Why are you getting belly fat?

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No one escapes the aging process and the deposition of belly fat, without replacing testosterone.

The most frequent question asked by my patients, both women and men, the first time they see me is, “Why is my belly getting bigger? I never had a big belly before, and I can’t get rid of it!”. My answer is individualized to the patient, but there is one change that occurs as the first trigger of aging and ends in a distended and obese abdomen—Low free testosterone, and high estrone blood levels.   The cause is loss of the production of the “all important hormone” testosterone, from the ovary or testes, and the result is a slower metabolism and gain of fat in the abdomen.

But why do we crave a thin waistline?  Having a thin waist is indicative of a youthful body, and youth in general.  It is one of the biggest reasons that we crave, desire, even demand that our bodies revert to a thinner waist to bring back our youth! The aging process takes the thin waist away and deposits fat where we once had a narrow middle!

When we turn 40-50, our body changes from a highly metabolic body that was fertile, into a lower, more efficient metabolism that is slowed even more by carbohydrates in the diet. We can bring our metabolism back to normal by one medical intervention and a healthy lifestyle specifically created for postmenopausal women and aging men. No one escapes the aging process and the deposition of belly fat, without replacing testosterone in a non-oral and bio-identical manner. I explain this to every patient and since I know each of my patient’s medical histories, family histories, medications, diet and exercise programs, I can target my advice to their individual need. At my office at BioBalance Health® we make a plan to get rid of that belly fat for each of our patients and we measure the about of belly fat that they have by measuring their body composition with an INBODY® machine.


What IS Belly Fat, Really?

Let me specify exactly what belly fat really is made of:

A portion of an individual’s belly fat is from the accumulation of fat inside the abdomen around the intestines, in an organ called the omentum.  This belly form of belly fat is called Visceral fat, which increases a person’s risk of diabetes and heart disease, and takes a long time to dissolve this form of belly fat, requiring low carb diet and daily aerobic exercise. This is usually a long-term project (a year).

The second type of belly fat, subcutaneous fat, is deposited between your skin and your muscles, most often seen in women who have had pregnancies that stretched their skin and caused the collection of fat under their skin. To lose this type of fat, this fat requires specific abdominal exercises, and or radio wave treatment to melt fat and tighten skin, and sometimes surgery to remove excess skin and liposuction of fat deposits. Generally, this type of fat is the first to respond and decrease when testosterone pellets and lifestyle changes are instituted.

The last type of” belly fat” is really intestinal distention from gas collection in the intestines or from constipation, food allergies or intolerances,  diseases like intermittent bowel obstruction after abdominal surgery, or a variety of GI diseases that must be diagnosed and treated by a board certified gastroenterologist. Many people confuse abdominal distention with one of the first two types of fat accumulation.  Bowel distension (or abdominal distention sometimes called bloating is generally a GI mobility problem, or an anatomic defect like an abdominal hernia and may require probiotics, fiber, diet changes like avoiding gluten and milk products, getting a low thyroid treated, treating diabetes or prediabetes, or repair of abdominal wall abnormalities surgically. Abdominal distention can also come from very lax abdominal muscles which require dedicated exercises if they are not severe, and sometimes require surgery if they are greatly lengthened and lax.

What causes belly fat to occur as we age?  First it is low testosterone that lowers the metabolism in everyone as they age so you burn fewer calories. Second it is lack of exercise and poor diet. You just get more “efficient” and save your calories and make fat out of them instead of energy. Last is the metabolic changes of aging including Insulin resistance or Pre-diabetes that occur at or right before menopause, and the production of more estrone which is made in belly fat from conversion of testosterone into estrone, which both lowers free testosterone levels and makes more belly fat to make more estrone.  A viscous cycle ensues!

The triggers that stimulate the production of belly fat: Pick the ones you have working against you and determine your individual issues that make losing belly fat more difficult.

  • Menopause
  • Low T in men and women
  • Aging causing higher estrone levels
  • Inactivity
  • History of multiple pregnancies with excessive weight gain which left extra skin hanging
  • Poor diet
  • Lack of abdominal wall strength
  • No abdominal exercises

Lifestyle, Diet and Habits that cause belly fat.

You can assess your personal causes of belly fat on your own, but then you should take the initiative to change your lifestyle to decrease belly fat. The following list include the things you can change to lose belly fat.


