Pilates guide

Pilates for love handles: why no move burns side fat, what does shrink a waist, your obliques, the evidence, and a routine

Love handles, also called side fat or a muffin top, are ordinary fat under the skin at the sides of your waist, and they're normal at any size. Pilates won't burn them off: no exercise takes fat off the part of the body it works, and in the Pilates trials that measured it, the waist didn't change significantly.

Love handles shrink, if they do, with the rest of you: through moving more, especially brisk activity, and eating a little less. Pilates still earns its place. The side bend, side planks, the criss-cross and the twists work the muscles under your love handles, and Pilates counts towards your two strength days a week.

This guide covers what love handles are, why no move targets them, what the Pilates trials show, what does shrink a waist, the side-body moves worth doing, and a week built from our classes. Bodies come in many shapes, and nothing here promises a particular one.

The short version

Love handles are ordinary fat, normal at any size

They're fat under the skin at the sides of your waist, the kind you can pinch. Where your body keeps fat is largely inherited: in twins, genes explained 82% to 85% of the differences in trunk fat.

Source 1

No Pilates move burns fat from your sides

Across 13 studies of 1,158 people, training one part of the body didn't take more fat off it, and 6 weeks of ab exercises didn't change the skinfold just above the hip bone. No study has tested Pilates, twists or side bends for love handles.

Sources 2, 3, 4

Pilates hasn't been shown to shrink the waist

In the two Pilates reviews that measured it, the waist changes (2.7 cm from 2 trials, and 3.6 cm from 3 studies) weren't statistically significant. Pilates took off about 2.4 kg against doing nothing, and only in programmes longer than 10 weeks.

Sources 5, 6

What shrinks a waist is losing fat from your whole body

Each extra 30 minutes a week of aerobic exercise took about half a centimetre off the waist in trials, and more than 150 minutes a week may be needed for a change that matters. Eating a little less matters most for weight. Our training guide to losing love handles has the full plan.

Sources 7, 8

Pilates is light work, so pair it with brisk activity

Pilates averages about 3 METs (metabolic equivalents: 1 MET is the energy you use sitting still), similar to walking slowly at 3.2 km/h. Our walk and Pilates workout does both in one session.

Sources 9, 10

The side moves build the muscles underneath

Side planks worked the outer oblique at about 63% of its maximum in one lab study, and side-bridge holds nearly doubled in 8 weeks of reformer classes. The side muscles grow only a little (8% on one side in 36 weeks in one small study), so side bends neither widen nor slim your waist.

Sources 11, 12, 13

What love handles are

Fat you can pinch, at the sides of your waist

Love handles are fat under the skin at the sides of your waist, just above the bony rim of your pelvis, sometimes spilling over a waistband. Clinicians measure a skinfold at this spot, just above the hip bone. Our guide to losing love handles has the anatomy in full.

Source 3

The muscles underneath

The outer and inner obliques and the deep transversus abdominis wrap the sides of your waist, with the quadratus lumborum further back. They bend and turn your trunk and, just as often, stop it bending or turning. One teaching guide to the classical mat says the side bend "focuses on the abdominals, obliques and shoulder stabilizers" and that the spine twist will "strengthen the obliques and back extensors".

Source 14

Largely inherited

In Danish twins, genes explained 82% (younger) and 85% (older) of the differences in trunk fat on DXA (dual-energy X-ray absorptiometry) scans. At the same BMI (body mass index), women carried more fat under the skin of the tummy and men more fat around the organs, in one MRI (magnetic resonance imaging) study of 80 adults. Love handles are common in women and men at many sizes, and they aren't a sign of being unfit.

Sources 1, 15

Not the deep belly fat

Love handles are fat under the skin. Visceral fat sits deeper, around the organs, and our Pilates for belly fat guide covers it. With every weight-loss method studied, from diet and exercise to medicines and surgery, the two fell together, and no method targeted one store.

