Abdominal obesity: what is it and how to get rid of the problem. Abdominal (upper) type of obesity

Humanity is getting fat - a fact. However, does this mean that fullness is dangerous to health? Is "surplus" harmful or is it a psychological problem for most women? The facts about fat, obtained as a result of the latest scientific research, are truly amazing.

Good bad evil

It is generally accepted that the fatter a person is, the less healthy he is. This is not entirely true, since it all depends on the location of fat on the body. The danger is internal fat accumulating in the liver and organs abdominal cavity, and not at all his subcutaneous "brother". Internal fat cannot be seen or felt. Its share in relation to the total fat content in the body is small. If the amount of fat in a woman's body is on average 20-25 kg, then only 2.5-5 kg ​​of them are internal, abdominal.

Finding out the real size of your internal "reserves" is possible only with the help of a special procedure: computed or magnetic resonance imaging. But you will get a general idea of ​​\u200b\u200bsurplus fat if you measure your waist circumference. Came out more than 85 cm? There is something to think about…

Why is internal fat dangerous? It does not affect the appearance, sits quietly in the abdomen, does not touch anyone. But at the same time, it actively releases elements into the bloodstream. fatty acids, they immediately attack the liver, which, in turn, has a short circuit, and away we go ... Excess insulin, increased pressure, increased levels of cholesterol and triglycerides (fat particles) in the blood - this condition is called " metabolic syndrome". It usually precedes diabetes and heart disease.

Abdominal (abdominal) fat is a “pupil” of stress, a concentrate of cortisol (stress hormone). When you are chronically anxious, the body unleashes a wave of cortisol on the internal systems and at the same time creates a "factory" for its processing - the abdominal layer of fat.

Subcutaneous fat, on the contrary, does not bring harm to health. Neither the notorious crease at the waist, which you critically examine in the mirror, nor the hated "riding breeches" on the hips are not terrible. Scientists prove (argued) that “popin ears” serve as protection against cardiovascular diseases: excess fat from the bloodstream settles on the thighs, and does not clog the arteries, and does not interfere with the most important metabolic processes.

In Canada, a study was conducted: under the supervision of doctors, 12 pairs of male twins for 6 weeks ate 1000 kcal per day in excess of the norm. Both the places of fat deposition and the purely gained kilograms (from 4.5 to 12) within one pair of twins varied greatly! To the question that not everything in our life is managed by genetics.

Comforted, called

A fat plus of a female physique is a pear-shaped figure (a woman usually retains her forms until menopause). 80% of women in the world are pear-shaped. Fat is distributed in "safe" areas for health. Nevertheless, weight gain should not be taken lightly - after 50 years, women lose their “immunity” laid down by nature, and the chance of acquiring metabolic syndrome increases many times over. All because due to age hormonal changes fat is redistributed - not in favor of health. The base that you prepare in your youth is important here - this is a kind of fund, it will help you painlessly transfer side effect menopause.

Donation

Geneticists say that our physiology is predetermined by heredity by about 70%. So the rhetorical question that losing weight plumpers ask themselves after another fruitless attempt to maintain weight: “Maybe this is my fate and there is no point in fighting it?” - well justified. Monica Bellucci will never be as slim as Uma Thurman. This is not directly related to obesity - your genetically determined fat "subtext", or, in other words, the features of the figure, does not adversely affect health.

Nevertheless, the same Bellucci needs to make more efforts to keep the weight under control than people with an asthenic physique. If there are overweight people among your relatives, carefully monitor your health, switch to a low-calorie diet and devote at least three hours a week to sports. With these simple precautions, you will be able to conclude a "truce agreement" with your genetics.

We can console all Monica Bellucci: if a thin woman does not follow her diet, relying on her explosive metabolism, health problems cannot be avoided - after all, internal fat and external fat accumulate in different ways.

And it's not just the calories. There are many factors that predetermine fullness: for example, temperamental, restless people burn more energy than phlegmatic people due to nervous experiences. However, experts different countries unanimously conclude: no matter what genetic cards you fall out, the accumulation of dangerous fat (internal) depends on lifestyle.

Further more

The good news is that the fat that causes the most harm to the body is the easiest to “drive out”. Tempting thighs, even after many hours in a fitness club, can stay with you for life, but internal fat with favorable conditions burns out quickly. Studies show that those who lose at least 10% of their total weight lose up to 30% of abdominal fat at the same time!

Which is more effective - diet or exercise? If you are interested in immediate results, then a low-calorie diet works faster. An average woman weighing 70 kg will need an average of 1 hour and 10 minutes of vigorous walking at a speed of 6 km / h to use up 390 kcal. You can save the same amount by skipping dessert. Again, it is easier for the average woman not to eat a chocolate cake than to wander drearily along a treadmill.

