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Weekly Column

Hips, Abs, and Thighs

Do you ever wonder if it's actually possible to alter those "problem" areas (e.g., large thighs or buttocks) that you can't seem to get rid of, no matter how hard you think you're trying? Fortunately or unfortunately, much of your "body type" is genetic. But the question remains: Is it possible to overcome this genetic predisposition and change your body shape? Well, I have good and bad news. Yes, these areas can be changed or reduced, but it isn't easy.

Understanding Fat
There are two types of fat: subcutaneous and intra-abdominal. Subcutaneous fat is below the skin, and intra-abdominal fat (the traditional "apple" shape) is behind the stomach muscles, and around the organs. Most women store their fat subcutaneously, in their breasts, hips, buttocks, and thighs (the traditional "pear" shape), while most men store theirs in the abdomen, lower back, chest, and the nape of the neck.

Intra-abdominal fat is considered the most dangerous. "All of the potential health risks, including diabetes, hypertension, and heart disease, are related to the intra-abdominal fat," says David Heber, M.D., Ph.D., professor of medicine and director of the UCLA Center for Human Nutrition and author of The L.A. Shape Diet.

Can You Get the Perfect Body?
"Theoretically, you can get rid of every 'pocket' of fat, if you want to take it to the extreme and become obsessive about it," says Ed McNeely, Msc., an exercise physiologist at Sports Medicine Specialists in Toronto, Canada, who has worked with more than 30 Olympic medalists.

But you need to keep things in perspective. "Sometimes, no matter what you do, you're not going to get that elite model body. For instance, if you have a wide pelvis, that's not going away," says McNeely. He adds that even Olympic athletes still have pockets of fat they can't lose — and they're training for thousands of hours each year. "The only time they manage to lose those fat deposits is during an Olympic year," adds McNeely.

Dr. Heber is even less optimistic, saying simply "there is fat you can change and fat you can't." His point is that your genetic blueprint is hard to overcome. "It requires tremendous discipline, and even then you're not going to move mountains," agrees Byron Hoogwerf, M.D., an endocrinologist at the Cleveland Clinic in Ohio. In fact, he adds that you can work really hard, train very seriously, and still have slight fatty deposits in some areas.

Losing It
The problem is that most people try to get rid of these fat deposits by restricting calories and increasing the duration of their aerobic exercise. "This is exactly what not to do," says Dan Benardot, Ph.D., R.D., L.D., researcher at the Laboratory for Elite Athlete Performance at Georgia State University in Atlanta. If you start to significantly decrease your calories, whether they're made up of carbs, fat, or protein, your body will begin to protect itself and go into "starvation" mode.

Unfortunately, this is what most popular diets accomplish. "Your body is very efficient, and when you start to restrict calories and increase your energy expenditure [exercise], it will attempt to conserve fuel, meaning even more fat is stored," says Benardot. And where does it store that fat? "Precisely where you don't want it to be stored — in your hips, abs, thighs, or buttocks. To rid yourself of fat in these areas of the body, you have to think more about energy balance than weight loss — that's where most people get confused," says Benardot.

Just losing weight doesn't mean you will realize your objective and get rid of those "fat" areas. "In fact, those 'pockets' of fat are always the first to be filled up and the last to leave," says Heber. So, you will end up losing weight in areas where you don't necessarily want to, and the problem areas will remain problems, even though you believe you're exercising and dieting "correctly."

Not only that, but when you go on any quick-fix diet and restrict calories or carbs, "you start to lose lean muscle tissue, which is the opposite of what you want," says Gary Granata, Ph.D., R.D., director of the Applied Physiology Laboratory at the Ochsner Clinic Foundation in New Orleans, Louisiana.

Combine It
Don't lose hope. There are ways to increase your chances of changing your body shape and overcoming your genetic disadvantage. In order to get your body in the best possible shape, experts recommend a combination of weight training, eating balanced meals (without severe caloric restriction), and increasing aerobic intensity, not necessarily duration.

Weight training helps to preserve your muscle tissue, speed up your metabolic rate (so you burn more calories while at rest), and increase the size of your muscles. Keep in mind that you can't spot train — meaning that you can't focus on one spot (e.g., your thighs) and have the fat burn away just because you exercise intensely in that area. "In order to burn fat, it all must go through the liver to be converted into energy," says Granata.

However, you can increase the size of the muscle under the fat, which will make the fat look more "toned." "Increasing muscle mass in a specific area means that the fat will be spread over a larger area, and that firms it up. You will look like you've lost fat and appear leaner even though you didn't burn any fat," says McNeely.

Most people don't wait long enough to see the results; they're scared off by the increase in muscle mass (and the larger size of the very body part they're trying to reduce). "We tend to panic and stop training when our muscles start to grow under the fat — that's a mistake. You need stick with your entire program — which has to include diet, cardio, and strength training — for at least four months in order to see real change," recommends McNeely.

In terms of diet, Benardot and Granata recommend eating smaller meals over the course of the day. Eating one meal that is 1800 calories (instead of eating smaller meals throughout the day that total 1800 calories) doesn't have the same effect in fueling your body.

And finally, experts claim that if you're already exercising, increasing the duration of your aerobic exercise isn't the answer. How many times have you seen someone running or biking or using the stair climber who is in great shape — except for those problem areas? "When you do aerobic exercise at a higher intensity, you burn energy at a higher rate, and you burn more fat than carbohydrates, provided you're fueled properly." And Benardot warns, "Never exercise while hungry. It's counterproductive — you need to feed the exercise."

Liposuction
Some experts contend that the only way to truly eliminate regional fat is to perform surgery (i.e., liposuction). However, Dr. Hoogwerf cautions that even doing liposuction only removes about four and a half pounds of fat, and many times a person can have as much as 20 pounds or more of excess fat in these areas. Hoogwerf also asserts that, "diet and exercise are critical in removing the most dangerous fat, the visceral fat behind the stomach and around the organs."

Bottom Line
Lastly, when asked if there is a specific exercise, food, or supplement for each body type, all experts agreed — any such claim is nothing more than a marketing gimmick.


Originally published: 6/2/2004 | Last reviewed: 6/2/2004
This site does not provide medical advice, diagnosis, or treatment. More information.

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