Visceral Fat Doctor: The 4 Types of Belly Fat & How to Lose it for Good - Dr. Sean O’Mara

Intro (0s)

• Visceral fat can cause damage to the body through the influence of collective harm from micro bullets over a period of time, which can lead to a degradation in appearance and performance that is not immediately detectable (15s).
• A laparotomy, or a big incision, can be used to illustrate the impact of visceral fat, where a person may look great initially but experience a decline in appearance and performance over time as the micro bullets start firing (41s).
• The average human being's state of health is affected by the slow degradation caused by visceral fat, making it essential to understand the different types of fat in the body (51s).
• There are subcategories of fat that may be more dangerous than just visceral fat, and understanding these can help people identify and address the issue (1m7s).
• There are good fats and bad fats in the body, but most people tend to lump all fat together and view it as bad, without understanding the exploitable value of knowing the difference (1m27s).
• Understanding the different types of fat can provide a wealth of knowledge, which can be used to improve appearance, performance, and overall health (1m42s).
• Health is defined as how well a person looks and how well they perform, and understanding good fat and bad fat can help people optimize their health and quality of life (2m5s).
• Dr. Sean O'Mara emphasizes the importance of understanding the different types of fat to improve health and quality of life (54s).

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Understanding Visceral Fat (3m12s)

• Visceral fat is a type of fat that people generally know is bad for them, but they often lack detailed knowledge about it, and having a better understanding of it is crucial for overall health (3m13s).
• Visceral fat is one of the four bad inflammatory areas of fat inside the body, and it is essential to educate oneself about these areas to address them effectively (3m47s).
• There are two beneficial types of fat: brown adipose tissue, also known as brown fat, which is associated with thermogenesis and can be increased through cold plunging, and superficial subcutaneous fat (4m2s).
• Brown fat requires a specialized protocol to visualize and is not typically shown in scans, but it can be developed through practices like cold plunging (4m17s).
• The four bad areas of fat are referred to as "The Four Horsemen" because they are destructive to the body over time, and understanding them is crucial for addressing visceral fat (4m39s).

Visceral Fat MRI (4m55s)

• A medical device called an MRI is used to take images of the abdomen, specifically in the axial plane, which creates a slice-like image of the abdomen, similar to a pizza pie (4m57s).
• When looking at an MRI image, anything that appears white is typically fat or fluids, while dark areas are usually muscles, organs, or bones (5m47s).
• The rectus abdominis muscles, also known as the six-pack, and the iliacus muscles, which are part of the core, appear as dark areas on an MRI image (6m13s).
• Organs such as the colon, small intestine, stomach, liver, and even bones like the vertebral body, also appear as dark areas on an MRI image (6m32s).
• Visceral fat appears as white on an MRI image and is associated with chronic diseases, as discovered by Dr. CJ Zang, a researcher at the University of Washington (6m58s).
• Dr. CJ Zang found that people with the most chronic diseases had a significant amount of white stuff, later identified as visceral fat, inside them when using an MRI (7m17s).
• Visceral fat is not typically taught in medical school, despite its inflammatory properties and association with various chronic conditions (7m49s).
• Research has shown a strong connection between visceral fat and various chronic conditions, although proving causality is problematic due to the need for a study model that would require causing people to develop the disease process (9m22s).
• The connection between visceral fat and chronic conditions is stronger than the connection between cholesterol and these conditions (9m45s).
• The first type of bad fat is visceral fat, and the second type is myositis, which is always associated with visceral fat in proportionality (9m48s).

Myosteatosis (10m0s)

• Myosteatosis is a condition where fat streaks are deposited in the muscles, as seen in Dr. Zen's scan from 15 years ago, which shows a significant amount of white fat despite having a 31-inch waist (10m6s).
• A higher-resolution scan of a current patient shows a huge amount of white fat, or visceral fat, in the middle, which is proportional to the amount of fat inside the muscle (10m27s).
• The proportionality of visceral fat to fat inside the muscle is generally consistent, but there is an exception in people who use performance-enhancing gear, such as testosterone or hormone replacement, which can affect the ratio of visceral fat to muscle fat (10m54s).
• When individuals try to put on more muscle mass, they often have a higher amount of visceral fat and less myosteatosis, or fatty muscle replacement, which may be related to testosterone levels (11m14s).
• Myosteatosis is also known as human marbling or fatty muscle replacement, similar to the marbling seen in Wagyu beef (11m35s).
• People who use performance-enhancing gear tend to accumulate more visceral fat and have less myosteatosis, resulting in leaner muscles (11m30s).

