This is unpublished
Laura J. den Hartigh
June 18, 2024

The truth about body fat? It's not all the same

While some subcutaneous fat is good for you (protecting you, giving energy, etc.), too much visceral fat can lead to everything from stroke to diabetes to certain cancers.
Scroll for more
arrow icon
Back to top
Clinical Faculty

Though you may not always love the few extra pounds that can collect around your hips, thighs, belly and elsewhere, a little bit of fat is not a terrible thing. It can, in fact, be good for you, acting as a cushion against physical external stress, providing insulation and even producing beneficial hormones.

However, when that subcutaneous fat (the fat right below the skin’s surface) increases too much, it can begin to accumulate in other places, like between your intestines and other abdominal organs. This fat is called visceral fat and it can pose serious health concerns.

Here is how to tell how much of each kind of fat you have, and what you can do to decrease the kind that can be detrimental to your health.

Subcutaneous versus visceral fat

“Subcutaneous fat lies just beneath the skin throughout most of the body, most commonly in the upper arms, legs and buttocks, while visceral fat is stored within and between our internal organs, such as the liver and intestines,” says Laura J. den Hartigh, research associate professor of medicine for the Division of Metabolism, Endocrinology and Nutrition at the University of Washington School of Medicine, an expert when it comes to understanding the kinds of fat and how they function.

She explains that generally people who are healthy store most of their fat (around 80% of it) in the subcutaneous regions because that's where it's most useful to your body. There, the fat protects your muscles and bones from impact, gives you energy, helps control your body temperature and even attaches the middle layer of skin, called the dermis, to your muscles and bones with special connective tissue.

Visceral fat, on the other hand, isn’t nearly as useful. Though having some visceral fat can be helpful for protecting your internal organs, an excessive amount doesn’t serve any positive purpose and can easily put you into dangerous territory.

What are the health risks of visceral fat?

Though having too much of any kind of fat can be unhealthy, it’s clear that visceral fat poses more of a threat to your health.

"Having most of your fat as subcutaneous fat is likely to be healthy,” explains den Hartigh. “But if a person accumulates too much visceral fat, or if that visceral-to-subcutaneous fat ratio gets too high, this can increase a person’s risk for diabetes, heart disease, certain types of cancer and fatty liver disease.”

Too much visceral fat can increase your blood pressure and risk of stroke and even complicate surgeries by making it harder for the surgeon to see your organs.

What causes visceral fat?

Both your genetics and environmental factors can affect your body’s relationship with fat. Genetics can determine your body shape and how you store fat, while environmental factors like your diet, exercise routine and the amount of stress you’re dealing with can also affect the kinds of fat you collect.

For example, if you consume a lot of fatty and carb-rich foods and don’t get moving very often, you’re more likely to increase your chances of accumulating visceral fat.

Plus, if you’re a seriously stressed-out person, you may be producing more cortisol, a stress hormone that research suggests stimulates the accumulation of visceral fat.

How can you tell how much visceral fat you have?

Ok, now that you’re aware of the two kinds of fat, how do you know how much of each you’re dealing with?

It’s easier to actually see subcutaneous fat since it’s the kind that’s located just below the skin, often in the hips, butt, belly and thighs (and you can even pinch it!). Since visceral fat is located deep within the body, it’s not visible — but it’s safe to assume that if you’re dealing with an excessive amount of subcutaneous fat, then you may have extra visceral fat as well.

According to Dr. Laura Montour, an obesity medicine expert at the UW Medicine Center for Weight Loss and Metabolic Surgery at Meridian Pavilion, the best way to understand your amount of visceral fat is by measuring your waist circumference. Your doctor can also have you get fasting labs done and check your blood pressure to see if you’re showing signs of excessive visceral fat.

den Hartigh agrees, adding that some people also compare the circumference of the waist to the circumference of the hips (waist-to-hip ratio), but she acknowledges that this isn’t a perfect process for determining visceral fat.

Your doctor may also calculate your body mass index (BMI), which is based on your height-to-weight ratio and your waist-to-hip ratio.

In addition, doctors will often look at your metabolic health because they want to know whether your amount of visceral fat is causing changes that can lead to disease. These changes can show up as high cholesterol, elevated blood sugars and diabetes, high blood pressure, inflammation and hormonal imbalances.

"Other more precise methods rely on abdominal imaging techniques that need to be done in a doctor’s office, including computed tomography (CT) scanning, magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA or DEXA),” she explains.

However, these imaging techniques are expensive and aren’t commonly used just for looking at visceral fat.

How can you get rid of visceral fat?

Unfortunately, there isn’t a way to specifically target and remove visceral fat, but there are tips for dealing with body fat in general, which can help you stay healthy and should help lower your amounts of visceral fat.

Eat a healthy, balanced diet

Never underestimate the importance of what you put in your body.

“Decreasing your intake of saturated fat and processed foods, while increasing consumption of fiber-containing fruits and vegetables plus lean protein, is a great first approach,” says den Hartigh.

Get moving

den Hartigh also explains that frequent mild to moderate exercise (i.e., 30 minutes of brisk walking, four to five times per week) has also been shown to effectively reduce total body fat.

Plus, some experts have said that visceral fat may metabolize quicker than subcutaneous fat, which means your body can get rid of it efficiently through sweating.

Get your zzzz’s

For Montour, sleep is key — which means avoiding screen time two hours before bed and getting to sleep at a reasonable time (we see you, nighttime scrollers).

Say no to stress (or at least try)

Practice stress reducing techniques like meditation or yoga, since stress can activate the hormone cortisol which can signal your body to hold onto excess fat.

Check in with your doctor regularly

Montour emphasizes that you should meet with your primary care provider at least yearly for a wellness exam. Plus, if your waist circumference is over 35 to 40 inches she says that you should talk to your doctor.

Though you can’t completely control the amount of visceral fat in your body (thanks again, genetics), you can reduce your risk by keeping these tips in mind and reaching out to your doctor with any questions.