Providing independent clinical excellence since 2005
Menopause often brings a hidden shift in fat storage—from hips to abdomen—driven by falling oestrogen and loss of muscle. This article explains why visceral fat matters more than weight, how simple screening can detect risk early, and how HRT, lifestyle change, and modern tools can protect long-term heart and metabolic health.
N-of-1 medicine shifts the focus from population averages to personal biology. This blog series explores how individuals can run simple, safe self-experiments — using themselves as the control — to test plausible health hypotheses, track meaningful outcomes, and discover what genuinely improves their own health and wellbeing over time.
Ten minutes of strength training, five days a week, is enough to change metabolic health. Like brushing your teeth, it works because it’s sustainable. Keep the time fixed, increase the weights gradually, and focus on strength, not scales. Small daily habits protect muscle, reduce visceral fat, and support long-term health.
Measuring your waist isn’t about shape or clothing size. It’s a simple health check that reflects harmful visceral fat around the organs. Measuring the narrowest point can miss risk. For meaningful results, waist must be measured at a fixed anatomical point and tracked consistently over time.
In cardiometabolic medicine, muscle is not a cosmetic tissue but a metabolic organ. Evidence consistently shows that strength, not muscle mass, predicts insulin resistance, cardiovascular risk, and survival. Many older adults are not losing muscle tissue — they are losing muscle function, and that is the pathology that matters.
A 2026 BMJ systematic review confirms that weight regain is the rule after stopping pharmacological weight-management therapy. Across drug classes, most lost weight is regained within 24 months, with parallel loss of metabolic benefit. This reflects biological defence of adiposity, not patient failure.
Smart body composition scales are not metabolic truth machines. Their value lies in engagement, not precision. During weight loss—especially with GLP-1 therapy—hydration and glycogen shifts distort “muscle” readings. Used within a tiered system that prioritises waist, strength, and function, they can support behaviour without undermining progress.
January isn’t just about weight loss. Much winter weight gain occurs as visceral fat, which drives insulin resistance and cardiovascular risk. Measuring your waist, not just your weight, gives a clearer picture of metabolic health. Building muscle and reducing visceral fat supports a healthier metabolism long after January ends.
Reducing saturated fat intake is known to lower “bad” cholesterol (LDL-C) and reduce heart disease risk, but responses vary widely between individuals. Research shows that genetics strongly influence how much LDL rises when people eat foods like butter, cheese, or fatty meats compared with unsaturated fats such as olive oil, nuts, and oily fish. Even on the same diet, LDL responses can differ by up to 1 mmol/L, reflecting genetic differences in intestinal cholesterol absorption and how efficiently LDL is cleared from the bloodstream.
One of the greatest challenges in the online world is investigator bias. Any “expert” with a strong conviction — whether pro- or anti-statin — can easily find studies that appear to confirm their view. The internet is full of such cherry-picked data. When presented with confident authority, this can sound utterly convincing to a lay audience. The reality is that true medical understanding does not come from one paper, one YouTube video, or one self-proclaimed authority.
Santa’s famous belly is festive, but it highlights an important metabolic lesson: WHERE fat is stored matters more than how it looks. Visceral fat, hidden deep around the organs, drives inflammation and cardiometabolic risk — unlike softer, subcutaneous fat. Understanding this difference is key to real metabolic health.
The most effective path to reducing visceral fat with the help of GLP-1 mimetic is not just to “eat less.” It’s to build more muscle, eat smarter, and track your progress. In this blog, which also forms one of the chapters of an ebook, I outline the programme and tools our patients use in our cardiometabolic clinic.