Subcutaneous Fat (11m48s)

• Subcutaneous fat is located around the love handles, and it can be felt around the top of the iliac crest, with a membrane separating it into two compartments (11m50s).
• The two compartments of subcutaneous fat are biologically different, with visceral fat, muscle fat, and deep subcutaneous fat being inflammatory due to the secretion of inflammatory molecules such as tumor necrosis factor-alpha and interleukin six (12m16s).
• These inflammatory molecules induce inflammation and disease throughout the body, with traditional subcutaneous belly fat still being problematic, although not as bad as internal visceral fat (13m22s).
• Abdominal subcutaneous fat may have different properties than subcutaneous fat in other areas of the body, such as the triceps, and it is a topic that requires further research (13m43s).
• Deep subcutaneous fat and superficial subcutaneous fat exist in the thoracic abdominal region, and it is possible that the same principles apply to other parts of the body, such as the legs (14m14s).
• Studies have shown that an increase in subcutaneous fat in males on their legs is associated with an increased risk of carcinoma within the prostate and mortality (14m52s).
• Women tend to accumulate fat in their thighs, lower extremities, and buttocks, whereas men tend to accumulate fat in their abdominal region (15m10s).
• Deep subcutaneous fat in males is more problematic, and increasing superficial subcutaneous fat is beneficial, making it a "good fat" (15m43s).
• Superficial subcutaneous fat is beneficial and does not secrete inflammatory molecules, making it a desirable type of fat to have (15m58s).
• There are four types of belly fat, and one of them, superficial subcutaneous fat, is actually beneficial and protective against disease, as it secretes a molecule called adiponectin, which reduces mortality and incidence of diseases like heart attacks, strokes, and diabetes (16m31s).
• The other three types of belly fat - visceral fat, muscle fat, and deep subcutaneous fat - are harmful and secrete inflammatory molecules that can cause damage to the body over time (16m12s).
• Visceral fat, in particular, is hyperresponsive to stress and has a high concentration of cortisol receptors, making it a significant contributor to disease formation (19m56s).
• Stress is a major contributor to visceral fat formation, but deliberate good stress through intense exercise may have a positive impact on visceral fat due to the presence of glucocorticoid receptors (20m26s).
• The harm caused by the three types of bad belly fat is not immediate but rather accumulates over time, causing damage to the body and leading to disease, a process referred to as "diseasing" rather than aging (19m23s).
• The proportion of beneficial superficial subcutaneous fat to the three types of bad belly fat is important, and having more of the former and less of the latter is desirable for overall health (17m51s).
• The micro-bullets or inflammatory molecules secreted by the bad belly fat are undetectable and can cause damage to the body without noticeable symptoms, leading to a decline in appearance and performance over time (18m26s).
• Stress in the presence of insulin can compound and add fat, making it a significant factor in the formation of visceral fat (20m45s).
• A 58-year-old CEO with a large amount of visceral fat was given a protocol developed from research funded by the National Science Foundation, which aimed to study the causes and effects of visceral fat (21m27s).
• The research, conducted in collaboration with Dr. Zenc, focused on understanding what causes visceral fat to form and how to eliminate it (21m50s).
• Stress is a known cause of visceral adiposity, the formation of visceral fat within the abdominal cavity (22m7s).
• A follow-up scan of the CEO showed no improvement in visceral fat reduction, prompting further investigation into the reasons behind the lack of progress (22m42s).
• Factors that can hinder the effectiveness of strategies to eliminate visceral fat include cheating and eating processed foods (23m3s).

Contributors to Fat Gain (23m9s)

• Processed foods, especially processed carbohydrates, are a significant contributor to visceral fat gain, as they cause an increase in visceral fat when consumed (23m13s).
• Poor sleep quality can hinder overall health and lead to increased visceral fat, despite the implementation of healthy strategies (23m24s).
• Stress can contribute to visceral fat gain, particularly in individuals experiencing high levels of stress in their personal or professional lives (23m31s).
• Consuming alcohol can make visceral fat more difficult to eliminate, as it increases its refractoriness (23m49s).
• Distance running and durational exercise, when done excessively, can make it challenging to lose visceral fat, whereas stress heresis has been found to be a more effective approach (24m3s).

