Part of Strength training for older adults
Exercises for seniors to lose belly fat: what works and what does not
Warning signs, and when to get help
Can exercises for seniors take belly fat off?
Not off the belly in particular, no. Fat does not come off where you work, and the studies that tested that properly are the ones nobody quotes. Researchers train one limb and leave the other one alone, which holds diet, genetics, hormones and habits steady because both limbs belong to one person. Pool 13 of those trials, 1,158 people between 14 and 71, and the trained side ends up level with the untrained side (Ramirez-Campillo 2022).
Most of the lists you will find on this subject admit that in one line and then sell you five moves for the midsection anyway. We would rather say it once, plainly, and spend the rest of the page on what exercise can actually do for you, which is more than the lists give it credit for.
Here is the second half of the answer, and it is more encouraging than the first. In a review of 15 supervised exercise studies in 852 overweight and obese adults, exercise with no diet change at all reduced the fat sitting deep inside the abdomen, a pooled effect size of 0.50 in favor of exercise (Vissers 2013). Aerobic work at moderate or high intensity was the subgroup that carried it. So exercise does reach that fat. It just reaches it the way it reaches all of your fat, as a whole body, and never on request.
Read the population there before you bank on it. Those were adults with a mean body mass index above 25 and no upper age limit, and the reviewers name age only as one of the ways their studies differed from each other. It was not a trial in 75 year olds, and we are not going to pretend it was.
What causes belly fat in older adults?
We cannot tell you why your own middle changed, and any page claiming to know that about you is guessing. What we can do is name the things that sit behind it often enough to be worth checking, so that you are not training for a problem you do not have.
Age itself is part of it, and that is the part the lists leave out. A review of how fat is distributed across the lifespan reports that abdominal fat, and the visceral fat deep inside the abdomen in particular, is commonly found to rise with age, while the fat under the skin of the hips and legs falls, and that this reshuffling can happen with no change in your total fat, your weight or your waist measurement (Kuk 2009). So a middle that has changed while the scale has not is a real thing rather than a failure of will. It also tells you something about measuring. A tape measure is a blunt instrument for this, which is worth remembering when you reach the one figure current guidance does give, further down the page.
Muscle is the one people miss. Strength and muscle fall away with age to the point where it causes problems, which the European working group on sarcopenia describes as a muscle disease rather than a fact of life (Cruz-Jentoft 2019), and our strength program for older adults covers what that is and what to do about it. A middle can look larger while the scale has not moved at all, simply because what used to hold it has gone softer.
Activity usually drops for a reason, not out of laziness. A knee that started hurting. A chest infection that took six weeks. A bereavement, a move, the end of a job that had you on your feet. Nobody decides to become less active; it happens around them, and the weight follows quietly.
For women, there is a stage of life with its own body composition story behind it, and muscle and bone loss in midlife is the page for that rather than this one. If you are on a weight loss medicine, the questions that come with it are answered on older adults on GLP-1 medicines, including what comes off alongside the fat.
Two more, and both are appointments rather than exercises: some medicines change your weight, and so do some conditions. If yours has changed and you cannot account for it, tell your doctor and let them look, and never change or stop a prescribed medicine on your own.
Can you spot reduce belly fat?
No. Enough people half know this already that it is one of the things they search for, and the honest answer is the same one the measurements gave: localized training had no effect on the fat over the trained muscle (Ramirez-Campillo 2022). Across those 37 comparisons, 17 came out in favor of the trained limb and 20 in favor of the untrained one, which is what a coin looks like.
Think of the fat as something your whole body draws on, not a set of separate stores with their own taps. Where it comes off first, and where it hangs on longest, is not something you get to choose, and for most people the middle is the stubborn end of it.
Do core exercises or chair exercises take fat off the middle?
Neither one does, and the reason is the same for both. A muscle contracting does not empty the fat lying over it.
They are still worth your time for what they do. Trunk and hip work supports your back and your balance. Chair work builds the leg strength that decides whether a low sofa is a problem, which is why sit to stand and the chair squat sit near the front of our program, and whether chair exercises really work answers that question properly. The mistake is not doing them. The mistake is doing them for the waistband, giving up at six weeks because the waistband has not moved, and losing the strength you had started to build.
