Sumiko At 61: I set out to lose belly fat but gained 1kg of muscle
No exercise can get rid of my menopause belly, say doctors. They suggest building up my muscles instead.
It is not at all a nice feeling to realise your waist is getting bigger.
But menopause does things to your body, and after the last of my symptoms finally subsided about three years ago, I was left with a wad of belly fat.
I gained about 3kg through my late 50s. I didn’t really mind how some of the new weight plumped up my cheeks as that counterbalanced the facial hollowing that ageing brings. But the rest of it seemed to have gravitated to my belly.
Not that I was wasp-waisted or rippling with abs to begin with, but I’d always had a reasonably flat tummy and could squeeze into size 24 jeans well into my early 50s. Then I couldn’t.
The first warning sign was when my abdominal skin changed. Once smooth and taut, it started to look disturbingly wobbly. (As you age, skin loses elasticity and muscle tone diminishes.)
Then, centimetre by centimetre, my waistline started to expand. Even sucking in my tummy couldn’t get rid of the little mound that had formed.
Sit-ups and an abdominal cream which promised to “sculpt and help redefine areas prone to sagging, especially for women over 50” didn’t help either.
I sought professional advice.
Unfortunately, there is no magic exercise or treatment for belly fat.
“Targeting fat loss in specific areas like the belly is largely a myth,” said Dr Shannon Chia, team lead at Sport Singapore’s Active Health division.
“While certain exercises can strengthen muscles in specific areas, they do not directly lead to fat loss there,” said Dr Chia, who has a PhD in sports and exercise science.
“Doing countless seated abdominals will strengthen abdominal muscles but won’t necessarily reduce belly fat.”
Dr Sarah Tan, a consultant at the department of endocrinology at the Singapore General Hospital, explained that fat in the body is stored in two primary areas.
One is the subcutaneous region, that is, directly under the skin.
It accounts for the bulk of fat in the body including the abdomen, thighs, hips and buttocks. This fat acts as an energy reserve and provides insulation and cushioning.
Fat is also found in the visceral region, which is the area surrounding internal organs such as the liver, intestines, kidneys and heart.
Abdominal fat, especially when accompanied by a high waist circumference – defined as over 90cm in Asian men and over 80cm in Asian women – is reflective of high visceral fat, said Dr Tan.
Visceral fat is associated with an increased risk of cardiovascular disease, insulin resistance, Type 2 diabetes and liver disease, among other health woes.
Where fat is stored in a person’s body is influenced by many factors including genetics, hormones, diet and physical activity.
Oestrogen plays a key role in determining where women store fat, said Dr Tan.
This hormone promotes fat accumulation in the hips, thighs and buttocks. But during menopause, declining oestrogen levels may lead to fat redistribution to the abdominal region, Dr Tan said.
There is no specific method to target abdominal fat, the doctors agreed. You just have to lose weight overall, through a healthy diet, more physical activity, proper sleep and stress management.
“Address obesity, then you will address visceral obesity as well,” said Dr Benjamin Lam, clinical director of the Integrated Care for Obesity and Diabetes Centre at Khoo Teck Puat Hospital (KTPH).
Exercising and eating healthily help to create a calorie deficit, where fewer calories are consumed while more calories are burned. When this happens, the body turns to its fat stores to release energy. This leads to a reduction in fat stores over time, Dr Tan said.
Speaking to the experts, what I kept hearing instead was the importance of building up muscles if I wanted to combat belly fat.
As Dr Chia explained, muscle tissue burns more calories at rest compared with fat tissue. This means that a person with more muscle mass will burn more calories throughout the day, contributing to overall fat loss.
While aerobic exercise can effectively burn calories, combining it with muscle strengthening exercises yields better results for reducing fat, Dr Chia added.
Another big advantage of building your muscles is in combating sarcopenia, which is the progressive and involuntary loss of muscle mass, strength and function when you age.
Dr Lam, who is a senior consultant in family and community medicine at KTPH, said sarcopenia predisposes one to loss of bone density, leading to osteopenia and osteoporosis.
It also leads to loss of function such as balance and mobility, and frailty, which can result in falls and loss of independence.
A lack of muscle strength can result in less physical activity and difficulty performing daily tasks. “The reduced activity further exacerbates muscle loss, creating a cycle of inactivity, muscle loss and loss of function,” Dr Lam said.
With all this in mind, I decided to do something about gaining muscle and building strength.
Active Health
In 2017, national sports agency Sport Singapore launched Active Health, an initiative to get Singaporeans to set and meet health and fitness goals.
It runs nine Active Health Labs, which are mostly located at regional sports centres.
The approach is holistic, said Dr Chia. Health coaches don’t just get people to exercise, but also teach them about better nutrition and better sleep.
I began my journey in October 2024 at the Active Health Lab in Delta Sports Complex in Henderson. It isn’t a gym but a cheerful space furnished with chairs and basic exercise equipment.
The introductory, hour-long session involved a fitness and health assessment ($11 for citizens and permanent residents but currently available at $7 per person).
You get a thorough body composition reading on a bio-electrical impedance analysis machine, which measures health parameters by sending bio-electrical pulses through the body. You are also tested on how you perform everyday movements, such as sitting and standing from a chair.
