Bloated Belly

Q. I feel bloated much of the time. What can I do to not feel so puffy?

A. There is no simple solution. That feeling of puffiness in the belly is a little understood symptom that seems to have many causes. A 2005 review of abdominal bloating in the journal Gastroenterology noted that some people define bloating as a feeling of fullness in their stomach. Others describe their abdomen as swollen or distended. What can be confusing to doctors is that sometimes there is no real evidence of bloating: A patient complains of it, but the physician can’t see it. Some patients agree that their abdomen is not swollen, yet they still claim that they are bloated. In other cases, a person has an obviously distended stomach.

The doctors who published the 2005 review explain that bloating may be caused by some sort of abnormal sensation in the gut that a person experiences. It may result from tension in the muscles of the abdominal wall or a hypersensitivity to fluctuations in fluids or gas. And while there can be a medical basis for bloating, such as constipation or gut disorders like irritable bowel syndrome, a feeling of bloating often can be simply an obsessive focus on belly fat.

In fact, it’s normal for body weight to fluctuate around 3 to 5 pounds up or down, depending upon fluid changes throughout the day, and this can be reflected in abdominal contents or stomach volume. Some women swear that their puffiness fluctuates with the time of the month, and report an accumulation of fluid in the days before their period.

Whatever the trigger, belly bloating appears to be common, with up to 15 to 30 percent of the population reporting it, according to the review.  While the causes of bloating are unclear, what to do about it is even more uncertain.

Avoiding salt or excess fiber in beans or certain vegetables are common, but unproven, recommendations. Some people say that large, high-fat meals, carbonated drinks or dairy foods can cause bloating, and so cutting these foods out helps reduce it. Stopping chewing gum may help, too, because sugar-alcohol artificial sweeteners in some sugar-free products (like sorbitol and xylitol) may increase gas in the gut. Those with lactose intolerance or other food allergies may find an alleviation of symptoms by eliminating the trigger foods.

Clearly, since bloating can be different for different people, no one remedy is a surefire fix. It’s a good idea to keep a diary to track your symptoms and see if you can identify triggers. Jot down what, when and how much you eat for a week or two, along with comments on how your belly feels. You may be able to spot a trend—noticing that every time you eat ice cream you feel bloated, for example. You might then eliminate a trigger food from your diet for a few weeks, then gradually add small amounts back in to test the effects. If you notice that you feel bloated after every meal, it might not be what you eat, but how much. Try reducing portion sizes so that you don’t feel stuffed.

Keep in mind that women especially may mistake bloating with increased body fat. If you’re having a tug of war getting into your jeans, you may simply be seeing signs that excess calories are creeping into your diet. Analyze what you eat for a week with a food and fitness log. Then, create an energy deficit of at least 250 to 500 calories per day by eating less and exercising more.

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Martica is a Manhattan-based exercise physiologist and nutritionist and an award-winning fitness instructor. She has written for a variety of publications including Self , Health , Prevention , The New York Times and others. Martica is the author of seven books, including her latest, - Cross-Training for Dummies . (Read her full bio.)