Is visceral/abdominal fat a thickening of the submucosa and a cirrhosis/mesentery layer of the GI tract? Does it accumulate as a protective response in the event of intestinal permeability, and is it an accurate indicator [of] gut-related pathologies?

I think of visceral and abdominal fat, I think of it a little bit more as, like, obesity, and that’s where some of the extra calories are being stored. I mean, I think I have plenty of thin patients with intestinal permeability or GI-related pathologies who are pretty thin, and on CT [computed tomography] scan, we don’t necessarily see any stranding, etc. Even a little bit of intestinal permeability, I don’t think you’re necessarily going to see a strong inflammatory reaction outside of the gut wall in terms of looking macroscopically. I think visceral and abdominal fat, the way I’m thinking about it a little bit, more is that’s just where some people have fatty accumulation. You can talk about the gynoid and android body types in terms of where people store their fat. If you have, like, estrogen dominance, in particular, you’re going to [have] your fat stores around your hips and get that more classic pear shape, and the sort of apple shape or android phenotype that you’re going to get, I think this is just kind of where people are storing their excess fat. I don’t necessarily think of it as an indicator of GI pathology. Of course, the two often go hand in hand if you’re not metabolically healthy. We know that abdominal fat is higher risk in terms of cardiovascular disease and more often associated with being less, kind of, metabolically healthy. Certainly, I think the two can be correlated without causation. Hopefully, that answers that question.