Spare tire. Beer belly. Apple shape. Whatever you call it, excess fat around your midsection is bad news — and not just because it makes your jeans uncomfortable.
Belly fat, or what experts call visceral fat, is a particularly dangerous type of fat that forms inside the abdomen. "It's a type of fat that surrounds the internal organs, like the liver and intestines," explains obesity medicine specialist Jaime Harper, MD. "The dangers of visceral fat aren't completely understood, but it has been shown to contribute to inflammation and insulin resistance."
What might that mean for your health, exactly? Here's a closer look at visceral fat and the surprising ways it could harm your health.
Belly Fat vs. Other Fat
Visceral fat — sometimes called hard fat — is different from subcutaneous, or soft, fat, which is the type that sits directly under your skin. "Subcutaneous fat is fat you can pinch. Unlike visceral fat, it sits outside your organs," Dr. Harper says.
Since visceral fat lives deep in your belly, it's not always easy to figure out if you have too much. "You can have too much belly fat even with a normal BMI," Dr. Harper says. So pay attention to your waist circumference rather than the number on the scale.
You might have an unhealthy amount of visceral fat if you're a woman with a waist larger than 35 inches or a man with a waist larger than 40 inches, according to the National Heart, Lung, and Blood Institute.
The Dangers of Belly Fat
More and more, experts are learning that too much visceral fat can pose significant risks to your health. Here's a look at six conditions that have been linked to belly fat.
There seems to be a close connection between too much belly fat and the risk for developing type 2 diabetes, according to research published February 2017 in the Journal of the American Medical Association. One reason may be that visceral fat produces cytokines, which are harmful immune system chemicals that can make cells less sensitive to the blood sugar-regulating effects of insulin.
High Blood Pressure
The cytokines produced by visceral fat don't just affect insulin levels. They can also affect cells' ability to regulate blood pressure. Among the many studies tying belly fat to high blood pressure is research published April 2017 in the journal Heart that followed more than 10,000 Chinese adults for six years. It found that just a 5 percent increase in weight circumference upped the risk for high blood pressure by 34 percent for men and 28 percent for women.
Having too much body fat in general can raise heart attack risk. But belly fat might be particularly dangerous because it pumps out fatty acids that signal the liver to produce more bad cholesterol and less good cholesterol, according to Harvard Health Publishing. In fact, one major study published February 2018 in the Journal of the American Heart Association found that adults who carried more weight around their midsection were more likely to have a heart attack compared to those who were simply heavier overall.
What's more, heart attack survivors who have a larger waist circumference are more likely to have another heart attack down the road, according to study of 22,000 people published January 2020 in the European Journal of Preventive Cardiology. The study authors noted that abdominal obesity increases the risk of a repeat heart attack even when a person is on therapies to reduce other risk factors, such as high blood pressure and high blood sugar.
Too much belly fat could affect brain function, too. A November 2019 study of nearly 900,000 older adults in the journal Obesity found that waist circumferences greater than 35 inches for men and 33 inches for women were tied to a significantly higher risk of dementia — that's regardless of things like age, BMI, blood pressure, cholesterol, liver health or other lifestyle factors. That could be due to visceral fat's ability to increase inflammation throughout the body, the researchers say.
A June 2020 study of more than 6,000 older adults in the International Journal of Epidemiology produced similar results: Having a waist circumference greater than 40 inches for men and 34 inches for women was linked with a 28 percent higher chance of developing dementia over the 15-year study period.
Several studies have found a link between large waist size and asthma risk, even in people who have a normal body weight overall, according to an editorial published February 2013 in the European Respiratory Journal. Higher levels of inflammation are partly to blame. But having more fat in the abdominal cavity could actually make it harder for the lungs to take in as much oxygen as they need, the authors note.
Research has linked too much belly fat to a greater risk for certain cancers. One study published October 2016 in the European Journal of Cancer found that women whose waists were the same circumference as their hips were up to four times more likely to develop breast cancer compared to women with smaller waists. Another, published November 2014 in the journal PLOS One, found that too much belly fat could double the risk for colorectal cancer.
How to Get Rid of Belly Fat
Overall, excess belly fat is particularly bad for your health. The good news is that losing it isn't all that complicated. In fact, it's the easiest type of fat to lose.
Regardless of whether you're trying to burn belly fat or burn fat elsewhere on your body, though, it comes down to eating a healthy diet and exercising, Dr. Harper says. Cut back on your calorie intake by keeping your portions in check and be active every day. "Resistance training is probably more helpful than just cardio to replace fat with muscle mass," Dr. Harper says.
- National Heart, Lung, and Blood Institute: "Assessing Your Weight and Health Risk"
- Journal of the American Medical Association: "Genetic Association of Waist-to-Hip Ratio With Cardiometabolic Traits, Type 2 Diabetes, and Coronary Heart Disease"
- Heart: "Association of 6-year waist circumference gain and incident hypertension"
- Harvard Health Publishing: "Abdominal fat and what to do about it"
- Journal of the American Heart Association: "Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results From the UK Biobank"
- Obesity: "Association Between Waist Circumference and Dementia in Older Persons: A Nationwide Population‐Based Study"
- European Respiratory Journal: "Obesity and asthma: location, location, location"
- European Journal of Cancer: "Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity."
- PLOS One: "Visceral Fat Accumulation Is Associated with Colorectal Cancer in Postmenopausal Women"
- European Journal of Preventive Cardiology: "Abdominal obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction"
- International Journal of Epidemiology: "Higher risk of dementia in English older individuals who are overweight or obese"