Your Neck Size Can Reveal Your Risk for Heart Disease, Stroke, and Diabetes
Story at-a-glance
- A thick neck is more than a cosmetic issue — it’s one of the clearest physical signs of metabolic stress, indicating higher risks for diabetes, heart disease, and stroke
- Research shows neck circumference predicts disease risk more accurately than BMI or waist size because it reflects harmful visceral fat stored around vital organs
- Fat around the neck and upper torso releases inflammatory chemicals and stress hormones that disrupt blood sugar, blood pressure, and heart rhythm
- Visible changes in your neck, such as swelling, lumps, bulging veins, or sagging tissue, offer early clues about thyroid dysfunction, heart strain, or oxygen deprivation during sleep
- Tracking your neck size each month is an easy, no-cost way to monitor your metabolic health, helping you take early action before serious conditions develop
When it comes to fat accumulation, most people are concerned about the flab around their waist or the numbers on the scale and how it affects their risk of disease. But did you know that there’s another area of your body that could also serve as a warning sign of illness? It’s your neck.
According to a growing body of research, the circumference of your neck could be an indicator of a higher likelihood of serious metabolic diseases, including heart disease, diabetes, and sleep disorders. Another troubling fact is that even if your body mass index (BMI) index is healthy, just how large your neck is could still be a determining factor in your predisposition to developing these conditions.
Neck Fat Is a Hidden Metabolic Warning Signal
Although a thick neck often gives the impression of strength, especially in athletes, research shows it can also signal underlying health problems that aren’t visible on the surface. A 2022 longitudinal study published in Nutrition, Metabolism & Cardiovascular Diseases journal provided insights on this. A team of researchers from Shanghai found that a simple measure of the fat stored around the upper body, specifically the fat around the neck, may help predict a person’s likelihood of cardiovascular events.1
•The study participants — The researchers followed 1,435 adults aged 50 to 80 years old living in Shanghai between 2013 and 2022. Participants were free from cardiovascular or cerebrovascular disease at the start of the study and underwent extensive health evaluations, including body measurements, blood tests, and lifestyle assessments.
•The researchers looked at the neck circumference of the participants — They defined the parameters of a “high” neck circumference, namely 38.5 centimeters (cm) or higher for men and 34.5 cm or higher for women.
•Over nearly eight years of follow-up, 148 cardiovascular events occurred — These included 62 cases of ischemic heart disease and 86 cerebrovascular events. Men were notably more affected, with a 13.3% incidence compared to 8% in women.
•Bigger necks, bigger risks — The researchers noted that with every 1 standard deviation increase in neck circumference, there was an associated 45% higher risk of cardiovascular events. When comparing individuals with high vs. low NC, they found that the risk of heart disease rose by 59% overall.
•Men with bigger necks have a nearly doubled risk — In women, however, the association was weaker and not statistically significant. Further analysis revealed that neck size was particularly predictive of ischemic heart disease (IHD), such as heart attack and coronary artery blockage, but was not strongly linked to strokes.
This pioneering research underscores that neck circumference is more than a body measurement — it’s a potential biomarker for cardiovascular health. Most importantly, the predictive ability of NC was found to be comparable to traditional measures like BMI and waist circumference, both of which are standard tools for evaluating obesity-related health risks. As the researchers concluded:
“The identification of other simple measures that reflect obesity and fat distribution may help to better predict the occurrence of CV events in more dimensions.
NC is a new measurement index that is simple, saves time, has little variability, and can reflect upper-body fat content. Emerging evidence has supported the link between NC and multiple CV risk factors such as diabetes, hypertension, and subclinical atherosclerosis.”2
So Why Does Neck Size Matter?
Many people think that neck fat is just a cosmetic issue, but apparently, it can tell so much more about your health. This is because the fat stored in the upper body, especially around the neck, may be metabolically active and closely tied to the body’s inflammatory and hormonal systems.
•The researchers believe that neck fat acts like perivascular adipose tissue — This is the type of fat that surrounds blood vessels. When this tissue becomes dysfunctional, it can trigger a cascade of inflammatory signals and oxidative stress, damage the vascular lining, and accelerate the development of atherosclerosis, or the buildup of plaque in arteries.
In short, excess fat in the neck region may be a visible marker of internal metabolic stress that contributes to cardiovascular disease.3
•Neck circumference also helps identify visceral fat — This is the type of fat wrapped around your internal organs. Visceral fat is far more harmful than fat carried in the lower body, because it’s highly active, constantly releasing fatty acids, stress hormones, and inflammatory chemicals into your bloodstream.
