Let go of my love handles

When is fat not just fat?

When it's visceral fat. Visceral fat is the fat that infiltrates the intestinal lining, the liver, kidneys, even your heart. It's the stuff of love handles, the flabby fat that hangs over your belt, or what I call "wheat belly."

Unlike visceral fat, the fat in your thighs or bottom is metabolically quiescent. Thigh and bottom fat may prevent you from fitting into your "skinny jeans," but its mainly a passive repository for excess calories.

Visceral fat, on the other hand, is metabolically active. It produces large quantities of inflammatory signals ("cytokines"), such as various interleukins, leptin, and tumor necrosis factor, that can trigger inflammatory responses in other parts of the body. Visceral fat also oddly fails to produce the protective cytokine, adiponectin, that protects us from diabetes, cancer, and heart disease.

Visceral fat also allows free fatty acids to leave and enter fat cells, resulting in a flood of fatty acids and triglycerides (= 3 fatty acids on a glycerol "backbone") in the bloodstream. This worsens insulin responses ("insulin resistance") and contributes to fatty liver. The situation is worsened when the very powerful process of de novo lipogenesis is triggered, the liver's conversion of sugar to triglycerides.

Visceral fat is also itself inflamed. Biopsies of visceral fat show plenty of inflammatory white blood cells (macrophages) infiltrating its structure.

So what causes visceral fat? Anything that triggers abnormal increases in blood glucose, followed by insulin, will cause visceral fat to grow.

It follows logically that foods that increase blood glucose the most will thereby trigger the greatest increase in visceral fat. Eggs don't lead to visceral fat, nor do salmon, olive oil, beef, broccoli, or almonds. But wheat, cornstarch, potato starch, rice starch, tapioca starch, and sugars will all trigger glucose-insulin that leads to visceral fat accumulation.

Fructose is also an extravagant trigger of visceral fat. Fructose is found in sucrose (50% fructose), high-fructose corn syrup, agave syrup, maple syrup, and honey.

Increased visceral fat can be suggested by increased waist circumference. The inflammatory hotbed created by excess visceral fat has therefore been associated with increased likelihood of heart attack, cardiovascular mortality, diabetes, cancer, and total mortality.

So I'm not so worried that you can't squeeze your bottom into your size 8 jeans. I am worried, however, when you need to let your belt out a notch . . . or two or three.

Comments (44) -

  • Anonymous

    9/14/2010 2:19:48 PM |

    I also wonder if coffee/caffeine plays a role for some people. I know that coffee tend to make me hungry, and i wonder if it is due to an effect on insulin.

  • Anonymous

    9/14/2010 3:06:03 PM |

    Before most people begin to worry..

    Major Correction:  love handles and fat that makes you look soft & flabby is subcutaneous fat, not visceral fat as stated in this post.

    If you can pinch it, it's subcutaneous.

  • Anonymous

    9/14/2010 4:17:07 PM |

    Does high fruit consumption with it's high content of fructose increase viceral fat?

  • Jenny

    9/14/2010 5:35:04 PM |

    Visceral fat occurs behind the abdominal wall--where the organs are.

    The stuff you can grab a handful of is subcutaneous fat and it is metabolically inert.

    The most concerning fat is intracellular liver fat which is deposited, as the name suggests, between the cells of the liver.  It appears to be a major cause of insulin resistance, and hence obesity.

    Liver fat is made out of fructose. Dietary changes including very strict Atkins-style diets do not reduce liver fat significantly (according to biopsy studies) even after 6 months.

    Most treatments for fatty liver change the liver enzyme test results which doctors interpret as meaning that the fatty liver is healing, but sadly the biopsy results don't confirm this either.

    Perhaps years of eating no fructose might burn off the intracellular liver fat, but I have not seen any evidence to support this in the research.

  • Anonymous

    9/14/2010 6:21:04 PM |

    Something that's always puzzled me is that, soft drinks typically use high fructose corn syrup, but what sugar are they using when they refer to sodas using "real" sugar?


    If they are using sucrose, or table sugar, then isn't that 50% fructose anways?  

    Jenny, is there ANY research that suggests fructose above and beyond sucrose/glucose contributes to liver fat?

