How To Lose Stubborn Fat: Belly, Butt, Hips & Thighs

If you want to know how to burn stubborn fat, you have to understand a few key points. I realize many people who read the Metabolic Effect blog are not interested in the science and just want to know what to do. For those types please skip down to the section called "Overview and Action Steps"

First, lets review the fat burning process. In order for fat to be lost from a particular area the following events need to occur

1. Fat needs to be released from a fat cell (this process of fat breakdown and release is called "lipolysis").
2. Fat needs to be carried to another cell through the blood stream (poor blood flow to an area means slow fat loss from an area).
3. Fat needs to enter another cell to be burned (this process of fat actually being burned is called "lipid oxidation").

It is important to note here that just because fat is broken down and released (lipolysis), does not automatically mean it will find its way to another cell and ultimately be burned (lipid oxidation). It could be restored and this is often the case in people who are very insulin resistant.

Brief biochemistry overview

To further understand stubborn fat we need to cover some basic biochemistry first. Fat enters or leaves fat cells mainly due to the activity of two enzymes, lipoprotein lipase (LPL) which acts to store fat and hormone sensitive lipase (HSL) which acts to release fat. Notice the name of the major fat releasing enzyme? Is called hormone sensitive lipase and not calorie sensitive lipase for a reason.

HSL releases fat due to signaling of a compound called cyclic AMP. And this is impacted by the activity of hormone receptors in fat tissue called adrenergic receptors (AR).

There are two type of adrenergic receptors. Alpha adrenergic receptors and beta adrenergic receptors. The alpha receptors slow fat release and beta receptors speed fat release. To keep this straight in your head think "A" for "anti-burn" and "B" for "burn".

In addition to having an impact on fat release directly, these receptors also impact blood flow. More alpha receptors mean less blood flow to an area, and more beta receptors mean greater blood flow to an area.

Hormones & Stubborn fat

So what makes stubborn fat more stubborn? Fat gain or loss is about two things, calories and hormones. But stubborn fat may be more impacted by hormones compared to other types of fat.

Many types of hormones impact fat gain and fat loss. These hormones have this impact because of their direct or indirect effects on the enzymes and receptors we just mentioned. Hormones that store fat tend to increase the number or activity of alpha receptors and/or LPL. Hormones that stimulate fat release increase the number or activity of beta receptors and/or HSL.

Certain hormones have a very straightforward impact on fat gain or loss. For example, Insulin is a fat storing hormone because it increases LPL activity and suppresses HSL activity. Insulin also impairs the normal function of beta receptors, which is another form of HSL inhibition (i.e. insulin lowers HSL activity directly and indirectly via beta receptor disruption).

Catecholamines (adrenaline & noradrenaline to our UK/European friends and epinephrine & norepinephrine to us Americans) speed fat release when they bind beta receptors, which would increase HSL activity. But they can also slow fat release when they bind alpha receptors. This is one of the reasons stubborn fat, which has a higher concentration of alpha receptors, can be so slow to respond.

Other hormones have more complex and overlapping activity. Estrogen seems to both increase the number AND activity of alpha adrenergic receptors. The female fat distribution, where fat is stored in the lower body, is primarily due to the impact of estrogen (the subcutaneous fat and especially the lower body subcutaneous fat of women is richer in estrogen receptors).

Thyroid hormone increases beta receptor activity, blocks the activity of alpha receptors and works in opposition to estrogen making stubborn fat less stubborn. However, thyroid hormone is disrupted itself by estrogen (one of the reasons women have larger thyroid glands compared to men).

Is your head spinning yet? Don't worry, it will all make sense soon. Here are a few takeaways regarding stubborn fat in general and some hormonal effects to keep in mind.

