When we think of the fat on our bodies, we tend to associate it with just hanging out and not really doing much of anything. What we’ve learned over time, is that it couldn’t be farther from the truth. Fat, also known as adipose tissue, is truly active—metabolically speaking. While it forms to store those extra calories our body doesn’t really need now, fat doesn’t just take a holiday and wait to be called into action. Fat communicates with the other cells in your body and sometimes the messages aren’t so great.
Your fat network, a term I use, consists of fat cells, nerves, blood vessels and immune cells. I like using the term network because it highlights how fat is not a solitary, lonely tissue just hanging out. Fat may seem quiet but it’s biologically busy—like a house at night where the lights are off, but the electricity, plumbing and Wi-Fi are all still running. Fat is a major part of our endocrine system and a key player for metabolic function in the body.
Our fat is divided into three main types: subcutaneous, visceral and brown fat. Subcutaneous fat (white fat), found below the skin, is the one we tend to focus on more because we can actually pinch it or it gives us the famous muffin top. Subcutaneous fat’s primary purpose is to store those extra calories and help insulate our bodies and maintain our temperature. Belly fat, known as visceral fat, is found in between your internal organs. When someone has too much visceral fat, they present with a large abdomen that seems tight. If someone has too much visceral fat, then it can interfere with organ function and lead to health issues like insulin resistance, diabetes, high cholesterol or heart disease and metabolic syndrome. And finally, brown fat, which I call boutique fat, is often found in the neck, chest and shoulders. It can store energy but also has a superpower because it also produces energy in the form of heat, which helps burn excess white fat. Most people think of brown fat during infancy. In fact, brown fat makes up 2% to 5% newborn total body weight but this decreases as we get older. Interestingly, athletes have higher amounts of brown fat compared to the average adult. So yes, another reason to hit the gym!
So what are all these communication signals in the fat network actually doing? The chemical messengers are called adipokines and help regulate metabolism, appetite, and inflammation. White fat, which includes both visceral and subcutaneous fat, produces leptin, adiopoleptin and resistin. Leptin tells your brain that you’re full and suppresses your appetite, which is a good message to have. Adiopoleptin increases insulin sensitivity and reduces inflammation, another positive. However, resistin, a bad actor, can cause insulin resistance. Fat also produces TNF-alpha and IL-6 Inflammatory messengers that help cells communicate and can contribute to chronic diseases.
The dilemma with our fat is having too much or too little of it. When we have too much, our fat produces less beneficial adiponectin and increases resistin and other proinflammatory cytokines which fuels inflammation with skin conditions like psoriasis. Psoriasis patients tend to have more visceral fat, which is metabolically active. Being obese is a risk factor for developing psoriasis and psoriatic arthritis. In addition, obesity is also associated with more severe psoriasis and a reduced response to psoriasis therapies. The psoriasis-obesity connection is rooted in fat making metabolic noise and fueling inflammation.
Trotter’s Take: Think fat isn’t on the move? Think again. Fat is metabolically active and needs to be addressed as a part of a complete therapeutic regimen for psoriasis.
Fat does more than store–it stirs the pot. Listen to my podcast with Dr. E. James Song on obesity, inflammation and psoriasis.
