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Trunkal obesity, measured by waist-hip ratio (WHR) is correlated with increased risk of diabetes mellitus in susceptible individuals. The risk increases with a WHR greater than 1.0 in men and 0.8 in women. The adverse metaolic effects of visceral fat occur independent of subcutaneous or total body fat. Therapy is directed towards behavior modification (eating physical exercise), psychotherapy which lowers sympathetic overactivity, correction of hormonal imbalances (if present, eg testosterone) and other pharmacological agents.