Visceral fat in men is a clinically significant form of deep abdominal fat that surrounds vital organs and drives serious metabolic disease. Understanding what causes visceral fat in men is essential for prevention, as it involves a complex interplay of diet, physical inactivity, hormonal changes, chronic stress, alcohol consumption, and genetics. Unlike subcutaneous fat, visceral fat actively releases inflammatory chemicals and hormones that raise the risk of type 2 diabetes, cardiovascular disease, and liver conditions. This article explains the key causes, associated health risks, how to measure visceral fat, and the NHS-recommended strategies men can use to reduce it.

What Is Visceral Fat and Why Does It Matter for Men's Health

Visceral fat is deep abdominal fat surrounding vital organs that acts as an endocrine organ, releasing inflammatory cytokines and free fatty acids linked to type 2 diabetes, cardiovascular disease, and MASLD in men.

Visceral fat is a type of body fat stored deep within the abdominal cavity, surrounding vital organs such as the liver, pancreas, and intestines. Unlike subcutaneous fat — the fat you can pinch beneath the skin — visceral fat is metabolically active and behaves similarly to an endocrine organ, releasing hormones and inflammatory chemicals into the circulation.

Omental and mesenteric visceral fat depots drain directly into the portal vein, delivering inflammatory mediators and free fatty acids to the liver; other visceral depots may drain via the systemic circulation. This proximity to major organs means that excess visceral fat can influence metabolic health through multiple pathways.

For men, visceral fat accumulation is particularly relevant. Men tend to store excess fat in the abdominal region — a pattern sometimes referred to as 'central' or 'android' obesity — though this varies between individuals and is influenced by genetics and ethnicity. This contrasts with the 'gynoid' pattern more commonly seen in women, where fat tends to deposit around the hips and thighs.

Because visceral fat releases pro-inflammatory cytokines — including interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) — higher levels are associated with systemic inflammation, insulin resistance, and dyslipidaemia. These processes contribute to several chronic conditions that are common in men in the UK, including type 2 diabetes, cardiovascular disease, and metabolic dysfunction-associated steatotic liver disease (MASLD, previously known as non-alcoholic fatty liver disease or NAFLD). Understanding what causes visceral fat in men is therefore a meaningful step towards prevention and long-term health management (NHS Live Well; NICE obesity identification guidance).

Common Causes of Visceral Fat Accumulation in Men

Visceral fat accumulates due to diets high in free sugars and processed foods, physical inactivity, excess alcohol, chronic stress, smoking, certain medicines (e.g. corticosteroids), and genetic or ethnic predisposition.

Visceral fat builds gradually in response to a combination of dietary, behavioural, physiological, and medical factors. Understanding these causes is important for both prevention and targeted intervention.

Dietary patterns play a central role. Diets high in free sugars, saturated fat, and highly processed foods — and low in fibre and unsaturated fats — are associated with visceral fat deposition, partly by promoting elevated insulin levels and encouraging the liver to store surplus energy as fat. The NHS Eatwell Guide recommends basing meals on fibre-rich starchy foods, eating plenty of fruit and vegetables, choosing unsaturated fats, and limiting foods high in fat, salt, and sugar.

Physical inactivity is another primary driver. Sedentary behaviour — particularly prolonged sitting, which is common in desk-based occupations — reduces the body's capacity to oxidise fat and impairs insulin sensitivity. Men who engage in little or no moderate-intensity physical activity are more likely to accumulate visceral fat over time.

Excess alcohol consumption is a frequently overlooked contributor. Alcohol is calorie-dense and is associated with increased abdominal fat deposition. Regular heavy drinking is linked to greater visceral adiposity in men. UK Chief Medical Officers advise drinking no more than 14 units of alcohol per week, spread across at least three days, with several alcohol-free days each week (NHS alcohol guidance).

Chronic stress contributes through elevated cortisol levels, which directly stimulate visceral fat storage (discussed further in the following section).

Smoking is associated with increased central adiposity and cardiometabolic risk, even in people who are not overweight overall. NHS Stop Smoking services can provide support.

Certain medicines — including long-term systemic corticosteroids and some antipsychotic medicines — can promote central fat gain as a side effect. Underlying medical conditions such as hypothyroidism and Cushing's syndrome can also cause or worsen central adiposity and should be considered if other causes are not apparent.

Genetic and ethnic background also influence where fat is stored. Some ethnic groups — including South Asian, Black African, and Black Caribbean men — may be at increased cardiometabolic risk at lower waist circumferences than the general population thresholds suggest (NICE PH46).

Taken together, these factors represent important targets for reducing visceral fat accumulation, though individual responses vary.

How Hormones, Age and Lifestyle Contribute to Visceral Fat

Declining testosterone from the mid-30s, chronically elevated cortisol, poor sleep, and age-related reductions in growth hormone all promote visceral fat deposition and can create self-reinforcing metabolic cycles.

