It's frustrating when weight gain hits the same areas every time—your hips, stomach, or buttocks. Why does this happen? We consulted Mariëtte Boon, an internist-in-training at Leiden University Medical Center, for answers.
Mariëtte Boon: "This pattern is influenced by sex hormones. Women typically have higher estrogen levels than testosterone, directing fat more to the hips than the belly. During menopause, declining estrogen shifts the balance toward testosterone, promoting abdominal fat. Women with Polycystic Ovarian Syndrome (PCOS) often have elevated testosterone, leading to a rounder stomach."
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"Men experience the opposite: youthful testosterone protects against belly fat, but as levels drop with age, abdominal storage increases. Stress hormones can also redistribute fat from arms and legs to the midsection. Sensitivity varies—about 10 to 15 percent of people are particularly prone. Medications like prednisone, which mimic stress hormones, often lead to abdominal fat gain too."
"Genetic factors largely determine these patterns. If broad hips run in your family, genes are likely dictating where fat cells store excess. Spot reduction myths peddled by infomercials—like melting belly fat with gadgets or targeted exercises—don't hold up. When you create a calorie deficit, your body decides where fat is lost. Influence it through exercise, healthy eating, good sleep, stress management, and reviewing medications. Results vary by individual."
Mariëtte Boon (31) is an internist-in-training at Leiden University Medical Center. She earned her PhD cum laude in 2014 for research on brown fat. Co-authoring Fat Important (€20.99, Ambo|Anthos) with professor Liesbeth van Rossum, she debunks myths about body fat with science-backed facts.