    For example, if you read this headline, "High Levels of Fructose, Trans Fats Lead to Significant Liver Disease, Says Study"
    ( http://www.sciencedaily.com/releases/2010/06/100622112548.htm

    you would think it's about fructose, but if you read the article it's really sugar in general they are talking about!

  • Anand Srivastava

    9/14/2010 6:47:27 PM |

    The glucose part of sugar is mostly benign, for people with good insulin sensitivity. We need glucose in our blood in our muscles etc. It is only a problem if you do not maintain correct levels, ie insulin resistant, or insulin deficient.

    Fructose does cause problems for everybody. But there also it will cause more problems to the insulin resistant than the sensitive.

    Another thing is that Liver and other tissues have a limited capacity to convert fructose to fat. If it gets overwhelmed then the fructose can escape and stay in the blood far longer than it should.

    A good way to prevent this is to not drink the fructose, but eat it with food. So Fruits are OK, and eating some fructose with food is OK. Trouble with liquids is that the stomach does not store the liquid for long and releases it in the blood supply, allowing the fructose control system to be overwhelmed.

    Do not think that fruit juices are healthy. Fruits are healthy but not their juice, even if it is very fresh. With food it would not be much dangerous, in limits.

  • Anonymous

    9/14/2010 7:00:48 PM |

    Per Sandra Cabot M.D.

    "The liver is able to repair itself and grow new healthy liver cells and over one to two years you will be able to reverse the fatty damage to your liver and achieve a healthy normal liver.

    If you are overweight you will lose significant amounts of weight within several months, however the liver will take longer to completely repair itself..."

    Recommended course of action:

    Follow a low carbohydrate way of eating - eliminating all grains, sugar, fructose, etc.;
    Increase the amount of raw plant food in the diet;
    Eat first class protein with every meal or for a snack;
    Consume healthy fats;
    Do not eat very large meals;
    Take a liver tonic everyday;
    Drink plenty of hydrating fluids;
    A regular exercise program is important.
    The above is paraphrased from Dr. Cabot's book: Fatty Liver: You Can Reverse It.

    Obviously more research is urgently needed.

  • Anonymous

    9/14/2010 7:41:40 PM |


    Abdominal obesity=love handles = visceral fat= NASTY


  • Kevin

    9/14/2010 7:55:57 PM |

    The fructose in fruits and even HFCS will be burned for energy if the person is exercising.  If not, it turns into visceral fat.  Sorry, I can't give a url as proof but I know I read it from someone knowledgeable.


  • malpaz

    9/14/2010 9:33:12 PM |

    AGREED....ARE YOU MORE A FAN of mono-fat or saturated fat?

  • Anonymous

    9/14/2010 11:11:21 PM |

    I've been able to dramatically reduce my abdominal and pectoral fat through a low-carb diet. I look very toned and lean. However even after strict adherence for 3 years, there is still some fat in the abs and pecs that refuse to go away. I don't eat any grains or wheat products and very little sugar and fructose, yet, this one last bit of fat refuses to perish. Perhaps it is possible that some of our bodies will genetically always store more fat than others?

    paradoxically, I know 2 people who eat so many grains and wheat products and cannot get fat. They have remained lean all their life, don't have man boobs, and don't do that much exercise. What gives?

  • Anonymous

    9/15/2010 12:35:35 AM |

    low carb with only just enough protein (atkins is high protein and gives high insulin from this), raw green veges, healthy fats (omega 3, nuts, avocados and olives) is the only way to fix it

  • kellgy

    9/15/2010 4:02:52 AM |

    Funny thing, I have been eating the types of food you recommend and avoiding those you don't on this post. After 4 months, I have lost 80 pounds, moved from morbidly obese to overweight and now see those love handles and tummy fat softening and starting to disappear (bye bye visceral fat). I can't wait to see what happens in the next four months! My energy is spontaneous and mental acuity has returned. I am even back in college pursuing an advanced degree in nursing. The benefits are much more than physical. Thank you for your insight. My life is better as a result.

  • Finn

    9/15/2010 9:38:53 AM |

    Same Wikipedia source as mentioned before says: "Visceral fat, also known as organ fat or intra-abdominal fat, is located inside the peritoneal cavity, packed in between internal organs and torso...". So "love handles", "polka handles" or whatever you call them, is not visceral fat!