Source 16

Often among the slower places to change

On a 6-month diet in 61 women, fat under the skin fell everywhere it was measured, but more at the middle of the arm and thigh than at the waistline and hipline. In a scan trial of 60 men and women losing about 11 kg, men and women lost fat from the same places. The order is partly inherited, and it's no sign that something isn't working.

Sources 17, 18

Why no Pilates move burns side fat

Spot reduction means losing fat from the part of the body you exercise. Most of these studies are small, and several were read only as abstracts.

Training one area didn't take fat off itStrong evidence

Across 13 controlled studies of 1,158 people aged 14 to 71, the trained arm or leg didn't lose more fat than the untrained one. That review pooled limb studies only and set the trunk studies aside, so for the belly and sides the evidence rests on the two small trials below. When 11 adults trained one leg for 12 weeks, fat came off their arms (10.2%) and trunk (6.9%), not the trained leg, and in 104 adults who trained one arm, scans showed fat loss under the skin all over.

Sources 2, 19, 20

Ab exercises didn't shift the fat above the hip boneEmerging evidence

In 24 inactive adults, 7 ab exercises on 5 days a week for 6 weeks changed no fat measure, including the waist and the skinfold above the hip bone, though curl-ups improved. In 40 women, ab training added to a diet did no better than the diet alone for belly fat or the waist. Both trials were small and run at one centre.

Sources 3, 21

A thinner skinfold can be muscle, not fat lossEmerging evidence

In one small 1979 study, a thinner skinfold over a trained muscle was put down to the muscle growing underneath it, not to fat coming off.

Source 22

The small studies that disagreeMixed evidence

In 16 men with overweight, 57 minutes of crunches and trunk rotations plus treadmill work took 697 g more fat off the trunk on DXA scans than treadmill work alone. But those sessions were almost twice as long, the trunk region includes the chest and back, and the waist fell by about 5 cm in both groups, with no difference between them. A circuit study in 14 adults reported a thinner skinfold above the hip bone within one group only. Fat next to a working muscle releases a little more fat during a session, but no lasting local loss has followed.

Sources 23, 24, 25

No study of Pilates, twists or side bends for love handles

Our searches found 27 records for love handles, flank fat or side fat: all cosmetic procedures, livestock or unrelated. No trial of oblique training measured the waist or side fat, and no Pilates trial measured fat at the sides of the waist.

Sources 4, 26

What the Pilates trials show

Most of these trials are small and short, several were read only as abstracts, and none measured fat at the sides of the waist.

Weight: a little, in longer programmesEmerging evidence

In 11 trials of 393 adults with overweight or obesity, Pilates took off 2.4 kg against doing nothing, but only in programmes longer than 10 weeks. The certainty was low to moderate for weight and very low to low for body fat, and no trial compared Pilates with other exercise.

Source 5

The waist: no significant changeMixed evidence

The same review found no significant change in the waist (2.65 cm, from only 2 trials). The newest review, of 12 studies in about 540 women, found the waist fell by 3.6 cm in a result that wasn't statistically significant (low certainty, 3 studies), and hip size and body fat percentage didn't change.

Sources 5, 6

Mat Pilates in healthy adults: no better than other exerciseMixed evidence

Across 10 studies, mat Pilates was no better than control groups or other exercise for body composition or the waist. A review of healthy people called the evidence uncertain, and an umbrella review rated 25 of 27 Pilates meta-analyses low or critically low quality.

Sources 27, 28, 29

Pilates or walking: the waist shrank with bothEmerging evidence

In adults with overweight, 3 hours a week of Pilates or walking for 8 weeks, with no change to diet, trimmed the waist by about 3 cm in both groups, with no difference in body composition between them. The trial was small and only partly randomised.

Source 30

Recent trials add no clear waist effectMixed evidence

Reformer classes 3 times a week for 8 weeks took weight from about 76.0 to 74.7 kg in women with overweight, but the trial didn't measure the waist. In women after breast cancer, the waist fell in every group, controls included, and rose again at follow-up. Light Pilates twice a week for 8 weeks didn't change body composition, and in 90 women with prediabetes or type 2 diabetes, body composition didn't differ between groups.