  • Diet High in carbs
  • Diet High in Lectin foods which interfere with carbohydrate metabolism
  • Lack of any exercise
  • Lack of daily targeted abdominal exercise
  • Lack of aerobic exercise
  • Poor posture
  • Sitting all day
  • Over-eating poor quality food (junk or fast food)
  • Intestinal issues like constipation, and irritable bowel from lack of good bowel bacteria.
  • Alcohol consumption
  • Smoking
  • Type 2 Diabetes without medication, or following a low carb diet
  • Alcoholism with liver disease
  • Fatty liver
  • Eating foods that are not compatible with your genetics (blood type).

To achieve your goal of a narrow waist and a flat belly, look at the list above and eliminate as many bad habits as possible and foods that you can, and begin an exercise program specifically aimed at working out your abdominal muscles, (Pilates?).

A word about Lectins are proteins in most foods and some are harmless but others many interfere with your health and are  considered anti-nutrients that bind to carbs in foods which can cause malnutrition, abdominal pain, GI disease, autoimmune disorders and are in every food. We teach our patients to avoid certain foods with lectins by their blood type. Dr Da Damo MD spent his life researching the foods containing lectins and how they genetically affected people in each blood type. In the future we list foods by blood type that should be eaten and those that should not be based on your genetics. We will dedicate an entire Healthcast to the lectins that are dangerous to your health individualized by your blood type, so you will know what to avoid and what is beneficial for you to eat. Luckily, Lectins can be inactivated by cooking the vegetables, fruits, grains that have lectins! To find the Blood type diets for each blood type look in the back of my book, The Secret Female Hormone®.

Sometimes my patients adjust everything they can on their own and still need medical help. All of my patients have their testosterone replaced if they are over 40 and if their thyroid is low, I replace their thyroid back to normal levels. Both of these treatments will make getting a younger smaller abdomen possible. The following list will provide the possible medical imbalances that can stimulate belly fat growth, and that can only be treated by a doctor.

Factors that can only be treated by your doctor that have a great impact on the loss of belly fat:

  • Low testosterone—replace T with pellets
  • Low thyroid hormone—replace women with Armour Thyroid and men with Levothyroxin
  • High cortisol—suppress with relaxation and or Endodren supplements
  • Low growth hormone –stimulate production with aerobic exercise and weight training exercise, replace testosterone, and or stimulate GH with a peptide.
  • Insulin resistance/ Pre-diabetes-treat with Metformin ER, Victoza, Trulicity, or Ozempic
  • Overall Inflammation throughout the body-Treat with anti-inflammatory drugs
  • Elevated triglycerides—treat with metformin ER
  • Low protein intake and low protein in the blood: increase, meat, cheese, milk products as well as eggs and ultra-filtered whey protein shakes
  • Inadequate vitamin D intake—take 5,000 MIU per day
  • Inadequate vitamin B intake—increase Methyl B12 + Methyl Folate
  • Decrease Intake of lectins that (not eating right for your blood type)
  • For Severe overwhelming hunger-treat with stimulants to suppress hunger


There are some things that will make your journey harder, but we all have genetic challenges. Our past sometimes makes our current work harder such as genetics for adult-onset diabetes, family history of obesity, a history of childhood inactivity and overeating.  Unchangeable things in our past can cause roadblocks to losing belly fat, but you can still succeed.

The following are examples of situations that you may have to overcome to lose your belly fat.  It is not a race with other people, it is a race with yourself!

  • An endomorphic body type (pear-shaped build) which is genetic
  • Obesity as a child
  • Lack of exercise as a child
  • Genetically low testosterone
  • Family history of obesity
  • Genetics that cause you to be hungry all the time
  • Genetics that cause you to never feel full no matter how much you eat
  • Bowel disease that must be treated before your nutrition can be made normal
  • Inherently bad gut biome you are born with limited gut bacteria that causes us to gain weight from early on.
  • Lack of a good sleep cycle because of your normal rhythms, or your job or disturbances throughout the night like kids coming in to sleep with you or getting up multiple times because of a very small bladder or a large prostate. If possible, increase your hours of sleep to at the minimum of 7 hours a night.

Follow your progress by measuring your waistline once a week with a tape measure to keep track of your progress.

By taking care of our patients and eliminating all the high-risk factors, changing lifestyle and bringing all hormones back to normal young healthy levels, we are very successful at helping our patients lose their belly fat.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author.   www.BioBalanceHealth.com  (314) 993-0963

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