Joseph S. Galati, M.D., FAASLD, FACG 3 MIN READ
This is an excerpt from Dr. Galati’s latest podcast. Listen to the full podcast HERE.
It is late March in Houston, Texas, and the weather is warming up. I see people shifting their wardrobes from sweaters and jackets to short sleeves. Specifically, we are seeing a rise in men wearing short-sleeve shirts that are designed to be worn untucked.
Companies like Untuck It have built entire brands around this concept. I want to clarify that I am not attacking any specific company; rather, I am discussing the general concept of untucked shirts from a health standpoint. While clothing manufacturers focus on aesthetics and confidence—making a guy look respectable among his peers—I view this trend differently.
Over the last 10 to 15 years, wearing untucked shirts has become increasingly acceptable. But why is this happening? Often, it boils down to obesity. When men gain weight, they develop a larger abdominal girth. Tucking in a shirt can make it feel too tight or draw unwanted attention to the midsection. The solution for many is simply to untuck the shirt and let it hang.
From a fashion perspective, shirts engineered to be worn untucked are designed to fall midway between the belt and the zipper, avoiding the sloppy look of a traditional dress shirt. While this improves appearance, it ignores the underlying health conditions men might be hiding. The issue isn’t about fat-shaming; it is about the reality that untucked shirts allow men to conceal expanding waistlines instead of addressing weight gain.
Some might ask why a doctor needs to impose a medical opinion on fashion. “Let me wear my shirt to the barbecue in peace,” you might say. I understand that perspective. However, the normalization of the “dad bod” is concerning. The fashion industry produces products to help you achieve a certain look, but they are not focused on resolving health issues.
As a physician, specifically a hepatologist, nothing is more disturbing than seeing a middle-aged man who has gained significant weight over the last decade and developed hypertension, high cholesterol, or type 2 diabetes, only to suffer a massive heart attack. Friends might be shocked because “Bill looked okay,” but appearance matters little against biology. The leading cause of liver disease today is fatty liver, which can lead to cirrhosis and liver cancer. These diseases are on the rise, and they don’t spare anyone.
Instead of buying a new wardrobe to accommodate weight gain, men should be asking, “Why have I gained this weight?” The focus should be on cutting back on alcohol, exercising, eating a whole food/plant based diet, checking cholesterol levels and blood pressure, not just finding a shirt that hides the problem.
The health risks associated with obesity are severe. They include type 2 diabetes, coronary artery disease, stroke, sleep apnea, osteoarthritis, and seven unique cancers. Truncal obesity—fat accumulation around the belly—is particularly dangerous. For men, a waist measurement over 40 inches indicates a high risk for obesity-related diseases. When you accumulate belly fat, shirts no longer fit properly, and the “untuck it” route becomes the easy solution.
This specific type of “belly fat,” known medically as visceral fat, is not just inert storage. It is metabolically active tissue, distinct from fat stored in other parts of the body like the thighs or buttocks. Visceral fat acts almost like an organ itself, releasing hormones and inflammatory substances. This promotes systemic inflammation throughout the body, which is the primary driving force of chronic disease. It is this internal inflammation that eventually leads to the heart attacks and strokes we see too often.
My negative view of the untucked shirt movement is rooted entirely in concern for your health. I recently observed men at church who were at a healthy weight wearing untucked shirts, and they looked fine. My comments are focused on those who are clearly overweight and using fashion as a shield.
Watching preventable disease unfold is disheartening. The trend of wearing untucked shirts often serves as a band-aid for serious underlying medical problems. Don’t let a fashion choice distract you from the vital work of taking care of your body.
YOU CAN REACH DR. GALATI @ 713-794-0700