Over time, this overactivity drives up blood sugar and inflammation, making it harder for your cells to respond to insulin. The result is a steady progression toward metabolic syndrome, a condition that dramatically increases your risk for heart disease and stroke.4
•In contrast, BMI only estimates body fat based on height and weight — This is why it often misses the full story. A fit, muscular person might score a high BMI even with very little fat. Basically, it fails to distinguish between muscle and fat.
•Having a larger neck also predisposes you to diabetes — Studies have found a link between neck circumference and a higher risk of Type 2 diabetes.5 In fact, a 2021 study published in Clinical Diabetes and Endocrinology found that there’s an association between neck circumference and gestational diabetes.6 So if you’ve noticed your neck getting thicker or your shirt collars feeling tighter, it might be your body’s way of signaling that it’s time to rebalance your metabolism.
Previous Studies Have Associated Neck Size with Cardiovascular Disease
The featured study is just one of numerous studies linking neck circumference with cardiovascular health. In fact, multiple studies have found that a thicker neck was strongly linked to higher blood pressure, elevated triglycerides, and lower HDL (“good”) cholesterol levels — all of which are markers of cardiovascular disease.
•Having a thick neck is also linked to a higher risk of atrial fibrillation — Also known as AFib, this is an abnormal, often rapid, heart rhythm that occurs when the atria, your heart’s upper chambers, beat out of sync with the ventricles, the heart’s lower chambers. This can lead to palpitations, fatigue, and an increased risk of stroke, blood clots, heart failure, and premature death.7
In a 2022 study published in the Journal of the American Heart Association, researchers looked at participants from the Framingham Heart Study and assessed their neck circumference. They found that those with a high neck circumference had an increased risk of AFib.8
•This association was statistically significant even after adjusting for BMI, waist circumference, height, and weight — The researchers also found that the risk was highest among obese participants. “[O]ur findings indicate that neck circumference potentially may be used as an easily obtainable measure for assessing risk of incident AF,” they concluded.9
•Neck size can also predict the risk of cardiovascular mortality — A 2024 study published in Preventive Medicine also found that neck circumference (NC) and neck-to-height ratio (NHR) can serve as independent predictors of cardiovascular disease (CVD) mortality, even after accounting for BMI and waist-to-hip ratio.
According to the study findings, individuals in the highest quartile of neck circumference had a 1.83-fold greater risk of CVD death and a 2.40-fold higher risk of coronary heart disease (CHD) death than those in the lowest quartile.10
•So how big is too big? While the featured study provided different parameters of “high” neck circumference, Science Daily notes that men with a neck circumference of 17 inches (43 cm) or more and women with 14 inches (35.5 cm) or more face a notably higher risk of health complications. Plus, the likelihood of hospitalization and premature death rises significantly for every additional centimeter beyond this range.11
Measuring your neck is quick and easy. Simply use a soft measuring tape and wrap it around the narrowest part of your neck, keeping the tape snug but not tight.
“While neck circumference shouldn’t replace established health assessments, it provides a valuable, easy-to-use tool for understanding cardiovascular and metabolic health,” ScienceDaily notes.12
So What Else Is Your Neck Telling You?
Beyond cardiovascular disease and diabetes, your neck size could also serve as an indicator of other health conditions. One example is obstructive sleep apnea (OSA). According to a study from the Journal of Clinical Sleep Medicine, neck circumference-to-height ratio (NHR) can be a reliable and reproducible predictor of OSA across both children and adults.13
Neck size can also be a sign of infertility, particularly in males. According to a study in the First International Journal of Andrology, men with erectile dysfunction had significantly larger neck circumferences than their healthy counterparts.14
Aside from thickness, other symptoms pertaining to your neck also point to certain health problems. In a Telegraph article, Dr. Mike Dilkes, an ENT surgeon at London’s HealthHub, provides seven warning signs to be wary of:
1.Sagging jowls and a flabby neck — Similar to neck circumference, having these excess fat deposits may be a clear red flag for sleep apnea. When you lie on your back, these fatty tissues press inward, narrowing the airway and restricting airflow.
“Muscle tone is lost, and the general weight of the fat compresses the airway. Even if the tissue is not very heavy, if there’s enough of it, it will obstruct the airway sufficiently to stop breathing,” Dilkes explains.
