Looking Beyond the Scale: Why Visceral Fat Matters

When we think about body fat, we often think about appearance or the number on the scale.

But from a health perspective, we need fat. The key question is not whether we have fat, but
where it is stored, because that can be just as important as how much we carry.

There are two main types of body fat:
1. Subcutaneous: fat just beneath the skin that you can pinch
2. Visceral: fat that sits deeper within the abdomen, surrounding organs like the liver, pancreas, and
intestines

We need both types of fat! Fat stores energy, cushions our organs, supports hormone production,
and helps regulate body temperature.

Understanding visceral fat gives us a better understanding of metabolic health. And metabolic
health influences many aspects of our wellbeing, including hormone balance, fertility,
cardiovascular health, energy, and healthy aging.

Why Is Visceral Fat Different?

Unlike subcutaneous fat, visceral fat is metabolically active.

This means it doesn’t simply store energy. It also releases inflammatory compounds, hormones,
and free fatty acids that influence how the rest of the body functions.

Because of this, adipose tissue is considered an endocrine organ—it communicates with the rest
of the body and plays an active role in metabolic regulation.

One important feature of visceral fat is that it drains directly into the liver. When visceral fat is
elevated, it delivers higher amounts of free fatty acids and inflammatory signals to the liver,
which can disrupt normal metabolic function.

Why Does This Matter?

Higher levels of visceral fat are associated with an increased risk of:
• Insulin resistance
• Prediabetes & type 2 diabetes
• Elevated cholesterol & triglycerides
• High blood pressure
• Fatty liver disease
• Cardiovascular disease

These risk factors often occur together as metabolic syndrome, which significantly increases
long-term disease risk.

The Hormone Connection

Hormones and metabolism are deeply interconnected.

Insulin, cortisol, estrogen, progesterone, and thyroid hormones all influence how the body stores
and uses energy. At the same time, excess visceral fat can influence hormone function by
increasing inflammation and contributing to insulin resistance.

Fertility: Healthy ovulation depends on healthy metabolic function. When insulin resistance and chronic inflammation are present, they can disrupt the communication between the brain and ovaries that regulates ovulation. This can contribute to irregular cycles or difficulty with ovulation in some individuals.

Perimenopause and Menopause: As estrogen levels decline during perimenopause and menopause, many women notice changes in body composition, even without major changes in weight. Research shows that lower estrogen levels are associated with increased visceral fat accumulation and changes in cholesterol metabolism. This contributes to the increased cardiovascular risk seen after menopause.

This is why menopause is not only a hormonal transition. It is also a metabolic and
cardiovascular transition.

Can We Change Visceral Fat?

Yes!  While genetics influence where we store fat, visceral fat is also responsive to lifestyle factors,
including:
• Nutrition
• Physical activity
• Muscle mass
• Sleep
• Stress
• Alcohol intake
The encouraging news is that improving metabolic health is often associated with reductions in
visceral fat over time.

Why I Use Body Composition Data in Practice

Weight alone does not tell the full story of health. Two individuals can have the same weight but very different levels of muscle mass, body fat, and visceral fat.

This is why I use body composition tools such as InBody scans to provide additional context,
including:
• Skeletal muscle mass
• Body fat mass
• Estimated visceral fat
• Basal metabolic rate

This allows us to look beyond the scale and better understand what is actually changing in the
body!