Harvard Women's Health Watch

Ask the doctor: Why am I carrying more of my weight around my middle?

Q. I am postmenopausal, and I've noticed that my belly isn't as flat as it once was, even though my weight hasn't changed much in the past 15 years and I am healthy. Is this change in shape something I am just going to have to get accustomed to, or can I do something about it?

A. Your weight may not have changed over the years, but has your height changed? One of the normal changes associated with aging is some loss of height. This is due to a loss of volume in the intervertebral discs of the spine. (Some women lose height because of osteoporotic fractures of their vertebrae; however, that is not a normal change of aging.) You can lose up to several inches in height (some women lose even more) as you get older. The contents of your abdomen then have less vertical volume to inhabit. That volume has to expand somewhere, so it moves horizontally.

The accumulation of fat around your middle also may have to do with hormone-related changes in weight distribution that occur after menopause. It's not just unsightly; abdominal fat (called visceral fat) has also been linked to an increased risk for cardiovascular disease and type 2 diabetes.

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