Why Your Weight Doesn’t Tell the Whole Story: Understanding Abdominal and Visceral Fat

When it comes to weight, it is easy to focus on what we see in the mirror or the number staring back at us from the weighing scale. But health experts say there’s more to weight and health than kilograms or body shape.

Where fat is stored can be just as important as how much fat a person carries.

This is particularly relevant in Malaysia, where abdominal obesity continues to be a growing health concern. The National Health and Morbidity Survey (NHMS) 2023 found that 54.5% of Malaysian adults had abdominal obesity based on waist circumference, compared with 45.4% in 2011.

That is why looking only at weight or Body Mass Index (BMI) may not provide the complete picture of a person’s metabolic health.

Not All Body Fat Is the Same

There are different types of body fat, and where it is stored can make a difference.

Subcutaneous fat sits directly beneath the skin. It is the fat that can usually be seen or felt around areas such as the abdomen, hips and thighs.

Visceral fat, however, is stored deeper inside the abdominal cavity, surrounding internal organs. Excess visceral fat has been associated with several metabolic health risks, including insulin resistance, type 2 diabetes, high blood pressure, cardiovascular disease and chronic inflammation.

What makes this particularly important is that a person does not necessarily have to look severely overweight to have increased abdominal or visceral fat.

In other words, appearing slim or having a weight that does not seem particularly high does not automatically mean there is no underlying metabolic risk.

“Many people think that if their weight is not extremely high, there is no reason to be concerned. But weight alone does not tell the whole story. Abdominal obesity can be an important warning sign of underlying metabolic risk,” said Dr Foo Wing Jian, Senior Aesthetic Doctor and LCP holder at Premier Clinic.

“This is why it is important to look beyond kilograms lost and consider factors such as waist circumference, body composition, medical history and metabolic health when assessing an individual’s weight management needs.”

Why Losing Weight Can Be Difficult

For some people, managing weight is not simply a matter of eating less or exercising more.

The human body has complex biological systems that regulate hunger, fullness, energy intake and body weight. During weight loss, changes in appetite and other physiological processes can make it difficult for some people to maintain their progress over the long term.

This can contribute to cycles of dieting and regaining weight.

Nutrition, regular physical activity, sufficient sleep and sustainable behavioural changes remain important foundations of healthy weight management. However, some individuals may need additional medical support depending on their health and circumstances.

Where Medical Weight Management Comes In

This is where medical weight management can play a role.

Rather than treating weight purely as a cosmetic concern, healthcare professionals can assess a person’s overall health, weight-related risks, medical history and lifestyle before deciding whether additional treatment may be appropriate.

One of the treatments increasingly discussed in this area is Mounjaro (tirzepatide), a prescription medicine administered once weekly under medical supervision.

Tirzepatide works through two hormonal pathways, activating GIP and GLP-1 receptors. These hormones are involved in appetite regulation, food intake and glucose metabolism.

For eligible patients, this mechanism can help reduce appetite and increase feelings of fullness, which may support lower food intake and weight loss when combined with appropriate lifestyle measures.

“Medications such as tirzepatide are changing the way we think about obesity because they address some of the biological pathways involved in appetite and metabolism,” Dr Foo explained.

“For certain patients, this treatment can provide an additional tool alongside nutrition, physical activity and behavioural changes. However, Mounjaro is a prescription treatment and should be used following proper medical assessment and under the supervision of a qualified healthcare professional.”

Weight-Loss Medication Isn’t for Everyone

With weight-loss medications receiving increasing attention, health experts are also emphasising the importance of proper medical assessment.

Simply wanting to lose weight does not automatically make someone a suitable candidate for prescription treatment.

A healthcare professional may consider factors including BMI, waist circumference, existing medical conditions, current medications, metabolic health, lifestyle and individual treatment goals before recommending a treatment approach.

This is important because weight management should be about more than achieving a lower number on the scale.

Moving Beyond the Numbers

The growing focus on medical weight management reflects a broader understanding of obesity and weight-related health.

Instead of concentrating solely on rapid weight reduction, a more sustainable approach looks at the bigger picture — including metabolic health, body composition, lifestyle and the factors that may be contributing to weight gain.

For Malaysians, understanding the difference between visible subcutaneous fat and deeper visceral fat can be an important part of having a more informed conversation about health.

Healthy weight management is not about chasing a particular appearance. It is about understanding your individual health risks and finding an approach that can be maintained over the long term.

Medical treatments such as Mounjaro may have a role for clinically appropriate patients, but they are not intended to replace healthy lifestyle habits or become a shortcut to rapid cosmetic weight loss.

Premier Clinic says its approach is centred on individual assessment, personalised treatment planning, lifestyle guidance and ongoing professional monitoring to help patients work towards healthier and more sustainable outcomes.

If you are concerned about your weight, waist circumference or metabolic health, speak with a qualified healthcare professional rather than relying solely on the weighing scale or appearance.