Katie Talks to Experts About Her Belly Fat

woman trying to close her pants

Not me, but could be! (Getty Images)

With all this talk about New Year, New You…is your belly mocking your 2023 resolution?

On the verge of turning (yikes) 66, I’ve noticed my body changing over the last few years. While I used to gain weight in my thighs and derrière, I now seem to have a belly that just won’t budge. When I try on some of the sheath dresses I wore back in the day, it looks like I’m expecting. So, what’s the deal? Have I gained a “menopause belly“? And can anything be done about it? I decided to ask my friendly (and honest) gynecologist (with the help of many of your great questions) Dr. Becky Brightman what gives, since my jeans no longer do! 

Katie: OK, Dr. B, what the hell is going on? I know my estrogen ain’t what it used to be. Is that why my midsection seems to be growing by the minute? According to many of my friends, I’m not alone! Is menopause belly a real thing?

Dr. B: Yes. Metabolism does change with each decade of life. And we know that estrogen does facilitate metabolism. So, the decline in estrogen during menopause probably plays a role in weight gain. Also, fat does redistribute itself as we age, and the fact simply is that many women gain weight in the midsection. 

A lot of readers want to know if there’s anything we can do to prevent or get rid of menopause belly. Wake-Up Call reader Elise writes: 

I had a flat stomach all my life. My challenge areas were always hips and thighs. (I feel you, Elise!) But now I’ve got a protruding stomach, too. I’m a size 6, 5’4, and 122 pounds. I exercise through gym classes, pickleball, and biking. I do stomach exercises regularly. I’ve read about supplements including bone broth, magnesium, and everything else under the sun. But that seems like a sales pitch to me. What can I do about this belly fat?

They’re all myths: Don’t buy the broth or the magnesium — unless you obviously need the magnesium for some other element of your health. The most important things are eating healthfully and making sure you sleep. Sleep deprivation and insomnia impact the metabolic rate, increase the risk of cardiovascular disease, and increase weight gain. 

What about intermittent fasting? I’ve heard a lot about this diet where you only eat during, say, an eight-hour window, and not before or after. Could that help with later-in-life weight gain? 

It can. It’s not for everybody. But many women do find it helpful for maintaining weight or actually losing a little weight.

What about exercise? What types of exercise can reduce menopause weight gain, if any? 

I’d suggest exercises that help build muscle — and I’m not talking about going into weightlifting competitions, but building lean muscles by working out with light weights. Muscle mass facilitates metabolism. I also suggest working on core strength with exercises like planks — and I don’t think I started to do any of that stuff before I turned 50, but it really makes a big difference. A strong core can hold everything in like a corset and minimize the sensation or accumulation of belly fat. The other thing I think you and I’ve talked about is posture. When we work on posture and alignment, we’re less likely to slump over. And poor posture can create belly protuberance. We have to embrace our age — we’re all changing, but we need to be the best selves we can be. 

Here’s another question from a reader named Cheryl: 

Since ending menopause, I’ve been struggling with my weight and my breasts have increased three sizes from 36C to 38DD. I remember this happening to my aunt as well. However, at the time I had no idea that post-menopause was responsible. Is this normal? 

This is not unusual at all. About 50 percent of women do notice breast growth after menopause, and women do have a greater percentage of body fat. Body fat does turn some of the male hormones that women continue to make after menopause into estrogen. So estrogen probably does play a role in breast enlargement, but there’s a lot that we just don’t know. Again, eating more healthfully and building and maintaining muscle will help with metabolism and minimize fat. And when we gain weight, it tends to go into the midsection and then into the breasts. 


OK, Wake-Up Callers, clearly I have been on a mission to figure this out. I think my phone must know because all I get are ads for reducing belly fat — but so far, I haven’t clicked or bought any of the so-called “miracle cures.” 

In addition to Dr. B, Mark Hyman, MD, is one of my go-to’s for health and nutrition information, so I turned to him to find out why fat builds up in this particular part of the body, especially as we age. Here’s his take on your spare tire…and mine.

Katie: Mark, what the hell is happening to my belly? (Can you tell how many times I’ve asked myself this question, dear readers?) 

Mark Hyman: Not all body fat is created equal. Where the fat is on your body makes a big difference when it comes to your overall health. The fat inside your belly is called “VAT” or visceral adipose tissue, and this type of fat can be dangerous. When you begin to put on weight, especially this belly fat, your biology shifts out of balance, and can veer into an unstable and unhealthy territory, which in turn often leads to more weight gain. The primary contributor to the development of VAT is a Standard American Diet (SAD), which consists of too many empty calories and excess consumption of processed foods. But sometimes, a higher carb, lower fat diet can lead to excess belly fat. Lack of sleep can also lead to belly fat. Gut imbalances and hormonal imbalances are big contributors as well. 

Can stress lead to lower belly weight gain?

Prolonged unremitting stress is also a huge factor. Additionally, when you lose muscle mass, your belly VAT increases making your cholesterol, blood pressure, and triglycerides go up. You’re more tired but your sleep is restless, and you could get depressed. The immune system gets turned up and the inflammatory response increases, as does the oxidative stress. Your thyroid gets sluggish and your detoxification system gets overloaded. Without a way of counteracting the effects of chronic stress, we are all on a slippery downward slope to unhealthy weight gain. 

Not only does your body slow down your metabolism and tell you to eat more, but the fat that you gain from being stressed actually communicates negative messages to your body: When you feel stress, your brain triggers a series of chemical responses that slows down your metabolism and starts to store calories. A good portion of this is VAT. 

One of the main hormonal messengers that your fat creates is cortisol, which is your major stress hormone. It’s responsible for setting off the entire physiological chain of events associated with stress. This includes slowing down your metabolism. This whole process very quickly turns into a vicious cycle where stress and weight gain feed each other constantly. You get stressed out, your body releases cortisol that inhibits your responsiveness to leptin and slows down your metabolism. As a consequence, you gain VAT. Then this VAT starts sending out more cortisol into your bloodstream starting the whole process over again. 

Are there certain foods I should be avoiding to limit lower belly weight gain? 

The best diet for reducing belly fat is one that is low in refined carbs and starchy foods and high in plants, clean protein, and healthy fat. Essentially, the Pegan Diet! You want to fill your plate with 75 percent vegetables (by volume), add in a palm-sized portion (or 4-6 oz) of protein, and top it all off with some healthy fats like olive oil, nuts and seeds, and avocado. You especially need more protein as you age to help build muscle and prevent things like sarcopenia. I find that most people undereat protein — you need about 30 grams per meal to build muscle. When you lose muscle, you age faster. Make these things a priority! Avoid super starchy foods, processed foods, and refined sugar. 


So there you have it, friends. There is no miracle cure for reducing belly fat. Eating well, moving our bodies, and reducing stress all seem to be the ticket to keeping it in check. But I also think radical acceptance isn’t a bad idea. I don’t know about you, but I’m grateful to have reached an age that’s allowed me to accumulate a little extra baggage around my waistline. While I’m going to keep an eye on those pounds creeping up, I’m also going to invest in a few more oversized blouses and sweaters and continue to enjoy my life!