We're Eating Too Much

Look around you and you'll see that America's putting on weight. Is it lack of physical activity or are we just plain eating too much? Well, it's a combination of both, but the European Congress on Obesity has proclaimed that increased food intake is the main culprit. You need to stay physically active to be fit and strong, keep body fat reined in, and have an optimal body shape.
But it's how much you're eating (healthy or junk food), that's really packin' on the pounds.

Actually, the scientists predicted that Americans would be about 24 pounds heavier than thirty years ago. But, instead, on average Americans carry an extra 19 pounds. The difference is that some people have picked up more physical activity which makes a real difference over time. Interestingly, if we want to get back to the slimmer weights of the 1970's, researchers recommend decreasing 350 calories per day for kids (a serving of French fries) and 500 calories for adults (a large burger). How do we accomplish this? If we used physical activity alone, children would have to walk 150 minutes per day and adults 110 minutes. Who's got that kind of time? Instead, how about just eliminating the fries and burger and bumping up the physical activity a little as well? The bottom line is that you need both.

Here's a recent posting from LadyPilot1998 on my weight management message board:

"Hi, I need some real HELP! I need to lose weight in order to keep my joints from hurting. I just have not been able to get this going and the several times I have got going... I just poop out. I live in hot, humid South Florida and need exercises that someone with limited range of motion can do inside. Frustration with myself is building and I am now at a real loss as to what to do. I would love to get any advice that could get me on the road to success. Thanks."

The road to success is paved with both healthy nutrition and physical activity. The key is not to launch into heavy duty running or lifting, especially if you have disabilities and perhaps have been sedentary for a long time. You'll get injured and, as LadyPilot noted, "poop out". When people want to drop weight, for many it's suddenly a crisis, and out of desperation, folks try to go too far too fast. There are better options.

For those with physical disabilities, there's nothing like water aerobics as well as strength training. The water carries your weight and your joints are protected so that you can engage in water based exercise classes. Good grief, there has to be a pool somewhere in LadyPilot's Florida locale. In addition, restorative yoga is wonderful. This movement therapy helps to build strength and flexibility. Walking to tolerance is a great exercise. The elliptical is kind to knees, while a recumbent bike is great for those with back issues. Tai Chi is a weight bearing movement that is gentle on the joints yet helps you with balance and flexibility. There are indeed many options. You also have to be realistic. If you cannot do intense training, it will take you longer to achieve your fitness goals. Time to take your patience pill.

The key to relieving those joints and getting into better shape is smart eating. Pay attention to quality- stick with whole foods, veggies, fruits, whole grains, lean proteins. Eliminate processed foods and refined sugars. Next up, be mindful of quantity. Even if you're eating whole foods, eating mountains of them still packs on pounds. While to remove excess fat, most women do well sticking to about 1300-1500 calories a day. Read labels carefully and stick to serving sizes. And last up, frequency of meals and snacks is critical. Eating roughly every 3-4 hours from breakfast through dinner is the way to go. If you eat appropriate servings of balanced meals and snacks (lean proteins with high quality fat and carbohydrates), your hunger is better controlled, which helps you rein in your appetite as well.

LadyPilot and everyone out there needs to whip out a journal and keep track of what, when and how much you eat for just a week. It's usually an eye opener to see how much you're actually consuming. Clean it up and add creative ways to move your body and you've got the winning combination to get this weight removal journey going.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

Blast Your Back Fat: Part Two

Two weeks ago I wrote the Blast Your Back Fat blog post and heard back from lots of you. Many of you wanted to know more about the role of exercise in getting rid of your fat. For instance, does spot reducing work? In my original post, I made it clear that in order to drop those love handles, you needed to activate my three M's: Mind (get that stress under control so you don't stress overeat), Mouth (rein in the calories and eat smaller meals of high quality foods more frequently throughout the day), and Muscle (combine intensity intervals of cardio along with weight training, and don't forget cross training). It takes an integrative approach to minimize fat anywhere on your body.

