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Answer · metabolic

Which pathway addresses stubborn belly fat?

Short answer

Central adiposity is routed by metabolic and hormonal context. BMI-eligible candidates with insulin resistance → GLP-1. Men with low testosterone and central adiposity → TRT in parallel. Peri/menopausal women → BHRT. Lipo-B is adjunct.

Reviewed by Dr. Laura PurdyMay 29, 2026

Full answer

Visceral adiposity is the most cardiometabolically harmful fat depot. Provider review reads fasting insulin, A1C, lipids, ApoB, total/free testosterone, estradiol, and cortisol context. BMI-eligible candidates with insulin resistance or weight-related comorbidities are routed to GLP-1 pathways. Men with confirmed low testosterone and central adiposity are evaluated for Testosterone Optimization in parallel. Peri/menopausal women with matching biomarkers are evaluated for BHRT. Lipo-B is an adjunct, never a primary pathway. Every plan is synchronous-video reviewed.

Educational. Not a substitute for individualized provider review.

References & sources
  • Glp1 Semaglutide pathway — Primary source · oMeds
  • Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29

Related pathways

All pathways →
Pathway
TRT
A provider-reviewed pathway designed to explore testosterone, recovery, hormonal wellness, and longitudinal performance — built around your biomarkers, not assumptions.
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Pathway
BHRT
A bioidentical, provider-reviewed pathway designed to support hormonal balance, recovery, sleep, and longitudinal wellbeing — informed by biomarkers, not guesswork.
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Pathway
Lipo-B
A lipotropic pathway designed to support metabolic continuity, body composition context, and methylation — reviewed against your biomarkers, not assumed by symptoms.
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Related answers

Can cortisol cause belly fat?
Yes. Chronically elevated cortisol preferentially drives visceral (abdominal) fat accumulation by increasing lipoprotein lipase activity in abdominal adipose tissue, promoting insulin resistance, and increasing appetite for energy-dense food.
Why am I gaining weight in my midsection?
Central weight gain reflects insulin resistance, declining sex hormones, elevated cortisol, sleep disruption, and reduced muscle mass. It tracks more closely with metabolic risk than total body weight.
Primary source
Glp1 Semaglutide pathway