One method deserves a mention because so many older readers are shown it. Wall pilates covers what has and has not been measured for that one, and it is the same honesty as this page.
What exercise does change, and how soon you would notice
This is where exercise earns its place, and it is measurable in weeks rather than months. Liu and Latham's review gathered 121 trials of progressive resistance training in older people, pooling them outcome by outcome. Where the load was pushed up as people got stronger, the effect on muscle strength was large, from 73 of those trials, and the effect on rising from a chair moderate to large, which rests on 11 trials and 384 people (Liu and Latham 2009).
The first changes do not show up on a tape measure. They show up in the small decisions that stop being decisions: getting out of the low chair, or carrying the laundry basket up without putting it down halfway, which you tend to notice only afterward. Our parent page sets out what progress actually looks like, including the habits that let the stronger leg quietly take over, and it is worth reading before you judge how you are doing.
If you want something countable, count the thing that is changing. The 30-second chair stand test repeats easily because the chair is always there, and a tape measure around your middle can sit still for a long time while that number climbs. Balance work belongs in the same plan, because the right kind lowers the rate of falls: see balance and falls prevention for the evidence and the staged program.
For how often, and for which half to start with, strength and balance exercises for seniors holds the answers with the guidelines behind them. The numbers themselves live on the exercise pages, and your physio will adjust them to you.
How do you lose belly fat after 60?
The same way anyone does, which is why the number in the question changes less than you would expect: the whole body loses fat, you do not pick the site, and food does most of the work on the scale while exercise does most of the work on what you can still do. The visceral fat review is the one encouraging exception to that split, because those people changed nothing about their diet and the deep abdominal fat came down anyway (Vissers 2013).
What does change after 60 is the cost of getting it wrong. Losing weight with no strength work behind it takes muscle and bone with it, and the section below on chasing weight loss has the numbers for that.
So the useful plan is unglamorous. Keep the strength work going, add the aerobic side with something you will still be doing in a year, and take the food half to the people whose field it is. The NHS publishes its own advice on managing your weight, and your doctor is the route to whatever weight management help exists where you live. Food plans are not a physio's field and we are not going to improvise one.
For the aerobic half, brisk walking is the one most people can start tomorrow. If you have fallen in the past year or feel unsteady on your feet, start with the strength and balance work and build up to brisk walking from there: the UK osteoporosis consensus recommends that order for the frailer older adult, to prevent an increase in falls risk (Brooke-Wavell 2022). The strength half does not have to look like a gym either: among the activities that count for older adults, the NHS gives carrying heavy shopping bags, working with resistance bands, exercises using your own body weight, and heavy gardening such as digging and shoveling. If a full session is the thing that never happens, exercise snacks makes the case for a few minutes at a time through the day.
Exercises to lose belly fat for seniors: what we would give you instead
A physio handed this request in clinic does not write out five moves for the midsection. Here is what we would actually give you, and why each one is on the list. The checks that come before any of it, after an operation and with a heart condition or blood pressure that is not under control, are below the list.
- Leg strength first, through sit to stand and the chair squat, because rising out of a seat without help is the movement most of the rest of your day hangs on.
- Aerobic work you will actually keep up, since aerobic training was the subgroup that moved the deep abdominal fat in that review (Vissers 2013), and brisk walking is the version most people are still doing a year later.
- Balance work alongside it, because the right kind lowers the rate of falls, and balance and falls prevention holds that evidence.
- A referral for the food half, to your doctor or a dietitian.
The staged program, with video on every exercise and its own starting numbers, is on strength training for older adults. The numbers belong to those pages and not to this one.
With a heart condition or high blood pressure, check with your doctor before you start. If you have high blood pressure, breathe steadily through every repetition and never hold your breath.
If you have had an operation recently, or have broken a bone that is still healing, follow the program from your surgeon, fracture clinic or physio rather than this one. A healing bone has its own timetable for how much weight and load it can take, and that timetable comes from the team looking after it rather than from how the arm or leg feels.
A repair runs to its own clock in the same way. Where a tendon, a ligament or a muscle has been stitched back together, it can feel comfortable long before it can take load, so the limits your surgical team set on lifting, pushing, reaching and leaning on the arm hold until that team lifts them, whatever the limb feels able to do.
