Watch Your Waist: Fat Around the Middle Can Be Dangerous

We all know that carrying extra weight is not healthy. But do you know that where you carry your weight matters? It turns out that not all fat is the same. Fat at the waistline can indicate an increased risk for some serious health problems.

Visceral Fat Is Dangerous

Your waist size may shed light on how much “visceral” fat you have. Visceral fat is the fat stored in your abdomen, so it surrounds vital organs like the liver, stomach, small intestines and pancreas. In general, a larger waist indicates more of this kind of fat. In large amounts, it can damage these organs.

It can also be the first clue that someone will develop insulin resistance, a steppingstone to Type 2 diabetes if not reversed. And it raises the risk of heart disease, cancer and Alzheimer’s.

“It’s the most dangerous kind of fat,” said Dr. Susan Anderson, a medical director with Blue Cross and Blue Shield. “The good news is that lifestyle changes, and not medications, are your best bet to not only fight visceral fat, but also high blood pressure, diabetes and even dementia.”

A waistline of 35 inches or more for women and 40 inches or more for men is also one of the main risk factors for metabolic syndrome. Metabolic syndrome means you have more than one of these high-risk health issues: high blood pressure, raised blood sugar, low HDL (“good”) cholesterol or high triglycerides. Metabolic syndrome puts people at risk for serious health problems like Type 2 diabetes and heart disease.

What Can You Do?

“Getting rid of this dangerous visceral fat is not about wearing a smaller size, but decreasing disease,” Anderson said. There are simple steps you can take to lower your risk for this type of fat and the dangerous health problems it can bring.

Measure your waist. Know what your number is. If it’s high, talk to your doctor about what it means for you. A large waist may not always signal visceral fat, and being slim doesn’t always mean you have no risk. But if your doctor says your number puts you at risk, take steps to reduce it.

Pay attention to your lab tests. Look at your bloodwork. Your health care provider can help you understand your blood sugar numbers and any changes you see in them over time. You can have insulin resistance or diabetes even if your blood sugar is still in the normal range.

Decrease your sugar intake. “There are no essential sugars or carbs,” Anderson said. Your body can make sugar (glucose) from scratch to feed those few cells in the body that actually need it. Cut back on refined sugar. Then reduce your intake of simple carbohydrates that turn into sugar as soon as you eat them, like breads, pasta, rice and potatoes.

Read food labels and be aware of “hidden sugars.” Become familiar with all the words that mean sugar, like fructose, dextrose and more, so you can avoid these foods. Cutting back can be hard at first, but the less sugar you eat, the less you crave.

Look for whole foods and natural foods. Eat whole foods like meat, chicken, fish, vegetables, low-sugar fruits, and natural oils like avocado and olive oil, Anderson said. Healthy, natural fats and proteins will make you feel full much longer and will decrease blood sugar highs and lows. And you won’t feel the need to snack as much.

Step up your exercise. Regular exercise is essential. Exercise can help you lose visceral fat and help keep it from coming back. Aim for least 30 minutes of moderate-intensity activity most days.

Studies have shown that combining aerobic activity (such as brisk walking) and strength training (exercising with weights) may be especially good for reducing visceral fat. One thing to note, abdominal exercises like sit-ups can tighten abdominal muscles, but they won't reduce visceral fat.

Get the right amount of sleep. Too little sleep can make you more likely to develop visceral fat. But for adults under 40, too much sleep isn't good, either. Young adults who sleep more than eight hours may increase their risk of added visceral fat.

Don’t smoke. Smoking makes it more likely that you’ll store fat in your middle instead of other areas.

Talk to your doctor. Your doctor can help you safely start to make healthy lifestyle changes to reduce visceral fat.

Sources: What Is Metabolic Syndrome?,  National Heart, Blood and Lung Institute, NIH, 2022; What Are Overweight and Obesity?,  National Heart, Blood and Lung Institute, NIH; Should you worry about your waistline?,  Harvard Health Publishing, 2024; Taking aim at belly fat,  Harvard Health Publishing, 2024

 Originally published 12/16/2019; Revised 2024