Does your belly fat make you crazy?

Stop obsessing and read this.

Being FOF comes with so many great things–wisdom, levity, experience, humor…..And one not-so-great thing: belly fat.

So we paused in the middle of our daily sit-up regimen to speak with Dr. Michael Kaplan, one of the nation’s foremost experts on weight loss. Dr. Kaplan revealed the truth behind belly fat over fifty–why it’s there, what you can do about it, and why you should stop obsessing.

  • FOF: We hear it from FOFs all the time: ‘It’s so much harder for me to lose weight now, and I’m gaining in my belly area. What can I do?’
    • Dr. Kaplan: The unfortunate consequence of aging–for everyone–is that your metabolism slows by about 5-10 percent per decade. When women hit menopause, it slows an additional 5-10 percent. Many women spend their lives at a normal BMI [body mass index] of 23 or 24, and then they hit menopause and find themselves at a BMI of 27 or 28–ever so slightly overweight. And they can’t take off the pounds. Also, the body is programmed during menopause to lay down extra subcutaneous fat in the abdomen. So even if you’ve never had fat in your abdomen, all of a sudden you have a belly.
  • Ack. Why do our bodies suddenly put fat in the middle?
    • We don’t know, but it’s universal. It’s just kind of in our DNA that this is going to happen to a woman when she hits menopause.
  • Can you get rid of it?
    • Yes. But the truth is, a woman has to work really hard to get rid of it. First, you have to exercise more. Even if you went your whole life at a normal weight and you exercised, you have to start adding exercise as you approach menopause. I see patients who have never exercised in their lives, and then they start menopause and suddenly have to start in order to maintain their bodies. The average recommendation for a woman to really be doing well at this age is 5 hours per week.
  • That’s a lot of hours.
    • It absolutely is. In all studies I’ve ever read, you have to do about three hours a week to lose weight, but after menopause, it is definitely harder.
  • What about diet?
    • A woman’s metabolism once she hits menopause–if she’s normal weight–is usually about 1300 calories a day. That means she’s burning about 1300 calories every day, so she has to eat 1300 calories to maintain her weight. It’s pretty hard to lose weight at that rate, because you have give up 3500 calories to get rid of just one pound.
  • How do you give up 3500 calories if you can only eat 1300?!
    • It’s over time! So if you ate 1000 calories a day, you would lose 1 lb every 12 days. It’s really discouraging for a lot of women, and we usually see them after they’ve gone on multiple commercial programs and the weight isn’t coming off. Or it’s coming off so slowly that they’re discouraged…
  • What’s your approach?
    • As doctors, we have the advantage that we can prescribe a low-calorie diet. Anything under 1000 calories per day has to be medically prescribed–by law. We prescribe nutraceuticals–low calorie shakes, bars and soups that are made according to the same standards as pharmaceuticals. Each one is 160 calories and patients consume 5 daily. A woman can temporarily use these to get back to her pre-menopausal weight. While she’s doing that, we’re working on the behavioral issues that are going to keep the weight off long term.
  • So that helps you speed up the initial weight loss, but what’s the long-term strategy?
    • We try to figure out a day-to-day routine, Monday through Friday, where she can eat about 1100 calories a day. We’ll come up with meal options and an exercise plan. If we do that, we’re banking about 2000 calories for the weekend, so she can relax and go out on Saturday and Sunday. We also address the psychological issues–that’s a huge part of this. We help women figure out their triggers—what causes them to overeat.
  • If someone ups her exercise and changes her diet and deals with her psychological issues, is it possible that she still won’t lose her belly fat?
    • ImageYes. Often, a part of this isn’t going to go away. These fat cells develop and get bigger during menopause. You can make them smaller, but you can’t get rid of them completely. If you get down to the weight you’re happy at, but you still have belly fat that’s bothering you, I might suggest surgery. Liposuction would actually get the cells out. I recommend that as a last alternative.
  • It sounds like you’re saying, in a nutshell, if you want to want to completely lose that belly, you’re going to need to make it–and your weight–a major focus of your life.
    • Right, it has to become a battle that you’re fighting everyday.
  • Do you ever suggest that women just accept the extra pounds around their middles and stop obsessing?
    • You know, I have said that to people. There was a study published in the Archives of Internal Medicine a few years back that said women actually live the longest with a BMI of 27-28 over age 70. But what we run into is people who are used to having a certain look. And if you spend your whole life with a BMI of 24 or 25 and now you’re 27 or 28, psychologically you don’t feel right.
  • Are there certain foods that trigger belly weight?
    • I wish I could say yes to that question, because it would make things easier, but really, there aren’t. I will say that if you are insulin resistant you probably will feel hungrier and eat more when you eat carbohydrates. It’s not the carbs themselves, it’s how your body reacts to them. Many people have that problem.
  • How do you know if you’re insulin resistant?
    • If you’ve been diagnosed with PCOS, diabetes or pre-diabetes. Also, there’s a medical test we can do, but I came up with a test that anyone can do at home: One morning, eat 200 calories of carbs for breakfast–an English muffin with jelly, for example. Write down the time you eat and then the time when you feel hungry again. The following day, eat 200 calories of fat and protein for breakfast–2 eggs with a small amount of cheese, for example. Again, write down when you eat, and when you feel hungry again. If you find that you are hungry an hour or two earlier on the carbohydrate day, you’re probably insulin resistant.
  • Is that something you can fix, or do you just need to avoid carbs?
    • It could get better. Sometimes losing weight actually makes the insulin resistance better. There’s also a medication called Metformin than can help the cravings–we use this often and patients don’t feel as hungry. And of course, if you just avoid those foods, then you won’t have those cravings.
  • Is there any way to lose weight specifically in the belly area?
    • No. That’s a huge myth. If you lose weight, you lose fat everywhere. A pound of fat comes from every fat cell in your body–they all shrink a little bit.
  • I’ve heard there’s a connection between stress and belly fat. Is this true?
    • Stress is absolutely related to gaining weight, but not specifically in the belly. The stress response–secreting cortisol and epinephrine–does make us hungry and does make us crave food. Lack of sleep does the same thing. A lot of menopausal women have hot flashes and don’t sleep well as a result, which can make them hungrier the next day. So if you treat your menopause symptoms, you may experience weight loss as a result.
  • What about situps? Can those help get rid of your belly?
    • Another major myth. All sit-ups do is strengthen the abdominal muscles–they don’t get rid of fat. So in some cases they can actually make your abdomen look a little bigger. The ideal is to lose the fat and then strengthen the muscles to get definition.
  • So it sounds like there’s no magic bullet that gets rid of all belly fat.
    • Yes, but it’s not hopeless. People have definitely done it. The most important thing to recognize is that it is a factor of aging…it’s not anything you did wrong.
Author
Dr. Michael Kaplan, MDDr. Michael Kaplan, MD, is the Founder and Chief Medical Officer for The Center for Medical Weight Loss, the largest network of non-surgical medical weight loss providers in the U.S., with more than 420 offices in 46 U.S. states. He live and works in New York.
  • Patient 059739

