Without a doubt, abdominal (belly) fat is the focus of much of our negative emotion as we get older. Studies have shown that estrogen plays a major role in body fat distribution, hence why women experience a much greater change in visceral fat with age particularly after menopause (400% vs 200% in men between the ages of 30 and 70).
Multiple studies, including this one published in the Journal of Menopausal Medicine, have also found that estrogen replacement therapy (ERT) can reduce some of this weight gain. However, estrogen replacement is not without its risks and is unsuitable for many.
Namely, ERT can increase the risk of blood clots leading to strokes and embolisms and cause headaches, swelling, or edema. ERT is also often linked to an increased risk of breast and ovarian cancer, but studies reviewed by Breastcancer.org have shown that the risk is only significant after using ERT 10 years or more (in the case of estrogen-only therapy). Combination HRT poses a much greater risk.
As such, ERT is certainly not a ‘silver bullet’ for treating menopause-related abdominal weight gain.
Three Reliable Strategies For Reducing Abdominal Fat
The good news is that it’s possible for virtually anyone to reduce abdominal fat. The bad news is, there’s no real shortcuts and you can’t cheat your way to a trim waist!
For most people, it comes down to those two worrisome words: diet and exercise.
Does Spot Reduction for Abdominal Fat Work?
But wait, is there an easier way? It might seem logical to start an intense abdominal workout regime to tackle excess belly fat. This is known as spot reduction.
The concept of spot reduction is not new, but studies including this one published in the Journal of Strength and Conditioning Research generally show that spot training is ineffective. In fact, the concept of spot training has been almost entirely debunked.
Moreover, spot training doesn’t rate as a great use of exercise time either – you’re likely better off spending that time on other types of holistic core or full body workouts.
However, this isn’t to rule out the benefit of strength and conditioning training with a focus on the abdomen and core, as strengthening this part of the body will boost your metabolism and help you fight age-related weight gain. The studies just show that you can’t ‘target’ one part of the body with one specific exercise.
Strategy 1: Core Exercises Without the Sit-ups
Spot training doesn’t work in the way many imagine it to work, but core training is an excellent way to lose weight in general. Core training will strengthen the abdominal muscles, which will increase muscle tone in the area and also help deal with over-stretched skin.
In recent years, sit-ups have fallen out of favor as they put immense strain on the back. Harvard Health suggests that they would be replaced with planking, which is excellent for the core and easier on the back.
Mountain climbers and burpees are also great alternatives to sit-ups and both can be modified to reduce joint strain and impact.
Exercise the core and legs to support muscle mass and increase metabolism.
Core exercises also build stability and balance, which become increasingly important with age.
Skip the crunches and sit-ups in favor of mountain climbers, burpees, and planks.
Strategy 2: HIIT For Cardio
High-intensity interval training (HIIT) is a recurring theme in any article aimed at helping people lose abdominal fat. In a nutshell, HIIT involves short bursts of intense exercise followed by rest periods, with the average session lasting around 15 minutes at the most.
HIIT burns calories quicker and more efficiently than steady-state cardio (e.g. a treadmill). It’s also easier to slot into your day and you can spend the rest of your workout time on strength training.
Those who aren’t used to intense exercise should seek advice before starting a HIIT training regime, though studies have shown that even lower intensity sessions are excellent for burning calories and improving cardiovascular health.
High-intensity interval training is a quick and efficient way to burn calories.
Almost any exercise can be used in a HIIT training regime, so you can pick your favorite one.
For seniors, HIIT is still generally safe and the benefits are proven even when the intensity is reduced to what one can handle.
Strategy 3: Make Long-Term Dietary Changes
You may often hear that diet is more important than exercise when it comes to losing weight, and this is generally true. As the old adage goes; “you are what you eat”!
In our previous article, we explored how different types of food affect the metabolism (i.e. the thermic effect of food). Protein uses more energy to digest than fat or carbs, so switching to a protein-rich diet that incorporates more raw, unprocessed foods is ideal for burning abdominal fat.
There are various diets proposed for dealing with hormonal changes relating to age or menopause, and perhaps the most promising is the Mediterranean diet. The people of Mediterranean countries in Southern Europe enjoy some of the lowest rates of cardiovascular and heart disease, as well as lower rates of degenerative diseases (like Alzheimer’s), diabetes, and even some cancers.
Harvard Health has created a diet review of the Mediterranean diet here. In essence, it involves consuming less red meat and more fish, more raw foods and healthy fats (e.g. from olive oil), and drinking practically mostly water.
Avocados, seeds, nuts, and oily fish all feature prolifically, as well as heaps of dark leafy greens. Oh, and you can still eat cheese and drink wine in limited quantities (this is a Mediterranean diet, after all!).
Cut processed foods from the diet wherever possible.
Bump up consumption of raw and unprocessed foods (but make sure you don’t overcompensate with high-fat options like nuts).
Don’t forget to avoid sugary drinks. Choose water instead.
Summary: Abdominal Fat and How to Lose It
It’s important to understand that abdominal fat is NOT the same as generalized body fat (subcutaneous fat).
For those with an hourglass body shape and thin waist, this is perhaps good news.
For those suffering from the beer belly or middle-age spread, this is probably not good news! And let’s face it, more people fall into this category.
Abdominal fat is worse than any other fat and a bulging waistline is a cause for action, even if the rest of you is relatively slim. Whilst it can be stubborn, abdominal fat is not unshiftable and with dedication and perseverance, it’s possible to shift even the most problematic fat.
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The mission of the The Thyroid Project is to encourage sharing of information and experience between the public and the medical community about the treatment of hypothyroidism (low thyroid function). For at least the past few decades there is a growing awareness of â€œsomething missingâ€ in the way suffers of hypothyroidism are treated for their disease.
Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
By Gary M. Pepper, M.D. Ozempic, Rybelsus, Trulicity, Wegovy, Saxenda are the central players in the weight loss craze sweeping across the globe. Metabolisim.com has been monitoring this phenomenon from its beginnings in 2008 with its report “Lizard Spit Reduces Blood Sugar and Appetite”, regarding the first drug in this class, Byetta (exenatide). Caught In the middle of the current chaos are the medical experts who treat diabetes and have been prescribing these medications for more than a decade. Here is a brief commentary from one such board certified endocrinologist; “I started treating Type 2 diabetics with GLP-1 agonists more than 10 years ago. In some respects, these medications have revolutionized the treatment of diabetes by lowering blood sugar effectively and promoting weight loss at the same time, a unique combination of benefits. Not everyone benefits from these drugs to the same degree unfortunately, and I have seen lots of patients experience unacceptable side effects from them. Nothing though, has prepared me for what is happening now. Too often, I find myself confronting someone who expects me to prescribe one of these drugs just so they can lose weight. Sadly, one extreme example was someone who, despite battling a life threatening medical condition, was insistent on getting a prescription. At the same time my diabetic patients are scrambling to find a place to buy their medications if they can even afford it. It is disheartening, to say the least, and I dread the negative interactions with some of my patients I now face almost daily.”
Off- Label Use
The FDA is the U.S. government’s department tasked with evaluating and approving drugs for specific medical conditions. When a new medication is approved for treating a medical condition by the FDA the agency will, at the same time, set strict guidelines for exactly which patients may use the newly approved drug. When a medication is used “off-label” it means that these limitations are being overridden by the provider for a potential benefit which outweighs the drugs risks. It is a general misconception that off-label means illegal; it does not. This practice has been going on for ages and more than 20% of prescriptions in the United States are prescribed off-label. A common example is the use of beta-blockers (approved for heart problems) for the treatment of performance anxiety.
GLP-1 agonist drugs, as discussed recently by metabolism.com. were originally approved for the treatment of Type 2 diabetes in adults. In the past few years most of these same medications have gained unprecedented popularity for their “off-label” weight loss benefit. Of the 5 GLP-1 agents presently in U.S. pharmacies only Wegovy (semaglutide) and Saxenda (liraglutide) are FDA approved for treating obesity. Of these two, Wegovy is the newer and had been much more popular that its sister drug Saxenda, probably due to being dosed only once weekly compared to daily for Saxenda and less likely to cause side effects. Due to Wegovy’s soaring popularity, its manufacturer, Novo Nordisk, increased the price of Wegovy two times since its initial release.
by Gary M. Pepper, M.D. and Sam Jeans, MSc The global anti-obesity drug market, in 2021was valued at over $2 billion. Within one year this figure had skyrocketed to $8 billion and is expected to climb to nearly $ 20 billion by 2027. This astounding growth is a reflection of soaring obesity rates, and the arrival of a new class of weight loss medication fueling a craze both in the USA and across the world.
The FDA and global health regulators, until very recently, had maintained a very tight ship when it comes to treating obesity with medication, placing the emphasis on diet and exercise rather than weight loss drugs. Since the 80s, anti-obesity drugs continued to be controversial, and a more stringent FDA implemented ongoing safety trials along with other precautions. There is some speculation that a shift in attitude toward approval of weight loss medication by the FDA , is underway
Weight loss drug controversies are far from over and, in fact, may soon rival the amphetamine crisis of the 70’s. For that reason, metabolism.com has felt it important to provide our guide to weight loss drug issues, past and present.
Anti-Obesity Drugs Timeline
Prescription drugs for lifestyle diseases such as obesity were marketed heavily throughout the 1950s to the 1970s. Amphetamines entered the public domain after the Second World War where they were used extensively in the military.
In the 50s, walk-in clinics prescribed diet pills with other medications almost at random, with or without genuine concern for one’s weight. These brightly colored pills became known as “rainbow pills”.
In the 1960s and 1970s, the so-called “rainbow pill diet” of pills was finally coming to an end as the FDA began to systematically ban many of the drugs involved. A high-profile expose by investigative journalist Susanna Mcbee, published in Life magazine, brought attention to this new modern public health crisis.
The rainbow pill diet combined amphetamines, laxatives, thyroid hormones, and even diuretics to produce extreme weight loss, combined with benzodiazepines, barbiturates, and steroids to reduce side effects, and antidepressants to suppress medication-induced insomnia and anxiety.
In 1968, rainbow pills were linked to over 60 deaths, with numerous accounts of their devastating impact surfacing in the news and media. Within just two months, 48 million pills were seized and destroyed. Nevertheless, amphetamine-based diet pills remained extremely popular throughout the 1970s. In 1978, some 3.3 million prescriptions for amphetamines were written each year, with some 50 million pills a year ending up in the black market.
In 1979, the FDA banned amphetamines as a weight loss aid, but that is hardly the end of the USA’s love affair with obesity medication.
Here’s a brief timeline of recent anti-obesity drugs:
Lack of energy and inability to lose weight are constant challenges for many people and are every day complaints encountered in the doctor’s office. Almost anyone can find some relief from these problems by accessing the healing properties of physical activity. Mentioning to a patient the need for ‘more exercise’ often causes rolling of the eyes, sighing, shrugging, snorting or worse yet, the hundred-yard stare. We all know exercise is important but who has the energy for that? It seems like a vicious cycle. Surprisingly, when done correctly, exercise can improve energy with the additional advantage of promoting weight loss and restoring tone and stamina. It is helpful to remember that the human body was designed for a lot more physical activity and a lot less food than we are privileged to experience in present day life. It therefore takes will power and knowledge to maintain the environment required for optimal health. Here are eight steps to get in the swing of regular exercise. Some suggestions may surprise you.