Effective Weight Loss Strategies: Addressing Stubborn Fat and Muscle Concerns - Family Medicine

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Weight loss-related issues?


Hello Doctor, I have been on the heavier side since childhood, with my highest weight reaching 98 kg at a height of 170 cm, 37% body fat, and 26% skeletal muscle.
Ten months ago, due to high blood pressure and high cholesterol, I decided to lose weight (using a low-sugar diet, intermittent fasting, and bodyweight training).
Currently, I weigh 58 kg, have 18% body fat, and 35% skeletal muscle.
However, I have a few questions regarding my weight loss journey:
1.
I have noticed that the subcutaneous fat in my lower abdomen (below the navel) and thighs is particularly difficult to reduce, and there is still a noticeable amount of subcutaneous fat.
Is this normal? What methods can I use to eliminate this stubborn fat?
2.
I have not been doing much aerobic exercise in the past few months.
Does aerobic exercise help in reducing fat?
3.
I have heard that aerobic exercise can lead to a decrease in muscle mass, and with less muscle mass, it can be easier to gain weight.
Does supplementing with high-protein whey after aerobic exercise help reduce muscle loss, or is it necessary to incorporate strength training to maintain muscle mass?
Thank you, Doctor.

Nìmíng, 20~29 year old female. Ask Date: 2021/02/12

Dr. Wu Zongying reply Family Medicine


Hello: I'm glad to hear that you have successfully lost weight.
Regarding your questions and weight loss methods, here are my responses: The most effective weight loss methods generally involve controlling your diet while incorporating aerobic exercise.
Previously, you were only engaging in bodyweight training.
Although you managed to reduce your body fat percentage through diet, which increased your skeletal muscle percentage, reducing abdominal fat and fat in the thighs or buttocks is best achieved through aerobic exercise.
Aim for aerobic exercise three to four times a week, with each session lasting about 45 minutes, and try to reduce prolonged sitting to minimize fat accumulation in the buttocks.
Aerobic exercise primarily helps in fat reduction, so there’s no need to worry about muscle loss, and you don’t need to specifically consume high protein.

Reply Date: 2021/02/12

More Info


Effective weight loss strategies, especially when addressing stubborn fat and muscle concerns, require a multifaceted approach that combines diet, exercise, and lifestyle modifications. Your journey from 98 kg to 58 kg is commendable, and it’s clear that you’ve made significant progress. However, it’s common to encounter challenges, particularly with stubborn fat in areas like the lower abdomen and thighs. Let’s address your questions one by one.

1. Stubborn Fat in the Lower Abdomen and Thighs: It is entirely normal to experience difficulty in losing fat in specific areas, often referred to as "stubborn fat." This can be attributed to various factors, including genetics, hormonal balance, and body composition. Fat distribution is largely determined by genetics, and certain areas may hold onto fat more tenaciously. To target these areas, consider incorporating a combination of strength training and cardiovascular exercises. High-Intensity Interval Training (HIIT) can be particularly effective as it not only burns calories but also boosts metabolism post-exercise. Additionally, maintaining a caloric deficit through a balanced diet rich in whole foods can help further reduce body fat overall.

2. The Role of Aerobic Exercise: Aerobic exercise is indeed beneficial for fat loss. It helps to create a caloric deficit, which is essential for weight loss. Engaging in aerobic activities such as running, cycling, or swimming for at least 150 minutes per week can significantly aid in reducing overall body fat. Since you mentioned that you had previously done less aerobic exercise, integrating it into your routine can help accelerate fat loss, particularly in stubborn areas. Aim for at least 30-45 minutes of moderate to vigorous aerobic activity several times a week.

3. Muscle Loss Concerns with Aerobic Exercise: It’s a common misconception that aerobic exercise leads to significant muscle loss. While excessive cardio without strength training can lead to some muscle loss, incorporating resistance training into your routine can mitigate this risk. After aerobic workouts, consuming a high-protein meal or supplement, such as whey protein, can help preserve muscle mass. Protein is crucial for muscle repair and growth, especially after workouts. However, it’s essential to combine aerobic exercise with strength training (at least 2-3 times a week) to maintain and build muscle mass. This combination will not only help in fat loss but also improve your overall body composition.

In summary, to effectively tackle stubborn fat while preserving muscle mass, focus on a balanced approach that includes:
- Diet: Maintain a caloric deficit with a diet rich in lean proteins, healthy fats, and complex carbohydrates. Monitor your macronutrient intake to ensure you’re getting enough protein to support muscle maintenance.


- Exercise: Incorporate both aerobic and resistance training into your routine. Aim for at least 150 minutes of aerobic activity weekly, along with 2-3 sessions of strength training.

- Lifestyle: Ensure adequate sleep and manage stress, as both can impact weight loss and fat distribution.

By following these strategies, you can continue your weight loss journey effectively while addressing concerns about stubborn fat and muscle preservation. Remember, consistency is key, and it’s important to be patient with your progress.

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