2.Lump at the front or side of the neck — A visible swelling or lump near the Adam’s apple often signals an enlarged thyroid gland, also known as goiter. The thyroid is responsible for producing hormones that control metabolism. An overactive thyroid (hyperthyroidism) triggers symptoms like rapid heartbeat, weight loss, tremors, and heat intolerance, while an underactive thyroid (hypothyroidism) often leads to fatigue, hair loss, and weight gain.
Identifying thyroid imbalances early helps prevent complications like thyroid storm, a dangerous surge in hormone activity that can cause heart failure.
3.Persistent neck pain — Neck pain is one of the most common complaints among adults, especially those who sit at desks or look down at screens for hours. Most cases stem from muscle tension or poor posture, which restricts blood flow and strains the cervical spine.
However, ongoing or severe pain could point to more serious conditions like disc herniation, spinal cord compression, or even infections such as meningitis.
4.Swelling and difficulty swallowing — When swelling in your neck makes swallowing uncomfortable, it might indicate an iodine deficiency. Iodine is an essential mineral your thyroid needs to produce hormones, and being deficient disrupts everything from metabolism to reproductive health.
5.Swollen glands or lumps in the side of the neck — These often indicate that your lymph nodes are working overtime to fight an infection. These nodes are part of your immune system and swell in response to illnesses like tonsillitis or throat infections. However, persistent swelling could suggest more serious issues, such as sepsis in the mouth or, in rare cases, tongue cancer.
Dilkes cautioned that lingering lumps deserve medical attention, especially when paired with sore throat, fever, or fatigue.
6.Bulging veins — A bulging, rope-like vein on your neck might seem harmless, but it’s actually a live indicator of your heart’s pumping efficiency. These are your jugular veins, which return blood from your head and neck to the heart. If the right side of your heart struggles to pump efficiently, blood can back up, causing the veins to swell visibly. This condition often accompanies right-sided heart failure, liver disease, or pulmonary hypertension, where pressure builds in the lungs’ blood vessels.
7.Throbbing lump or pulsing mass — A throbbing lump that beats in sync with your pulse can indicate vascular issues, such as a weakened artery or a carotid body tumor (paraganglioma), which is an abnormal yet usually benign mass located near a major neck artery.
In rare cases, a weak arterial wall can balloon and form an aneurysm, a dangerous condition that risks rupture or blood clot formation. These can lead to stroke or even death if left untreated.
In simple terms, your neck can be your own built-in health tracker. A smart move would be to measure it, even once a month, and see how it changes over time and correlate it with your energy, sleep, and focus. It’s also important to be watchful of the seven symptoms listed above, and to seek a healthcare practitioner if any of them arise.
If the primary concern is neck circumference, the good news is you can decrease it with positive lifestyle changes. Consuming a balanced diet focused on whole food supports weight control and helps reduce unhealthy fat accumulation. This, along with regular exercise and movement, sufficient high-quality sleep, and safe sun exposure will help you maintain a healthy metabolism and a slimmer, healthier neck.
Frequently Asked Questions (FAQs) About Neck Size and Risk of Disease
Q: What does neck size have to do with diabetes or heart disease?
A: Neck size reflects how and where your body stores fat. Fat around the neck is metabolically active — it releases inflammatory chemicals that disrupt how your body regulates blood sugar, blood pressure, and cholesterol. A thicker neck often signals insulin resistance and early metabolic stress, which can lead to diabetes or cardiovascular disease if ignored.
Q: How do I know if my neck size is in the danger zone?
A: For men, a neck circumference above 17 inches is considered high risk. For women, it’s 14 inches or more. If your collars feel tighter or your neck looks thicker, it’s worth tracking. Even small increases in neck size often appear before lab tests show problems with blood sugar or cholesterol.
Q: What other health conditions does neck size reveal?
A: Changes in your neck can signal thyroid problems, sleep apnea, circulatory strain, or heart failure. For instance, swelling near the thyroid area can indicate an overactive or underactive thyroid, while bulging veins may point to heart or lung issues. Recognizing these visible clues gives you a chance to intervene early.
Q: How can I reduce neck fat and improve my metabolic health?
A: The key is fixing the root causes — poor diet, low activity, and cellular energy imbalance. Replace seed oils with tallow, butter, or ghee. Eat enough clean carbohydrates to fuel your cells and restore thyroid function. Get daily sunlight, strength-train a few times a week, and stay consistent. Over time, your metabolism strengthens and neck size naturally reduces.
Q: What’s the easiest way to track progress?
A: Use a soft tape measure to check your neck circumference once a month. Record it alongside your energy levels, sleep, and mood. Watching that number shrink is one of the simplest and most motivating ways to confirm that your body is healing and your metabolism is improving.
