What the SHAPE of your tummy reveals about your health – from ‘apron belly’ to bowling ball and the paunch

BEER bellies, spare tyres and washboard abs - stomachs come in all shapes and sizes.

While it may be easy to assume the smaller and less wobbly the better, that's not always the case, according to Dr Simon Theobalds.

The GP, from Manchester, says that the appearance of our middles can reveal a significant amount about our health, but it's vital to consider someone's overall wellbeing - including their diet, exercise routine and genetics.

Just because someone looks lean, it doesn't mean there isn't something more sinister going on inside, and they're not at risk of complications down the line, he adds.

"Stomach shape may reveal health clues, but it's not the full story," the doctor tells Sun Health.

That said, there is a fair amount you can tell about someone just by looking at their abdomen.

"Various illnesses can influence stomach appearance," Dr Theobalds says.

"Fat accumulation could indicate potential health risks like heart disease, while a bloated stomach might signal digestive issues."

To understand the key indicators, it's important to distinguish between the different types of fat.

There are two main ones: subcutaneous and visceral.

"Subcutaneous fat lies just beneath the skin and is relatively harmless, while visceral fat surrounds internal organs, contributing to health risks," the GP says.

"Visceral fat is associated with higher chances of heart disease, diabetes, and metabolic issues, while subcutaneous fat is often considered less harmful.

"Excess fat in both areas can lead to an increased waistline."

From love handles to pesky paunches, here's what the shape of your stomach - and the fat that's there or not - could be trying to tell you.

A flat stomach - many people's dream - and generally, a sign you're in decent shape.

It means you have a very low body fat percentage, and you're likely active - especially if you have a six-pack.

This puts you at lower risk of obesity-related health problems, such as high blood pressure, type 2 diabetes and stroke.

However, "while a flat stomach can be a sign of good health and an aesthetic goal, it doesn't guarantee it," Dr Theobalds says.

"Factors like diet, exercise, and genetics play a role, and organ function, hormonal balance and cardiovascular health are also crucial."

Dr Chun Tang, a GP and medical director at Pall Mall, adds: "A person with a flat stomach could still have poor dietary habits, lack physical activity, or face other health issues which are not externally visible."

So it's saying, you're probably pretty healthy - but it's still important to eat well and get moving.

If you're someone who likes to sink a few pints, you may well have what's known as a 'beer belly'.

"Excessive alcohol consumption leads to a beer gut," Dr Theobalds says.

It's mostly down to the number of calories in booze.

With around seven calories per gram, alcohol contains almost as many calories as pure fat, according to Drinkaware.

A pint of lager is about the same as a slice of pizza (180kcal), and a large glass of wine is similar to an ice cream sundae (230kcal).

While you may laugh it off down the pub, a beer belly - characterised by a protruding roundness where the waist is larger than the hips - can mean serious trouble.

"Stomach fat, particularly visceral fat, is dangerous as it's linked to increased risks of heart disease, diabetes, and metabolic issues," Dr Theobalds says.

One study, published in the journal Nature Medicine, found drinking can increase your risk of over 60 diseases, including more obvious ones like liver cirrhosis and gastrointestinal cancers, as well as gout, cataracts, fractures and stomach ulcers.

If you have a beer belly, it is important to think about cutting down on your intake, experts say.

You should also try to increase your cardio workouts with activities like cycling or swimming, as well as weight training.

Got excess skin on both hips that hangs over the top of your jeans? This is what some people call 'love handles'.

Though not always the case, these are generally caused by taking in too many calories, or not burning as many as you're consuming.

This excess energy gets stored as fat around the waist and hips.

"Love handles are a type of subcutaneous fat and can indicate an imbalance in diet and exercise," Dr Theobalds says.

"But they can also be an indicator of an accumulation of visceral or 'toxic' fat stored deep inside the body," Dr Tang adds.

Other potential contributing factors include hormones (especially too much cortisol), age, sleep deprivation and undiagnosed or untreated conditions, such as an underactive thyroid, according to Healthline.

While not necessarily dangerous themselves, the presence of love handles can indicate you have an underlying risk of high blood pressure, high cholesterol, heart disease, sleep apnoea and other breathing issues, stroke, type 2 diabetes, liver disease, osteoarthritis, and cancer.

Lowering your calorie intake and hitting the gym should help reduce the appearance of love handles, and the associated potential risks.

