Historically, carrying excess adipose (fat) tissue around the abdomen has been considered a significant risk factor for developing metabolic disorders.
“Metabolic disorder” is a blanket term that covers a wide range of health conditions. These disorders result in impaired metabolism or breakdown of various chemicals and substances in the body.¹
In this article, we will focus on metabolic syndrome — a type of metabolic disorder most commonly associated with belly fat and larger waistlines.
As one of the primary diagnostic features used in the early detection of metabolic syndrome, carrying excess belly fat is currently considered a risk factor or symptom of metabolic syndrome.² But is this really the case?
In a Western society that’s seemingly obsessed with losing weight and staying thin, it should come as no surprise that excess weight is commonly presented as a “problem” that needs solving.
However, while research has shown that living with excess weight can contribute to an increased risk of chronic health disorders, new findings have found that belly fat may not be as big of a risk factor for metabolic syndrome as we once thought.
So, is belly fat really the enemy, or is it actually a consequence of other (more important) factors that cause metabolic syndrome?
Before we jump into the latest clinical research, we need to define what adipose (or fat) tissue means.
Fat tissue develops throughout the body in two primary locations:³
Visceral fat — This type of fat surrounds the vital organs. While you might assume that any fat covering your organs is unhealthy, you actually need a layer of fat around your vital organs to keep them protected and supported. On the other hand, a larger amount of visceral fat (particularly in their abdominal region) commonly leads to symptoms of insulin resistance and other medical comorbidities. This type of fat is commonly associated with metabolic syndrome.
Subcutaneous fat — Located below the epidermis, this type of fat is one of the skin’s layers. It acts as a barrier and cushion, protecting your muscles and bones. It’s less common to have large quantities of subcutaneous fat, but it can still impact your overall health.
As we mentioned above, the term metabolic disorder can be used to describe a wide range of health conditions that impair metabolism.
Not all people living with metabolic disorders present with excess body weight and belly fat, but it’s a common theme in people diagnosed with these types of conditions.
Historically, medical professionals have used fat distribution patterns to identify a person’s risk of developing metabolic disorders:⁴
People with this body shape commonly carry excess visceral fat above their waistline, often around the abdomen and stomach area. This gives them a round, top-focused shape similar to an apple.
In most cases, people with this body shape present with a larger-than-average waist circumference. It’s most commonly seen in cisgender (where a person’s gender identity matches their assigned sex at birth) men.
The apple body shape is currently used to indicate an increased risk for metabolic syndrome.
People with this body shape are more likely to carry excess weight below the waistline, causing more significant natural curves.
The top portion of a person’s body is often thinner with this body shape, so this fat distribution is named after the pear-like shape it creates.
It’s most commonly seen in cisgender women and is often associated with carrying a larger amount of subcutaneous fat rather than visceral. As a result, people with this body shape are less likely to be diagnosed with metabolic syndrome.
However, just because a person has a particular body shape does not necessarily mean that they have a higher risk of experiencing a metabolic disorder. This is one of the primary reasons why there has been more research on this topic — trying to get a better picture of the true underlying cause of health conditions like metabolic syndrome.
So, what exactly is this health condition that appears to be connected to a person’s weight?
Metabolic syndrome is a metabolism-based health condition characterized by a wide range of symptoms. It is also referred to as syndrome X or insulin-resistance syndrome.
Currently, the American Heart Association estimates that 37% of Americans have metabolic syndrome.⁵ Many cases are undiagnosed.
Not all people living with metabolic syndrome present with the same expected body composition we mentioned earlier. It’s common for people with metabolic syndrome to have a higher body mass index (BMI), but other symptoms are commonly used to diagnose this condition, including the following:⁶
Having a waist circumference larger than 40 inches (for cisgender men) and 35 inches (for cisgender women) is considered a risk factor for metabolic syndrome.
That being said, everyone’s body is unique. A large waist circumference doesn’t accurately predict a person’s risk for the disease in all cases.
Triglyceride is a type of fat used throughout the body for various purposes. Therefore, it’s common for people with metabolic syndrome to present with blood work that shows higher than average triglyceride levels.
A triglyceride reading of 150mg/dL or more is considered a risk factor for metabolic syndrome.
There are two types of cholesterol:
Low-density lipoprotein (LDL) — generally referred to as “bad” cholesterol
High-density lipoprotein (HDL) — known as the “good” cholesterol
Both LDL and HDL are needed in a healthy person’s body.
It’s common for people with metabolic syndrome to have low HDL cholesterol levels (less than 40mg/dL in cisgender men and less than 50mg/dL in cisgender women).
People living with metabolic syndrome commonly report having high blood pressure (hypertension). A resting blood pressure that’s higher than 130/85mm Hg is considered a red flag for a potential metabolic syndrome diagnosis.
Because metabolic syndrome impairs insulin function, it’s common for someone with the condition to experience increased fasting blood glucose levels.
