abdominal obesity. Methods for Burning Abdominal Fat (1 photo) Abdominal Obesity Disorders

Abdominal obesity is a pathology in which fat is deposited in the waist and upper torso. Illness has a negative impact on work internal organs. In men, it occurs more often than in the fair sex. main reason deviations - an excess of calories in the diet. Abdominal obesity in women, the treatment of which requires dietary adjustments, may occur as a result of stress or hormonal imbalance. If untreated, the disease contributes to the development diabetes.

Obesity of the abdominal type is characterized by the accumulation of fat masses in the area abdominal cavity. Outwardly, the figure resembles the shape of an apple.

In medicine, this type of obesity is also called the android type. According to ICD-10, the disease is classified as an endocrine disorder, as a result of which the metabolism slows down.

Fat deposits accumulate not only under the skin, but also on the internal organs. In advanced cases, this disrupts the functioning of organs, which leads to serious diseases. Against the background of obesity, there are problems with the hormonal background. Ultimately, this ends in infertility.

Symptoms of pathology in women include:

• violation of the menstrual cycle;
• depressive state;
• varicose veins of the lower extremities;
• cessation of breathing during sleep;
• increased insulin resistance;
• frequent heartburn;
• decreased immunity;
• reduced performance;
• drop in libido.

Diagnosis of the disease is carried out by an endocrinologist or gastroenterologist. The symptoms are primarily studied, an anamnesis is collected regarding the patient's lifestyle. What matters is her physical activity, the presence bad habits and susceptibility to nervous disorders.

Then the abdominal cavity is palpated. The waist circumference is measured and the BMI coefficient is calculated. The diagnosis is made on the basis of the totality of the data obtained. If necessary, additional diagnostic manipulations are prescribed.

Anorectic drugs for obesity

Anorectics are a group of pharmaceuticals aimed at reducing appetite. As a result of their intake, the parts of the brain responsible for the feeling of fullness during meals are blocked.

The action of the drug is based on the following principles:

• increased thermogenesis, which contributes to the activation of metabolism;
• blocking the receptors responsible for appetite;
• decrease in the ability of the intestine to absorb fats.

Initially, anorectics were part of sports nutrition. They helped to saturate the body with nutrients during increased physical exertion. Later medications began to be used in order to quickly lose weight with serious health problems.

The most common drugs in this category include:

• Sibutramine;
• Lorcaserin;
• Cabergoline.

antidepressants for obesity

Abdominal obesity in women is often treated with antidepressants. Their main goal is to reduce the symptoms of stress and mental disorders. Some of them affect certain areas of the brain, reducing food cravings. Drugs with a sedative effect are prescribed for obesity, provoked by mental disorders.

Contraindications for such drugs include:

• glaucoma;
• diseases of the digestive system;
• diabetes;
• lactation period and pregnancy;
• pathology of the urinary system;
• epilepsy.

Side effects may occur while taking medications in this category. These include: violation of the chair, drowsiness, tachycardia, tremor of the limbs and skin rashes. To avoid their occurrence, you should not take medicines without first consulting a doctor.

The most popular antidepressants include:

1. fluoxetine. The action of the drug is due to the suppression of neuronal uptake of serotonin. Taken 1-4 tablets per day. The maximum daily dosage is 80 mg. Taking pills promotes weight loss without having a depressing effect on the work of the digestive organs.
2. Bupropion. The drug promotes fat burning during intense training. Can be used as part complex therapy. The maximum daily dose is 600 mg.
3. Zoloft. Tablets not only reduce appetite, but also replenish energy reserves. To fight nervous disorders prescribed 200 mg per day. In order to lose weight, the drug is taken in a dosage of not more than 150 mg.

Antidepressants should not be combined with alcoholic beverages.

Fat and carbohydrate blockers

Male-type obesity is often eliminated with the use of carbohydrate and fat blockers. They are divided into two main groups. The first includes drugs that slow down the process of lipase formation. The second group includes drugs that prevent the digestion of fat.

There are many drugs on the pharmaceutical market that prevent the absorption of carbohydrates. Initially, they were intended for people with diabetes. A prominent representative of such drugs is Glucobay.

It reduces the level of sugar in the body, preventing carbohydrates from being absorbed into the mucous surface. small intestine. The drug is taken immediately before meals.

