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An_247680 posted:
I have been dieting and exercising for the last 30 years after losing 40 pounds. I'm not overweight. I've kept my weight off after I lost it years ago. My BMI is 24 and my doctor does not think I am over weight.

However I have such belly fat and no matter what I do, I cannot lose it. As I have said, I diet and exercise. What is wrong with me? It's not my thyroid. I've had that checked. I eat healthier than any one that I know. My friends think I am finicky because they don't think I'm over weight. I'm not. I just want to lose the dangerous belly fat. What more can I do?

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Pamela Peeke, MD, MPH, FACP responded:
HI and thanks so much for your posting. Belly fat was my main research interest at my NIH lab. My findings led me to write after Fight Fat after Forty, as well as Body for Life for Women. In both books, i describe where extra belly weight comes from after the age of 35-40 in both men as well as women.

Let me clarify some points for you.

There are two kinds of belly fat. There is a layer of fat that lays on top of the AB muscle. This is the "pinch an inch" fat that you can actually grab. This is not associated with medical disease unless you have an enormous amount. As women and men age, they will pick up around 5 pounds extra due to downward shifts in sex hormones--- estrogen in women, testosterone in men. This is typical in the aging process.

The second kind of belly fat is found deep inside the belly. Everyone has some fat inside their abdominal cavity below the AB muscle to maintain core body temperature and to provide a backup source of fuel. The problem is having too much of this--- that's what leads to medical conditions like diabetes, heart disease and cancer. In the two books i mentioned above, i show you how to measure this. lay down on your back and look at your belly. if you see that it's pretty flat from pelvic bone to pelvic bone and there is no hump there (like a pregnancy), then you have mostly the benign kind of fat. If you see a hump that's too much fat in there and then you have dangerous fat.

Measure your waist size across your belly button. It needs to be less than 35 inches for a woman, less than 40 inches for a man.

I'll wager you have mostly the benign fat. I have a name for that in my books--- the MENOPOT (MANOPOT for men) If so, what can you do to minimize your MENOPOT?

Two things:

1) Increase the intensity and frequency of your cardio and your weight lifting. As you age, you need to carefully bump it up with high intensity inter al training. look at my blog archives and you'll see my descriptions of this, as well as my books.

2) Watch your portions--- as you age you actually need less food, just smarter and more high quality food, whether you are a man or woman. Watch your eating times--- eat dinner earlier and make it lighter. Watch out for alcohol--- if you're adding that to meals frequently, you pack on the pounds.

Try these ideas and let me know how it goes.

Good luck

Dr. Peeke


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