If you have had a hip or knee replacement, or a broken hip fixed with screws, a nail or a plate, or with part or all of the hip replaced, get the go-ahead from your surgeon or physio before you try the sit to stand exercises or the chair squat. Some operations limit this kind of work for the first months, so the timing depends on your surgery.
If you have fallen in the past year, feel unsteady on your feet, or take medicines that make you dizzy, keep a hand on a kitchen counter or the back of a sturdy chair for the whole of the standing exercises, practice only when someone else is at home, and ask your doctor or physio about a falls check.
If you live alone, that rule still stands, so plan around it rather than ignoring it. Do the exercises that ask for someone to be at home at your physio appointments or in a class instead, keep to the seated and supported work when you are on your own, and ask your physio which of the standing exercises you may do alone. Keep your phone in a pocket rather than in another room, so you can reach it from the floor, and ask about an alarm you wear.
Stop at once if you get any of these: chest pain or pressure, dizziness or feeling faint, a racing or irregular heartbeat, or being far more out of breath than the effort should cause. Sit or lie down. If chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
Getting up out of a chair is handled differently again, since a short wooze on standing is common enough to expect. You feel dizzy, lightheaded or faint as you get up. Sit back down and wait for it to pass. If it does not pass within a minute or two, or it keeps happening, get medical advice the same day before you practice again. If you faint, or it does not settle within a few minutes of keeping still, call emergency services.
Why chasing weight loss without strength work backfires after 70
This is the part of the subject that an older reader is rarely told, and it has a good trial behind it. Villareal and colleagues randomized 107 adults aged 65 and over with a body mass index of 30 or more, average age about 70, into four groups for a year: nothing, diet, exercise, or diet and exercise together. Ninety-three of them finished (Villareal 2011).
The diet group lost the most weight, about 10 percent of their body weight. They also lost about 5 percent of their lean body mass, 3.2 kg (7 lb) of it, and 2.6 percent of the bone density at the hip. The group that dieted and exercised lost nearly as much weight, about 9 percent, and lost less of both: about 3 percent of lean mass, 1.8 kg (4 lb), and 1.1 percent of hip bone density. The exercise-only group gained lean mass, 1.3 kg (3 lb), and gained hip bone density.
Then look at what any of it was for. On the trial's main measure of physical function, the diet and exercise group improved by 21 percent, against 15 percent for exercise alone, 12 percent for diet alone and 1 percent for the group that did neither (Villareal 2011). Dieting without exercising gave the biggest number on the scale and the smallest gain in what these people could do.
Muscle and hip bone are not things to spend at 75. They are what keeps you out of a chair and what decides whether a fall breaks something. If your bones are already thin, read osteoporosis before you start losing weight on purpose, and talk to your doctor about it. If you are wondering whether this applies at your age at all, strength training over 70 takes that question on its own.
Muscle needs food as well as exercise. The NHS notes that people aged 65 and over are particularly at risk of malnutrition. How much protein and energy you need depends on you and your health, so discuss it with your GP or a dietitian. If you are losing weight without trying, see the warning signs below.
When a bigger middle is not fat
Some of the people who search for this are not describing fat at all, and the exercises would be beside the point.
Bloating is the common one. The NHS puts most of it down to gas in the gut, with food and drink, constipation, food intolerance, celiac disease and irritable bowel syndrome among the causes, and it says to see a GP if you feel very bloated, if you are often bloated, if it does not go away, if changing your diet has not helped, or if the bloating comes with weight loss you did not intend or blood when you poo. Persistent bloating is occasionally a sign of something more serious, including ovarian cancer, which is reason enough to have it looked at rather than trained around.
A middle that is swollen rather than larger, or one that has changed over days or weeks rather than years, is also a question for a doctor first. So is a tummy that is uncomfortable, tender or painful. Nothing on this page applies until somebody has looked at that.
Posture plays a part in how a middle looks, which is the one cheerful line in this section. Stand taller and the same abdomen sits differently with no fat going anywhere. Worth having, and not the same thing as having lost any.
The warning signs below carry the abdominal routes that must not wait: sudden severe tummy or back pain in anyone with a swelling of the main blood vessel in the tummy, or with the risk factors for one, and a bloated, swollen tummy with a sudden severe tummy ache, with blood in your vomit, or with severe trouble breathing. A same-day line sits under those, for bloating that comes with being sick, a tummy ache, a temperature, a lump, or not being able to pass urine, stool or wind.
