If you're over the age of 40, you may have noticed that losing weight in your mid-section is a bit harder than it used to be. That's not just in your head — a combination of many different factors, including hormone changes and a decrease in metabolism, make losing belly fat more difficult as you get older.
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Here's precisely what's to blame for some of the weight gain you may be seeing in your belly — and how you can fight it.
There are two types of fat in the body: the softer kind right beneath the surface, called subcutaneous fat, and visceral fat, which is harder and stored deeper in your abdomen and wrapped around organs, explains Sherry Ross, MD, an ob-gyn and women's health expert at Providence Saint John's Health Center in Santa Monica.
Visceral fat is a concern because it's linked to a slew of health issues, such as insulin resistance, diabetes, cardiovascular disease and an increased risk of cancer, Dr. Ross says. Belly fat is often comprised of visceral fat, and it's the kind that can be increasingly difficult to lose as you age.
So, why is belly fat harder to lose after 40? There are a few factors:
Age alone doesn't necessarily change where visceral fat is stored, Dr. Ross says. But for many people, the proportion of visceral fat starts to increase as they age. This is because of a combination of factors, including the fact that our diets usually change, we burn less calories as we age and we tend to exercise less, all of which contribute to weight gain and ultimately, gaining fat in the abdominal area, Dr. Ross says.
Fat gain and loss is hormone-driven, explains Kristi Veltkamp, RDN, a Spectrum Health outpatient dietitian. Storage-wise, women tend to store more subcutaneous (soft) fat in the abdominal and thigh area and men store more visceral (hard) fat in the abdominal area.
Those types of differences become apparent in puberty when both sexes increase in weight — men will typically see more muscle gains from higher testosterone, while women will gain more curves, due to estrogen.
As we age, however, and as women go through perimenopause and menopause, fat storage tendencies shift. As men age, they gain more "soft" fat while women gain more "hard" abdominal fat due to lower testosterone and estrogen levels.
Speaking of hormones, perimenopause in those with female reproductive organs can impact abdominal fat. As the shift occurs from perimenopause into menopause, hormone levels that previously helped keep weight in check start to fluctuate, Dr. Ross says.
On a technical level, during perimenopause, estrogen begins to decrease, explains Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.
And because estrogen affects fat disposition, when it goes down, it can lead to increased visceral fat stores. There are additional metabolic disturbances that occur with menopause, such as insulin resistance and glucose and lipid metabolism disturbances, per a June 2017 overview in Menopause Review. All of these factors, combined with a gradual decline in muscle mass, tend to increase weight gain in the abdomen and mid-section over age 40.
Our metabolism starts to slow down as we age, which means we burn less calories, start to lose muscle and can see weight gain, Dr. Ross explains.
According to Dr. Ali, for each decade we age over 40, our metabolic rate slows down at an increased rate. That's backed up by a July 2014 review in _Medicine and Science in Sports and Exercise_, which found that the resting metabolic rate decreases with age. Plus, hormones tend to continue to decrease, so the combination make maintaining muscle more challenging, Dr. Ali notes.
Stress can also affect fat storage, Veltkamp says. And long-term stress over time can really add up.
"High stress lifestyle leads to increased cortisol levels in the body and the 'fight or flight' response," Veltkamp explains. "Since we are usually not actually running from danger, having this reaction constantly firing in our system can be very detrimental. Cortisol actually causes fat to be stored or taken from other areas of the body to be stored in the abdomen area."
In addition to the direct impact that cortisol can have in adding fat to the abdominal area, it can also have an indirect effect — higher baseline cortisol levels and increases linked to stress lead to more fat cell development, increased blood glucose and insulin suppression and more cravings for highly processed foods, per an April 2017 article in _Obesity_.
The Best Ways to Lose Belly Fat
Abdominal fat can be reduced similarly to any approach to lose weight, with a healthy diet, reduced calories and exercise, Veltkamp says.
It's important to remember that spot reduction fat loss is not possible, so the only way to reduce belly fat is to reduce your overall body fat, Dr. Ross says. Here's how to target belly fat, especially over the age of 40.
