This Is Why It’s So Hard to Trim Your Waistline as an Adult

This Is Why It’s So Hard to Trim Your Waistline as an Adult featured image
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According to the Centers for Disease Control and Prevention, larger waistlines among adults in the United States are high. A larger waistline is defined as 40 inches or more for men and 35 inches or more for women, and according to the latest available data, approximately 47 percent of adults in the U.S. have a large waist circumference.

“Our waist circumference tends to increase with age,” explains Pittsburgh plastic surgeon Brian Vassar Heil, MD. “As we age, our hormone levels can shift, which can impact our body composition and fat distribution. Women experience a decrease in estrogen levels and men see a dip in testosterone levels, which leads to an increase in abdominal fat.”

Stress + Slower Metabolism

Another thing that happens as we age is our metabolism naturally slows down, so our body burns fewer calories making it harder to burn fat. “We also pick up bad habits and more stress in life,” adds Dr. Heil. “We don’t eat regularly, we have higher stress levels, and when we put on more weight, a lot of that tends to be around the trunk.” Dr. Heil points out that as our stress levels rise, cortisol spikes and weight loss stalls. “Cortisol is a steroid that’s made by our adrenal glands. This is important when our body is under stress, but it’s actually a hindrance when we’re trying to lose weight.”

Reduced Muscle Mass

Losing muscle mass as we age can also contribute to a slower metabolism, which makes it harder to burn fat. “This can also contribute to an increase in abdominal fat, as the body may store more fat in this area due to reduced muscle mass,” he says.

Nosurgical Advances

When a more dramatic change in waistlines and body contours is desired, Dr. Heil says a surgical approach may be needed, but when patients are looking at less extensive changes, they have both surgical and nonsurgical options.

Weight Loss

The first nonsurgical approach Dr. Heil employs at his practice is a weight loss program. “We start by offering a healthy lifestyle which involves some counseling and coaching for better eating habits, better exercise habits, getting better sleep and encouraging positive mental health to spark a more effective metabolism,” he explains.

Emsculpt NEO

“The second approach is using external treatments that can reduce internal fat,” notes Dr. Heil. “We offer an advanced treatment called EmSculpt NEO that utilizes a combination of two technologies. One is HIFEM, or High Intensity Focused Electro Magnetic energy and the other is radio frequency energy.” By combining these energies, fat is noninvasively reduced by up to 30 percent over a series of 30-minute treatments. It also builds up to 25 percent more muscle mass simultaneously.


This uses cryotherapy to destroy excess fat cells. “This allows our body to eliminate up to 20 percent of fat in treated regions,” says Dr. Heil. The Emsculpt NEO effect is more global around broader regions, but with CoolSculpting you’ll experience the treatment where the applicators are positioned on the body.”

Permanent Body Contouring

Liposuction, considered the gold standard of fat reduction, is primarily only going to remove excess, unwanted fat says Dr. Heil. If you want to reduce both fat and excess skin, then an abdominoplasty will work better. “It does more than just reduce fat. A tummy tuck specifically eliminates excess skin and tightens the abdominal muscles that have stretched away from the midline and created a gap or a weakness in between the muscles down the midline of the abdomen.” An abdominoplasty is working on three levels: the muscle layer, the fat layer, and the skin layer,” he adds.

Dr. Heil employs “VASER liposuction,” a more minimally-invasive method of fat removal which breaks up fat cells using ultrasound energy before being gently suctioned out. Compared to traditional liposuction, Dr. Heil says there is less pain and downtime associated with VASER liposuction. He’s able to remove fat, sculpt the body while leaving other tissues intact. “There is also greater skin retraction with this method.”

Whether surgical or nonsurgical, Dr. Heil says seeing an improvement in your waistline is possible as you age if you chose the right modality for you. “There are several noninvasive treatments out there now, but the ones I’ve mentioned are the ones I’ve found to be most effective with the least downtime and the most dramatic effects if you’re trying to lose 10-20 percent of your abdominal fat. If you have loose skin that’s been stretched out by pregnancies and weight gain, you’ll want to opt for surgery and more permanent results.”

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