Tamara Duker Freuman, MS, RD, CDN
The Bloated Belly Whisperer
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Bloated Belly Q&A Index

"Why did stress steal my flat belly?"

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“Dear TBBW,

I’ve had chronic stomach bloating for the past 7 years. I used to have a flat stomach but after a stressful episode, it got bloated and I have never gotten my flat stomach flat again. It is ALWAYS bloated no matter what I do. A liquid diet helps but its insanely difficult. My belly looks 4 or 5 months pregnant all the time. (Except after a meal—and particularly a large meal—when it’s even more bloated.) Weird thing is, it’s not painful. I am not overweight— about 5’3” and 132 pounds—though I have lots of belly fat, as my fat gets stored there. What can I do? I miss my flat belly :(

-JM”

Dear JM,

You’ve given me a few very helpful clues: (1) that the bloating started after a stressful period of your life; (2) that it’s pregnant-looking but not painful; (3) that it’s relatively better on a liquid diet and much worse after a meal. All of these factors raise my index of suspicion for a condition called Abdominophrenic Dyssynergia (which we’ll abbreviate as APD for convenience.) APD is one of the “food baby” types of bloating I describe in my book, and it results from abnormal nerve signals directing the muscles of the abdominal wall that result in complete and utter relaxation of the abdominal muscles in response to even the slightest bit of food (or gas) in the stomach. The stretch is exaggerated relative to the volume you’ve ingested, and only gets moreso with larger volume intake. (Hence the relative improvement in appearance on a liquid diet, but still not flat…) . Chapter 3 of The Bloated Belly Whisperer describes this condition in great detail, including its causes, its diagnosis and the variety of medical treatment options available. If you do have APD, then until you can retrain underlying nerve signals with medication or physical therapy/biofeedback, you’ll look less bloated by following a grazing/sipping type of pattern rather than eating consolidated meals, and by sticking to softer textured, cooked foods that empty the stomach relatively faster. (Salads and popcorn are NOT your friend right now.)

As for the belly fat, that’s quite a different story. There are a variety of reasons people are predisposed to storing fat in their belly even if they aren’t overweight: age, natural body shape (e.g., “apples” versus “pears,” drinking alcohol, smoking cigarettes…) . Weight loss is the only way to get rid of belly fat, I’m afraid…

-Tamara

Tamara Duker Freuman