The hidden chain — How obesity silently leads to diabetes, heart disease

Murthy Chavali

Jan 13, 2026

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Imagine a cascading set of dominoes, each piece striking the next in an inevitably accelerating sequence. This is the metabolic story of obesity.

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Understanding this chain — from fat accumulation to insulin dysregulation to diabetes to cardiovascular issues  — is essential for recognising why early intervention matters.

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The journey does not begin with high blood sugar or heart attacks, but with fat cells doing what they were designed to do: expanding.

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When excessive calories accumulate, white adipose tissue (fat) expands, but in obesity, something more sinister occurs.

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The tissue undergoes pathological remodelling characterised by chronic inflammation, fibrosis, and abnormal hormone secretion, leading to metabolic liability.

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Visceral fat, the intra-abdominal fat surrounding organs, emerges as the primary villain in this story.

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Understanding this chain of causation underscores why obesity in India represents not merely a cosmetic concern but a public health emergency requiring urgent, intensive intervention.