So, do spot reducing exercises work? No, they don't. It's hard not to look at one part of your body that's stubbornly holding onto extra fat, and not to want to hammer on it endlessly. But that doesn't work. Spot reduction is a myth. You can't work a specific muscle group and hope to drop the fat around it. You'll strengthen the muscle, but the exercises will result in removing fat throughout the body. Look around the gym at guys and gals crunching away on ab balls, but they never seem to drop weight there. Well, it's because they're probably going home and overeating. The great news is that underneath their belly fat, their abs are strong. You just can't see them. As the abs go, so goes the back.

Are there any exercises you can do to tone and shape your back muscles so that as you adhere to a better nutritional program and remove fat, you can look more firm and fit? There sure are. Here are a few of my favorites. You can look in my book Body for Life for Women for specifics for many of these, which you can do at home as well as the gym. For instance, I use tubing (inexpensive and you can buy at any sports goods store) for home and travel workouts. Give them a whirl while also remembering to do your cardio no less than 5 x week, trying to burn 400 caloriess (you can accrue over the day), and using intervals of intensity (see my blog post on Vitamin I - Intensity).

1. Seated Rows:
   
   Gym machine: Sitting on the apparatus with back straight and holding a handle from the cable in each hand. Slowly bend forward keeping the back straight and let the weight of the cable pull you forward, and then draw back to a straight back sitting position. It's like using both hands to row a boat.
   
   Home: Or, take your tubing and wrap it around the leg of a table, bed or heavy sturdy object. Sit on the floor far enough away from the leg so that there is plenty of tension on the tubing, and grab one handle in each hand. Again, with a straight back, allow the tension to pull you forward and then pull back to a full upright sitting position. You should feel a stretch throughout your back. 10-12 reps in 3 sets.


2. One-Arm Rows:
   
   Gym: using a workout bench, place one hand on the bench and the other hand is holding a moderately heavy (you should feel fatigue around the 8-10th rep) hand weight, letting the arm hang straight down. Bend forward at your hips, suck in your stomach, while your back and head are parallel to the floor. Now, retracting your shoulder blade, bend your elbow and pull the weight up until you feel your hand touch your body midway between your breast and pelvic bone. Hold, and then slowly lower your arm down. Repeat 10-12 times, then switch sides. Do this for three sets.
   
   Home: If you don't have a bench, you can do all of this simply using a sturdy chair, whereby you put your free hand on the seat of the chair for stability. It helps to have a mirror so that you can watch alignment.


3. Rear Delt Fly:
   
   Home or gym: Sitting on the edge of a chair or bench, grab a lighter weight in each hand and position hand behind each leg. Now, lean forward from the hips with your back flat. Tuck your chin into your chest. Raise your arms to the sides, gradually bending your elbows as they come up. Squeeze your shoulder blades together. Pause at the top of the extension and then slowly lower your arms. In my book I call this the Prone Fly, which can be done lying on your stomach on a bench with arms hanging to each side. Gym: Many gyms have a rear delt machine that's easy to use.


4. Opposite Arm and Leg Rises:
   
   Home or gym:Lie flat on your stomach with your arms extended over your head and your legs straight. Either rest your forehead on the floor or turn your head to one side. Slowly and simultaneously raise your right arm and left leg until it's difficult to keep your pelvis and chest flat on the floor. Lower and repeat with the opposite arm and leg combination. Don't twist or rock your body to make this easier. Stop if you feel pain.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

Shake Up Your Fat Cells at Any Age with "Vitamin I"

I just returned from Arizona where I led a women's health and fitness retreat. Most of the participants were frustrated and wanted to know why, despite regular exercise and healthy nutrition; they weren't seeing their body fat change. After observing them work out, I concluded that they were "Vitamin I" deficient. What does that mean? I made it up when I wrote Body for Life for Women. Vitamin I is intensity. Without using intervals of intensity on a regular basis, those feminine fat cells won't give up that fat fuel and let you slip into a smaller pair of jeans.

