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Apple Pear or Something Else Does Your Body Shape Matter for Health

Medically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS — By Katey Davidson, MScFN, RD, CPT on September 16, 2022Bodies come in different shapes and sizes, making us all unique. Though there is immense pressure from society to look a certain way, it’s important to prioritize your health over beauty ideals — and to keep in mind that “health” looks different for everyone. For some time, people have described body shapes by comparing them to fruit, particularly pears and apples. People who have “pear-shaped” bodies are often thought to be healthier than those with “apple-shaped” bodies. But is this true? This article dives into the apple and pear body shapes, the research behind them, and whether they truly mean anything for your health. Share on PinterestIllustration by Bailey Mariner

Understanding the fruit body shape comparisons

People have used fruit terms to describe body shapes for many years because this is an easy way to describe body types without using more scientific, formal terms. The “apple” body shape is known in the scientific community as “android,” meaning that most of the fat is stored in the midsection and less fat is stored in the hips, buttocks, and thighs. People with android body types tend to have a larger waist-to-hip ratio, meaning their waist is larger or close to equivalent in circumference to their hips. In contrast, the “pear” body shape is known as “gynoid,” which means more fat is stored in the hips, buttocks, and thighs than in the midsection. People with gynoid body types often have a smaller waist-to-hip ratio, which means their hips are usually wider than their waist. Though there are more formal terms to describe body shapes, the average person can better imagine an apple or a pear than an android or gynoid body type.

Does body shape affect your health

First things first: The way a person’s body looks does not automatically tell you whether they are healthy. That said, certain body shapes may be at an increased risk of negative health outcomes, according to numerous research studies. One 2020 review of 72 studies found that people with greater fat distribution in the stomach area (an apple shape) had a significantly higher risk of death from all causes than those with pear-shaped bodies. In one 2019 study involving 2,683 postmenopausal women, those who had an apple body type — more fat in the midsection and less fat in the legs — were three times more likely to have heart disease than those with a pear body type. Interestingly, having a pear body type had a protective effect against heart disease, reducing risk by up to 40%. Another study found that apple-shaped bodies were significantly associated with an increased risk of heart disease and type 2 diabetes, regardless of body mass index (BMI). (Remember: The BMI has limitations as a predictor of health, especially for People of Color.) Also, a small study including 49 males found that despite having the same BMI, body weight, and body fat percentage, men with more android fat had lower endothelial function, which leads to poorer blood flow in the body. They also had higher insulin resistance, blood lipid levels, and heart rates, suggesting worsened heart and metabolic health. Finally, a 2021 review of 31 studies found that excess weight around the midsection is significantly associated with greater risk of heart disease. The review found that for every 10-cm (3.9-inch) increase in waist circumference, there was a 3% and 4% increased risk of heart disease for women and men, respectively. Other negative health outcomes — such as kidney disease, lung and colorectal cancers, and even cognitive decline — are linked with central obesity (the presence of excess fat in the midsection). Ultimately, most research suggests that fat distribution — not necessarily body weight or BMI — can affect health outcomes.

A note on gender

You’ll notice that the language used to share stats and other data is pretty binary — “male” and “female” or “men” and “women.” We recognize that these terms don’t encompass all identities and experiences. However, specificity is key when reporting on research participants and clinical findings, so we use the same language that the studies we cite use. We encourage you to talk with a healthcare professional if you need support in navigating how the information in this article may apply to you.

The fruit metaphors have limitations

Though using fruit metaphors to describe body types may be convenient, it’s not ideal. Using objects to describe a person’s body type creates the opportunity for others to make general assumptions about someone’s health and body. For instance, people with higher body weight and body fat tend to experience weight bias in healthcare settings, meaning that healthcare professionals may focus only on their weight, regardless of their reason for seeking medical care. This can cause people to lose trust in healthcare professionals and can delay diagnosis, treatment, and care. Making assumptions about people’s health based on their body type can also be a disservice to those with pear-shaped bodies, as the healthcare professionals they interact with may not screen for health conditions based on their body type. Further, using such terms can worsen a person’s body image by suggesting that they do not have the “ideal” body type. The binary nature of these terms also fails to recognize that there are other body types besides pear- and apple-shaped ones. What’s more, positioning one body type as superior to another can lead to judgment and stigma against people with other body types. No one needs to modify their body to resemble another’s, and research suggests that body shape isn’t a choice, anyway. Genetics can play a role in your body shape. Some people have longer torsos and shorter legs, while others may have shorter torsos and longer legs or be somewhere in between. Your height and limb length can play a huge role in the way your body looks. Hormones can also play a role. For example, hormonal differences between men and women can lead to differences in fat storage. Men often store more fat in their stomach area, while women tend to store more fat in their hips, legs, and buttocks. As women’s estrogen levels decline with age, their bodies tend to store more fat in the stomach region and less in the lower body. While research has linked apple or android body types to greater risk of chronic disease, this is not always the case. Someone with more fat in the stomach area can be in terrific health, while someone who has a different body type may not be. Finally, the available research is mostly based on observational data, which means it can’t confirm cause-and-effect relationships. Thus, while apple body types are associated with increased health risks, it’s not certain that the apple body shape is the cause of those risks.

