What Is Visceral Fat, and How Do You Lose It?

Key takeaways

• Visceral fat comes off as total body fat comes off. Across 37 imaging studies, it fell by roughly 1.3 percent for every 1 percent drop in total fat mass.²
• In the Framingham Heart Study, each standard-deviation step up in visceral fat raised the odds of metabolic syndrome about 4 to 5 times, compared with about 2.5 to 3 times for subcutaneous fat.³
• In studies where weight did not change, exercise was linked to about a 6 percent drop in visceral fat, while diet showed almost none.¹⁰
• DEXA visceral fat had a precision error of 28.9 percent on repeat scans, and the ISCD says its clinical value is currently uncertain.¹³¹⁴
• Smart scales estimate visceral fat with the maker's own equations, and individual readings were often far off when checked against MRI.¹⁶¹⁷

What is visceral fat?

Visceral fat is the fat stored inside your abdomen, around your organs and beneath the muscle wall. Subcutaneous fat is the fat just under your skin. Visceral fat comes off as your total body fat comes off. Across 37 imaging studies, it fell by roughly 1.3 percent for every 1 percent drop in total fat mass, whatever method people used to lose weight.¹²

Why does visceral fat matter?

In 3,001 adults in the Framingham Heart Study, both kinds of belly fat were linked to higher blood pressure, blood sugar and triglycerides. Visceral fat had the stronger link. Each standard-deviation step up in visceral fat raised the odds of metabolic syndrome about 4 to 5 times, compared with about 2.5 to 3 times for subcutaneous fat. Visceral fat still explained risk after accounting for BMI and waist size.³

A 2019 position statement from two international expert groups concluded that visceral fat, measured by CT or MRI, is an independent risk marker for heart disease, metabolic disease and death. It added that fat stored in the liver and around the heart may also raise risk. Fatty liver disease with metabolic risk factors is now called MASLD, short for metabolic dysfunction-associated steatotic liver disease. That is the 2023 name for what was called NAFLD.⁴⁵

Is visceral fat lost first?

Partly. It depends on whether you count in percent or in pounds.⁶

In percent, yes. A review of 89 studies found the percent drop in visceral fat was always larger than the percent drop in subcutaneous fat, with diet and exercise, weight-loss drugs and surgery alike.⁶

In pounds, no. Most people carry much more subcutaneous fat, so more of it comes off by weight. The same review found no method that targets visceral fat on its own. Visceral fat loss was linked to subcutaneous fat loss.⁶

The POUNDS Lost trial shows both at once. After six months, people had lost about 1.5 kilograms of subcutaneous belly fat, or 13.6 percent, and 0.9 kilograms of visceral fat, or 16.1 percent, measured by CT.⁷

The percent edge is largest with modest weight loss. A review of 61 studies found modest weight loss took off a larger percent of visceral fat than of subcutaneous fat, and the gap shrank as weight loss grew.⁸

Hallgreen and Hall's model turns this into numbers. Visceral fat changes with total fat raised to the power of about 1.3.²

A drug trial fits the same pattern. In a DEXA substudy of the STEP 1 semaglutide trial, the 95 people on the drug lost 19.3 percent of their total fat mass and 27.4 percent of their visceral fat over 68 weeks. The model's central estimate for that much fat loss is about 24 percent, so the drug result sits a little above it but in the same range.⁹²

How do you lose visceral fat?

The evidence points to one main lever, and that is losing body fat overall. Hallgreen and Hall's model held for diet, diet plus exercise, exercise alone and surgery.²

What you eat matters less than the total. In POUNDS Lost, diets with different amounts of fat, protein and carbohydrate produced the same drop in visceral fat and liver fat. People did not fully stick to their assigned diets, so the real contrasts were smaller than planned.⁷

Exercise helps, even without much weight loss. A review of 117 studies with 4,815 people found both diet and exercise reduced visceral fat. In studies where weight did not change, exercise was linked to about a 6 percent drop in visceral fat, while diet showed almost none. The same review found weight change was a poor stand-in for visceral fat change after exercise.¹⁰

Ab exercises do not burn belly fat. Six weeks of ab exercises, five days a week, improved ab endurance but did not change belly fat, waist size or body fat percent.¹¹

How is visceral fat measured?