Intensity:

1. Helps you burn calories more efficiently during and after your workout;


2. Increases the fun of exercise while cutting the boredom of endless hours on workout equipment at the same slower pace;


3. Increases your aerobic capacity and endurance while promoting fat loss;


4. Reshapes your body, redistributing fat and toning muscle for the fittest look;


5. Results in more fat loss in a shorter workout time than women who maintained the same moderate exercise level;


6. Applies to both cardio as well as weight training.

Research has shown that women who train with intensity look like it. They've got more toned muscle and less fat, resulting in a leaner, fit-looking body. Intensity also helps override the powerful innate programming in a woman's body to store fat that is so specific to a woman's body. Adrenalin and growth hormone help to stimulate fat release. As women age, fat cell breakdown is more of a challenge. Intervals of intensity will get the fat release ball rolling.

Here's what you need to know to start to incorporate intensity intervals into your training. First, here are the precautions:

1. Anyone who is over the age of 40 and/or has any medical condition that may be affected by intensity (e.g. heart, lung, muscle/joint injury, etc) must first clear any such training through their physician. Moderate levels of exercise are perfectly fine and yield terrific results for health and wellness. Sometimes higher levels of intensity simply cannot be used.


2. It is absolutely imperative and required that everyone who engages in interval training must first warm up at a low and then moderate intensity for no less than 10 minutes prior to starting an intensity interval.


3. For people who are presently unfit (e.g. not regular exercisers and/or overweight or obese), it is essential that you begin very gradually. This means you engage in low and moderate levels of intensity for no less than 6-8 weeks prior to initiating intensity intervals. A fitness professional will help get you started.


4. Intensity intervals in weight lifting must be initially supervised by a fitness professional. I will not address high intensity weight training techniques as this should always be created and guided by a professional.


5. The elliptical trainer and stationary bike are the safest ways to practice intensity intervals. The treadmill requires more pounding and stress on weight bearing joints and the back, but is fine is the individual is already trained and comfortable with brisk walking and running.

Actual high intensity interval training used by athletes is pretty grueling. It involves first the warm up, then going all out at 100% of effort for 30 seconds, then resting at a low level of intensity for 4 minutes, repeating this cycle 4-8 times. I do my own adaptation of this which involves a much more gradual increase in intensity suited for beginners and non-athletes.

1. Do a 10 minute warm up gradually moving from a baseline of lower intensity to moderate intensity;


2. For the first interval, increase the intensity one level up by increasing the speed, resistance, or incline for 30-60 seconds;


3. Bring down to your baseline moderate level of intensity for 3 minutes;


4. Repeat the intensity interval and rest period again;


5. If you feel that the increase of one level up doesn't feel hard enough to cause you to sweat, increase one more level up (now you're up 2 levels of intensity);


6. Repeat this 3:1 interval cycle just twice for starters. Add another cycle every week or so until you're comfortable with between 4-8 cycles.

You need to do cardio no less than five times per week. Try the interval training once per week as a start, working up to doing it three to four times per week. You may notice that over time, your baseline warm up levels may increase and your intensity levels will be higher. That means you're achieving the training effect and improving strength and endurance. Take body size measurements before you begin your intensity interval training and watch the reshaping and toning take place. Get your body fat percentage measured and pay attention to that number, not just your weight. We're talking about changing the quality of your body, not just the quantity.

Start today and reap the rewards of shaking up your fat cells with Vitamin I.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

Why Fat Doesn't Disappear Where You Want It To

Go figure. You're working diligently to achieve a healthier weight, and the fat you want to keep (e.g. your breasts) is the first to disappear, and the fat you want to shed (fill in body part here: stomach, thigh, butt, arm, chest, back) is the hardest to remove. From a recent posting on my weight management message board, dmarchi says,

"Hi, I'm 23 and for the past year I have been dieting and exercising on a regular basis. I try to work out 3-4 times a week. This includes spin classes, running, and step classes. I try to keep my calories at or below 1500 calories a day. I do not count carbs, but I am thinking I might have to. I have lost about 25lbs so far. The problem is I haven't dropped a pant size! It seems like the weight I have lost has come off of places other than my stomach and hips. This is the area I am really wanting to lose weight from. I don't know what to do anymore, I am becoming discouraged and on top of it, I have hit a plateau. Does anyone have any recommendations on how or what I can try doing to improve my weight loss around the stomach and hip area? I would love to lose at least 10 more pounds. I am not sure if I need to change my diet or exercise. Thanks!"

