The World Cup is sadly over and while it was a glorious five weeks of excitement, it's no doubt left many people – mostly men – concerned about their beer bellies.

As a nation, we love a drink, but football turns the dial up on our consumption. During each England game around 8million pints were consumed across the country.

For many, this will have added to the merriment of the occasion, but it will have also put a strain on livers, mental health and, crucially, waistbands. Beer, after all, is filled with calories.

But just how dangerous is a so-called beer belly? And is it any worse than carrying weight elsewhere on the body?

As a GP, there is one simple test I always recommend to my patients that reveals whether a belly, beer-fuelled or not, is a genuine health concern.

Doctors have traditionally used body mass index (BMI) to classify people as underweight, healthy weight, overweight or obese. It is calculated by dividing weight in kilos by height in metres squared.

Anything between 18.5 to 24.9 is healthy, 25 to 29.9 is overweight, while 30 and above is obese. But BMI has a crucial flaw.

It cannot tell muscle from fat, nor where that fat sits. A muscular rugby player with very little body fat can score a high BMI, showing the measurement's limits.

During each England game at the World Cup around 8million pints were consumed across the country

A second calculation, done at home with nothing more than a tape measure, adds another level of detail: the waist-to-height ratio.

The rule of thumb is simple – waist circumference should be less than half of height.

Someone 175cm tall should keep their waist under about 87 to 88cm. To measure it, wrap a tape measure around the belly button after a normal breath out, not sucked in.

This measurement is one of the best predictors of future risk of type 2 diabetes, heart disease and stroke, because it reflects fat stored around the belly, rather than simply how much someone weighs.

This is crucial to understand. Not all body fat behaves the same way.

One form, called subcutaneous fat, sits just beneath the skin – the bit you can pinch at the waist or hips. We often refer to this as the 'spare tyre' or 'love handles'.

It contributes to obesity but is generally the less dangerous of the two main fat types.

The other is visceral fat, which lies much deeper, wrapped around organs such as the liver, pancreas and intestines, and produces the firm, rounded, classic 'beer belly'.

Unlike subcutaneous fat, it is metabolically active, which means it releases hormones, inflammatory chemicals and fatty acids that interfere with the body's normal metabolism.

Over time this can increase blood sugar, raises blood pressure, worsens cholesterol and contributes to fatty liver disease – a major reason abdominal obesity is so strongly linked to heart disease and diabetes, even in people who are not dramatically overweight overall.

This is why body shape matters as much as body weight. An 'apple' shape, fat concentrated around the middle and largely visceral, carries higher health risks than a 'pear' shape, where fat sits around the hips, thighs and buttocks and is mostly subcutaneous.

Two people can weigh exactly the same, wear the same size of clothes, have a BMI in the healthy weight zone and carry very different health risks, depending on where that fat is stored – doctors sometimes call this 'TOFI', thin outside, fat inside.

In other words, a beer belly is often a warning sign that life-threatening health problems could be on the horizon.

But, despite its name, beer isn't the sole culprit.

Visceral fat wraps around organs and produces the firm, rounded, classic 'beer belly' - and raises the risk of deadly diseases

GP, author and broadcaster Dr Philippa Kaye

The main cause is consistently taking in more energy than the body burns. Alcohol does play a role: it is calorie-dense, loosens inhibitions around food, and temporarily halts fat-burning because the liver prioritises metabolising alcohol over burning fat.

But plenty of people who barely drink still develop abdominal fat, driven by genetics, poor diet, inactivity, poor sleep and chronic stress.

Men and women store fat differently, thanks to hormones.

Before menopause, oestrogen encourages women to store fat around the hips and thighs – the pear shape that likely evolved to support pregnancy and breastfeeding.

Men, with lower oestrogen and higher testosterone, are more likely to store fat around the abdomen. After menopause, falling oestrogen often shifts fat from hips to abdomen, even without much change in overall weight – one reason cardiovascular risk rises for women in midlife, and waistlines expand independent of what the scales say.

The good news is that visceral fat tends to respond to lifestyle changes faster than the more stubborn subcutaneous fat.

Regular activity is one of the most effective ways to shift it – a combination of aerobic exercise such as brisk walking, cycling or swimming with resistance training burns calories while preserving muscle.

Diet matters too: more vegetables, fruit, whole grains, lean protein, legumes and healthy fats, less ultra-processed food, sugary drinks and alcohol.

Even losing 5 to 10 per cent of body weight can meaningfully improve blood pressure, cholesterol, insulin sensitivity and liver health, often within a matter of months.

Sleep and stress count too – both push up the hormone cortisol, which encourages the body to store fat around the middle.

The scales tell you how heavy you are, not how healthy you are. So even if the number barely moves, a shrinking waistline is often a genuine sign that the more dangerous, visceral kind of fat is coming down.