CT and MRI are the reference methods.⁴

DEXA estimates visceral fat by measuring all the fat in the lower belly and subtracting an estimate of the layer under the skin. Across a group of people, it agreed well with CT. But repeat scans of the same person vary a lot. In 233 adults scanned twice, the visceral fat precision error was 28.9 percent, against 0.7 to 2.6 percent for total fat, lean mass and bone. A change had to exceed about 130 grams to count as real, and precision was worse in people with obesity. The International Society for Clinical Densitometry says in its own words that the clinical value of DEXA visceral fat is currently uncertain.^1121314

A tape measure is the practical home option. An expert consensus statement says waist size adds information beyond BMI for predicting disease and death, and that a shrinking waist is an important treatment target.¹⁵

What about the visceral fat number on a smart scale?

Home scales that show a visceral fat level estimate it with the maker's own equations. When researchers checked two such devices against MRI, the average was close but individual readings were often far off. In the authors' words, the result was only a qualitative index. A second study of two consumer devices also found wide gaps against MRI for individuals.¹⁶¹⁷

So read it as a rough estimate, not as a measurement of the fat around your organs.¹⁶¹⁷

How to track it

Since visceral fat follows total fat, the most useful home data are your body weight trend, your waist size and what you eat.²¹⁵

An app like TrueCal keeps your food log and weight history together, so you can see your intake next to your weight trend. Waist size you can note by hand.

Visceral fat is linked to blood sugar, triglycerides and HDL cholesterol. If you have questions about your own heart and metabolic risk, a clinician can check those with blood tests.³

• Weigh at the same time each morning and watch the weekly average.
• Measure your waist with a tape about once a month, at the same spot, before eating.
• Log your food so you can see what your intake was while the trend moved.

Common myths

• Myth, crunches burn belly fat. Ab exercise alone did not reduce belly fat in a controlled trial.¹¹
• Myth, a special diet targets visceral fat. Diets with very different macros produced the same visceral fat loss. No method has been shown to target it on its own.⁷⁶
• Myth, my scale's visceral number is a measurement. Consumer scales estimate it with the maker's own equations, and when two such devices were checked against MRI, individual readings were often far off.¹⁶
• Myth, visceral fat only comes off after you get lean. It falls from the start, and by a slightly larger percent than total fat.²

A note on medical advice

This article is for general information and isn't medical advice. Talk with your clinician about your own situation.

Worked example

Hallgreen and Hall's model says visceral fat changes with total fat raised to the power of about 1.3. Take someone whose total fat mass falls by 20 percent, so 80 percent of it remains. Raising 0.8 to the power of 1.3 gives about 0.75, so about 75 percent of their visceral fat remains and about 25 percent is gone. That matches the model's row for 20 percent, and it shows why the visceral share lost is larger than the total share lost.²

A closer look

Visceral fat falls by a larger percent, but more subcutaneous fat comes off by weight. In the POUNDS Lost trial, people lost about 1.5 kilograms of subcutaneous belly fat, or 13.6 percent, and 0.9 kilograms of visceral fat, or 16.1 percent, after six months, measured by CT.⁷⁶

Questions and answers

Related guides

• TDEE calculator
• Calorie deficit calculator
• What a DEXA scan measures
• What metabolic syndrome is

Sources

1. Quantitative Imaging in Medicine and Surgery. Messina. 2020.
2. International Journal of Obesity. Hallgreen, Hall. 2008.
3. Circulation. Fox. 2007.
4. Lancet Diabetes and Endocrinology. Neeland. 2019.
5. Hepatology. Rinella. 2023.
6. International Journal of Obesity. Merlotti. 2017.
7. American Journal of Clinical Nutrition. de Souza. 2012.
8. International Journal of Obesity. Chaston, Dixon. 2008.
9. Journal of the Endocrine Society. Wilding. 2021.
10. Obesity Reviews. Verheggen. 2016.
11. Journal of Strength and Conditioning Research. Vispute. 2011.
12. Obesity. Kaul. 2012.
13. Obesity. Meredith-Jones. 2018.
14. Official Positions. ISCD. 2023.
15. Nature Reviews Endocrinology. Ross. 2020.
16. Obesity Facts. Bosy-Westphal. 2008.
17. Journal of Clinical Densitometry. Xu. 2011.