How Do I Lose Visceral Fat? A Deep Look

Bottom line

• Exercise and weight loss seem to reduce visceral fat the most¹
• Harder exercise may cut visceral fat more in some trials, but the evidence on doing more is thin and the two trials disagreed (GRADE: low).²³
• Vigorous aerobic work and interval training ranked above resistance training for reducing visceral fat in reviews of trials (GRADE: high).⁴⁵
• Great sleep hasn't been shown to decrease visceral fat, but poor sleep has been shown to increase it
• Decreasing stress hasn't directly been shown to reduce visceral fat, but it's very connected to lowering weight and so it is a likely support to visceral fat reduction
• As we age, particularly women in perimenopause and menopause, we must expect visceral fat to increase, particularly with more sedentary lifestyle, weight gain, and decreases in hormones such as estrogen and progesterone⁶

What is visceral fat?

Visceral fat, according to the Cleveland Clinic, is a type of body fat you have deeper inside you. It gets its name from its location.⁷ Viscera is a term for internal organs and tissues. Visceral fat lines your abdominal walls and wraps around many of your internal organs. According to the Cleveland Clinic, the main areas where visceral fat aggregates are in your heart, intestines, kidneys, liver & gallbladder, mesentery, pancreas, and stomach⁷.

Visceral fat has gained such attention because high levels are strongly linked to conditions. Heart disease, Alzheimer’s, cancer, type 2 diabetes, stroke, and high cholesterol are some of the conditions that are strongly linked to having too much fat in your belly.

How is visceral fat measured?

The way that visceral fat is measured by a CT scan or an MRI unit is in centimeters squared, cm^2. CT and MRI use very small doses of radiation to measure "slices" of fat around the abdomen area, so the cm^2 is the 2D image, if you will, of that slice of fat under the subcutaneous fat. Machines such as InBody's use electrical "charges" + formulas to estimate visceral fat, so it is fair to say that a CT scan or MRI will be more accurate, albeit more invasive.

Often, scores of 104cm^2 or higher are deemed "high" scores suggesting higher risk to the individual.⁸

We have seen scores from almost 0 to almost 300cm^2 so the range is quite large. Our general statement to folks is that visceral fat, unless at extremely low levels - think below 10 - is something we'd like to see generally trend lower until they reach advanced ages where our goal is to maintain visceral fat because of its expected large annual rise, all things equal. Below is a chart based on this study showing visceral fat and waist circumference levels vs expected risk.

What the research shows on losing visceral fat - An Overview

I expected to see stronger clinical data around stress reduction and better sleep reducing visceral fat, but there wasn't strong data there that I found. The strongest data resides in two places:

1. Consistent aerobic exercise executed at at least moderate intensity, done consistently, helps reduce visceral fat
2. Losing weight, primarily through better eating habits, which can be aided by GLP-1's, helps reduce visceral fat

Does aerobic or interval training reduce visceral fat more than resistance training?

In a network meta-analysis, vigorous-intensity aerobic exercise and HIIT had the highest probability of being the best way to improve visceral fat, with resistance training-only ranked least effective.⁴

From further research, the reason this seems to be the case is that total energy expenditure is the main driver. Quite simply, too slow of aerobic exercise for too short of time uses little energy, and weight training is typically done in much shorter total working time, ie you do a set for let's say 1 minute but then you rest for 3 minutes. It doesn't make resistance training bad, far from it. It makes resistance training less good for reducing visceral fat, specifically.

Below are data points on how big of an effect the exercise interventions had on visceral fat vs the control group of non exercise. Contextually, you could say that a -0.63 is apx 25cm squared

Does more exercise (longer, more often, or harder) reduce visceral fat more?

In one trial in obese women, visceral fat loss was greater with higher-intensity interval groups than with moderate training, but it did not respond to further intensity increases at or above 90% VO2peak.²

In short, this makes logical sense to me because the test group most likely output more total energy when they "tried harder." That is simply my own belief based on seeing how people output energy at different effort levels.

Do GLP-1 receptor agonist drugs reduce visceral fat?

In a review of trials, GLP-1 receptor agonist drugs reduced visceral fat compared with control treatments, and the reviewers found that GLP-1's did help reduce visceral fat levels.⁹

The mean difference of -0.59 likely corresponds to 20-25cm^2 of visceral fat reduction in the test groups, and interestingly this was vs placebo groups, other medications, and lifestyle-only interventions.