Sources 12, 31, 32, 33

Scans and scales disagreeEmerging evidence

Many Pilates body-fat results come from bioimpedance scales. In 19 Pilates-trained women, 10 weeks of reformer and Cadillac classes showed less fat on the scales, but on DXA scans only arm lean mass rose. The authors note that of the few earlier studies that used DXA, three found no change in body fat with Pilates and one found a decrease.

Source 34

Pilates isn't a special fat-loss exerciseEmerging evidence

Nordic walking took off 6.4% of body weight against 1.7% with Pilates in 196 women after the menopause (not randomised), a high-repetition group class improved body composition where Pilates didn't, and a weights circuit did about the same as Pilates in 18 women. The ACSM (American College of Sports Medicine) says no one type of activity is better than the others for weight loss.

Sources 35, 36, 37, 38

How hard Pilates works

About 3 METs, like a slow walkEmerging evidence

Across 6 studies, Pilates averaged about 3.0 METs and 2.9 kcal a minute, at very low to low certainty, with shorter rests making it harder. In 31 young adults, a Pilates session was like walking at 3.2 km/h, and easier than walking at 4.8 km/h. The Compendium of Physical Activities lists general Pilates at 2.8 METs and brisk walking at 4.8. So Pilates counts as strength work, not brisk activity; our Pilates for weight loss guide has the calorie table.

Sources 9, 10, 39, 40

Your obliques: what Pilates does build

Muscle-activity studies show how hard a move works a muscle in one session, not what it does over weeks, and none of them measured fat.

Side planks work them hardest of the moves measuredEmerging evidence

In 25 adults, a side bridge with a rotation worked the outer oblique at 62.8% of its maximum, and the authors say about 50% or more is needed for strengthening. In 15 men, side plank versions worked the inner oblique at 38% to 77% of its maximum. Both were lab studies of moves from outside Pilates.

Sources 11, 41

The Pilates moves that have been measuredEmerging evidence

In 32 beginners, the criss-cross worked the trunk muscles, obliques included, hardest of three mat moves, ahead of the single-leg stretch and the dead bug. On ultrasound, the inner oblique thickened during the imprint, the hundred, the leg circle and the roll-up in 26 practitioners, and the leg pull front worked both obliques in 20 adults. Experienced practitioners used the outer oblique more than beginners did.

Sources 42, 43, 44, 45

No study has measured the saw, spine twist, side bend, mermaid or side kick

Our searches found no muscle-activity study of these moves, so what they work comes from Pilates teaching, not measurement.

Source 46

Pilates isn't special for the deep obliquesEmerging evidence

In a pilot trial of 34 gym members, after 8 weeks the strength training group had a thicker inner oblique during Pilates moves than the Pilates group. Experienced Pilates and resistance exercise instructors had similarly thick inner obliques.

Sources 47, 48

Endurance rises; size, a littleEmerging evidence

In women with overweight, 8 weeks of reformer classes raised side-bridge holds from about 11 to 19 seconds while the control group didn't change. In 9 inactive women, 36 weeks of Pilates grew the side tummy muscles by 8% on one side only, with no comparison group; professional tennis players had 18% more on one side after years of play.

Sources 12, 13, 49

Side bends neither widen nor slim your waistEmerging evidence

No trial has measured the waist after oblique training. A change of a few percent in the side muscles is small next to the several centimetres that whole-body fat loss can take off a waist, so ordinary Pilates side work won't make your waist wider or narrower (our reading).

Sources 13, 4, 7

What does shrink a waist

Brisk activity, dose by doseStrong evidence

In 116 trials of 6,880 adults with overweight or obesity, each extra 30 minutes a week of aerobic exercise took about 0.56 cm off the waist (high certainty) and 0.52 kg off body weight, and more than 150 minutes a week of at least moderate activity may be needed for a change that matters. In 25 trials, aerobic exercise cut the waist by 3.2 cm. In 300 adults over 24 weeks, every exercise group lost 3.9 to 4.6 cm more waist than the control group, and harder exercise added nothing.

