Advertisement
Icon WebMD Expert Blogs

Everyday Fitness

with Pamela Peeke, MD, MPH, FACP

Living life to the fullest is all about striving for a mind-body balance every day. Achieve a mental, nutritional, and physical transformation for life with tips from wellness expert Pamela Peeke, MD.

Important:

The opinions expressed in WebMD User-generated content areas like communities, review, ratings, or blogs are solely those of the User, who may or may not have... Expand

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.

Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.

Hide

Tuesday, November 10, 2009

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 indoor cycling 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.  

  3. 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.
  4.  

  5. 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.
  6.  

  7. 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.
  8.  

  9. 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:

Posted by: Pamela Peeke, MD at 5:56 pm

Comments

Leave a comment

Subscribe & Stay Informed

Weight Loss Wisdom

Sign up for the Weight Loss Wisdom newsletter and keep up with all the latest dieting news, exercise and health tips from WebMD.

Archives

WebMD Health News