The presence of excess fat above the pubic bone, often referred to as suprapubic fat, is a common source of frustration. This area, like the lower abdomen, is a frequent site for fat accumulation that can be resistant to general weight loss efforts. The biological reality of fat loss requires a systemic approach, as you cannot target fat reduction in one specific area. This article focuses on strategies necessary to reduce overall body fat, which is the only effective way to diminish deposits in this localized area.
Understanding Localized Fat Storage
The body’s pattern of fat storage is primarily determined by genetics and hormones. Specific areas, including the lower abdomen and pubic area, contain a higher concentration of hormone receptors, which can make fat cells in these locations more resistant to mobilization for energy use. The body follows a genetically predetermined sequence for where it gains and loses fat.
This mechanism explains why “spot reduction”—attempting to burn fat from a single area by exercising that specific muscle—does not work. When the body needs energy, it draws fat from storage deposits throughout the entire body, not just from the fat tissue surrounding the contracting muscle. Reducing fat in the pubic area requires reducing the body’s overall fat percentage.
Foundational Strategies for Systemic Fat Loss
The most effective strategy for reducing fat is establishing a consistent caloric deficit. This means consuming fewer calories than the body expends, forcing the body to draw energy from stored fat. A sustainable daily deficit of 500 to 750 calories is recommended to achieve a healthy weight loss rate of one to one and a half pounds per week.
Increasing the body’s total daily energy expenditure is also beneficial. Non-Exercise Activity Thermogenesis (NEAT) accounts for calories burned through non-structured movements like standing, walking, and fidgeting. Simple actions such as taking the stairs or using a standing desk can significantly increase daily calorie burn and support the energy deficit.
Integrating regular cardiovascular exercise further increases energy expenditure. Guidelines recommend aiming for a minimum of 150 minutes of moderate-intensity aerobic activity per week, or 75 minutes of vigorous-intensity activity. Moderate intensity includes brisk walking, while vigorous intensity involves activities like running. Those aiming for weight loss may benefit from increasing this to 250 to 300 minutes of moderate activity weekly.
Targeted Strengthening for Improved Appearance
While exercise cannot target fat loss in the pubic area, strengthening the underlying muscle groups can improve the appearance of the entire lower torso. Building muscle tone in the core, particularly the lower abdominals and pelvic floor, supports better posture and cinches the waistline. A stronger core structure can make the area appear flatter and firmer, even before significant fat loss occurs.
Exercises that involve moving the pelvis toward the ribs, known as “bottom-up” movements, effectively engage the lower portion of the rectus abdominis muscle. Examples include reverse crunches, leg raises, and pelvic tilts. It is important to engage the transverse abdominis (TVA), the deepest core muscle that acts like a natural corset, by drawing the navel toward the spine during these movements.
Focusing on the deep core muscles helps prevent excessive upper abdominal tension, which can push the lower abdomen outward. Training the core with control ensures the work is done by the targeted muscles, contributing to a more supported and streamlined lower abdominal contour.
When Lifestyle Changes Are Not Enough
For individuals who have achieved a healthy body weight but still retain genetically stubborn fat deposits, medical procedures offer alternative solutions. These localized pockets of fat are often the last to shrink, and procedures should only be pursued after maximizing healthy lifestyle efforts.
Non-invasive body contouring treatments, such as cryolipolysis (fat freezing) or radiofrequency therapy, use controlled temperature to destroy fat cells without surgery. While effective for fat reduction in other body areas, specific clinical studies on their efficacy for suprapubic fat are limited. These options require no incisions and have minimal downtime, but may require multiple sessions for noticeable results.
Surgical options are the most direct method for removing localized fat. Liposuction uses a small tube, or cannula, to physically suction out the fat cells from the area. In cases where significant fat and skin removal is needed, a procedure called a monsplasty or panniculectomy may be performed to excise excess tissue and skin. Consulting with a qualified medical professional is necessary to discuss the risks and benefits of these procedures.