- this is an excessive accumulation of adipose tissue in the upper half of the body and on the abdomen. With this type of obesity, the silhouette of a person begins to resemble the shape of an apple. Abdominal obesity is very dangerous not only for health, but also for life, as it greatly increases the risk of developing arterial hypertension, and. If we turn to the numbers, then the likelihood of oncological diseases increases 15 times, cardiac ischemia - 35 times, and stroke - 56 times.
In the context of the overweight problem, the consequences pose the greatest danger to the patients themselves and a huge burden on the healthcare system. Weight and fat reduction as urgent measures. Therefore, reducing weight and fat is a top priority in order to avoid disease. The only targeted method for this is a combination of daily physical activity and modified eating behavior. According to Toplak, research recent years show the risk of metabolic syndrome and the need for lifestyle changes. "No other therapy affects metabolism as positively as lifestyle interventions," says Toplak.
Abdominal obesity is also called visceral, upper or android obesity. In this disease, fat surrounds everything internal organs human, including the heart, pancreas, liver, heart, and lungs. The maximum accumulation of adipose tissue is observed in the intestine, it also forms the anterior wall of the peritoneum. If we weigh the visceral fat of a person with normal body weight, then it will be about 3 kg, in obese people this figure can be safely multiplied by 10. If normally, fat simply envelops the internal organs and allows them to function normally, then in a person with abdominal obesity it compresses all the organs. As a result, lymphatic drainage and blood circulation suffer.
Scale and measuring tape as well as body fat measurement are an essential part of sound medical care or sustainable therapy. Bernhard Ludwik exhorts: The increase in excess weight in Austria is dramatic. Over the past ten years, we have seen a 30% increase in overweight, obese patients. We need to be wary that this wave of overweight will also lead to an epidemic of diabetes. It would also be a disaster for the healthcare system, as we could no longer fund it due to the effects of the disease.
People with this type of obesity are unable to tolerate physical activity normally. After all, the heart has to work not just in an enhanced, but in an extreme mode. In parallel, the functioning of the lungs and other important internal organs is disrupted. Most often, men suffer from abdominal type of obesity.
Symptoms of abdominal obesity
Symptoms of abdominal obesity are reduced, first of all, to an excess of adipose tissue in the upper half of the body and on the abdomen. A similar diagnosis can be made when the waist circumference of a man exceeds 94 cm, and that of a woman is 80 cm. Moreover, the mass index often remains within the normal range.
Even small weight loss and reduction of visceral fat bring big health benefits. The mantra of all health experts for long-term and long-term weight loss has been for many years: change your lifestyle! - both eating behavior and access to movement.
Reduction of internal abdominal fat. Study participants lost approximately 5% of their weight within three months and lost an average of 10% of the dangerous visceral fat. Even a small weight loss of 5-10% reduces health risks such as hypertension, type 2 diabetes, and fat metabolism disorders. Undigested fat is simply excreted with the chair again. In principle, alli is taken three times a day in a low-fat meal or up to one hour thereafter in the form of a non-chewable capsule.
Another sign indicating abdominal obesity is the presence of concomitant diseases, including:
Type 2 diabetes;
Arterial hypertension;
insulin resistance;
Violation of the metabolism of uric acid;
Dyslipidemia.
It has been established that visceral fat accumulated in the abdominal type of obesity acts as an endocrine organ and produces the stress hormone cortisol. As a result, the patient's body experiences chronic stress, which makes the internal organs work in an enhanced mode.
Source: Press Conference Real Fat! Visceral fat: an underestimated danger in the stomach. More than half of Germans are overweight. That's why every second person can speak here. But what is overweight now, how it occurs, what consequences it has and, above all, how it is eliminated, opinions differ widely. In this article, we apply order to a wealth of information.
In the introduction, it's already: A small pule can be felt as very unsettling, while others find a huge beer belly perfectly normal. So feeling doesn't help with the question of when someone is overweight. Even comparing with others doesn't do it anymore. It used to be simple: who was the fattest of all, was too heavy. And who was thinner, was underweight. If we applied this standard today, normal people would be considered anxious because, on average, people are too heavy.
Another hormone produced by belly fat is interleukin-6 (an inflammatory hormone). Therefore, even a minor disease, such as SARS, can lead to serious complications.
In men with abdominal obesity, the amount of female sex hormones increases, which leads to problems with potency and infertility. Female sexual function suffers from visceral fat no less, especially if its volume exceeds the norm by 40% or more.