The dosage depends on the purpose of use. Normally, it should not exceed 600 mg.

Fat blockers act on the principle of sorbents. They bind fat molecules and remove them from the body. The effectiveness of drugs is observed only when a low-calorie diet is observed. Otherwise, the treatment will be inappropriate.

The advantages of drugs in this group include the ability to rid the body of toxins. Among the minuses, excretion of micronutrients, which are necessary to maintain the life support of the whole organism, is distinguished. The most common fat blocker is Chitosan in the form of drops.

Among the drugs that slow down the synthesis of lipase, Orlistan is distinguished. It does not have a systemic effect on the body. The drug is active only within the digestive tract.

To side effects medicinal product include:

• flatulence;
• dysmenorrhea;
• headache;
• liquid stool;
• feeling of weakness.

Exercise for obesity

Physical activity is considered the basis complex treatment obesity. It is advisable to perform exercises under the supervision of specialists. When overweight, excessive loads can be traumatic.

Team Sports and Gym Classes for Obesity abdominal type contraindicated. It is advisable to give preference to callanetics or basic gymnastic exercises.

The optimal frequency of classes is 3 times a week. Over time, the load can be increased.

Liposuction is a radical method

Liposuction is surgical intervention, within the framework of which fat is pumped out in the abdomen by the 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 taken. This is necessary to identify contraindications. To minimize the risks, additional diagnostic procedures may be prescribed.

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.

During and after the drug therapy The result is fixed with the help of a diet. Nutrition for abdominal obesity in women is based on the reduction of foods high in fat. The daily calorie intake is also limited.

If a woman has a deviation in the level of testosterone, restrictions are imposed on protein foods. In situations where obesity is accompanied by diabetes, sweets are excluded from the diet.

The doctor will tell you in detail about how to deal with abdominal obesity with the help of a diet. He selects an individual scheme for each patient.

to the main principles proper nutrition include:

• refusal of carbonated drinks, flour, fatty and overly spicy;
• increase in meals up to 5 times;
• enrichment of the diet with fruits, vegetables and cereals;
• reducing salt and sugar.

Courses of curative fasting for obesity

Often, the treatment of abdominal obesity in women is carried out by fasting. This method is resorted to only in the absence of contraindications. Proper fasting is accompanied by the improvement of all life support systems.

The patient's fatigue disappears and the work of the nervous system normalizes. In the first days there is an intensive weight loss - up to 2 kg per day. In the future, the patient loses 300 g daily.

Therapeutic starvation has the following features:

1. The intensity of physical activity does not affect the rate of weight loss.
2. Women who often practice fasting do not notice such results as beginners in this matter.
3. In case of serious diseases of the digestive system, fasting is strictly prohibited.
4. Dry fasting is allowed to practice only in the first 2-3 days. In the future, you should gradually increase the amount of water you drink.
5. In the presence of serious diseases, the process of weight loss slows down.
6. The effectiveness of fasting has a woman's age. The younger she is, the faster the body weight will decrease.

The duration of the first fasting experience should not exceed 3 days.

Vegetarianism, veganism and the raw food diet

Female android obesity can be overcome by globally changing the approach to nutrition. It is believed that the simplest and effective method weight loss is the rejection of meat. There are three areas that promote the exclusion of meat from the diet - a raw food diet, vegetarianism and veganism. Each of them has branches.

The differences are as follows:

1. Vegetarianism means giving up meat. But at the same time, products of animal origin are present in the diet. These include eggs, butter, cottage cheese, etc.
2. Veganism means avoiding all products derived from animals. A vegan diet is free of honey, eggs, cheese, gelatin, and butter. The basis of the diet is cereals, vegetables and fruits. For cooking, use any method of thermal exposure.
3. A raw food diet is a current that supports the rejection of food of animal origin. Proponents of a raw food diet do not use heat during cooking. They eat vegetables and fruits only raw.

In order to treat central obesity, any dietary direction can be practiced. But it is advisable to periodically visit a doctor to monitor the state of health. You can't change your diet drastically. Transitions from one type of food to another should be gradual.

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 eat right and exercise.

Hello everyone. And especially lovely ladies.

