Having a large belly is associated with a greater risk of heart disease and death, but to understand the beer belly (which you can’t actually blame on beer), you have to look inside it.
Some fat lives just under the skin
Subcutaneous (literally meaning “under the skin”) fat is everywhere in your body. Your earlobes are made of fat. This is the fat that you can touch and squish. It may be annoying, but it’s not the harmful belly fat you’ve been warned about.
Your body puts subcutaneous fat in whatever place your genetics and hormones tell it to. Women tend to put it more on their butts and thighs, men more on their bellies, but plenty of people have a mix of the two, or a pattern that doesn’t fit either extreme. All of these are possible with a normal, healthy body, although you may notice your subcutaneous belly fat more if you also have visceral fat.
Fat surrounding your organs is the type to worry about
If you’ve heard that “belly fat” is bad, stop thinking about love handles and start thinking about what’s inside your abdomen. The fat that’s most strongly associated with health risks is the visceral fat that surrounds your organs.
This fat is inside, behind a wall of muscle. If you poke your belly, you’ll feel the soft squishy subcutaneous fat, and then you’ll feel that wall of muscle. The visceral fat is past that.
It’s this fat that increases your risk (or perhaps signals that you’re already at risk) for heart disease, insulin resistance, and inflammatory chronic conditions.
This is why waist size is a useful indicator of your health risks. It’s not perfect, but tells this story better than BMI or total weight.
There are other ways to get a swollen belly
A beer belly can come from other causes, and I don’t just mean pregnancy. Some health conditions cause your liver or other organs to enlarge. One in particular is linked to alcohol use.
A lifetime of heavy drinking can lead to liver damage called cirrhosis. In extreme cases, this can result in ascites, a buildup of fluid inside the abdomen. If you have ascites, your doctor may be able to drain the fluid, but it’s a serious condition that often indicates you need a liver transplant.
Other than that, beer doesn’t have any particular connection with a beer belly. If you consume a lot of alcohol, you may be consuming a lot of calories, which can give you more fat of both types; you may also have other risk factors for cardiovascular disease. But you can’t blame your beer belly on beer.