is leading to this expenditure. And excess nutrients, when you have excess nutrients, they're stored in adipose tissue. So essentially fat cells. And a chronic net surplus will lead to increase adipose tissue hypertrophy, which is growth of them, beyond the limit of what's a healthy expansion, right? So leading to adipocyte stress, essentially. So they're stressing these adipocytes, so the fat cells, and consequently leads to adipose tissue inflammation and fibrosis. So what we're saying here is, when we have more calories than we need, they start to grow the fat cells and they get bigger. And as they get bigger, bad things happen to them. They become inflamed and can become fibrotic or hard, and that's not good. And if not controlled, this local inflammation can actually spill over to other organs and can affect the whole body. In this article, I talked specifically as a process known as metaflammation, meaning, hey, it kind of just spills over and leads to inflammation everywhere. And there's tons of detrimental systemic consequences that such as insulin resistance, hyperglycemia, cholesterol abnormalities, and hypertension. And a kind of metabolic syndrome is when you think about multiple of those things. So essentially three of those conditions, meaning you're having insulin resistance, you have abnormalities in your cholesterol, you have waist circumference issues, you have hypertension, lots of different things, we don't necessarily talk about that. But metabolic syndrome is kind of the aggregate of multiple of those things all put together. And a lot of those are happening because of excess adiposity. And the pathogenis of the vast majority of non-chemical diseases is negatively affected by excess adiposity in some way, meaning there's some factor going on, the extra fat is not helpful and is being detrimental and causing these NCDs potentially. So moving on, let's talk about specific diseases. So talking about cardiovascular diseases, right? So living with obesity, I put here a heart attack waiting to happen. That's not necessarily the case, but it does increase your risk. Cardiovascular diseases are the number one cause of death globally. And obesity has a strong correlation with cardiovascular disease. Specifically, there's multiple conditions we talk about, things like ischemic heart disease and strokes, so heart attacks. So heart attacks and strokes, big ones. Obesity is a significant independent risk factor for coronary disease. Independent meaning it in and of itself seems to have relationship with it. And there's a direct causal relationship between obesity and both coronary heart disease and ischemic stroke. And chronic overnutrition tends to lead to increased concentrations of VLDL, or very low density lipoproteins, and chylomicrons in the blood, which over time, that leads to higher concentration of atherogenic lipoproteins, which we've talked about these all the time, right? So this leads to lots of LDL essentially, or APOB particles floating around. And we know that the deposition of these atherogenic lipoproteins, specifically LDL and predominantly, into the subendothelial space of the vascular wall, this is what starts it. And you get inflammation that adds onto it and it creates this atherosclerotic lesion and initiates a setup for heart disease and creating plaques. So that's kind of the big one. But you also, on top of that, so not only do you have increased atherogenic particles going around when you have obesity, you also have the reverse, where you have blunted reverse cholesterol transport. So essentially you're gonna lower your HDL. Once again, an HDL is thought to be, you know, quote unquote good. Cholesterol can't be good or bad, it's just carried on these lipoproteins. But HDL essentially works with reverse transport, so it kind of clears out the excess cholesterol and gets it out of the arteries. And that's really important. And you have a lower HDL when you have adiposity to increase obesity. And so that's very, not good for you. And on top of that, just having an elevated level of just nutrients, so overnutrition, eating more calories, that can trigger endothelial dysfunction. So we think about heart disease, right? You gotta have the lipoproteins and then you have endothelial dysfunction for them to get in and then you have inflammation and all that stuff. So just literally eating too much can lead to that endothelial dysfunction, which kind of goes in. And essentially also what can happen is excess adiposity can decrease your insulin sensitivity at specific organs. It can lead to just lots of issues, meaning you have the wrong lipoprotein concentration, you have extra glucose around, lots and lots of issues there. And if you think about it, obesity often leads to a chronic state of systemic inflammation. Like they talked about in the article, this meta-flammation, and that enhances the risk of increased lipids, endothelial dysfunction. It just really creates a storm for a heart attack or a stroke, something like that. And on top of that, this inflammation increases increased levels of cytokines. And it may worsen the progression and stabilization of atherosclerotic plaque. So long story short, it is not good to have extra inflammation in your body. And so that's why we find that increased adiposity leads to the inflammation. The next disease they talk about specifically is hypertensive heart disease. And obesity is a major cause of hypertension with an estimated 65 to 78% of hypertension cases attributed directly to overweight and obesity. Not directly necessarily, but related to that. And obesity initiates hypertension