Many people with stubborn low back pain, neck pain, or migraines are told their problem is purely structural — a worn joint or an old injury. In a conversation with the Low Carb & Fasting podcast, Dr. Gurpreet Singh Padda, MD, MBA, MHP, described a different lens: much chronic pain shares a common root with type 2 diabetes and obesity, which he calls metabolic inflammation. This article summarizes the medical ideas from that discussion — how visceral fat, seed oils, sugar, and food addiction can keep the body inflamed, and the practical diet steps his clinic uses to cool it down.
The common thread: metabolic inflammation
Dr. Padda described metabolic inflammation as the shared nexus behind chronic pain, type 2 diabetes, and obesity — so much so that he said if he renamed his clinic today he would call it a center for metabolic inflammation. In the conversation he noted that most patients do not arrive asking about metabolism; they come in with severe pain, addiction, or another problem that bothers them, and the metabolic issue is found underneath. He described patients who often carry more than one chronic disease at once, and framed the clinic’s job as unwinding those linked problems together rather than treating pain in isolation. The reversal and success figures he cited are practice-reported outcomes, and individual results vary.
How visceral fat and leptin keep the body inflamed
A central idea in the conversation was that fat is not just storage — it behaves like an organ, carrying immune functions alongside energy storage. Dr. Padda explained that fat cells release a hormone called leptin that normally tells the brain you are full. As fat accumulates, the body releases more leptin and can become leptin resistant, so that signal stops registering — and because leptin is also a potent inflammatory messenger, high levels drive body-wide inflammation, especially from visceral fat around the organs. He connected this to insulin: chronically high insulin pushes excess glucose into cells and storage, can strain the mitochondria (the cell’s energy units), and over time contributes to insulin resistance. He also described fat deposited inside muscle as a separate problem that can reduce strength. These are mechanistic explanations offered in the interview, not individualized medical advice.
Why seed oils, sugar, and food can be addictive
Dr. Padda singled out industrial seed oils (omega-6 oils) as directly inflammatory. He explained that they can stiffen cell membranes and blunt the receptors on them, feed the arachidonic-acid pathway toward inflammatory prostaglandins, and often go rancid without any noticeable smell. On sugar, he distinguished fructose — which he said is processed largely in the liver, can promote fatty liver, and activates the dopamine (reward) system — from glucose, which he tied more to serotonin. That reward effect, he argued, is why hyper-palatable processed foods are engineered to keep people coming back, and why he treats food as genuinely addictive. He also flagged artificial sweeteners: even without raising blood sugar, he said, the sweet taste can trigger an anticipatory insulin release and disturb the gut microbiome, though he noted allulose seemed better tolerated by his patients. These reflect his clinical views expressed in the conversation.
What lowering inflammation looks like in practice
Dr. Padda described a sequenced, food-first approach. Early steps include getting patients off vegetable oils and supplementing omega-3s, then moving away from processed refined carbohydrates toward real food, alongside sleep counseling and time-restricted eating to deplete glycogen so the body can begin burning fat and entering ketosis. He said ketosis can itself reduce pain and, in some people, help with migraines. Exercise comes later and carefully: he cautioned that carrying excess weight adds large axial loads to the spine, so mobility and weight reduction come before intense exercise, with walking after meals as a simple starting point. He also emphasized gut-microbiome and sleep hygiene. On cholesterol, he argued that particle count (LDL-P) matters more than the commonly measured LDL-C, and that inflammation, not cholesterol alone, is the driver he watches. This is his clinic’s practice-based framework; individual results vary, and it is not a substitute for personal medical advice.
Frequently asked questions
Can changing my diet really reduce chronic pain?
In this conversation Dr. Padda argued that much chronic pain is tied to metabolic inflammation, and that reducing processed carbohydrates and industrial seed oils while restoring metabolic health can lower the inflammation that keeps pain alive. This is a practice-based approach, and it is used alongside — not instead of — appropriate pain evaluation. Individual results vary.
Will a very low-carbohydrate diet raise my cholesterol?
Dr. Padda said that for most people without familial hypercholesterolemia, the more important measure is LDL particle count (LDL-P) rather than the standard LDL-C, and that he watches inflammation and insulin resistance more than cholesterol alone. He noted some triglyceride rise can occur early, especially with fasting. These points reflect his clinical opinion in the interview and are not a personal recommendation; discuss your own labs with your physician.
Should I stop my diabetes or pain medication if I start a low-carb diet?
No — changes to diet can quickly affect blood sugar and other needs, which is exactly why this must be supervised. Do not start, stop, or change any medication without consulting your physician. Type 1 diabetes in particular was described as more complex and requiring expert oversight. Individual results vary.
Where are you located and how do I book?
Padda Institute Center for Interventional Pain Management, 4477 Woodson Rd, Suite 100, St. Louis, MO 63134. Book at painmd.tv/appointment/ or call (314) 481-5000.
Key takeaways
- Dr. Padda frames chronic pain, type 2 diabetes, and obesity as sharing one root: metabolic inflammation.
- Visceral fat and leptin, plus industrial seed oils and fructose, are described as key drivers that keep the body inflamed.
- The clinic's approach is sequenced — remove seed oils and refined carbs, deplete glycogen and reach ketosis, then add movement.
- Next step: ask the Padda Institute to evaluate the metabolic drivers of your pain rather than treating symptoms alone.
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — Board Certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed July 2026.
This article is educational and is not a substitute for evaluation, diagnosis, or treatment by a physician. Individual results vary. Do not start, stop, or change any medication without consulting your physician.
Find the source of your pain — not just the signal
Padda Institute Center for Interventional Pain Management builds a customized, root-cause plan for each patient. Interventional care and metabolic medicine, under one roof in St. Louis.
Or call (314) 481-5000 or text (314) 886-5902 — 4477 Woodson Rd, Suite 100, St. Louis, MO 63134.
Msg & data rates may apply. Reply STOP to opt out, HELP for help. Text is not a secure channel — please don’t send medical or personal health information by text, and don’t use text for emergencies.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