Current: body mass index
For men it is still 10%, for women 15% is subtracted, then this is the ideal weight. A terrible calculation, because it was too unfair for women. Today we will look at the body mass index. The calculation is simple: the weight is divided by the square. This leads to the following restrictions.
Today, the optimal weight for health and longevity is also known. It is not as falsely assumed, as low as possible, but very normal, which means that against 25 years old, in old age is also somewhat higher. But everyone saw Klitschko already half naked, he does not look like being overweight!
An excess amount of hormones negatively affects the functioning of all organs and systems, every cell of the body suffers. It accumulates in the vessels, the intestines are not able to process the volumes of food entering it, people often suffer from, while the process of deposition of visceral fat does not stop. People with abdominal obesity often have sleep apnea, which is accompanied by respiratory arrest.
Because he certainly doesn't have too a large number fat, but it consists mainly of muscle. He looks different with a man who is the same size as Klitschko but has belly or butt fat instead of muscle. Muscle should be evaluated differently than fat. And so it is necessary to study how the body is formed.
In fact, medical guidelines define obesity not with any amount, but with excess fat! It is best to measure not obese wages, but professional devices such as. They show us the exact composition of the body of muscles, fat, water.
Found a mistake in the text? Select it and a few more words, press Ctrl + Enter
The causes of abdominal obesity in 90% of cases are the inability of the body to fully spend the energy received from outside. It comes in the form of kilocalories with food. That is, low physical activity combined with overeating will definitely lead to the accumulation of excess fat.
More importantly, where is the fat?
Sometimes it is noticeable that there are differences between women and men. Historically, men have fat, and women tend to have a thigh on their belly. Men used to have heart attacks, women were rare. For several decades, women have had as many heart attacks as men. At the same time, it is noticeable that women also get belly fat. And here the scientists asked themselves if there could be a connection.
Indeed, fat between organs in the abdomen has been found to have a property that fat elsewhere in the body does not: it produces hormones. Hormones that make you sick, such as arterial calcification or diabetes.
Factors that provoke abdominal obesity are considered to be:
Hypodynamia;
Hereditary predisposition to malfunctions of the enzymatic system;
An irrational approach to nutrition with an excess of fatty, sweet, salty foods. Abuse of alcoholic beverages;
Overeating against the background of stress, namely, psychogenic overeating;
Again, there are numbers that help us distinguish between normal and risky. It is very easy to measure: only the waist circumference is required. This is measured midway between the lower rib and the upper limit of the pool. But what's the risk? In addition to the premature wear and tear of the hip, knee and ankle joints, which are not made for heavy weight and back pain, the most important consequence of obesity is a combination of problems that are not well known: Metabolic syndrome. Metabolic syndrome is also known as the "death quartet" because there are 4 risk factors.
Diseases of the endocrine system, for example, etc.;
Obesity due to an altered physiological state, for example, during childbearing or during;
Syndrome chronic fatigue, stress, taking psychotropic and hormonal drugs.
Treatment of abdominal obesity
Treatment of abdominal obesity should begin with the right mental attitude. It is important that a person is motivated not only to improve appearance but also to address health problems. At the same time, the goals must be realistic, that is, those that he would be able to achieve.
- Obesity in the abdomen.
- Insulin resistance.
- Hypertension.
- Dyslipoproteinemia.
As described above, the problem here is that the so-called visceral fat produces hormones that make you sick. You can measure risk by waist circumference. Insulin resistance is a metabolic disorder that is mainly caused by being overweight and eating too much. Thus, the cells of the body no longer respond, and to insulin, these cells no longer receive sugar from the blood adequately. This increases the level of glucose in the blood. As a result, the pancreas must produce more and more insulin to achieve sufficient effects.
The diet should be built in such a way that the amount of kilocalories consumed per day is reduced by 300-500 kcal. In parallel, it is necessary to increase physical activity. It is important to limit the consumption of animal fats and refined carbohydrates, and protein and fiber should be ingested in normal amounts. Food should be boiled, baked, steamed, but not fried. You should eat at least 5 times a day, while it is important to limit the intake of salt and spices.
Unfortunately, the cells of the body become even more insensitive, and everything develops into the circle of the devil. As a result, there is too high level blood glucose and excessively high insulin levels. Both damage blood vessels in the long term and increase body fat.
If the pressure is too high in the water pipe, the seals may come out. Likewise, excessive blood pressure permanently damages blood vessels that are not designed for that pressure. This initially causes fatty deposits and therefore calcification in the arteries.
