Question for all the mommies out there!

So my question is, is it possible to lose the pooch that hangs out from your lower abdomen? And I know there is a difference between a 'pooch' and 'extra skin', but here is why I am asking: A co-worker of mine, who has had 2 kiddos and preg. with her 3rd, was telling me that her doc said if she has any more kids, it will be impossible to lose the pooch - that she would have to have a tummy tuck if she wanted to get rid of it. I have had 4 kids! Part of my motivation for all this work is to lose the belly bulge and have a flatter stomach and abs to show for all the work I'm putting in. I suppose there are many other factors to consider, like how big you get during pregnancy, etc. - this girl is 3 or 4 inches taller than me, but she's always been thin - she runs miles and miles to stay that way. Anyway, I guess I'm looking for mommas that have had success to offer up some encouragement! I was pretty discouraged after the conversation we had at work, thinking no matter what I did I would just be stuck with this pooch for life. Thanks for the help everyone - much appreciated!