OBESITY AS A CHRONIC INFLAMMATORY CONDITION
DOI:
https://doi.org/10.31435/ijitss.1(49).2026.4878Keywords:
Obesity, Metaflammation, Adipose Tissue, Inflammatory MacrophagesAbstract
Introduction: Obesity is defined as a disease of civilization, i.e., a non-communicable disease related to lifestyle. Its development is influenced by numerous factors, including environmental, genetic, and psychological factors. It results from disorders of weight control at the central level and can develop as early as childhood, predisposing individuals to obesity during adolescence or adulthood. (1)
Objective: The aim of this review was to present obesity as a cause of low-grade chronic inflammation in the body.
Method: In order to present obesity as a cause of low-grade chronic inflammation in the body, a systematic review was conducted between 2020 and 2025, covering the PubMed database.
Conclusions: Obesity causes chronic low-grade inflammation in the body through various mechanisms, known as meta-inflammation. Excessively developed adipose tissue becomes hypoxic, and the immune cells that flow into it take on an inflammatory phenotype and secrete numerous pro-inflammatory cytokines. Mitochondria, which are essential for proper metabolism, are damaged, ATP production mechanisms are disrupted, and numerous ROS are produced. Cells and tissues become resistant to circulating insulin, leading to the development of insulin resistance. Adipokines, which are essential for maintaining normal body weight, regulating appetite, and acting against atherosclerosis and inflammation, become dysregulated. In the gastrointestinal tract, the intestinal epithelium is damaged and the diversity of intestinal bacteria is reduced. The intestinal endothelium is damaged, peripheral blood flow in the vessels decreases, which promotes the development of cardiovascular diseases. The changes occurring in cells and tissues sustain and intensify inflammatory processes, which promote the persistence of inflammation. The data collected indicates that metaplasia is an important mechanism linking obesity to the development of cardiovascular diseases, cancers, fertility disorders, and autoimmune diseases. Obesity should be treated not only as a metabolic disease, but also as a condition of chronic inflammation with broad systemic consequences. Hence, we should put emphasis on the importance of early prevention and weight reduction in order to avoid complications connected with being obese.
References
Nathan Faccioli, N., Poitou, C., Clément, K., & Dubern, B. (2023). Current treatments for patients with genetic obesity. Journal of Clinical Research in Pediatric Endocrinology, 15(2), 108–119. https://doi.org/10.4274/jcrpe.galenos.2023.2023-3-2
Yárnoz-Esquiroz, P., Olazarán, L., Aguas-Ayesa, M., Perdomo, C. M., García-Goñi, M., Silva, C., Fernández-Formoso, J. A., Escalada, J., Montecucco, F., Portincasa, P., & Frühbeck, G. (2022). “Obesities”: Position statement on a complex disease entity with multifaceted drivers. European Journal of Clinical Investigation, 52(7), e13811. https://doi.org/10.1111/eci.13811
Majcher, A., Czerwonogrodzka-Senczyna, A., Kądziela, K., Rumińska, M., & Pyrżak, B. (2021). Development of obesity from childhood to adolescents. Pediatric Endocrinology, Diabetes, and Metabolism, 27(2), 70–75. https://doi.org/10.5114/pedm.2021.105297
Schleh, M. W., Caslin, H. L., Garcia, J. N., Mashayekhi, M., Srivastava, G., Bradley, A. B., & Hasty, A. H. (2023). Metaflammation in obesity and its therapeutic targeting. Science Translational Medicine, 15(723). https://doi.org/10.1126/scitranslmed.adf9382
Lee, Y. S., & Olefsky, J. (2021). Chronic tissue inflammation and metabolic disease. Genes & Development, 35, 307–328. https://doi.org/10.1101/gad.346312.120
Xiong, P., Zhang, F., Liu, F., Zhao, J., Huang, X., Luo, D., & Guo, J. (2023). Metaflammation in glucolipid metabolic disorders: Pathogenesis and treatment. Biomedicine & Pharmacotherapy, 161, 114545. https://doi.org/10.1016/j.biopha.2023.114545
Kim, S., Choi, C., Son, Y., Lee, J., Joo, S., & Lee, Y.-H. (2025). BNIP3-mediated mitophagy in macrophages regulates obesity-induced adipose tissue metaflammation. Autophagy, 21(9), 2009–2027. https://doi.org/10.1080/15548627.2025.2487035
Pivonello, C., Negri, M., Patalano, R., Amatrudo, F., Montò, T., Liccardi, A., Graziadio, C., Muscogiuri, G., Pivonello, R., & Colao, A. (2022). The role of melatonin in the molecular mechanisms underlying metaflammation and infections in obesity: A narrative review. Obesity Reviews, 23(3), e13284. https://doi.org/10.1111/obr.13390
Shi, W., Tan, H., Liao, C., & An, Z. (2025). Cross-regulation between adipose tissue innervation and metaflammation: A potential therapeutic target for obesity. American Journal of Translational Research, 17(6), 4087–4100. https://doi.org/10.62347/AIWS5429
