Extra weight matters most when it sits around the waist.
Weight comes on when the body takes in more energy than it uses, but why that happens differs from person to person: food, sleep, stress, medicines, hormones and genes all play a part. Fat stored deep inside the tummy, around the organs, is the kind most linked to diabetes, fatty liver, high BP and heart disease.
In plain words.
For Indian adults a BMI of 23 to 24.9 counts as overweight and 25 or more as obesity. These cut-offs are lower than on Western charts, because Indians tend to carry more body fat at the same weight.
The waist often says more than the scale. A waist above 90 cm (about 35 inches) in men or 80 cm (about 31½ inches) in women points to fat around the organs, even when the BMI looks normal.
A few causes are worth ruling out: an underactive thyroid, some medicines (steroids, insulin and some diabetes tablets, and some medicines for mood or fits), polycystic ovaries (PCOS) in women, poor sleep, and rarely a hormone illness. Most often there is no single hidden cause, only the slow sum of daily habits.
Losing even 5 to 10 percent of your weight often brings sugar, BP and liver fat down noticeably.
A slice across the waist
The waist cut across and seen from above. A thin layer of fat under the skin, a little fat among the bowel, and the organs with room to work.
Fat builds up deep inside, around the bowel and liver, and the waist grows. This deep fat sends out signals that push up sugar, BP and liver fat: that is why the tape matters more than the scale.
Go to hospital now if
See a doctor within a few days if
- Weight rises quickly over days or weeks with swelling of the legs, face or tummy: this can be fluid from the heart, kidneys or liver, not fat
- You snore loudly with pauses in breathing, or fall asleep in the day, above all while driving
- Weight comes on with a rounder face, thin skin with purple stretch marks, and weak thigh muscles
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| HbA1c or fasting sugar | Diabetes and prediabetes often come with extra weight. |
| Lipid profile | Cholesterol and triglycerides. |
| Liver tests and ultrasound | Fatty liver is very common with weight around the waist. |
| Thyroid (TSH) | To rule out an underactive thyroid. |
| Creatinine and urine albumin | Whether the kidneys are being affected. |
| Others, only when needed | Hormone tests for PCOS in women with irregular periods, or a sleep study for heavy snoring. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Be wary of pills, powders or teas that promise quick weight loss: some contain hidden medicines that harm the heart or liver.
A video call can
- Look for what is driving your weight: food, sleep, stress, medicines, hormones
- Check for the illnesses that come with it, and plan the tests
- Build a realistic food and activity plan, and follow it month by month
- Discuss whether a weight medicine could suit you, and its risks
Needs a visit in person
- Blood tests, at a laboratory
- A sleep study, when sleep apnoea is likely
- Assessment for weight-loss surgery, by a surgical team
- Chest pain or sudden breathlessness: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759