  • Dr. William Davis

    9/15/2010 2:13:22 PM |

    Re: comments about "love handles" not being visceral fat.

    Absolutely correct.

    "Love handles" are simply an INDICATOR of visceral fat. Last I checked, I can't grab your liver or intestinal fat.

  • Dr. William Davis

    9/15/2010 2:14:02 PM |


    80 lbs!

    That's fabulous. I'd love to hear more.

  • Bling

    9/15/2010 2:33:05 PM |

    I feel better though and I seem to heal better too (could be my imagination but I had a real bad scar after my hand was stabbed with glass and it has been getting so much better). Nose bleeds have significantly decreased too (only 2 minor ones in a hole year whereas I was having them everyday before I changed my diet). I have also successfully (I think) fought off a candida yeast infection as all digestive trouble and urine infections and perpetual belly button infections have ceased too!
    There was no doubt I was fat deficient after following a low fat diet all my life. I just can't lose weight though. I suspect that I have fatty liver and damaged kidneys because I get back pain alot too (used to be both left and right sides almost every day after I started HFLC but now it is only the left side occasionally). But because I am in my twenties I go to see the doctor and they can do nothing for me. They don't believe in extensive liver tests and kidney tests for someone so young. They analysed my urine and found nothing wrong so that's it. Please, someone in the know tell me my next move...
    Forgot to mention I take chromium every day (because Atkins says it is good for IR) and milk thistle every day because it is supposed to help fatty liver. Also to note, my blood sugars have improved and I no longer get dizzy like when I first started HFLC. So that is some progress with the symptoms. But no matter how little I eat I can't lose weight. I'm afraid to do more exercise because I don't understand why my blood sugar readings are so high afterwards. I do a bit but not much. I tried weight training but even that gives me a liver dump. Even walking around the block gives me a liver dump. Also please note, I am HFLC. I eat alot of animal fat. I don't eat too much protein, I always eat excess of fat to try and reach ketosis and I eat somewhere in the region of 20-50g of carb a day (although I think it depends where your carbs come from as to whether they matter, so the carb in an almond is locked in with all that fat. The 6% carb of 100g of almonds is better and lower carb than eating 6g of candy. I think this because of the fat burning index (heard of that?) and the fact almonds don't impact my blood sugar  hardly at all and also the fact they seem to get me into ketosis quicker than any other food).
    Anyway I'm stumped.
    Someone mentioned fructose. I was reading hyper lipid's post about rats who ate saturated fat with fructose/alcohol and it protected the liver. Rats who ate a low fat diet with fructose/alcohol developed "fois gras". So, believing that fructose is worse for the liver than alcohol I avoid all fruit and most veggies.
    Advice/comments would be appreciated. I don't want to fall off the wagon because I believe HFLC is the way to go. I just believe myself to be damaged beyond belief. I have been overweight ALL of my life since the age of 2. But now I'm giving HFLC a bad name because I've been on it almost a year and lost only the initial 10-12pounds. :-(

  • Bling

    9/15/2010 2:34:46 PM |

    My first comment said it wa posted but didn't show up. So here's part 1:

    Great post - it is straight to the point. I'm not going around pinching my fat to decide whether it is visceral or not because that isn't the point. For those of you who are obsessing about what is and what isn't visceral, read this:
    "Increased visceral fat can be suggested by increased waist circumference"
    Another point which is a great one:
    "Visceral fat, on the other hand, is metabolically active. It produces large quantities of inflammatory signals[...] Visceral fat is also itself inflamed."

    I find that my waist measurement can change overnight or within 2 or 3 days up to 3 inches either way.

