Belly fat is not all the same
When people talk about "belly fat", they often mean the visible waistline. In fact, two very different types of fat are involved: subcutaneous fat directly beneath the skin and visceral fat, which lies deep inside the abdominal cavity and surrounds the internal organs. From a medical point of view, visceral fat is particularly important because it is closely linked to metabolic health.
In this article, you will learn how the two types of fat differ, what health effects visceral fat can have and which measures can help to reduce belly fat.
Subcutaneous fat vs. visceral fat
Subcutaneous fat
Subcutaneous fat tissue lies directly beneath the skin. Among other things, it serves as an energy store, thermal insulation and mechanical protection. This fat can be pinched, for example on the belly, hips or thighs, and in moderate amounts is a normal part of the body.
Visceral fat
Visceral fat lies deeper, inside the abdominal cavity, and surrounds organs such as the liver, pancreas and intestines. It is not visible or palpable from the outside, but it can contribute to a markedly protruding belly – even in otherwise slim people.
Unlike subcutaneous fat, visceral fat is metabolically active: it produces signalling substances (adipokines), hormones and inflammatory factors that can act throughout the body.
Why visceral fat is particularly relevant
An increased proportion of visceral fat has been scientifically linked to a range of health changes. These include:
- Insulin resistance: cells respond less sensitively to insulin, which can affect blood sugar levels in the long term.
- Increased risk of type 2 diabetes: studies show a clear connection between visceral fat and impaired glucose metabolism.
- Altered blood lipid levels: triglycerides often rise, while HDL cholesterol (the "good" cholesterol) may fall.
- High blood pressure: blood pressure can also be influenced by hormonal and inflammatory processes.
- Cardiovascular disease: in combination with the factors mentioned above, cardiovascular risk increases.
- Non-alcoholic fatty liver disease: visceral fat is closely linked to fat deposition in the liver.
- Chronic low-grade inflammation: visceral fat tissue releases pro-inflammatory signalling substances that can place long-term strain on vessels and organs.
These factors are often grouped under the term metabolic syndrome, with visceral fat regarded as one of the key contributors.
How can visceral fat be assessed?
An exact measurement is only possible with imaging methods such as MRI or CT. For everyday use and medical assessment, however, there are practical indicators:
- Waist circumference: measured midway between the lowest rib and the top of the hip bone. Many guidelines consider values above around 88 cm in women and around 102 cm in men to be elevated.
- Waist-to-hip ratio: compares waist and hip circumference.
- Waist-to-height ratio: ideally, the waist circumference should be less than half of body height.
- Bioimpedance analysis: some devices estimate the proportion of visceral fat, although with limited accuracy.
If you feel uncertain or have risk factors, it is worth discussing the topic in a medical consultation.
Reducing belly fat: what can really help
There is no "miracle method" for losing fat specifically from the belly. Targeted fat loss in one area is not physiologically possible. However, visceral fat often responds particularly well to lifestyle changes – frequently even faster than subcutaneous fat.
Adjusting your diet
- Fibre-rich foods such as vegetables, pulses, wholegrain products and fruit can be filling and help stabilise blood sugar.
- Reduce sugar and highly processed carbohydrates: sugary drinks, white flour products and sweets promote the accumulation of belly fat.
- Choose healthy fats: vegetable oils (e.g. olive or rapeseed oil), nuts, seeds and oily sea fish provide valuable fatty acids.
- Keep protein intake sufficient: high-quality protein sources help preserve muscle mass, which in turn supports basal metabolic rate.
- Limit alcohol: alcohol provides many calories and has been linked to an increase in belly fat.
Integrating physical activity
- Endurance activities such as brisk walking, cycling, swimming or running can help increase energy expenditure and reduce visceral fat.
- Strength training supports muscle building, improves insulin sensitivity and can contribute to metabolic health.
- Everyday movement: taking the stairs instead of the lift, longer walks or standing up more often during sedentary work adds up over the day.
A combination of endurance and strength training is considered particularly worthwhile. The key is to find a form of movement that fits into daily life in the long term.
Do not underestimate sleep and stress
Chronic stress and insufficient sleep can influence hormonal processes linked to the storage of belly fat – including those involving the stress hormone cortisol. Measures that can help include:
- Regular sleep times and sufficient sleep duration (often 7–8 hours)
- Relaxation techniques such as breathing exercises, yoga or progressive muscle relaxation
- Deliberate breaks during the day
Stopping smoking
Smoking is associated with an unfavourable distribution of fat in the abdominal area. Stopping smoking is – regardless of body weight – one of the most effective measures for health.
When medical support is advisable
If you notice no change despite lifestyle adjustments, have pre-existing conditions such as diabetes, high blood pressure or lipid metabolism disorders, or already have a markedly increased waist circumference, you may benefit from medical support. Possible elements of an assessment include:
- Blood tests (blood glucose, HbA1c, blood lipids, liver values)
- Blood pressure measurement
- Assessment of your individual risk profile
- Advice on nutrition, exercise and, if appropriate, further therapies
An individually tailored strategy is usually more sustainable than short-term diets.
Conclusion
Visceral fat is more than a cosmetic issue – it is a metabolically active tissue that can have a relevant impact on health. Those who want to reduce belly fat generally benefit from a combination of a balanced diet, regular exercise, sufficient sleep and stress management. Even moderate lifestyle changes can contribute to metabolic health and reduce the long-term risk of secondary conditions.
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This article does not replace medical advice.