Sometimes I wonder if for older women some of the belly pooch is fibroids. I had a fibroid the size of a grapefruit in my uterine wall. I didn't even realize it until the doctor pointed it out to me and then I could actually feel it pressing on my abdomen. Apparently really super big fibroids aren't always symptomatic so women can have them and not notice. I had a smaller one inside my uterus that was causing me huge problems. I got the whole shebang removed. My grapefruit wasn't big enough to make my belly stick out, but bigger ones might do that for other women.
Female, 5'3", 50, Max squat: 202.5lbs. Max deadlift: 225 x 3.