The adverse metabolic consequences of obesity are best predicted by the qua
ntity of visceral fat. Excess glucocorticoids produce visceral, obesity and
diabetes, but circulating glucocorticoid levels are normal in typical obes
ity. Glucocorticoids can be produced locally from inactive 11-keto forms th
rough the enzyme 11 beta hydroxysteroid dehydrogenase type 1 (11 beta HSD-1
). We created transgenic mice overexpressing 11 beta HSD-1 selectively in a
dipose tissue to an extent similar to that found in adipose tissue from obe
se humans. These mice had increased adipose levels of corticosterone and de
veloped visceral obesity that was exaggerated by a high-fat diet. The mice
also exhibited pronounced insulin-resistant diabetes, hyperlipidemia, and,
surprisingly, hyperphagia despite hyperleptinemia. Increased adipocyte 11 b
eta HSD-1 activity may be a common molecular etiology for visceral obesity
and the metabolic syndrome.