Today the topic will be of interest to you, first of all. We all want to be slim, we want to admire our reflection and please our beloved man with our appearance. Many of us have the impression that everything we eat is deposited around the waist. Slender legs, arms, but where does this belly come from? And as often happens, diets do not bring the desired effect: for some reason, the chest is losing weight, but the stomach still sticks out proudly. Abdominal obesity in women often becomes a cause for concern and anxiety.

Friends, read the article below, there will be a lot of interesting things in it! And those who want to: restore their health, remove chronic ailments, start eating themselves properly and much more, starting today, go to this one and get FREE video tutorials from which you will learn:

• Cause of infertility in modern, married couples.
• How to feed a child?
• How does a piece of meat become our flesh?
• Why do you need protein?
• Causes of cancer cells.
• Why is cholesterol necessary?
• Causes of sclerosis.
• Is there an ideal protein for humans?
• Is vegetarianism allowed?

Therefore, today we will consider how to properly deal with this problem, what nutrition should be in order to remove fat from the abdomen. There should be more happy women in the world, go ahead!

The root of the problem

Excess weight is dangerous in itself. First of all, it increases the load on the spine, legs. It is harder for fat people to breathe, it is difficult to lead an active life, they get tired quickly. Not to mention everyday problems, for example, that it is difficult to find clothes and shoes.

And behind obesity, it is the abdominal type that can hide the deposition of fat on the internal organs. It is clear that this greatly complicates their full-fledged work, and over time, such a pathology as the replacement of organ tissue with fatty tissue can develop.

In general, most often fat on the abdomen accumulates in men, which is associated with a decrease in their body.

But why does this occur in beautiful women?

And the reasons are very banal - the lack of a nutritional culture and inactivity, with the exception of rare cases when brain tumors, polycystic ovaries, are to blame.

It would seem that everyone knows from childhood that food should be not only tasty, but also healthy, and in moderation. However, year after year, abdominal obesity covers more and more people. And everything is getting younger.

- This is a disease accompanied by the deposition of excess fat in the trunk and internal organs. The main signs are a waist circumference of more than 100 cm, systematic overeating, cravings for sweets, increased thirst. Arterial hypertension, sleep apnea syndrome, apathy, drowsiness, fatigue, chronic constipation and other digestive disorders are often determined. The endocrinologist is engaged in diagnostics, a clinical survey is used, an examination with the measurement of waist circumference, and the calculation of BMI. Treatment includes adherence to a diet, regular physical activity, and drug therapy is additionally prescribed.

General information

Abdominal obesity is also called central obesity, visceral obesity, male-type obesity, and apple-type obesity. In ICD-10, it is categorized as "Diseases endocrine system, eating disorders and metabolic disorders". The problem of excess weight has been known since the time of Hippocrates, but progress in the treatment of this disease is very modest, and epidemiological indicators are gradually increasing.

The latter fact is associated with the development of the food industry, unhealthy eating habits and inactive people. According to WHO, 30% of the world's population is overweight. Men are more susceptible to the abdominal type of obesity; in recent decades, the prevalence of this pathology among children and adolescents has increased.

The reasons

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, its consumption a large number in the evening and at night, the transition from traditional national food 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.

Pathogenesis

In most cases, abdominal obesity according to the mechanism of origin is exogenous-constitutional. The disease is based on hereditary factors, regular overeating and lack of physical activity. Excessive food intake leads to an increase in the concentration of glucose in the blood and the development of hyperinsulinemia - increased production of insulin, stimulation of appetite, activation of liposynthesis. Thus, a vicious cycle is formed that promotes an increase in food consumption.

The emergence of feelings of hunger and satiety depends on the activity of the ventrolateral and ventromedial hypothalamic nuclei. The activity of the hunger center is controlled by the dopaminergic system, the satiety center functions according to adrenergic regulation. With the development of abdominal obesity, primary or secondary (exogenous) deviations are determined in all links of neuroendocrine regulation - in the pancreas, hypothalamus, pituitary gland, thyroid gland, adrenal glands and gonads.

Classification

In the practice of communication between doctors and patients, there is a spontaneous division of abdominal obesity into primary, alimentary and secondary, provoked by an endocrine or other disease, medication. The first type is more common, due to the diet and nature of the patient's physical activity, requires the application of strong-willed efforts for recovery.

