Being a Normal Weight With Extra Belly Fat Is Deadlier Than Being Obese

The way your body carries fat may be a better indicator of heart health and longevity than the number on the scale.

You may want to take in a deep breath — and suck in your gut — for this one.

Carrying excess belly fat increases your chances of early death more than being overweight or slightly obese, according to a February 2017 study in the Journal of the American Geriatrics Society.

The large multiethnic study looked at women 50 to 79 years old and found, regardless of ethnicity and age, those with a larger waistline were at a higher risk of death (as were those who were underweight).

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And it's not just postmenopausal women – a November 2015 study analyzed the waist-to-hip ratios of more than 15,000 adults aged 18 to 90 years and found adults at a normal weight with "central obesity" – aka excessive belly fat — have the worst long-term survival compared to groups who were overweight or obese with fat evenly distributed.

In short: Your health depends on more than just the number on the scale.

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"What this study highlights is that body composition matters," says Shanna Levine, MD, instructor of general internal medicine at the Icahn School of Medicine at Mount Sinai in New York City, who was not involved with either study.

It's well established that excess visceral fat – aka the deeper layer of belly fat that hugs your organs – is a risk factor for metabolic syndrome, which can increase your risk of developing heart disease, stroke, and diabetes, but now it looks like it also increases your risk for total and cardiovascular mortality.

But this research doesn't mean that overweight and obese people with more evenly distributed body fat should abandon their goals of getting to a healthier weight.

"Until we are looking at studies that control for specific factors, like muscle mass amounts, waist circumference, etc., you can't generalize," says Dr. Levine. "Instead, you should follow the key principles of health: eat well, maintain a normal weight, and move. We know excess abdomen fat leads to poor health outcomes, but don't focus solely on it or numbers. Focus on how your clothes fit and how you feel."

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