You can look “healthy” on the outside while carrying enough excess fat deep inside your abdomen and around your vital organs to put your heart, liver, pancreas, and intestines under strain. Known as visceral fat, it is biologically active, releasing hormones and inflammatory substances that can interfere with how the body functions and drive up the risk of disease.
According to Dr Gerhard Vosloo, Founder and Head Consulting Practitioner at Dr GL Vosloo Medical Practice, managed by BioWell, visceral fat is one of the most serious hidden metabolic health risks a person can carry.
“Everyone has visceral fat, and a normal amount is useful. We need some of it to store energy and help protect our organs. The problem starts when too much builds up. That excess can interfere with how the body works and raises the risk of insulin resistance, inflammation, type 2 diabetes, and heart disease,” he explains.
An analysis of over 824,000 people found that those with the highest visceral-fat levels carried 55% higher cardiovascular disease risk and 45% higher stroke risk than the lowest. Other studies found sevenfold greater odds of fatty liver disease, while fatty pancreas has been linked to nearly four times the risk of acute pancreatitis and nearly twice the risk of pancreatic cancer.
Dr Vosloo says there’s no one simple answer for reducing high levels of visceral fat, but that a combination of diet, exercise, and a few other lifestyle changes can make an outsized impact. Additionally, where clinically justified, controlled, doctor-prescribed pharmaceutical treatment can be beneficial for certain people.
To understand the best combination of interventions, he recommends consulting a holistic metabolic- and weight-management physician. Patients particularly concerned about visceral fat should ask the following questions during consultation:
- What would a healthier way of eating look like for me?
Focus should be on a sustainable eating pattern that supports fat loss and metabolic health, with appropriate calorie control, enough protein and fibre, and less highly processed food and excess sugar.
- What type of exercise would benefit me most?
Regular aerobic activity can help reduce visceral fat, while resistance training may help preserve or build muscle and support metabolic health. Combining both is generally more effective than relying on either alone.
- Could alcohol or poor sleep be contributing?
Frequent alcohol intake and inadequate sleep can make weight and metabolic health harder to manage and should be considered alongside diet and exercise.
- Do I have an underlying metabolic problem that needs attention?
Insulin resistance, prediabetes, diabetes, abnormal cholesterol levels, and other metabolic problems can accompany excess visceral fat. Appropriate testing can identify these issues and guide treatment.
- Could prescription treatment be appropriate for me?
Medication may be considered where clinically appropriate, particularly when lifestyle changes alone are insufficient. It should support a broader metabolic-management programme rather than serve as the primary intervention.
Dr Vosloo notes that doctors at his practice only prescribe weight-management medication such as compounded GLP-1 treatments when medically necessary. Where appropriate, these treatments can support overall fat loss, including visceral fat, by improving appetite control and metabolic regulation. However, he stresses that no medication selectively targets visceral fat, so treatment must still address the factors driving its accumulation.
“The goal is to reduce the amount of dangerous fat around the organs, but we also need to understand why it built up in the first place. For one person, insulin resistance may play a major role. For another, it could be diet, inactivity, poor sleep, hormonal changes, or several factors together. At the right dose, treatment can give someone breathing room to make the changes their body needs.”
He adds that visceral fat should not be judged by appearance alone. Waist measurements, body composition, blood pressure, blood-sugar control, cholesterol, and other metabolic markers can help build a clearer picture of the risk a person may be carrying beneath the surface.
“Visceral fat is an issue we can do something about. Once we know it’s there and understand what is contributing to it, we can design the right combination of interventions to start bringing patients’ health risk down and build toward real long-term positive change.”
