2005-02-11 / Columnists

Eye On Physical Therapy

By Dr. Tim Rohrs

Every few weeks I am asked a question that I find so frustrating that I decided to write this month’s column about it. What I find so frustrating about it is that there is no quick two- minute answer.

This question comes in a variety of flavors.

“How can I get rid of the fat around my stomach?” “Which of the abdominal machine work best for losing fat?” “How can I lose this fat hanging on the under side of my arm?” The quick one-second answer is “You can’t.”

That answer really is not much of an answer and deserves an explanation. The first myth is that you can “spot reduce” fat. That means through special exercise or diet or pills, you can make the fat disappear from the stomach area and leave other body areas as they are. Can’t be done. Hence people ask for the abdominal exercise that will reduce the fat on their belly. This myth is perpetuated by the advertising of the ab machine of the year; the ab roller, ab lounger etc.

It is also perpetuated by the pill that promises to reduce the fat around the abdomen and thighs that was deposited there because of stress levels and cortisol. If you are able to use more calories than you take in then you will mobilize the fat stores in your body to use for energy.

It is impossible to target one specific area, such as the stomach, to mobilize the adipose tissue. Some of you may be thinking, “Well surely if I were to do a lot of sit ups that would do it?” No. The energy used to do sit ups or lift a gallon of milk or to walk to the beach all come from the same place.

That is why people fall hook line and sinker for the ab products advertised on TV. Doing sit ups or abdominal work does not do a whole lot for weight loss, calorie expenditure or for slimming the waist. I am going to use an analogy that I hope will make it clear.

The muscle groups of the body are much like different cars. You have small energy efficient fuel hybrids like the Toyota Prius that gets 50 miles to the gallon and huge gas- guzzlers like the Hummer that gets 12 miles to the gallon. The gasoline used by the car is like the fat we have stored on our body. We want to get rid of our fat (gasoline) as quick as possible. To do that, we have to use the car (muscles) that use the most gas (fat). Some muscles in our body are small like the hand muscles and forearm muscles and some are very big, like the muscles on the front and back of our thighs.

The abdominals are a muscle group that runs from the bottom of our ribs to the pubic bone. It is narrow and thin. If we were to put the abs on a scale from 1 to 10 with 1 being the smallest muscle that uses very little energy to 10 being the biggest muscles that uses a lot of calories, the abs would probably fall around a three. So if we wanted to really use a lot of gas (fat), should we use the Toyota (abdominals) or the Hummer (hamstrings, quadriceps)?

In my experience, most overweight people have strong abdominals and low back muscles. They have become strong from carrying that extra weight for years on end. They do not need stronger abs. They need to shed the layer of adipose tissue that is covering that six pack, and the ab lounger is not the answer.

The answer is aerobic work on a bicycle, treadmill, stepper for at least 20 minutes and at least 3 times per week.

Seek the advice of your physician before starting any training program.

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