Visceral Fat Explained

Not all body fat behaves the same way. The fat you can pinch under your skin is called subcutaneous fat. The fat packed inside the abdomen, around the liver, intestines and other organs, is called visceral fat. For your heart and metabolism, visceral fat is the one that matters most.

Why location matters

Subcutaneous fat is mostly storage. Visceral fat is more active. It releases fatty acids and inflammatory signals at a higher rate, and much of what it releases drains through the portal vein straight to the liver.

That direct line to the liver is the key picture. When the liver is steadily supplied with extra fatty acids, it stores more fat, responds less well to insulin and sends more triglycerides into the blood. Over time that pattern is linked to:

• Insulin resistance and type 2 diabetes.
• Fatty liver disease.
• High triglycerides and low HDL cholesterol.
• Higher blood pressure and heart disease.

This is why two people with the same body fat percentage can have very different risk. The one carrying more of it around the organs usually has worse blood sugar and lipids.

You cannot see it in the mirror

Visceral fat sits behind the abdominal wall, so it is hard to judge by looking. A waist above 40 inches in men or 35 inches in women is a rough warning sign. It is only rough. A hypothetical 48 year old man at a normal weight can carry more visceral fat than expected, especially if he drinks regularly, sleeps poorly and has lost muscle over the years. His BMI and his waist may both look fine.

A DEXA scan gives an estimate of visceral fat along with total fat, lean mass and bone density. That lets us see not just how much fat you carry, but where it is.

It responds to change

There is good news in this. Visceral fat tends to respond early to exercise and to modest weight loss, often before the change shows up much on the scale or in the mirror. Regular exercise, enough sleep, less alcohol and fewer refined carbohydrates all push in the right direction.

That makes it a useful number to track. If a plan is working, visceral fat is often one of the first things to come down, and seeing it move on a repeat scan is a good sign the effort is going where it counts. We repeat DEXA about every 6 months for that reason.

That's the kind of thing we measure.

Book a DEXA scan at HYBRD Health ($199)

This article is educational and is not medical advice.