Doing all the right things in terms of diet and exercise and still struggling with your middle area?
There could be something else going on. A number of health-related issues could be causing your belly issues, and each one has slightly different characteristics.
Here, we look at four common problems that can affect your tummy shape, and explain what you can do about them.
THE CAUSE: Cortisol is a key stress hormone often triggered by physical or psychological stress as your body prepares for fight or flight, says GP Dr Samarra Toby. Research has linked cortisol to extra fat, particularly in the abdominal area. Because it increases the production of insulin, cortisol can affect your appetite for sugar and fatty foods at the same time as directing fat cells towards your middle.
The fix: Build your stress resilience. "Exercise, relaxation strategies and meditation are excellent ways to combat stress," advises Dr Toby. "Making sure your sleep habits are healthy can also help." It's a good idea to see your doctor to discuss other possible causes and to rule out serious conditions such as ovarian cancer, which can also cause abdominal distension.
THE CAUSE: The type of food you eat and how much air you swallow determine how much gas you're producing and holding onto. The distension is often caused by reluctance to release that gas, says Professor Andrews.
The fix: Let it go! Producing gas is a good sign because it means you have healthy bacteria in your gut, explains Professor Andrews, adding that the normal person farts 12-20 times a day.
"If it's happening frequently, limit high-FODMAP foods, which include onions, garlic, cabbage and wheat. If you have a real problem with gas it's a good idea to consult a dietitian before drastically changing your diet and possibly missing out on essential nutrients," advises Professor Andrews.
THE CAUSE: Your thyroid gland produces thyroxine, a hormone that regulates metabolism. In hypothyroidism (underactive thyroid) insufficient thyroxine is produced and this can lead to abdominal weight gain. The most common cause is an autoimmune disorder called Hashimoto's thyroiditis, the result of immune cells attacking the thyroid gland. Iodine is vital to thyroid function so you can also develop problems if you don't have enough iodine in your diet.
The fix: It's vital to see your GP if you experience any of the symptoms of hypothyroidism because it can lead to serious complications if left untreated. Your doctor can order a blood test to measure your thyroid hormone levels and check for Hashimoto's thyroiditis. Treatment may involve taking a daily tablet containing thyroxine for the rest of your life.
THE CAUSE: Heavy drinking – more than two standard drinks in one sitting – causes fat to accumulate around your middle. While your liver is busy trying to deal with toxins instead of helping with digestion, any extra kilojoules are stored as fat.
The fix: "Be aware of your alcohol consumption and stay within the recommended guidelines of no more than one or two drinks on any given day, and a couple of alcohol-free days every week," advises Dr Toby. "If you do like a glass of wine or two, make sure your diet is healthy, exercise daily and let your doctor know if you have difficulty controlling the amount or frequency of your drinking."