by a couple of different ways. We're not entirely sure, right? In the medical world, we call it essential hypertension, meaning, hey, you have hypertension. And the traditional medical establishment, like, well, that's it, like, here you go, go on meds. And that's it. Without like trying to understand what's the underlying thing. So let's dive a little deeper here. This is a little nerdier, but there's a couple of mechanisms that could be happening here. So one is, it could be an inherent kidney function. So they may lead to like mechanisms that include physical stress or compression of the kidneys by the abdominal fat cells. So like actually compression of the kidneys so that kind of can impact your blood pressure. It may activate the sympathetic nervous system, which is our, you know, you think about fight or flight, this is your fight one and it kind of raises your blood pressure, stuff like that. And on top of that, it may activate the renin and angiotensin/aldosterone syndrome or the RAS syndrome. And this is the one where our most common medications affect, you know, a lot of times we're looking at our ACE inhibitors, our ARBs, things like that. We work on the renin/angiotensin/aldosterone system to decrease our blood pressure. So adiposity may affect all those things. And obesity may also lead to mass hypertension and increased pulse pressure due to increased cardiac output during everyday activity. So if you have extra tissue, you gotta work a little bit harder and it's, yeah. So that can sometimes happen and lead to risk factor for hypertension as well. So we're not sure necessarily why, but we think adiposity, insulin resistance plays a role. The next one we talk about is aortic stenosis. Aortic stenosis is essentially a hardening of one of the valves of your heart. And obesity has been demonstrated to be a risk factor for aortic stenosis development. And they found this study and they mentioned at least that an increase in BMI of only one kilogram per meter squared. So one number increases the risk of aortic stenosis by over 50%. So that's quite a bit. And another one, and we talk about the last one here is aortic aneurysm. Aortic aneurysm is kind of an outpouching of a blood vessel and obesity has once again been associated with that. And it's a frequent in, you know, when we see aortic aneurysms, a complication and risk factor that. So lots and lots of cardiovascular diseases that are tied to obesity. So once again, this is just, this is the biggest cause of these is cardiovascular disease, but obviously cardiovascular disease, stroke, aortic aneurysms, all those things are bad. We don't want to get them. And they have a direct relationship to obesity and increased adiposity. So that's interesting. So let's talk about lung. So this is one that was very kind of interesting, intriguing to me, 'cause I didn't think it would necessarily make a difference you know, in your lungs, like what's going on? Well, inflammation can affect your lungs too, not chocolating. And obesity seems to have a tie with predominantly asthma. When we talked about these lung pathologies is predominantly asthma. It seems like obesity does have a risk of that. And weight loss interventions seem to improve lung function in asthmatic patients, specifically in children's they're mentioning. And maternal obesity can increase the risk of developing asthma. And so we typically, once again, have extra adipose tissue that causes inflammation. And this inflammation is seen in a higher level than those who have obesity. And that can lead to inflammation in lungs causing things like asthma, which is I thought super interesting. And metabolic dysfunction actually was found to be a stronger predictor of asthma than development, than fat mass and obesity. So specifically metabolic dysfunction, what that means is, you know, more like or insulin resistant or on that spectrum, that seemed to be a better indicator than necessarily fat mass or, you know, in obesity. So more metabolic dysfunction, but once again, they go hand in hand, right? We're talking about metabolic syndrome, all those things. So they definitely go hand in hand. But once again, I thought this kind of interesting that your lungs can be affected by obesity too. Moving on to diabetes, we are definitely struggling to diabeat this. That is a reference to the office, but type two diabetes is the most common comorbidity obesity. And severe obesity incurs a lifetime risk of developing type two diabetes by about 70 to 75%. So in this study, they mentioned like severe obesity. They didn't really mention what that was, but they're saying pretty much a lifetime risk of developing diabetes if you have severe obesity is like 70, 75%. So you're pretty much saying, hey, yep, if you are at a severe level, which I imagine for them is probably like 35 or 40 BMI, probably somewhere around there that I didn't mention, but really increases your risk of having type two diabetes. And more than about 80% of patients with type two diabetes are obese. So obviously every once in a while we get people who are not obese, right? Have a normal BMI and you're like, oh, this is definitely abnormal. But the vast majority of patients who have type two diabetes are indeed obese. And more than 6% of the world's population have type two diabetes and over 1 million deaths per year can be attributed to the disease. This is one you don't wanna get folks. For anybody who's ever taking care of patients with diabetes, specifically it's not well controlled. It really leads to a lot of issues. It leads to issues with your eyes, with your lungs, with your