Is your waist size putting your health at risk?

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Excess fat around your middle can raise your risk of type 2 diabetes and heart disease. We explain why, and how shifting abdominal fat may not be as hard as you might think

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Quick facts

  • Fat around the middle, known as visceral fat, fuels inflammation in the body
  • A high waist-to-hip ratio (WHR) may indicate higher risk
  • The WHO says that women should have a WHR of 0.85 or less, and for men it should be 0.9 or lower
  • You can calculate your WHR by dividing your waist measurement by your hip measurement

It’s no secret that being overweight or obese is not good for your health. Not only can excess weight increase your odds of developing diabetes, heart disease and many other serious health problems, it can also add to your chances of complications from Covid-19.

Why does where you carry your weight matter?

There’s now a body of evidence which shows that being an ‘apple shape’ and having additional fat around your belly is more dangerous than being a ‘pear shape’ and carrying excess fat on your buttocks and thighs.

This is because it’s now known that fat produces healthy — and unhealthy — body chemicals. This cocktail of body chemicals varies, depending on where you tend to deposit your body fat.

The most dangerous is abdominal or ‘visceral’ fat. It’s sometimes called intra-abdominal fat, because most of it is hidden away in the abdominal cavity. This fat also builds up in an apron-like flap of tissue called the omentum, located under the diaphragm, which blankets and protects the intestines and other organs.

‘Visceral fat is important as it increases the risk of health problems such as type 2 diabetes and heart disease,’ Dr Rhianna McClymont, Lead GP at Livi explains.

It also produces inflammatory chemicals called cytokines. These are associated with severe illness from Covid-19, as well as with increased blood pressure and pushing up levels of free fatty acids in the blood and organs, which may contribute to heart disease risk.

Why your waist-to-hip ratio is important

The most obvious clue that you have too much visceral fat is having an ‘apple’ body shape, in which your waist seems wider than your thigh area. That’s why measuring waist to hip ratio (WHR) can be a useful tool for assessing your weight-related health risks. This is often done in addition to calculating your body mass index (BMI), which doesn’t account for where excess weight is distributed on the body.

To calculate your WHR, divide your waist measurement by your hip measurement. If your waist is 80cm and your hips are 90cm, your ratio is 0.89. The World Health Organization (WHO) says that women should have a WHR of 0.85 or less and for men it should be 0.9 or lower.

How do you know if your measurements put you at risk?

If calculating WHR is confusing, you can simply measure your waistline (around the belly button).

The NHS and Sweden’s Karolinska Institutet advise losing weight if your waist is more than 94cm (37in) for men, or 80cm (31.5in) for women.

Men with a waist measurement of more than 102cm (40in) and women measuring 88cm (34.5in) or more are at high risk of health problems and should speak to a doctor.

Do age, genes and stress play a part?

Lots of factors beyond your control will influence your tendency to store visceral fat. These include your genes, getting older and hormones. Visceral fat for example, may increase after menopause.

But stress also plays a key role. ‘Studies have also shown that stress can play a role in obesity through the increase in a hormone called cortisol,’ says Dr McClymont. ‘This is released in response to periods of chronic stress. Cortisol causes increased deposits of visceral fat and has been shown to increase appetite and a preference for energy-dense foods.’

Why shifting belly fat isn’t as hard as you might think

The good news is that it’s easier to reduce visceral fat with diet and exercise than it is to shift fat from the hips and thighs.

Exercises like sit-ups will tighten abdominal muscles but won’t target visceral fat. The best ways to shift it are through a combination of healthy diet and increased exercise.

The NHS recommends 150 minutes of moderate physical activity like walking, swimming or gardening or 75 minutes of vigorous activity like aerobics, rowing, strength training or jogging each week.

Reducing alcohol intake can also be a good way of reducing waist size,’ adds Dr McClymont. ‘Getting plenty of sleep and reducing stress levels can also help,’ she says.

How Livi can help

‘Certain people who are very obese and have not managed to reduce their weight with diet and exercise may benefit from a medication to help with weight loss, or a referral to a bariatric clinic to discuss weight-loss surgery,’ says Dr McClymont. If you’re concerned about your waist size or impact of visceral fat, speak to a doctor for medical advice.

This article has been medically approved by Dr Rhianna McClymont, Lead GP, Livi.

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