Sometimes, when you are on a weight-loss programme, you might experience a plateau where the number on the scale does not seem to budge.
Do not be discouraged by this.
It is important to remember that a steady scale does not always mean no progress.
In fact, these plateaus can be a sign that your body composition is changing and that you are losing belly fat, even if the overall weight remains the same.
Understanding this can help you stay motivated and focused on your health journey.
Below are 12 signs that indicate you’re losing belly and visceral fat, even if your body weight remains temporarily unchanged.
Your face, hands and fingers look less puffy.
You may see a slimmer face, less puffiness around the eyes or rings becoming looser.
This can happen as overall fat and fluid retention change.
It’s encouraging, although it doesn’t prove visceral fat loss by itself.
Your waist circumference is shrinking.
This is one of the most useful signs.
You can lose belly fat and still build muscle, so your waistline can decrease even though your body weight doesn’t change.
Measure your waist on a consistent basis to observe the trend.
Your clothes fit differently around your abdomen.
Your trousers feel looser, your belt is one notch tighter and clothes that used to be tight around your stomach are more comfortable.
These changes may be apparent before big changes on the scale.
Your waist-to-height ratio is improving.
Measuring waist circumference with respect to height is another good measure of central adiposity.
As waist circumference decreases, this ratio is better even if total body weight is relatively stable.
Your body fat percentage or abdominal fat measurements improve.
DEXA (used to measure bone density), and MRI (magnetic resonance imaging) or CT (computed tomography) when clinically indicated, can reveal body composition changes that body weight alone cannot.
Bioelectrical impedance can also help track trends, although hydration status can strongly affect individual readings.
You maintain or gain muscle while losing inches.
This is a big reason why the scale may look “stuck”, as muscle weighs more than fat.
Losing fat while maintaining or increasing lean mass is generally better than simply losing kilogrammes.
Your fasting glucose and HbA1c levels improve.
Visceral fat is associated with insulin resistance.
Better glucose control, in combination with a smaller waist, may be indicative of improved metabolic health.
Your triglycerides and other cardiometabolic markers improve.
Lower triglycerides, a healthier HDL-to-triglyceride distribution, improved blood pressure and better metabolic markers are likely to be related to reductions in visceral fat as well.
Your post-meal glucose response improves.
Meals that previously produced large glucose spikes may now show smaller rises as metabolic health, diet, physical activity and insulin sensitivity improve.
It is not a direct measure of visceral fat, but it is part of the picture.
You feel your energy level is more stable.
You have fewer energy dips or afternoon crashes.
Better diet, sleep, physical activity and glucose control can all contribute.
You can go longer between meals.
Some people experience less hunger pangs and don’t need to snack constantly.
This may be because of changes in meal composition, appetite regulation or metabolic adaptation – not ketosis.
Your fitness and physical performance improve.
Walking feels easier, stairs are less tiring to climb, exercise tolerance increases and recovery may improve.
If your waist is shrinking, these changes are evidence of body composition improvement and metabolic fitness.
Misleading signs
The three signs below may occur when a person attempts to lose weight, but they do not necessarily indicate visceral fat loss.
In some cases, they may indeed require medical attention.
> Fruity breath
Your breath may smell metallic or fruity during nutritional ketosis.
When carbohydrate availability is low enough, the liver can produce excess ketone bodies.
Acetone is a common form of ketone and can be detected in the breath, due to its fruity or solvent smell.
But ketone breath means ketones are being produced; it does not prove that visceral fat is being lost.
A key safety distinction is important: fruity breath with very high glucose levels, nausea, vomiting, abdominal pain, intense thirst or dehydration, deep or rapid breathing, drowsiness, or confusion can indicate diabetic ketoacidosis.
This requires urgent medical assessment, especially in people with diabetes or those taking SGLT2 (sodium-glucose cotransporter 2) inhibitors.
> More frequent urination
You may urinate more often when you begin a lower carbohydrate diet.
Glycogen stored in the liver and muscles holds water.
When carbohydrate intake drops dramatically and glycogen stores fall, some of this water is released, increasing urine output and early weight loss.
But this is mainly a fluid and glycogen effect, and is not evidence that abdominal fat is rapidly disappearing.
Persistent excessive urination, especially when accompanied by excessive thirst, fatigue, unexplained weight loss or elevated glucose levels, should be assessed as a medical concern – not interpreted as successful fat burning.
> Muscle cramps
Muscle cramps or eye twitching may occur, but they are not signs of fat loss.
Changes in diet, fluid intake, strenuous exercise, sweating, dehydration and electrolyte disturbances may cause cramps or muscle twitching.
They should not be taken as signs of visceral fat burning.
Persistent or severe symptoms should be assessed, especially if they occur with weakness, palpitations or other neurological symptoms.
In addition, here are two common misconceptions about fat loss:
> Mitochondria produce more energy
Ketosis can occur during fat loss, but mitochondria do not produce “400% more energy”.
Fatty acids become important fuel sources during fasting, carbohydrate restriction or a ketogenic diet, which results in the liver producing ketones.
Ketones can be very efficiently used by the brain, heart and skeletal muscle under appropriate metabolic conditions.
The claim that ketones cause mitochondria to produce 400% more energy, and therefore, dramatically raise basal metabolic rate, is not an accurate representation of established human physiology.
You can lose a lot of visceral fat without being in nutritional ketosis and ketosis doesn’t automatically mean you are losing body fat.
> Breathing out fat
Most of the mass from oxidised fat eventually leaves the body through the lungs as carbon dioxide.
When triglycerides are broken down, most of their carbon atoms are converted into carbon dioxide, while hydrogen atoms combine with oxygen to form water.
A commonly cited calculation shows that when 10kg of human fat is fully oxidised, about 8.4kg leaves the body through the lungs as carbon dioxide, while about 1.6kg becomes water that is eliminated through urine, sweat and breath.
That does not mean you can lose belly fat by breathing more, and that if acetone is on the breath, visceral fat is physically “coming out through your mouth”.
The underlying fat has only to be metabolised.
Key message
Don’t judge fat loss by the scale alone.
Body weight is the total mass of fat, muscle, water, glycogen, bone and other body parts.
Short-term changes in water can easily disguise changes in fat mass.
A much stronger picture is created when several indicators occur together.
Reductions in waist circumference and abdominal or visceral fat, along with the maintenance or increase of muscle mass, should lead to better glucose regulation, increased triglyceride levels, decreased blood pressure and better physical health, and thus, a noticeable metabolic improvement.
So if the scale has not changed for two weeks, but your waist is smaller, your clothes fit better, your strength is preserved and your metabolic markers are improving, your programme may still be delivering the desired result: losing fat while protecting valuable muscle.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