1. Stubborn fat has more alpha receptors
2. Stubborn fat has less beta receptors
3. Stubborn fat stores more fat and releases less of it under the influence of insulin
4. Stubborn fat has less blood flow through it
5. Hormones that increase HSL activity and/or inhibit LPL activity stimulate fat release
6. Hormones that decrease HSL activity and/or stimulate LPL action encourage fat storage
7. Calories matter too. It is impossible to store fat regardless of hormonal action in a low calorie state and it is unlikely to lose fat if you are in calorie excess
8. Stubborn fat is stubborn not because it can't be released, but rather because it releases fat much more slowly compared to less stubborn fat.
9. The sex steroids (estrogen, progesterone and testosterone) have receptors in fat tissue and play an important role in HSL/LPL activity as well as impact alpha versus beta receptor number and activity

The most stubborn types of fat

So based on the points above, where are the most stubborn types of fat? We store fat in several different places.

There is fat stored just underneath the skin. We call this fat "subcutaneous fat". This is the stuff that hangs over your belt. Then there is fat we store deep in our middle area around our organs (another name for organs is viscera) and under our abdominal muscles. This fat is called visceral fat. This is the stuff that gives many men that large protruding belly. You can't pinch this stuff. Finally there is fat stored in and around our muscles. This is called intramuscular fat.

The most stubborn fat on the body is the fat under our skin, the subcutaneous fat. Female subcutaneous fat is more stubborn compared to male subcutaneous fat. The most stubborn fat in the majority of women is lower body subcutaneous fat around the hip, butt and thighs (also called saddle bags, thunder thighs or bubble butts). The most stubborn fat on men is the subcutaneous fat of the lower abdomen (often called the love handles)

So here is how it breaks down:

• Subcutaneous fat is far more stubborn compared to visceral fat
• Subcutaneous fat is stubborn because it is more reactive to insulin, has lower blood supply AND has more alpha receptors
• Visceral fat is less stubborn because it has more beta receptors, greater blood flow and is less reactive to insulin
• Female subcutaneous fat in the lower body has about 9 to 10 times more alpha receptors compared to male lower body fat
• The place on men that is most stubborn is the lower belly fat and love handle area
• The places that are most stubborn on women are the saddle bags, inner thighs, butt and lower belly fat.
• Another reason stubborn fat is stubborn is due to poor blood supply. Both the fact that it is in colder areas AND has more alpha receptors make this so
• Stubborn fat is impacted directly or indirectly by many different types of hormones. These hormones have varying effects on the activity of HSL and LPL as well as alpha and beta receptors

The shocking truth about dieting and stubborn fat

One of the most frustrating things related to stubborn fat is that dieting does not help it. In fact, dieting makes stubborn fat more stubborn!!

Let me slow down here and let you take that in for a minute. When you go on a diet, and by diet I mean the popular approach of "eating less and exercising more", the end result is that you will often make your fat parts fatter.

Many people are not aware, but dieting has never been proven by research to work over the long run. In fact, it has actually been proven not to work. 95% of people who go on diets end up gaining all of the weight back and 66% of those people end up fatter than they were before they started the diet. When they gain the weight back most of it goes straight to the stubborn fat areas. Very depressing I know.

When you diet by the popular method of "eating less and exercising more", the law of metabolic compensation kicks in (I call it a law because it is probably the most predictable and agreed upon phenomena in all of dieting). I am not going to go through this compensatory effect of dieting in detail here, but I did an in-depth blog on this in the past you will want to review. That article is HERE.

In short, this is how dieting (eating less and exercising more) makes your fat parts fatter. First, compensatory changes take place that make you more hungry, cause unstable energy and create insatiable cravings for high calorie palatable food. This is why 95% of people gain all the weight back or more. At the same time thyroid hormone levels decline and the fat cells themselves become more reactive to insulin. This means HSL is turned down (less fat release), LPL is turned up (more fat storage) and alpha receptor activity is elevated and beta receptor activity is supressed. Remember, stubborn fat is stubborn because of the alpha receptors so we certainly don't want those pesky guys being any more active. All of this makes the fat cell far more greedy (more fat storage) and stingy (less fat burning).

Why did I take the time to go through all that? Because if you hope to beat stubborn body fat you have to first realize that dieting is hurting rather than helping your efforts. To beat stubborn fat one of the first things you need to do is escape the eat less, exercise more mindset.

