Lower Abdominal Fat

Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.

Q. I am a 47-year-old woman. I have a well proportioned body except for a five-inch "tire" of fat around my lower abdomen under my navel. I have done yoga two to three days a week consistently for almost four years. It feels like this part of my body is another appendage that is not able to shrink, even when I eat smaller portions. I have always had a pouchy tummy, since I was quite young, but this is bigger than ever and I wonder if it is at all possible to shrink this area? It is physically uncomfortable.

A. Most women gain weight in the abdominal area as they age, mostly due to the effects of pregnancy. This "pouch" that you describe may be more resistant to exercise if it has been there for many years.

"Modified" sit-ups can help. Lie on your back with your feet flat on the floor and your knees bent at a 90-degree angle. Tuck your interlocked hands behind your head, then lift your shoulders off the floor. As you lift, twist your torso so your right shoulder moves toward your left hip. Return to the start position and repeat, twisting the left shoulder toward your right hip. Continue, alternating sides.

This type of sit-up strengthens the muscles running up and down the front of your abdomen (the rectus muscles) as well as the muscles running in a "V" from the sides to the middle of your abdomen (the oblique muscles). It's important to hold in your tummy throughout your sit-ups. The slower and more concentrated your effort, the more muscle fibers you will recruit.

Bear in mind that waist-toning exercises won't remove much body fat and must be combined with a low-fat diet and aerobic exercise (brisk walking is great). But they will give added definition to your abdominal muscles and aid good posture, both of which will make you more lithe and shapely. If all else fails, and this small area of sagging tissue truly is uncomfortable, consult with a board certified plastic surgeon about having liposuction or abdominoplasty to remove the "pouch."