Thick around the waist? Learn how to lose those extra inches

Excess abdominal fat is a dangerous condition Dr. Travis Stork frequently sees when treating patients in the emergency department. Stork, a practicing physician and host of “The Doctors,” has written "The Lean Belly Prescription: The Fast and Foolproof Diet & Weight-Loss Plan from America’s Top Urgent-Care Doctor,” a guide to help you lose dangerous belly fat for good without feeling like you are on a diet. Read an excerpt.

The Belly Fat Crisis
If you’re carrying extra weight in your abdomen, you’d probably admit that it looks pretty unsightly on the outside. Well, it looks even worse on the inside. I know, because I’ve seen it there.

Many times, sick or injured patients come under my care soon after they’ve eaten an excessively fatty meal. How do I know? I can literally spot the fat globules that are swimming in their blood, just like an oil slick from a broken drilling platform. More times than not, those globules help explain why these unfortunate folks are in the E.R. in the first place.

Blood-borne fat blobs are like homing pigeons, looking to roost in the body’s fat cells. And unless a famine breaks out, that’s right where they’ll stay. There are serious health implications to that, for both men and women. Men are most likely to pack excess fat around their internal organs, which is known as visceral fat. (Ladies, that can happen to you, too, though you’re more likely to pack it in your legs, arms, and butt. That’s no picnic, either. After menopause, though, you’ll be more likely to gain weight in the gut, too.) You know you have visceral fat if your gut is round and firm, your waist is bigger than your hips, or your Wranglers have a waist size of 40 or higher for men, and 35 or higher for women.

If that description fits you, it probably means your body is storing your excess fat like packing peanuts that surround and infiltrate your muscles, heart, liver, kidneys, intestines, and pancreas. But visceral fat doesn’t just lie there, looking ugly. It actively works to harm your body by secreting a number of substances, collectively called adipokines. Adipokines include a hormone called resistin, which leads to high blood sugar and raises your risk of diabetes; angiotensinogen, a compound that raises blood pressure; and interleukin- 6, a chemical associated with arterial inflammation and heart disease.

Visceral fat also messes with another important hormone called adiponectin, which regulates the metabolism of lipids and glucose. The more belly fat you have, the less adiponectin you have, and the lower your metabolism. (And here’s the crazy part: The lower your metabolism, the more belly fat you’ll store. It’s as though belly fat is conspiring to harm you by breeding even more belly fat!) Meanwhile your liver, faced with a high tide of fat globules, feels like it’s swimming in energy. But as it burns that overly abundant energy source, it produces excess cholesterol, which in turn gunks up your arteries in the form of plaque.

Allow that plaque buildup to continue for a decade or more, and that’s when you and I will meet in the E.R.; your increased risks of stroke, heart attack, and diabetes will pay off in an “event.” But just because it’s more business for my shop doesn’t mean I’ll be particularly happy to see you there in that condition.

The most frustrating part of my job as a doctor is having to treat people who are a long way down a road they never should have taken in the first place. The more belly fat you carry, the greater your risk for any number of health worries. And the greater your health risks, the more you’re going to find your medicine cabinet filled with little brown prescription bottles. In the medical journal BMC Family Practice, I saw a chart showing that people with body mass indexes of 30 or higher took up to twice as many prescription drugs as those whose BMIs were less than 25. In fact, overweight people spend 37 percent more money at the pharmacy each year than people of desirable weight; once you reach the level of obesity, your prescription medical costs are an average of 105 percent higher than those of normal-weight folks! That’s a burden on not just your checkbook, but also your health in general.

I’m not a negative man at heart. I became a doctor to help people, not run them down with lectures about how they’re doing themselves in. So let’s talk about reversing that process. Oftentimes you’ll hear people talk about a vicious cycle — how one negative action leads to another and another. I believe in something I think of as a “virtuous cycle,” and people who decide to lose weight can hop onto it.

Let’s say you follow one of the simplest and most effective weight-loss tricks I know: Swapping sweetened beverages for unsweetened. Each of us takes in an average of 450 calories in sweet drinks every day. Over the course of a week, that adds up to around 3,000 calories.

What a coincidence: it takes 3,500 calories to make a pound of fat.

So you start weaning yourself off the sweet stuff, and swapping in healthful beverages like peppermint tea, unsweetened ice tea with lemon, or lemon-lime sparkling water. (Three of my favorites, by the way.) Do this for a couple of weeks, and you might notice a little loosening around the waistline of your pants, a little more definition at your jaw line. So far, you’re the only one who’s in on the secret, but it makes you feel pretty good. So now you elect to take a walk at lunch, rather than surfing the internet while eating a sandwich. A couple of coworkers note the flush in your face when you return, and ask if they could go next time, as well.

After a month, your weight loss is visible, and people start commenting, asking you how you did it. Suddenly, you’re an expert. That makes you try a few other healthy tips, like scheduling more activity on weekends, and registering for a dance class on weeknights. When you drop your first ten pounds, you buy some new clothes, and book an active vacation for the summer — camping near the Grand Canyon, on the North Rim. Now the wholesale makeover is on, motivated by the joy in making improvements, and the way you feel as you’re liberated from a layer of fat.

You’ve gone from the vicious cycle to the virtuous one, where one good decision leads to another. You feel better, you look better, and you’re motivated to try even more strategies for lean living. I’ve seen it happen with people close to me, and I’d like to see it happen to you.

When can you start?

Excerpted from “The Lean Belly Prescription: The Fast and Foolproof Diet & Weight-Loss Plan From America’s Top Urgent-Care Doctor” by Travis Stork. Copyright (c) 2010, reprinted with permission from Rodale.