kidneys, with your heart, with like literally anything that has blood vessels there, like we can have issues with it. So predominantly what we see are increased risk of heart attacks. We see wounds, diabetic foot ulcers that leads to amputations and all that stuff. So there's just a lot of stuff. And we now know there's a causal link between obesity and type two diabetes and that's well understood and we wanna protect that. And the mechanism behind that, a little less clear, but evidence suggests that a combination of at least three factors are playing. One is increased insulin resistance due to once again, chronic adipose tissue inflammation and dysregulation of different cytokines. Two might be increased hepatic leukoneogenesis. So we're just making more glucose 'cause we think we need it. And then decreased function of the pancreatic beta cells where the insulin comes from. We think those are kind of like the causal things and it's led and triggered by a lot of times inflammation. And yeah, so that's just something I thought that was interesting. And another comment, we talked about type one versus type two. Type one also seems to have a some association, both parental and maternal obesity do seem to increase the risk of developing type one diabetes in their offspring. So in your kids, a higher risk. So patients who have obesity have a higher risk of having children who have type one diabetes. And like I said, we're learning more and more and more about autoimmune diseases and stuff like that. But overall, the theme that we're constantly seeing here over and over and over is that increase adipocytes leads to increased inflammation and leads to bad stuff is pretty much the simpleton way of thinking about that. So moving on here, next we're talking about a gut wrenching reality of essentially hepatostatosis and cirrhosis. So there's something called metabolic dysfunction associated with steatotic liver disease or MASSLD formerly known as non-alcoholic fatty liver disease. That's so much easier, so much easier non-alcoholic fatty liver disease, but they separate it now and that's okay. But it's characterized by excessive fat accumulation liver. And over nutrition is the primary cause of this MASSLD and obesity or overweight is one of the five cardio metabolic criteria for massively diagnosis, right? You don't just get that if you are metabolically healthy, it happens being metabolically unhealthy. And the prevalence of this massively and overweight and obese patients is around 70 to 75%. And I can attest to this, man, it seems like every time I have a patient who has obesity and I'm worried about and they're just, their A1C is not good and their blood sugars are bad. I'll check a lot of times labs looking at their liver numbers and quite frequently their liver numbers are elevated. It's almost always because of this super common thing. And then if they lose a bunch of weight, it seems to get better and improve most of the time, which is crazy. And the reason we care so much about this is because this can then progress to something called cirrhosis. And cirrhosis is really bad. It's kind of essentially scarring of the liver tissue and it is reported in about nine to 12% of morbidly obese patients. And so, yeah, that's it. But as I mentioned before, weight loss leads to reduction in hepatic steatosis and massively patients in a dose dependent manner. Meaning the more you lose, the better you're gonna get on that. So that's a big one. That's probably the most common one that we see, you know, all over primary care. Like every single day, you'll pretty much see that in patients who are not well controlled. Another one to mention though is inflammatory, bowel disease. So things specifically like Crohn's. There does seem to be some association with obesity and Crohn's. And it seems like obesity increases the risk of Crohn's disease in a more rapid clinical course. That is one that is still being explored, but I thought it was interesting. And another one is pancreatitis, which you see quite frequently as well. Obesity does increase the risk of acute pancreatitis. Hypertriglyceridemia, which is common in obese patients, also can be tied to pancreatitis. So once again, hand in hand, obesity, inflammation, dysfunction in your lipid panel, high triglycerides, that is a big risk of pancreatitis as well. And yeah, that's one that we've seen pretty commonly and definitely not a fun one. Anybody who's ever taken care of anybody hospitalized for pancreatitis knows it does not look like a fun time. So that is another one there. Moving on here, it's all in your head and fat cells talking about cognitive impairment and the relationship there. And there have been links between overweight and obesity with cognitive impairment. Specifically adiposity and its comorbidities, you know, it does influence both the development and potential progression of the most common neurodegenerative diseases. So specifically Alzheimer's we're talking about here, Parkinson's our big one. Alzheimer's, there's an association between midlife obesity and Alzheimer's, diagnosis later in life. And metabolic syndrome as a consequence of obesity might be a strong risk factor. So once again, a lot of times we're saying, oh, like it's obesity. It's very hard to isolate that out, right? It's not gonna be like, hey, we're gonna give you obesity and you not obesity and see what happens in life. Like we can't do those trials. So we're saying we, you know, run statistical analysis, the fancy ones and the covariates trying to pull out confounders and they say, oh, we think it's the obesity. How do you tie that away from the metabolic dysfunction? Oh, it's really hard. 