A fasting blood glucose level of greater than 100mg/dL (5.6mmol/L) is one of the factors considered when diagnosing metabolic syndrome.
So, what does the research say about metabolic syndrome and excess belly fat? As it turns out, multiple studies present arguments against excess fat as a primary risk factor for developing the condition.
In a recent 2022 study, researchers at London’s King’s College studied the genome of a large group of twins. They wanted to better understand the role genetics plays in a person’s risk of developing metabolic disease.⁷
Of the 538 samples studied, researchers were able to link nine specific genes to an increased risk of developing the disease. Interestingly, of the nine genes found, one was believed to impact how food accumulates as fat throughout the body. This possibly shows that weight alone may be a secondary symptom of metabolic syndrome rather than a pre-existing risk factor.
In another study, a team of researchers at Yale University found that excess belly fat may not be the primary cause of insulin resistance in people with metabolic syndrome.⁸ Instead, they found that skeletal muscle may contribute to insulin resistance over time.
As we age, our muscle cells are less able to use, convert, and store extra blood sugar after a meal. This causes increased blood glucose and lipid levels that are commonly attributed to excess fat and metabolic syndrome.
New research suggests that carrying excess weight may not be a direct risk factor for developing metabolic syndrome. However, being obese or overweight negatively impacts your health in other ways.
Excess weight (around the belly or not) puts you at greater risk of developing the following diseases:⁹
Heart disease — Obesity is one of the leading causes of cardiovascular disease diagnosis and mortality worldwide.¹⁰ Research shows that excess body weight increases a person’s risk of developing potentially fatal heart conditions, including high blood pressure, heart attack, stroke, and coronary artery disease.
Diabetes — Living with excess weight increases your risk of developing type II diabetes (a condition caused by insulin resistance). If left untreated, type II diabetes can cause significant damage to the kidneys, nerves, and cardiovascular system.¹¹
Dementia — A 2020 study found a connection between obesity and an increased risk of developing dementia later in life.¹² As one of the most common neurological disorders that impacts older populations, the rise of dementia is a serious health crisis.
Cancer — 40% of all annual cancer diagnoses are attributed to cancers that list obesity as a potential risk factor.¹³ Many types of cancer, including breast, uterine, colon, kidney, and liver, are listed as conditions that obesity can increase your risk for.
So, if this article has you thinking about your overall health and weight, there is some good news — it is possible to lose weight in a healthy, natural, and sustainable way.
Nobody is suggesting that weight loss is a simple or easy process. However, it’s important to know that even small lifestyle changes can be incredibly effective for significantly changing your overall health and weight.
If you are looking to tackle excess belly fat, here are some natural lifestyle suggestions to try:
What you eat plays a significant role in your overall health. If possible, switch to a balanced diet of fruits, vegetables, and lean protein.
You might find it more manageable to make smaller healthy changes at first. This is a great place to start. These small changes may not feel significant in the beginning, but over time, they will result in healthy habits that positively impact your health and weight.
When in doubt, sweat it out!
Getting up and moving is a great way to burn some extra calories throughout the day. Whenever possible, walking, moving, stretching, and adding exercise into your daily routine is a great way to achieve a healthy body weight.
Feeling well-rested and getting enough sleep every night are essential factors for maintaining a healthy body weight.
Nighttime is when your body can recover and compartmentalize the events of the previous day. Therefore, quality sleep is a must for anyone looking to improve their overall health.
Living with chronically high stress levels negatively impacts your entire body. Some people use food as a coping mechanism for stress, which can result in weight gain. Because of this, finding ways to reduce your daily stress levels is a helpful way to maintain a healthy body weight.
So, is belly fat a significant source of concern when it comes to metabolic syndrome? The answer is not entirely clear, unfortunately.
While we need to conduct more research to better understand the true underlying cause of metabolic syndrome, it’s clear that carrying excess body weight increases a person’s risk of experiencing a wide range of adverse health outcomes.
As a result, finding ways to maintain a healthy weight for your unique body is one of the best ways to reduce your risk of developing obesity-related diseases.
Metabolic disorders | MedlinePlus
What is metabolic syndrome? | NIH: National Heart, Lung, and Blood Institute
The nutrition source: Body fat | Harvard T.H. Chan
The relationship of obesity to the metabolic syndrome (2003)
What is metabolic syndrome? | American Heart Association
Metabolic syndrome (2023)
Adipose methylome integrative-omic analyses reveal genetic and dietary metabolic health drivers and insulin resistance classifiers (2022)
The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome (2007)
Health effects of overweight and obesity | Centers for Disease Control and Prevention (CDC)
Relationships between obesity and cardiovascular diseases in four Southern States and Colorado (2011)
Type 2 diabetes | Centers for Disease Control and Prevention (CDC)
Obesity associated with a higher risk for dementia, new study finds | NIH: National Institute on Aging
Obesity and cancer | Centers for Disease Control and Prevention (CDC)
Claire Bonneau is a medical writer and certified trauma operating room nurse.
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