For centuries, a potbelly in men was eyed with envy; it was considered a sign of prosperity. Also, there were no problems with pants not fitting since they wore a dhoti that could be tied loosely. Women too did not bother much about potbellies, whether their own or their husband’s. They were happy that their husbands were prosperous. After all, a pear-shaped figure could always be hidden in the voluminous folds of a sari or A-line salwar kameez.

Times have changed. Men and women have become conscious of their appearance. They no longer want to look like they accidentally swallowed a pot or to lead with the belly. And it is not just aesthetics that are impacted when it comes to a pot belly, it has health implications as well.

There are two types of potbellies. The first has subcutaneous fat, which can be pinched up and accumulates in the lower body, giving it a pear shape. The other has the more dangerous visceral fat. It results in an apple- shaped body. The fat here cannot be pinched up as it is inside the abdomen, around the internal organs. If you are overweight, exactly what your fat will accumulate as, subcutaneous or visceral, is influenced by heredity and hormones. Females are more likely to be pears than apples.

Visceral fat acts as an extra endocrine gland. It releases cytokines, which increases the risk of cardiovascular disease. They also make the body resistant to its own insulin so that diabetes is precipitated. They elevate the blood pressure and increase blood clotting. Also, visceral fat reaches the liver and elevates cholesterol and triglycerides.

All of this makes the person vulnerable to heart attacks and strokes. Also, it has been linked with an increased likelihood of cancer and early onset of dementia.

You are overweight if your BMI (weight divided by height in meters squared) is more than 23 or if your waist is more than 35 inches (if you are a woman) or 40 inches (in a man).

There is a paradox in India, a person may appear thin but still have a waist larger than the cut-off; that is an unhealthy thin person with visceral fat.

When measuring the waist, it is important not to measure at the thinnest spot but at the widest. This is usually at the umbilicus or the level of the iliac crest or hip bones. Therefore, sometimes the waist-hip ratio is used to determine visceral fat. It is calculated by dividing the waist measurement by the hip measurement. If the waist-to-hip ratio (WHR) is 1.0 or higher in men and 0.86 or higher in women, it indicates a significantly increased risk of health issues.

Babies and young children sometimes look like they have pot bellies. One way to confirm this is to make the child stand and lift both arms above the head. If the belly disappears, it is a normal abdomen. Also, a toddler’s potbelly is nothing to worry about unless the swollen belly is accompanied by other symptoms such as abdominal pain, fever or vomiting. A potbelly should also be evaluated by a physician if the swollen belly appears suddenly or the child exhibits a short stature.

It is not possible to spot reduce belly fat by doing crunches and push-ups. These exercises, along with core strengthening, will improve overall posture and tighten the abdomen but not remove the fat. To remove visceral fat, you need to work 150 minutes a week, eat only 1,500 to 2,000 calories a day, not smoke, sleep eight hours a day and remember that there is no quick fix. Bariatric surgery and liposuction are only temporary fixes. You will still have to maintain a diet and do regular exercise.

There are several newer weight loss drugs. They are usually anti-
diabetics, which also produce weight loss and appetite suppression. Herbal supplements, too, are widely advertised. They have many side effects. The natural way is the better, safer way.

The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in