Sound familiar? Let's demystify what goes on with your body fat when you're dropping that excess fat. Here are some rules of the "where the fat's going" road:

1. Genetics. Look at the other people in your family. Your body shape will often appear similar to someone in your family line. Sometimes the similarities are striking - - apple or pear shaped with nuances involving short/long legs, tiny waist or no waist line at all. J Lo can try all she wants to drop weight, but she will always have that famous behind. The same applies to Beyonce's behind and thighs. Your job is to optimize your body shape as best you can, and then live with what genetics endowed.


2. Age and Gender. Throughout their life, men tend to store fat in the abdominal area and they'll note that any excess body fat in their extremities will shed first and the belly is last to go. Most women (there are exceptions) tend to store most of their fat in the hips, thighs and buttocks prior to age 40. Weight reduction classically decreases waist and breasts first, followed by the lower half of the body. After 40, due to declining levels of sex hormones, it is easier to store fat in the belly area as well. In addition, other hard to reduce fat deposits appear in the back, upper abdomen under the breasts, as well as arm pit areas. Weight reduction after 40 often results in removal of fat in the breasts and lower part of the body, followed by the waist and the back - - the exact opposite of the pre-40 years. Again, there's wide variation and we're talking about general patterns.


3. Medical Conditions. Things happen in people's lives. Pregnancy is one example. Many women develop the postpartum "jelly belly" which can be a challenge to manage. The more pregnancies, the tougher it is to shed all of subcutaneous fat that has accumulated. Again, the goal is to minimize this fat, as it's impossible to completely eliminate it in most cases. Polycystic ovarian syndrome (PCOS) can give rise to an increase in belly fat at any age in women. Treatment of the syndrome can help manage this problem. The long term use of prednisone related medications make it difficult to remove abdominal fat. These are a few examples of conditions and medications that can complicate the weight management experience.


4. Plastic Surgery. Many people have gone under the knife and had liposuction, body sculpting and abdominal skin tightening. If weight is gained after liposuction, you may note that fat accumulates in other locations not touched by the procedure and sometimes these regions (back) can be tough to reduce. That's fair warning for those who are considering lipo. If you do it, stick with the program and don't gain weight.


5. Lifestyle Program. A balance of good nutrition and physical activity are the foundation upon which all healthy weight management is based. Cardio and weight training are essential to minimize fat and optimize body shape and muscular tone.

Let's look at dmarchi's comments. She's young and has done a great job removing 25 pounds of fat using a balance of exercise and good nutrition. She's dropped the weight in other places and is frustrated with her hips and stomach. She's also complaining about the plateau in her weight. I'd recommend getting a body composition analysis and finding out what her current body fat percentage is. She's looking to be somewhere between 20-25%, unless she's very athletic. She needs to look at her own genetic pool and she'll probably find that women in her family line have relatively speaking heavier hips and thicker waistlines. Her goal is to optimize her body composition and see where she settles.

To shake things up, I'd recommend introducing more cross training and lots of intensity intervals. She should change up cardio routines every six weeks. I notice she said nothing about weight training. Of all the thing she could do to reshape her body, lifting weight 2-3 times per week will enhance muscularity and minimize body fat.