In the second case, treatment of the underlying disease is necessary, the responsibility for a positive outcome is shifted by the patient to the doctor, the effect of the drugs. In clinical endocrinology, there is a more complex clinical and pathogenetic classification, according to which 4 forms of obesity are distinguished:

• Abdominal-constitutional. It is associated with the peculiarities of the diet, physical inactivity and hereditary conditionality of fat accumulation. BMI usually does not exceed 40 points.
• Hypothalamic. Develops with pathologies of the hypothalamus. Based on an increase in the feeling of hunger, dulling the feeling of satiety.
• Endocrine. Occurs as a result of hormonal failure. Characteristic for hypothyroidism, hypercortisolism, hypogonadism. The BMI coefficient is above 40-50 points.
• Iatrogenic. Medical form of obesity. Its development is provoked by the use of drugs - corticosteroids, antidepressants, antipsychotics, contraceptives.

Symptoms of abdominal obesity

A key symptom of the disease is an excessive accumulation of body fat in the abdomen, upper half of the body. The silhouette of the patient becomes rounded, hence the common name for this type of obesity is an apple. The waist circumference of men exceeds 94 cm, women - 80 cm. At the same time, BMI may remain within the normal range, because in other parts of the body body fat normal or hypotrophic, underdeveloped muscle tissue.

The diet consists of high-calorie foods. Eating behavior is characterized by frequent snacks, plentiful dinners, eating at night, the abuse of sweets, smoked and fried foods, and low-alcohol drinks. Often, patients do not notice or misestimate the high calorie content of food: they do not take into account random snacks, the addition of fatty sauces, the method of cooking (deep frying, regular frying).

Another characteristic feature of patients is an overestimation of their daily activities. Many people have a low tolerance for physical activity - insufficient fitness of the body, inability to perform exercises to develop endurance and muscle strength. This contributes to the formation of an energy-saving mode of activity. Obese people refuse to walk in favor of transportation, do not participate in team games or remain inactive in them, avoid homework requiring physical effort (washing floors, cleaning).

Often, patients have disorders from other body systems. Obesity is accompanied by arterial hypertension, coronary heart disease, type 2 diabetes mellitus and its complications, obstructive sleep apnea syndrome, cholelithiasis, constipation, polycystic ovary syndrome , urolithiasis disease, osteoarthritis. Disorders of the nervous system are manifested by apathy, drowsiness, fatigue. Patients complain of depression, increased anxiety, communication problems, feelings of insecurity, and an inferiority complex associated with being overweight.

Complications

In people with central form obesity increases the likelihood of type 2 diabetes mellitus, which occurs as a result of impaired glucose tolerance, the appearance of stable hyperinsulinemia, arterial hypertension. Most of the complications are associated with the metabolic syndrome, which is characterized by hyperglycemia, abnormal carbohydrate metabolism, and dyslipidemia. Against the background of metabolic disorders, atherosclerotic plaques form on the walls of blood vessels.

In women, abdominal obesity provokes hormonal dysfunction, in particular, it leads to an increase in the activity of the adrenal glands that produce androgens. This is manifested by the growth of hair on the face, chest and back (male type). In the later stages of obesity, infertility is diagnosed, in men - a deterioration in potency, impaired reproductive function.

Diagnostics

Examination of patients is carried out by an endocrinologist. In the process differential diagnosis and detection of concomitant diseases, other specialists take part - a cardiologist, a neurologist, a doctor of functional diagnostics, laboratory assistants. The complex of procedures includes:

• Collection of anamnesis. The specialist finds out the presence of obesity, type II diabetes, insulin resistance syndrome among the next of kin. Asks about the features of nutrition, physical activity of the patient. Since patients tend to underestimate the calorie content of their diet and overestimate the volume of loads, diary entries are prescribed for a week with their subsequent analysis.
• Inspection. The specialist visually and with the help of a caliper evaluates the presence of excess fat, the nature of its distribution (in the upper body, waist area). Patients often have increased activity of sweat and sebaceous glands, which is manifested by skin luster, greasiness, pustular rashes, furunculosis, pyoderma.
• Measurement of volumes, weighing. Weight, height, hip and waist circumference are measured. With abdominal obesity in girls and women, the OT exceeds 80-84 cm, the OT / OB ratio is more than 0.85; in boys and men, OT is over 94-98 cm, the OT / OB index is more than 1.0. Based on the patient's height and weight, the body mass index is calculated. For alimentary obesity, a BMI of more than 30 is characteristic, for endocrine obesity - more than 40.
• Laboratory tests. To diagnose the complications of obesity, to identify the causes of the disease, a lipid profile study is prescribed. Characterized by an increase in plasma levels of triglycerides (≥ 150 mg / dl) and glucose levels (> 5.6 mmol / l), a decrease in the concentration of high density lipoproteins (< 40 мг/дл), повышение холестерина (< 5,2 ммоль/л). Дополнительно проводится изучение гормонального статуса – типичен вторичный гиперальдостеронизм, повышение концентрации эстрадиола, отклонение от нормы показателя ЛГ/ФСГ.
• Instrumental research. The assessment of the amount and location of the fat layer is performed by computed tomography and magnetic resonance imaging of the abdominal region, dual-energy x-ray absorptiometry. The area and volume of adipose tissue is calculated. The area of ​​visceral fat is most often located at the level of 3 and 4 or 4 and 5 lumbar vertebrae.

Treatment of abdominal obesity

With secondary or symptomatic obesity, treatment of the underlying disease is required. A significant proportion of patients have an alimentary-constitutional type of illness, in which the most important lifestyle correction is a change in eating habits, the introduction of regular physical activity. The treatment regimen is compiled individually by an endocrinologist, nutritionist, sports instructor. The degree of obesity, the presence of severe somatic pathologies in the patient (CHD, osteoarthritis, diabetes, and others) are taken into account. The program may include:

• Diet. The main principle of clinical nutrition is to reduce the calorie content of the diet: for women up to 1200-1500 kcal, for men up to 1400-1800 kcal. The consumption of fats and simple carbohydrates is minimized, the menu includes foods containing proteins and fiber. The nutrition plan is drawn up by a nutritionist, and keeping a food diary is recommended to monitor its implementation.
• Increase physical activity. The degree of load and the mode of exercise depend on the general physical fitness, the state of health of the patient. With a severe degree of obesity, classes begin with an increase in the duration of walking, at the second stage, gymnastics complexes and swimming are prescribed, at the third stage - visiting fitness rooms, running, and other sports of medium and high intensity.
• Medical correction. Medication is indicated for severe obesity, diet ineffectiveness, the presence of complications that do not allow increased physical activity. Treatment is aimed at reducing the process of splitting and absorption of fats, increasing the activity of serotonin and adrenaline receptors (acceleration of satiety, suppression of appetite, increased thermal production). Therapy is carried out with HMG-CoA reductase inhibitors (statins), fibrates, ACE inhibitors.
• Operative treatment. Bariatric surgery may be used for severe forms obesity, the absence of general contraindications for surgery. positive result can be achieved by the formation of a small stomach, bypass gastric bypass, resection of part of the intestine.

Forecast and prevention

Compliance with the two main prescriptions of the doctor - diet and increased physical activity - allows you to cope with abdominal obesity in the vast majority of clinical cases. Prevention includes visiting dispensary examinations, moderate food intake, and regular exercise. People with a predisposition to be overweight are advised to limit high-carbohydrate and fatty foods, increase the amount of vegetables, fruits, lean meats and dairy products, refuse to eat 3 hours before bedtime, set aside time daily for hiking, morning exercises, and 2-3 times a week - for sports.

If you are not strong in anatomy, then the phrase "abdominal fat" may seem unfamiliar to you. But what 9 out of 10 people over the age of 25 are familiar with is belly fat. Some have very little of it, and someone can "boast" a decent tummy. This fat differs from subcutaneous fat in that it is located in the abdominal cavity and covers the internal organs. If subcutaneous fat can be grasped with fingers, and we see it in the form of folds hanging over the belt of trousers or a belt, then abdominal fat looks like a bulging belly.

Be that as it may, even if not everyone strives for model parameters, everyone wants to remove belly fat. In this article, we will tell you how to remove abdominal fat from the abdomen with the help of proper nutrition and simple exercise.

Why is abdominal fat dangerous?

