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Posted on Sunday August 3, 2025 in Health Screening
An article written by Dr Edward Leatham, Consultant Cardiologist
An AI audio construct is available as a podcast fo rthis story below.
Tags: Mens Health, Visceral Fat, Coronary heart disease, search website using Tags to find related stories.
Most men over 30 will recognise the slow but steady expansion of the waistline. Whether you call it a spare tyre, a dad bod, or just a bit of extra padding, not all belly fat is created equal — and not all of it is harmless.
Some types of abdominal fat are mostly cosmetic. Others are dangerous, inflammatory, and metabolically active — the kind of fat that silently drives heart attacks, strokes, dementia, and even advanced cancers.
Let’s break down the three main culprits behind the male belly — and what you can do about them.
Type of obesity illustration. Abdominal sectional View. (visceral fat , subcutaneous fat)
Research has established that the metabolic syndrome and cardiovascular/cancer risk are very clearly dependent on which body compartment surplus adipose is distributed.
This figure, based on Figure 1 from a review article by Ken Shida et al in 2011 (reference 7 below), illustrates a more powerful association between the number of obesity-related risk factors and visceral than subcutaneous fat.
This is the soft fat just under the skin. You can pinch it, and it tends to gather around the lower abdomen and love handles.
Unlike flabby subcutaneous fat, visceral fat lies deep inside the abdomen, packed around vital organs like the liver, pancreas, and intestines. You can’t pinch it — but you can feel it in a hard, protruding belly that’s often mistaken for “bloating” or “beer gut”.
Image processing software of a single slice of two different male patients abdominal CTs at the level of third lumbar vertebrae.
This allows the detection and quantification of fat tissue in subcutaneous (Blue) and visceral compartments (Green). It will be apparent that, whereas the subcutaneous fat is roughly similar 134 versus 154 cm/2, there is a large difference in the visceral fat of the patient in panel B.
Not all belly bulges are caused by fat. Loss of abdominal muscle tone is a key contributor, especially in sedentary men and post-injury recovery.
Another short term cause of a larger waist measurement is trapped gas – common after air flight where cabin pressure is lowered or after meal contents that produce more methane. These explain why your belly may bloat for a few days after travel or an unusual meal.
| Belly Type | Feel | Risk Level | Looks Like |
|---|---|---|---|
| Subcutaneous | Soft, pinchable | Low–moderate | Floppy or squishy |
| Visceral | Hard, tight | High | Firm, rounded protrusion |
| Poor Tone | Soft but not fat | Low (functional) | Bloating or sagging |
No matter which type of belly you’re dealing with, you can improve it — and your health — with the right combination of interventions.
Key steps:
Your belly might just be a result of sitting too much or eating too well — but it could also be a marker of deeper risk. Especially if it’s firm and central, it’s worth digging deeper.
In short:
Is your belly just flabby — or is it killer fat hiding in plain sight?
To find out more on how we measure and treat visceral fat see our related articles or our metabolic toolkit page
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