And finally, she needs to take a patience pill. If indeed she really needs to drop that "last 10 pounds", it's always the slowest to go. Consistency in lifestyle habits is key. When each of us reaches a point where we have done all we can reasonably do to optimize our lifestyle, we'll smile and simply learn to be proud and content with our marvelous, amazing and fit bodies.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

Diet Program Dilemmas

Let's just say you've been thinking about shedding your extra pounds. Then, one day you decide to finally take action. But, suddenly you're confronted with the dilemma of which way to turn. You do a little homework, whip through some magazines, watch TV commercials and call a few friends. Somehow you make your decision and then wonder if you did the right thing. Read what Detwaa sent me on my weight management board recently:

"I just signed up for a weight loss program where you have to follow a routine diet, drink and eat certain foods they offer, exercise, and check in several times per week to see progress. Is that something you'd advice, is it effective? The shakes are incredibly expensive and I'm supposedly required to have them in order to lose 60 pounds in 15 weeks. Did I make a big mistake? Was this something I could have done simply on my own? I have an option to buy the shakes one at a time as I go, or buy them all at once for a discounted price, and I just want to know if I can still lose weight if I don't drink them. This is a healthy low fat, hight protein, calorie restrictive diet."

I'll bet a few folks out there can relate to her angst. The good news is that there is a terrific book written by the Institute of Medicine called Weighing the Options: Criteria for Evaluating Weight Management Programs. The book is unbiased and written by academic experts who prioritize the consumer's health and welfare above any commercial interests. I'd highly recommend this to anyone considering a program. Meanwhile, here are a few helpful tips.

Beware programs that:

1. Promise you the moon. Watch out for programs that guarantee big weight reductions in a short period of time. Most people can safely remove up to 2 pounds per week on a healthy weight management program. Detwaa's program is promising to deliver double that number.


2. Cost you an arm and a leg. I'm not happy when I read "incredibly expensive shakes". Heck, you can buy cheap whey protein powder, add water or skim milk and perhaps fresh or frozen fruit and make your own for pennies. Commercial programs make their money by selling products (e.g. shakes, meals, supplements). Watch out for programs that require you to purchase these products.


3. Are run by people with questionable backgrounds. How long as the organization been around? Always ask many questions about who owns and runs a program. What certifications and qualifications in the field of weight management do these people have? What are the staff qualifications? What is included in your initial assessment? It should be comprehensive and ideally this group would be teaming with your own doctor to achieve optimal results. Did your doctor refer you to this program? What about success rates, and comments and references from other clients? Programs should be supervised by physicians and medical professionals who can answer questions related to each person's unique medical status, as that would change over time with appropriate weight reduction. Also be on red alert for programs offering pills, potions and injections for weight reduction. You absolutely must be fully informed about the professionals and staff involved as well as study thoroughly any materials related to these services and products. Programs operated by hospitals, medical centers, researchers and academics in the field (e.g. University of Colorado's "Colorado Weigh Program") can usually be counted on to deliver the most updated, credible and comprehensive programs.


4. Stress weight loss and not maintenance. The best programs have a strong emphasis on both phases, and provide an excellent maintenance element. Watch out for programs that spend 90 percent of their efforts on shedding weight, and offer only a cursory coverage of any long term maintenance.

The best program for weight reduction involves an interplay between my favorite three elements: Mind, Mouth and Muscle.

1. Mind: Research has clearly shown that when you have a strong mental health component, you'll achieve your best program success. That means there should be a qualified counselor for ongoing help and guidance in person, on the phone and/or through email communications. People need coaching and encouragement as well as answers to ongoing questions involving how to navigate life's stresses while also maintaining an optimal nutrition and exercise program. These experts help people learn behavior skills that will assure not just weight reduction, but maintenance for life.


2. Mouth: It's necessary to have qualified registered dietitians to supervise any program and to customize plans for people's unique needs. In the best of worlds, you're eating whole foods, an appropriate number of calories in balanced meals and snacks, as well as a minimum of commercial (and especially processed) products.


3. Muscle: All programs need to have a reasonable and appropriate physical activity component. It should be based upon established standards like those of the American College of Sports Medicine. Many offer a network of health club facilities as well as fitness professionals who will help guide you as you become more physically active.

So, for Detwaa and other men and women seeking weight management program advice, get serious and do a thorough job of studying your options. Your reward will be a safe and credible path towards sustainable weight reduction and a lifetime of optimal wellness.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

It's Not Just About the Scale

Lee Carson /
CC BY-SA 2.0

While filming the National Body Challenge series for Discovery Health TV, I recall the humorous antics that occurred while I was being taped weighing each of the show's participants. The scale I used was actually a body composition analyzer. In addition to body fat and muscle mass, it also showed overall weight. That was enough to strike fear in the hearts of the women, but not the men. Fully clothed, guys would merrily hop up on the equipment, chuckle at the numbers (which weren't pretty), and high five each other laughing about who had the highest body fat.

