Excess belly fat can put you at risk for heart attack, stroke, diabetes and other health complications.

Feeling a bit thick around the middle? It happens to the best of us. The years go by and our profiles look just a bit rounder. But belly fat is more than a stubborn these pants don’t fit issue it can be a symptom of serious underlying health problems. The good news? You have the power to win the battle over belly fat.

And its a challenge you want to take. Every day in my practice, I see patients carrying too much around the middle. In most cases, I can predict the effect that fat is having on their entire body. A look at their blood sugar, blood pressure, cholesterol and triglycerides (a so-called metabolic profile) shows they are flirting with diabetes and have an increased risk of heart disease. In many cases, people have these conditions already but don’t know it. These patients often also have signs of plaque in the arteries of the neck and abdominal aorta, which increases their risk of heart attack and stroke. But that s not all belly fat is also linked to sleep apnea, colorectal cancer, gout, blood clots in the legs, osteoarthritis, back problems, yeast infections, skin conditions and psychological problems.

Understanding belly fat

It’s not the excess lapping over your belt that doctors are concerned about. We worry about whats going on deeper inside your abdominal cavity. A belly bulge hints at the visceral fat that surrounds your liver, kidneys and pancreas. This kind of fat isn’t just extra padding. It releases glucose, making our own insulin work harder to keep blood sugar stable. When that happens, your risk of diabetes increases. In other words, a tummy tuck isn’t the answer to the belly fat problem. You need to lose the fat around your organs, and the only way to do that is to lower your overall weight.

Shrink that waistline

You don’t need a washboard stomach to increase your heart health. Aim instead for this basic goal: Whatever your height is, divide it in half. That should be your waist measurement. For example, if you’re 6 feet tall (72 inches) try to get your waistline to 36 inches.

A woman’s risks

While visceral fat is a problem for both genders, women tend to gain weight around their waistlines at an even greater rate than men as they go through menopause and enter their middle years. Along with other associated health risks, Harvard Medical School reports that breast cancer and the need for gallbladder surgery can also be consequences of a woman’s belly fat. The solution? As always, a healthy diet, more exercise, better sleep and reduced stress.

No one relishes the idea of dieting, but small changes can yield big results. I tell my patients to follow these recommendations:

  • Use an online app to count your daily calorie intake. The Daily Food Plan at choosemyplate.gov uses your weight, height and activity level to determine how many calories you should consume per day to lose weight and start eliminating belly fat.
  • Exercise regularly to increase and maintain muscle mass. The more muscle you have, the more calories you burn throughout the day even when you’re not doing anything at all.
  • Cut down on foods containing sugar and sodium. One prime example is to stop drinking soda, including low-calorie versions. Both diet and regular sodas have been linked to an increased risk of diabetes.

Reap the benefits

As you move toward a healthier lifestyle and see the scale move downward, you’re bound to feel fantastic. You’ll sleep better and have more energy. But be warned feeling that good has a price. As that belly shrinks, you’ll definitely want a new wardrobe to go along with it.

Steven Feinleib, M.D., works with the Department of Preventive Medicine at the Cleveland Clinic, specializing in preventive medicine, health screening, wellness coaching, cancer and heart disease risk assessment, and men’s health. A Diplomat of the American Board of Internal Medicine, he completed his undergraduate training at Cornell University and his medical degree at the University of Maryland School of Medicine.