What this page gives you, and what it will not
No numbered list of moves for the midsection, because the list would be a lie and you would stop in six weeks when it did not work.
One measurement, and not the one you expected. Current UK guidance does not set a waist size in inches or centimeters for you to hit. What it sets is a ratio: keep your waist to less than half your height, and NICE classes a waist-to-height ratio of 0.4 to 0.49 as healthy, 0.5 to 0.59 as increased central adiposity and 0.6 or more as high, in adults whose body mass index is under 35 (NICE NG246).
Two cautions come with that ratio in later life. People lose height as they age, and a ratio with height on the bottom moves when that happens, so a rising number is not always a growing waist. And the deep fat can increase while your weight and your waist stay where they are (Kuk 2009), so a passing ratio is not proof that nothing has changed.
No body mass index for you to aim at. NICE does classify weight by body mass index, and in the same guideline it asks that the reading be interpreted with caution in people aged 65 and over, taking account of other conditions, of anything affecting how well you function, and of the possible protective effect of a slightly higher reading when you are older (NICE NG246). A number needing that much interpretation belongs in a consultation rather than on a page.
No body fat percentage. NICE tells professionals not to use bioimpedance, which is the method behind body fat scales and handheld meters, as a substitute for body mass index in adults (NICE NG246).
No calorie figure, no weekly rate of weight loss and no protein figure. The protein question is answered properly on strength training for older adults, which also refuses to give a number, and for the same reason: the answer depends on you, your health, your appetite and what else is going on, and a page cannot know any of that.
No diet, no fasting window, no meal timing and no supplement. Not because they are all worthless, but because none of that is a physiotherapist's job, and the people whose job it is are one appointment away.
Weight you are losing without trying needs a doctor, not a workout
If you came here because your weight is falling and you did not set out to lose it, close this page and call your doctor. Unintentional weight loss in an older adult is not a win and it is not a sign the exercise is working.
The NHS lists several causes, including mental health conditions such as depression and anxiety, problems with digestion such as celiac disease or inflammatory bowel disease, hormone conditions such as an overactive thyroid, heart conditions such as heart failure, poor nutrition or a lost appetite, and the side effects of some medicines. Cancer can cause it too. The NHS advice is to see a GP if you keep losing weight without changing your diet or exercise routine, and to go as soon as possible if the weight loss comes with other symptoms.
These three lines are also in the warning signs below, and they are the most important thing on this page.
- Losing weight without trying. If you are being treated for cancer now, contact your cancer team the same day.
- Losing weight without trying. If you also have new back or neck pain, get medical advice the same day.
- Losing weight without trying. See your doctor within a day or two and mention it.
We see the other version of this in clinic as well: someone pleased about a looser waistband who turns out to have changed nothing at all about how they eat or move. Weight that leaves on its own gets checked, every time, whether or not you are glad to see it go.
When to see a physio, a doctor or a dietitian
The three of them own different parts of this, and sending you to the right one is most of what this page is for.
A physio or physical therapist is the first call when the everyday jobs have quietly got harder, when standing up has started to need a hand on the chair, or when you cannot work out what level to begin at. One appointment usually settles the starting level and how much support to keep. Ask about the strength and the balance halves together.
Your doctor is the right call for the weight itself, for a change you cannot account for, for your medicines, and for any of the warning signs below. They are also the route to whatever weight management help is available where you live, which is a different thing from a diet book.
A dietitian is the right call for what you eat, especially if your appetite is small, if your weight is falling, or if you have been told to lose weight and want to do it without losing muscle at the same time. Your doctor can refer you.
Each warning sign below sets its own timing, from an emergency call to an appointment in the next day or two. Read them before you start anything on this page.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: if chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
- Emergency: sudden, severe pain in your lower back or tummy that is not like your usual back pain, if you have been told you have a swelling of the main blood vessel in your tummy (abdominal aortic aneurysm), you are over 60, you smoke or used to smoke, or you have high blood pressure. The same applies if sudden, severe back or tummy pain comes with feeling faint or passing out, pale, sweaty or clammy skin, a racing heartbeat or being short of breath. Call emergency services straight away. This can be a sign of an aneurysm bursting, which needs treatment in hospital at once.
