I’m often asked what causes belly fat. But that question doesn’t always lead to a great answer. Instead, the question you should be asking, is:
Why isn’t my stomach flat?
“Belly fat”, more scientifically known as visceral fat, is certainly a contributing factor. But there are three other important causes of a stomach that isn’t flat. Let’s go through all four:
Often called “belly fat”, or visceral fat, this is the fat that is actually inside your abdominal cavity, deep to your abdominal muscles. This fat is all intermixed with your internal organs, and this is truly the bad fat. Increased intra-abdominal fat is associated with an increased risk of heart disease and diabetes. Because this fat is all mixed in with critical anatomy, liposuction is not an option. The only way to get rid of intra-abdominal fat is to lose weight.
Cutaneous refers to your skin. So sub-cutaneous fat is literally the fat under the skin. This is the fat you can pinch between your fingers and thumb. This is the fat we remove with liposuction.
The rectus muscles are the two six pack muscles down the front of your abs. With pregnancy or weight gain these muscles stretch apart (diastasis = widening). They may heal back close to their normal position after pregnancy, but not always. And if you have a lot of intra-abdominal fat pushing on your muscles, you’ll have to lose that before trying to fix the space between the muscles (e.g. in a tummy tuck).
Often what people mistake for excess fat is really just lose skin. Skin will shrink up a bit after weight loss or pregnancy, but it’s not uncommon to have loose skin over the stomach. A tummy tuck will remove this.
So you can see that asking what causes belly fat only gives you part of the picture. If your goal is to get a flat stomach, it’s critical to understand that:
- You may have multiple things going on. It’s not uncommon to have loose skin, and stretched muscles, and excess fat.
- You unfortunately can’t treat all of them at the same time. Intra-abdominal fat can only be removed by losing weight. Subcutaneous fat can be treated with liposuction, but aggressive liposuction cannot be done at the same time as a tummy tuck.
- A two staged approach is often necessary: Losing weight or having lip before having a tummy tuck may be very helpful.
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Dr. Greer is a Plastic Surgeon who practices in Cleveland, OH. Her passion is helping moms regain self-confidence by getting rid of sagginess, wrinkles, and stubborn fat. Read more about her at www.greerplastics.com.
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