But this easy way. Physical activity, of course, is more reliable, the result is fixed for a long time and, moreover, it does not cause psychological discomfort, which is easy to earn if you constantly refuse the cake (after all, you can burst into tears). The trade-off is a combination of training with a gradually increasing load and a modest nutritional reform. You can get by with a little blood: instead of mayonnaise - vinegar or mustard (saving: 100 kcal per tablespoon), an apple instead of a glass of apple juice (saving: 45 kcal). In parallel, practice meditation, yoga - stress inhibits the burning of internal fats.

And one more important note: do not rush to lose weight. A kilogram per week is a tempting and, most importantly, very realistic goal, but you will have to tighten the regime, first of all - reduce the diet by 1000 kcal per day. It's hard. Ride quietly: 250 g per week. In a year, the result will be impressive: 12 kg! At the same time, not only the wardrobe that has become dimensionless will leave your life, but also all the “superfluous” - that which you will not see in the mirror.

risk zone

Enemy number one - dissatisfaction with yourself

At the word "riding breeches" women wince and wince. Years of war with an unaesthetic enemy can undermine health and upset the psyche. Dissatisfaction with one's own body, which is experienced by more than half of all women on the planet, entails a violation eating behavior(anorexia, bulimia), lowers self-esteem. Any physical exercise (morning exercises, funny games with a dog while walking, or incomplete workouts in the gym) will successfully improve your relationship with your own body.

20.12.2019 18:39:00 These foods should not be eaten together. There are foods that, in certain combinations, have a very positive effect on the body: for example, jacket potatoes and cottage cheese are a source of protein and saturate well. But there are also foods that cannot be eaten together.

20.12.2019 17:48:00

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When people talk about abdominal obesity

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• An increase in OT (waist circumference) in excess of the standard figures. For women, this figure should not exceed 88 cm, for men - 102 cm. Waist measurement is considered a key screening test for the routine diagnosis of abdominal obesity.
• Change in the ratio between the circumference of the waist and hips. In women, this parameter becomes more than 0.85, in men - more than 1.0.

The “apple” figure is not at all a constitutional feature; you should not write it off for the lack of training of the abdominal muscles. This is a fairly serious pathology with a proven high risk of developing various diseases. People with such a problem are advised to consult a doctor, as it can be difficult for women to get rid of abdominal obesity and cope with already formed complications without the help of a specialist.

Classification: main varieties

• Subcutaneous-abdominal type, with a predominance of subcutaneous fat. This is a more favorable type of obesity, but it rarely occurs in isolation.
• Visceral type, with pronounced intra-abdominal fat deposition. It is located around internal organs and partially in their thickness, in the space around large vessels, in the greater and lesser omentum, in the mesentery of the intestine, in the retroperitoneal region. Such fat is also found outside the abdominal cavity, mainly around the heart and kidneys.

Often meets mixed type when visceral deposits are supplemented by a general increase in the volume of subcutaneous fat with the involvement of the abdomen. At the same time, the greatest negative impact is also associated with an excess of intra-abdominal fat, the fight against which requires an integrated approach.

What contributes to this pathology

• Sedentary lifestyle.
• Unbalanced high-calorie diet. People prone to obesity prefer highly nutritious, easily digestible foods, with an excess of animal fats in the diet, frequent use of pastries, other carbohydrate foods, the so-called "food garbage" (chips, crackers with flavoring additives, cookies, etc.). Overeating, frequent plentiful snacks are also significant.
• endocrine imbalance. It may be associated with the period of pregnancy and lactation, insufficient selection of oral contraceptives, dysfunction thyroid gland and the hypothalamic-pituitary system, taking some hormonal drugs. Great importance also have changes during menopause.
• Some mental disorders(mainly anxiety-depressive spectrum), taking antidepressants, neuroleptics and other drugs with a psychotropic effect.
• Tendency to alcoholism.
• Chronic stress, repetitive psycho-emotional overload, overwork.
• Lack of sleep, non-compliance with the sleep-wake cycle (for example, during daily duty, shift work, etc.).

Why you need visceral fat

• Estrogens formed from adrenal androgens under the action of adipocyte aromatase. They are also synthesized in the male body, and with obesity, the level of this hormone becomes clinically significant.
• Leptin is a hormone responsible for the feeling of satiety. An important component of the energy metabolism regulation system in the body, it is involved in the regulation of appetite and maintaining cell sensitivity to insulin.
• Adiponectin is a hormone also responsible for energy homeostasis. Participates in the regulation of glucose and fatty acid metabolism in skeletal muscle, myocardium and liver. It also has anti-atherosclerotic (antiatherogenic) and anti-inflammatory effects.
• Angiotensinogen. It is a precursor of the hormone angiotensin, which has a vasoconstrictive effect and thereby contributes to an increase in the level blood pressure.
• Substances involved in non-specific inflammatory and immune reactions in the body: prostaglandins, interleukin 6 (IL6), tumor necrosis factor α (TNFα). Some of them also regulate cell growth and are included in antitumor defenses.
• Insulin-like growth factor 1 (IGF1), which regulates life cycle cells, the rate of their proliferation (division, growth and specialization).
• Adrenomedullin. It has a vasodilating and antioxidant effect, protects the heart from damage (cardioprotective effect)
• Fibrinogen, which is involved in the cascade processes of blood coagulation.