- Emergency: a bloated, swollen tummy together with a severe tummy ache that came on very suddenly, vomiting blood or vomit that looks like ground coffee, or severe trouble breathing where you are gasping, choking or cannot get words out. Call emergency services or go to an emergency department straight away, and do not drive yourself.
- Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away.
- Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
- Emergency: you fell and cannot remember the fall or how it happened. Go to an emergency department straight away, and do not drive yourself. You may have blacked out or hit your head without knowing it.
- Emergency: you have had a fall or an injury and now have severe hip pain, or you cannot walk or put weight on the leg. Call emergency services or go to an emergency department. This can be a sign of a broken hip (hip fracture).
- Emergency: you have had a hip replacement and have sudden severe pain in your hip or groin, sometimes with a clunk or pop, and you cannot move the leg or put weight on it, or the leg suddenly looks shorter or turned in or out. Do not try to walk on it or push it back into place. Keep still and call emergency services or go to an emergency department, and do not drive yourself. Your new hip may have come out of its socket (dislocated), and a medical team needs to put it back.
Get help today
- Same day: you blacked out or fainted, even for a moment. Get medical advice the same day. Call emergency services instead if the person is not breathing, cannot be woken within 1 minute, has not fully recovered or has trouble speaking or moving, has chest pain or a pounding, fluttering or irregular heartbeat, fainted while exercising or lying down, is shaking or jerking, or was badly hurt.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, use the fainting line above.
- Same day: dizziness or feeling faint during or after exercise, other than the brief lightheadedness as you stand up covered in the line above, without any of the emergency signs above. Stop the exercises and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
- Same day: after a fall, you are in pain, have hurt yourself or feel unwell, or you were on the floor for an hour or more, without any of the emergency signs above. Get medical advice the same day, even if you managed to get up.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: new hip or groin pain after a fall, even a small one, if you are older, have low bone density (osteoporosis) or have taken steroid tablets for a long time, even if you can still walk. Get medical advice the same day. A broken hip is not always obvious at first.
- Same day: since an operation, the wound is red, hot, swollen, leaking fluid or opening up, you have a fever or feel hot and shivery, or the pain in that area is new or getting worse quickly. Contact your surgical team or the ward you went home from the same day rather than waiting for your physio appointment, and if you cannot reach them, go to an emergency department the same day. This can be an infection in the wound or deeper, around a repair or a new joint.
- Same day: you have had a hip replacement and, after a fall or a knock, even a small one, your hip, groin or thigh is newly painful, bruised or swollen, even if you can still walk and your leg looks normal. Stop the exercises, go back to your crutches or frame and keep your full weight off that leg, and contact your surgical team or get medical advice the same day. A break in the bone around a new hip is not always obvious at first, and walking normally on one can move the broken ends apart.
- Same day: you have had a hip replacement and your hip clunks and feels as if it partly slipped out of place and went back, even if it settles straight away and your leg looks normal. Stop the exercises, avoid the movement that brought it on, go back to your crutches or frame, and keep away from deep bending, crossing your legs and twisting on that leg until you have been seen. Contact your surgical team or get medical advice the same day. If the leg then looks shorter or turned, or you cannot move it or put weight on it, call emergency services.
- Same day: back pain after a minor fall or strain if you are older, have low bone density (osteoporosis) or have taken steroid tablets for a long time. Get medical advice the same day. Until it has been checked, stop the exercises and keep away from lifting, bending forward and twisting, because those load a bone in the spine that may be broken.
- Same day: bloating or a swollen tummy together with being sick, diarrhea or constipation, a tummy ache, a high temperature or feeling hot, cold or shivery, a swelling or lump in your tummy, not being able to pee, poo or pass wind, or heartburn with acid coming up into your throat, without any of the emergency signs above. Get medical advice the same day.
- Losing weight without trying. If you are being treated for cancer now, contact your cancer team the same day.
- Losing weight without trying. If you also have new back or neck pain, get medical advice the same day.
Book an appointment
- A new fall, even if you were not hurt. If none of the lines above apply, book an appointment with your doctor within a few days and tell your physio before your next session. A doctor can check for causes such as muscle weakness, weak bones or eyesight problems, and may refer you to a falls service.
- Losing weight without trying. See your doctor within a day or two and mention it.
Common questions
Can you spot reduce belly fat?