    You’re so smart, Dr. Kaplan. I wish you could be my doctor. All my docs are dumb as rocks.

  • pfitz@stites.com

    This was a really good article. Thank you. It made a lot of sense and relieved some “stress” – lol

  • Suburbohemian

    It is full of hard truths and not misconceptions and I thank you for it.

  • spcale

    Tha’s all I have to say.
    Woman-55, 56 next month.

  • Andy

    OK, just what I’ve always thought. No magic. However, it might be time for me to look at the bank account and see if I can afford a tummy tuck.

  • melissiana

    I do a power yoga class with Susan Powter here in Taos, New Mexico. She kicks our a…s, but amazing results 3 times a week. Also live stream every day on her radio show KVOT.com

  • JJKnaack

    There wasn’t one positive thing said in this article for women. I felt something was missing with all this for sure. Where’s the hope???

  • linaperl

    Hi JJ – I understand what you’re saying. As an editor for the site, I just want to say, we tried to be as honest as possible with this article. I think a lot of outlets will give you “hope” at the expense of truth. The fact is, you CAN lose your belly fat, and it IS hard work.

  • olympicgirl

    My doctor doesn’t seem to be that sympathetic. I feel like it’s something I’ve done, but I know it’s not. And it is way more work than I ever thought it would be.

  • belindabg

    In my youth, I had liposuction to remove the ‘pregnant’ belly look I’d inherited from my Mom and all the female relatives on her side. Then, when I reached my early 40’s the pounds came creeping on – blame a tough career, being the main breadwinner in a bad marriage, and health problems, combined with MASSIVE amounts of stress. When the weight you remove from liposuction comes back, it comes back in new areas – for me it was my upper arms and BACK and lower jaw area. UGH. Now that I’ve hit menopause, I’ve got this nasty little HUGE fat pad at the lowest part of my abdomen – the pudendal area, and it’s VERY UGLY in clothes and naked. I know the only thing to remove it will be more surgery – but I’m just not up for it anymore, and neither is my wallet after losing my career after 23 years and being out of work for 2. I’ve tried all I can over the years to lose weight – literally every diet that ever came down the pike and then some – and I’m herniated in L5 so exercise is NOT an option at this point. I swim three times a week, used to walk 4 miles a day at my former job. Now I’m basically resigned to it, I’m FAT AND FABULOUS AND FIFTY next week and the world will just have to TAKE ME AS I AM!!

