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Obesity and Weight Management

Abdominal swelling

10/30/2007

Question:

How do I know if my swollen abdomen is due to fat or another issue? People think I`m 9 months pregnant, yet my hip bones stick out. I`m not thin by any means, but my huge belly makes me completely disproportionate. I have to buy clothes 2 sizes too large to fit around my belly. Could it be fluid?

Answer:

People have large abdomens for many different reasons. Abdominal fat (which is a combination of subcutaneous and visceral fat) is a common cause for a large stomach, especially as more and more people are becoming overweight. Subcutaneous fat is the fat found underneath the skin, while visceral fat is found packed tightly around the abdominal organs. Visceral fat increases the risk for heart disease.

However, apart from your stomach, you do not appear to be overweight. From your question, it is not clear how long you have had a big belly, or whether you have other symptoms or problems with it. Fluid in the abdomen, also called ascites, can give you a big belly, but usually there are other associated symptoms and signs, e.g., swollen feet, swelling around your eyes, fatigue. Ascites can be due to serious dysfunctions in organs such as the kidneys, liver, heart. Abdominal tumors can also give you a large belly.

I would recommend you see your physician for a thorough evaluation. If all medical conditions have been ruled out and it is due to visceral fat, you should improve your dietary habits and physical activity. Target polyunsaturated fats instead of saturated fats, and in addition to aerobic activity, learn exercises that help build muscles like weight training and resistance exercises.

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Response by:

Ihuoma U Eneli, MD Ihuoma U Eneli, MD
Associate Clinical Professor of Pediatrics
Medical Director of the Center for Healthy Weight and Nutrition
College of Medicine
The Ohio State University