Central Obesity
Fat carried around the waist, which drives insulin resistance far more than fat elsewhere.
Key Takeaways
- Waist measurement predicts metabolic risk better than body weight or BMI.
- South Asian patients face raised risk at lower thresholds than other populations.
- Abdominal fat is metabolically active, driving insulin resistance and inflammation.
- It responds well to dietary change and exercise, often faster than overall weight.
Why Does Waist Fat Matter More?
Central obesity: excess fat stored around the abdomen and internal organs, measured by waist circumference rather than total body weight.
Fat around the organs releases inflammatory signals and free fatty acids directly into the circulation feeding the liver. Consequently, the liver becomes resistant to insulin, produces more glucose, and blood sugar rises. Fat stored under the skin on the hips and thighs does not behave this way.
Why Are South Asians at Higher Risk?
Because we accumulate visceral fat at lower body weights and lower BMI values. A person here can have a normal BMI and still carry significant abdominal fat with genuine insulin resistance, a pattern sometimes described as thin outside, fat inside. Waist thresholds for Indian patients are therefore set lower than international figures.
How Is It Measured?
- Waist circumference at the midpoint between the lowest rib and the hip bone
- Waist to hip ratio, showing distribution
- Body composition analysis estimating visceral fat directly
- Metabolic markers including fasting insulin and triglycerides
How Is Central Obesity Treated?
Encouragingly, it responds well. Dietary change reducing refined carbohydrate, regular activity combining aerobic and resistance work, adequate sleep and stress management all reduce visceral fat. Notably, it often falls before overall weight changes much, so metabolic markers improve early.
Where progress stalls despite genuine effort, medical options are discussed.
What Does Assessment Cost and What Results Are Realistic?
Measurement is part of a metabolic evaluation, priced as a package with body composition and blood work. Expect waist reduction of several centimetres across three months with consistent effort, and improvements in fasting sugar and triglycerides often appearing sooner than that.