  • ragtop

    Interesting and informative. Just one question: “One morning, eat 200 calories of carbs for breakfast . . . The following day, eat 200 calories of fat and carbohydrates for breakfast–2 eggs with a small amount of cheese, for example.” Should second day read “fat and protein”?

  • linaperl

    ragtop – you are right! want to come be our copyeditor? :) correction made….

  • semills40

    I am so glad to hear someone (a man)come to the aid of the premenopause and post menopause women!! I knew alot of the article because I have been living the “belly fat” nightmare for many years now. If there was just a safe pill to eat up all that fat, that would be fantabolous!!!!!!!!!!

  • floggingwally

    Ah-ah – yes I did lose belly fat by
    1. removing sugar from my diet
    2. removing all foods with preservatives from my diet
    3. only eating sprouted grains
    4. training for a half marathon
    5. work out 4 days a week
    sounds like a lot, but it has become a life style change for both my husband and for me – we are both major foodies and still enjoy wine, but we are 100 percent more active and really have fun creating new recipes with fresh ingredients – We feel amazing!
    It works!

  • sherry57

    Finally somebody who is being straight with us. As a prediabetic currently on metformin, I can attest to smaller meals more frequently does seem to prevent weight gain. Now weight loss is another matter. I was able to lose 10 lbs but could not sustain it. I could not eat fruit, rice, pasta, bread etc., and I felt deprived. I do have two questions: Are hormonal imbalances addressed since this does impact insulin levels and for someone who is already pre-diabetic are the less invasive surgical corrections? This population usually healy much more slowly and run the risk of more post-operative infections/complications. Thank you.

  • Becky Beer

    Yes!, My belly fat makes me very crazy, I’ve tried all the $$$ tricks,not one has worked.[snake oil] I’m sure. I workout as much as I can,[not 5 hrs. though]I wish I could. I’m happy to hear the truth about menopause and aging ;I will live with being the best I can be at my age and weight. And no more spending my money on the latest breakthrough weight loss product on the market! [snake oil!] I am FOB and happy with myself for now on! Thank you for the truth.

  • RenaeMoore

    It can be done! I’m 54 years young and have found that clean eating (if it doesn’t grow don’t eat it!, shop the perimeter of the grocery store, nothing from a box, etc.) a good weight training program and ‘moving’ at least 4-5 days a week works. I like to know what I am eating is good ‘fuel’ for my engine, eat 3 meals plus 2 snacks a day, drink plenty of water, don’t eat anything after dinner (best by 6 or 7pm) and if I want have a glass of wine or sweet treat on the weekend. It’s true that we have to work harder than we did when we are younger, make time to be good to yourself!
    I am an avid cyclist and it’s great for burning lots of calories!

  • Womens Voices

    Weight during menopause is certainly a big concern, as it is harder to lose it! Well phrased that it is a factor of aging and not anything we do wrong, but it is something that should be worked at, as there are many health concerns that tie into excess body weight (http://womensvoicesforchange.org/menopause-and-excess-body-weight-ask-dr-pat.htm).

  • d2thewin

    This is honest talk about a problem that more woman than not have. I appreciate the information and it certainly makes me understand that I can work out to feel good but I don’t have to kill myself to lose all the fat.

  • Polly

    I think it would be best if we just accepted who we are, wear clothes that flatter a ‘fuller’ figure, and LIVE YOUR LIFE :) I’ve had a tummy most of my life – and at age 56, it’s not getting any smaller. It’s ridiculous that we obsess over this stuff – it adds nothing to the quality of our lives, and unless your weight is a health hazard, I say “stop worrying!” Now, where’s that ice cream cone I was promising myself? ;)

  • musicteac60

    The best diet that I have found to help with belly fat is the
    the Fat Flush Diet/Ann Louise Gittleman. I always go back to this diet: Spring and Fall. It works for me. I can see a different in my abdominal area within days after beginning this diet. It so works for me! I incorporate exercising as well. I am 65 years old.

  • tigggerbunny

    I too found the article somewhat negative, but you can change the belly fat! I started exercising, first at curves, and then when a half hour exercise was not enough I moved to a regular gym three or four times a week. I have forced myself into the gym and realize if I don’t go, nobody else will take care of my body… I’ve lost weight and inches around my belly. You can do it too! It takes hard work and I exercise more than I ever did in my 30’s. I’m in better shape now at 47 than I was in my 30’s too. Now I am treating my belly fat with a Lipo Laser to break down the fat cells on my belly. IT’S WORKING!!! You don’t have to accept it, but can work on it and make it go away! I’ve dropped from a size 11 jean down to a size 8….size 6 here I come!!

  • ArtInMyHeart

    I also was in better shape at 47 than in my 30s, but now that I’m 56 (and still making myself be active over an hour a day) the belly fat is there just as the doctor said, even though the rest of my body is fine. Sorry to have to tell you that!