Sources 7, 50, 51

Even when the scales don't moveStrong evidence

Without weight loss, exercise still cut fat around the organs by 6.1%, while diet alone barely changed it. In 12 trials, exercise cut belly fat under the skin by 9.1%.

Sources 52, 53

Eating a little lessStrong evidence

In 40 trials, eating less cut fat around the organs more than exercise did. The UK Chief Medical Officers say "Diet is the important factor in weight management", with activity in a supporting role. NICE (the National Institute for Health and Care Excellence) advises against restrictive diets that are nutritionally unbalanced, and the NHS suggests aiming to lose 0.5 to 1 kg a week.

Sources 54, 8, 55, 56

Strength work helps tooStrong evidence

Resistance training trimmed body fat by about 1.5 percentage points across 58 studies, and European obesity experts advise it to keep muscle while you lose weight. The NHS counts Pilates as muscle-strengthening activity, so Pilates can be your two strength days a week.

Sources 57, 58, 59

Your waist: the number that matters

Keep your waist to less than half your height

NICE uses the waist-to-height ratio for adults with a BMI under 35: 0.4 to 0.49 means no increased health risks, 0.5 to 0.59 increased, and 0.6 or more further increased. Measure halfway between the bottom of your ribs and the top of your hips, which is just above your belly button, after breathing out naturally. The NHS calculator isn't for use in pregnancy, with an eating disorder or with a BMI over 35.

Sources 60, 61

Stand the same way each time

In 48 women, the Pilates stance (drawing the tummy in and up) measured up to 5.2 cm less around the waist than a normal stance, and more after 10 weeks of classes. That's how you stand, not fat loss, so measure in the same relaxed stance each time.

Source 62

Measuring isn't for everyone

NICE asks professionals to explain the risks in an inclusive and non-stigmatising way. If measuring makes you anxious, leave it: what you can do, your energy and how your clothes feel are fair guides too (our suggestion).

Source 60

The part that trims a waist: brisk activity

Brisk walk: 20 minutes, at a pace where you can talk but not sing, and marching on the spot: 2 minutes (both our walk and Pilates workout); step jack, with no jumping: "30 to 45 seconds within a circuit, 2 to 3 rounds" (from the move page's dose), keeping your arms to shoulder height with shoulder pain.

Oblique exercises: your side body, for strength (not fat loss)

Knee side plank: 2 holds of 20 s each side (our Pilates for golfers class); side bend: 3 to 5 each side, once a 20-second side plank feels steady, and a knee side plank instead if your wrists or shoulders hurt; side plank: 15 to 40 s each side (our oblique workout); criss-cross: 6 each side, slowly; saw: 3 to 4 each side; spine twist: 3 to 4 each side; mermaid: 3 each direction, each side; kneeling side kick: 4 each side, leaving it out with knee, wrist or shoulder pain (the side bend and the last five from their move pages' doses).

The whole trunk

Hundred: 50 beats to start, building to 100, and single-leg stretch: 6 to 10 each side (both from the move pages' doses); dead bug: 6 each side (our Pilates for golfers class); bird dog: 6 each side (our Pilates for posture class); forearm plank: 30 s (our 10-minute Pilates abs class); leg pull front: 3 to 5 each side (from the move page's dose), leaving it out with shoulder pain.

Outside Pilates: a trunk that resists turning

Pallof press: 10 each side, and suitcase carry: 20 m each hand (both our oblique workout), for when you want the side muscles to hold you steady against a pull.

Cool down

Open book: 8 to 10 slow openings each side, pausing 2 seconds at the end, and child's pose: 1 to 3 minutes, breathing into the back ribs (both from the move pages' doses).

Change or leave out

Our suggestions, unless a source is given.

