Midlife & Menopause Moments

Join Dr. Bitner in a lively discussion about midlife changes and menopause.


The Dreaded Belly Fat

by on July 30, 2013 8 Comments

I’ve told all of you about my mantra — lean and ease of movement — in some of my earlier blogs. My plan to help me achieve this mantra is to eat hold the measuring tapesmall, frequent meals of complex carbohydrates and protein, plus one simple carb treat each day. How many of you came up with your own mantra to help you make good decisions every day? I ask that question because I really believe everyone needs a little help to make smart choices, especially during middle age and menopause.

One of the most important reasons to choose what you eat wisely is because of the relationship between middle age, menopause, and belly fat. Even if you have always had a flat stomach, or mostly gained weight below your waist, you may have noticed that has changed as you’ve reached middle age (and beyond). A common complaint I hear from women who visit my practice is that they gain belly fat easily and have a difficult time losing it. Why is belly fat so bad? There are several reasons, including both medical and personal issues, with belly fat:

• Belly fat makes you feel unhealthy.

• Belly fat can change your mood from cheerful to irritable.

• Belly fat greatly increases your risk for heart disease, diabetes, and overall weight gain.

• Belly fat adds more insulation, which can cause hot flashes and night sweats.

In addition, belly fat is extremely powerful because it is inside your abdominal cavity, not just under the skin like fat elsewhere on your body. When fat is so close to your liver, it can cause a condition called “insulin resistance.” This means that your insulin receptors on your cells require more insulin to make the sugar go into your liver, muscle, or brain cells. Thus, as insulin increases to meet this demand, it increasingly makes you crave sugar and promotes fat storage. When you answer the craving and eat sugar, the sugar goes directly to the belly fat and makes it bigger, which then makes your insulin increase even more. You get the picture: The belly fat has a voice that says, “feed me.” That “voice” is insulin, and the only way to shut it up is to starve it of simple sugar.

So, what’s the answer? It’s simple: Get off the sugar. There are simple carbs all around you every day, but you need to figure out how to stay away from them without feeling cheated. I was at a baseball game recently, and you can imagine how many simple carbs were right next to me — blueberry muffins, licorice, white hot dog buns, slushes, and so much more. Here’s what I did before I went to the game: I had a late breakfast of brown rice, poached egg, and mixed greens. Plus, I took a baggy of frozen grapes to munch on during the game. I was completely satisfied and had no craving for that blueberry muffin next to me.

You can’t always avoid simple sugars, but you can make smart choices. Ice cream with the family? Choose a baby cone and throw away the cone (or get the ice cream in a dish). Heading to a party or a baseball game? Eat a healthy meal or snack before you go and take a sweet snack (like frozen grapes) with you to help you avoid the cravings before they start. And, keep repeating your mantra — whatever it may be. If you do not feed the fat, you will take back your power to be healthy.

About the Author ()

Diana Bitner, MD, is board certified in obstetrics and gynecology. She received her medical degree from Wayne State University School of Medicine in Detroit and completed her residency in obstetrics and gynecology at Butterworth Hospital in Grand Rapids, Michigan. Dr. Bitner has special interests in women’s wellness and prevention of heart disease, menopause, perimenopause, laparoscopic and robotic pelvic surgery, and pelvic pain. She is also fluent in Portuguese.

Comments (8)

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  1. Julie Ehlich says:

    Thank you for this blog. I turned 50 this year and I can attest to the belly fat dilemma associated with middle age. I will create my mantra and attempt avoidance of simple carbs. Thank you for all you do for middle-aged women.

  2. Sugar is the bane of so many lives. And so difficult to get out of your system but you are right, it is the best way to reduce belly fat.
    I recently done a post on how to get rid of belly fat and some of the tips like sugar are so basic, you would not believe.

