Brief Answer:
Consult endocrinologist, physical trainer, dietitian for guidance.

Detailed Answer:
Hi XXXX,
Thanks for the query. I have read it & understand your concern. It's good that you are eager to get rid of love handles ,before you start getting bad effects on health.
Love handles are extra fat deposition on both sides of body. Such deposition makes the skin & muscles weak & as a result.. the skin seems to sag down forming the love handles.
* Causes of such fat deposition can be-
- Faulty life style ( sedentary life, excessive eating, eating high caloric food ,absence of regular exercises, alcohol indulgence)
- Hormonal problems like insulin resistance, hypothyroidism, low testosterone levels in body.
- Over stressful life can lead to obesity - stress is known to raise appetite ( stimulation of Adrenalin & raised cortisol hormone )-causes excess consumption of fatty & sweet food.
* In order to get of the love handles & saggy skin, you need to strike on the causative factor along with exercises & local treatments to remove the handles.
- A through health check up & investigations to find/ exclude basic causes & hormonal assay followed by specific treatments. Please consult an Endocrinologist.
- Correction of life style with help of a dietitian ( eating healthy food , avoiding harmful food, irregular eating habits)/ physical trainer to guide the exercise schedule would help.spot treatment for abdominal muscles as well as whole body exercises like jogging- running/ aerobics/ swimming / playing needs to be incorporated in the lifestyle.
- Management of stress by mind concentration exercises( meditation)/ positive thinking & counselling by psychotherapist if needful would be adding to your efforts.
- A sound sleep makes lot of effect on correcting hormonal imbalance.Use sleep aid techniques like Yoganidra.
* Thus two pronged efforts done regularly over a period of few months would start showing + ve results & will help to get rid of the dreaded love handles!
I hope, you have found the answer both informative & helpful. If you have any doubt, please feel free to ask.
Thanks.

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Brief Answer:
Hormonal imbalance needs to be corrected.

Detailed Answer:
Hi XXXX..
Thanks for the follow up query.
I can think of two options for your query.
-You are correct to say.. it seems to be female type of fat deposition.. that you have.
It is possible by low testesterone levels.. which need to be estimated & replaced as per need .
Psychological stress causes rise in appetite & overeating of harmful food items like fats/sugar... this causes lowering of testesterone &increase in female hormones estrogen..this causes female pattern of fat deposition.
*You should go to endocrinologist &consult for the obesity.. tell him your problem freely.. he would get you investigated & advise .
Psychological counselling &stress management would help in cutailing the stress & consequitive hormonal imbalance.
The problem can be removed with proper consultation for correcting hormonal imbalance along with personal care (diet changes&physical work outs).. as you have already started.
Wish you all the best!
Thanks.

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Brief Answer:
Personal efforts to be tried first .. surgery only if it fails.

Detailed Answer:
Hi XXXX,
Thank you for the follow up query. I have read it & understood the confusion in your mind.I would try to clear your doubt to my level best . Let us try to start from the basic.
* weakness of muscles is another effect of obesity..due to constant stretch of muscles by visceral fat / lack of exercises.
* There are different ways of fat utilization in male & female body.
- In male, the energy required is more- so the fats are mostly utilized in body activities.When more calories are consumed/saved due to non utilization , they are converted in fat . These get deposited in viscera/ in upper thorax - upper part of body.( due to testosterone)
- Female do not consume that much energy in bodily activities - they need fat depositions as a reserve energy needed during menstruation, pregnancy & lactation. so normal / excessive fat deposition ( due to overeating/ lack of exercises) is in lower part of body- abdomen,thighs, buttocks.(due to estrogen)
*Both male & female hormones are present in both the genders & it is the balance between testosterone & estrogen.. which decides type & site of fat deposition.
That is why I had referred to the fact that- excessive eating & sedentary life style causes excess fat formation ,stimulating estrogen activity & cause female type of fat deposition.
* Cellulite is a normal condition where such fat is deposited under skin in certain chambers formed by collagen strands- thus an orange peal like skin is formed if more fat is pushed in the compartment.( more evident in female )
The fat thus stored can be utilized by another female hormone Progesterone when needed by breaking the collagen partitions & such breakage itself forms stimulus to reform & recollection of fat .
* Let me clear here the estrogen predominance in management of fat deposition is mostly predisposed by genetic tendency.
* I have seen your photographs .. lower abdomen has hardly any fat deposited. But yes is evident at pelvic curve... may be genetic predisposition to estrogen shuffle.
Cellulite formation is somewhat seen with magnified view. But I not sufficient to opine .You can see it yourself with pinch & role of skin test & comparing the look with non fat deposited part of skin
Please note- though one is genetically predisposed for pattern of fat deposition & cellulite formation such problem can be easily managed by adopting healthy life style( eating fat free, high protein, fiber rich diet & drinking lot of water/ having prescribed exercises , avoiding stress)- which will avoid shuffle of estrogen dominated fat deposition.
* I would suggest total life style changes / positive thinking & prolonged efforts before you think of plastic surgery, Physical work outs would strenghen muscles, reduce/ use up fat to give +ve results.In case there is no result after one year effort.. you can consult a surgeon for Lyposuction/ plastic surgery.
I hope that satisfies you. Any follow up query is welcome.
Thanks.

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Brief Answer:
Hormonal profile should be done. Deficiencies can be corrected

Detailed Answer:
Dear Mr. XXXX.
Thanks for the follow up query.
Yes, You should go for complete Hormone assessment/ glucose tolerance test.It would detect / exclude hormonal cause for the problem/ give you a - psychological stability & remove negative thoughts from your mind thus you can start the endeavor with more confidence & determination.
Testosterone deficiency can be corrected ( injections/ patches).. but I don't expect any in your case.. as you seem to have normal hairs. sexual drive.
I hope that satisfies you.any follow up is always welcome.
In case you find answers useful,please grade the answer before you close the query.
Thanks.

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