Portal Circulation

Blood passing through the intesines and its associated fat tissue does not return directly to the heart but passes first through the liver where the absorbed food is metabolized. The system works well in lean people but when the visceral adipocytes become enlarged they produce toxic substances which damage the liver and cause it to release other substances which damage other organs. So, just losing subcutaneous fat by liposuction will not eliminate the metabolic consequences of obesity.

You have dangerous excess visceral fat if your waist circumference at the level of the umbilicus is more than half your height.

Enlarged adipocytes are toxic

When adipocytes become enlarged, for unknown reasons, they secrete factors which attract inflammatory cells, called macrophages which in turn release toxic factors such as the interleukins responsible for damage to the liver and other organs including the arteries and promote the insulin resistance causing type 2 diabetes.

Abdominal obesity is a state of chronic visceral inflammation. Any person with abdominal obestiy is sick regardless of any other measurement such as blood pressure, blood cholesterol or blood glucose. So, eliminating visceral fat must take priority over drugs in preventing these disease of lifestyle.

Visceral Fat

There is now substantial evidence that the metabolic diseases asssociated with obesity, such as hypertension, type 2 diabetes and atherosclerosis are caused in part by toxic substances released by visceral fat. Visceral fat cells (adipocytes) are functionally the same as subcutaneous fat cells but their blood flow is part of the portal circulation.