The acronym blog😜
THE BOTTOM LINE
In my recent blog, The Menopause Goldrush, I pointed out that not a single recognised health authority — including the World Health Organization (WHO), U.S. National Institutes of Health (NIH), North American Menopause Society (NAMS), American Association of Clinical Endocrinologists (AACE), or the European Association for the Study of Obesity (EASO) — has ever prescribed an ideal body fat percentage (BF%) for women over 50.
And yet, countless “experts” and influencers continue to promote arbitrary numbers as if they were health gospel.
The irony? BF% does matter — sort of — but not as a cosmetic benchmark.
Its real value lies in what it reflects about metabolic health, and even then, we should actually be more concerned with our levels of visceral fat, rather than our percentage of body fat.
When we shift the focus from aesthetics to physiology, the conversation changes entirely.
When we talk about body composition in midlife, we should not be chasing a number on a scale or a reflection in the mirror. We should consistently be cultivating a body that will move through midlife with calm strength.
Because midlife isn’t about shrinking — it’s about expanding your capacity to move, live, and thrive.
Quick detour
To understand the nuances here we need to do a quick VAT 101: The Basics
In the academic literature, the acronym for belly fat is VAT (visceral adipose tissue).
This makes me giggle because VAT is taxing, so to keep smiling, I’ll continue to use the acronym.
VAT is quite different to either ASAT (abdominal subcutaneous adipose tissue) which is the fat that sits just under the skin or GFAT (gluteofemoral adipose tissue) – your, err, bottom🍑
Giggle, 🤭some more – don’t you love these silly acronyms?
THE HOW TO
Stop chasing BF% as a health goal
BF% does not tell us a whole lot about VAT.
BF% tells you how much of your body weight is fat – which includes VAT, ASAT and GFAT, but this percentage won’t tell you where that fat is stored, or whether you have more VAT than ASAT, for example.
And the realm of measuring BF% is fraught with inconsistency at best, or downright inaccurate. In fact, the most accurate way to measure BF% is via an autopsy, which is ironic, since at that point in the person’s life, it’s pretty useless information!
What Really Matters for Health?
When it comes to understanding what truly matters for our health, it’s not just about how much fat we have, but where that fat is — particularly VAT.
Unfortunately, the tools that can pinpoint VAT most accurately, such as MRI and CT scans, are largely inaccessible outside research or clinical settings. Even DEXA and BIA scans, while useful, have inherent limitations in how precisely they estimate VAT.
And traditional measures like BMI or waist circumference can’t reveal this distribution at all.
Two people can share the same BMI, yet have entirely different fat profiles and therefore, very different health risks.
Use smarter proxies for visceral fat
What we can use is Waist-to-Hip ratios.
Waist circumference ÷ Hip circumference
e.g. 78 cm ÷ 98 cm =0.80
According to WHO:
- Healthy for women: < 0.85
- Healthy for men: < 0.90
WHR is easier to measure than either VAT or BF% because BIA is often expensive or inaccessible.
WHR doesn’t tell the whole story, but it gives a far better indication of visceral fat risk than BMI or BF% alone — and it’s accessible, repeatable, and cheap.
“But I Already Bought My Smart Scale😩”
Good news — you can still use it!
Smart scales (Omron, InBody, etc.) estimate VAT, BF%, and lean muscle mass Footnote
The trick? Consistency.
Measure at the same time, under the same conditions(morning, post-toilet, same clothing — or not😉).
Typical VAT Scores:
- 1–9 → Low metabolic risk
- 10–13 → Caution zone
- 14+ → High visceral fat and elevated risks of inflammation, insulin resistance, and metabolic issues.
Just remember: hydration matters. If you’re well hydrated, BF% will appear lower; dehydrated, higher — because bioelectrical impedance relies on water in muscle tissue to conduct the signal.
WHR doesn’t tell the whole story, but it gives a far better indication of visceral fat risk than BMI or BF% alone — and it’s accessible, repeatable, and cheap.
Warning Received! My VAT Is Heading the Wrong Way — Now What?
High VAT isn’t just a signal that you have more fat. It also means:
- Glucose storage in muscles and liver is maxed out.
- Blood glucose levels maybe high → insulin release →insulin resistance.