Similarly to total energy expenditure supporting visceral fat reduction, GLP-1's support a reduction in caloric intake and have been shown to support weight and fat loss, so this tracks nicely with the broad idea that lowering weight supports a reduction in visceral fat.

What did other studies suggest?

• Resistance training was beneficial for visceral fat loss, but adding calorie restriction to resistance training didn't benefit visceral fat loss additionally.¹⁰
• Visceral fat reduction was maintained to a decent degree 5-7 years after an 18 month dietary intervention even after weight was regained

What does Dr. Rhonda Patrick suggest about visceral fat reduction?

What I've found time and time again is that I can't just learn facts, I must also learn what influencers are suggesting to be true, too. And, one of the strongest voices I find credible is Dr. Rhonda Patrick.

She's been on many of the big podcasts, but this video she did with Stephen Bartlett from Diary Of A CEO caught my attention. In the video she really digs into visceral fat, saying:

“Exercise does cause you to lose visceral fat. It's not just any type of exercise. Really has to be aerobic. And the more vigorous the better.” at 3:22

“So what I mean is resistance training and lifting weights don't really move the needle in terms of helping you lose visceral fat.” at 3:37

“intermittent fasting is essentially a good tool that people can use to reduce their calorie intake without having to count their calories.” at 5:15

“there are studies, multiple studies showing that if you do aerobic endurance training, this kind of running, cycling, swimming type of training, you actually have better adaptations if you're fasted versus fed.” at 10:19

— Dr Rhonda Patrick on Stephen Bartlett's Diary Of A CEO podcast

I do think it's important to attempt to put some context around some of her comments.

She further suggested that intermittent fasting worked for her mainly because it allowed her to keep her calories in check while still being able to do fasted cardio, ie moderate-to-vigorous aerobic activity.

The context here is that based on the research I did, it doesn't appear that intermittent fasting is comparatively better than calorie restriction and/or quality moderate-to-vigorous exercise, it's just the way that Dr. Patrick needed to execute her day to achieve the exercise and calorie goal to see visceral fat outcomes she wanted.

By no means am I suggesting she hid that information, I just know that people pluck out snippets and spin them, so I think it's important to say as much.

How do we apply these learnings to drop visceral fat?

How does proof3 act to help members lose visceral fat?

Our members, most adults in our experience, want to get the foundation of their fitness results from one place, and the more research we do the more we harden our belief that long-term success must include both strength and aerobic endurance training in addition to lifestyle and food support when your goal is to Live Stronger for Longer®.

Summary

It's important to be honest with ourselves about if something isn't lining up with what our stated goals are. If there isn't a biological or chemical/hormonal issue, losing visceral fat likely comes down to the interventions discussed in this article, but as coaches we see time and time again that many people misperceive what they are actually doing daily. Perhaps they are eating or drinking far more calories than they think, perhaps they don't ever get into the more vigorous exercise realm, perhaps they don't set themselves up to lose weight.

We're here to tell you that that is normal. It doesn't help to fault yourself for any of those things. What we see work for most people is when they connect their daily habits, and more importantly, their view of themselves to the goal they want to achieve. ie it is easier to know, and say, "I don't drink alcohol" (if you believe it) than it is to say "I am going to try not to drink alcohol tonight." This is the same phenomenon we see when people perceive, and believe, themselves to be athletes. "As an athlete, I'd never dream of ______."

When you are something, temptation drops precipitously for many people, and that reduces our stress levels which often helps under our body's hood.

Appendix

What interventions may not work as well as we think to drop visceral fat?

• Vigorous exercise didn't do better than moderate exercise for abdominal visceral fat in overweight and obese postmenopausal women during calorie restriction, as all groups lost about 25%.³
• Resistance training plus calorie restriction didn't show a clear edge over calorie restriction alone for visceral fat in a meta-analysis.¹⁰
• Time-restricted eating schedules didn't do better than usual care for visceral fat change in adults with overweight or obesity in one trial.¹¹

What are the limits of these studies?

• The evidence on more exercise rests on two small trials that disagreed, so confidence is low.²³
• The exercise-type rankings come from network comparisons of trials, not direct head-to-head tests, and the people studied had overweight, obesity, or diabetes.⁴⁵
• The calorie-restriction finding is a single review with mixed study results across arms and an unclear mix of designs, so confidence is very low.¹⁰
• Several of the reviews I relied on did not publish a funding or conflict-of-interest statement, so we can’t rule out industry influence; their findings were consistent with the independent trials.

This article is for general education about fitness and health. It is not medical advice. Talk to your doctor before changing medication, diet or training because of anything here.