Weighted, fast or forceful twists

None is needed for this page, and none burns side fat. Keep twists slow and comfortable (our suggestion).

With osteoporosis, leave out the weight in the Russian twist and twist only as far as is comfortable; after a spinal fracture, ask a physiotherapist first.

The corkscrew, hip twist and boomerang

These advanced classical moves carry neck, osteoporosis and hip replacement cautions on their move pages. Leave them to our classical mat exercises guide (our suggestion).

Holding your breath in side bends and side planks

Breathe out as you lift, and don't hold your breath.

Stomach vacuums and waist trainers

There's no good evidence that either gives you a smaller waist, as our guide to a smaller waist explains.

A week that works

Our editorial plan, built from the NHS activity and strength guidelines, the aerobic dose trials, NICE's advice on diets and the NHS weight advice. It's a starting point, not a prescription.

  1. On most days, walk briskly or do other activity you enjoy, at a pace where you can talk but not sing. Start with what you can do, even 10 minutes, and build towards 150 minutes a week or more; our walking plan builds up over 8 weeks.
  2. Twice a week, do Pilates as your strength days: our walk and Pilates workout, or the full-body mat class with the side-body moves above.
  3. If you enjoy it, add one short trunk session: our 10-minute Pilates abs class or our Pilates for golfers class.
  4. If you want to lose weight, eat a little less, without a restrictive diet, aiming for 0.5 to 1 kg a week at most.
  5. If it suits you, measure your waist every few weeks, standing normally and breathing out. Judge by months, not days.

See the movement on the 3D figure: Treadmill walking

Classes to follow

There's no love handles class on purpose: no class can burn fat from your sides. Start with the walk and Pilates workout, a brisk walk for your waist and then Pilates for strength. The abs and golfers classes hold the side-body moves, the oblique workout adds a press and a carry, and the plus-size, chair and postnatal classes are other ways in.

Walk and Pilates workout

A 45-minute session for weight loss and health: a 20-minute brisk walk, which does more for the scales, then a short-rest Pilates circuit for strength.

45 minBeginner11 movesCardio machine

10-minute Pilates abs

Ten minutes of the classic Pilates abdominal series: the hundred, the roll-up and the series of five, with a plank to finish.

10 minIntermediate11 movesNo equipment

Rotation-focused Pilates for golfers: a 25-minute mat and standing class

A 25-minute Pilates class for golfers: upper-back and hip rotation, trunk control, side-hip strength and one-leg balance, done equally on both sides.

25 minBeginner19 movesWall

Full-body mat Pilates workout

A 30-minute intermediate mat Pilates class that follows the classical order, from the hundred to the push-up, with prep versions of the hardest moves.

30 minIntermediate22 movesNo equipment

Oblique workout: side planks, Pallof presses, carries and Russian twists

A 25-minute oblique workout at home: side planks, a band Pallof press and a suitcase carry to hold your trunk steady, then slow Russian twists and side-lying crunches.

25 minIntermediate8 movesBand, anchor point

Low-impact cardio workout (no jumping)

A 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.

25 minBeginner9 movesBench or box, step

10-minute walk and move after meals

A 10-minute routine for straight after a meal: an easy walk, a few simple standing moves from blood sugar trials, then a short walk to finish.

10 minBeginner6 movesCardio machine, bench or box

Chair-to-mat Pilates for bigger bodies: a 30-minute class standing, at a chair and on the mat, with a chair-only option

A 30-minute Pilates class for bigger bodies: a standing warm-up, wall and chair strength, a supported way down to the mat and up, mat moves and a seated cool-down.

30 minBeginner18 movesBench or box, wall

Chair Pilates workout

A 20-minute chair Pilates workout for beginners and older adults: breathing, sitting tall, gentle spine and leg moves, and a standing finish at the chair.

20 minBeginner14 movesBench or box, something with weight

Gentle postnatal Pilates: a 20-minute class from about 6 weeks after birth, with an early stop point and caesarean options

A 20-minute postnatal Pilates class: breathing and pelvic floor, lying, side-lying and hands-and-knees moves, upper back work for feeding and a standing lift.

