Cohen Medical Associates is a family medical center and research center located in Delray Beach, FL.
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belly fat

Fighting the Battle of Belly Bulge

Are you among the many who picked up the COVID-19 “19”? Pounds, that is, which is the average weight gain resulting from the widespread pandemic-related shutdowns last year. Between sheltering at home with little exercise and turning to comfort foods like sourdough bread, it’s not surprising that we’ve tended to pack on more weight recently.

But our family practice doctors want you to know that there’s fat, and then there’s belly fat, which is far more concerning than the fat that lies just below the skin (subcutaneous fat). That’s because belly fat is dangerous.

The research

For example, a 2015 study researched more than 15,000 people over 14 years. It found a 35 percent increase in the likelihood of death in normal-weight men with big bellies compared to those without the extra abdominal fat.

“Not all fat is equal,” Francisco Lopez-Jimenez, a Mayo Clinic cardiologist and the study’s leader.

That’s because belly fat, also known as visceral fat (because it tends to surround the internal visceral organs) disrupts the hormones that allow these organs to function properly.

Another 2016 study, published in the Journal of the American College of Cardiology, found that increasing stomach fat is associated with newly identified and worsening heart disease risk factors. 

“These adverse changes in cardiovascular risk were evident over a relatively short period of time and persisted even after accounting for changes in body mass index (BMI) and waist circumference, two commonly used methods to estimate whether someone is a healthy weight or not,” Science Daily reported.

Forty-four percent of the study subjects were women, and 56 percent were men, proving that the dangers of belly fat affect both sexes equally.

Other dangers

The researchers also noted that “individuals with greater increases in fat inside the abdominal cavity showed substantial increases in metabolic risk factors, including high blood sugar, high triglycerides, and low HDL, or good, cholesterol.”

According to numerous studies, visceral fat not only increases your risk of cardiovascular disease, but also of:

  • insulin resistance and type 2 diabetes
  • colorectal cancer
  • sleep apnea
  • high blood pressure
  • abnormal cholesterol
  • breathing difficulties
  • dementia

In addition, research also associates belly fat with an increased risk of premature death, regardless of overall weight.


There are several factors that influence whether and how much visceral fat your body produces:

  • Your age: People tend to accumulate belly fat with age, even if the scale shows they aren’t gaining weight. Muscle mass tends to be replaced with fat as they get older, and less muscle mass means calories are metabolized more slowly.
  • Your sex: Women often begin to accumulate belly fat as the body goes through menopause, because of hormonal changes.
  • Stress: A 2000 Yale University study found that women who are more prone to stress were more likely to accumulate belly fat, even if they were otherwise healthy and of normal weight.
  • Heredity: Your genetic makeup plays a role in whether you tend to accumulate belly fat. If either of your parents had belly fat, you may be predisposed to store visceral fat.

What you can do

Measure your waist with a tape measure around your bare stomach, just above the hipbone. Exhale, but don’t suck in your belly.

If your waist measures over 35 inches for women or 40 inches for men, you are at risk for the heal issue mentioned above.

So what can you do? First, lose weight. Even a modest reduction in weight will make a difference. Focus on eating plant-based foods, limiting portions, and reducing sugar intake.

Second, begin to exercise regularly, for 30 minutes a day, if possible, but at least 75 minutes a week.

Realize that you can’t “target” belly fat through exercise. Abdominal crunches and sit-ups may tighten belly muscles, but they won’t reduce the visceral fat deep within the belly. 

Exercise, however, is key, particularly high-intensity aerobic exercise.

“When people lose weight, some of their weight they lose will be muscle mass, if they don’t exercise,” Lopez-Jimenez told USA Today. “If you just lose weight but don’t build muscle, you may not be improving your health that much.”

Finally, reduce stress as much as possible. Stress raises cortisol, which increases the storage of visceral fat. It also interferes with sleep, which in turn increases stress, which raises cortisol, and so forth, in an unhealthy circle.

Regular exercise will help reduce stress, as can slow rhythmic movements such as yoga or tai chi. Meditation, cognitive behavioral therapy (CBT), and mindfulness training have also proven helpful to many.

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