Spare tire, jelly belly or muffin top. There’s a lot of lighthearted names for it, but the reality is having an excess of abdominal fat is a risk factor for health problems such as hypertension, high cholesterol and diabetes.

So how much is too much when it comes to weight around your middle? Often your doctor will calculate a body mass index (BMI), the measurement that incorporates your height and weight, because a BMI of 30+ is linked to an increase in disease. However, a more reliable measure of your disease risk may be to look at your BMI along with your waist circumference. For men, a waist of 40 inches or more and for women, a waist of 35 inches or more are considered the levels where your chances for health problems increase.

If you’ve been working at losing your abdominal fat without much luck, read on to see what’s holding you back.

Not knowing your caloric needs

You need to know what your caloric needs are for your weight. Once you know this number, you can decrease your intake by 250-500 calories a day. This will put you in a caloric deficit helping you to maintain your weight. There are many calculators available on the web or through mobile apps where you can do this calculation. One popular one is the Harris-Benedict calculator.

Not knowing what portion sizes are

Take a week and read the labels of the foods you routinely eat. Get used to what normal portion sizes of these foods are. Most people severely underestimate the amount of food and calories they consume per day. Overeating, even food that is good for you, will result in weight gain.

Eating out/Eating prepackaged meals

Prepare your own meals so you know the exact ingredients. This will allow you to calculate the number of calories you are consuming with each meal. The best foods to eat are whole, non-processed foods.

Don’t drink your calories

Twelve ounces of most sodas have about 150 calories. One cup of fruit juice is unfortunately equally offensive with about 130 calories. Drink only non-caloric beverages. Water is the best beverage there is, however any non-caloric beverage is acceptable.

Too much cardio workout

Spending hours and hours doing cardio workouts can be tedious and cause unfavorable metabolic adaptations. Your body adapts to cardiovascular/aerobic exercise quickly, so to continue the weight loss benefits, you must either increase the intensity or duration regularly. Eventually, you run out of energy or time. Also the amount of energy you burn is easily replaced with a 300-500 calorie snack because most people burn no more than 500 to 1000 calories at best per typical cardio workout session.

Not enough resistance workout

Weight training produces a condition called EPOC (excess post-exercise oxygen consumption). This means that your metabolism stays elevated after you exercise, so you continue burning calories even after you are done training. Sometimes, the metabolism stays elevated up to 72 hours after an intense weight training session.

Not enough sleep

Not getting enough sleep disrupts the hormones that control appetite in a detrimental way. When you lack sleep your body produces more ghrelin (the hormone that makes you want to eat more) and less leptin (the hormone that tells you you’re full).  It is recommended that adults get at least 7-8 hours of sleep each night.

Written by Dr. Johnny Weeks, family medicine doctor with Roper St. Francis Physician Partners.