'Cause a lot of times if you have increased adiposity, obesity, you're gonna have metabolic dysfunction as well. So they're saying here though, it might be more your metabolic dysfunction that is linked to the stronger risk for Alzheimer's disease, but not entirely sure. And for Parkinson's, they did find that abdominal obesity or waist circumference and body shape index have been found to be significantly increased, increased risk for Parkinson's disease. And once again, type two diabetes, the risk factor for Parkinson's. Another one they mentioned in this study is multiple sclerosis and obesity in either childhood, adolescence or early adulthood has been shown to significantly increase the risk of MS later in life, which is interesting. And there's a, seems to be a causal relationship between both BMI and visceral adiposity once again. And they actually did that through Mendelian randomization. So Mendelian randomization means you look at a trait. One group has one trait, one group does not have the other and see what happens in them saying, hey, the ones that are triggered that have a higher, you know, BMI and visceral adiposity tend to have a higher risk of MS. You know, this one's not quite as strong and well-known. Alzheimer's a little more well-known, but there's a lot of people talking about this now, right? They're kind of saying, have you heard some people say that Alzheimer's is type three diabetes, which I mean, I don't know what to make of that, but they're saying that it's so strongly associated with metabolic disease. So there's definitely something to that, which I thought was really interesting. All right, so now let's move on to the link between obesity and cancer. And there's a well-established link between many types of cancer and obesity. Globally about 4 to 8% of all new cancer diagnoses in adults and between 5 to 20% of all cancer deaths have been attributed to obesity. So that's pretty significant. And some cancers show particularly strong associations with BMI, specifically gastrointestinal, uterine, kidney, pancreatic and breast cancers. And as I mentioned before, esophageal cancer, obesity is a major risk factor. Colorectal cancer, it seems like weight gain in adulthood and early life increase your risk for colorectal cancer. And they've even shown that really interesting bariatric surgery for weight loss has been shown to reduce the risk of colon cancer by approximately 27%. So just the act of losing the weight seems to decrease the risk for cancer. Gynecologic cancers, carcinoma of the endometrium is the most common and shows strongest correlation with obesity. Breast cancer, there are definitely ties to that. In post-menopausal women, obesity is positively correlated with a increased risk of cancer. Pancreatic as well, several meta-analyses have found a significant increased risk of pancreatic cancer in obese individuals, which is interesting. And weight loss induced by bariatric surgery, once again, has been shown to significantly reduce the risk of pancreatic cancer, which I thought just absolutely fascinating. Once again, showing that the weight loss does do something. It's not just weight. We know that that's important. And you used to just be like, oh, like, it's good to lose weight because it's good to lose weight. But we've learned now like how inflammatory adipocytes can be and just extra adipose tissue can be inflammatory. That's not ideal. And there's one thing I did wanna mention real quick, and you may see this online. This is why I wanna mention. It's called the obesity paradox. So they'll say, oh, obesity is actually good or being overweight is good sometimes. Sometimes in the data, increased BMI seems to be beneficial. And the obesity paradox actually has been recognizing cardiovascular disease patients for over two decades, yet remains kind of controversial. But there have been more recent data looking at this. And these analyses that looked at waist to hip ratios instead of BMI have not found a protective effect about apostasy. So what they did essentially, you know, BMI is crude, right? It's just height over, it includes your height and your weight. It's all it is. It doesn't do anything about body composition or fat distribution. They're saying when you look at a waist to hip ratio, that is measuring how your fat is distributed through your body. That has a much closer tie to that and does not seem to have a protective effect. So essentially they saw people who have really big hips and their fat distribution is around their belly, you know, visceral fat, all that stuff, that those people do not seem to be protected. You know, obesity and BMI, for those people may seem protective, but then you actually delve out where that fat's being stored does not seem to be doing that. And they thought maybe they found this protection because it was due to a reduced cardiovascular fitness, sarcopenia and increased fidelity in the non-obese groups, meaning the non-obese groups were like not healthy to begin with. So like comparing them didn't seem to matter. But once again, we're looking for kind of body fat distribution, it seems to matter. And the obesity paradox has also been observed in cancer patients. And once again, it seems like body composition may matter. Obese patients with sarcopenia have the worst outcomes. So there may not be a paradox when using better markers for adiposity. Once again, sarcopenia means also decreased muscle mass. So when you have increased adiposity, so increased fat and decreased muscle, that is a really bad recipe. And so