Reducing Fat Accumulation (24m19s)

• Sprinting, or maximum intensity exercise in a very short period of time, can eliminate visceral fat, as seen in a study where a participant reduced their visceral fat in just two months by switching from distance running to sprinting (25m4s).
• Reducing visceral fat also reduces deep subcutaneous fat, as the same participant showed a significant reduction in both types of fat after switching to sprinting (25m26s).
• Fasting and being in a fasted state can also help eliminate visceral fat, as the elevated levels of adrenaline and epinephrine in this state make it more efficient for the body to pull from visceral fat (26m4s).
• Combining fasting with short, intense exercise can be an even more efficient system for the body to pull from visceral fat, as the stress state of fasting and exercise can help drain visceral fat into the portal vein (26m34s).
• A person's skin turgor, or the speed at which their skin snaps back after being pinched, can be a measurement of their overall health, and can be improved by combining multiple biohacks or supplements together (27m8s).
• Stacking certain supplements or biohacks together can create a synergistic effect, where the results are greater than the sum of the individual parts, as seen in the example of improving skin turgor by combining four different methods (27m58s).
• A combination of four factors - sunshine, fasted state, maximum intensity exercise, and sauna - can increase nitric oxide production, which improves blood flow, as observed in a personal experience where a visible pulse was noticed after a Thomas Delow workout in his gym (29m9s).
• Nitric oxide, the subject of a 1999 Nobel Prize in medicine, enhances blood flow, making it visible and apparent, and is produced exponentially by the combination of the four factors (28m51s).
• Improved blood flow, enhanced by nitric oxide, allows for better perfusion of tissues on a cellular and organ level, collectively benefiting the body (30m2s).
• Blood flow is crucial for health, and nitric oxide production by endothelial cells is improved when inflammatory fat depots, such as visceral fat, myosis, and deep subcutaneous fat, are reduced (30m28s).
• Paying attention to the body, including skin turgor and how fast it snaps back, can help individuals analyze and improve their health, as nature favors organisms that adapt and respond well (30m46s).
• Humans have become distracted and often rely on poor health advice from physicians who may not prioritize their own health and well-being, highlighting the importance of finding a knowledgeable health coach or physician (31m35s).
• A physician's appearance and quality of life can be an indicator of their expertise in health advice, and individuals should consider seeking guidance from those who prioritize their own health and well-being (31m46s).
• In emergency situations, however, a board-certified emergency medicine physician is the best option, as they have the necessary training and expertise to provide immediate care (32m20s).
• Nasal breathing can improve nitric oxide levels in the body and induce a parasympathetic state, which is associated with lower stress levels (33m1s).
• Increasing nitric oxide in the body and achieving a parasympathetic state can help reduce stress, which is a main reason for the accumulation of visceral fat (33m17s).
• Inducing a parasympathetic state throughout daily life with deliberate sympathetic states, rather than living in a constant sympathetic stress state, is beneficial for overall health (33m39s).
• As people get older, vigorous intensity exercise becomes harder due to mental barriers, leading many to gravitate towards longer, slower distance exercises (34m12s).
• Older individuals often prefer lower-intensity, longer-duration exercises, such as zone two exercises, as they are easier to mentally prepare for and have a lower barrier to entry (34m53s).
• The ability to exercise intensively in a maximal state is more connected to quality of life than the ability to do something for a long period of time (35m41s).
• Quality of life is more connected to the capacity for exercising intensively in a maximal state rather than the ability to sustain a long period of exercise (35m43s).
• The capacity for vigorous exercise declines with age, making it essential to find alternative exercise methods that can be adapted to individual needs and abilities (34m38s).
• Long-distance running, such as marathons, can result in atrophied bodies, whereas maximum intensity exercises like sprinting, pull-ups, or push-ups to failure can be more beneficial for quality of life, especially as one ages (35m56s).
• The type of exercise that is important depends on one's goals, such as distance running for long-distance events or maximum intensity exercises for overall quality of life (36m19s).
• Maximum intensity exercises can help improve respiratory drive, which is essential for fighting for one's life and overall quality of life, especially in older age (37m52s).
• Jogging or slow twitch muscle exercises may not engage the maximum capacity of inhalation and expiration, which can limit energy and performance in critical situations (38m15s).
• Having the capability to engage in maximum intensity exercises can improve quality of life, especially in older age, as it allows for better survival and fighting abilities (38m34s).
• For Homo sapiens, the ability to survive and fight was crucial for staying in the gene pool, and this can be emulated through intensive workouts that mimic the intensity of fighting or running from predators (38m48s).
• Incorporating maximum intensity exercises, such as sprinting, into one's workout routine can have a significant impact on overall quality of life and can be beneficial for people of all ages (39m40s).
• People have limited time for exercise, and it's often a choice between distance work or intense, vigorous activity, but there's a growing trend of hybrid athletes who combine both (40m45s).
• In the past, athletes tended to specialize in one type of exercise, such as running, and wouldn't engage in strength work or intense, glycolytic activities (41m8s).
• However, some people are now able to combine different types of exercise, and it's becoming more popular (40m50s).
• The absence of intense, vigorous exercise is likely what's missing from many people's routines, rather than the presence of distance work (41m27s).
• Exercise intensity should be the catalyst for chemical changes and other benefits, while zone two work should come from everyday life and activities (41m34s).
• Cultures that live the longest and look the best often have a deliberate approach to exercise, with short bouts of activity and a high level of everyday physical activity (41m57s).
• Ancestors likely engaged in a mix of intense, short bursts of exercise and longer periods of zone two work, such as when chasing or being chased, or moving from one location to another (43m7s).
• Research into biological optimization and human performance should look to the past and how our ancestors lived and exercised (43m43s).