- Organs that your VAT is cushioning may become inflamed or compressed.
- Hormone signaling maybe disrupted.
What You Can Do
1. Create more storage space. Build lean muscle — especially in your lower body.
Lean muscle acts like a blood-glucose sponge, tackling points 1 and 2 above.
2. HIIT steps up — short, sharp, and seriously effective
Improving how insulin does its job, allowing your body to expend more energy after the effort and mobilizing fat away from the viscera.
3. Tackle inflammation
Check your nutrition, stress, sleep, and the “Belly Fat Bullies” (aka cortisol and insulin).
You Have Options
👉 Explore my Made To Move program to rebuild lean muscle and learn how to “HIIT it,” or unwrap calm with Cortisol Calmers to better manage your stress hormones.
THE SCIENCY STUFF
Where VAT Lives
VAT is tightly packed around our organs, is highly vascularised and very metabolically active. It is found specifically in deposits inside the abdominal cavity and internal organs (liver, intestines, kidneys, etc.).
Of course, I wanted to know if there is VAT in fascia too, but actually it isn’t inside the fascia, but rather within the spaces and folds that fascia creates. If you think of the fascia as the body’s inner scaffolding that keeps your organs suspended and separated, then VAT hangs out in these folds.
What VAT Does (When It’s Healthy and When It’s Not)
In a healthy state, VAT acts as an energy reservoir, regulates metabolism through hormones such as leptin and adiponectin, and cushions and insulates the organs it surrounds.
However, since it is metabolically active, excess VAT can become inflammatory, disrupt metabolism and insulin function and can negatively affect the organs it is packed around. In other words, both the location and the function of VAT can be problematic.
How We Measure VAT
Imaging techniques (MRI or CT scans) are the gold standard for measuring VAT. DEXA scans and very sophisticated bioelectrical impedance analysis (BIA) only give estimates of VAT, based on algorithms. Typically, MRIs are not easily accessible to us and since DEXA and BIA are estimates, it’s prudent to only use them for monitoring purposes.
Why Excess VAT Is a Problem
The distribution of fat, rather than the amount or BF%, is a far better predictor of health outcomes.
By way of example, Agrawal et al. (2023) describe the function of the fat in the different fat deposit sites (VAT, ASAT and GFAT), noting particularly that VAT is correlated with an increased risk of Type 2 diabetes and coronary artery disease, whilst ASAT is largely neutral. GFAT may even be adaptive, serving as an additional storage facility and may modify insulin resistance.
Chen et al. (2019) found that among postmenopausal women with a normal Body Mass Index (BMI), a higher proportion of VAT was associated with greater cardiovascular disease risk, whereas a higher proportion of GFAT was associated with a lower risk. They proposed that GFAT may serve as a metabolically protective storage depot — so when this “safe” storage capacity is reduced or underutilized, excess fats are redirected to VAT.
💡 Turns out, “tiny waist, big butt” wasn’t patriarchal fantasy
— it was biological foresight.
GFAT protects your heart while VAT stirs the metabolic pot.
VAT and Chronic Pain
Unhealthy VAT triggers systemic inflammation, which activates nerves within fascia— nearly doubling the risk of chronic pain.
“Obesity is more metabolically relevant to pain than biomechanically.”
Final word
If BF% is the headline everyone argues about, visceral fat is the small print that actually matters.
The most important question in midlife isn’t “How much fat do I have?”
It’s “How well is my body managing what it has?”
Visceral fat reflects how effectively we store energy, regulate blood sugar, recover from effort, and manage stress over time. None of that shows up reliably in a mirror — and very little of it is captured by a single percentage.
When we stop chasing numbers and start paying attention to physiology, the goal shifts. Midlife isn’t about shrinking your body to meet an arbitrary benchmark.
It’s about expanding your capacity to move, regulate, recover, and live with calm strength.
And that is something you can train.
Footnote: Since you have the smart scale and are probably using it to record your BF%, you should know that your level of hydration will affect your measurement. If you are more hydrated your BF% will appear less. This is because water is stored in muscles, and it is the water that conducts the electrical current for this scale. If you are dehydrated, your BF% will be higher, because the muscle is not represented in the BIA