I think the belly fat is an overall side effect of the collapse of the spinal structure with osteoperosis and not a direct effect of the Tymlos. It is hard to know but as we lose spinal structure it is mostly in the thoracic spine that we lose the inches in height. This causes the upper body to retreat down and push the belly out. The main height loss is in the upper body. Diet and exercise can help with the belly fat and protrusion. The Mind diet is particularly good at reducing belly fat with age.