Not All Fat is Created Equal

Dr. Christopher McGowan
marzo 7, 2022

When a person decides that it’s time to lose weight, it’s usually because they’ve noticed their clothes fitting tighter or their face looking fuller in the mirror. Carrying extra body fat is often thought of as a cosmetic issue given how image-conscious American culture can be. Yet as understandable and fundamentally human as that is, the actual impact on your overall health is a much more important concern. That’s why it’s helpful to understand the difference between the two main types of fat stores in the body: subcutaneous and visceral.  

Visceral Fat vs Subcutaneous Fat 

The connection between excess body fat and negative health outcomes has been researched and clarified greatly in recent decades. What doctors have also been able to clarify, though, is the fact that the type of fat we carry is the biggest factor. Perhaps surprisingly, the type of fat we recognize as involved in “being fat”—the kind you can pinch with your fingers—is actually the least dangerous type, known as subcutaneous fat

As the name implies, subcutaneous fat is located under the surface of the skin but above muscle tissue. Any fat you can see in a mirror or poke with a finger is subcutaneous fat. Everyone (even skinny people!) has subcutaneous fat on their bodies, and for most people it makes up about 90% of their total body fat. In addition to providing energy storage for cells all over the body, subcutaneous fat also functions as padding and insulation from cold temperatures.   

The other 10% of body fat is referred to as intra-abdominal fat or visceral fat. Visceral fat is out of poking range, however, and lies beneath the muscles of the abdominal wall. Rather than the larger masses of subcutaneous fat that can protrude through the skin, visceral fat is found in the spaces between stomach, liver, intestines, and other abdominal organs. While subcutaneous fat is generally solid in form (even if somewhat squishy to the touch), visceral fat is able to surround the organs of the abdomen because it is in a semi-liquid state. 

The Dangers of Visceral Fat

One of the most important differences between subcutaneous and visceral fat is related to their impact on a person’s overall health. Recent studies have shown that subcutaneous fat, while unappealing to some from a visual perspective, is not directly linked to classic obesity-related health problems. This subcutaneous adipose tissue sits safely under the skin until needed to supplement the energy gained from food. 

Even though lipids stored in fat tissue are primarily used as cellular fuel, research in the field of endocrinology has demonstrated that both subcutaneous and especially visceral adipose tissue are biologically active. Hormones secreted by visceral fat impact insulin sensitivity, inflammation, nutritional uptake, and a variety of other processes in the body. Part of the reason this happens is that visceral fat produces cytokines, small protein molecules that affect cell interactions and can cause inflammation. This type of inflammation can cause vasoconstriction and high blood pressure (hypertension) as well as lead to chronic conditions like heart disease.  

As visceral fat accumulates, an excess of triglycerides can cause lipotoxicity. Lipotoxicity is a type of metabolic syndrome that involves these excess triglycerides sending free fatty acids into the bloodstream. Eventually, these free fatty acids build up in the liver and other organs. In addition to causing organ dysfunction, the free fatty acids can impair the body’s ability to regulate cholesterol, insulin, and blood sugar levels. 

Risk Factors Related to Excess Visceral Fat

For reasons that aren’t fully understood, visceral fat tends to accumulate in the abdomen. Since men generally carry excess body fat in the abdominal area, this makes them significantly more likely to have excess visceral fat. Beyond the risk of cardiovascular disease, carrying visceral fat increases the chances of developing type 2 diabetes, some types of cancer, and even possibly dementia. 

Both types of fat begin to accumulate in the body for the same basic reason: consuming more calories than the body uses to function. While you can safely build up some subcutaneous fat, eventually this caloric imbalance—along with related effects from insulin resistance—will lead to a build up of visceral fat as well. A diet high in simple carbohydrates (a fairly typical American diet) and a lack of physical activity both contribute to weight gain, but smoking and alcohol consumption are also drivers. 

How Much Fat is Too Much?      

Another major difference between these two types of fat is that subcutaneous fat is visible but visceral fat is not. This fact makes it challenging to determine how much visceral fat a person is carrying as well as simply defining “obesity.” Traditionally, doctors have used índice de masa corporal (BMI) as a means of determining overweight or obesity, but it doesn’t indicate anything about visceral fat. Instead, since visceral fat actually increases the size of the abdomen, one’s waist circumference is a more accurate way of keeping track.  

How to Reduce Visceral Fat 

Unfortunately, there are no easy or efficient ways to specifically track the amount of visceral fat in your body composition. Nevertheless, the way to reduce visceral fat is the same way you reduce subcutaneous fat: by changing the metabolic balance so that you are using more calories than you’re consuming. Below are some common, traditional ways to achieve this: 

  • aerobic exercise 
  • strength training 
  • healthy diet high in fruits, vegetables, and whole grains 
  • quit smoking 
  • get adequate sleep each night

Alternative Weight Loss Solutions

Even though it’s true that weight loss can be achieved through diet and exercise, it’s also true that there are a variety of hormonal and genetic factors that play a role in body fat deposition and weight gain. For some people it is especially difficult to find success with these traditional methods. Moreover, quick cosmetic fixes like liposuction can’t actually reach the visceral fat behind the abdominal wall. 

At True You Weight Loss, we understand how frustrating and seemingly futile a weight loss journey can be. Too often people run themselves ragged and become emotionally drained while trying different exercise routines and fad diets. That’s why we instead offer several state-of-the-art, non-surgical weight loss solutions that can help you finally make sustainable progress towards your goals. 

If you have been unable to have success at those traditional weight loss methods, you might be a good candidate for one of our incisionless procedures like an endoscopic sleeve gastroplasty (ESG). For more information about ESG or our other offerings, please contact us today to solicitar una consulta. Our friendly staff is eager to hear your story and help you find the freedom you’ve been looking for.  

Dr. Christopher McGowan
Dr. Christopher McGowan
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