Central Obesity

Central Obesity, also known as abdominal, truncal, or visceral obesity, is the condition of excessive fat accumulation specifically in the abdominal region around the stomach and waist, creating a "pot belly" appearance. Unlike general obesity, where fat distributes throughout the body, central obesity concentrates visceral adipose tissue (VAT) deep within the abdomen around organs like the liver, pancreas, and intestines.

This fat distribution pattern is far more dangerous than peripheral obesity. Central obesity poses significantly higher risks for cardiovascular disease, type 2 diabetes, hypertension, dyslipidemia, metabolic syndrome, stroke, and all-cause mortality—even in individuals with normal BMI. Visceral fat is metabolically active, releasing inflammatory substances and free fatty acids that cause insulin resistance and endothelial dysfunction.

Diagnosis relies on waist circumference measurements. In the United States, central obesity is defined as waist >102 cm (40") in men or >88 cm (34.5") in women. For Asia-Pacific populations, thresholds are lower: >90 cm for men, >80 cm for women. Waist-to-hip ratio (>0.9 men, >0.85 women) and waist-to-height ratio also assess central adiposity.

Treatment emphasizes lifestyle modifications: calorie-restricted diets, regular aerobic exercise, and strength training. Reducing central adiposity can reverse cardiac remodeling and improve metabolic health.