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How to Lose Belly Fat

The first time it happened I was in my early twenties, straphanging in a crowded New York City subway car on my way to work. I was wearing a slim-fitting T-shirt dress, one that for reasons that will soon become horrifyingly clear, I subsequently used to scrub out the litter box and then tossed. The seated woman I was standing in front of met my eyes and smiled. Then she stood up. I smiled back and stepped to the side so she could make her way to the door. She stood right next to me.

"Would you like to sit?" she asked kindly. "I remember how tired I was during my pregnancy. You look like you're into your second trimester; it gets easier."

If I had been pregnant, her act of generosity would probably have sent me into early labor right there on the F train.

But I wasn't. (Even so, I took the seat.)

Once in a while I'm still offered a seat on the train, thanks to a belly that seems to always enter a room a split second before the rest of me does.

Every woman's got her own hang-ups about some body flaw, but flabby abs seem to be a universal sore spot. In a recent FITNESS poll, they ranked number one on the list of trouble zones women wanted fixed. Not only has my apple-shaped middle been a preoccupation of mine since I was a tween, it's also been the subject of articles I've written (like this one) and the object of literally hundreds of attempts on my part to accept and/or flatten it. It was only after having twins that I pretty much resigned myself to the fact that my belly was jelly for good.

So when my editor at FITNESS read on my blog that I thought my abs were permanently "stretched out" and I'd abandoned the abs DVDs she'd given me, she asked if I wanted to take a more scientific approach. I thought, sure. Lord knows, endless crunches haven't gotten me far. She set me up with an appointment at the renowned Women's Sports Medicine Center at the Hospital for Special Surgery in New York City, where I would get an ultrasound and find out what's really going on with my middle.

I was all over the idea of getting a scan. I strongly suspected I had what many women who have been pregnant have, diastasis recti, or separated abdominal muscles. That wouldn't explain why I've always had a pooch, but it could partially explain why I had one now. "Diastasis recti occurs when the abdominal muscles separate along the midline because of an enlarging uterus," says Virginia Lupo, MD, chair of the department of obstetrics and gynecology at Hennepin County Medical Center in Minneapolis. "It's unrelated to whether or not the muscles are strong." That means it makes no difference if your abs are made of steel or mush; the chance that they'll pull apart depends on the strength of the connective tissue that fuses them. In a study of women not long after they had given birth, 68 percent had the condition above their navel and 32 percent below. (Deep breath: Most women's abs will move back together again naturally after a while even if we don't rush to Pilates class the minute we get the okay to exercise.) The more pregnancies a woman has had, the more likely she is to have diastasis recti. I've had only one pregnancy, but it was a double, so the odds were good that this was part of my problem.