However, only a hypocaloric diet is not enough to reduce body weight, since the effect will be minimal due to a slowdown in metabolic processes. That is why physical activity is so important.
As for the drug correction of obesity, it is prescribed if a hypocaloric diet does not work for 12 or more weeks. Drugs that allow you to eliminate the feeling of hunger - Fepranon, Regenon, Desopimon, Mirapont. They accelerate saturation, but their reception threatens with the development side effects among which the most formidable is addiction.
Overweight and obesity properly and consistently
The weight loss benefit can be obtained directly from the above. At least everyone has an opinion on how it works best. Magazines, TV, the Internet, we present countless possibilities for easy or complex, fast or slow. And statistically, every German has a diet in his life.
Time should be carbohydrate, sometimes no fat. Sometimes only eggs, no eggs. Only salad or only meat. Over 500 different diets will help us lose fat. Everything should help - and at first glance, a lot helps at first. If you prefer intense flavor, use it sparingly.
Sometimes patients are prescribed the antidepressant Fluoxetine or the fat-mobilizing drug Adiposin. However, most doctors prefer drugs such as Xenical (reduces the absorption of fats in the intestine) and Meridia (accelerates the satiety process). They are considered the safest and are not addictive.
Only half sounds reasonable because it also means only half fat and only half calories. And in fact, this is a success story: weight loss. And these muscles are our best friends when we want to lose weight, because they are the biggest calorie consumers. Proteins are also required for assembly from antibodies, hormones, enzymes, blood clotting factors, etc.
To do this, the body requires constant protein - and this is not supplied with food, the body must take it, so where it is most optional: From the muscles and connective tissue. Less muscle consuming calories. If after the diet start re-normal diet halfway, the muscles are less than before consumed calories to consume. Now there are many calories left that the body does not throw away, but saves in bad times. And the body stores calories as fat. After some time, the initial weight is often reached again - unlike before, but with large quantity fat.
It is necessary that a person receives psychological support, changes his attitude to the culture of nutrition, to eating behavior, to the way of life in general. It is important not only to achieve your goal and lose extra pounds, but also to keep the weight in the future.
As for surgical methods of treatment, it is possible to carry out operations aimed at reducing the volume of the stomach or removing part of the intestine. But the long-term effect of such interventions remains unpredictable.
At the same time, reduced connective tissue leads to smoother skin, reduces vitamins to a less healthy body. So the other 500 diets can be discussed here.
- Weight loss with many diets.
- Not the disease is much more difficult.
- The weight in the back is almost impossible.
Declining and maintaining success
If you want to lose weight, do not diet. Anything that does not seek lasting change is doomed to failure. As much as we like to make life easier in life and look for cuts, this acronym doesn't exist if we want to constantly change weight. The most important changes are diet and exercise. In short, unless you're willing to continually improve your diet and get more exercise, you don't necessarily need to start losing weight.
In order to achieve a cosmetic effect, you can resort to liposuction. However, recent studies conducted by scientists from the University of São Paulo have made it possible to draw certain conclusions regarding the effectiveness of liposuction. Those women who did not start exercising after surgical fat removal increased their visceral fat reserves by 10% after 4 months. Therefore, in order to avoid health problems, you need to give up a sedentary lifestyle and start active training.
What is now proper nutrition known, despite all the conflicting information in medicine. The following principles apply today.
- Limited and Conscious Only then the right amount is eaten.
- So the feeling of fullness is felt.
- All hormones are in it.
- But not hungry, but do not lose weight.
- But low carb.
Author of the article: Zubolenko Valentina Ivanovna, endocrinologist, specially for the site site
... the frequency and severity of obesity-related disorders and diseases depend not only on the degree of obesity, but also on the characteristics of the deposition of adipose tissue in the body.Introduction. It is known that adipose tissue performs not only traditional physiological functions aimed at energy storage, regulation of heat transfer and protection, but is also a kind of endocrine gland, the cells of which are adipocytes that actively secrete various hormones and cytokines, regulate a number of other physiological processes (blood pressure, reproductive function in women, etc.), which, accordingly, can be impaired in obesity.
Back in 1947, J. Vague described two types of fat deposition - android (male, abdominal) and gynoid (female, gluteofemoral, lower), - drawing attention to the fact that android obesity is more often than gynoid obesity combined with diabetes mellitus, coronary artery disease, gout , thus emphasizing the importance of the topography of adipose tissue in the body in the development of diseases associated with obesity.
