When it comes to body types, it’s not just how much weight you carry — it’s where you store it.
Research shows that people with apple-shaped bodies — those with a wider midsection and less defined waist — face a higher risk of serious health problems compared to their pear-shaped counterparts, who tend to carry excess weight in the hips, buttocks and thighs.
This body type isn’t just a cosmetic concern: Extra weight around the stomach often signals a dangerous buildup of visceral fat, which wraps around your internal organs — unlike the fat stored just under the skin.
That means even if you aren’t technically overweight, carrying extra fat around your midsection increases your risk for heart disease, high blood pressure, diabetes, sleep apnea and even certain cancers.
In fact, a 2020 review of 72 studies found that people with an apple shape had a significantly higher risk of death from all causes than those with pear-shaped bodies.
Cancer
Obesity has long been considered a risk factor for several types of cancer, but a growing body of evidence suggests that excess abdominal fat may be an even stronger predictor.
In one study, researchers found that people who were “generally obese” — defined as having a body mass index (BMI) over 30 — faced a 10% higher risk of developing colon cancer compared to those of a healthy weight.
The real surprise came when researchers looked at people who weren’t technically obese but carried extra weight around their midsection. Those with an apple-shaped body were 12% more likely to develop colon cancer than people with smaller waists.
Women with this body type were at an even greater risk, facing an 18% higher chance compared to men of the same shape.
Other research has linked excess abdominal fat to an increased risk of cancers of the womb, gallbladder, kidney, liver and breast.
Heart disease
An apple-shaped body could also be a major red flag for your heart.
A 2021 review of 31 studies found that extra weight around the midsection is directly tied to a higher risk of heart disease. For every 3.9-inch increase in waist circumference, the risk of heart disease went up by 3% for women and 4% for men.
While men are more likely to accumulate fat around the abdomen, women’s bodies often become more apple-shaped as they age. A 2019 study found that postmenopausal women with an apple-shaped body were at a higher risk of heart and blood vessel problems—even if they have a normal, healthy BMI.
On the flip side, women with a pear-shaped body — where fat is stored around the hips and legs — were 40% less likely to develop cardiovascular disease compared to their apple-shaped peers.
“In addition to overall body weight control, people may also need to pay attention to their regional body fat, even those who have a healthy body weight and normal BMI,” said study’s senior author, Qibin Qi, an associate professor at the Albert Einstein College of Medicine.
Qi’s findings echo research from 2018, which revealed that waist-to-hip ratio is a far more accurate predictor of heart attacks than BMI. This was especially true for women, for whom an apple-shaped body was three times more likely to predict heart attack risk compared to men with the same body type.
‘We need further research to try to disentangle the different ways women and men store body fat and understand how, and why, this is linked to different health risks,’ said Dr Sanne Peters, Research Fellow in Epidemiology at The George Institute, Oxford, who led the study.
Diabetes
While obesity is linked to a variety of health conditions, extra belly fat is particularly dangerous — especially when inflamed.
A 2018 study from Columbia University Irving Medical Center found that an enzyme produced by the liver, called DPP4, causes inflammation in abdominal fat, raising the risk of insulin resistance and type 2 diabetes.
“If we can develop ways to target liver DPP4 in people, this may be a powerful new way to treat obesity-induced type 2 diabetes,” said study leader Ira Tabas, the Richard J. Stock professor of medicine at Columbia University Vagelos College of Physicians and Surgeons.
How to find out your body shape
Your body shape is determined by a combination of genetics, bone structure, hormones, and lifestyle. Generally, people fall into one of five standard body shapes:
- Apple: Rounder in the middle
- Pear: Fuller bottom half
- Inverted triangle: Wider in the shoulders and chest with a narrow waist and bottom
- Ruler: More-or-less straight up and down
- Hourglass: Proportional chest and hips with a smaller midline
To find out your body shape, try calculating your waist-to-hip ratio. To do so, measure your waist and hip circumference and then divide your waist measurement by your hip measurement
The World Health Organization defines abdominal obesity in men as a waist-to-hip ratio of at least 0.90. For women, it’s 0.85 or more. A ratio higher than 1.0 for either sex significantly increases the chance of health problems.
