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Belly fat in women: How to keep it off

Belly fat hasn't always been your problem — you've worried more about hips and thighs. Now your midsection's making up for lost time. What's up?

By Mayo Clinic staff

Whether it's because of heredity, hormonal changes or aging-related weight gain, many women notice an increase in belly fat as they grow older — and especially after menopause. Gaining fat in your abdomen is particularly unhealthy when compared with other locations in your body. Excess belly fat increases your risk of cardiovascular disease, diabetes and certain types of cancers. The good news is that a few lifestyle changes and some targeted abdominal exercises can help you battle your belly bulge.

When fat gathers in your abdomen

CLICK TO ENLARGE

Illustration showing where belly fat accumulates Belly fat

As you age and your metabolism slows down, the amount of fat in your body slowly increases. Women experience an even greater fat percentage increase than men do. Then after menopause, your body fat distribution tends to shift — less in your arms, legs and hips, and more in your abdomen.

You may think belly fat is limited to the stuff out front that you can grab with your hand — but it's the fat you can't see that's really a cause for concern. Visceral fat lies deeper inside the abdomen, surrounding the abdominal organs. Gaining this type of fat has been linked to cardiovascular disease, diabetes and other health problems. Subcutaneous fat, located between the skin and the abdominal wall, is more visible but also less likely to be a health risk.

While a slowing metabolism and decreased physical activity contribute to overall weight gain as you age, those factors don't influence visceral fat accumulation directly. Heredity may be the culprit — you may simply have inherited a tendency to gain weight in your midsection. Hormones also play a role. Hormonal changes after menopause may change the way that your body breaks down and stores fat, leading to more fat accumulating in your belly.

Some women even experience a widening waist without gaining any weight. Although you may not be gaining extra fat, your abdominal fat is increasing as limb and hip fat decreases. Even in women of a normal weight, too much fat concentrated in the midsection is unhealthy.

The midsection matters

Gaining weight in your abdomen does more harm than simply making your waistband too tight. While putting on weight in general can have negative effects on your health, abdominal weight gain is particularly unhealthy. Too much belly fat increases your risk of:

  • Heart disease
  • Breast cancer
  • Diabetes
  • Metabolic syndrome
  • Gallbladder problems
  • High blood pressure
  • Colorectal cancer

Researchers also have found that abdominal fat cells aren't just dormant energy waiting to be burned up. The cells are active, producing hormones and other substances that can affect your health. For example, some fat-cell-produced hormones can promote insulin resistance, a precursor to type 2 diabetes; others can produce estrogen after menopause, which may increase your breast cancer risk. Researchers are still sorting out how the excess hormones affect overall health, but they do know that too much visceral fat can disrupt the body's normal hormonal balance.

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References
  1. Abdominal fat and what to do about it. Harvard Women's Health Watch. 2006;14:1.
  2. Kontogianni MD, et al. Does body mass index reflect adequately the body fat content in perimenopausal women? Maturitas. 2005;51:307.
  3. Ferrara CM, et al. Differences in adipose tissue metabolism between postmenopausal and perimenopausal women. Journal of Clinical Endocrinology & Metabolism. 2002;87:4166.
  4. Eliassen AH, et al. Adult weight change and risk of postmenopausal breast cancer. Journal of the American Medical Association. 2006;296:193.
  5. Gozansky WS, et al. Mitigating the menopausal middle. Obesity Management. 2007;3:267.
  6. Dubnov-Raz G, et al. Diet and lifestyle in managing postmenopausal obesity. Climateric. 2007;10(suppl):38.
  7. Teixeira PJ, et al. Resistance training in postmenopausal women with and without hormone therapy. Medicine & Science in Sports & Exercise. 2003;35:555.
  8. Green JS, et al. The effects of exercise training on abdominal visceral fat, body composition, and indicators of the metabolic syndrome in postmenopausal women with and without estrogen replacement therapy: The HERITAGE family study. Metabolism. 2004;53:1192.
  9. Chen Z, et al. Postmenopausal hormone therapy and body composition — A substudy of the estrogen plus progestin trial of the Women's Health Initiative. American Journal of Clinical Nutrition. 2005;82:651.

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April 16, 2009

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