Why Can’t I Lose That Darn Belly Fat?
This is a question I hear every day from women in my practice. And it’s a legitimate one. Various factors are involved including the hormonal changes that occur with perimenopause and menopause. In addition, the process of aging and losing muscle mass also contributes to slower metabolism and deposition of fat in the belly area.
Sounds depressing right? Well, what if I told you that reducing your stress and getting sound sleep can help fight this abdominal bulge?

How does stress contribute to abdominal fat?
One of the first responses of our bodies to stress is to release large amounts of cortisol, the stress hormone. This occurs through the brain’s release of CRH and ACTH, which signals the adrenal glands to release cortisol.
In evolutionary terms, this was advantageous. When faced with a saber-toothed tiger, we needed cortisol to deliver energy to our main muscles, brain and muscles to run from this danger. During this energy releasing process, fat cells are signaled to deposit more fat into our blood streams, liver cells to produce glucose and muscle cells to break down protein to supply amino acids. This metabolic process allowed us to flee from the looming animal threat.
“Chronic” versus “Acute” Stress: The Key to Understanding Stress and its Effects
The real problem arises when we experience this type of stress throughout the day, not infinite, limited time frames. This chronic “perceived” stress causes levels of cortisol and insulin to rise together to send a signal to fat cells to store as much fat as possible. Fat cells are instructed to hold onto their fat stores – reducing the body’s ability to release fat from its stores for use for energy.
Many scientific studies have shown that in the very early stages of stress, “acute stress”, CRH actually suppresses appetite. So, when the saber-toothed tiger started to chase you, high levels of CRH would be released allowing you to run faster — and not have an appetite! On the heels of increased CRH levels comes a dramatic rise in cortisol levels, which stimulates appetite within minutes to hours following the stressful event. CRH levels return to normal within seconds, while cortisol levels may take hours to return to normal. This means your appetite stays revved up for a very long time!
Again, the deleterious process arises in the light of chronic stress, or “perceived stress”. This may take the form of a frantic 24/7 lifestyle, unreasonable expectations of a boss or partner, or taking care of aging parents. I’m sure that all of you could list a whole lot more!
So, how does cortisol lead to more belly fat?
During periods of chronic stress, both the levels of cortisol and insulin increase, which signal the fat cell to store as much fat as possible. This accumulation of body fat is especially distributed to the abdominal, or belly, region. Researchers have coined this fat, “stress fat”. From an evolutionary perspective, in the short term, this stress fat would have a protective effect because fat stored in the abdominal region could be delivered to the bloodstream and tissues faster than fat stored in other regions such as the thighs and buttocks.
Yet, in today’s age, we do not need these huge fat stores to survive. Grocery stores and refrigerators allow us to buy and store food for our daily needs. We do not face the environmental challenge of a 4-5 month winter hibernation or possible period of starvation/decreased food supply.
But this isn’t all of it! Apple vs. Pear
As you can see from the image on the left, there is much more fat in her abdominal region compared to the woman on the right, who has more fat in her hip and thigh region. This pattern of fat deposition has been coined, “the pear” shape, whereas the one on the right, “the apple”. Studies have shown that the “apple” shaped distribution of fat is closely associated with heart disease, diabetes, Syndrome X, hypertension and high cholesterol.
Okay, have I convinced you that chronic stress is bad for you?
Rather than dwell on this, and further potentiate this stress, let’s cover some healthy ways to combat stress and reverse some of these harmful processes.
Four stress reducing tips:
1. Remember to breathe. The 60 second breathing exercise is simple and easy to do. Breathe in for 5 seconds, then exhale for 5 seconds. Do this six times and feel your body gradually relax.
2. Exercise. Get outside and walk for 30-40 minutes, 3-4 times/week.
3. Take a soothing bath. Indulge yourself in this luxury at least once a week!
4. Get a good night’s rest. Adequate sleep is critical to reducing cortisol and maintaining a healthy body weight.
In next week’s blog, we’ll focus on how night sweats and interrupted sleep during the perimenopause/menopausal transition lead to increased weight gain.
In health and happiness,
Dr. Diana