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You don’t always have to step on a scale to know when something feels off. Maybe your pants fit tighter around the waist, or your shirts stretch more around the middle. Perhaps you haven’t gained much weight overall, but your body shape has changed.
This kind of shift could be a sign of truncal obesity. It’s a condition where excess fat builds up around the belly and upper body. Also known as central obesity or abdominal obesity, this type of fat doesn’t just sit under the skin. It surrounds your internal organs and affects your health in ways you can’t always see. Fat in this area can raise your risk for serious medical conditions, even if your body mass index (BMI) — a number based on your height and weight — is in the normal range.
This article explains what truncal obesity is, how to tell if you have it, and simple ways to take control of your health.
Truncal obesity happens when most of a person’s body fat gathers in the chest, abdomen (belly), and pelvis rather than being spread out across the hips or legs. You may also hear it referred to as central obesity or abdominal obesity, or a body type often described as “apple-shaped.” The terms male-type obesity and visceral obesity are used to describe this, too. However, this type of fat distribution is more than just a body shape.
Fat that builds up deep inside the belly and chest is called visceral fat. It covers your vital organs, like your liver, stomach, and intestines. Visceral fat is more harmful than the fat under your skin. This is because it produces hormones and chemicals that can raise the risk of health conditions, such as:
Doctors sometimes use the term “phenotypic classification” to describe how fat is stored in the body. The android phenotype refers to fat stored in the trunk — the belly, chest, and upper back. The gynoid phenotype, or “pear-shaped” body type, describes fat stored around the hips, thighs, and buttocks. While gynoid obesity is less risky, truncal or android obesity has been linked to higher rates of health issues, like insulin resistance.
You don’t have to have a high BMI to have truncal obesity. In fact, people with a normal weight can still have too much abdominal fat. That’s part of what makes it an often-overlooked but serious health concern.
To figure out if someone has truncal obesity, doctors usually start by measuring BMI. This is a number that helps estimate body fat based on a person’s height. It’s calculated by dividing your weight in kilograms by the square of your height in meters.
BMI is a helpful starting point, but it doesn’t tell the whole story. That’s because it doesn’t show where fat is located in the body. Also, BMI may not always be accurate. For example, in athletes or very muscular people, BMI can overestimate fat because it doesn’t distinguish between fat and muscle mass. Meanwhile, in older adults, BMI might underestimate body fat due to age-related muscle loss.
If your BMI falls between 25 and 40, doctors may use additional tools to check for truncal obesity and its related health risks. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), these include:
By using a combination of BMI and body measurements, doctors can more accurately spot truncal obesity, even when weight alone doesn’t show the whole picture. However, if BMI is above 40 — which is classified as severe obesity — these extra measurements are usually not needed.
Truncal obesity doesn’t happen because of just one cause. It’s the result of a mix of factors — some you can control, and others you can’t.
One major factor is genetics. If close family members have excess abdominal fat, you may be more likely to develop it, too. Hormones also come into play. For example, high levels of the stress hormone cortisol or problems with insulin resistance can lead to fat building up in the belly area. This is common in health conditions like Cushing’s syndrome or polycystic ovary syndrome (PCOS).
Age and sex matter, too. As people get older, they tend to lose muscle and gain fat, especially around the waistline. Men are also more likely than women to develop central or android obesity, as noted by the NIDDK.
Lifestyle habits are another key cause. Eating a diet high in sugar and processed foods, not getting enough physical activity, poor sleep, and chronic (long-term) stress all increase the risk of storing more visceral fat.
Truncal obesity isn’t just about eating too much. It often signals a deeper problem with how the body uses energy and stores fat. That’s why it’s treated as a complex medical condition, not just a weight issue.
Managing truncal obesity starts by focusing on health, not just weight loss. Whether you have obesity or a higher body weight, the goal is to improve how your body functions, especially when it comes to managing blood sugar, cholesterol, and blood pressure.
The foundation of treatment is a comprehensive lifestyle plan. This includes regular physical activity, healthier eating habits, and lifestyle changes that support long-term success. Even small improvements can make a big difference over time.
Moving more helps burn fat, lowers insulin resistance, and supports heart health. Most people should aim for at least 150 minutes of moderate-intensity exercise every week. Try to pick activities you enjoy so that you’re more likely to stay motivated. Brisk walking, swimming, or cycling might be a good place to start. Adding strength training can help you keep muscle and boost your metabolism. When you combine it with healthy eating, you may see results even faster.
Eating a balanced, lower-calorie diet is an important way to manage truncal obesity. This can include eating fewer calories overall, cutting back on sugary drinks, and limiting processed foods, unhealthy fats, and white bread or pasta. Diets like the Mediterranean diet — rich in vegetables, fruits, whole grains, lean proteins, and healthy fats — are highly recommended. This diet can also reduce cardiovascular risk and prevent diabetes. Even a 5 percent to 10 percent weight loss can improve blood pressure and reduce the risk of heart disease and type 2 diabetes.
Poor sleep and chronic stress can raise cortisol, a hormone that promotes visceral fat storage. Adults should aim for seven to nine hours of quality sleep each night. Getting enough sleep helps your body manage energy and keep blood sugar levels steady. Simple habits like going to bed at the same time every night, limiting screen time, and deep breathing can help lower stress and improve both mental and metabolic health.
For some people, lifestyle changes may not be enough to manage truncal obesity. In these cases, doctors may recommend anti-obesity medications.
These medications help with appetite control, insulin sensitivity, and weight loss. They work best when combined with healthy eating, physical activity, and regular follow-up care with your healthcare team. Your doctor will likely recommend medication when BMI is 30 or higher, or 27 and higher with additional health complications.
Truncal obesity is more than a body shape — it’s a medical condition that can affect long-term health. The good news is, it’s manageable. With the right mix of awareness, daily habits, and support, you can make simple, lasting changes that support your health.
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Do you have truncal obesity? What lifestyle changes have been most effective for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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