Adipose tissue is also the main source of free (non-esterified) fatty acids. In the body, they are an important energy substrate for muscle cells and are converted into triglycerides and phospholipids, which are used to build cell membranes and secrete a number of biologically active substances. Visceral fat is an important component of the body's metabolic regulatory system. A change in its amount negatively affects the state of health, and many developing complications are almost irreversible and are associated with the risk of premature mortality. It is they who in most cases become the reason for going to the doctor, and often obesity as the root cause of diseases remains without due attention. This approach reduces the effectiveness of treatment and worsens the prognosis.

What is dangerous excess visceral fiber

The main manifestations of the metabolic syndrome in abdominal obesity include:

• Increase in serum levels of triglycerides, free cholesterol and low fraction lipoproteins. Such an imbalance in the lipid profile is called atherogenic dyslipidemia, it contributes to the deposition of cholesterol under the intima (inner shell) of the arteries with the development of atherosclerosis.
• Increased levels of pro-inflammatory compounds. This contributes to non-specific damage to the walls of blood vessels, myocardium (heart muscle), joints and other structures, slows down the regeneration process, increases the risk of complications and chronicity of emerging diseases.
• Changes in carbohydrate metabolism in the form of insulin resistance (reduced sensitivity of cells to insulin) with compensatory insulinemia (increased blood insulin levels). This predisposes to the development of subsequent type 2 diabetes and supports existing eating disorders. Moreover, insulin resistance can exist without a decrease in glucose tolerance, including in people with a slightly exceeded BMI.
• Change in reactivity vascular walls predisposition to arterial hypertension.
• Decreased quality of antitumor protection.
• Reproductive system dysfunction.
• Violation of the blood coagulation system, with a predisposition to thrombosis.

Complications of abdominal obesity

• Cardiovascular diseases, mainly due to atherothrombotic changes in the cardiac (heart) vessels. Obese people are predisposed to coronary artery disease with pain and chronic heart failure, myocardial infarction, heart rhythm disturbances. Studies have shown that every 10% increase in weight leads to a 10% increase in the risk of developing coronary artery disease within 5 years.
• Hypertension and associated risks of acute vascular accidents (heart attack and stroke) and chronic dyscirculatory encephalopathy. Even a 5% increase in body weight increases the risk of developing arterial hypertension by 30% (within 4 subsequent years).
• insulin resistance and diabetes 2 types.
• Atherogenic dyslipidemia, followed by atherosclerotic lesions of the main arterial vessels. Most often, cholesterol plaques are found in the thoracic and abdominal aorta, in carotid arteries, in the vessels of the heart, brain, kidneys, arteries lower extremities. They can block up to 70-80% of the lumen of the vessel, which is fraught with the development of ischemia ( oxygen starvation) in blood-supplying organs.
• Reproductive disorders. They are associated with an increase in the non-ovarian fraction of estrogen and with secondary changes in the level of other sex hormones. Women develop disorders of the ovarian menstrual cycle high risk of infertility. With adolescent obesity, a delay in sexual development is possible. In men, there is a deformation of the figure according to female type, libido and potency decrease, gynecomastia appears.

Non-metabolic complications of obesity

Is a big belly always obese?

Such disorders in bodybuilders are associated with an artificially created hormonal imbalance that occurs when certain drugs are used to stimulate muscle growth (hypertrophy). The most dangerous in this regard are funds based on growth hormone also called growth hormone. They not only provoke metabolic disorders, but can also contribute to the excessive growth of internal organs and individual parts of the body.

What examination is needed

• Consultation of a therapist (primary and based on the results of the examination), with an assessment of the level of blood pressure, fixing anthropometric indicators and determining BMI. In some medical institutions such a primary diagnosis is carried out by a nutritionist with a basic therapeutic specialization.
• Blood chemistry. Blood glucose, total bilirubin and its fractions, urea, creatinine, total protein, lipid profile (triglycerides, total cholesterol, lipoprotein fractions) are checked. Other indicators are evaluated as necessary.
• Endocrinologist consultation.
• Identification of insulin resistance and disorders of carbohydrate metabolism: determination of fasting insulin levels, conducting a glucose tolerance test. Such an examination is usually prescribed by an endocrinologist.

Examinations are also required for patients with overweight, who initially consulted a doctor about diseases associated with overweight. After all, getting rid of obesity will reduce their risk of cardiac and cerebral complications, compensate for the current pathology and improve the overall prognosis.