Overview & Action Steps

Now we can get into how to lose stubborn fat. Here are the three steps up front and I will get into details below

1. Stop dieting. Move from an eat less exercise more approach (ELEM) to either an eat less, exercise less (ELEL) or an eat more, exercise more (EMEM) approach. This fights the law of metabolic compensation.
2. Cycle your diet. Cycle the diet in a way to have periods of more food and exercise with periods of less food and exercise. This helps build muscle and burn fat (or at least maintain it) and keeps you from becoming skinny fat or bulking up. It also fights against the law of metabolic compensation.
3. Target the area. Use targeted supplements, exercise and lifestyle strategies to suppress and/or bypass the alpha receptors AND elevate the beta receptors to speed fat release from stubborn areas.

Stop dieting

Imagine driving down the highway with your parking break on. Because of the compensatory processes dieting induces, you can't attack stubborn fat in this way. To burn fat you require two things, a calorie deficit and hormonal balance. Eating less and exercising more (ELEM) gives you the calorie deficit but has a negative impact on metabolic balance so that you won't maintain that deficit for long and will soon rebound back to eating more and exercising less (the law of compensation makes it so you will feel lazy/tired and feel hungry and crave. It's only cause your body loves you ;-))

You will have better luck with a different approach. You can eat less and exercise less (ELEL) OR eat more and exercise more (EMEM). Both of these approaches can create a calorie deficit AND will balance metabolic biochemistry. This way you are not chasing your hunger, energy and cravings around all day. More importantly, this makes the thyroid decline that accompanies traditional dieting far less likely which means the alpha and beta receptors are kept in check.

Cycle the diet

You already learned about what I call the law of metabolic compensation. This is when dieting (eating less and exercising more) causes increased hunger, unstable energy, more cravings and metabolic slow down. There is another law of metabolism I call the law of metabolic multitasking. This law informs us about the body's inefficiency when it comes to burning fat and building muscle at the same time. It is not good at doing both and instead likes to focus on one or the other.

Cycling your diet between periods of more food and exercise (EMEM, building phase) and less food and exercise (ELEL, burning phase) allows you to circumvent the law of metabolic multitasking. It also works against the law of metabolic compensation as well. A two for one deal.

This approach could be as simple as having one or two heavy eating and exercise days on the weekend followed by 5 weekdays eating less and exercising less (if your interested in more details on this see this blog). It also could mean a week or two in an eat less, exercise less state followed by a few weeks in an eat more, exercise more state. Again, to review how cycling the diet in such a way can circumvent the law of metabolic compensation see this blog.

Target the area

Now that you have increased fat burning globally by taking care to control the law of compensation and multitasking, it is time to target your stubborn fat. For the sake of simplicity we will divide the stubborn fat into three areas 1) female lower body 2) female belly 3) male belly.

Female lower body fat:

• Stop eating less and exercising more (ELEM) and use an eat less, exercise less (ELEL) or an eat more, exercise more (EMEM) approach instead.
• For ELEL use a 3:2:1 approach for nutrition and exercise. Nutrition= 3 meals per day, 2 of the three meals are 30-40g protein shakes, 1 regular meal per day. Exercise= 3 R&R workouts (covered in this blog), 2 traditional full body weight training workouts, 1 hour or more of leisurely walking on all or most days
• For EMEM use a 3:2:2 approach for nutrition and exercise. Nutrition= 3 meals per day, 2 protein shakes per day, 2 times the starch intake after workouts. Exercise= 3 traditional weight training sessions, 2 metabolic conditioning sessions, 2 traditional cardio sessions.
• Consider using the ELEL approach in lower estrogen states (i.e. the luteal phase of menstrual cycle which is two weeks after ovulation and before menses). See this article on female phase training for more details. The only adjustment to make to the protocol is to make the luteal phase more relaxing type activity.
• Use supplements to bypass or block the alpha receptors. Green tea extract (GTE) and Coleus Forskohli (Forslean) are two supplements that work by increasing intracellular cAMP which increases HSL activity. This is the same thing that happens when catecholamines bind beta receptors. The only issue is catecholamines also bind alpha receptors. Using GTE and Forslean allow the beta adrenergic effect without the negative alpha effect. Yohimbine HCL, synephrine, and berberine will all have an impact on directly blocking alpha adrenergic receptors with yohimbine being the most potent. These only work in a low insulin state and work best taken before fasted exercise. Given the strong stimulating impact of yohimbine (talk to a doctor before taking), GTE and Forslean are your best bet. Metabolic Effect has a product that combines both. Check it out here

