Hello,

I have to agree that weight issues can be very frustrating. You are also correct in concerns regarding visceral fat distribution as its association with cardiovascular risk. You mention asian background in your history. There are data that suggest that metabolic syndrome which includes features such as abnormal choelsterol, heart disease, and diabetes occurs at lower body mass index levels compared to caucasians. There is also data that maternal effects during pregnancy such as gestational diabetes impacts body fat distribution. All of these items may impact your current situation.

Some thoughts specific to your case include
- Avoidance of fructose-sweetened beverages or products
- Avoidance of tran-fats
- Regular aerobic activity

If not done, I suggest screening by your health care provider for metabolic risk factors and development of a treatment regimen to address any abnormalities detected.

I hope this helps you.

Joel Steelman, MD
Pediatric Endocrine
Cook Children's Medical Center