Visceral Fat and Abdominal Obesity — Skinny-Fat Is Also Dangerous
Table of Contents
What is visceral fat — the invisible danger
Visceral fat is fat that accumulates between organs in the abdominal cavity. Unlike subcutaneous fat, it may not be visible from the outside. Even when BMI is in the normal range (18.5–24.9), a waist circumference of 90 cm or more for men and 85 cm or more for women is classified as metabolically obese normal weight (skinny-fat). Visceral fat is a direct cause of insulin resistance, dyslipidemia, hypertension, and fatty liver, and it raises cardiovascular disease risk by 2–3 times.
Phlegm-damp (痰濕) and visceral fat
In Korean medicine, abnormally accumulated body fat and waste are called phlegm-damp (痰濕). When the transport-and-transformation function of the spleen-stomach (脾胃) declines, food is not properly converted into refined essence (精微) and instead becomes turbid damp-phlegm (濕痰), accumulating in the abdominal cavity. Late-night eating, overeating, oily foods, and lack of exercise are major causes of phlegm-damp formation.
Modified Bangpungtongseong-san (防風通聖散)
Bangpungtongseong-san is effective for excess-pattern (實證) abdominal obesity with combined phlegm-damp and heat. Saposhnikovia and ephedra disperse pathogens from the body surface, rhubarb and mirabilite drain heat-toxin from the intestines, and talc and gardenia drain damp-heat through urination. Atractylodes, schizonepeta, and forsythia simultaneously promote internal circulation.
- For severe constipation: increase rhubarb and add hemp seed
- With hyperlipidemia: add hawthorn and cassia seed to dissolve fat (消脂)
- Stress-induced overeating: add bupleurum and cyperus to circulate liver qi
Exercise and diet to reduce visceral fat
Visceral fat responds to exercise faster than subcutaneous fat. At least 150 minutes per week of moderate-intensity aerobic exercise (brisk walking, jogging, cycling) is most effective, and adding strength training twice a week improves insulin sensitivity. Reduce refined carbohydrates (white rice, wheat flour, sugar) and increase fiber, protein, and healthy fats (olive oil, nuts). Alcohol — especially beer — is a direct cause of abdominal fat accumulation.