In subsequent years, numerous observations and studies have confirmed: excessive accumulation of abdominal adipose tissue, as a rule, is accompanied by metabolic disorders and significantly increases the risk of developing arterial hypertension, diabetes Type 2 and atherosclerotic diseases.
abdominal obesity- excessive deposition of fat in the abdominal region, provided that the index (coefficient) of the ratio of waist circumference to hip circumference (OT / OB) for men > 1.0, for women > 0.85.
Using CT or MR imaging, subtypes of abdominal obesity were identified: subcutaneous abdominal and visceral, and it was proved that patients with visceral obesity have the highest risk of developing complications, which, as a rule, develop early and are asymptomatic for a long time.
! Detection of the visceral type of obesity is most effective using CT and MRI, but the high cost of these methods limits their use in wide practice.
Studies have confirmed (via MRI/CT) a strong correlation between the degree of development of visceral adipose tissue and waist circumference (WC). It was found that WC equal to 100 cm indirectly indicates such a volume of visceral adipose tissue, in which, as a rule, metabolic disorders develop and the risk of developing DM 2 increases significantly.
! Waist circumference (WC) can be considered a reliable marker of excessive accumulation of visceral adipose tissue: WC > 100 cm at the age of up to 40 years and WC > 90 cm at the age of 40-60 years in both men and women is an indicator of abdominal-visceral obesity .
A feature of abdominal (especially visceral) fat is its high density of receptors for catecholamines (b-adrenergic receptors), somatotropic hormone (STH), sex steroids, thyroid hormones; including in the abdominal adipose tissue there are a-adrenergic receptors and insulin receptors (but with a much lower density), which leads to the active flow of metabolic processes in the abdominal adipose tissue.
In this regard, the increased accumulation of abdominal fat is a major risk factor for the development of diabetes mellitus, impaired glucose tolerance, hyperinsulinemia, arterial hypertension, cancer, arthritis, sclero-cystic ovarian syndrome, and many other pathological conditions; in addition, with obesity in women, the production of male sex hormones by the ovaries and adrenal cortex increases, as a result of which hirsutism develops, as well as menstrual dysfunction.
Usually, the main complications of abdominal-visceral obesity are considered within the metabolic syndrome:
• visceral obesity (having a close causal relationship with the development of insulin resistance, which, according to most researchers, predetermines the development of other components of the metabolic syndrome);
• hyperinsulinemia;
• impaired carbohydrate metabolism in the form of fasting hyperglycemia or impaired carbohydrate tolerance, or type 2 diabetes mellitus;
• dyslipidemia in the form of hypertriglyceridemia;
• arterial hypertension;
• left ventricular hypertrophy;
• hyperuricemia;
• decrease in fibrinolytic activity of blood.
! The clinical significance of the metabolic syndrome is to accelerate the development and progression of atherosclerotic vascular diseases and their complications.
Abdominal obesity and insulin resistance. It is believed that the development of insulin resistance and associated metabolic disorders contributes to obesity with a predominant localization of fat in the abdominal cavity - abdominal or android obesity.
Abdominal fat, that is, the fat of the omentum and mesentery, is easily exposed to lipolytic factors, for example, during stress. At the same time, a significant amount of non-esterified (free) fatty acids is released into the bloodstream, which enter the liver through the portal vein in a short way. Free in the liver fatty acid disposed of in two ways:
1 - or are converted into glucose through the processes of gluconeogenesis; as a result, an excess amount of glucose is secreted into the bloodstream, followed by hyperinsulinemia and insulin resistance of tissues;
2 - or used for the synthesis of triglycerides (TG); increased TG synthesis in the liver leads to an increase in the synthesis of the main protein of atherogenic low and very low density lipoproteins (LDL and VLDL) - apolipoprotein (apo) B and an increase in VLDL secretion into the bloodstream. Hypertriglyceridemia develops, which, with the active process of VLDL lipoprotein lipolysis, may be accompanied by an increase in the level of LDL, especially the subfraction of small dense particles; such small dense LDLs have increased atherogenicity, as they are more prone to oxidation and active capture by macrophages.
