I asked Katz if, after removing all lifestyle confounders, it really is the body fat itself that is so damaging. "When you look at it from all angles," Katz said, "the conclusion you reach is that an excess of body fat is inevitably harmful." The problem, specifically with abdominal obesity, is that it infiltrates the organs. "Especially the liver, which interferes with insulin metabolism. Then the pancreas pours out extra insulin, and it creates a self-generating cascade that leads directly to diabetes and increased cardiac risk." He spoke of research showing an increased risk for most forms of cancer as well.