PT on the Net Research

Distended Abdominals


I have a question concerning a member at the wellness center where I work. This member has a history of cardiovascular disease and is on several different medications. This member's main concern is to lose inches and fat around the abs. The rest of his program is progressing well. He performs his abdominal exercises very well, including the drawing in of the abdominals. However, he continues to have a distended abdomen. I know that I have been general with this member's information. Any suggestions you have and can make from the above information would be greatly appreciated.


First of all, you mentioned your client's concern with "losing inches around his waist." I would suggest having a conversation with your client about the critical importance of regaining the function of his core musculature as well as the rest of his body and to make that the priority. Explain to him that adhering to a good lifestyle and nutritional strategy combined with the right type of exercise will always bring with it a solid aesthetic result. Remind him also that there is no such thing as "spot reduction" of fat (i.e., one cannot crunch stomach fat away, nor can one AB/ADduct thigh fat away).

The distended belly or "Visceroptosis" is a classic sign of problems with the visceral-digestive system (the internal organs of digestion - large/small intestine, etc.). The phenomenon known as the "Visceral-Somatic Reflex" occurs when the organs of digestion are stressed by one or several of the 6 forms of stress (i.e. nutritional, chemical, mental, physical, electromagnetic and thermal). Due to the fact that the core muscles share the same neurological loop/pathways as the large and small intestine, any excess stressors mentioned above to these organ structures will "reflexively" inhibit/weaken/shut-down the corresponding core muscles (i.e., small intestine = muscles above the navel, large intestine = muscles below the navel), and vice-versa. Yes, what I'm suggesting is: poor/faulty nutrition = weak abs, chemical toxicity due to prescription meds = weak abs, personal/professional stress = weak abs, etc.

You mentioned that your client has suffered from Cardiovascular Disease (CVD) and is on several medications. Most cases of CVD can be traced back to poor lifestyle choices, in particular POOR NUTRITION. This, in concert with the medications that are currently being taken, are undoubtedly enough to stress your client's visceral system into the altered posture of visceroptosis.

The core training you mentioned (drawing in maneuver, etc.) is all well and good and should certainly be continued and progressed accordingly. However, your client's lifestyle and nutritional factors must be addressed as well. Your client's disease developed from the inside out. Therein lies the priority system your approach should follow! Below are a few vital tips your client should begin to implement into his life as well as a few key resources for you and your client's benefit.

  1. SLEEP (9-12 hours/night, should be asleep between 10pm-6am)
  2. EAT ACCORDING TO YOUR METABOLIC TYPE (What/how one eats is according to one's genetics, see reading below)
  3. EAT ORGANIC UNPROCESSED FOOD (Must attempt to avoid the now 10,000 chemicals added to otherwise conventionally produced foods and food products)
  4. DRINK PURE WATER (1/2 bodyweight in ounces daily, add a pinch of unrefined sea salt to every liter to maximize hydration)


  1. Batmanghelidj, PhD. (1997). Your Body's Many Cries for Water.
  2. Chek, P. (2004). How to Eat, Move and Be Healthy! C.H.E.K Institute.
  3. Chek, P. "Why Getting Pumped Makes You Feel Good." Online., Internet. 2004.
  4. Flatten Your Abs Forever by Paul Chek. Video Cassette. C.H.E.K Institute, 2000.
  5. Hittner, N. "Sleep, Water, & Food - Three Books To Make You Smarter Than Your Doctor!" Personal Training on the Net. Online. Internet. 2003.
  6. Wiley, TS; Formby, PhD. (2000). Lights Out.
  7. Wolcott, W; Fahey, T. (2000). The Metabolic Typing Diet.

Be Healthy,

Noah Hittner, BS, CHEK-NLC Level II, PES, RTS, CPT
Founder - "FOUR HEALTH" Nutrition, Fitness, & Lifestyle Coaching