Why Men and Women Gain and Lose Belly Fat Differently

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Why Men and Women Gain and Lose Belly Fat Differently featured image
Jordan Beal/EyeEm/Getty Images; Daniel Grill/Getty Images
This article first appeared in the Spring 2023 issue of New Beauty. Click here to subscribe

From how we gain weight to where we hold it, our sex plays a major role in how our bodies change as we get older. Whether it’s post-baby or post-“dad bod,” getting back to fighting weight can be an uphill battle. Experts say, no matter your gender, finding the right balance is the key to a tighter core.

Storage Wars

Compared to men, women are inclined to have a higher percentage of body fat. Where it accrues is different, too. When estrogen drops, fat is redistributed mainly in the hips, thighs and belly. “Women tend to store fat subcutaneously under the skin, which is why we see cellulite more so in women,” says Vero Beach, FL plastic surgeon Jimmy Chim, MD. Men tend to amass visceral fat in the abdomen next to the internal organs. “It’s not clear why, but current science points to the hormonal differences between men and women.”

Conversion Rate

The ways we process food and how many calories we burn at rest also differ vastly, as women are known to have slower metabolisms. “Our metabolic rates are largely determined by the amount of lean muscle mass we have, which is one of the reasons men’s metabolic rate tends to be higher,” says nutritionist Jennifer Hanway. “However, metabolic rate can also be affected by estrogen levels, thyroid health and even our gut microbiome.”

Ab Separation

Women not only have less muscle mass than men, but there is also a common condition called diastasis recti that can lead to a softer belly and a weaker core post-baby. “During pregnancy, the abdominal wall, which includes the abdominal fascia and the six-pack muscles, is basically stretched for about nine months,” says Denver plastic surgeon Philippe A. Capraro, MD. “The muscle and fascia weakens, separates and never goes back the way it was. Even very thin women will say their stomachs feel ‘floppy’ after pregnancy, no matter what they do.” While more common in women, diastasis recti can also occur in men who have gained significant weight that has stretched the ab muscles and fascia. “This is sometimes caused by a ‘beer belly,’ and losing that visceral fat is very hard,” adds Dr. Capraro. Because visceral fat is firmly embedded inside the abdominal cavity, it cannot be suctioned out with liposuction.

Artem Varnitsin/EyeEm/Getty Images

Stress + Hormones

No matter your gender, managing nutrition and balancing hormones helps to trim waistlines. “Managing our blood sugar and stress levels are key,” says Hanway. “To keep blood sugar balanced and insulin steady cut out sugar and refined carbs and eat protein, veggies and healthy fats.”

Studies have shown that higher cortisol reactivity and poorer coping skills in women can lead to “muffintop” fat. Breathing exercises, cutting caffeine, meditating and getting more sleep can naturally lower stress.

“Men also go through dips in testosterone levels,” explains Pittsburgh plastic surgeon Brian Vassar Heil, MD. “When this occurs, we accumulate fat instead of burn it.”

Making Moves

Skip the spot-training, says fitness trainer and Pilates expert Grace Albin. “Target the rectus abdominis, obliques and lower back. Many people only work those showy ‘six pack’ muscles but maintaining proportion with the adjoining muscles will improve posture.” Albin suggests trying Pilates moves like the Criss-Cross for obliques, and the Superman for the lower back.

Abdominal separation occurs in 60% of childbearing women

Source: The Cleveland Clinic

New Tools

Added options for abdominal weight loss include injectable drugs like Semiglutide and Tirzepitide which have been shown to produce results that rival gastric bypass surgery.

Nonsurgical Contouring

When diet and exercise take you only so far, Dr. Heil recommends Emsculpt NEO treatments to build muscle using HIFEM electro magnetic stimulation and melt fat with radio frequency. “It’s been shown to reduce up to 30 percent of fat and increase muscle mass by 25 percent,” he says. Recent studies have shown a 14 percent decrease in visceral fat as well.

Fort Lauderdale, FL dermatologist Dr. Matthew Elias targets stubborn fat with CoolSculpting Elite, which has shown a 30 percent reduction. A rare side effect called Paradoxical Adipose Hyperplasia can occur (it happens in 0.025 of patients), so review possible risks and benefits with your doctor.

This 34-year-old patient wanted a slimmer waistline without surgery. Dr. Elias treated her with CoolSculpting Elite to reduce excess stomach fat.

Liposuction + Tummy Tuck

Nonsurgical modalities are a good option for some patients, but liposuction remains the gold standard for fat removal. Las Vegas plastic surgeon Mary C. Herte, MD adds that loose skin or stretched abs are best treated with a tummy tuck. “The struggle to address these problems can be very frustrating for both men and women. Learning that the only solution is liposuction or tummy tuck surgery is a validation for those who have struggled for years.” Dr. Chim adds that body contouring techniques can masculinize or feminize the body. “Women desire a narrow waistline while most men tend to look better with a more square and flat abdomen,” he says. In men, ab etching may also be performed to give the illusion of muscle definition.

After losing over 150 pounds, this 35-year-old patient underwent a tummy tuck with Grand Rapids, MI plastic surgeon David Alfonso, MD Ab Separation to complete his transformation.

Proper Form

These handy tools help boost metabolism, combat stress and strengthen the core.

1 / 3

Heat Healer Sauna Blanket ($598)

Some studies have found sauna sessions can increase metabolic rate, and this blanket lets you sweat from home.

2 / 3

Stealth Core Trainer ($99)

This portable planking tool turns a full-body workout into an interactive game that targets 29 muscles.

3 / 3

Sensate 2 ($299)

Soothe the nervous system from cortisol spikes with this pocket device that delivers relaxing vibrations and sounds.

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