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Not many people can distinguish between feeling bloated and feeling fat. However, it is also common to feel bloated while gaining weight. Although people sometimes use these words interchangeably, it may be necessary to distinguish one from the other, because these may be symptoms of a condition that needs further evaluation and treatment.

Gaining a few inches around the waist is often a sign of weight gain. People may gain weight and distribute bodily fat in different places, but it is usually in the waist where most complaints are focused.

An enlarged waist is often due to abdominal fat.

And yet, we must also distinguish if the fat is mostly in the subcutaneous tissues (beneath the skin) or deep in the abdominal cavity, surrounding the abdominal organs (visceral fat). Having visceral fat, which is common in obese individuals, is linked to an increased risk of metabolic disturbances, which can lead to diabetes and heart disease. In women, it may also increase their likelihood of developing gallbladder disease or breast cancer.

On the other hand, one may feel bloated when there is a feeling of fullness in the abdomen. Bloating is a subjective feeling may be due to an increase in gas or fluid inside the abdomen. It may or may not be accompanied by an actual enlargement of the abdomen, but just a feeling of tightness. Bloating is usually associated with intestinal gas, belching, and flatulence. If the abdomen does increase in size, it is said to be distended. Abdominal distension may sometimes occur intermittently(on and off), especially when it is due to a poor diet, malabsorption or maldigestion, or bacterial overgrowth, which causes an increase in gas production in the intestines.

However, continuous abdominal distension may be associated with a growing tumor, organ enlargement, intestinal obstruction, or accumulation of fluids inside the abdomen.

When to Call a Doctor

In most cases, improvement in diet and eating habits, and an increase in physical activity can help reduce belly fat. These can also help reduce symptoms of bloating, if the cause is related to a functional disorder in digestion. Over-the-counter medications such as simethicone, or probiotics may be helpful in relieving symptoms of indigestion and flatulence.

However, you may need further evaluation and treatment if your abdominal enlargement does not improve, or if it is accompanied by other signs and symptoms such as abdominal pain, vomiting, diarrhea, constipation, and other unusual symptoms.

Tests that may be used to evaluate bloating and abdominal enlargement include:

  • Simple X-ray exam of the abdomen, which can show the presence of air or fluids in the stomach and intestines
  • Barium study of the small intestines, which can show if there is an obstruction
  • Gastric emptying studies, which can determine if there is an obstruction between the stomach and the small intestines
  • Imaging studies such as ultrasound, CT scan or MRI, which can identify the cause of distention such as enlargement of an abdominal organ, increase in abdominal fluid, or intra-abdominal tumor.

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