    I am classed as morbidly obese. I have a BMI of 38. I have terrible insulin resistance (of the liver) and have pre-diabetic blood glucose readings. I have been on HFLC since October 2009 and although I seemed to deflate 10 pounds or so within the first 2 weeks of starting it, I haven't lost a pound since. I think this is because of my insulin resistance of the liver. Just like a diabetic, I get a "morning effect" of high blood sugars without eating anything. After exercise I get the highest blood sugars I've ever got since going HFLC. I know my liver is churning out too much sugar, so I've been trying to eat a tiny amount (5g) of carb every 5 hours to prevent the liver dump, yet eating HF to try and reach ketosis for as many as possible of my waking hours (I find ground nuts, butter and cream, in the form of cakes, is the fastest way to get my into ketosis, but I only ever manage a mild ketone reading although I get the breath sometimes). Every morning I feel groggy, can't wake up and have a terrible morning effect so I think I've been fat burning during the day and then just putting it on again in my sleep, once my liver dumps the sugar, which raises the insulin.
    I've been researching for months and I think I need some Metformin drug, but can't have any cos I am in the UK and they only prescribe it for diabetics. I could probably fake it and pass a diabetic test because I have researched, but should I do this? Aside from increased life insurance and the pure morals of it, I would certainly be better off as a diabetic on the NHS as I'd get free BG measuring strips and free kidney and liver tests too.
    I'm really struggling now and faking it may seem extreme but I don't know what else to do. I'm so overweight and because everyone knows I am HFLC they think the diet is rubbish because I am not getting any thinner. They see me eating fat and losing no weight and they turn back to their low fat diets thinking I'm a crazy woman.

  • Anonymous

    9/15/2010 3:08:38 PM |

    So if you can grab love handles, then that's visceral fat? Then what about the type of obesity where the belly is round and tight?   You can't grab ANY of that fat, and by all definitions THAT is visceral fat...   They can't be both visceral fat.

  • Kevin

    9/15/2010 9:08:08 PM |

    Can't remember where I read it but one test for visceral fat is to measure your waist while standing and again while lying on your back.  It the measurements are the same, that's sq fat.  If the measurements are different, that's internal visceral fat moving away from the waist.  


  • Anonymous

    9/15/2010 9:37:59 PM |

    WebMD can be total garbage, just read what they had to say on the link you provided:

    "Can Whole Grains Help You Lose Belly Fat?

    A recent study in the American Journal of Clinical Nutrition showed that a calorie-controlled diet rich in whole grains trimmed extra fat from the waistline of obese subjects.

    Study participants who ate all whole grains (in addition to five servings of fruits and vegetables, three servings of low-fat dairy, and two servings of lean meat, fish, or poultry) lost more weight from the abdominal area than another group that ate the same diet, but with all refined grains.

    "Eating a diet rich in whole grains while reducing refined carbohydrates changes the glucose and insulin response and makes it easier to mobilize fat stores," says study researcher Penny Kris-Etherton, PhD, RD, a distinguished professor of nutritional sciences at Penn State University."

    --these stooge researchers, never bother to compare a whole grain vs. a NO GRAIN diet, because they know what the outcome will be.

  • Peter

    9/15/2010 10:26:30 PM |

    Rats that avoid  fructose also have other healthy habits, so it's hard to be sure why they got skinny.

  • kellgy

    9/16/2010 3:30:47 AM |

    The changes are evolutionary and ongoing. I started with Jorge Cruise's, Belly Fat Cure, and then decided to look into the underlying causes of my weight loss and came across Good Calories, Bad Calories by Gary Taubes. His book awakened my critical thinking and after stumbling across your site and TYP well, it just dominoed from there. I found resource after resource and incorporated the evidenced based research into my life health plan and it is turning into a rebirth of sorts.

    Currently, I am looking into exercise techniques since my body just naturally wants to do more (I didn't do any for the weight loss.) It looks like HIIT or PACE, some cardio, resistance training, and being bare foot as much as possible are now part of the plan.

    One interesting thing occurred during my low carb/sugar transition (about the time of wheat elimination), I became very dehydrated. I drank plenty of fluids but it persisted for nearly two weeks. I later learned that my food elimination was acting as a diuretic not only for water but also for sodium. I then tapered myself off my Atenolol (and onto supplements) and now have a baseline BP of 110/75. It was 145/95 on the medication. The rapid heart rates I have been experiencing for the last ten years have completely gone (not sure of the association yet).

    Sleep apnea gone, hunger cravings gone, chronic fatigue gone, most back and body aches gone, wow! The dietary principles and supplements when applied properly are very powerful. Through careful evaluation, research and follow up, I am looking forward to applying these principles in my practice.

  • Louis

    9/16/2010 8:17:39 AM |

    Your site is amazing.I am very impressed to see this,i want to come back for visiting your site.Keep doing Good as well as you can..

