Cardiovascular Disease and Stroke (P Perrone-Filardi and S. Agewall, Section Editors)

Current Atherosclerosis Reports

, 16:409

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Adiposopathy, “Sick Fat,” Ockham’s Razor, and Resolution of the Obesity Paradox

  • Harold BaysAffiliated withLouisville Metabolic and Atherosclerosis Research Center Email author 


Among lean populations, cardiovascular disease (CVD) is rare. Among those with increased adiposity, CVD is the commonest cause of worldwide death. The “obesity paradox” describes seemingly contrary relationships between body fat and health/ill-health. Multiple obesity paradoxes exist, and include the anatomic obesity paradox, physiologic obesity paradox, demographic obesity paradox, therapeutic obesity paradox, cardiovascular event/procedure obesity paradox, and obesity treatment paradox. Adiposopathy (“sick fat”) is defined as adipocyte/adipose tissue dysfunction caused by positive caloric balance and sedentary lifestyle in genetically and environmentally susceptible individuals. Adiposopathy contributes to the commonest metabolic disorders encountered in clinical practice (high glucose levels, high blood pressure, dyslipidemia, etc.), all major CVD risk factors. Ockham's razor is a principle of parsimony which postulates that among competing theories, the hypothesis with the fewest assumptions is the one best selected. Ockham’s razor supports adiposopathy as the primary cause of most cases of adiposity-related metabolic diseases, which in turn helps resolve the obesity paradox.


Adiposopathy Adiposity Cholesterol Diabetes mellitus Lipids Metabolic syndrome Obesity Obesity paradox Ockham’s razor Sick fat