What to do. Principles of treatment

Obesity is a disease, the main symptom of which is the excessive accumulation of adipose tissue in the body.

Obesity develops as a result of an imbalance in the energy balance of the body, when the energy intake from food exceeds the energy expenditure of the body. Excess calories from what you eat is used to synthesize fat, which is deposited in fat depots. Gradually, fat depots increase, body weight is steadily growing.

There are three types of obesity:

Abdominal(from lat. abdomen - belly), or android (from the Greek andros - man), or the upper type of obesity is characterized by excessive deposition of adipose tissue in the abdomen and upper torso. The figure becomes like an apple. Obesity type "apple" is more common in men and is the most dangerous to health. It is with this type that diseases such as diabetes mellitus are more likely to develop. arterial hypertension, heart attacks and strokes.

femoral-gluteal, or the lower type of obesity is characterized by the development of adipose tissue mainly in the buttocks and thighs. The figure is shaped like a pear. Pear-type obesity is often found in women and, as a rule, is accompanied by the development of diseases of the spine, joints and veins of the lower extremities.

Mixed, or intermediate type of obesity is characterized by a uniform distribution of fat throughout the body.

To determine the type of obesity, you need to measure the circumference of the waist and hips and calculate their ratio: with abdominal obesity, the indicated ratio in men exceeds 1.0; in women - 0.85. A simpler measure of abdominal obesity is waist circumference. If the waist in men exceeds 102 cm, and in women - 88 cm - this is abdominal obesity and a serious cause for alarm.

Most of the adipose tissue in the abdomen is visceral fat. Unlike subcutaneous adipose tissue, visceral fat surrounds the internal organs - the liver, pancreas, and others. It accumulates hormones produced by the body, reduces the sensitivity of tissues to insulin, and thus can cause diabetes and various health problems.

Visceral fat is not affected by any external cosmetic methods (such as myostimulation, electrolipolysis, massage, body wraps, vacuum therapy, etc.). This type of body fat can only be fought with the help of dietary correction and physical activity (aerobic, not strength).

But, as a rule, most men also have superficial fat. And it is the superficial fat that is the most "stubborn" if it is located in areas typical for men. These "male" fatty deformities are located in the abdomen - "beer belly", around the waist - "lifebuoy", in the lower back - "handrails of love", on the chest. These "problem areas" are not corrected with the help of diet, physical activity, but require a specially designed program of physiotherapy treatment.

In order to prevent the abdominal type of obesity, it is necessary to introduce basic knowledge of rational nutrition, to cultivate a reasonable attitude towards food.

The amount of food consumed should be moderate, not cause a feeling of oversaturation, and patients with abdominal obesity should gradually reduce the amount of food. It is not recommended to eat a lot in the evening, when a person's motor activity is reduced, and food mainly serves as a source of body fat.

If signs of abdominal obesity appear, sugar, confectionery and white flour products, alcohol, sugary drinks and juices should be removed from the diet, cereals and potatoes should be limited or completely abandoned, avoided. fatty foods especially of animal origin. In nutrition, in the treatment of abdominal obesity, dishes from lean meats, fish, poultry, eggs, low-fat dairy products, rye flour bread, vegetables, herbs, seasonal berries, especially blueberries, black currants, should prevail.

Patients with abdominal obesity are advised to eat slowly, slowly. The feeling of satiety depends on many factors, and, above all, on the level of glucose in the blood. Carbohydrates begin to break down already in the oral cavity. When eating quickly, the feeling of fullness is delayed due to the shortening of the breakdown and absorption of sugars, so those who eat quickly often overeat. The feeling of hunger can also be combated with the help of physical activity. Intense exercise reduces hunger. Patients with abdominal obesity are also recommended to take warm water before meals, preferably alkaline mineral without gas, you can drink a few sips of warm milk or tea brewed with milk.

Abdominal obesity is the most common, but at the same time the most dangerous kind of overweight. It is worth noting that the disease most often affects males, and in women it develops relatively rarely. Both the wrong way of life and the reasons that have a pathological basis can serve as a source of the disease. In addition, the influence of genetic predisposition is not excluded.

In addition to the gradual increase in the volume of the abdomen, clinical picture are such signs - fatigue, decreased performance, shortness of breath, decreased sexual desire and infertility.

Only a clinician can make a correct diagnosis and find out why a person develops abdominal obesity, based on information obtained during a physical examination, laboratory research and instrumental procedures.

You can get rid of the accumulation of adipose tissue in the abdomen using conservative methods, for example, by taking medicines and performing gymnastic exercises aimed at strengthening the abdominal muscles. However, in severe cases, surgery is the only treatment option.