  3. KK says:

    I have changed my eating habits and eat greens, veggies, protein (meat and beans), fresh fruit and some dairy, along with complex carbs…avoiding white processed foods and candy/sweets. (all organic when I can and/or minimal ingredients) Have lost 5# and have noticed it around my waist but need some more. I have a hx of hypertension (controlled) and family history of heart disease.
    My belly fat is outside of the abdominal wall. Annoying and hard to get rid of. Is this the same type of fat that is unhealthy as described above?

    • Diana Bitner, MD says:

      Everyone’s physiology is different, but if you have a family history of heart disease and hypertension, any fat you carry around your middle probably fits the category of fat fed by sugar and is therefore hard to lose. So, great job on changing your diet — keep it up! Sometimes it takes patience to make up for years of less-than-healthy eating habits. I can understand your frustration, so let me share some tricks with you:
      1. Finish all of your carbs by 3:00 p.m.
      2. Make sure you are getting good and adequate sleep.
      3. If you have stress (and who doesn’t), add five minutes of metered breathing to your day.
      4. Start a gratitude journal.

      Sleep deprivation and feeling stressed make losing belly fat almost impossible. If the weight just won’t budge with good effort and doing these suggested tricks, confirm with your doctor that your fasting blood sugar is less than 100 and your lipid profile is in a good range. You want to aim for a waist circumference of 35 inches. If you have pre-diabetes, sometimes medications can be helpful, even if taken for a short time. Good luck!

  4. June Sinkfield says:

    I think part of the problem too is as we get older our skeletons shrink (but obviously we keep the same amount of skin); then gravity pulls skin down causing the skin to settle down around our waist and abdomen. I don’t have stomach fat, but do have a muffin top due gravity pulling the skin. This is why women complain of ‘fat back’ around their bras. It’s not really fat, but skin that is beginning to sag down. what think? Thanks for the interesting article.

  5. Marin Darr says:

    Hi Dr. Bitner! You delivered one of my babies almost 3 years ago! I had a baby in 2011, one in 2012 (I had complete previa and bed rest at Butterworth for weeks) and then a complete hysterectomy in December 2012. I’m struggling big time w belly fat. I run 5 miles a day, 6 days a week (been running for 10 years) eat clean (no fast food, sugar treats, junk), and cannot lose weight to save my life. Ideally I have 15lbs to lose. I wake up w my son 2-3 times a night so am sleep deprived but other than that I’m at a loss. It’s very frustrating. Do you have any suggestions/advice? Should I take vitamins, herbs, lift weights? Those are things I’m not currently doing. Could my body still be healing from the traumas of the past 3 years? Could my metabolism have slowed to a halt?

    • Diana Bitner, MD says:

      Hi, Marin,

      Thanks for writing! So, if I saw you in the office, I would definitely want to know more about your sleep habits. From what you are telling me, your lack of good quality sleep is likely affecting your “insulin resistance,” making it harder for you to lose weight. The fact that you are gaining belly fat at such a young age tells me that you have the tendency to be insulin resistant, and I would want you to be tested for prediabetes with a fasting blood sugar level and HgA1C. If these are normal, it means that by making some small changes, your efforts will likely be effective without medication.

      Here are my suggestions:
       Have your entire carbohydrate intake done by 3 p.m. Dinner will consist of protein and veggies. If you work out at night (like I do), a fruit just before your workout can help you have a more efficient and productive workout, so I think it is worth it.
       Give up a few of your long runs for interval training runs (bursts of fast and slow) and replace another one or two with weight training.
       Read the book titled “Body for Life for Women,” by Pamela Peeke. She really nails it with good explanations, and in the back of the book, she has a lower body workout and an upper body workout. She also details some stretches I recommend for every day, plus abdominal work that I switch on and off, depending on what else I am doing.

      I hope this helps! I know you can do it! Please keep a picture of yourself (how you want to feel and look) in your mind as you encounter barriers or resistance to putting a healthy lifestyle in place. Now is the time to start; it will never get easier (Well, maybe when your kids are all sleeping through the night and sleeping in as well, like mine do now.)

  6. bookmarked!!, I lοve your sіte!

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