What can excessive body fat lead to in terms of metabolic health?

Excessive body fat can lead to insulin resistance and type 2 diabetes due to the way that excess adipose tissue interacts with the body's metabolism. When there is an overabundance of body fat, particularly visceral fat located around the organs, it can negatively affect insulin signaling. This results in the body's cells becoming less responsive to insulin, the hormone responsible for facilitating the uptake of glucose from the bloodstream into the cells. Over time, this can lead to chronically elevated blood sugar levels and ultimately contribute to the development of type 2 diabetes.

In contrast, the other options present scenarios that do not align with the effects of excessive body fat. Increased energy levels and enhanced immune function are typically associated with healthy body composition and fitness levels, not excessive fat. Improved cardiovascular fitness and agility usually require lower body fat percentages and higher levels of physical activity. Lastly, excessive body fat is often linked to higher cholesterol levels rather than lowering them. Therefore, the relationship between high levels of body fat and the risk of developing insulin resistance and type 2 diabetes is well established, making that the correct answer.