Etiology

The abdominal type of obesity is most often the result of an unhealthy lifestyle, namely poor nutrition. However, overeating is not the only predisposing factor leading to the development of such a pathology.

The disease can be provoked:

• dysfunction of the hypothalamus, in which the food center that regulates satiety is located. Such a deviation leads to the fact that no matter how much a person eats, he constantly feels hungry. In such situations, it is not enough just to follow a sparing diet and play sports - the basis of therapy is the work of a psychotherapist with a patient;
• lack of serotonin, which is a hormone responsible for mental stability and positive emotions, which is why it is also called the hormone of joy. Deficiency of this substance leads to the development depression, with which some people prefer to fight by eating large amounts of junk food;
• a sedentary lifestyle - sedentary working conditions and a complete rejection of sports greatly increase the likelihood of overweight accumulation;
• long-term addiction to bad habits, namely to drinking alcoholic beverages, which, in turn, increases appetite;
• irrational use of medicines, namely hormonal and psychotropic substances.

Do not forget that the cause of abdominal obesity is a genetic predisposition. Knowing this, a person can independently prevent the accumulation of a large amount of adipose tissue in the peritoneal area - for this it is enough to lead an active lifestyle and eat right.

In females, such a disorder is often the result of pregnancy and labor.

Classification

Abdominal obesity in women and men has several options for the course:

• the accumulation of fat cells directly under the skin is the most favorable type of disease, since it lends itself well to conservative therapy, consisting of therapeutic exercises and diet. Complications in such cases develop extremely rarely;
• the formation of adipose tissue around vital organs - while getting rid of extra pounds is much more difficult. In addition, there is a high probability of formation of life-threatening consequences. Often, therapy includes medical intervention.

Pathology has three degrees of severity:

• Stage 1 - waist circumference in men does not exceed 94 centimeters, and in women 80 centimeters;
• Stage 2 - indicators for males vary from 94.2 to 101.3 centimeters, for women - from 81.2 to 88.6 cm;
• Stage 3 - in such cases, the waist circumference in men is from 102.6 cm and above, and in women - 88.9 cm or more.

Symptoms

With abdominal obesity, the clinical picture will include a combination of the following signs:

• an increase in the volume of the abdominal cavity;
• cell resistance to insulin, which almost always leads to the appearance;
• increase in blood tone;
• changes in the composition of the blood;
• decreased sexual activity;
• shortness of breath that appears even with minimal physical activity;
• male and female infertility;
• violation of the menstrual cycle in females;
• rapid fatigue and decreased performance;
• development of depression;
• heartburn, which occurs against the background of the reflux of gastric contents into the esophagus;
• lower limbs;
• development of sleep apnea syndrome;
• frequent exposure colds;
• violation of the functioning of the digestive system.

It should be borne in mind that with the accumulation of adipose tissue around the internal organs, it can lead to the appearance of symptoms indicating their dysfunction. The most common targets are:

• heart and liver;
• kidneys and pancreas;
• vessels and omentum;
• thick and small intestine;
• lungs.

It is noteworthy that similar clinical manifestations are observed in women and men.

Diagnostics

A gastroenterologist or endocrinologist can find out the reasons for the accumulation of excess body weight in the abdomen and prescribe adequate treatment. In addition, you need to consult a nutritionist.

The process of diagnosing abdominal obesity in men and women includes several stages, the first of which is aimed at:

• studying the history of the disease - this will allow you to establish a pathological predisposing factor;
• collection and analysis of a life history - this should include information regarding nutrition, physical activity, mental health and addiction to bad habits;
• a thorough physical examination - involving palpation and percussion of the anterior wall of the abdominal cavity, measurement of the circumference of the abdomen and determination of the body mass index on an individual basis for each patient;
• a detailed survey of the patient - to compile a complete symptomatic picture, determine the severity of symptoms and establish the stage of the course of the pathology.

The second step of diagnosis is laboratory research, which is limited to the implementation of general and biochemical analysis blood, which will indicate a change in its composition, characteristic of such a disease.

The final stage of diagnosis is the implementation instrumental examinations, among which:

• Ultrasound of the abdominal cavity;
• gastroscopy;
• radiography using a contrast agent;
• CT and MRI - to detect lesions of internal organs.

Treatment

The fight against abdominal obesity is complex and takes a fairly long period of time.

Complex therapy consists of:

• lifestyle changes;
• compliance with a sparing diet;
• performing gymnastic exercises;
• taking medications;
• treatment of comorbidities.

The following medications are considered the most effective:

• "Orlistat" - reduces the absorption of fat in the intestine;
• "Sibutramine" - an antidepressant that reduces appetite;
• "Rimonabant" - belongs to the category of antagonists, reduces appetite and promotes rapid weight loss;
• "Metformin";
• "Pramlintid" - creates a feeling of saturation;
• "Exenatide Byeta".