20 minBeginner16 movesBench or box

Plans

The walking plan builds up your weekly walking step by step; the weight loss plan mixes strength and cardio; the 4-week Pilates plan and the wall Pilates challenge are gentle ways to start, and neither promises a new shape.

When your shape becomes a worry

Love handles are searched for as a body worry as much as a fitness question. Your sides aren't a problem to fix.

Love handles aren't a health verdict

Health risk follows your waist compared with your height and the deeper fat around the organs, not the look of your sides. The UK Chief Medical Officers say activity improves physical health whatever your weight.

Sources 60, 8

Signs of an eating disorder: see a GP

The NHS lists signs such as spending a lot of time worrying about your weight and body shape, exercising too much, and having very strict habits or routines around food. If that sounds like you, see a GP as soon as you can. You can also talk in confidence to the eating disorder charity Beat: 0808 801 0677 (England), 0808 801 0432 (Scotland), 0808 801 0433 (Wales) or 0808 801 0434 (Northern Ireland), 3pm to 8pm, Monday to Friday.

Sources 63, 64

Worrying a lot about one area of your body

If you worry a lot about one area of your body, spend a lot of time comparing your looks with other people's, or check or avoid mirrors, it can be body dysmorphic disorder (BDD). The NHS says "You should see a GP if you think you might have BDD." You can also refer yourself to NHS talking therapies (our suggestion, from the NHS page).

Source 65

Yoga and Pilates don't protect against itEmerging evidence

In a survey of 2,287 young adults, women who did yoga or Pilates had disordered eating as often as those who didn't, and men who did them reported more extreme weight-control behaviours (18.6% against 6.8%). Set goals for strength, control and how you feel, not calories burned.

Source 66

Who should change what

Living with a higher weight

Start where you're comfortable: chair, wall and standing versions all count. Our Pilates for plus-size bodies guide covers getting up and down from the floor and the equipment that helps.

Pregnancy

Ask your midwife or doctor first. From the end of the first trimester, keep moves on your back short, prop your upper body up, or switch to side-lying, all-fours or standing versions, as our walk and Pilates workout says.

In pregnancy, after the first trimester, keep time flat on your back to a few minutes: prop your upper body up, or use a side-lying or all-fours version.

Osteoporosis

Keep your head down in the hundred and single-leg stretch, as our walk and Pilates workout advises, or choose the dead bug, bird dog and planks instead of the curl-up moves. Our Pilates for osteoporosis guide has more.

The side bend and mermaid pages add: "If osteoporosis gives you a high risk of fracture, Osteoporosis Canada advises avoiding or changing side bending in Pilates."

Back pain

If twisting brings on back pain or pain down a leg, keep to the side planks, leave out the twists and see our back pain guide. A sudden sharp pain at the side of your tummy during a twist can be an abdominal strain: see our abdominal strain guide (our suggestion, adapted from our guide to losing love handles).

A hernia

With a hernia, stop any move that makes it hurt or bulge, and see a GP if you think you have one.

Source 67

A sore neck in the criss-cross and curl-ups

If your neck works harder than your abs, lower your head, rest it in your hands, and nod gently without jamming your chin down. Neck pain that persists, or spreads into an arm, is a reason to see our neck pain guide or a professional.

Source 68

Men and women

Men tend to keep more fat around the organs and women more under the skin, but both lost fat from the same places in a scan trial, so the plan is the same.

Sources 18, 15

Warning signs: when to get help

These are the warning signs from our love handles, belly fat and Pilates guides, word for word, apart from the lines marked as our suggestion. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.

Chest pain or fainting while exercising: call 999

Call 999 if:

  • You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
  • The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
  • You have chest pain and feel sweaty, sick, light-headed or short of breath.
  • Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.

Sources 69, 70, 71

Unusual breathlessness

Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.

