Fat stored around the organs behaves differently from fat under the skin: it is metabolically active and drives insulin resistance, raised triglycerides and blood pressure. Indian populations carry more of it at any given BMI, which is why waist measurement is the more useful number.
Two kinds of fat
Subcutaneous fat sits under the skin. It is largely inert storage. Visceral fat sits around the liver, pancreas and intestines, and it is metabolically active tissue — it releases fatty acids directly into the portal circulation and produces inflammatory signalling molecules.
This is why two people of the same weight can have entirely different metabolic profiles, and why someone of an apparently normal weight can have fatty liver, raised triglycerides and insulin resistance.
Is this what is happening to you?The two-minute check further down asks four questions and shows the result immediately. No email, no call.
Take the 2-minute checkWhy BMI is the wrong instrument here
BMI was developed on European populations and it measures weight against height. It says nothing about composition or distribution.
Asian populations develop metabolic disease at lower BMI values than European ones, which is why Asia-Pacific criteria set the thresholds lower — risk begins to rise from a BMI of 23 rather than 25. Even those thresholds are a blunt instrument compared with a tape measure.
- Waist above 90 cm in men, or 80 cm in women, indicates raised risk under Asia-Pacific criteria
- Waist-to-height ratio above 0.5 is a simple and useful check — your waist should be under half your height
- Both are more informative than BMI, and both cost nothing
2-minute check
What is causing your weight gain?
Four questions. Your result appears immediately — we do not ask for an email.
What happens when you diet?
How is your energy and temperature?
Do you get strong cravings or afternoon crashes?
How do you sleep?
No strong metabolic driver shows up
That usually means the plan is the issue rather than your physiology — a much easier problem.
A driver may be involved
Thyroid and insulin are the two worth testing first. Both are common and both are treatable.
Your answers strongly suggest a metabolic driver
This is the pattern where dieting alone tends to fail. Testing thyroid, insulin and vitamin D is the sensible next step.
This check is an indication, not a diagnosis. It does not replace medical advice.
How to measure it properly
Measure at the midpoint between the lowest rib and the top of the hip bone, not at the navel and not where the trousers sit. Stand relaxed, breathe out normally, and do not pull the tape tight.
Measure in the morning, before eating, and record it. A single measurement is a number; a series of them is information.
What shifts it
Visceral fat responds well to the things that improve insulin sensitivity, which is convenient because they are the same things.
Reducing refined carbohydrate and added sugar, raising protein and fibre, resistance training and adequate sleep all act on it. Alcohol and sweetened drinks act against it, and fructose in particular is routed to the liver.
We do not publish figures for how much or how fast. The mechanism is well established; the pace is individual and depends on where you are starting.
In short
Questions we are asked
Can you lose fat from one area?
Not by choice. Fat is mobilised from across the body, though visceral fat does tend to respond earlier than subcutaneous fat, which is why the waist often changes before the scale does.
My BMI is normal. Do I still need to check my waist?
Yes. Normal-weight metabolic obesity is well described in Indian populations. It is exactly the group that a BMI check reassures wrongly.
Reading about it is the easy part.The assessment turns this into your own numbers — free, with a free first consultation, and no figure quoted that we cannot substantiate.
Start my free assessmentConditions this relates to
Recipes that put this into practice
Methi thepla with curd
The same thepla, with a flour blend and a partner that flatten the glucose rise.
See the recipe →Moong dal chilla
Thirteen grams of protein at breakfast, and the difference shows up at four in the afternoon.
See the recipe →Cinnamon and fenugreek water
Two minutes, modest real evidence, and an honest account of its limits.
See the recipe →Related reading
Why weight will not move when your thyroid is underactive
When effort stops producing a result, the problem is often not the effort.
Read →Insulin resistance, explained without the jargon
One mechanism sits underneath PCOS, fatty liver, acne and stubborn weight.
Read →Eight numbers worth understanding on your blood report
Most reports get read for what is flagged. The useful information is often elsewhere.
Read →References
- World Health Organization — waist circumference and waist-hip ratio, report of a WHO expert consultation.
- WHO Expert Consultation — appropriate body-mass index for Asian populations.
- [Further references to be completed by the medical review panel.]
This article is general health information, written by a clinical nutritionist and reviewed by a doctor. It is not a diagnosis and it does not replace advice from your own clinician. Never change prescribed medication on the basis of what you read here.