The diet and the complex of therapeutic exercises are compiled individually for each patient, which depends on the severity of the disease. However, in any case, therapy should have an integrated approach.

With the ineffectiveness of conservative methods, as well as in severe stages of the course, the treatment of abdominal obesity in both sexes involves surgical operation. The intervention is aimed at partial removal intestines or reduced stomach capacity.

It is worth noting that in this case folk remedies do not give positive result and sometimes can exacerbate the problem and lead to complications.

Possible Complications

Abdominal obesity is a dangerous disease that can lead to a large number of dangerous consequences. The list of dangerous diseases includes:

• malignant arterial hypertension;
• inability to have children;
• secondary diabetes mellitus, which is a consequence of insulin resistance;
• atrial fibrillation;
• fatty degeneration of the liver;
• susceptibility to cancer and inflammatory processes;
• the accumulation of a large amount of cholesterol in the blood vessels, which disrupts the nutrition of the internal organs;
• salt deposits in the joints.

Prevention and prognosis

To avoid the development of abdominal obesity, the following simple rules of prevention should be followed:

• lifetime waiver bad habits;
• healthy and nutritious food;
• maintaining a moderately active lifestyle;
• permanent strengthening of the abdominal muscles;
• adequate use of medicines strictly as prescribed by the doctor;
• avoidance of emotional overstrain;
• regular passage of medical examination with a visit to all specialists.

The prognosis of the disease depends entirely on several factors - the severity of its course, the age category of the patient, the presence of concomitant pathologies and conscientious adherence to the recommendations of the attending physician.

Is everything correct in the article with medical point vision?

Answer only if you have proven medical knowledge

Abdominal obesity is the most common, but at the same time the most dangerous kind of overweight. It is worth noting that the disease most often affects males, and in women it develops relatively rarely. Both the wrong way of life and the reasons that have a pathological basis can serve as a source of the disease. In addition, the influence of genetic predisposition is not excluded. Next, we will consider in detail what kind of disease it is, what causes, symptoms and methods of treatment are used.

Abdominal obesity: what is it?

Abdominal obesity is a type of obesity in which adipose tissue is deposited only or mainly in the abdomen (waist) and around the internal organs. The term "abdominal" (from the Latin word "abdomen" - stomach) means abdominal, that is, it indicates that fat is deposited in the abdomen. The fat that is deposited in abdominal obesity is called visceral (visceral - referring to the internal organs), so the second name for this type of obesity is "visceral obesity".

In addition to the gradual increase in the volume of the abdomen, the clinical picture is made up of such signs - fatigue, decreased performance, shortness of breath, decreased sexual desire and infertility.

Only a clinician can make a correct diagnosis and find out why a person develops abdominal obesity, based on information obtained during a physical examination, laboratory tests and instrumental procedures.

Abdominal obesity can be in outwardly thin and slender people. There is evidence that indicates that 45% slim women and 60% of men without external signs Obesity has excessive deposition of visceral fat. It is important to know that athletes can also have abdominal obesity, as exercise affects fat under the skin more than fat inside the abdomen. At the same time, in people who do not perform regular exercise, but they eat right, the amount of abdominal fat is normal, although outwardly they may not look very thin.

The reasons

Abdominal obesity is an excessive accumulation of adipose tissue in the upper half of the body and on the abdomen.

This ailment is common in developed countries, and it was noted that the higher the standard of living of a person, the more he is prone to obesity in general and abdominal obesity in particular. In terms of impact on health, ordinary external obesity does not pose a serious danger, it is more of an aesthetic imperfection. Abdominal obesity is a threat to human health.

According to the etiological basis, obesity is alimentary-constitutional and symptomatic. The first option is much more common, due to heredity and lifestyle of a person. According to the clinical experience of doctors, weight gain on the basis of endocrine and other pathologies is a less common phenomenon. The list of causes of abdominal obesity includes the following items:

• constitutional features. Genetic predisposition is one of the causes of the disease in 25-70% of cases. The characteristics of metabolic processes, factors in the development of metabolic syndrome and diabetes are inherited.
• Power type. Obesity is promoted by excess caloric content of food, the use of a large amount of it in the evening and at night, the transition from traditional national nutrition to industrial. The diet of patients is dominated by fats, light carbohydrates, alcohol.
• Eating Disorders. Food addictions are determined by family and national food stereotypes and mental health. With emotional disorders, the metabolism of endorphins and serotonin is disturbed, the use of sweets and alcohol becomes “doping”, addiction is formed.
• Physical inactivity. An increase in the amount of fat is often caused by inactivity in everyday life - insufficient expenditure of energy from food. Fats and carbohydrates that are not wasted by the body for motor activity are processed and deposited in the "depot".
• endocrine disorders. Hypercortisolism, insulinoma, hypogonadism, and hypothyroidism lead to obesity. The disease is provoked by a change in the secretion of hormones, as a result, appetite increases, a habit of overeating is formed, and lipolysis slows down.