No, and the cleanest test of it has been done many times over. Researchers train one arm or one leg and leave the matching limb untrained, then measure the fat over both, which rules out diet, genetics and everything else by keeping them inside the same person. Pooling 13 of those studies, 1,158 people aged 14 to 71, the trained side came out level with the untrained side: a pooled effect size of 0.03, a hair in the trained limb's favor and far too small to mean anything, with a confidence interval straddling zero and a p value of 0.51, and the 37 comparisons splitting 17 in favor of the trained limb against 20 in favor of the untrained one (Ramirez-Campillo 2022). The authors put the popular belief down to wishful thinking and marketing, and that is a fair reading of where it comes from.
Do core exercises reduce belly fat?
Not the fat. They train the muscles under it, which is a different job and a worthwhile one. Nothing we have read supports the idea that working a muscle empties the fat lying over that muscle, and the limb studies above were designed to catch exactly that effect and did not find it (Ramirez-Campillo 2022). If your back or your balance is the reason you were given trunk work, keep doing it for those reasons. If you were sold it as a way to flatten your middle, that part was not true.
Do chair exercises work for belly fat?
They work, but not for that. Seated and chair-supported work is where our strength program for older adults starts, and for good reason: it builds the leg strength that gets you off a low seat, and it is safe to do alone on a day when standing work is not. If you have had a hip or knee replacement, or a broken hip fixed with screws, a nail or a plate, or with part or all of the hip replaced, get the go-ahead from your surgeon or physio first, because some operations limit this kind of work for the first months and the timing depends on your surgery. What it will not do is move fat from your abdomen, because no exercise does that. Expect the chair to get easier, not your trousers to get looser.
Is belly fat worse for your health than fat elsewhere?
Research treats the fat deep inside the abdomen, around the organs, as the depot most closely tied to disease. Vissers and colleagues write that it seems to be the most pathogenic fat depot, meaning the one most involved in causing disease, and that there seems to be a strong association between it and a raised risk of disease; the hedging in both of those is theirs, not ours, and an association is not a cause (Vissers 2013). Two things follow for you. You cannot tell by looking, or by pinching, how much of your own fat is deep inside and how much is under the skin, and the review of age-related fat distribution makes the same point about simple body measurements (Kuk 2009). And if you want a number, the one current UK guidance gives is a ratio rather than a waist size: NICE asks professionals to tell people to keep their waist to less than half their height, which is a waist-to-height ratio under 0.5, and it classes 0.4 to 0.49 as healthy central adiposity, 0.5 to 0.59 as increased and 0.6 or more as high, in adults whose body mass index is under 35 (NICE NG246). It also encourages adults in that group to measure the ratio themselves and to get advice if it points to an increased risk. What your own number means, alongside the rest of your health, is still a conversation with your doctor rather than a verdict.
How long does it take?
Longer than the headlines, and the first changes are not the ones you were watching for. The trials in the visceral fat review ran at least 8 weeks with at least two supervised sessions a week, which is the floor the reviewers set for a study to count at all (Vissers 2013), and the trial in older adults with obesity ran a full year (Villareal 2011). What moves sooner is what you can do. In the review that gathered 121 trials of progressive resistance training in older people, the gain in muscle strength was large and the gain in rising from a chair moderate to large, provided the resistance kept going up (Liu and Latham 2009). Measure that instead and you will have something to show in weeks. Your physio will adjust the program as it changes.
References
- Ramirez-Campillo R, Andrade DC, Clemente FM, Afonso J, Perez-Castilla A, Gentil P. A proposed model to test the hypothesis of exercise-induced localized fat reduction (spot reduction), including a systematic review with meta-analysis. Human Movement. 2022;23(3):1-14. doi:10.5114/hm.2022.110373
- Vissers D, Hens W, Taeymans J, Baeyens JP, Poortmans J, Van Gaal L. The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis. PLoS One. 2013;8(2):e56415. doi:10.1371/journal.pone.0056415
- Villareal DT, Chode S, Parimi N, et al. Weight loss, exercise, or both and physical function in obese older adults. New England Journal of Medicine. 2011;364(13):1218-1229. doi:10.1056/NEJMoa1008234
- Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database of Systematic Reviews. 2009;(3):CD002759. doi:10.1002/14651858.CD002759.pub2
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Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.