First, let's look at the difference between visceral (or abdominal) fat and subcutaneous fat. This fat consists of brown cells, is located under the muscles of the press, it is more difficult to burn it than subcutaneous fat. In addition, abdominal fat poses a greater health risk than body fat.

Such a "burden" is fraught with a malfunction of the hormonal system, a slowdown in the processes of digestion, metabolism, kidney and liver diseases, a possible heart attack or thrombosis. And this is not to mention the aesthetic side of the issue. But the fact that abdominal fat is burned harder than subcutaneous fat, this process is not at all impossible. We will analyze further how to get rid of visceral fat quickly and irrevocably.

“This is not a stomach, this is a bundle of nerves!”

The quote from the movie, despite the humorous component, is 100% true. Where does belly fat come from? It's not just about malnutrition or a sedentary lifestyle, but also in a constant state of stress. At the end of the last century, doctors proved that the harmful hormone cortisol (“stress hormone”) does not allow fat to be broken down even as a result of physical exertion, and besides, “thanks to” it may not increase muscle tissue.

As a result, you can regularly do exercises or go to the gym, do not eat after six in the evening, and generally eat right, but you will still have a belly. Cortisol may not interfere with the burning of fat under the skin, but removing abdominal and visceral fat (they are the same thing, as we found out above) will be very difficult.

So, the first reason why such fat appears is a feeling of anxiety, depression, stress, lack of sleep. Start by eradicating these causes and, perhaps, you won’t have to change anything else in life, as the figure will come into shape on its own.

Check your hormones

We are made men and women not only by primary and secondary sexual characteristics, but also by the correct hormonal background. “I’m losing weight, but instead the weight is only gaining”, “I just can’t get rid of acne"," Such a terrible mood all the time, I already want to cry. If you are characterized by such or similar statements, then you need to check the level of hormones in the medical center by passing tests. This procedure is inexpensive, but can subsequently save a lot of time, effort and money.

The hormonal background is a subtle tool that can go wrong due to illness, stress, a sudden change in climate, during puberty. One of the signs that not everything is in order with the proper level of hormones is piling up abdominal fat. This is more pronounced in women than in men. In the representatives of the stronger sex, fat begins to accumulate on the hips and sides. So, if this is a problem, then until the hormonal system is put in order, it will not be possible to lose weight and feel good.

It should be noted that there is a connection between abdominal fat and hormonal levels. So, an excess of this fat can cause a disorder in the level of hormones, and a failure in the hormonal system can lead to the appearance and accumulation of visceral fat. If you have both, fight on all fronts.

"Man does not live by bread alone"

Not bread at all, but quite the contrary. So, you are a cheerful person, sleep well, are satisfied with work and feel comfortable at home.

It is when all is well that many of us tend to gain by overeating. The statistics of the CIS countries shows that after marriage in the first two years, 70% of girls and 45% of men recover significantly. This is due to the fact that food is the easiest way to express your love to loved ones. Couples begin to treat each other with goodies, order pizza at home, watch movies with a long tea party and sweets. And how to refuse a couple of bottles of beer with chips? Even by nature, slender and beautiful ones become heavier, and an unsympathetic belly grows in place of a flat tummy.

Replacing bad calories with good ones

In fact, diet is the most unfortunate and ineffective way to remove abdominal fat in men and women. Fat cannot be removed pointwise, that is, “I’ll sit on kefir for a couple of days and wake up with a flat stomach” - this is an idea that will not come true. Most likely, it will take you a few centimeters in the girth of the hips or abdomen, but this will not be fat, but muscle mass.

No diet works as it should, just because when you are undernourished, your body only stores fat more actively. Forget about diet as a way to lose belly fat, and take a different approach - replacing harmful calories with healthy and necessary ones.

Meat and fish - to fight fat

The correct calories are all the same proteins, carbohydrates and fats, but a lot depends on their quantity and quality. The basis of nutrition for those who are losing weight should be protein. This is low-fat poultry meat, beef, fish, egg, cottage cheese. Fats are best taken from vegetable oils, nuts, seeds.

In addition, in the meat of poultry, fish, egg yolks there are enough fats necessary for the body to work.

Don't forget about carbohydrates. Vegetables, breakfast cereals, baked potatoes, durum wheat pasta are healthy foods that are not only satiating and tasty on their own, but also form a good metabolism and allow you to lose weight.

