I’m no expert, but from what I’ve seen with heart disease is that when the immune system is trying to fight fat, it gets stuck in it. So possibly the people who have the obesity might have the same issue going on. That doesn’t sound right, because it’s the white blood cells that would be stuck. Cytokines (from my biology/anatomy courses) are the signal cells that attach to antigens. Maybe it’s the signalling part that gets stuck and then the brain tries to send out more signals and with immune suppressed people and cancer patients (who are likely immune suppressed from chemotherapy), their brain isn’t signalling for more or it’s not getting stuck or reacting as much. So I bet it’s something like that happening here. Hope that helps.
I just think the difference is that one has an immune system and one doesn’t - hence the difference, even though they both have not great bodies to work with.