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New Delhi: Carrying excess fat around the stomach may place far more strain on the heart than simply being overweight, according to new research from Germany. Scientists have found that abdominal obesity – often described as a “beer belly” – is linked with harmful structural changes in the heart, particularly in men, even when overall body weight does not appear extreme.
Dr Jennifer Erley, who led the study, explained that excess visceral fat around the abdomen seems to trigger a distinct and worrying pattern of heart remodelling known as concentric hypertrophy. In this condition, the muscular wall of the heart thickens, but the organ itself does not grow in size. “As the walls thicken, the internal chambers actually shrink,” she said. “That means the heart holds and pumps less blood, and its ability to relax between beats becomes impaired. Over time, this can set the stage for heart failure.”
The findings come from an analysis of cardiac MRI scans from 2,244 adults aged between 46 and 78, none of whom had been diagnosed with cardiovascular disease. Researchers examined both participants’ body mass index (BMI) and their waist-to-hip ratio (WHR), a measurement that better reflects the amount of visceral fat stored deep around internal organs.
The contrast between the two measurements was striking. Based on BMI alone, roughly two-thirds of the men and just over half of the women were classified as overweight or obese. But when WHR was considered, the proportion skyrocketed: 91 per cent of the men and 64 per cent of the women met the criteria for abdominal obesity.
Dr Erley, a radiology resident at University Medical Centre Hamburg-Eppendorf, noted that the pattern of heart changes differed depending on the type of obesity. “Higher BMI tended to correlate with larger heart chambers,” she said. “Abdominal fat, on the other hand, was associated with thicker heart muscle and smaller chamber volumes.” These changes were especially marked in men, who showed more prominent alterations in the right ventricle — the chamber responsible for pumping blood to the lungs. The team believes this may reflect the way abdominal fat can affect breathing and pressure around the lungs.
The study also found abnormalities in heart tissue which could only be detected via an MRI. These signs suggest that men may experience strain on the heart before the signs appear.
According to Dr Erley, the sex differences are notable. Men may accumulate visceral fat earlier or more rapidly, while women may benefit from the protective effects of oestrogen. She stressed that efforts to reduce health risks should focus not only on lowering body weight, but specifically on preventing the build-up of abdominal fat through regular physical activity and balanced eating habits.
The team also encouraged greater awareness among clinicians. A simple tape measure, Dr Erley said, can help people estimate their waist-to-hip ratio at home. “When radiologists see this particular remodelling pattern, we often think of hypertension or cardiomyopathy,” she noted. “This study shows we should also be considering obesity — especially abdominal obesity — as a potential underlying cause.”
