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In part one of this series, we introduced how reducing belly fat (particularly visceral fat) can improve metabolic health. In that post, we used surgery and cancer treatment preparation as examples of urgent situations during which this sped up timeline would need such a strategy. The point was that measuring changes in belly fat using waist circumference can be a simple way of tracking progress, so you can be confident your health is meaningfully improving without needing frequent blood tests. Really, you can apply this approach in any scenario when time is short and motivation is high.
-So how can you actually pull this off?-
In this post, we'll walk through how a combination of weight training and aerobic exercise can reduce belly fat, partially by improving insulin sensitivity and reducing fat storage in the liver. We'll also explain how lifting weights can quickly “hide” belly fat less by emphasizing muscle tone, which draws attention away from the waist. The cool part is that building muscle also helps your body more easily store blood sugar in muscles instead of allowing it to overwhelm the liver, which would otherwise lead to or worsen “fatty liver disease.”
Insulin sensitivity refers to how well your body responds to insulin, a hormone your pancreas releases to lower blood sugar (glucose) levels. When you have high insulin sensitivity, your body easily takes in glucose from your bloodstream and burns it for energy or stores it for future use. Think of insulin as the quarter you throw in a tollbooth to pass through. With insulin resistance, it’s like the toll went up, so your body has to throw 50 cents to pass the same car through. Eventually, the toll price exceeds the spare change you have sitting in the cup holder- the onset of diabetes, when the pancreas can no longer keep up with demand for blood sugar control.
Here's where exercise comes in. Both aerobic exercise (like walking, running, or cycling) and resistance training (like weight lifting) can help improve insulin sensitivity in different ways:
Together, these two types of exercise create a powerful, synergistic effect. While aerobic exercise provides quick improvements in insulin sensitivity, weight lifting offers longer-term benefits by increasing muscle size and improving your body's glucose storage.
Beyond the health benefits, weight lifting also changes your body's appearance in ways that naturally emphasize a more toned and athletic look. Strength training builds muscle mass in areas away from the waist like the shoulders, chest, arms, and legs, creating a more balanced physique that draws attention away from the waistline. This helps improve your body aesthetics while working to reduce belly fat over time.
Moreover, building more muscle mass increases your resting metabolism — meaning, all else held equal, you'll burn more calories even when you're not working out. This changes the “algebra of weight loss” to further help reduce belly fat.
*We’ll discuss this further in a future post, but the algebra of weight loss simply means that in the end, to lose weight you need to burn more calories than you consume in a day. Yes, the source of those calories (sugar, protein, fat, etc.) matters but only because it changes the calories in/out that your metabolism measures.*
As always, anything I write here is for informational purposes and is not medical advice. If it appears to be counter to the recommendations given by your personal provider, go with what they say- they know you better.
You don’t have to lose a lot of weight to see significant improvements in your health. Research shows (*cite) that even a modest weight loss of 5% of your body weight can lead to improvements in conditions such as high blood pressure, polycystic ovarian syndrome (PCOS), osteoarthritis, and acid reflux (GERD).1,2,3,4,5 Losing 10% of your weight can help improve obstructive sleep apnea and reduce the risk of developing non-alcoholic fatty liver disease (NAFLD, now often called “metabolic associated fatty liver disease”). 6
In fact, you can see meaningful improvements in insulin sensitivity and glucose control with as little as 3% weight loss when combining aerobic and resistance training . This means you don’t have to wait to reach large weight loss goals to see significant health benefits.
Home Workout Plan to Target Belly Fat and Improve Insulin Sensitivity
This workout plan combines both aerobic and resistance exercises to maximize fat loss (preferentially belly fat), improve insulin sensitivity, and build muscle. You can do this at home with minimal equipment or in a gym for a little extra variety. I’ve left a lot open to personalization, based on preferences, time availability, and other potential issues like joint/back pain.
Activity: Fast-paced walking, cycling, or jogging
Frequency: 3-4 times per week
Duration: 30-45 minutes per session
Intensity: Aim for 40-60% of your maximum heart rate. Roughly, this is a pace at which you should be able to talk with mild difficulty but too intense to comfortably sing.
Frequency: 2-3 times per week
Equipment: Dumbbells, resistance bands, or body weight
Exercises: Focus on compound movements that target multiple, large muscle groups. Example:
Squats: 3 sets of 8-15 reps
Push-ups: 3 sets of 8-15 reps
Bent-over rows (with dumbbells or resistance bands): 3 sets of 8-15 reps
Lunges: 3 sets of 8-15 reps per leg
*Planks: 3 sets, hold for 30-60 seconds.
By incorporating aerobic and resistance training into your routine, you can target belly fat for aesthetic benefit and improve insulin sensitivity, supporting better metabolic health. This workout plan doesn’t just help you lose fat — it reshapes your body, increases glucose storage in muscles, and reduces the risk of conditions like type 2 diabetes and fatty liver disease. Start with smaller goals, such as a 3-5% reduction in body weight, and focus on consistency. Big weight loss quickly is typically less sustainable than the same weight loss over longer periods of time.
Alexander Watson, MD is a distinguished physician specializing in physical medicine & rehabilitation (PM&R) with a clinical focus on obesity medicine. He is the lead physician and founder of Admire Medical in Middletown, DE. Dr. Watson earned his medical degree and a master’s degree in business administration from Rutgers, The State University of New Jersey. He completed his residency training at the University of Pittsburgh Medical Center, where he provided prehabilitation counseling for patients prior to solid organ transplant, spine surgery, bariatric surgery, and cancer treatments. Dr. Watson has published multiple book chapters and articles on back pain, obesity medicine, and the continuum of care during cancer rehabilitation. He is also the author of Healing in Advance, Your Prehabilitation Handbook, a book for patients (publication date 1/7/2025) and co-editor of A Prehabilitation Guide for All Providers, expected to be released Fall/Winter 2024.
For more on these, check out this page.
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