Surprising Places Body Fat Can Hide

• By Dr. Sanjay Gupta

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  Fat and Health Risk

  Our bodies require a certain amount of fat to remain healthy. Fat or adipose tissue provides warmth and energy, plays a key role in metabolism and hormone production, and helps protect internal organs. When too much fat accumulates in certain parts of the body, however, it can pose serious health risks.
  “Not all fats are alike,” says Catherine Fleisher, MD, of the Cleveland Clinic’s internal medicine department. “In general, visceral fat, which surrounds the internal organs, and fat deposits around the heart and within the liver, are very significant in terms of overall health risk.” Excess subcutaneous fat, found beneath the skin, is not necessarily healthy, but it doesn’t have as high a correlation with significant health problems, according to Dr. Fleisher.
  People may outwardly seem to be at a normal weight but have unhealthy fat deposits in their body – something referred to as being “thin outside, fat inside.”
  Here’s a look at some places where fat deposits can be found in the body and the potential health implications.
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    Collection CNRI/Phototake

    Heart

    Fat is not meant to be stored in the heart, explains Ruth Loos, PhD, professor of preventive medicine at the Icahn School of Medicine and director of the genetics of obesity and related metabolic traits program at the Charles Bronfman Institute for Personalized Medicine at Mount Sinai Hospital in New York City. “But if the other depots for fat storage in the body, in particular the subcutaneous fat, are full, the fat finds a way to be stored somewhere else,” Dr. Loos says.
    The amount of fat that can be stored in one subcutaneous fat cell varies from person to person, and it is determined to some extent by genetics, Loos says. When excess fat goes to the heart, it may interfere with its normal function. It’s important to lose weight by eating less and staying physically active in order to reduce this abnormal or ectopic fat. “Being physically active helps you burn fat,” Loos says “Expend more calories than you take in.”
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      Collection CNRI/Phototake

      Heart

      Fat is not meant to be stored in the heart, explains Ruth Loos, PhD, professor of preventive medicine at the Icahn School of Medicine and director of the genetics of obesity and related metabolic traits program at the Charles Bronfman Institute for Personalized Medicine at Mount Sinai Hospital in New York City. “But if the other depots for fat storage in the body, in particular the subcutaneous fat, are full, the fat finds a way to be stored somewhere else,” Dr. Loos says.
      The amount of fat that can be stored in one subcutaneous fat cell varies from person to person, and it is determined to some extent by genetics, Loos says. When excess fat goes to the heart, it may interfere with its normal function. It’s important to lose weight by eating less and staying physically active in order to reduce this abnormal or ectopic fat. “Being physically active helps you burn fat,” Loos says “Expend more calories than you take in.”
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      Javier Domingo/Phototake

      Liver

      “The liver is the laboratory of your body,” Loos says. “A lot of chemical processes happen there...If you disturb these processes, you may develop diabetes, high cholesterol, and other disorders.”
      Symptoms of fatty liver vary, depending upon how severe it is, says Paul Gaglio, MD, medical director of adult liver transplantation at Montefiore Medical Center in New York City. “You could be achy in the right upper quadrant of your body, or you could have no symptoms and it is discovered on lab tests,” he says.
      Nonalcoholic fatty liver disease (NAFLD) occurs when there is extra fat – more than 5 to 10 percent of the liver’s weight is fat, according to the American Liver Foundation – not caused by alcohol consumption. People who are overweight or have diabetes or high cholesterol are most at risk for NAFLD, which affects as much as 30 percent of the public in Western countries. 
      The good news: “You can reverse fat in the liver and muscles,” Loos says. “Change your diet and get more exercise, which will 
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        Alamy

        Eyes

        Fat deposits can develop in the periphery of the cornea, which covers the front of the eye. This condition, known as arcus senilis, is common in older people. It is marked by a white ring at the edge of the cornea but does not impact vision.
        If you have an overactive thyroid and are diagnosed with the immune system disorderGraves’ disease, you are at risk for developing Graves’ ophthalmopathy, a condition that affects the eye muscles and surrounding tissue. The eyes can actually appear to bulge forward, says Frank Greenway, MD, chief of the outpatient clinic at Pennington Biomedical Research Center in Baton Rouge, Louisiana. “It’s been found that a lot of the reason the eyes are bulging forward is due to fat behind the eyes,” he says. “Fat behind the eyes is an issue for vision and for cosmetic reasons. People with this condition may be unable to close their eyes, which means tears can’t properly moisten the eyes.”
        Surgery is one option, as is treatment with corticosteroids like prednisone. “People with this condition are usually not overweight, and the fat that is there is not due to overweight,” Dr. Greenway says.
        
