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Nat. Rev. Endocrinol. doi:10.1038/nrendo.2017.90 Figure 1 Adaptive and maladaptive phases of inflammation in metabolic disease Figure 1 | Adaptive and maladaptive phases of inflammation in metabolic disease. In chronic inflammatory diseases, an initial stress gives rise to a physiological adaptive response intended to alleviate the stress. Over time, the adaptive response morphs into a maladaptive response that has pathological effects. In the case of obesity, the initial trigger is homeostatic stress triggered by the anabolic pressure of a positive energy balance. The adaptive inflammatory response is catabolic, and alleviates the anabolic pressure and supports the expansion of adipose tissue. However, over time, the system strives to re‑establish homeostasis with a new set point for weight, blood levels of sugar and other hormones, culminating in the pathological effects of long-term obesity. Reilly, S. M. & Saltiel, A. R. (2017) Adapting to obesity with adipose tissue inflammation Nat. Rev. Endocrinol. doi:10.1038/nrendo.2017.90