Belly fat happens especially as our metabolism slows down with age, and it largely has to do with genetics. Another culprit of belly fat? You're not eating a balanced diet and exercising. But two endocrinologists POPSUGAR spoke to, Rocio Salas-Whalen, MD, board-certified endocrinologist at New York Endocrinology, and Jaime Knopman, MD, board-certified reproductive endocrinologist at CCRM Fertility, explained that hormones might also be to blame.
Dr. Salas-Whalen said that hormonal belly fat is commonly associated with visceral fat, which is the fat that attaches to internal organs like your liver and pancreas. Subcutaneous fat, in contrast, is what you can pinch with your fingers. It's the visceral fat that causes worry, she said, because of the health problems that could come with it. For instance, this type of fat could indicate or lead to metabolic syndrome — meaning you have a cluster of metabolic disorders such as obesity, high blood pressure, and high fasting glucose levels — or even diabetes.
Another possibility? Polycystic ovarian syndrome, or PCOS, which affects women of childbearing age, and occurs when they produce too much of the male hormones. This can predispose them to type-2 diabetes due to high blood sugar levels. Of course, hormonal belly fat doesn't always have to indicate these conditions. Women going through menopause or IVF can also accumulate belly fat because of fluctuations in hormones — during menopause specifically, there's a decrease in estrogen. Read more about these potential causes of hormonal belly fat here.
How to Lose Hormonal Belly Fat
You cannot spot-reduce belly fat, or any fat for that matter — we've written about this plenty of times, but it's worth repeating. There are some key things you can do, though, to help improve your health and shed fat overall. We'll get into what you can do for hormonal belly fat if you don't have the underlying conditions these endocrinologists talk about and what to do if you do have them (or think you do).
Without Underlying Conditions: Nutrition, Exercise, Etc.
Dr. Knopman is a fan of weight loss in the healthiest way possible, which involves focusing on nutrition best practices and staying away from fad diets. "Have all of the food groups but in moderation. If that means you have to go sit with a nutritionist and come up with a healthy diet for you, then do that," she said. Check out foods that benefit your metabolism here (also here).
Exercise is important too, Dr. Knopman said. The U.S. Department of Health and Human Services recommends that adults do at least 150 to 300 minutes of moderate-intensity aerobic workouts or 75 to 150 minutes a week of vigorous-intensity aerobic activity per week. HIIT, strength training, and cardio are most effective for targeting fat overall.
Stress, the two endocrinologists agreed, doesn't help because the stress hormone cortisol can also contribute to belly fat. So, you may want to evaluate your lifestyle and see if you need to incorporate practices of self-care and get more sleep (since lack of sleep can increase cortisol production). For more on the basics of fat loss — like eating in a caloric deficit, and staying active outside of the gym — check out this easy-to-follow guide.
With Underlying Conditions: Treatments Vary but Take Notes
Similar guidelines go for people who might have PCOS, metabolic syndrome, and diabetes, because these all have to do with insulin resistance (which you can read about here). "The starches, the white flour, the sugars, all of that is contributing to the belly fat. So by cutting back on that, they're going to lose the weight and improve whatever metabolic problem they have," Dr. Salas-Whalen said, adding that they really do need to monitor intake of simple carbs. Having an exercise routine is strongly recommended as well.
Dr. Salas-Whalen explained that if a doctor evaluated a patient with this type of belly fat and found things like elevated enzymes, cholesterol, and blood pressure, that doctor may suggest either a weight-loss medication — a newer class is GLP-1 analogs, a family of injectables, she said — or a targeted treatment for PCOS or diabetes. One oral medication used for PCOS and diabetes is Metformin.
Dr. Knopman said that birth control is used for PCOS symptoms as well. "If you're having these wide fluctuations in your hormones, the pill's going to even you out," she said. Find more information about diabetes treatment at diabetes.org and more about PCOS treatment on the PCOS Awareness Association website. And please do contact your doctor for further information.
One Last Note About Contacting Your Doctor
Going through menopause is a natural process that occurs when you age. Also occurring with age is a slower metabolism. Fat is going to accumulate on your body as you get older; that's just how it is. But if you're doing everything you can to lose wight — eating healthy, exercising, reducing stress — and you're not seeing results, you may want to contact your doctor, as it may be hormonal belly fat linked to a more serious underlying condition. Dr. Salas-Whalen suggests visiting your primary care provider first or going directly to an endocrinologist.