  • LHowe

    for at least ending on a slightly more positive note than the rest of the article. how depressing.

  • BlueBear

    I am 66 and, as my days on this earth dwindle down, I too believe we have to accept the things we cannot change. Life is so very short (my Mother died at 52!) and spending it worrying over 5-10 lbs is simply ludicrous at this age. Eat healthy, love wisely and muchly and be kind. In the end, nobody will mention your belly fat but they certainly will say if you were mean-spirited and so obsessed with your body that you forgot what was important in life!

  • sugard49

    so thanks! I really feel like I am turning into a short, squat fireplug! I have a huge bust and am now only 5’1″ tall, down almost 2 inches at age 61. My belly fat is embarrassing and annoying and makes it difficult to find flattering clothes. I thought it was because I’d been on steroids ten years ago and it seemed to begin then, however, I gain 5 lbs. without breathing now! I was always a stable weight and well-built. Now I have to accept the inevitable, it seems. How much is genetics involved? Are we programmed to end up a certain way genetically?

  • sugard49

    Thanks for the diet info…I will try that!

  • Indigo Girl

    I couldn’t agree more!! I don’t want to have to “fight this battle every day for the rest of my life”. I’ve already battled breast cancer and the treatment for that put me into early menopause. Now I’m of menopause age (this was 6 years ago). I like who I am and don’t want to deprive or deny myself…life is too short. As long as I stay healthy I’m good!

  • TACACMS

    They would move heaven and earth to solve it. My thinking is this: If they can put a man on the moon, they can help women with this post menopausal weight gain . Like I said, if men had to deal with this, solutions would pop up all over the place!!!

  • elegantlady63

    I recommend Zerona treatments as seen on Dr Oz to get rid of belly fat. These treatments really work. They are non-invasive and give me a chance to relax for the 40 min sessions every 72 hours until I have achieved my desired results. Prices vary by location. My friend in NY is paying twice what I pay in Md. Try it!

  • imcoreman

    Lap band surgery may also be an option for reducing the belly.
    http://weightloss.marinahospital.com/

  • Rockyred

    No kidding…if men suffered ANY of the maladies women have…..you just nailed it!!!! There would be a solution to everything! Argh!

  • veritas2011

    SPANX!

  • MissSBB

    The fat on my body has migrated from my arms, thighs and face to my torso. I weigh exactly the same weight as I did two years ago, but it’s just in a different place now. If I try to drop any weight, it comes right off of my face, which is gaunt-looking enough already, and my thighs, which are looking like toothpicks. I’m probably the only woman in America who wishes her thighs were two inches fatter. (yeah, I know no one’s going to throw me a pity party any time soon) I’m at my wits end and can’t believe there is no solution other than some kind of fat removal procedure.

  • hananghaddar

    Thank you for this beautiful article, it helps a lot.

  • colenMD

    I am a plastic surgeon (myself over 60 yrs old) and stumbled upon this site. For your information In my office I have a laser called the Zeltiq which melts abdominal fat in one hour treatment by 25%. Four treatments 3 mo apart and all is gone. No scars, no side effects, no pain and lots of gain. Check it out. My website is http://www.colenmd.com and my face book link ishttp://www.facebook.com/pages/Colen-MD-Plastic-Surgery-Suite/139406812795604. if you click to like it all blogs and info is there as well. I am glad to provide this information

  • The Most Selfish Woman in America

    Ladies – face it! The sooner we accept this fact, the sooner we can get on with enjoying our lives. Being healthy is far more important that being skinny! And we’ve just been told that we would have to obsess on our intake and exercise, and still not conquer the problem totally. So relax, eat healthy, be the best you can be, and accept our new phase of life.
    If we are constantly obsessing about our bodies not being good enough, then we are constantly telling ourselves that we are not good enough, and that’s just wrong!
    Choose to be happy. Accept each phase of life with grace and balance. Enjoy every moment. You deserve it!
    Christia Sale
    Women’s Life-After-Divorce Expert
    http://www.themostselfishwomaninamerica.com

  • EuniceC

    I was thinking that there was something wrong with me but now, I realize I’m just like everyone else at this age! Life for me at age 70 is really going to be great since I’ve been at a BMI of 28 and 29 my whole life, lol. Very helpful info, thanks.

  • 1wicket46

    Spanx and spandex! You might as well get stock in both…they will never go away because there will always be woman with bigger bellies! :-)

  • tovismom

    Have heard this works but…. When money is an issue then this is not the option or the answer. Thanks anyway.

  • dwjenpsych

    Useful information – confirmation that there is no easy way – deprivation and hard exercise versus acceptance. I hate the fat stomach which seems to grow daily but hate to diet more and my commitment to exercise is off and on – more off.