In my book, THE BROWN FAT REVOLUTION, I divide the diet and exercise programs into two categories:  pre and post menopause.  Why?  The distribution of fat, fat metabolism, and amount of lean muscle are dramatically affected by menopause (estrogen levels).  It has always intrigued me that diets and exercise programs fail to consider this baseline fact when formulating their programs.  As a plastic surgeon, I am consistently aware of the difference in the quality of the skin, fat and muscle in each decade.  In fact this knowledge determines the nuances of a surgical plan because my result is only as good as the “ingredients” that I start with.  The same holds true for a woman who is planning the most effective exercise and nutrition program seeking a flat belly.

A  WOMAN’S ABDOMEN can be flat at any age but we start by recognizing what lifestyle, genetics, sports history, nutrition, pregnancy history and overall health bring to the table.  Left me distill these multiple factors and generalize per decade.  As I do this, woman will find “aha!” moments in their decade that may allow them to pivot to a more efficient way to achieve that universally desired:  FLAT BELLY!

30’s: In this decade xs fat is more commonly seen in the hips.  I am a strong proponent of CORE training:  Pilates, Yoga, Ball routines and varied core routines can build the PILLAR of the entire body…tight, strong but not bulky and fit.  For those women who desire that “cut” look a cleaner diet is necessary…low carbs….this look is achieved in the kitchen…not only the gym per se….

Of course, if pregnancy occurs, the program should be intensified and occasionally there may be some excess skin once optimal shape and fat volume is achieved..then and only then should a “tuck” be entertained….but this is a rare need if diet and exercise are usednsynergistically after pregnancy…of course, a young woman who comes into pregnancy with a fit abdomen will have a quicker recovery…

40’s: The fat distribution changes to preferentially deposit fat in the flanks (muffin top) and lower abdomen. (below the umbilicus)….exercise should continue as in the 20’s but now focus on more attention to the lower abdomen: the transverses abdomens muscle.  The diet need to be cleaner with less carbs….

50’s: The fat distribution continues to be more prominent in the lower abdomen and flanks…the muscle wall weakness becomes more of an issue in creating that ” middle age” bulge…decreased overall metabolism encourages an increase in visceral fat ( inside the abdomen) causing the bulge below the umbilicus to expand and become more of an issue….so manynwoman know this shape and recognize it as looking matronly….solution:  core routine as previous decades but add intense lower abdominal routine to ab workout and concomitantly take a close look at the carbs and alcohol in the diet…..these calories seem to go directly to the belly in this decade!

60’s: The same changes as the 50’s, but more of a challenge to control visceral fat…so, attention to diet and control of carbs, alcohol, artificial sweeteners, coffee very important….these will all bloat the belly.  Exercise the same as in the previous decade.  I find that women who find fun things to love like ballroom dancing, ballet, tennis….will get a total body workout, core training, improvement in posture and metabolic boost while enjoying themselves while they create youthful, fit, tight bodies with youthful fat distribution ….flat belly, beautiful posture, arms, legs, breasts, neck look better because the HUB of the body is firm….it is a great look….and best achieved proactively….not surgically!


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Have you ever noticed that the same throngs of people are on the cardio deck every day, sweating and working so hard, but that no one’s body looks any different than it did last year?  Why?  Most people engage in robotic cardio. The focus is on duration of time on the machine and not on the choice of machines/resistances/intensities of movement.  What is the goal of cardio:  to lose white fat (and expose their abdominal contour) , build lean muscle (and increase metabolism 24/7 not just right after cardio), change the shape of their bodies (butts, legs  and core) and increase their 1.cardiopulmonary stamina.    Here is how you can use cardio to really work  quickly and efficiently:

1. Most importantly, do your cardio first thing in the morning BEFORE you eat at   least 3 times a week.   Be consistent!

2. Choose a machine that allows you to connect with your body in a non-robotic manner (so that you feel the movement):  treadmill with a sharp incline, bike with high resistance, stairs with resistance….a flat treadmill where you are running is almost ineffectual since your body will just go into automatic pilot and your muscles do not read this as “work.”  Sprint:   go as intensely as you can for as long as you can then go into a cool down pace then repeat the intense run.  Studies have shown a 20 percent increase in fat loss with sprinting.

3. If you do sprint, you can limit cardio to a 20 to 25 minute experience per session.  That is enough!

4. While you are doing the exercise, visualize your tight butt, firm thighs, and firm abdomen and transfer your energy into these parts to consciously work them in the movement.

5. Keep your abdomen tight while doing the exercises, assuming an erect posture with shoulders back. Remember CORE, CORE, CORE and MORE!

6. Use music (an Ipod) to get into a zone of feeling your body and what the muscles are doing with every movement

7.Your post cardio shack should be high in protein….low in carbohydrates

Go ahead and watch the white fat shred off of your body with this regimen!