  • Anonymous

    9/16/2010 3:58:06 PM |

    Ha, Peter!  That was funny.

  • Anonymous

    9/16/2010 4:30:31 PM |

    Bling, I have had a similar experience to yours. I've read several of the books and understand the low-carb/high-fat science, but my body refuses to lose weight after the first 10-15 pounds. No matter how low carb I go or how much exercise I do.

    Worse, I also have a weird hypoglycemic response to induction. I get extreme hunger and carb cravings when I absolutely should not -- after eating plenty of protein, fat and fiber. I can eat an avocado or nuts or meat and vegetables with butter and still feel like I'm going to pass out from hunger.

    It's so frustrating and I'm still looking for a way off this roller coaster.


  • Geoffrey Levens

    9/16/2010 9:33:04 PM |

    "It's so frustrating and I'm still looking for a way off this roller coaster."

    Kali, I beat my head (entire physiology really) against low carb diet for 9 long months.  Followed Bernstein's max 6 g carbs for breakfast and 12 g each for lunch and dinner.  Felt constantly more and more tired, irritable, brain fogged.  Mild exercise would leave me exhausted for 2 days...  Finally tried McDougall's diet and it helped but was having high sugar spikes.  Ended up w/ Fuhrman's Eat to Live diet, beans instead of grains. The combo of a bit higher fat that he allows from nuts/seeds and resistant starch in beans and that is working for me. Some bodies I think just do not work well in ketosis or near it for prolonged periods of time.

  • Larry

    9/16/2010 10:11:28 PM |

    My local news just profiled a Diabetic who had a stroke.
    In their "advice" comments from an RD, she advised that it's okay for him to have....are you ready ?...
    Up to 75 grams of Fructose a day.

    A Diabetic patient... 75 grams a day of Fructose ?
    Do he or his doctors actually understand the grave condition of his health ?
    If he listens to them, he might as well buy ownership in a Dialysis Center.

    Do the schools that teach and graduate RD's have any clue at all ?
    Or are they this corrupted ?

  • Dr. William Davis

    9/16/2010 10:22:06 PM |



    Please be sure to come back and update us on your progress.

  • Dr. Amr Ebied

    9/16/2010 10:26:14 PM |

    Hi there,
    I've been e-mailed by a friend telling me about a juice that can lower cholesterol and blood pressure if taken twice daily.
    If you wanna know more go to the following links :




    I'm sure you'll find that information helpful. Just give me your feedback.


  • Anonymous

    9/17/2010 2:35:25 PM |

    i have read that non alcoholic fatty liver disease can be reversed by vitamin e supplementation.  


  • Anonymous

    9/17/2010 4:00:38 PM |

    Geoffrey - did you eat high fat? Simply cutting out carbs results in undernourishment. Your body will shut down to save it's energy stores. You still need to feed it sufficiently. Watch Gary Taubes' latest videos http://livinlavidalowcarb.com/blog/ims-lecture-with-slides-and-qa-why-we-get-fat-by-gary-taubes/8971

    Anon - Atkins is not high protein; it's high fat.

    Dr. Amr - Acai Berry = Spam. Actually Spam is much healthier than that juice crap.

  • Anonymous

    9/17/2010 4:32:15 PM |

    "Love handles" are an indicator that you have significant amounts of visceral fat???  I'm a female, with a 26 inch waist and 21% body fat.  Yet, I have love handles.

    To my knowledge, the best indicator of visceral fat is a waist circumference.

  • bighippedlady

    9/17/2010 4:40:54 PM |

    @Anon - I think you missed the point deary.

    Hips are always desirable on a woman but that roll of fat above them that sometimes accompanies them on overweight women may be a marker of the visceral fat problem.

    But I agree with you about waist measurement seemingly being a better indicator. "Waist" measurement on a woman is different to a man. One health leaflet I saw was saying that the "waist" meaurement is around the belly button level, which for a woman is obviously wrong.

    But take note, when guys have "love handles" it just ain't right.

    Give the guy a break! LOL He was trying to post a semi-humorous blog title to get people's attention. If you wrote as many long, detailed and useful posts as this guy (or had half the readership he does) maybe you'd try out an almost funny title now and again.

