How visceral fat contributes to a wide range of health conditions and how weight loss can help mitigate risks
Obesity is responsible for over 200 medical conditions, ranging from heart disease, stroke, and cancer to diabetes and kidney failure. The main culprit is excess fat, particularly visceral fat, which surrounds vital organs such as the heart, liver, and kidneys. Though a small amount of visceral fat is normal, when it exceeds 10% of total body fat, it can lead to serious health issues.
Dr. Tham Kwang Wei, a senior endocrinologist at Woodlands Health in Singapore, explains that losing even a small amount of weight—such as 10-15%—can significantly improve health outcomes, especially in conditions like diabetes. A 3% weight loss can improve diabetes control, but a 15% weight loss may be necessary for diabetes remission, potentially normalizing blood sugar levels for diabetics.
Excess fat primarily accumulates when calorie intake surpasses energy expenditure. When the body’s fat storage capacity—located in subcutaneous tissue under the skin—is exceeded, fat spills into areas it shouldn’t, such as internal organs. This excess visceral fat sticks to organs and impairs their functions, leading to inflammation and oxidative stress, which are associated with heart disease, cancer, and Alzheimer’s disease.
Fat that infiltrates organs also promotes the release of adipokines, proteins that encourage tumor growth, potentially accelerating cancer. As visceral fat continues to grow, it causes inflammation, which can harden tissue and form plaques, leading to blocked blood flow and increasing the risk of heart attack and stroke.
Though the most straightforward method to address obesity is reducing food intake, exercise also plays an important role in burning fat. For people struggling with obesity, Dr. Tham suggests reducing meal portions by 25%, which can help with gradual weight loss. However, losing 10-15% of body weight may require medical assistance, such as the use of new glucagon-like peptide-1 (GLP-1) drugs, which have shown to reduce appetite and aid in significant weight loss.
One example is the UK’s National Health Service (NHS) offering Eli Lilly’s Mounjaro to people with obesity and weight-related disorders like hypertension and Type 2 diabetes. Studies suggest that GLP-1 drugs can help patients lose up to 20% of their body weight, leading to improvements in metabolic health and a reduction in the risk of diseases caused by obesity.
However, not all medical conditions attributed to excess fat are directly caused by obesity. Thin individuals can also suffer from diseases like heart failure or high blood pressure. While obesity often exacerbates these conditions, it is not the sole contributor. Interestingly, some obese individuals have metabolically healthy bodies, with normal blood sugar and insulin levels despite excess fat. Studies estimate that 10-30% of obese individuals fall into this category.
Even those who may not appear obese can still experience health issues like fatty liver disease, which is caused by hidden visceral fat. Prof. Tai E Shyong of the National University Hospital suggests that weight loss can help reduce fat in organs, particularly in the liver, where a 10% weight loss in overweight individuals led to a 60% reduction in liver fat.
The use of GLP-1 drugs, like dulaglutide, is revolutionizing treatment, offering solutions previously unavailable. Some patients who had persistent kidney damage, indicated by protein in their urine, saw improvements after using these medications. The ability to address obesity with such drugs offers hope for better management of weight-related health problems.
