Have you ever had a doctor measure your waist, and not really known why? It’s not to make you feel bad about your shape. It’s because it matters where fat is. Fat at the waistline can indicate a risk for some serious health problems.

Visceral Fat Is Dangerous

The number on the measuring tape may shed light on how much “visceral” fat you have. Visceral fat is the fat stored in your abdomen, so it surrounds vital organs like the liver, stomach, small intestines and pancreas. In general, a larger waist indicates more of this kind of fat. In large amounts, it can damage these organs.

“It’s the most dangerous kind of fat,” said Dr. Susan Anderson, a medical director with Blue Cross and Blue Shield.

It can be the first clue that someone will develop insulin resistance, a stepping stone to Type 2 diabetes if not reversed. It also raises the risk of heart disease, cancer and Alzheimer’s.

Extra weight in your middle, a waistline of 35 inches or more for women, 40 inches or more for men, is also one of the main risk factors for metabolic syndrome. Metabolic syndrome is diagnosed in people who have any combination of the following: high blood pressure, raised blood sugar, low HDL (“good”) cholesterol or high triglycerides. Metabolic syndrome puts people at risk for serious health problems like Type 2 diabetes and heart disease.

What Can You Do?

Measure your waist. Know what the number is. If it’s high, talk to your doctor about what it means for you. A large waist may not always signal visceral fat, and being slim doesn’t always mean you have no worries. But if your doctors says your number puts you at risk, take steps to reduce it.

Pay attention to your lab tests. Look at your bloodwork. Your health care provider can help you understand your blood sugar numbers and any changes you see in them over time. You can have insulin resistance or diabetes even if your blood sugar is still in the normal range.

Decrease your sugar intake. “There are no essential sugars or carbs,” Anderson said. Your body can make sugar (glucose) from scratch to feed those few cells in the body that actually need it. Cut back on refined sugar. Then reduce your intake of carbohydrates that turn into sugar as soon as you eat them, like breads, pasta, rice and potatoes.

Read food labels and become aware of “hidden sugars.” Become familiar with all the words that mean sugar so you can avoid these foods. Cutting back can be hard at first, but the less sugar you eat, the less you crave.

Look for whole foods and natural foods. Healthy, natural fats and protein will make you feel full much longer and will decrease blood sugar highs and lows. You won’t feel the need to snack as much.

Step up your exercise. Since you’re aiming for a lifestyle change, rather than just trying a new diet, regular exercise is essential.

Talk to your doctor. Your doctor can help you safely start to make healthy lifestyle changes to reduce visceral fat.

Sources: Metabolic Syndrome,  Overweight and Obesity,  National Heart, Blood and Lung Institute, NIH; Why Worry About Your Waistline?,  Harvard Health Publishing, 2019