Not All Body Fat Is the Same

When most people think of body fat, they imagine the pinchable layer just under the skin. That’s subcutaneous fat, and while too much of it isn’t ideal, it’s not the most dangerous type when it comes to your heart.

The real threat is visceral fat—the fat stored deep inside your abdomen, surrounding your liver, pancreas, and intestines. This type of fat acts more like an active organ than a passive storage site, and unfortunately, it’s an organ that works against you.

Why Visceral Fat Is So Dangerous

Unlike subcutaneous fat, visceral fat is metabolically active, meaning it releases inflammatory chemicals and hormones that affect your entire body. Over time, it can:

• Increase insulin resistance, leading to type 2 diabetes
• Raise blood pressure
• Elevate LDL cholesterol and lower HDL cholesterol
• Promote chronic inflammation
• Disrupt normal blood vessel function

These changes dramatically increase the risk of heart attack, stroke, and other cardiovascular events.

The Link Between Visceral Fat and Heart Disease

Visceral fat releases inflammatory cytokines such as TNF-alpha and interleukin-6, which contribute to endothelial dysfunction—a condition where blood vessels lose their ability to relax and regulate blood flow. This dysfunction is an early step in the development of atherosclerosis, or plaque buildup in the arteries.

It also increases production of C-reactive protein (CRP), a blood marker of inflammation that is strongly linked to cardiovascular risk.

Even more concerning—research has shown that you can have a normal weight on the scale and still have dangerous levels of visceral fat, a condition sometimes called TOFI (“Thin Outside, Fat Inside”).

What Causes Visceral Fat to Accumulate?

Several factors can promote visceral fat storage:

• Poor diet – Diets high in refined carbohydrates, added sugars, and processed foods.
• Sedentary lifestyle – Lack of regular physical activity.
• Chronic stress – Elevated cortisol levels encourage central fat storage.
• Hormonal changes – Menopause and low testosterone can shift fat storage toward the abdomen.
• Poor sleep – Short or irregular sleep patterns disrupt metabolic regulation.
• Excess alcohol – Promotes fat storage in the liver and abdominal cavity.

How to Know if You Have Too Much Visceral Fat

You can’t grab visceral fat with your fingers, but you can estimate your risk:

• Waist circumference – Over 35 inches for women or 40 inches for men suggests higher visceral fat.
• Body shape – An “apple-shaped” body is often a sign of visceral fat storage.
• Advanced body composition testing – Tools like DEXA scans or bioimpedance analysis can measure visceral fat directly.

At Sheen Vein & Cosmetics, we use body composition analysis as part of our functional medicine evaluations to help patients understand their metabolic health beyond the scale.

Reducing Visceral Fat – A Functional Medicine Approach

The good news: visceral fat is metabolically active in another way—it responds quickly to the right interventions.

Our St. Louis functional medicine program for reducing visceral fat may include:

1. Nutrition Reset – Prioritizing whole foods, lean protein, vegetables, healthy fats, and reducing refined carbs and sugars.
2. Targeted Exercise – Combining resistance training with high-intensity interval training (HIIT) for maximum fat loss and insulin sensitivity improvement.
3. Stress Management – Techniques like deep breathing, mindfulness, and gentle movement to lower cortisol.
4. Optimizing Sleep – 7–9 hours of restorative sleep to support metabolic balance.
5. Hormone Balance – Addressing low testosterone, estrogen, or thyroid function when appropriate.
6. Inflammation Reduction – Identifying and removing triggers such as food sensitivities or environmental toxins.

A Real-World Example

A 54-year-old man came to our St. Louis office with normal cholesterol but a growing waistline and high blood pressure. Body composition analysis revealed elevated visceral fat.

Through a tailored functional medicine plan—including a low-glycemic diet, strength training, stress reduction, and sleep optimization—he lost 15 pounds in three months, most of it from visceral fat. His blood pressure normalized, energy improved, and his inflammatory markers dropped significantly.

The Takeaway

Visceral fat isn’t just a cosmetic concern—it’s a silent driver of cardiovascular disease. Even if your weight seems “normal,” excess fat around your organs can quietly increase your risk for heart attack and stroke.

The good news? With the right lifestyle, nutrition, and medical support, visceral fat can be reduced—often more quickly than subcutaneous fat.

At Sheen Vein & Cosmetics, we use advanced testing, personalized nutrition, and targeted lifestyle strategies to help patients reduce visceral fat and protect their heart health. We offer in-person visits in St. Louis and telemedicine consultations across Missouri and Illinois.

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