An expanding waistline is sometimes considered the price of getting older. For women, this can be especially true after menopause, when body fat tends to shift to the abdomen. Yet belly fat is about much more than just how you fit into your clothes. Research shows that belly fat also carries serious health risks. In my work with women across the United States I have seen the causes and the effects of belly fat. I am compelled to address this topic head-on.
The trouble with belly fat is that it’s not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs. Although subcutaneous fat poses cosmetic concerns, visceral fat is linked with far more dangerous health problems, including:
Cardiovascular disease
Type 2 diabetes
Colorectal cancer
Research also has associated belly fat with an increased risk of premature death — regardless of overall weight. In fact, some studies have found that even when women were considered a normal weight based on standard body mass index (BMI) measurements, a large waistline increased the risk of dying of cardiovascular disease.
Belly fat doesn’t just lay idle at your beltline. Researchers describe it as an active “organ” in your body — one that churns out hormones and inflammatory substances.
“Abdominal fat is thought to break down easily into fatty acids, which flow directly into the liver and into muscle,” says Lewis Kuller, MD, DPH, professor and past chair of epidemiology at the University of Pittsburgh School of Public Health.
When these excess fatty acids drain into the liver, they trigger a chain reaction of changes — increasing the production of LDL ‘bad’ cholesterol and triglycerides. During this time insulin can also become less effective in controlling blood sugar, so insulin resistance sets in, he explains.
Blood sugars start to get out of balance. Fats and clots get into the bloodstream, and that sets the stage for diabetes, heart disease, and more.
And research shows that abdominal fat triggers a change in angiotensin, a hormone that controls blood vessel constriction — increasing the risk of high blood pressure, stroke, and heart attack, Kuller explains.
Indeed, belly fat is a key indicator of “metabolic syndrome,” a cluster of abnormalities that include high levels of blood sugar, blood pressure, and triglycerides, as well as low levels of “good” HDL cholesterol. This combination of risks has an impact on mortality from heart disease. In addition to all of this, there is another very common effect of belly fat that uniquely impacts women.