Hormonal changes are among the most significant contributors to visceral fat in men. Testosterone plays a role in regulating fat distribution. As men age, testosterone levels naturally decline — a process that typically begins in the mid-30s and may accelerate after 40. Lower testosterone is associated with reduced lean muscle mass and a shift towards central fat deposition. Visceral fat itself may further suppress testosterone production by converting it to oestrogen via the enzyme aromatase, creating a self-reinforcing cycle.

It is important to note that age-related changes in testosterone are common and do not automatically indicate a clinical deficiency requiring treatment. If a man has symptoms that may suggest hypogonadism — such as persistent low libido, erectile dysfunction, low energy, or low mood — assessment should include measurement of morning total testosterone on at least two separate occasions, in line with NICE CKS guidance on testosterone deficiency in adult males. Testosterone replacement is not indicated solely for weight reduction.

Cortisol, the body's primary stress hormone, has a well-established relationship with visceral fat. Visceral adipose tissue contains a high density of glucocorticoid receptors, making it particularly sensitive to cortisol. Chronic psychological stress — whether from work, financial pressures, or relationship difficulties — can sustain elevated cortisol levels, which is associated with fat storage in the abdominal region. Prolonged use of high-dose corticosteroid medicines can have a similar effect, and Cushing's syndrome (a condition of excess cortisol) is a recognised secondary cause of central adiposity; a GP should be consulted if clinical features suggest this (NICE CKS: Cushing's syndrome).

Poor sleep quality compounds these effects. Evidence suggests that sleep deprivation raises cortisol and ghrelin (a hormone that stimulates appetite) whilst suppressing leptin (a hormone that signals fullness), increasing appetite and the risk of weight gain. Aiming for 7–9 hours of quality sleep per night is generally recommended.

Insulin resistance creates a further feedback loop. As visceral fat accumulates, it can impair insulin signalling, causing the pancreas to secrete more insulin. Elevated insulin levels may then promote further fat storage, particularly in the visceral compartment. This cycle is one reason why visceral fat can be difficult to reduce without addressing multiple lifestyle factors concurrently.

Age-related reductions in growth hormone secretion also reduce the body's ability to mobilise stored fat, contributing to gradual visceral fat gain even in men whose diet and activity levels remain relatively stable. As with testosterone, growth hormone deficiency should only be investigated and managed in appropriate clinical contexts.

Health Risks Linked to High Visceral Fat in Men

High visceral fat in men is associated with cardiovascular disease, type 2 diabetes, MASLD, obstructive sleep apnoea, certain cancers, erectile dysfunction, and mental health conditions including depression.

The health consequences of excess visceral fat in men are wide-ranging and well-evidenced. Because visceral fat is metabolically active, its effects extend beyond simple weight gain, influencing multiple organ systems.

Cardiovascular disease is among the most serious associated risks. Visceral fat is linked to atherogenic dyslipidaemia — characterised by elevated triglycerides, low HDL cholesterol, and small dense LDL particles — alongside hypertension and chronic low-grade inflammation. Together, these factors contribute to increased risk of myocardial infarction and stroke. NICE CG181 recommends using the QRISK3 tool to assess an individual's 10-year cardiovascular risk; central adiposity is one of several factors that contribute to this overall risk assessment.

Type 2 diabetes is strongly associated with visceral adiposity. The inflammatory cytokines and free fatty acids released by visceral fat are thought to impair insulin receptor signalling in the liver and skeletal muscle, contributing to insulin resistance. NHS data consistently show that men with high waist circumference are at substantially elevated risk of developing type 2 diabetes.

Additional health risks associated with high visceral fat in men include:

• Metabolic dysfunction-associated steatotic liver disease (MASLD, previously NAFLD) — now the most common liver condition in the UK (NICE NG49)

• Obstructive sleep apnoea (OSA), worsened by fat deposition around the neck and thorax (NICE NG202)

• Certain cancers, including colorectal and oesophageal cancer — the World Cancer Research Fund UK (WCRF) identifies excess body fatness as a risk factor for several cancers

• Erectile dysfunction and reduced fertility, partly associated with testosterone suppression

• Mental health conditions, including depression and anxiety — these are associated with chronic inflammation and central adiposity, though the relationship is multifactorial

These risks are not inevitable. Evidence consistently shows that even modest reductions in visceral fat — achievable through sustained lifestyle change — can produce meaningful improvements in metabolic and cardiovascular health markers.

How to Measure and Monitor Visceral Fat Levels

Waist circumference is the most practical clinical proxy; men should aim to stay below 94 cm, with measurements above 102 cm indicating substantially elevated cardiometabolic risk requiring GP review.

Accurately quantifying visceral fat requires clinical imaging, but several practical tools are available for routine monitoring in both clinical and home settings.

