Diabetes Self-Management Blog

I don’t know about you, but pretty much every week, I receive e-mails from a certain company that promise to help me “blast away” my belly fat. Belly fat is big (again, no pun intended) and the media invokes a certain urgency for people to get rid of it. Oh, if only it were that easy.

Last week we talked about visceral fat, that sneaky, silent fat that literally wraps itself around internal organs (it reminds me of that movie Alien — all of a sudden it’s there, and then it’s too late!). We also know that, unlike subcutaneous fat, visceral fat is potentially harmful to our health.

Researchers reiterated this in a study published in Arteriosclerosis, Thrombosis, and Vascular Biology: Journal of the American Heart Association late in July. This study, done in Sweden and Finland, found that obese men who have high levels of abdominal (visceral) fat and liver fat may have a higher risk of heart disease, due, in part, to high triglyceride (blood fat) levels. The obese men who had high triglycerides also had a higher liver fat content of 13% (for reference, the non-obese men in this study had a liver fat content of just 2.9%). Liver fat isn’t good, either. Too much can lead to nonalcoholic fatty liver disease. And having high triglycerides boosts your risk of heart disease and an early death. While we probably already knew some of this, the authors emphasize the importance of health-care providers checking for abdominal fat and signs of liver fat, as well.

How Do You Know?
How do you know if you have too much visceral fat? Well, there are the “high tech” ways of measuring it, such as using CT scans, MRIs, ultrasound, or bioelectrical impedance. Unless you’re part of a research study, however, it’s unlikely that your primary-care provider will order one of these tests for you (and even less likely that your health insurance will cover it!). But sophisticated tests are probably not even needed: As I mentioned last week, by looking at yourself in the mirror, you’ll get a fairly good indication of where you carry most of your weight. So, quick and easy ways to figure out if you might have too much visceral fat include:

• Looking to see if you’re an “apple” or a “pear”, remembering that “apples” carry much of their weight around their stomach.

• Measuring your waist circumference with a tape measure: Measure at the level of your navel, keep the tape measure at the top of your right hip bone, and don’t suck in your stomach! If you’re a woman and your waist is greater than 35 inches, or if you’re a man and your waist is greater than 40 inches, you may have too much visceral fat.

• Continuing to measure. A single waist measurement doesn’t tell the whole story. Just as you might weigh yourself on your bathroom scale regularly, you should also measure your waist regularly. Is it increasing in size? Are your pants or skirts starting to feel too snug?

• Know your body-mass index (BMI). This old standby is also a predictor of visceral fat. Your BMI tells you where your weight stands in relation to your height. A BMI between 25.0 and 29.9 puts you in the overweight category, and anything above 30 can indicate obesity. You can easily figure out your BMI with one of the online BMI calculators.

What Do You Do?
OK, you have too much visceral fat. Now what? There really are ways to help decrease visceral fat, but like many things in managing your health, it takes time and patience. I’ll mention one way that isn’t so successful, and we’ll finish the rest off next week.

Liposuction. Who doesn’t dream of having their excess fat sucked out of them? Liposuction is primarily a cosmetic procedure whereby fat is removed from various parts of the body, including the abdomen, thighs, buttocks, back, neck, and chin, using a cannula. Not surprisingly, it’s one of the most popular cosmetic procedures in the US. While liposuction permanently removes fat cells, it doesn’t get rid of cellulite (darn!) and what’s more, it doesn’t really remove visceral fat. Instead, liposuction removes that subcutaneous fat that we talked about earlier.

And guess what? If you have your subcutaneous fat sucked away, your body may compensate by redistributing fat in the abdominal area, thereby increasing…you guessed it, visceral fat stores. So while your thighs may be thinner, you’ve lost that double chin and you no longer have back fat after liposuction, you haven’t done anything to reduce visceral fat, and you may have even made it worse, sorry to say. Liposuction has a number of other health risks, too, including uneven skin contouring, fluid build-up, numbness, and infection. More serious complications include heart and kidney complications, fat embolisms (large fat droplets that enter the bloodstream and can potentially block blood vessels), and damage to internal organs from the cannula.

So, sorry to say, liposuction isn’t a recommended way to get rid of visceral fat. But tune in next week to find out what really can work.

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