Abdominal obesity and arterial hypertension. Although the question of the mechanisms of development of arterial hypertension in the framework of insulin resistance (which, according to most authors, is due to abdominal-visceral obesity), is still being discussed, there is no doubt that the complex effect of insulin resistance, hyperinsulinemia, and lipid metabolism disorders play important role in mechanisms to increase blood pressure in patients with abdominal obesity. The following effects of insulin are of decisive importance in the development of arterial hypertension:
1 - proliferation of smooth muscle cells of the vascular wall;
2 - sympathetic stimulation nervous system;
3 - changes in transmembrane ion transport.
In addition, abdominal adipose tissue, like adipose tissue in other parts of the body, is a completely independent endocrine organ, the dysfunction of which can also provoke the development of arterial hypertension and dysfunction of the reproductive system in women.
Adipocytes are able to independently synthesize angiotensinogen, the excess of which leads to increased synthesis of products of the renin-angiotensin-aldosterone system (RAAS) - angiotensin I and angiotensin II (AT I and AT II). With excess weight, adipose tissue is in a state of macrophage infiltration, which contributes to the synthesis of pro-inflammatory cytokines and the production of peroxidation products. This, in turn, additionally induces the activation of the RAAS and the sympathoadrenal system (SAS), which is the main mechanism for increasing blood pressure in overweight patients. In addition to the direct production of angiotensinogen, fat cells contain all the components of the RAAS necessary for the local formation of AT II.
Abdominal obesity and reproductive dysfunction in women. Increased accumulation of abdominal fat is a risk factor for the development of not only cardiovascular diseases, diabetes mellitus, a number of cancers, but also reproductive system dysfunction.
Obesity is considered as a condition that is associated with excessive production of estrogens (especially their active metabolites), which correlates with body weight and the amount of adipose tissue. Excessive conversion of androgens to estrogens, which occurs during obesity due to an increase in aromatase activity in adipose tissue, as well as a decrease in the concentration of sex steroid binding hormone, which leads to an excess of free estrogens, can also contribute to the emergence of a hyperestrogenic state.
It is known that an increase in the mass of adipose tissue above the norm by 20% or more leads to dysfunction of the hypothalamic-pituitary-ovarian system. Obesity, especially of the abdominal type, is one of the main risk factors for the development of ovarian hyperandrogenism, while more than 1/3 of women may develop polycystic ovary syndrome (PCOS). PCOS is the main cause of irregular menstruation, endocrine infertility, hirsutism (excess hair growth), alopecia (hair loss on the head), seborrhea, and acne.
! Obesity is 5-6 times more likely to cause menstrual irregularities, such as oligomenorrhea, amenorrhea, incl. and uterine bleeding, which is often based on hyperplasia and even precancer of the endometrium (against the background of hyperestrogenism and a progesterone-deficient state, the time of endometrial proliferation is prolonged, which leads to the development of endometrial hyperplasia).
Given the above, it becomes clear how important early diagnosis and treatment of abdominal obesity is.
Early diagnosis of abdominal obesity is based on dispensary examinations of the population in order to identify individuals with abdominal obesity. A carefully collected family and social history helps to assess the risk of developing complications associated with abdominal obesity, which makes it possible to identify patients with a hereditary predisposition and lifestyle characteristics that predetermine the development of abdominal obesity and insulin resistance. The scheme of examination of patients should include not only anthropometric measurements - BMI (body mass index), WC, WC / OB, but also the determination of markers of the insulin resistance syndrome: the level of triglycerides, apolipoprotein-B and insulin on an empty stomach.
Treatment Abdominal-visceral obesity should be aimed not only at optimal compensation for existing metabolic disorders, but also, first of all, at reducing insulin resistance.
Due to the fact that excessive accumulation of visceral adipose tissue is one of the main pathogenetic factors in the formation of insulin resistance syndrome, the leading place in the complex treatment of patients should be occupied by measures aimed at reducing the mass of abdominal visceral fat: hypocaloric nutrition in combination with regular physical activity.
The diet is compiled taking into account body weight, age, gender, level of physical activity and food habits of the patient. The consumption of fat is limited to 25% of daily calories, animal fats are not more than 10% of total fat, cholesterol is up to 300 mg per day.
Decrease in visceral adipose tissue mass, as a rule, leads to an improvement in insulin sensitivity, a decrease in hyperinsulinemia, an improvement in lipid and carbohydrate metabolism, and a decrease in blood pressure.
If the use of non-drug methods of treatment in patients with abdominal obesity and insulin resistance syndrome does not allow compensating for lipid and carbohydrate metabolism disorders and reducing insulin resistance and hyperinsulinemia, then apply medicines that can affect insulin resistance, for example, a drug from the biguanide class - metformin.