Crasan, I.-M., Tanase, M., Delia, C. E., Gradisteanu-Pircalabioru, G., Cimpean, A., & Ionica, E. (2025). Metaflammation’s role in systemic dysfunction in obesity: A comprehensive review. International Journal of Molecular Sciences, 26(21), 10445. https://doi.org/10.3390/ijms262110445
Purdy, J. C., & Shatzel, J. J. (2021). The hematologic consequences of obesity. European Journal of Haematology, 106(3), 306–319. https://doi.org/10.1111/ejh.13560
Li, W., & Chen, W. (2023). Weight cycling based on altered immune microenvironment as a result of metaflammation. Nutrition & Metabolism, 20, 13. https://doi.org/10.1186/s12986-023-00731-6
Zhang, L., Wang, P., Huang, J., Xing, Y., Wong, F. S., Suo, J., & Wen, L. (2024). Gut microbiota and therapy for obesity and type 2 diabetes. Frontiers in Endocrinology, 15, 1333778. https://doi.org/10.3389/fendo.2024.1333778
Bagheri, S., Zolghadri, S., & Stanek, A. (2022). Beneficial effects of anti-inflammatory diet in modulating gut microbiota and controlling obesity. Nutrients, 14(19), 3985. https://doi.org/10.3390/nu14193985
Mallick, R., & Duttaroy, A. K. (2022). Modulation of endothelium function by fatty acids. Molecular and Cellular Biochemistry, 477, 15–38. https://doi.org/10.1007/s11010-021-04260-9
Zhang, A. M. Y., Wellberg, E. A., Kopp, J. L., & Johnson, J. D. (2021). Hyperinsulinemia in obesity, inflammation, and cancer. Diabetes & Metabolism Journal, 45(3), 285–311. https://doi.org/10.4093/dmj.2020.025
Kim, D. S., & Scherer, P. E. (2021). Obesity, diabetes, and increased cancer progression. Diabetes & Metabolism Journal, 45(6), 799–812. https://doi.org/10.4093/dmj.2021.0077
Friedenreich, C. M., Ryder-Burbidge, C., & McNeil, J. (2021). Physical activity, obesity and sedentary behavior in cancer etiology: Epidemiologic evidence and biologic mechanisms. Molecular Oncology, 15(3), 790–800. https://doi.org/10.1002/1878-0261.12772
Caruso, A., Gelsomino, L., Panza, S., Accattatis, F. M., Naimo, G. D., Barone, I., Giordano, C., Catalano, S., & Andò, S. (2023). Leptin: A heavyweight player in obesity-related cancers. Biomolecules, 13(7), 1084. https://doi.org/10.3390/biom13071084
Klein, A. P. (2021). Pancreatic cancer epidemiology: Understanding the role of lifestyle and inherited risk factors. Nature Reviews Gastroenterology & Hepatology, 18(7), 493–502. https://doi.org/10.1038/s41575-021-00457-x
Brown, K. A. (2021). Metabolic pathways in obesity-related breast cancer. Nature Reviews Endocrinology, 17(6), 350–363. https://doi.org/10.1038/s41574-021-00487-0
Gonzalez-Gutierrez, L., Motiño, O., Barriuso, D., de la Puente-Aldea, J., Alvarez-Frutos, L., Kroemer, G., Palacios-Ramirez, R., & Senovilla, L. (2024). Obesity-associated colorectal cancer. International Journal of Molecular Sciences, 25(16), 8836. https://doi.org/10.3390/ijms25168836
Venkatesh, N., Martini, A., McQuade, J. L., Msaouel, P., & Hahn, A. W. (2023). Obesity and renal cell carcinoma: Biological mechanisms and perspectives. Seminars in Cancer Biology, 94, 21–33. https://doi.org/10.1016/j.semcancer.2023.06.001
Marinelli, S., Napoletano, G., Straccamore, M., & Basile, G. (2022). Female obesity and infertility: Outcomes and regulatory guidance. Acta Bio-Medica: Atenei Parmensis, 93(4), e2022278. https://doi.org/10.23750/abm.v93i4.13466
Tang, J., Xu, Y., Wang, Z., Ji, X., Qiu, Q., Mai, Z., Huang, J., Ouyang, N., & Chen, H. (2023). Association between metabolic healthy obesity and female infertility: The National Health and Nutrition Examination Survey, 2013–2020. BMC Public Health, 23(1), 1524. https://doi.org/10.1186/s12889-023-16397-x
Cannarella, R., Crafa, A., Curto, R., Condorelli, R. A., La Vignera, S., & Calogero, A. E. (2024). Obesity and male fertility disorders. Molecular Aspects of Medicine, 97, 101273. https://doi.org/10.1016/j.mam.2024.101273
Tang, S., Wu, H., Chen, Q., Tang, T., Li, J., An, H., Zhu, S., Han, L., Sun, H., Ge, J., Qian, X., Wang, X., & Wang, Q. (2024). Maternal obesity induces the meiotic defects and epigenetic alterations during fetal oocyte development. Advanced Science, 11(30), e2309184. https://doi.org/10.1002/advs.202309184
Bapat, S. P., Whitty, C., Mowery, C. T., Liang, Y., Yoo, A., Jiang, Z., Peters, M. C., Zhang, L. J., Vogel, I., Zhou, C., Nguyen, V. Q., Li, Z., Chang, C., Zhu, W. S., Hastie, A. T., He, H., Ren, X., Qiu, W., Gayer, S. G., Liu, C., … Marson, A. (2022). Obesity alters pathology and treatment response in inflammatory disease. Nature, 604(7905), 337–342. https://doi.org/10.1038/s41586-022-04536-0
Taylor, E. B. (2021). The complex role of adipokines in obesity, inflammation, and autoimmunity. Clinical Science, 135(6), 731–752. https://doi.org/10.1042/CS20200895
Biondi, B. (2023). Subclinical hypothyroidism in patients with obesity and metabolic syndrome: A narrative review. Nutrients, 16(1), 87. https://doi.org/10.3390/nu16010087
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Copyright (c) 2026 Dominika Gieroba, Anna Kamieniak, Kamila Kapłon, Wiktor Werenkowicz, Barbara Tomaszek, Aleksandra Blok, Gabriela Kapłon, Remigiusz Flakus, Karolina Glajcar
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