Types and types

There are 2 options for excessive accumulation of fat in the abdomen:

• Subcutaneous abdominal type, with a predominance of subcutaneous fat. This is a more favorable type of obesity, but it rarely occurs in isolation.
• Visceral type, with pronounced intra-abdominal fat deposition. It is localized around the internal organs and partly in their thickness, in the space around the large vessels, in the greater and lesser omentum, in the mesentery of the intestine, in the retroperitoneal region. Such fat is also found outside the abdominal cavity, mainly around the heart and kidneys.

The visceral variant of obesity is the most dangerous for health. It is he who is considered as a key risk factor for the development of many severe and even potentially fatal complications.

Often there is a mixed type, when visceral deposits are supplemented by a general increase in the volume of subcutaneous fat with involvement of the abdominal area. At the same time, the greatest negative impact is also associated with an excess of intra-abdominal fat, the fight against which requires an integrated approach.

And it has several flow options:

• the accumulation of fat cells directly under the skin is the most favorable type of disease, since it lends itself well to conservative therapy, consisting of therapeutic exercises and diet. Complications in such cases develop extremely rarely;
• the formation of adipose tissue around vital organs - while getting rid of extra pounds is much more difficult. In addition, there is a high probability of formation of life-threatening consequences. Often, therapy includes medical intervention.

Pathology has three degrees of severity:

• Stage 1 - waist circumference in men does not exceed 94 centimeters, and in women 80 centimeters;
• Stage 2 - indicators for males vary from 94.2 to 101.3 centimeters, for women - from 81.2 to 88.6 cm;
• Stage 3 - in such cases, the waist circumference in men is from 102.6 cm and above, and in women - 88.9 cm or more.

Symptoms

A characteristic feature is a large waist circumference due to an increase in the volume of the abdominal cavity. Patients with this diagnosis note a rapid heartbeat even after small physical exertion. Against this background, there are increased sweating, flatulence and belching, which was not there before. Other characteristics abdominal obesity:

• depressive state;
• heartburn;
• violation of the functioning of the digestive system;
• phlebeurysm;
• apnea;
• dyslipidemia - a violation of fat metabolism;
• infertility;
• menstrual irregularities in women;
• decrease in working capacity;
• decreased sexual activity;
• changes in the composition of the blood;
• heaviness in the abdomen after eating;
• increased appetite;
• prone to colds;
• increased blood pressure.

Possible Complications

Abdominal type of obesity is a dangerous disease that can lead to a large number of dangerous consequences. The list of dangerous diseases includes:

• malignant arterial hypertension;
• inability to have children;
• secondary diabetes mellitus, which is a consequence of insulin resistance;
• polycystic ovary syndrome;
• atrial fibrillation;
• stroke;
• cardiac ischemia;
• fatty degeneration of the liver;
• calculous cholecystitis;
• susceptibility to oncology and inflammatory processes;
• the accumulation of a large amount of cholesterol in the blood vessels, which disrupts the nutrition of the internal organs;
• heart failure;
• salt deposits in the joints.

Diagnostics

Abdominal obesity requires an integrated therapeutic approach, it is desirable to get rid of this problem under the supervision of a doctor. Before starting treatment, it is advisable to undergo advanced diagnostics to assess the severity of the metabolic syndrome and its complications. The examination will also help to identify aggravating factors and comorbidities that can slow down the achievement of the goal.

Basic diagnosis for visceral-abdominal type of obesity should include:

• Consultation of a therapist (primary and based on the results of the examination), with an assessment of the level of blood pressure, fixing anthropometric indicators and determining BMI. In some medical institutions, such primary diagnosis is carried out by a nutritionist with a basic therapeutic specialization.
• Blood chemistry. Blood glucose, total bilirubin and its fractions, urea, creatinine, total protein, lipid profile (triglycerides, total cholesterol, lipoprotein fractions) are checked. Other indicators are evaluated as necessary.
• Endocrinologist consultation.
• Identification of insulin resistance and disorders of carbohydrate metabolism: determination of fasting insulin levels, conducting a glucose tolerance test. Such an examination is usually prescribed by an endocrinologist.

If signs of atherosclerosis, cardiovascular pathology, hypertension, deviations in carbohydrate metabolism and other disorders are detected, an extended examination is possible. The patient can be referred for ultrasound of the abdominal organs, ultrasound of the main vessels and heart, to a cardiologist. It is advisable for women with menstrual irregularities to undergo an examination by a gynecologist.

Examinations are also required for overweight patients who initially consulted a doctor about diseases associated with overweight.. After all, getting rid of obesity will reduce their risk of cardiac and cerebral complications, compensate for the current pathology and improve the overall prognosis.

How to get rid of abdominal obesity?

