Hunger Hormones
Gut Hormones and Hunger: Why You Cannot Just Eat Less
Hunger is controlled by a complex system of gut hormones — ghrelin, GLP-1, PYY, CCK. When these are dysregulated by obes...
Not all fat is equal. The fat that accumulates around your abdominal organs — visceral fat — is metabolically active in ways that subcutaneous fat (the fat under your skin) is not. It produces inflammatory hormones, drives insulin resistance, and is one of the most significant predictors of cardiovascular disease, type 2 diabetes, and metabolic syndrome.
Visceral vs Subcutaneous Fat
Subcutaneous fat is stored under the skin and is distributed across the body — thighs, buttocks, arms, and under the abdominal skin surface. It is less metabolically active, serves as an energy reservoir, and is generally less associated with cardiovascular and metabolic risk.
Visceral fat is stored inside the abdominal cavity, surrounding the liver, pancreas, intestines, and kidneys. It is often invisible externally (though a large waist circumference correlates strongly with visceral fat accumulation). It behaves like an active endocrine organ.
Why Visceral Fat Is Dangerous
It Produces Inflammatory Cytokines
Visceral fat cells produce significantly more inflammatory cytokines — particularly TNF-alpha, IL-6, and resistin — than subcutaneous fat cells. These cytokines enter the portal vein (which drains directly into the liver) and the systemic circulation, producing chronic systemic inflammation.
Chronic low-grade inflammation is a primary driver of atherosclerosis, endothelial dysfunction, and progression of cardiovascular disease.
It Drives Insulin Resistance
The inflammatory cytokines and free fatty acids released by visceral fat directly impair insulin receptor signalling in the liver and skeletal muscle. This is the primary pathway through which visceral fat accumulation leads to insulin resistance and type 2 diabetes.
It Releases Free Fatty Acids Directly to the Liver
Visceral fat is in direct anatomical proximity to the liver via the portal circulation. Free fatty acids released from visceral fat go to the liver first, where they drive hepatic fat accumulation (fatty liver disease — NAFLD/MASLD) and increase triglyceride production, worsening the cardiovascular risk profile.
It Correlates With Cardiovascular Disease Risk
Multiple large studies have shown that waist circumference and waist-to-hip ratio — proxies for visceral fat — predict cardiovascular disease risk better than BMI alone. People with "metabolically obese, normal weight" (high visceral fat but normal BMI) have substantially higher cardiovascular risk than their weight suggests.
How to Measure Visceral Fat
Direct measurement requires imaging (CT or MRI) — expensive and not routine. Practical proxies:
Waist circumference: Greater than 80 cm in South Asian women or 90 cm in South Asian men indicates high visceral fat risk. Note that South Asian populations have higher visceral fat at lower BMI compared to European populations — the threshold is lower than Western guidelines.
Waist-to-height ratio: Waist circumference divided by height above 0.5 indicates excess visceral fat. This is a practical, easily calculated, and highly predictive measure.
HbA1c and fasting glucose: Elevated values in the prediabetes range strongly suggest visceral fat-driven insulin resistance even before obesity is clinically visible.
How to Lose Visceral Fat
Visceral fat is more responsive to calorie deficit and exercise than subcutaneous fat. It is typically mobilised first during weight loss, which is why metabolic improvements (blood pressure, blood sugar, cholesterol) occur early in weight loss even before visible body shape changes.
Most effective interventions:
- Calorie deficit: Creates conditions for fat mobilisation; visceral fat is preferentially mobilised early
- Aerobic exercise: Consistently shown to reduce visceral fat even without significant total weight loss
- Resistance training: Reduces visceral fat and improves insulin sensitivity independent of aerobic exercise
- GLP-1 pathway support: GLP-1 agonists specifically reduce visceral fat — in clinical trials, the proportion of visceral fat reduced was greater than the proportion of total fat reduced
- Reduced refined carbohydrate intake: Reduces insulin spikes that drive visceral fat accumulation
- Adequate sleep: Sleep deprivation promotes cortisol-driven visceral fat deposition
METASLIM's physician-guided 8-week program produces meaningful weight loss of 8 to 22 kg, with the visceral fat-preferential mobilisation characteristic of GLP-1 pathway activation providing early metabolic improvements. The program targets the metabolic disease at its most harmful storage site.