If you can't see your feet when you look down, your stomach may be put into the 'spare tyre' group, for people with additional fat right the way round their middles.

This kind of excess stomach fat, which is visceral, increases your risk of health problems such as cardiovascular diseases, type 2 diabetes, and metabolic syndrome - conditions that affect your heart or blood vessels, Dr Theobalds warns.

A six-year study found adults who carry a 'spare tyre' are at greater risk of heart disease than those who have 'love handles'.

Scientists say visible flab just under the skin may be protective, while 'hidden' fat around the belly is dangerous.

Usually caused by weight gain, weight loss, pregnancy, hormonal changes or unhealthy lifestyles, an 'apron belly' can also spell trouble.

Not only can this flap of excess fat and skin that hangs down at the bottom of your stomach make you feel uncomfortable, it is also linked to fungal infections, back pain, heart disease and dementia, according to research.

Personal trainer Jenny Francis-Townson says: "When your skin layers over itself, it is extremely likely to cause hygiene issues as the area can get very warm and moist - the perfect environment for fungal infections to occur.

"These can get pretty nasty if left untreated. But you can avoid problems by keeping the area clean and dry, and wearing loose-fitting clothing."

Carrying extra weight around the lower belly can also shift your centre of gravity and put pressure on your lower back, Jenny adds.

"This not only results in back pain, but can also weaken your pelvic floor, causing weakness and incontinence."

There is also an increased risk of heart disease, cancer and dementia, studies show.

But Jenny says you can combat an 'apron belly' with at-home workouts, incorporating deep core moves, and eating in a calorie deficit.

Bloating describes the feeling of your tummy being uncomfortably full, but it can trigger visible changes too.

Some people who get bloated report their stomach growing outwards and hardening.

This is very common, and not usually anything serious, but it is worth addressing, according to the NHS.

The most likely culprit is excess gas in your gut.

"This can be caused by some food and drinks, such as some vegetables and fizzy beverages, or by swallowing air when you eat," the health service says.

It can also be because of water retention or "digestive issues", including constipation, a food intolerance, irritable bowel syndrome (IBS) or coeliac disease, Dr Theobalds says.

Hormonal changes can affect the shape of your stomach and make you bloated, particularly around the time of your period, he adds.

"These things can all make the stomach feel temporarily distended - but it's not a result of fat accumulation," Dr Tang explains.

"Fat, on the other hand, tends to be more persistent and is influenced by factors like diet, exercise and genetics."

Bloating that does not go away can also be a sign of ovarian cancer.

Four ways to reduce bloating include eating more fibre, having protein throughout the day, resistance training, and drinking herbal tea, according to nutritionists. But if you're concerned, speak to your GP.

Similar to bloating, some people may sense their stomach looks and feels tense in the middle.

"This can be caused by stress", the GP says.

Sufferers may also experience diarrhoea, constipation, bloating, cramping, hiccups, nausea, burping, and stomach aches.

"Stress can affect the digestive system in various ways due to alterations in gut function, but symptoms vary," Dr Tang adds.

If any of this is you, your stomach might be trying to tell you to de-stress - so give relaxation techniques such as meditation a go.

Distension, or a distended abdomen, is when the stomach is abnormally swollen outward - a bit like a bowling ball.

It's a kind of ballooning effect, often caused by over-reating, Dr Theobalds says.

Other potential causes include pregnancy, menstruation, an obstruction in the small or large bowel, and internal bleeding, according to Cleveland Clinic.

Speak to your GP about your own experience, as every body is different and will therefore require different treatments.

A pesky paunch can arise at any point in life, but experts say it's particularly common during the menopause.

Although the hormonal changes that come on around one year after a woman has her last menstrual period vary, studies in Climacteric and the International Journal of Obesity have shown many store fat on their stomach rather than their hips and thighs.

Dr Tang says: "Menopause can bring changes that affect body composition.

"Many women experience an increase in abdominal fat during menopause, often referred to as visceral fat.

"This shift is linked to hormonal changes, particularly a decline in oestrogen levels.

"Visceral fat is associated with an increased risk of cardiovascular disease and metabolic issues.

"Additionally, changes in metabolism and muscle mass can contribute to changes in overall body shape and size during the menopause."

He says regular exercise and a healthy diet are "crucial" during this period, to help manage weight and "promote overall wellbeing".