Obesity is one of the biggest health concerns of our nation. According to the Centers for Disease Control, more than 70 percent of Americans are overweight and 39.6 percent are obese, defined as having a body mass index (BMI) greater than 30.

Obesity is one of the biggest health concerns of our nation. According to the Centers for Disease Control, more than 70 percent of Americans are overweight and 39.6 percent are obese, defined as having a body mass index (BMI) greater than 30. Holding on to extra fat may have more consequences than you know. Consider the following facts about fat.

It’s a myth that fat is fat and it doesn’t matter where you hold it. Belly fat comes with a higher risk of illness than fat stored in the hips and thighs. Belly fat is more inflammatory and releases harmful chemicals that have been linked to an increased risk of several diseases. Some of these chemicals can make you tired and hungry, making it even harder to lose the belly.

Being overweight reduces a woman’s chance of getting pregnant. According to the National Institute of Health, obesity is the No. 1 reason why the fastest growing group of women experiencing infertility is those under 25. The more fat you have, the less hungry you should feel. Fat cells produce the hormone leptin, which depresses hunger. Unfortunately, most overweight people have become insensitive to it.

Your total number of fat cells remains constant once you reach adulthood. About 10 percent of your fat cells die each year, but they are promptly replaced. Diet and exercise can shrink these cells, but the only way to reduce the number of fat cells is by liposuction.

Obesity is inheritable, but genes are not the main problem. Genes and ethnicity do play a role in how our bodies break down calories and store fat, but more important are shared and learned behaviors. If we teach our children to want large portions, to crave unhealthy food, to dislike healthy food and to be inactive, we are setting them up for a struggle with obesity.

There are different kinds of fat in our bodies. White fat is the inch you can pinch. This is the main form of fat stored in our cells for energy reserve. White fat produces leptin and a form of estrogen that can regulate hunger. Brown fat burns, rather than stores, energy. When stimulated, it provides energy to generate heat and keep the body temperature at ideal levels. Babies have especially high levels of brown fat. Adults have very little — only two to three ounces in a typical person.

Fat also acts differently depending on where it is stored. Subcutaneous fat is right underneath the skin. Visceral fat is stored in the abdominal cavity around the organs. It secretes chemicals that increase resistance to insulin, leading to glucose intolerance and diabetes. Visceral fat has also been linked to breast cancer, colorectal cancer, stroke, Alzheimer’s and dementia.

Extra fat means extra cancer risk. Fat cells make estrogen, and some cancers, including breast and uterine cancers, are fueled by high levels of this hormone. Excess weight often leads to higher blood insulin levels, which make cells multiply more rapidly.

Fat also can cause chronic low-level inflammation, which boosts the risk of cancers of the esophagus, kidneys, pancreas and colon/rectum. Fat affects your mood. It’s not just the negative emotions you feel when you see you’ve gone up a few numbers on the scale. Having extra belly fat may be a factor in serious mood disorders. Fat activates chemicals that can interfere with normal hormone functions and healthy neurotransmitter functions in the brain.

To reduce your body fat, and especially your visceral fat, focus on the following four steps.

1. Reduce your sugar and refined carbohydrate intake. Sugar and processed carbs are rapidly converted into simple sugars in the bloodstream, which triggers a large release of insulin. The more often and longer blood insulin levels remain elevated, the more likely the body is to store fat and accumulate visceral fat.

2. Exercise regularly. Among the many benefits of exercise, it helps balance your blood insulin levels, it burns extra calories that could become stored fat, it improves mood, it reduces stress, and it helps you sleep better.

3. Reduce stress. Stress triggers cortisol production, which interferes with appetite, sleep, metabolism and cravings.

4. Prioritize sleep. It’s well documented that seven to eight hours of quality sleep is beneficial for weight control and hormone regulation. Sleep resets our appetite and helps reduce stress.

Anita Marlay, R.D., L.D., is a dietitian in the Cardiopulmonary Rehab department at Lake Regional Health System in Osage Beach, Mo.