Heart Fat (49m55s)

• A patient, a highly accomplished trial attorney who worked with one of the U.S. presidents, had a significant amount of visceral fat around his heart, which is a combination of epicardial, pericardial, and medial fat, highly inflammatory and mechanically restrictive to the heart (49m56s).
• The patient was able to eliminate a substantial amount of this fat in about 3.5 months by learning and implementing certain strategies, demonstrating the importance of personality and motivation in improving one's health (50m51s).
• The patient's progress was measured by tracking the distance in the sagittal plane, which is a correlation with visceral fat, and his results showed a significant reduction in visceral fat and reversal of diverticular disease (51m45s).
• The patient's abdominal plane measurements changed from a larger red line to a smaller yellow line over three months, indicating a reduction in visceral fat and improvement in overall health (52m14s).
• Personality plays a significant role in someone's ability to improve their appearance and quality of life, and highly motivated individuals are more likely to make positive changes when given the right information and strategies (52m39s).
• Highly driven and motivated individuals, such as Special Forces operators and executives, are often wired to succeed and will make positive changes when given the right playbook and information (53m14s).
• These individuals often face a time constraint in finding the answers to improve their health, but once they have the information, they are willing to put in the work to make positive changes (53m27s).
• Personality type plays a significant role in achieving success, as individuals with a strong drive and willingness to apply themselves tend to be more successful in various aspects of life, including health and fitness (53m50s).
• Having a deliberate attitude and being able to endure for short periods of time, such as 15-60 seconds, can reflect positively on one's overall lifestyle choices, including food selection and self-control (53m57s).
• Research involving 6,000 Americans, including 100 standard soldiers, showed that average individuals who are not rewarded based on performance tend to have poor results and gravitate towards jobs with less motivation (54m26s).
• Top performers, such as those in the special operator community, tend to be highly motivated and achieve better results due to factors such as performance-based compensation and a potentially beneficial microbiome (55m6s).
• A study found an association between exercise and the presence of certain species of microbes in the human body, suggesting that the microbiome may play a role in motivation and overall health (55m54s).
• Spending time with individuals who have a high quality of life can potentially benefit one's own health through the acquisition of beneficial microbes (56m36s).

Where to Find More of Dr. O'Mara (57m19s)

• Dr. Sean O'Mara can be found on various social media platforms, including Instagram, YouTube, TikTok, and LinkedIn, under the handle @drseanomara (57m19s)
• He also has two websites: drseanomara.com and growingbolder.com (57m35s)
• Dr. O'Mara and his fellow physicians work with clients in his practice to help them become the best biological version of themselves (57m57s)