Americans are fatter than we've ever been, but at least the prevalence of obesity appears to be leveling off. That's the finding of a new study published Wednesday in the Journal of the American Medical Association. The study found that if obesity rates had continued to rise as rapidly as they'd been going up since the late 1980s, an increase of 6 to 7 percentage points would have been expected for men and women between 1999 and 2009. Instead, rates increased by less than 5 percent in men and didn't appear to increase much at all in women. "The data presented in our current study … suggest that the prevalence may have entered another period of relative stability," write the study authors, who are from the National Center for Health Statistics.
That's good news, but the rates are still shocking. About one third of Americans are obese, and another third are overweight, which means two thirds of us have a weight problem. Black women fare the worst: Nearly three quarters are overweight, and half are obese. "Obesity is associated with more chronic disorders and poorer health-related quality of life than smoking or problem drinking," writes J. Michael Gaziano of the Massachusetts Veterans Research and Information Center in an editorial that accompanied the study.
What to do? While the health risks of being, say, 50 pounds or more above a healthy weight remain undisputed, carrying around a few extra pounds isn't necessarily harmful. A growing body of evidence suggests it's where you carry your weight that determines your health risks. "Having extra fat in your legs, arms, or buttocks doesn't appear to hurt and may even be protective," says obesity researcher Gary Hunter, a professor of exercise physiology at the University of Alabama–Birmingham. "It's the fat that accumulates around the waistline that we worry about." This fat tends to collect near and around abdominal organs and releases chemicals that lead to inflammation, which is linked to heart disease, diabetes, and cancer. But scientists are pinpointing a combination of diet and exercise techniques to flatten your stomach—even if you can't quite shed those extra pounds:
1. Don't overdo it on exercise. Those who hit the treadmill, stationary bike, or elliptical trainer for an hour or more may find themselves gaining weight from exercise. And not because they're putting on extra muscle. "You get really hungry from burning all those calories, and then you feel justified eating that muffin or doughnut after your workout," says plastic surgeon James Lyons, author of The Brown Fat Revolution. He often encourages prospective patients to revamp their diet and exercise program instead of having liposuction. "I tell them to get a maximum of 10 to 15 minutes of aerobic activity, and focus on doing resistance training exercises that work the abdominal core like yoga or pilates and weightlifting to build arm and leg muscles." This will help you retain muscle, normally shed with aging, and since muscle requires more calories to maintain than fat, will keep your metabolism boosted throughout the day. Thus, you'll burn off belly fat without increasing your appetite.
2. But definitely do some moderate activity at least twice a week—especially if you've recently lost weight. It's well known that regular exercise is essential for maintaining weight loss, but University of Alabama researchers discovered last October that all it takes is 40 minutes a day, twice a week to keep the belly fat from creeping back on. Interestingly, it didn't matter whether the study participants—white and black women who had lost an average of 27 pounds on a low-calorie diet—did aerobic activity or resistance training as long as they kept it up twice a week for a year. "While they did regain some weight, they gained it in their legs and arms, not their midsection," says Hunter, who led the study. Those participants who didn't exercise, on the other hand, regained most of their lost weight, the bulk of it around their belly. Hunter theorizes that exercise triggers beneficial hormonal changes that make it easier for the body to store excess fat in the arms, hips, and thighs rather than near vital organs.
3. Eat a snack before and after a workout. This will give you energy for your activity and will keep your blood sugar levels from plummeting afterward, which can leave you feeling famished and likely to overeat, says Lyons. On his fat-shedding plan, he suggests having a light breakfast an hour before you exercise: two poached eggs on a whole-wheat English muffin, a serving of oatmeal mixed with soy milk, or 1 cup of whole-grain cereal mixed with 1 cup of Greek-style yogurt. As a post-workout snack, he suggests having a piece of fruit and a serving of starch: a slice of multigrain toast with 1 cup of strawberries, perhaps, or a 1-cup serving of cooked oat bran with 1 cup of blueberries.
4. Think six mini-meals a day. You can do 1,000 crunches a day and still have that dreaded abdominal "pooch" if you don't find an effective way to stop overeating. "Diet is 85 percent of the deal when it comes to shedding belly fat," says Lyons. He recommends eating six small meals a day every two hours to keep hunger at bay and reduce the midafternoon or before-bed binges. Following the pre- and post-workout meals comes lunch, which should consist of a lean serving of protein (4 ounces of grilled chicken breast or tuna, 6 ounces of baked tilapia, or 1 cup of beans) and 2 cups of chopped vegetables. A midafternoon snack on his plan consists of a serving of fruit: one apple, a cup of fresh berries, one fourth of a melon, a grapefruit half. Dinner is similar to lunch, with a protein such as grilled steak and steamed vegetables. And a nighttime snack can be a handful of nuts with some dried apricots, a smoothie made with skim milk and 1 cup of strawberries, or a ½-cup serving of cottage cheese with one fresh sliced peach.
5. Get adequate amounts of sleep. Too little sleep (less than six hours) or too much (more than eight hours) results in excess production of the stress hormone cortisol. This hormone promotes the storage of fat in the belly. A possible reason: Your body, knowing it's in a state of stress, shuttles fat off to a storage place where it can be easily burned off for fuel in an emergency. Fat on the hips and thighs isn't released from cells as quickly, which is why we often refer to it as "stubborn fat."
6. Find ways to de-stress. Live in the present moment, recommends psychologist Jon Kabat-Zinn, founding director of the University of Massachusetts Medical School's Center for Mindfulness in Medicine. This practice, called mindfulness, will help relax you and lower your cortisol levels. Don't think about that candy bar you ate yesterday—likely to increase your levels of stress hormones—or make promises to run 3 miles tomorrow. Instead, Kabat-Zinn says, think of every moment as the "ability to learn, grow, and change." That will allow you to be truly present when you indulge in, say, that rich Godiva truffle or a 10-minute shoulder massage at an airport kiosk. And you'll also appreciate those small, bright moments in your day: a joke from a coworker, conversing with the lady in front of you at the supermarket, a good-night hug from your child—all of which lower cortisol levels and thus help to keep stubborn belly fat at bay.