Diabetic Belly: Causes, Risks, and Management Tips

‘Diabetic belly’ is not a recognized medical term but a colloquial term used to describe a buildup of visceral fat in the body, often found in patients with type 2 diabetes. This article will provide information on the causes and associated risks of having too much visceral fat and provide useful management tips for maintaining a healthy level of visceral fat within the body.

What is 'diabetic belly'?

'Diabetic belly' refers to the accumulation of visceral fat often found in individuals with type 2 diabetes, creating a cycle where increased visceral fat contributes to worsening diabetes, and diabetes makes it easier to gain visceral fat. According to research, there is a strong association between measures reflecting abdominal obesity and the development of type 2 diabetes.

Most fat within the body is known as subcutaneous fat, which is stored just under the skin and typically makes up the majority of fat in humans. Visceral fat, however, is stored deep within the abdominal cavity, surrounding our internal organs such as the heart, liver, and intestines.

Both subcutaneous and visceral fat have some shared functions such as energy storage, protection and cushioning for surrounding muscles and organs, and hormone production. However, visceral fat is linked to several health risks, including its close association with type 2 diabetes. Furthermore, it is more difficult to lose visceral fat than subcutaneous fat overall.

It is important to note, however, that an increase in visceral fat can also be unrelated to diabetes and may be an indication of another medical condition.

Visual indicators and symptoms

The most noticeable visual indicator of ‘diabetic belly’ is abdominal weight gain, specifically an enlargement of the abdomen area due to fat accumulation. There may be little or no symptoms, but the characteristic of weight gain could manifest in many unspecific gastrointestinal issues.

One study concluded that fat distribution, namely increased visceral fat, is significantly associated with high blood pressure. Links have also been found between excess visceral fat and fatigue, sleep apnea, hormonal imbalances, and mood disorders, not to mention the risk of severe health complications, which we will discuss later in the article.

Causes of 'diabetic belly'

The causes of 'diabetic belly' are multifaceted, involving a range of different bodily functions and internal processes.

Insulin resistance

Researchers have found that levels of serum retinol-binding protein (RBP4), a retinol transporter secreted by fat and liver cells, are increased in patients with both obesity and type 2 diabetes, and more often found in visceral rather than subcutaneous fat. Elevated serum levels of RBP4 are also associated with insulin resistance.

Metabolic syndrome

The distribution of body fat has been identified as a major contributing factor in metabolic syndrome, particularly where there is an accumulation of visceral fat. Metabolic syndrome is a cluster of metabolic conditions, which combined make one extremely significant risk factor for complications such as stroke and cardiovascular disease. This cluster of factors includes abdominal obesity, high blood pressure, elevated fasting blood glucose levels, high blood triglyceride levels, and low blood HDL cholesterol levels.

Again, this can be both a precursor for and a consequence of type 2 diabetes. Research states metabolic syndrome increases the risk for the development of type 2 diabetes mellitus, as well as other conditions such as cardiovascular disease.

Cortisol

Cortisol, also known as the ‘stress hormone,’ has an impact on fat storage. Excess cortisol stimulates glucose production, which is then converted into fat. People with higher levels of visceral fat often have higher levels of insulin. Due to insulin resistance, cells do not respond properly to insulin, prompting the pancreas to produce more insulin to compensate. In the presence of insulin, excess cortisol increases the activity of the LPL enzyme, which plays a large role in fat storage, specifically promoting the accumulation of visceral fat.

Chronic stress can lead to high levels of cortisol, which in turn leads to a higher accumulation of visceral fat and abdominal obesity. High levels of cortisol may also lead to insulin resistance.

Lifestyle factors

According to one study, environmental and lifestyle factors have a huge impact on the prevalence of type 2 diabetes, including aspects of diet quality and quantity, physical activity, increased monitor viewing time, poor sleep quality, smoking, stress, and depression.

Researchers conclude that such factors promote an increase in body mass index, including an increase in visceral fat or the onset of 'diabetic belly,' which is a significant risk factor for the development of type 2 diabetes.

What does a 'diabetic belly' look like?