Waist circumference remains the most widely used and clinically validated proxy measure. The NHS recommends that men maintain a waist circumference below 94 cm (approximately 37 inches). A measurement between 94–102 cm indicates increased risk, whilst a measurement above 102 cm (40 inches) is associated with substantially elevated cardiometabolic risk. Measurement should be taken at the midpoint between the lower rib and the iliac crest, using a non-elastic tape measure, after a normal exhalation (NHS Live Well).

Ethnicity-specific thresholds are important to consider. Some ethnic groups — including South Asian, Black African, and Black Caribbean men — may be at increased risk at lower waist circumferences. NICE guidance (PH46) and NHS resources provide further detail on adjusted thresholds for these groups; a GP can advise on individual risk.

Waist-to-height ratio (WHtR) is increasingly recognised as a sensitive indicator of central adiposity. NICE (2022) recommends using WHtR alongside BMI for risk assessment in many adults. A ratio above 0.5 (i.e., waist circumference greater than half your height) suggests excess central adiposity and warrants attention.

Body mass index (BMI), whilst widely used, is a limited indicator of visceral fat specifically, as it does not distinguish between fat mass and lean mass, nor does it reflect fat distribution. Two men with identical BMIs can have markedly different levels of visceral fat.

For more precise assessment, dual-energy X-ray absorptiometry (DEXA) scanning and MRI can directly quantify visceral fat volume and may be used in research or specialist settings. CT imaging can also measure visceral fat but involves ionising radiation and is not appropriate for routine monitoring. Some bioelectrical impedance (BIA) scales provide an estimated visceral fat score; however, accuracy varies considerably between consumer devices, and these outputs should be regarded as estimates rather than diagnostic measurements.

Men concerned about their visceral fat levels should discuss waist circumference and overall cardiovascular risk with their GP. Those aged 40–74 without a pre-existing relevant condition may be eligible for an NHS Health Check, which includes assessment of blood pressure, cholesterol, blood glucose, and 10-year cardiovascular risk using QRISK3.

NHS-Recommended Ways to Reduce Visceral Fat in Men

NHS and NICE guidance recommends combining a Mediterranean-style diet, at least 150 minutes of weekly moderate aerobic activity, resistance training, 7–9 hours of sleep, stress management, and smoking cessation to reduce visceral fat.

Visceral fat tends to respond well to sustained lifestyle intervention, though individual responses vary. NHS and NICE guidance supports a multi-component approach combining dietary change, physical activity, sleep improvement, stress management, and — where relevant — smoking cessation.

Dietary modifications should be guided by the NHS Eatwell Guide and focus on:

• Reducing intake of free sugars, saturated fat, and highly processed foods, including sugary drinks

• Increasing consumption of fibre-rich foods (vegetables, legumes, wholegrains) — aiming for approximately 30 g of fibre per day — to support insulin sensitivity and gut health

• Replacing saturated fats with unsaturated fats (e.g., olive oil, oily fish, nuts, seeds)

• Adopting a Mediterranean-style dietary pattern, which has evidence supporting reductions in visceral fat and cardiovascular risk

• Moderating alcohol intake in line with UK Chief Medical Officers' guidelines (no more than 14 units per week, spread across at least three days, with several alcohol-free days)

Physical activity is one of the most effective interventions for visceral fat reduction. UK Chief Medical Officers' Physical Activity Guidelines recommend:

• At least 150 minutes of moderate-intensity aerobic activity per week (e.g., brisk walking, cycling, swimming) or 75 minutes of vigorous-intensity activity (e.g., running, fast cycling), or an equivalent combination

• Muscle-strengthening activities (e.g., resistance training, bodyweight exercises) targeting major muscle groups on at least two days per week, which builds lean muscle mass and improves insulin sensitivity

• Reducing prolonged sedentary time by incorporating regular movement breaks throughout the day

Sleep and stress management are often underemphasised but clinically important. Aiming for 7–9 hours of quality sleep per night and engaging in evidence-based stress reduction techniques — such as mindfulness, cognitive behavioural therapy (CBT), or regular physical activity — may help reduce cortisol-driven visceral fat accumulation.

Smoking cessation is an important component of overall cardiometabolic risk reduction. NHS Stop Smoking services offer free, evidence-based support.

When to seek further support: Men who have made sustained lifestyle changes without meaningful results, or who have a waist circumference above 102 cm alongside other metabolic risk factors, should seek a review with their GP. A GP can assess overall cardiovascular risk using QRISK3, check relevant blood tests (including blood pressure, fasting lipids, and HbA1c), and discuss eligibility for the NHS Health Check or the NHS Diabetes Prevention Programme (NDPP) — available to those with a non-diabetic HbA1c of 42–47 mmol/mol or equivalent impaired fasting glucose.

In some cases, referral to a structured, tiered weight management programme may be appropriate. For eligible individuals, specialist options — including pharmacotherapy or bariatric surgery — may be considered in line with NICE guidance on adult weight management (NICE CG189 and related updates). Investigation for underlying hormonal conditions, such as hypogonadism or hypothyroidism, may also be warranted where clinically indicated.

Frequently Asked Questions