Sven Wombwell
Article by: Sven Wombwell
Estimated 10 minutes read

Visceral fat is excess body fat stored in the abdominal cavity. This type of fat is dangerous because it surrounds crucial organs such as the liver, intestines, and pancreas. It is also known as 'active fat' because it is more metabolically active than subcutaneous fat. Visceral fat produces hormones that cause harm, increasing diabetes and heart disease risk.

People who store excess hidden fat have an increased risk of type 2 diabetes, insulin resistance, heart disease, and certain types of cancer. Clearly, anything we can do to reduce visceral fat will undoubtedly do us good. One important point to remember is that visceral fat could be hidden from plain sight within your abdominal cavity. Consequentially, you could be relatively skinny and still be carrying too much 'hidden fat.

Scales and feet

Because it is hidden, people refer to visceral fat as 'skinny fat.' Check to see if your hormones are to blame!

Subcutaneous or Visceral?

There are different types of fats that we store in the body. Subcutaneous fat under the skin is fat that you can pinch under your arms, on your stomach, and on the tops of your legs. In contrast, visceral fat is under the stomach muscles deeper inside the body.

Importantly a "beer belly" is a combination of both visceral and subcutaneous fat. Because visceral fat is deep within the body, it goes unseen, enveloping our internal organs and padding out the spaces between them.

Why is Visceral Fat so Dangerous?

Visceral obesity affects over 20% of the global adult population. Importantly, it's the main risk for metabolic syndrome, with some estimates saying that 50% of the world's population will be obese by 2030. Therefore, it is likely that metabolic syndrome will become the most significant drain on healthcare worldwide.

Many studies show that this type of fat is far worse for your health than subcutaneous fat. Visceral fat has a higher concentration of cells, carries more blood flow, and has more receptors for using up hormones. Visceral fat is also more biologically active, meaning the fat cells produce hormones via aromatase protein (which converts testosterone into estradiol). This conversion increases cytokines (a type of protein) that cause inflammation around the body.

Importantly, visceral fat can affect the portal vein. This vein carries blood from the intestine to the liver. In turn, this increases fatty acids in the liver, affecting blood lipid production (including cholesterol and triglycerides). Additionally, this increases insulin resistance, leading to an increased risk of type 2 diabetes.

Remember that exercise, diet changes, and hormone replacement therapy can reduce visceral obesity and have significant positive effects on your body and life expectancy.

Metabolic Syndrome

Metabolic syndrome is a combination of a least three out of five clinical risk factors often caused by an unhealthy lifestyle. These are:

  1. Abdominal (visceral) obesity
  2. Hypertension (high blood pressure)
  3. Elevated triglycerides (high 'bad' cholesterol)
  4. Low serum high-density lipoprotein (Low good cholesterol, HDL)
  5. Insulin resistance (leads to type 2 diabetes)

Visceral fat sits at the top of the list of risk factors, of which all the others are often a result. Everybody stores a certain amount of hidden fat, but developing metabolic syndrome, can cause dangerous health conditions, such as:

  • Heart Disease
  • Type 2 Diabetes
  • Atherosclerosis
  • Increased risk of stroke

How Can I Tell if I Have too Much Visceral Fat?

The only way to determine how much visceral fat you are storing is to have an MRI scan. However, this is an expensive procedure that is not common for this purpose. The usual method of diagnosis is to take waistline measurements, although this is not particularly accurate. About 10% of your body fat is visceral so if you are carrying too much fat overall, you are likely to have higher than safe amounts of hidden fat as well. Women with a waistline over 35 inches and men over 40 inches generally carry excess visceral fat. Notably, if you're of Asian descent, visceral fat measurement drops to 31.5 inches for women and 35.5 inches for men.

Why Does the Body Store Fat Around Organs?

No one really knows why your body stores fat internally, but apart from eating too much and not getting sufficient exercise, scientists have connected stress and the stress hormone cortisol. Repeated elevation of cortisol can lead to weight gain via visceral fat storage. Cortisol can mobilize triglycerides (unused fat from what you eat) from fat storage, relocating them internally. Cortisol also aids adipocytes' development into mature fat cells stored all over the body.

How Do You Prevent Visceral Fat?

It is pretty straightforward why people develop subcutaneous and visceral fat. It's no surprise that overeating, fatty food, and a lack of movement will increase fat levels. Fat play havoc with hormone levels, simply making the problems even worse. If you consume more calories than you burn, your body turns these extra calories into fat, storing the calories for use later on.

Your body stores excess calories as fat, both subcutaneous and visceral. Your body stores this fat within specialized fat cells called adipose tissue. More fat develops by enlarging fat cells, which are always present in the body, or by creating more of them.

So, the simple answer is to eat healthily, keep active, optimize hormones and not get too stressed.

  • Exercise regularly: Burn those extra calories.
  • Eat a healthy balanced diet: Avoid high-fat and processed foods that increase insulin levels.
  • Reduce stress levels: Cortisol (and insulin) directly increases your fat reserves and reduces testosterone.
  • Reduce alcohol intake: Alcohol is full of calories and carbs; it lowers testosterone and lacks nutrients beneficial for a healthy metabolism and will, therefore, hasten fat storage.
  • Don't smoke.
  • Get plenty of sleep: A lack of sleep increases stress and, therefore, cortisol levels.

