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Obesity and inflammation: the effects of weight loss
Open accessAbstract
Following the discovery of TNF-α and leptin as secretory products of adipocytes in the early 1990s, subsequent obesity research focused on the new functional role of adipose tissue, as an active endocrine organ. Many more inflammatory peptides have been linked to adiposity, which ultimately characterised obesity as a state of low-grade systemic inflammation, or ‘metaflammation’ which may link obesity to its co-morbidities. The aim of the present review is to examine the effects of weight loss on inflammation in overweight and obese, but otherwise healthy, populations. Studies were broadly classified into four types (diet, physical activity, diet and physical activity combined, and surgical interventions) and discussed according to the method used to induce weight loss. All studies measured at least one obesity-related inflammatory marker (ORIM). The overall finding from the present review is that weight loss does improve inflammation in terms of both the inflammatory (C-reactive protein, TNF-α, IL-6 and leptin) and anti-inflammatory (adiponectin) ORIM. Within this, the greatest improvements in ORIM are observed in studies achieving a weight loss of at least 10 %. However, a number of methodological issues have been identified as potential limitations within the literature including the sex and age of subjects, sample size, study duration and the assessment of body composition. In conclusion, although a period of weight loss per se is capable of reversing the unfavourable inflammatory profile evident in the obese state, further studies are required to determine the time needed, in which a reduced weight is maintained, in order to benefit from improved inflammatory status long term.
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“Obesity activates macrophages, mast cells and T lymphocytes, promoting a low-level inflammation that results in the secretion of tumour necrosis factor (TNF), leptin and growth hormone (GH)57–59.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [58]
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“Many efforts have been made to prevent and treat obesity and to reduce the low-grade inflammatory status, including hypocaloric diets combined or not combined with physical activity and drugs in humans [13].”
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“However, the extent of the inflammatory activation characterising the preceding state of diabetes or subsequently the development of the metabolic syndrome is not as large, and hence is termed “low grade” or “low-intensity” chronic inflammation, evidenced by an increased concentration of circulating inflammatory media…”
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“It has been shown in a wide range of studies that CRP, IL-6, TNF-a, and TNF receptor levels vary by body weight, with higher levels among overweight or obese compared with normal weight subjects, and with decreasing levels during weight loss (Himmerich et al, 2006; Forsythe et al, 2008).”
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Metadata
- Authors
- Forsythe, L. K., Wallace, J. M. W., & Livingstone, M. B. E.
- Affiliations
- University of Ulster (GB)
- Corresponding author
- Livingstone, M. Barbara E.
- Venue
- Nutrition Research Reviews
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-12
- Volume
- 21
- Issue
- 2
- Pages
- 117-133
- ISSN
- 0954-4224 (ISSN-L)
- 1475-2700
- OpenAlex
- W2162846451
- Cited by
- 381
- References
- 132
- Citations by year
- 2026: 12 · 2025: 20 · 2024: 21 · 2023: 21 · 2022: 23 · 2021: 21 · 2020: 28 · 2019: 23 · 2018: 25 · 2017: 15 · 2016: 17 · 2015: 19 · 2014: 28 · 2013: 22 · 2012: 34
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nutrition Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- obesity, weight loss, low-grade inflammation, metabolic inflammation, adipose tissue endocrine function, adipokines, TNF-α, leptin, adiponectin, C-reactive protein, interleukin-6, diet, physical activity, bariatric surgery, weight loss maintenance
- MeSH terms
- Adipose Tissue, Adult, Body Composition, Diet Therapy, Diet, Reducing, Female, Humans, Inflammation, Male, Middle Aged, Biomarkers, Weight Loss, Exercise, Adipocytes, Bariatric Surgery, Overweight
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