Source 72

See a GP

See a GP if:

  • fat is building up on your neck, upper back, chest and tummy while your arms and legs look thin, with a red, round face, easy bruising, stretch marks or weak muscles: it could be Cushing's syndrome, especially if you take steroid medicine (don't stop steroids without talking to your doctor)
  • you find a lump anywhere on your body, or a lump is painful, red or hot, hard and fixed, growing, or still there after 2 weeks: many soft lumps on the back are lipomas, which are harmless, but a GP should check

Sources 73, 74, 75, 76

One hip sticking out

See a GP if you think you might have scoliosis: the NHS lists uneven shoulders, one shoulder or hip sticking out, and the ribs sticking out on one side among the signs.

Source 77

A painful bulge: call NHS 111 or get an urgent GP appointment

For a bulge in your groin or tummy that is painful, or comes with a swollen tummy, being sick or constipation, as our guide to exercise for men explains. In the US, contact your doctor or urgent care.

Source 67

See a GP: bloating, losing weight without trying, or fat building up

If you feel bloated regularly, or have bloating with weight loss you can't explain or blood in your poo: the NHS says bloating that doesn't go away can sometimes be a sign of something more serious, such as ovarian cancer, whose symptoms include a swollen tummy or feeling bloated roughly 12 or more times a month. If you're losing weight without trying: it "can be a sign of stress or a serious illness. See a GP just in case." And if fat is building up on your tummy, neck and upper back while your arms and legs look thin, with a red, round face or stretch marks, especially on long-term steroid medicines: this can be Cushing's syndrome.

Sources 78, 79, 80, 73

Gaining weight you can't explain, in the NHS's words

The NHS lists health conditions that cause weight gain, such as an underactive thyroid, Cushing's syndrome and PMOS (polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome), and "certain medicines including some steroids, antidepressants and beta blockers". It says: "Speak to a GP for advice if you have a condition that makes it harder to stay a healthy weight." Don't stop a medicine without talking to your doctor (our suggestion).

Source 56

Help to lose weight

The NHS suggests seeing a GP if your BMI is in the overweight or obese range and you want help to lose weight, your waist is more than half your height, or you have conditions such as diabetes, high blood pressure or sleep apnoea.

Source 56

Medicines for diabetes or weight loss

If you take insulin or a sulfonylurea, exercise can bring on a hypo: see our type 2 diabetes guide. If you're on weight loss injections, see the exercise advice in our exercise for weight loss guide.

A heart condition

If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.

Stop the session if

You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.

Source 81

Before you start

The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.

If you have a heart, lung or joint condition, are pregnant or have recently been unwell, start gently and read our guide for your condition. Muscle soreness for a day or two after a new exercise is common and fades as you repeat it.

Source 81

Myths

"Side bends, twists and the criss-cross burn love handle fat"Strong evidence

Training one part of the body doesn't take fat off it, ab exercises didn't change the skinfold above the hip bone, and no study has tested twists or side bends for fat. The criss-cross and side plank work the obliques hard: that's strength, not fat loss.

Sources 2, 3, 4, 42

"You can lose fat from one spot"Strong evidence

Not in 13 studies of 1,158 people, and no method, from diet to surgery, targets one fat store. In the one trial that reported more trunk fat loss with long ab sessions, the waist fell by the same 5 cm in both groups.

Sources 2, 16, 23

"Pilates slims your waist"Mixed evidence

The waist results in the two Pilates reviews weren't statistically significant, and mat Pilates was no better than control groups or other exercise for the waist. Part of a slimmer look is how you stand: the Pilates stance alone took up to 5.2 cm off the tape.

Sources 5, 6, 27, 62

"Pilates torches calories and fat"Emerging evidence

Pilates averaged about 3 METs, like walking at 3.2 km/h; brisk walking is 4.8 METs. It's good strength work, not a calorie burner.

Sources 9, 10, 40

"Side bends make your waist wider"Emerging evidence

In one small study, 36 weeks of Pilates grew the side muscles by 8% on one side, and no trial has measured the waist after oblique training. Fat loss changes a waist far more.