Therapy against such obesity is complex. Treatment can take a long time as patients have to lose weight by a large number of kilogram. In general, the treatment regimen includes the following areas:

• lifestyle changes;
• transition to the right, low-calorie, but balanced diet;
• introducing a sufficient amount of physical activity into the daily routine;
• treatment of concomitant diseases;
• taking medication as prescribed by a doctor.

Complex physiotherapy exercises selected individually for each patient, taking into account the degree of obesity and health status. An important condition for the success of therapy is an emotional attitude. The patient needs to understand that getting rid of excess weight and improving the quality of life is possible only with his personal desire. If a person does not reconsider his diet, habits, physical activity, then no medicine will help him maintain health. Drugs are also part of the treatment, but only in conjunction with diet and exercise. Doctors may prescribe these medications:

Liposuction is a radical method

Liposuction is a surgical intervention in which fat is pumped out in the abdomen using a vacuum method. The procedure allows you to get rid of adipose tissue with minimal blood loss. No more than 6 liters of fat are removed in one session.

👩🏻‍⚕️ Before liposuction, a number of standard tests are given. This is necessary to identify contraindications. To minimize risks may prescribe additional diagnostic procedures.

The operation cannot be performed in the following cases:

• disorders of the nervous system;
• low immunity;
• diabetes;
• kidney failure;
• respiratory diseases;
• infections;
• diseases of the gastrointestinal tract;
• oncology;
• arterial hypertension;
• phlebeurysm.

To possible complications operations include:

• skin laxity;
• tissue ptosis;
• thromboembolism;
• extensive hematomas;
• puffiness;
• suppuration;
• loss of sensation in certain parts of the body.

Help from a psychologist

• Any forms and types of obesity can be provoked by psychosomatics. Food addiction occurs when there is an abundance of stress or dissatisfaction with oneself. The root of the problem is laid in childhood, when a child is instilled with a culture of nutrition.
• Looking at his parents, he eats his problems, which leads to food addiction. At a conscious age, food helps to get rid of negative emotions.
  Medications prescribed by a doctor help to cope with an eating disorder. Tablets allow you to normalize the functioning of the nervous system.
• But in addition, a frank conversation with a psychologist is necessary. He will identify the causes of the pathology and prescribe treatment, the basis of which is introspection. In some cases, hypnosis may be required.
• Treatment of abdominal obesity at home is not always effective. It is recommended to seek help from specialists. They will select the most effective and comfortable way to reduce weight. After the medical therapy it is very important to comply proper nutrition and play sports.

Diet and diet 🥑

Compliance low calorie diet is an important condition for the treatment of obesity. Caloric content is reduced by 300-500 units compared to the usual human diet. Weight loss is achieved not only by reducing energy value diet, but also thanks to the replacement harmful products to useful ones. The following are under the ban:

• sugar;
• sweet pastries;
• sweet carbonated drinks;
• candies;
• confectionery;
• fried potatoes;
• pork;
• mayonnaise, ketchup;
• dairy products with high fat content;
• semi-finished products.

Dishes need to be steamed, stewed or baked. You should not completely refuse fats - they can be obtained from vegetable oils, avocados, seeds, nuts, oily fish.

• dairy with a low percentage of fat content;
• seafood;
• eggs;
• lean meats;
• legumes;
• fresh vegetables and fruits;
• whole wheat bread;
• cereals.

Regular physical activity

However, no matter how hard you try, but one low-calorie diet for weight loss, getting rid of abdominal obesity is not enough. Metabolism with a new diet will slow down, and fat, if it stops accumulating, will not go away. It is very important to apply physical exercise to speed up the healing process.

There is no need to wear yourself out in the hall every day to a bloody sweat, this will only bring negative emotions, disappointment, and can lead to nervous breakdown. It is best to consult a doctor who will prescribe his own, individual training regimen, for example, three times a week. In addition, you need to walk more, give up the elevator, and also move more often on foot or by bike where you used to use cars or public transport.

Prevention

Timely steps taken to relieve symptoms, as well as eliminate the very cause of obesity, can have the most qualitative effect. Even with a decrease in body weight of at least 10-12%, it already reduces the risk of overall early mortality.

Prevention:

• Calories should be introduced into the body exactly as much as it is able to process. You have to take care of your own healthy diet.
• With a genetic predisposition, it is necessary to reduce the consumption of carbohydrates and fats to a minimum.
• Vegetable and protein foods should predominate in the diet.
• Physical activity without fanaticism will lead to keeping in shape. You don't have to train five times a week. Enough will be dancing, walking, cycling, morning jogging - whatever you like.

If especially “nothing is visible”, but dissatisfaction with one’s own physical form, there is a body, you must first go to the doctor, undergo an examination by an endocrinologist, talk to a nutritionist. Only then can any conclusions be drawn.