The Thread of Inflammation in Obesity, Diabetes, and COVID

People who think of obesity simply as a disease of fatness are walking around with a profound misunderstanding of this disease – it is very much a disease of inflammation. This thread of inflammation ties obesity to diabetes and ties both of those diseases to the complications of COVID.

New research on COVID and diabetes brings this thread into sharp focus.

The Link of COVID to Diabetes

In the pandemic, it became evident that COVID-19 infection was causing new cases of diabetes.

Now, Liuliu Yang and colleagues have published new research to demonstrate how COVID-19 does this. They showed that the infection prompts the activation of pro-inflammatory macrophages in the pancreas. In turn, those cells trigger pyroptosis of pancreatic β cells. Pyroptosis is a type of cell death that is part of a normal immune response to an infection or other stimulus. But when it kills off β cells in the pancreas, diabetes can begin or get worse.

In a nutshell, this is why new cases of diabetes started popping up in people who had COVID.

Explaining the Effectiveness of Obesity Medicines

In an excellent essay for the New York Times, Daniela Lamas explains how inflammation can explain a lot about our chronic diseases – including obesity. To explain this, she considers the remarkable benefits of obesity treatment with GLP-1 medicines that extend to preventing complications of obesity like heart attacks and kidney disease. She says:

“It’s easy to attribute this to the dramatic weight loss provided by Ozempic and other drugs in its class, known as GLP-1 receptor agonists. But that isn’t the whole story. Rather, the drugs’ numerous benefits are pointing to an emerging cause of so much human disease: inflammation.”

A person who looks at obesity through the lens of fatness might think, “Aah! All these other outcomes have nothing to do with obesity and weight loss. They come from a separate effect of these drugs on inflammation.”

But this proves the point. When people understand obesity as simply a problem of fatness or excess weight, they have lost the thread of inflammation that ties obesity to its many complications – heart, liver, and kidney disease, just to name a few. The list is quite long and inflammation is the thread running through all of it.

Click here for the study by Yang et al and here for the essay by Lamas. For more on the Yang study, click here.

The Mice at Work, Threading the Needle; illustration by Beatrix Potter / WikiArt

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September 18, 2024