10 reasons the weight is not shifting after 45

That is the part nobody explains, and it is the part you notice in photographs.

There are 2 kinds of fat on a belly, and they are not the same substance.

The soft kind sits under the skin. You can get hold of it. You can pinch an inch between your finger and thumb and pull it away from you.

The hard kind sits behind the muscle wall, packed in around your organs. You cannot pinch it, because there is nothing to get hold of. It pushes the whole wall out from the inside.

Push your thumb into your middle, now, while you are reading. A cushion gives. A full wheelie bin with the lid strapped down does not.

Sit-ups tighten the wall in front of that fat. They never reach what is behind it.

And the hard kind empties into somewhere very specific, which is the next thing on this page.

The soft layer under your skin drains into your general circulation, like fat anywhere else on you.

The hard kind, the kind behind the wall, drains through a single vein directly into your liver. Around 80% of the blood arriving at your liver comes up from your gut and your middle, not down from your heart.

Picture a block of flats where every pipe from every floor runs down through the ceiling of the ground floor flat. The people upstairs can be as careful as they like. Everything still goes through downstairs first, and when something goes wrong, downstairs is where the stain comes through the ceiling.

Your middle is upstairs. Your liver is the ground floor flat. And it does not have a door onto the street.

So your belly and your liver were never 2 separate problems. They are 1 system with a pipe between them.

This is where most people have the order backwards. They assume the weight came first and the liver followed.

Fat inside the liver usually turns up years before a blood sugar reading ever goes abnormal, and years before the diet stops working.

It is the damp behind the wallpaper in the back bedroom. You have redecorated that room 3 times. New paper, good paste, 2 coats. And every single time, 8 months later, the same corner lifts.

You have been blaming the wallpaper for 10 years.

Which means the liver is not the thing your weight did to you. It is closer to the thing that has been doing it to your weight.

If you only take one thing off this page, take this one.

Insulin is not really a fattening hormone. Insulin is a brake.

One of its main jobs is to tap your liver on the shoulder after you eat and say: stop. Stop pushing sugar out into the blood. There is plenty out here already.

In a liver with fat packed into it, that message stops getting through. The pedal goes soft. It is the brake on an old car that sinks almost to the floor before anything happens, and even then the car keeps creeping forward.

So your body does what you would do in that car. It presses harder. More insulin. Then harder again. Then it gives up and rides the pedal all day long.

And here is the cruel part, the part that explains your last 10 years.

The brake did not fail everywhere. It failed at the liver. At your fat cells it is still working perfectly.

So while you are standing on that pedal trying to get your liver to listen, all of that pressure is also landing on your fat cells. And their brake grips beautifully. They hold on to absolutely everything.

The harder you press to bring the sugar down, the tighter you clamp the fat in place.

Your liver holds roughly 100g of sugar as glycogen. That is your between meals petrol tank, the thing that carries you from lunch to dinner without a crash.

Fill that same space with fat and the tank shrinks. More of every meal has to be parked somewhere else.

You already know what this looks like. It is the freezer 3 weeks before Christmas. Packed solid, drawer will not shut, so the extra bag goes in the chest freezer in the garage, and by January you cannot find a thing and half of it has gone to waste.

Same dinner you ate at 35. Smaller tank to put it in.

Every cell in your body can burn glucose. Fructose is different. It is handled almost entirely by your liver.

So the orange juice, the innocent smoothie, the granola, the low fat yoghurt with the fruit stirred through it, the cereal bar that says no added sugar, and the 2 satsumas you had instead of a biscuit all come off different roads and arrive at the same junction.

And when that junction is already jammed, the liver's way of clearing a surplus is to turn it into fat on the spot.

This is the answer to the sentence you have said out loud in a GP's surgery, possibly more than once: but I hardly eat any fat.

Your liver makes the bile that breaks fat down in your food. Under load, that bile gets thicker and slower to arrive.

Try washing the Sunday roasting tin in cold water with no washing up liquid. You can stand there for 10 minutes with the scourer. The grease does not lift. It just moves around the tin and onto your hands.

That is a meal still sitting in you at 8pm, when you ate at half 6. Not a food intolerance. Not getting older. Not enough hot water.

4 different complaints. 1 organ underneath all of them.

Fat in the liver can come back out. That is well established, and it is the entire reason any of this is worth your time.

But inflammation that sits there for years quietly lays down scar tissue. And scar does not come out. Not with a diet, not with a supplement, not with 20 years of doing everything right afterwards.

It is the difference between a crease and a scorch mark on a shirt. A crease presses out in 30 seconds. A scorch is in the fabric for the life of the shirt, and you can iron that spot every week for the rest of your life and it will still be there.

Most women reading this are at the crease stage and have no idea, because the liver has no pain nerves in it. It cannot tell you. It will go on not telling you right up until it is a scorch.

That is the whole problem with it. It is also the whole opportunity.

They stopped calling it fatty liver disease. The new name is metabolic dysfunction-associated steatotic liver disease.

Read that again. They took a condition that used to be named after alcohol and renamed it after your metabolism.

Textbooks were reprinted. Letterheads changed. The heading on the file in your GP's system is not the heading it was 3 years ago.

You do not have to argue that your liver and your weight are connected any more. The doctors changed the name of the disease to say it for you.

Milk thistle is not the active ingredient. Silymarin is. It is the compound inside the seed that does the work, and how much of it survives depends entirely on how the plant is processed.

The research that made anyone interested in this plant used silymarin standardised to 80%. Most of what sits on a chemist shelf is standardised to somewhere between 30 and 50%.

But there is a second trick, and it is the one that fooled you.

Pick up a supermarket tub. The front shouts 5,000mg in letters you can read from the next aisle. That number is not extract. It is raw seed equivalent, a way of describing how much seed it would have taken, not how much of anything is in the capsule.

Work back through it and the real silymarin can land at around 4% of the number on the front.

So the 5,000mg you thought you were taking was closer to 200mg of the only part that matters, for 3 weeks, before you moved it to the back of the cupboard behind the vitamin D.

Uvera is 300mg of extract at 80%. 240mg of silymarin. 1 capsule. Printed on the bottle.

It is orange squash and orange juice. Both orange. Both out of the same fruit. One of them is mostly water, and you would know the second somebody poured you a glass.