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The facts on fat

Last Modified: February 18, 2019

Family Medicine

Is belly fat really the most dangerous fat? We asked Jolynn Wann, FNP-C, PPG – Weight Management & Bariatric Surgery, to set the record straight.

All fat is not created equal

There are actually two kinds of fat: white fat and brown fat. White fat is basically unwanted fat. It’s the fat that stores the extra calories. This type of fat often resides around the stomach, but can be found all over the body.

Brown fat is found around organs and some bone structures, like the spinal column. Brown fat burns energy, regulates body temperature, boosts metabolism, burns fat, improves glycemic control and improves insulin insensitivity. You have more brown fat when you’re a baby. It keeps you warm, and, as you get older and learn how to care for yourself, you lose some of it.

Current studies are looking into how to improve and retain brown fat, and even turn white fat into brown fat, as it’s thought to fight obesity (leaner individuals have more of it than obese individuals), and once it’s gone, it’s gone. Research has also shown that brown fat is activated in colder climates, so more work will be done around temperature.

Does location matter?

There’s a commonly held belief that belly fat is the most dangerous fat. While there is some truth to the concept, any excess fat is dangerous, though it does tend to reside most commonly in the midsection. While excess fat on the extremities is less common, it is still possible, and contributes to elevated risk factors.

Carrying an excess of white fat in the abdominal area does put one at a greater risk for metabolic issues, which can apply to other comorbidities as well. It’s also a lot of weight to carry around, so it puts strains on the back and joints.

What are the risks of carrying extra weight?

Excess weight contributes to an increased risk for diabetes, heart disease, cardio disease, metabolism issues, fatty liver disease, which turns into liver failure, cancer (colon, rectal, endometrial and breast, in particular), mental health issues (depression, anxiety, body image disturbances, psycho-social) and a decreased life expectancy of at least four years.

Are certain people more prone to carry extra weight?

Absolutely. Females are designed to bear children so they are more prone to carry extra weight. Men were biologically designed for manual labor, so they’re more muscular. A lot of times in the office, I see men lose weight faster because they’re predisposed to.

There are also hormone issues to consider. The leptin hormone is the satiety hormone, created by the fat cells themselves. When you’re eating, the fat cells release leptin and tell the brain to stop eating because you have enough energy to survive for the next several hours. For some, this signal is broken and they overeat, causing an excess of calorie stores in the fat tissue. For others, it’s a lack of leptin production.

When is weight considered dangerous?

An individual is overweight if their BMI is 25-39.9, they are obese if it’s greater than 30, and they’re morbidly obese if their BMI is greater than 40. What most people don’t realize, is that if you fall into one of these categories, and can lose as little as 5 percent of their total body weight, you will begin to reverse existing conditions and lower your risk for other risk factors. If you’re on medications, and can lose as little as 10-20 percent of your total body weight, you can typically start coming off of medications. It’s important to just get the ball rolling and start improving their life and health.

Start in the kitchen

When you start your weight loss journey, about 80-90 percent is diet alone. Exercise isn’t really a factor until you hit a plateau. Sure, we’ll have you start exercising to get your body in motion and engage the muscles, but it isn’t the key component of weight loss like diet is initially. Once your weight loss starts to stall, then exercise becomes the game changer. Exercise alone without nutrition will get you nowhere. Fad diets won’t work; you’ll just put it all back on. You have to pick sustainable, smart choices. It has to be about lifestyle changes.

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