Empowered Health Course · Lesson 12 · 2:18
We use type 2 diabetes as a model of "sick fat disease." As we've discussed, when the fat under the skin becomes inflamed, you get spillover of fat into the internal organs. On the right, healthy fat cells store fat well — and that can happen at different body sizes. Some people in larger bodies store fat very well, as do some people with lean bodies.
At some point, for some people, the fat cells under the skin overfill and become inflamed, and you get spillover into internal organs, including the liver and pancreas. This too can happen at different body sizes — in someone fairly lean with a BMI of 25, or in someone with a higher BMI.
In pre-diabetes, fat accumulates in the pancreas, and the body stops listening well to the hormone the pancreas makes — insulin — so the pancreas makes more of it. The reason there's pressure to act is that this is time-sensitive: the longer we wait to treat the adiposopathy, or sick fat disease, and to help with weight maintenance, the greater the risk of diabetes and pancreatic dysfunction.
This transcript has been lightly edited from the video for readability. For the complete experience, please watch the video above.