Female & Male Belly Fat

Luckily I have done an entire in-depth blog on female belly fat and belly fat in general. You can find the female belly fat article HERE. Notice it uses an ELEL approach. Find the more male oriented belly fat diet HERE. Here are the major points so you don't have to leave this blog.

• Female belly fat is more about stress. Women with high waist to hip ratios (i.e. bigger belly) whether overweight or underweight, are more stress reactive. This means that female belly fat is more about negative stress than food and exercise. Which is good to know, because when food and exercise are taken to the extreme they can become a stress. This is why we often say that a women with stubborn belly fat that does not respond to diet and exercise would be far better off spending an extra hour in bed than an extra hour on the treadmill.
• The stress that causes female belly fat leads to a unique hormonal situation where testosterone and cortisol are high while estrogen is low.
• ELEL may be the best approach to use for female belly fat since it is focused on relaxation and recovery
• Male belly fat is a bit different and is more an issue of lower testosterone and higher cortisol and insulin.
• Male belly fat will respond to either ELEL or EMEM and can even respond to ELEM.
• For male belly fat carbohydrate modification (not too low though as that can cause increased cortisol) is a big piece. So that you don't go too low find the carbohydrate tipping point. This is the amount/type/timing of carbs that give energy and keep stress hormones at bay.
• The dominant form of activity for males with belly fat should be weight training. For male belly fat it is best to use diet NOT exercise to create the calorie deficit and then use weight training to create the proper testosterone, cortisol and insulin levels.

Final Thoughts

Stubborn fat is unique physiologically because it is far more reactive to insulin and has greater amounts of alpha adrenergic receptors. Stubborn fat in certain areas of the body varies and there is definitely gender differences due to the impact of hormones like estrogen, progesterone and testosterone. To beat stubborn fat follow a three step process.

1. Stop dieting. The eat less, exercise more (ELEM) approach makes you more hungry, increases cravings and throws off energy making it more likely you will eat more and regain all the weight back and more. The decline in thyroid hormone and the increased insulin reactivity of stubborn fat created by diets also means your fat parts will get fatter and more stubborn. Move instead to an eat less, exercise less approach (ELEL) OR an eat more, exercise more approach (EMEM). Both the ELEL and EMEM approach are wonderful at blunting the body's natural compensatory reactions (law of metabolic compensation) and keep the body humming along in a calorie deficit and hormonal balance.
2. Cycle the diet. In order to further reduce the natural compensation of the body AND be able to circumvent the body' natural aversion to simultaneously burning fat and building muscle (law of metabolic multitasking), alternate between periods of ELEL and EMEM. This allows global shape change so you don't end up creating the two most common looks of dieting, the skinny fat look and or the bulky/bloated look.
3. Target the area. This was covered in detail above in the "overview and actions" section.

That's it. I hope this gives you an idea of how to target stubborn body fat and the steps required to deal with it. For references to the science and details please use the links provided throughout the article and the links to pubmed below in the reference sections.

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References:

Estrogen exposure upregulates alpha 2 receptor activity acutely

Another study on how estrogen increases alpha adrenergic receptor activity

Subcutaneous fat is more easily stored and harder to burn compared to visceral fat because of increased insulin reactivity

Thyroid hormone increases beta receptor activity

More info on hypothyroid and adrenergic receptor activity. Hypothyroid decreases beta receptor activity while leaving alpha receptor activity intact

low thyroid causes increased activity of alpha adrenergic receptors

Impact of estrogen, progesterone and testosterone on local fat storing & burning

Review of adrenergic receptor and regulation of fat metabolism