More on weight bias

Although studies often suggest that obesity is a risk factor for certain health conditions, they rarely account for the role weight stigma and discrimination play in health. Discrimination is one of the social determinants of health — the conditions in daily life that affect our health — and it can and does contribute to health inequities. Weight discrimination in healthcare can prevent people at high body weights from seeking medical care — and those who do may not receive accurate diagnoses or treatment, because doctors may attribute their health concerns solely to their weight. As a result, any health condition a person may have may be more advanced by the time they receive a diagnosis. Meanwhile, experiences of weight stigma in daily life, even outside of medical settings, are associated with negative mental and physical health outcomes. Everyone deserves appropriate and compassionate medical care. If you’re interested in finding weight-inclusive healthcare professionals, you may want to follow the work of the Association for Size Diversity and Health, which is developing a directory.

Other ways to gauge your body composition

There are many ways that you can better understand your body composition and health risk, such as:Waist circumference: A larger waist circumference (greater than 35 inches or 85 cm in women; greater than 40 inches or 101.6 cm in men) indicates greater body fat in the abdominal area and greater risk of chronic disease.Waist-to-hip ratio: This ratio compares the difference in waist and hip circumference, which can help indicate fat distribution. A ratio of greater than 0.80 in women and greater than 0.95 in men suggests greater fat stores in the stomach area. Those with a higher waist-to-hip ratio are at greater risk of chronic disease.Body fat percentage: This can tell you how much fat is stored in your body. While this may be generally helpful, not all tests tell you where the fat is stored.Lab tests: Blood work can tell you and healthcare professionals how your health is, regardless of your body type. While these measurements and tests can be helpful, healthcare professionals shouldn’t rely on a single test to make a judgment about someone’s health. Instead, they should do follow-up tests if they have any concerns. Also, it’s important to look at health from all angles, including diet, physical activity, sleep habits, stress, genetics, and mental well-being.

The bottom line

People often use the terms “pear” and “apple” to describe how bodies look and how fat is distributed. Historically, these terms have been used as indicators of a person’s health. Numerous research studies have found that greater fat distribution around the midsection — an “apple” or “android” body type — may be linked with a higher risk of chronic disease and poor health outcomes. However, because many of these studies are observational, the results do not clearly indicate how big of a role body type truly plays in health. Additionally, it’s problematic to use a person’s appearance to make generalizations about their health, since bodies come in all shapes and sizes. Such generalizations also promote weight bias, which can lead to delayed care and treatment. Instead, it’s important for you and any healthcare professionals you work with to look at your health holistically by considering all aspects of health, including lifestyle, genetics, and age-related factors. Last medically reviewed on September 16, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Chen G, et al. (2019). Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index.
ncbi.nlm.nih.gov/pmc/articles/PMC6933870/Dale C, et al. (2017). Causal associations of adiposity and body fat distribution With coronary heart disease, stroke subtypes, and type 2 diabetes mellitus: A Mendelian randomization analysis.
ncbi.nlm.nih.gov/pmc/articles/PMC5515354/Dong Y, et al. (2017). Abdominal obesity and colorectal cancer risk: Systematic review and meta-analysis of prospective studies.
ncbi.nlm.nih.gov/pmc/articles/PMC5725611/Forte R, et al. (2017). The body fat-cognition relationship in healthy older individuals: Does gynoid vs android distribution matter?
pubmed.ncbi.nlm.nih.gov/28244568/Hidayat K, et al. (2016). Abdominal obesity and lung cancer risk: Systematic review and meta-analysis of prospective studies.
ncbi.nlm.nih.gov/pmc/articles/PMC5188465/Jayedi A, et al. (2020). Central fatness and risk of all cause mortality: Systematic review and dose-response meta-analysis of 72 prospective cohort studies.
ncbi.nlm.nih.gov/pmc/articles/PMC7509947/Lawrence B, et al. (2021). Weight bias among health care professionals: A systematic review and meta-analysis.
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ncbi.nlm.nih.gov/pmc/articles/PMC5771660/Sari C, et al. (2019). Android fat deposition and its association with cardiovascular risk factors in overweight young males.
ncbi.nlm.nih.gov/pmc/articles/PMC6759693/Xue R, et al. (2021). Abdominal obesity and risk of CVD: A dose-response meta-analysis of thirty-one prospective studies.
pubmed.ncbi.nlm.nih.gov/33431092/Zhao Q, et al. (2021). Meta-analysis of the relationship between abdominal obesity and diabetic kidney disease in type 2 diabetic patients.
ncbi.nlm.nih.gov/pmc/articles/PMC8406252/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 16, 2022 By Katey Davidson, MScFN, RD, CPT Edited By Rose Thorne Medically Reviewed By Jared Meacham, Ph.D., RD, PMP, MBA, CSCS Copy Edited By Jill Campbell Share this articleMedically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS — By Katey Davidson, MScFN, RD, CPT on September 16, 2022

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