A surprisingly thick neck might be more than just an aesthetic concern; it could signal significant health risks, including cardiovascular problems and diabetes, according to extensive research.

Researchers revisited data from the renowned Framingham Heart Study, which has been tracking heart disease since 1948, to explore the relationship between neck circumference and atrial fibrillation. This irregular heartbeat condition, which was examined in a 2010 analysis and further studied in 2022, significantly increases the risk of stroke and heart failure.

Additionally, a larger neck is associated with sleep apnea—a disorder characterized by repeated interruptions in breathing due to relaxed throat muscles blocking the airway. This condition, along with other sleep disorders, can precipitate heart disease and stroke.

“Typically, a neck circumference exceeding 17 inches in men could be a red flag for several health issues,” states Dr. Mike Dilkes, an ear, nose, and throat surgeon at London’s HealthHub.

For women, Dr. Dilkes notes that a neck measuring over 16 inches might indicate excess upper body fat and act as a marker for visceral fat. This type of fat, concealed deep within the abdomen around key organs like the liver, pancreas, and intestines, poses serious health threats such as type 2 diabetes, heart disease, and certain cancers.

The latter is a type of body fat hidden deep inside the abdomen around vital organs such as the liver, pancreas, and intestines, but it can lead to serious health problems such as type 2 diabetes, heart disease, and certain cancers.

Larger necks do not solely indicate health issues, as seen in many athletes, such as rugby players, who have larger circumferences due to muscle mass, instead of fat.

They often also have better airway health and cardiovascular markers than those who are less active than they are with similar-sized necks.

Dr Dilkes has highlighted seven signs related to your neck which could be a subtle clue to something deeper going on:

Sagging jowls or a flabby neck

A sagging jowl or flabby neck may indicate risk of sleep apnoea as fat deposits around the neck can compress the airway, especially when lying down.

“Muscle tone is lost and the general weight of the fat compresses the airway,” Dr Dilkes explains, adding “even if the tissue is not very heavy, if there’s enough of it, it will obstruct the airway sufficiently to stop breathing.”

Lump at the front or side of the neck

This sign could be an enlarged thyroid gland (goitre). Often linked to hyperthyroidism, which affects metabolism and can cause symptoms like weight loss, anxiety, and fatigue.

“If you notice a swelling in the front or side of your neck, you should definitely have it looked at and have a blood test for thyroid function,” the ENT surgeon suggests.

Neck pain

Commonly due to muscle strain or arthritis, persistent neck pain might signal spinal issues, infections, or even tumours.

Swelling with difficulty swallowing

This may be due to iodine deficiency, historically known as “Derbyshire neck”. Though rarer, these symptoms are still a concern today due to changing diets, especially among women and girls.

Lumps or swollen glands on the side

Usually a sign of infection, lumps or swollen glands could also suggest tonsillitis, sepsis, or even tongue cancer.

“Swollen glands could suggest sepsis in the mouth or throat, or tonsillitis. Tongue cancer is also a possibility.”

Bulging neck vein

This sign might indicate heart or circulatory problems, such as right-sided heart failure or pulmonary hypertension. The jugular vein is often used as a visible gauge of central venous pressure.

“In medical exams, clinicians use the height of the jugular vein as a visible gauge of central venous pressure,” Dr Dilkes explains.

Throbbing lump (pulsatile mass)

This could be a carotid artery aneurysm or a carotid body tumour. These are rare but serious and may require surgery or monitoring.

Other potential causes include trauma-related swelling, an enlarged thyroid artery or arteriovenous malformation (AVM), an abnormal connection between arteries and veins that can result in death if left untreated.