A health coach then talks you through the body composition results and also gets you to reflect on your health targets and what lifestyle habits you can tap to achieve them.
Following the session, you can sign up for exercise, nutrition and sleep workshops. Fees range from up to $11 for a single session to $60 for a multi-session programme.
Some workshops are free for seniors.
One of the first things Dr Chia urged me to do was to not be too hung up about my weight and BMI, or body mass index, which is calculated based on weight relative to height.
BMI doesn’t accurately reflect body fat percentage or distribution, or differentiate between muscle and fat, she pointed out.
“A muscular person may be classified as overweight or obese despite being healthy. This can lead to misinterpretations of health risks based solely on BMI,” she said.
She added: “People who fixate only on their weight have a tendency to go on frequent diets, but most diets are unsustainable, leading to a cycle of weight loss and regain.”
The two measurements I should be more concerned about are skeletal muscle mass (SMM) and percentage body fat (PBF).
SMM is the total weight of the muscles attached to your bones and what allows you to perform a wide range of movements and functions. These muscles can be grown and developed through exercise.
PBF is derived from fat mass divided by body weight. The normal value for males is between 10 per cent and 20 per cent, and between 18 per cent and 28 per cent for females.
While my weight and BMI were in the “normal” range, my SMM and PBF weren’t.
My SMM was 18.5kg and quite substantially below “normal”. I should ideally put on 8kg of muscles.
Dr Chia said my profile was typical of seniors who do daily exercises such as walking and consider themselves active and healthy as their weight and BMI are normal. We might not be aware that our SMM could be low and of the dangers of sarcopenia.
My PBF wasn’t ideal, either.
My percentage of body fat was 32 per cent, clearly in the “over” range. This, though, was balanced by how the fat in the visceral area met the healthy range.
Dr Chia listed the benefits of strength training:
- My body composition would improve with more lean muscle mass and lower body fat.
- My metabolic health would improve, and I should see better lipid and cholesterol levels and lower blood pressure.
- I’d cut down the risk of developing chronic ailments such as diabetes and heart disease.
- I’d increase bone mineral density that may reduce the risk of osteoporosis.
- I’d have muscles that are more toned, and I’d feel and look better.
- I’d be preventing sarcopenia.
I went through an eight-session workshop called Combat Age-related Loss of Muscle 1.0 (Calm). It costs $60 before discount and ActiveSG credits can be used to offset part of the fee. Sessions comprise up to 15 participants.
The programme is for those aged 60 and above and unfamiliar with strength exercises. The sessions include tips on nutrition – especially the importance of protein – and good sleep.
I’d always been wary of “strength training” as it conjured images of doing heavy weights in sweaty gyms. Calm changed my mind.
Active Health coach Mavis Lo showed me simple exercises using my body weight and resistance bands, as well as household items such as backpacks and 1-litre bottles. When we progressed to weights, I used light ones.
The key is to focus on proper form, then gradually increase the weights as you become stronger, said Dr Chia. When performed correctly, these exercises can protect joints by strengthening the muscles around them.
This can help alleviate joint pain associated with conditions like arthritis, Dr Chia said.
I didn’t even need to do strength training every day.
Dr Chia said covering all major muscle groups at least two days a week was sufficient, as you should also let muscles recover.
Adults aged 18 to 64 are recommended to clock 150 to 300 minutes of moderate-intensity aerobic activity each week such as brisk walking, jogging, cycling and swimming.
Dr Chia said it’s best to add to this muscle-strengthening activities at least twice a week.
For those who can’t allot time to training, she suggested “movement snacks”, or short bouts of exercise throughout the day. Fitting in squats while watching TV or during a break at work all count.
“Compound” exercises working multiple muscle groups at once – such as those shown on this page – maximise efficiency.
“Most importantly, find something you enjoy doing, be it the environment you exercise in, type of exercise or sport you pick up,” Dr Chia said.
After a few sessions with Ms Lo, I pinned down about six exercises for the upper and lower body that I liked.
From October to December 2024, I did about two sets of 10 repetitions of each exercise, thrice a week. I continued with slow 40-minute jogs three to four times a week, and taiji twice a week. I tried to eat more protein.
In late December, I went for my final body composition reading. The results were encouraging.
My SMM had gone up from 18.5kg to 19.4kg, nearly 1kg. Although my skeletal muscle mass is still “under” – I should be putting on about 7kg more muscle – it was an improvement.
My PBF went down from 32 per cent to 30.4 per cent. It is still too high (28 per cent would make it “normal”), but I was happy with where it’s heading. My visceral fat reading also improved.
My weight increased as well, by 1kg, but I shrugged it off as muscle gain.
And my belly? The wad of fat is still there and I’m not sure my waistline has become any smaller.
But I’m confident that if I keep up with the muscle building exercises I was taught, my belly might be whittled down a little over time.
In any case, I feel stronger, and that’s a nice feeling.
- Sumiko Tan is Chief Columnist & Senior Editor, Publications, at The Straits Times
- Check out Active Health at go.gov.sg/activehealth
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