those people had the worst outcomes. They're saying probably has more to do with body composition once again, than necessarily just that. However, there was one interesting one they mentioned ALS. So amyotrophic lateral sclerosis. It's one of the few examples of these NCDs in which obesity seems to be protective. You know, the thought here is maybe there's a larger energy reservoir at the disease onset, which could prolong the health span of ALS patients. I thought that was kind of interesting. You're gonna find every once in a while, right, you'll find something like smoking actually can be protective of certain types of like colon disease. So it's like one of those things, it's not an example of like, oh, this is why it's okay. No, it's not ideal. We're definitely not going for that. So overall though, obesity is bad, but the people who have it are not. That's the biggest thing I wanna say. There's definitely a clear link between non-communicable diseases or chronic diseases and obesity. And obesity is that leading cause for developing these chronic diseases. Obesity is also linked to those NCDs that have grave consequence, right? So these are big things we're talking about here. Developing diabetes, hypertension, heart attacks, strokes, I mean, you name it, it's associated with obesity. They have grave consequences, but I think there's, we have to be careful, right? There's definitely an urgent need for enormous lifestyle change, right? So we need to change our food environment, maybe medications, lots of things. There's lots of things we have to do, but I wanna make sure we separate having obesity and those people who have obesity, right? So there's a clear link and it is not healthy. I mean, anybody who goes out there and says like, you can have adiposity and it's totally fine. I'm not worried about you. You got no risk for anything. They are maybe, I'll generously, I'll say they are misconstruing the data a little bit is how I say, I'll try to be charitable with that take. Couldn't, can you be metabolically healthy and have extra adiposity? Absolutely, you can, you can. But what we're showing here and what I'm trying to purvey here is that when you have increased adiposity, increased fat cells, lots of them, you are by definition, gonna have probably more inflammation in your body. And that is a ticking time on for bad things to happen. You don't want us to have uncontrolled, unchecked inflammation in your body. And that's what happens when we have excess adiposity. So once again, that's not to say, hey, you can run around with nothing, no body fat and you're gonna be perfectly healthy. That's not the case. Life's much more complicated than that. But like saying what's dangerous is when you say, hey, it doesn't matter at all if you're obese, like you can be healthy at any size, no matter what. And I think, yes, I want you to say that we want to strive to be metabolically healthy and continue to exercise and it doesn't matter what your size, do the right things, exercise, that's great. I want you to get amazing benefits from that. But to say that there's no association or anything like that, I just think that's, yeah, that's disingenuous and that's not helpful and it is a risk. But once again, separating that issue that people have versus those people, the people still deserve love and respect and good medical treatment. And that's something that's really important. I wanna say that a lot of times we'll just blame things they're like and forget, oh, you have obesity, that's it. There can be other issues as well. It's not necessarily a cause of everything. I might say it has a lot of causes and a lot of issues that may be related to, absolutely, but it's not everything. So that's just a big takeaway is that separate that, this is a disease someone has. This isn't something I always talk about. People who have high blood pressure, there's no real stigma there. You can't see it, someone walking around and you can't see someone has high blood pressure. And also in the medical community, it's like, oh, they have blood pressure, yep, let's treat it and let's keep moving on, let's work on other things. Like obesity is like the one disease where it's like, you can see it, right? You can see it on someone and we get fixated on it saying like, okay, this is causing everything. Yes, should you work on it? Yes, it's a risk factor and I will talk about it and we should work on it. And that is absolutely imperative, but there's a person underneath that who is struggling with that, who understands that as well. And so, yeah, just be kind and courteous and it's a lot more challenging for some people than others. And so that's just my one caveat there. But overall, that's gonna do it for the podcast today. Thanks so much for stopping by, I really appreciate it. If you liked this, it would mean the world to me. If you liked the video on YouTube, subscribe to the podcast or YouTube channel or share this with a friend. I mean, if you share it, that's the highest compliment you can give me. Now get off your phone, get outside and have a great rest of your day. We'll see you next time. Disclaimer, this podcast is for entertainment, education and informational purposes only. The topics discussed should not solely be used to diagnose, treat or prevent any condition. The information presented here was created with an evidence-based approach, but please keep in mind that science is always changing. And at the time of listing this, there may be some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified healthcare provider for questions regarding any medical condition.