By contrast, the women would start to peel every bit of clothing they could get away with on a family rated show, tossing off sweat shirts, rings, watches, bracelets and even earrings, before tentatively stepping on the analyzer. Several pleaded with us for a moment to hit the women's room and empty that bladder. Once on the apparatus, some women would squeeze their eyes shut and not look, a few just looked straight ahead never peering down to check out the numbers, and one even stepped on backwards to avoid looking at anything. No doubt about it. This is Scale Scare at its worst. Many people have lived a life of fearing the number that could mean the difference between having a great day, or the moody blues.

I'd like to help you by setting the record straight. Scale weight alone tells you nothing about what's really happening in your body or your health. Instead, you need to pay attention to other factors: body composition, Body Mass Index (BMI) and waistline measurement.

Scale weight is made up of the interplay between your basic body composition elements (bone, muscle, fat). Since bone doesn't change dramatically in the short term, your weight is all about the relationship between muscle and fat. The more muscle you have and the less fat, the smaller your size.Body composition is about not just the quantity but quality of your body. Also, don't confuse body fat with Body Mass Index (BMI). Your BMI is your weight divided by your height in meter squared and is a number that is used by doctors to assess your risk for medical conditions like heart disease and diabetes.

Also, don't forget your waistline! It's not just how fat you are, it's where the fat is at. If you have too much fat inside your abdomen, you're at high risk for disease. Measure your girth crossing your belly button. Guys need to keep that number below 40 inches, and women below 35 inches.

So you have four main numbers to keep in mind:

• Scale Weight = Bone + Muscle + Fat


• Body Mass Index = Weight/Height m2


• Body Fat Percentage = Total Fat/Total Weight x 100


• Waist size = tape measurement across belly button

Here's a great recent posting from Saginovi30 on my weight management board that makes the point about body composition:

"I'm 5'8", wear a size 4 jeans, but I weigh 145 lbs. Usually women my height and pants size weigh 120 or less. I exercise regularly, but I don't understand why on the outside I look 120 pounds, but in reality, I weigh 25 pounds more. Is it true that muscle weighs more than fat?"

My answer to her is that I can have five women who are all the same age, height and weight, and I will show you five different dress sizes, from a 4 to a 12. That's because the total amount of fat you carry on your body will determine your dress size. Fat occupies more space than muscle. When you're trying to zip up those jeans, that ain't muscle getting in the way! In this woman's case, there is no doubt that she has a low body fat (below 20%) and a higher muscle mass. This is the result of genetics and exercise.

The bottom line is please toss your scale and go out and get a body fat analyzer. They range from simple, inexpensive models that will provide just your weight and body fat percentage, to fancier scales that will show you how many pounds of muscle and fat you carry. To achieve your optimal body composition, it is absolutely necessary to do regular physical activity. If you simply starve yourself all the time to achieve some mythical scale weight, your muscle mass will fall and you'll actually end up with a higher body fat percentage. Instead, your goal is to maximize your muscle and minimize your body fat.

Here are some guidelines for average (non elite athletes or naturally thin people) height men and women:

1. Average adult men need to keep their body fat percentage between 18-25% for their lifetime.


2. Average women should aim to keep their body fat percentage about 20-25% until age 45-50, when the range can increase to 28%, and after the age of 65, up to 32% due to the age related decline in muscle mass after the seventh decade of life.