    Joker. hahaha

  • Coffee Table Plans

    9/19/2010 9:00:42 PM |

    Thanks for the info, I really enjoy reading it!

  • Glycerin Refine

    9/20/2010 10:12:39 AM |

    Such a very nice post.........

  • Anonymous

    9/21/2010 1:28:21 PM |


    Mine are definitely above the hips.  Trust me, it's not attractive.  I just don't see how this subcutaneous fat is indicative of visceral fat on someone like me.

  • bighippedlady

    9/21/2010 1:48:05 PM |

    @Anon what is "someone like me"?

    Let's not forget correlation is not causality. The big deal about abdominal fat (whether it be around the true waist or around the belly button - just around that area) is that's the first palce weight goes when you have insulin problems (usually caused by blood sugars).

    If you have a bit you can pinch then don't worry about it, but when it gets bigger and bigger really easily (10 month pregnant look as hyper lipid calls it on men) that's when you have a blood sugar/insulin problem.

    They have found visceral fat and other problems are "indicated" by increased in waist measurement probably because it is all a marker of insulin resistance and a trip down type 2 road eventually.

    So forget about pinching this fat or that fat on your body and assessing whether your flab's attractive or not. If you are overweight, mainly around the belly area, then get your blood sugar checked. And when the doctor says is "fine, nothing to worry about", don't believe him until you have seen the numbers yourself.

    Better still, get a blood sugar monitor (very cheap) some pure glucose (from the chemist or the baking aisle in the supermarket) and conduct your own mini glucose tolerance test, starting from fasting and then measuring every 15mins after consuming 50g of pure glucose. Do some googling and you'll soon see if you are normal.

    This is the stuff that counts. Do it and save your life. If there is anything remotely higher than normal about your glucose tolerance test then read Jenny's sites blooodsugar101 and get a good book like diabetes diet by Bernstein. Go low carb. Monitor your glucose tolerance at intervals. Watch out for your liver giving you a morning effect or a blood sugar dump which may mess up your figures.

    Do note that if you are already low carb you will get a truer reading if you carb up for a few days before taking the test.

    Also note that if you are severely overweight you will probably pass the test for "insulin resistance". Your doctor won't care about it and continue to call your "normal" unless your blood sugars reach the lofty heights of official diabetics. But acting sooner rather than later (i.e. by avoiding carbs) can prevent you from developing type 2 and essentially cure your insulin resistance. This is the basis of what low carb diets do and why you loose weight.

    I went off on one. Praise the Lord for low carb.

  • Laura

    9/29/2010 6:35:08 PM |

    Very interesting. Thanks for posting!

  • Terry Bayer

    11/23/2010 3:54:00 AM |

    I absolutely had no idea that visceral fat is that dangerous! You see, after giving birth to my youngest, I have had no restrictions on my food intake hence, my weight doubled. Tomorrow, I'm definitely going to consult with my doctor about having laser liposuction. Los Angeles, where most cosmetic surgery centers are located, luckily, is only a few miles away from my house. Anyway, after all that is done, I'm probably going to need to remove the excess skin through tummy tuck. Los Angeles and other cities need to help people with obesity and weight problems.

  • Microdermabrasion Tampa FL

    3/4/2011 4:37:49 AM |

    Well Terry, I take it that after giving birth you've had many sleepless nights taking care of the baby. In my case, that was the aftermath of my last child birth. I just opted for blepharoplasty. Florida seems to be the happening place for that kind of surgery at that time, so I asked my husband to accompany me there.

    But going back to the topic, what concerns me here is the fructose part. I'm an avid cola drinker, and it looks like I'm gonna have to change my lifestyle.

  • Anonymous

    3/24/2011 6:30:05 PM |

    We can't eliminate starch amd wheat thus carbohydrates !

    I think we are allowed to eat 150 grams of carbs a day . SO !!! We can eat starch and wheat after all.

    I think eating more than 150 grams of carbs a day it raises insulin and then we come to the conlculsions about visceral fat.

  • Best ripped power

    7/18/2011 8:09:26 PM |

    I am having trouble with these "love handles" The rest of me looks great. I am now back on the ground chicken and veggie diet with a side of crazy cardio!