'Diabetic belly' primarily follows the characteristics of an apple-shaped body, where the fat predominantly centers around the abdomen rather than a pear-shaped body, where fat centers around the lower body.

A good indication of whether or not you have 'diabetic belly' can be found by measuring your waist with a tape measure. For many, the belly button is an effective guide, but for others, it is advisable to find the top of your hip bone and the bottom of your ribcage and measure between these points.

A healthy waist size depends on factors such as gender and ethnicity, but generally speaking, this should fall under 31.5 inches for women, less than 37 inches for men, and less than 35 inches for South Asian men.

If your waist falls over the indicated measurements, it may be advisable to consult a healthcare professional for advice on lifestyle and behavioral interventions and assessment.

Health risks associated with 'diabetic belly'

Your body building up too much visceral fat can be a sign of much more serious underlying issues, leading to various other health complications, which we will go on to discuss.

Increased risk of cardiovascular diseases

A high amount of visceral fat has a significant impact on cardiovascular disease risk, as it is associated with increased levels of inflammation, insulin resistance, elevated blood sugar levels, hepatic steatosis, and many other metabolic and vascular disturbances, which all contribute to increased cardiometabolic risk.

Link to type 2 diabetes

As previously discussed, type 2 diabetes is closely linked to an increase in visceral fat, known as 'diabetic belly.' There is a strong association between measures reflecting abdominal obesity and the incidence of type 2 diabetes. At the same time, individuals with type 2 diabetes are more likely to gain visceral fat.

Potential for other disorders

Other potential health complications include Alzheimer's, cancer, and stroke. One recent study reported findings that visceral fat is associated with brain changes related to Alzheimer's up to 15 years before diagnosis. The authors of this pilot study hypothesized that excess visceral fat may play a role in brain inflammation, one of the main mechanisms contributing to Alzheimer’s disease.

Research linking obesity and cancer is well-considered. One review considers the possibility that chronic inflammation caused by excess visceral fat may cause long-term damage to your body, increasing the risk of cancer.

Impact on overall health and wellness

Individuals with 'diabetic belly' may also see an impact on their overall health and wellness, with links to symptoms such as fatigue, high blood pressure, decreased mobility, and impaired immune function — all impacting the quality of day-to-day life. Not only can it contribute to poor physical health, but also to mental health issues.

How to manage and reduce 'diabetic belly'

Visceral fat may be managed by introducing a range of dietary and lifestyle changes. Introducing nutritional adjustments, increasing physical activity, reducing alcohol consumption, and trying out new stress management techniques can help one take a certain level of control over their 'diabetic belly.'

Dietary adjustments

The Mediterranean diet stands out as one of the best dietary approaches to managing the accumulation of visceral fat, or 'diabetic belly, characterized by high consumption of vegetables, fruit, nuts, cereals, whole grains, extra virgin olive oil, fish, poultry, and a limited intake of sweets, red meat, and dairy products.

An alternative diet that has gained recognition in this area is the ketogenic diet; however, although this strategy may help with weight loss, it is highly advisable to discuss implementation with a healthcare provider prior to use.

Exercise recommendations

The introduction of simple exercise alone can have a beneficial effect on the reduction of visceral fat. One meta-analysis found that an aerobic exercise program, without a low-calorie diet, was shown to help reduce visceral fat over a 2-week period.

Nonetheless, a combination of dietary adjustments and exercise is preferred. Simple exercise routines and weight loss strategies can make all the difference. Picking an exercise and healthy meals you like will help encourage upkeep, and consulting with a healthcare professional may validate the importance of making changes to your lifestyle to lose excess visceral fat.

Medical treatments and interventions

If you think you may have too much visceral fat, seek medical advice. Treatment and intervention will depend on your individual history and physical exam, as well as any associated health issues. The medical discussion will center around lifestyle and behavior changes. Blood tests and an electrocardiogram may be done to asses any associated health risks. You can take control over your life through awareness and simple lifestyle adjustments.

Men with a waist circumference of over 40 inches and women over 35 inches are highly encouraged to see a healthcare professional.