How efficient is your metabolism? The answer depends on fat tissue

When it comes to your metabolic health, the amount of fat tissue in your body—and the way it is distributed—are the keys to good health. Within this growing field of metabolic medicine, specialized physicians are helping patients manage their obesity as a chronic disease and also providing nutritional support for malnutrition. These two health conditions often go hand-in hand.

Vlad Proudan, MD, a metabolic medicine specialist at Atlantic Health, answers some of his patients’ most common questions about fat tissue, cell health, and metabolism—and why it’s so important to maintain a healthy balance of fat tissue in your body.

1. What is dysfunctional fat tissue and how does it affect my health?

Excess fat tissue that accumulates in places it shouldn’t—around the liver, pancreas, heart, and kidneys—is called dysfunctional fat tissue. This kind of fat is metabolically active, which means it can damage vital organs. It's different from ‘normal fat’, which doesn’t have the same harmful effects.

2. How does metabolic syndrome affect my weight and health?

Simply put, metabolic syndrome is a cluster of symptoms that includes high blood pressure, high blood sugar, abnormal cholesterol levels, and increased fat around the waist—which is early warning signs of dysfunctional fat accumulation.

3. Could I be obese without having diabetes or metabolic disease?

If fat is distributed in places where it doesn’t belong—around your vital organs—it can cause health issues even if you’re not excessively overweight. On the other hand, if fat accumulates in your lower body only, you could be obese without having any metabolic issues.

4. What markers test for dysfunctional fat tissue?

We test for insulin resistance, inflammation, and hormonal imbalances. Body composition devices help us assess fat distribution and its impact on the organs. A family medical history and full blood panel also provide valuable insight. For our purposes, body mass index (BMI) is rarely a helpful marker.

5. Do you use medications to treat metabolic disorders?

Yes. Medications help treat the underlying issues caused by dysfunctional fat. GLP-1 medications are typically part of a patient’s overall weight loss plan. However, the best way to improve long-term metabolic health is through balanced nutrition, regular exercise, and healthy lifestyle choices.

6. Is metabolic medicine different from bariatric surgery for weight loss?

Metabolic medicine treats the root cause of obesity. Although bariatric surgery can induce significant weight loss, metabolic medicine takes a more holistic, long-term approach to managing weight and metabolic health. Our emphasis is on personalized education, prevention, and progress.

7. Is it important to have some fat in my body?

Yes, healthy fat tissue works very hard in your body. It supports energy storage, protects your organs, and helps produce hormones. It’s only when there’s too much fat tissue that it becomes dysfunctional and can lead to metabolic problems.

8. What happens if I have too much fat tissue?

When there is too much fat around your organs, it is known as visceral fat or dysfunctional fat tissue. This type of fat can lead to long-term health problems such as heart disease, diabetes, fatty liver disease, kidney damage, and more.

9. How did I get so much dysfunctional fat tissue in my body?

It’s all about your metabolism and how your cells convert food into energy. Overconsumption of sugary, processed foods and a sedentary lifestyle can slow down your metabolism. Genetics and natural aging also play a role.

10. What are the signs of dysfunctional fat tissue?

Excess fat tissue can cause continued weight gain, especially around the abdomen. It can make you feel fatigued after meals and increase your cravings for sugary and processed foods. You may even notice you’re extra thirsty or you’re urinating more frequently—all signs of insulin resistance.