        Alamy

        Breasts

        Individuals who are heavier tend to have larger breasts, Loos explains. Breast fat is considered subcutaneous fat, like the fat in your legs and hips. Unlike visceral fat in the abdominal area or ectopic fat in the liver or heart, “breast fat will likely not interfere with any of the metabolic processes,” Loos says.
        
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        Legs

        Fat in the legs, as well as in the hips and buttocks, is generally not considered a health hazard, says Mitchell Roslin, MD, a bariatric surgeon at Lenox Hill Hospital in New York City. Estrogen is believed to facilitate the accumulation of fat in this area, says Greenway.
        “In women, it’s thought to be a way the body stores up energy so that when she becomes pregnant, that fat can be mobilized to serve as fuel to support the growth of the baby and then lactation.” Greenway says. “It’s not considered too much of a medical risk.”
        
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        Abdomen

        Excessive abdominal fat is linked to metabolic syndrome, a group of factors that raise the risk for diabetes, heart disease, and stroke.
        People who have an apple-shaped body (larger waist circumference) rather than a pear shape (more weight around the hips) typically carry around more abdominal fat, says Dr. Roslin. “These individuals have a higher risk of metabolic diseases like diabetes,” he says. “There is a much greater likelihood of getting hypertension and coronary artery disease.” Weight loss and exercise are the best ways to reduce abdominal fat.
        Visceral fat can be measured with an MRI or CT scan, but imaging procedures are costly and not always readily accessible. A much more common measure is waist size. To reduce health risks, Greenway recommends a waist circumference (an indirect measure of the fat inside the abdomen) of less than 37 inches in men and less than 31½ inches in women.
        
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        BMI

        Body mass index (BMI) is another method to calculate body fat. BMI uses a mathematical equation: weight (in pounds) divided by height (in inches) squared, multiplied by 703. An adult with a BMI of 30 or higher is considered obese.
        BMI isn’t foolproof: Because it is based on body weight rather than body composition, it doesn’t take into account how much of that weight is from muscle, bone, or water as opposed to fat. “It’s not perfect but it’s definitely a useful tool,” says Ellen Demerath, an associate professor of epidemiology and community health at the University of Minnesota.
        The Centers for Disease Control and Prevention provides information about assessing body fat and weight, including how to measure waist size and calculate your BMI, on its website.
  • 
    Javier Domingo/Phototake

    Liver

    “The liver is the laboratory of your body,” Loos says. “A lot of chemical processes happen there...If you disturb these processes, you may develop diabetes, high cholesterol, and other disorders.”
    Symptoms of fatty liver vary, depending upon how severe it is, says Paul Gaglio, MD, medical director of adult liver transplantation at Montefiore Medical Center in New York City. “You could be achy in the right upper quadrant of your body, or you could have no symptoms and it is discovered on lab tests,” he says.
    Nonalcoholic fatty liver disease (NAFLD) occurs when there is extra fat – more than 5 to 10 percent of the liver’s weight is fat, according to the American Liver Foundation – not caused by alcohol consumption. People who are overweight or have diabetes or high cholesterol are most at risk for NAFLD, which affects as much as 30 percent of the public in Western countries. 
    The good news: “You can reverse fat in the liver and muscles,” Loos says. “Change your diet and get more exercise, which will 
• 
  Collection CNRI/Phototake

  Heart

  Fat is not meant to be stored in the heart, explains Ruth Loos, PhD, professor of preventive medicine at the Icahn School of Medicine and director of the genetics of obesity and related metabolic traits program at the Charles Bronfman Institute for Personalized Medicine at Mount Sinai Hospital in New York City. “But if the other depots