Your body fat says something about you, and you might not like what it’s saying…

Introduction

All too often, people get hung-up about their body weight in all the wrong ways. It’s common for people to wear their bodies like a fashion garment, desperately wanting to portray a certain image, even if that image isn’t real. In such instances, the idea that our body talks for us is quite common, but what if I told you that your body is quite literally communicating, sending and receiving messages, twenty-four-hours a day, seven days a week? And what’s more, your body-fat is actively taking part in that conversation, but what it has to say is often not good.

The conventional view of adipose tissue as passive fat storage is long outdated. Contemporary science reveals that adipose tissue is a dynamic endocrine organ, immunologically active and metabolically influential. The recent Nature (2023) article, 'Adipose tissue as a central metabolic and immunological organ' by Brestoff et al., brings together diverse strands of research that demonstrate the complexity of this tissue as both a sentinel of systemic health and a key modulator of inflammation. This brief review integrates that perspective within the broader scientific literature to explore how adipose tissue behaviour informs modern health and performance.

Adipose Tissue: Beyond Energy Storage

Adipose tissue is classified into three major types, white, brown, and beige, each with unique functional roles. White adipose tissue (WAT) primarily stores energy, while brown adipose tissue (BAT) dissipates it via thermogenesis, and beige adipose tissue exhibits properties of both. WAT is particularly notable for its endocrine activity, secreting a range of adipokines including leptin, adiponectin, and resistin, each implicated in glucose homeostasis, appetite regulation, and inflammatory control. Rajala and Scherer (2003) highlighted adipocytes as crossroads for inflammation, lipid metabolism, and vascular health, framing them as pivotal rather than peripheral.

Adipose Immunology: Crosstalk and Inflammation

The Nature (2023) review, by Brestoff et al., places strong emphasis on the immunological role of adipose tissue, focusing on the dynamic communication between adipocytes and immune cells. Adipose tissue harbours innate lymphoid cells, macrophages (notably the M1 and M2 subtypes), T-cells, and B-cells. In lean individuals, anti-inflammatory cytokines such as IL-10 and IL-33 predominate, supporting metabolic homeostasis. In obesity, however, pro-inflammatory cascades, particularly TNF-α and IL-6, become dominant, promoting insulin resistance. This immuno-metabolic dysfunction underscores the double-edged nature of adipose tissue as both buffer and amplifier of systemic inflammation.

Depot-Specific Diversity and Functional Implications

Not all fat is equal. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) differ not only in location but also in metabolic impact. VAT, which surrounds organs, is more metabolically active and prone to inflammation. It is strongly associated with insulin resistance, cardiovascular disease, and chronic inflammation. SAT, by contrast, has a more benign or even protective profile in some studies (Ibrahim, 2010). These insights have implications for both clinical risk stratification and intervention design, emphasizing quality and location of fat over sheer quantity.

Metabolic Flexibility and Lifestyle Interventions

Exercise, diet, and thermogenic stimuli (e.g., cold exposure) can shift adipose function toward more metabolically favourable states. Endurance training increases mitochondrial density and enhances the browning of WAT (Stanford et al., 2015). Intermittent fasting and low-glycaemic diets reduce VAT and improve insulin sensitivity (Patterson et al., 2017). Polyphenols and omega-3 fatty acids also modulate adipose inflammation and promote adiponectin expression (Kopecky et al., 2020). These findings empower clinicians and coaches alike to focus not just on fat loss, but on fat optimization.

Conclusion: A Practical Reframing of Fat

Adipose tissue (fat) is not merely a storage depot but a signalling hub and immune organ. Its metabolic behaviour is plastic, capable of adapting to environmental, dietary, and movement-based inputs. As Brestoff et al. (2023) argue, restoring adipose health may be central to addressing cardiometabolic and inflammatory diseases.

For the practitioner or coach, this implies that improving fat function, rather than simply reducing fat mass, should be the primary focus. Targeted lifestyle interventions can reactivate thermogenic, anti-inflammatory, and insulin-sensitising pathways, offering new routes to health resilience.

As with life in general, when it comes to optimising our biological health, good communication is central to achieving optimal outcomes. When it comes to weight-management, and achieving fat-loss, success rests upon meaningful dialogue and an eagerness to listen.

References

Brestoff, J. R., et al. (2023). Adipose tissue as a central metabolic and immunological organ. Nature, 616(7960), 749–760.

Rajala, M. W., & Scherer, P. E. (2003). Minireview: The adipocyte—at the crossroads of energy homeostasis, inflammation, and atherosclerosis. Endocrinology, 144(9), 3765–3773.

Ibrahim, M. M. (2010). Subcutaneous and visceral adipose tissue: Structural and functional differences. Obesity Reviews, 11(1), 11–18.

Stanford, K. I., et al. (2015). Exercise reduces risk and alters the trajectory of age-associated metabolic disease. Cell Metabolism, 21(1), 162–174.

Patterson, R. E., et al. (2017). Intermittent fasting and human metabolic health. Annual Review of Nutrition, 37, 371–393.

Kopecky, J., et al. (2020). Adipose tissue immune response: Novel insights into the mechanism of action of polyunsaturated fatty acids. Trends in Endocrinology & Metabolism, 31(3), 228–238.