Fat and Type 2 Diabetes

Research shows that visceral fat can cause insulin resistance, glucose intolerance, and type 2 diabetes. It is common for obese people to develop type 2 diabetes. In fact, obese people are 80 x more likely to develop diabetes than others.

People carrying high amounts of hidden fat are at risk of developing insulin resistance leading to glucose intolerance and type 2 diabetes. Visceral fat releases a protein called retinol-binding protein 4 (RBP4), which increases insulin resistance. It is widespread for obese people to suffer from low testosterone and type 2 diabetes.

Ultimately, visceral fat slows testosterone production. The more fat you develop, the less testosterone your body produces. Unfortunately, it all becomes a perpetual cycle. Low testosterone levels increase fat deposits, which slow testosterone production even further. Visceral fat cells promote the creation of an enzyme called aromatase, which converts testosterone to estradiol. The more fat you put on, the more aromatase enzyme you produce, and the more testosterone converts into estradiol.

Visceral Fat and Your Hormones

It is becoming more widely recognized that a growing belly can result from an imbalance in your hormones. Various complex processes are at work here, and your hormones are crucial to maintaining a healthy body weight. But which hormones play a part?


As discussed, overweight men often have high estrogen levels and low levels of testosterone. Testosterone actively increases muscle mass and decreases fat deposits, particularly visceral fat. For most overweight and obese men, losing weight will help increase testosterone levels. The fact is testosterone levels decrease with age, so the older you get, the more difficult it becomes to reduce that belly.

Testosterone replacement is recommended for patients to achieve optimum levels, making it easier to lose weight and gain lean muscle.


Estrogen is good for you and will not turn you into a woman or make you an over-emotional crybaby. This hormone will not make you grow man boobs! Estrogen results from a conversion from testosterone in the testicles, adrenal glands, and, most importantly, from fat via aromatase conversion. Increased visceral fat increases the 'speed of conversion' from testosterone into estradiol (a type of estrogen) and causes a spiraling imbalance between these two hormones.

Symptoms include all the typical signs of low testosterone levels, including

  • Weight gain (especially visceral fat)
  • Decreased muscle mass
  • Low energy
  • Decreased sexual desire
  • Erectile dysfunction
  • Depression

In this situation, guys will significantly benefit from testosterone therapy, correcting the estradiol and testosterone imbalance, making it far easier to lose that stubborn visceral fat.

Thyroid hormones

Crucially, the thyroid and the hormones it produces play a pivotal role in your metabolism, including how your body breaks down fat and lowers dangerous cholesterol. Doctors often misdiagnose thyroid issues with other conditions, such as low testosterone. If your thyroid isn't functioning as well as it should, you may experience similar symptoms to low testosterone, such as fatigue and weight gain.

For this reason, Male Excel healthcare providers always check thyroid function and test other hormones, such as testosterone. This way, we get an accurate picture (along with symptoms) of a patient's true hormone health. Our healthcare providers can then prescribe natural thyroid medication to enhance testosterone therapy for the best results.


Cortisol, also known as the 'Stress Hormone,' is produced in the adrenal glands. Its main function is to metabolize glucose, fats, and proteins to respond to physical and psychological stress. However, if you are always stressed and your cortisol levels are high, it has unfortunate side effects like suppressing your immune system, causing depression, and lowering testosterone.

Due to symptoms of reduced testosterone, such as being overweight, lack of concentration, and poor sleep patterns, cortisol increases - making the problem harder to fix. Cortisol increases visceral fat by converting fat from other areas of the body into this dangerous fat. Although testosterone replacement therapy will not remove stress from your life. It can give you the energy and the desire to fix the problems causing it.

How Can BHRT Help Reduce Visceral Fat

Stress, hormones, and lifestyle factors all add to visceral fat development. Testosterone replacement therapy can help your body fight many negative 'causes' of this dangerous type of fat. Along with other lifestyle changes, it can reduce the visceral fat stored in your abdominal cavity. The result is a reduced risk of heart attacks, diabetes, stroke, and other associated risks attached to visceral fat.

Regular exercise, eating a balanced diet, and avoiding processed foods will help delay some effects of 'aging.' However, your hormones will decrease over time, making it much harder to reverse symptoms like visceral fat.
Male Excel recommends measuring your hormone levels before any significant andropause symptoms develop. It is never too late to start your journey to optimal hormone health.

Your doctor won't tell you that hormone imbalance is a huge reason for visceral fat development and a whole host of related symptoms. They will blame diet, and a lack of exercise, even saying it's just part of 'old age.' Visceral fat is not part of old age, and you can do something about it. You can take control of your life and body again with bioidentical hormone replacement therapy.

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Serum retinol-binding protein 4 levels in patients with diabetic retinopathy. J Int Med Res. 2010 Jan-Feb;38(1):95-9. DOI: 10.1177/147323001003800111. PMID: 20233518.
Mittal B. Subcutaneous adipose tissue & visceral adipose tissue. Indian J Med Res. 2019;149(5):571-573. doi:10.4103/ijmr.IJMR_1910_18
Rytka JM, Wueest S, Schoenle EJ, Konrad D. The portal theory supported by venous drainage-selective fat transplantation. Diabetes. 2011;60(1):56-63. doi:10.2337/db10-0697
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