3. Aim for a BMI below 25.


4. Waist measurements should be less than 40 inches for men, and less than 35 inches for women.

I hope by now you see that scale weight alone is just one element of a more complex picture of your body and overall health.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

Blast Your Back Fat

Back fat, muffin top, love handles, fat roll or spare tire - call it what you want, but it all adds up to that rather not-so-lovely vision of extra rolls of fat popping up all over your back, from your bra line to your belt line. It's the kind of fat that makes you rethink buying a skimpy top where the whole world can revel in your rolls. Have a look in the mirror at your back while wearing a form fitting blouse or sweater. There's that back fat poking out along your bra strap lines. And how about the rolls at your armpits, and the back fat shelf line above your waist? Not a pretty picture. And, as opposed to the menopot which is seen primarily after age 40 (see my blog post "Minimize Your Menopot"), back fat can occur at any age in men and women, but is worse after the age of 40. So where does it come from?

Back fat is an accumulation of excess fat that occurs due to one or any combination of factors including:

1. Being overweight or obese at any age (over eating and lack of physical activity);


2. Genetics in which even some slender people tend to distribute more of their fat to the back area;


3. Ethnicity plays a roll (pun intended) in which some groups tend to pack on back fat more than others;


4. Lack of weight training to bring down body fat and increase muscle tone;


5. Being over the age of 40 in which the decline of sex hormones affects distribution of fat throughout the body.

So what can you do about Back Fat? Plenty. Here are the "Rules of the Roll" to blast your back fat:

1. Make an Action Plan. Sit down and write out your goals. Take measurements throughout your body so you know where you're starting. Take pictures for the visual impact. Create realistic goals and expectations (dropping ½-2 pounds per week is the normal range). The heavier you are to start, the more excess fat you'll be removing. Write down your commitment to change. Journal your progress. Develop a support system to help guide you - like our wonderful weight management board on WebMD.


2. Be patient. Back fat is often one of those stubborn places that sometimes takes longer to reduce. Be persistent.


3. Get real. If you're over the age of 40, you may not be able to completely eliminate all of your back fat, but, like the menopot, your mission is to minimize back fat.


4. Hide it while you remove it. Let's not invite trouble in the form of super tight spandex tops. While you're shedding pounds and getting more fit, try to wear looser, comfortable clothes and toss the muffin topping skinny jeans. There are also great elasticized undergarments that help smooth out the rolls.


5. You must do both weight training and cardio to blast back fat. Don't think you can do this with cardio alone. You'll drop some weight, but you need to reshape and redistribute fat and only a combination of weight training and cardio will do that. Lift 2-3 x week and concentrate on building strength and perhaps boosting your muscle mass a bit. Check out my MUSCLE section in Body for Life for Women for easy ways to do this at home gym-free. Check out the WebMD fitness sites for creative ways to strengthen and tone.


6. Eat a back fat blasting diet. Physical activity is key, and equally so is what you put in your mouth. There is no one food or beverage that will magically remove Back Fat. Instead it's all about eating a variety of healthy foods every day. Quality: whole foods and lean proteins build the foundation for removing Back Fat. Quantity: watch your portion size. Almost everyone out there is eating too much relative to their age and gender. If you eat too much, you wear it. Read the USDA label and know what a serving size looks like. Frequency: eat every 3-4 hours from breakfast through dinner. Stop eating 2 hours before going to bed. Try to eat your dinner no later than 8-8:30 PM, and keep it lean (veggies, lean protein). Wake up in the morning feeling truly hungry. Check out my MOUTH section in Body for Life for Women for healthy, easy nutrition options. Scroll onto WebMD's wonderful nutrition sites for endless suggestions and recipes.


7. Get creative and cross train. No one specific exercise is the ultimate back fat cure. You need to draw from a variety of back strengthening and toning modalities. Mix and change it up every 6 weeks to keep it fresh and challenging. Have some fun and get adventuresome. Take up belly dancing, hip hop or twirl around a ballroom. Ballet is a terrific way to pinpoint back flexibility and strength. Don't forget martial arts, yoga and Pilates. Each uniquely singles out the back for a fat blaster workout.


8. Enjoy a win - win. The stronger the back the stronger the abs, and vice versa. You're working the core of the body and what you do for one, helps the other.

Back fat is a fact of life. Don't waste another moment fretting about it. Take action. And remember, here at WebMD, we've got your back!

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!