Exercise can be one of the most effective strategies — and not for merely burning calories, Veltkamp notes. "Exercise helps to reduce insulin resistance and cortisol levels, which both lead to visceral weight gain if left unchecked," she says.
There's evidence that strength training can be effective for fat reduction, Dr. Ross notes. For instance, strength training with weights, in combination with a low-calorie diet, was more effective in reducing fat and maintaining lean muscle in adults than exercise with just cardio and diet alone, per an October 2017 study in _Obesity_, which looked at more than 200 adults over age 60.
While increasing your exercise levels drastically isn't always an option, changing up your exercise routine typically is, Dr. Ross notes. She recommends incorporating some high-intensity interval training (HIIT) as a way of raising your game. Interval training may be especially effective for targeting belly fat. For instance, among adults in their 70s, interval training helped reduce overall body fat and central obesity, per an April 2019 study in the _Journal of American Geriatrics Society_.
There are many forms of exercise that can be used for weight management. The most important thing is to work out consistently, Dr. Ross says. Her recommendation: Find a workout that you enjoy and can stick to.
2. Stress Management
Visceral fat storage tends to be higher with high-stress lifestyle, leading to increased cortisol levels and high insulin resistance. And because cortisol is a hormone that both increases visceral fat stores in the body and raises your hunger levels and cravings for unhealthy foods, it can lead to a vicious cycle of fat gain.
Since stress is so highly linked to abdominal fat, finding ways to lower and manage your stress levels can be a helpful way to also manage visceral fat. You could try strategies such as yoga, meditation, a spiritual practice or journaling to help reduce your stress.
3. Dietary Changes
Veltkamp specifically recommends a low-glycemic Mediterranean diet, because it's one that will not lead to blood sugar spikes or insulin resistance. Additionally, a Mediterranean diet is linked to decreasing levels of visceral fat, per a May 2019 study in _Journal of Hepatology_.
The Mediterranean diet is focused on foods that have a lot of fiber, are minimally processed and low in added sugars, along with lower levels of animal products such as dairy and meat. Following this diet means eating whole grains, beans and legumes, fresh fruits and vegetables and anti-inflammatory fats, such as olives, nuts, seeds and fatty fish.
Foods to Eat — and Ones to Avoid
Incorporate some of the following foods into your diet to help manage abdominal fat, recommends Veltkamp:
- Monounsaturated/polyunsaturated fats (in moderation): olive oil, walnuts, almonds, chia seeds, flax seeds, avocado and fatty fish like salmon or tuna
- Green tea
- Vegetables, such as tomatoes, broccoli and leafy greens
On the flip side, Veltkamp recommends avoiding these foods that can contribute to belly fat:
- Saturated fats, found in full-fat dairy, cream, butter or on meats and poultry, as well as in coconut oil, shortening and lard
- Trans fat (hydrogenated oil), found in margarines, fried foods, chips and pastries and powdered coffee creamer
- White and enriched/bleached flour, which is in many breads, cereal, crackers, pastries and desserts
And while all of the above strategies can be helpful in managing your weight, it is worth noting that it can be difficult to target visceral fat specifically.
But the good news is that visceral fat does tend to get burned off faster than subcutaneous fat, Dr. Ali says.
So, if you continue to exercise, eat a healthy diet and are mindful of stress management, as well as maintain other healthy lifestyle choices, you can help to minimize the accumulation of belly fat in your 40s.
- Journal of American Geriatrics Society: “Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70‐Year‐Old Individuals: A Randomized Controlled Trial”
- Journal of Hepatology: “The Eeneficial Effects of Mediterranean Diet Over Low-Fat Diet May be Mediated by Decreasing Hepatic Fat Content”
- Menopause Review: "Obesity in Menopause – Our Negligence or an Unfortunate Inevitability?"
- Medicine and Science in Sports and Exercise: "Examining Variations of Resting Metabolic Rate of Adults: A Public Health Perspective"
- Obesity: "Stress, Cortisol, and Other Appetite-Related Hormones: Prospective Prediction of 6-Month Changes in Food Cravings and Weight"
- Obesity: "Effect of Exercise Type During Intentional Weight Loss on Body Composition in Older Adults with Obesity"