Research paper
Björntorp P. Body fat distribution, insulin resistance, and metabolic diseases. Nutrition. 1997 Sep;13(9):795-803. doi:10.1016/S0899-9007(97)00191-3
Why we cite it
Review article examining how central (abdominal) body fat distribution leads to insulin resistance and metabolic disease. The central mechanism: the HPA axis is hypersensitive in abdominal obesity, producing elevated cortisol and reduced sex steroid and growth hormone secretion — these endocrine disturbances direct fat storage specifically to visceral depots and drive insulin resistance. Stress-related factors (depression, anxiety, alcohol use, smoking) sensitise the HPA axis, and a primate model shows that mild psychosocial stress is followed by the same cluster of psychological, endocrine, anthropometric, and metabolic abnormalities seen in humans — the animal work is what carries the causal argument, and Björntorp says it “strongly supports” rather than establishes the human case.
About the author
Per Björntorp (1931–2003; MD, PhD) was Professor of Internal Medicine at Sahlgrenska University Hospital, University of Gothenburg, Sweden (1977–1996) and Head of the Department of Internal Medicine until his retirement in 1996. His later career focused on the stress → HPA axis → abdominal obesity pathway. Awards: Willendorf Prize (1983), Söderberg’s Award (1990), FRCP (1991), Wasserman Award (2000), Henry Sebrell Award (2002). Edited the International Textbook of Obesity (Wiley, 2001).