Sources 13, 4, 7

"Pilates makes you long and lean"Strong evidence

No Pilates study has measured muscle length. In two reviews, static stretching left muscle fibres the same length, or only trivially longer at high volumes, and in one small study it was heavy loading that lengthened them. Lean means less body fat, which comes off the whole body.

Sources 82, 83, 84, 85

"Reformer Pilates melts love handles"Emerging evidence

Eight weeks of reformer classes took off about 1.4 kg in women with overweight, and the trial didn't measure the waist or the sides.

Source 12

"Stress hormones cause love handles, so calming Pilates melts them"

Pilates hasn't been shown to shrink the waist, by lowering stress hormones or any other route. Our Pilates for belly fat guide covers stress and cortisol (a stress hormone) in more detail.

Sources 6, 5

"Love handles mean you're unhealthy"Strong evidence

Health risk follows your waist compared with your height and the deeper fat, not the look of your sides, and activity improves health whatever your weight.

Sources 60, 8

Questions people ask

Can Pilates get rid of love handles?

Not on its own, and not from that spot. No exercise takes fat off the part of the body it works, and Pilates hasn't been shown to shrink the waist in trials. Love handles shrink, if they do, with the rest of you, through moving more and eating a little less; Pilates gives you a stronger trunk and two strength days a week.

What are the best Pilates exercises for love handles?

For the muscles underneath: the side bend, side planks, the criss-cross, the saw and the spine twist. For the fat: whatever keeps you moving briskly, such as a walk before your Pilates. No move targets the fat itself.

Will Pilates give me a smaller waist?

Not reliably. In the reviews that measured it, Pilates didn't change the waist significantly, while each extra 30 minutes a week of brisk activity took about half a centimetre off in trials. Measure in the same stance each time, because the Pilates stance alone can change the tape by up to 5 cm. Our Pilates for belly fat guide covers the waist in more detail.

Do twists and the criss-cross burn side fat?

No study shows it, and none has tested it. They're good for moving your spine and working your side muscles, but they don't burn the fat over them.

Is wall Pilates or reformer Pilates better for love handles?

Neither burns side fat. Wall Pilates is mat Pilates with a wall for support, and reformer classes took off about 1.4 kg in 8 weeks in one trial without measuring the waist. Choose the one you'll keep doing, and add brisk activity.

Is Pilates good for side fat or a muffin top?

It's the same fat as love handles, so the answer is the same: Pilates builds the trunk, and whole-body fat loss changes the sides. Where a waistband sits, and how tight it is, changes how a muffin top looks too.

How long does it take to lose love handles?

There's no reliable timeline, and the sides can be among the slower places to change. In trials, waist changes came over months, from activity and eating rather than from Pilates alone. Judge by months, not days.

Will Pilates make my waist wider?

No. In one small study, 36 weeks of Pilates grew the side tummy muscles by 8% on one side, far less than fat loss changes a waist.

Does Pilates work the obliques?

Yes. The criss-cross worked the trunk muscles, obliques included, hardest of three mat moves in one study, and side-bridge holds nearly doubled after 8 weeks of reformer classes. Strength training worked the deep obliques at least as well in a small trial.

What's the best exercise for love handles?

Any brisk activity you'll keep doing, building towards 150 minutes a week, plus strength work twice a week, which Pilates can be. Our walk and Pilates workout puts both in one session, and our training guide to losing love handles has the full plan.

Is Pilates enough to lose weight?

On its own it took off about 2.4 kg in programmes longer than 10 weeks, and Nordic walking did more in one comparison. The UK Chief Medical Officers say diet is the important factor in weight management, with activity in a supporting role.

Are love handles bad for my health?

Not in themselves. NICE uses your waist compared with your height as the health measure, and activity improves health whatever your weight. See a GP about fat building up while your arms and legs look thin, a lump, or weight that changes and you don't know why.

Sources

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Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.