Subcutaneous vs visceral fat
Subcutaneous fat sits under your skin — the fat you can pinch. Visceral fat wraps around organs in the abdomen (liver, pancreas, intestines). Visceral fat is more strongly linked to insulin resistance, elevated triglycerides, and metabolic syndrome.
Waist circumference often tracks visceral fat better than BMI alone. A larger waist with "normal" weight still carries metabolic risk.
Why the scale is not the whole story
Dr. Westman's clinic experience: improving blood sugar and reducing carb intake often improves metabolic markers before dramatic weight loss. Dr. Boz uses the Boz Ratio for the same reason — internal metabolism can shift while the scale stalls.
Intermittent fasting and low-carb eating both reduce insulin spikes, which helps the body access stored fat — including visceral depots — over time.
What you can do
- Track net carbs daily — start with 50g for insulin resistance.
- Prioritize protein at each meal to preserve muscle during fat loss.
- Add 16:8 IF once low-carb eating feels stable.
- Measure waist monthly, not just weight weekly.
- Discuss liver enzymes and A1c with your doctor annually.