Of course, it makes sense to abandon the harmful combination of fats and carbohydrates. We are talking about any confectionery sweets, flour products, chips, sweet fruits.

Exercise stress

Even if you switch to a proper and healthy diet, abdominal fat will not dissolve on its own. If until the age of 25 you can practically do nothing to maintain shape, then after your muscles will begin to decrepit, which will lead to sagging skin and deterioration appearance even at normal weight. Sport is essential if you want to look good not only in clothes, but also on the beach.

How to remove abdominal fat from the stomach? Most people, even those involved in sports, believe that you need to focus on ab exercises. However, even doing 200 repetitions a day, there is no guarantee that you will achieve the desired result. The muscles of the press from the load will be drawn if you have low level subcutaneous and abdominal fat. Otherwise, the muscles will grow, and due to the non-decreasing amount of fat, the stomach will seem even larger. Abs exercises are good, but as an auxiliary, and not the main tool in the fight against visceral fat.

Basic exercises as the basis for the fight against visceral fat

How to get rid of abdominal fat with the help of sports? Three basic weightlifting exercises are called to help you - these are squats, chest presses and barbell rows from the floor. It doesn't matter what gender, age or height you are. There is no need to immediately grab a huge weight and try to break world records. If you have never done a base or worked with weight, then first master the technique of proper squatting and pulling weight from the floor. Then you can move on to exercises with a body bar or an empty bar.

These exercises are classic for gaining muscle mass, losing weight and getting rid of fat in all places. You can do them at home, but it’s better to sign up for a fitness room, where you can work under the supervision of a trainer and experiment with different weights. Do no more than 3 times a week for 50-60 minutes.

Aerobic exercise

The second part of physical activity is aerobic exercise. Fast walking, running, cycling - you can choose what you like. In addition, it is not necessary to call aerobic exercise “exercise”. often, where possible, give up the elevator, get a dog to walk it. You will not only improve the overall physical form, but also make abdominal fat literally burn all the time, and not just in the gym.

Observe the drinking regime

You may have heard about the notorious two liters of water that everyone needs to drink a day. In fact, although it is necessary to drink water, but how much it should be - it is individual for everyone. Drink a glass of water every two hours - this will help you remove toxins, speed up your metabolism, and in addition, get rid of constant feeling hunger. Keep in mind that tea, coffee, juices are not considered "water" and therefore do not count these drinks in the total amount drunk.

Summarizing

Applying all of the above methods of getting rid of abdominal fat, you can achieve visible results in 3-4 weeks. Don't focus too much on weight loss.

Fat weighs little, but takes up a lot of volume. You can lose only a kilogram and a half, but at the same time decrease in the waist by 5 centimeters. Therefore, to fix the results, it is recommended not only to weigh yourself once a week, but also to measure volumes.

It is important to know that primary obesity is realized under the influence of external factors (lots of food, stress), but usually in the presence of a hereditary predisposition to obesity.

The following factors contribute to the development of abdominal obesity:

• age ( risk increases after age 40 due to slower metabolic rate);
• the presence of obesity and other metabolic disorders in family members;
• low birth weight less than 3 kg);
• low physical activity;
• chronic stressful situations;
• alcohol abuse.

Eating disorder

Eating behavior - an adequate feeling of hunger and satiety. Fat accumulates when the body expends less energy than it consumes, that is, there is more food than is necessary for the normal functioning and functioning of the body. Obesity that develops according to this mechanism is called primary exogenous, that is, associated with external causes (exogenous - coming from outside), in other words, due to overeating. Overeating in medicine is called "hyperalimentation". Hyperalimentation is considered a form of impaired adaptation of the human psyche under stress, therefore, overeating is often referred to as a borderline psychological disorder.

Overeating is possible in the following cases:

• habit- the habit once established to eat in a certain way ( three meals a day, "night meal" syndrome);
• communication- eating "for the company";
• rituals- eating while watching movies ( especially in the cinema), football and other events, while a person eats without feeling hungry;
• stress snacks- with unpleasant experiences, worries, a desire to protect oneself, a person, eating a certain product, feels calmer, which is due to psychological comfort and a sense of security when eating;
• gourmetism- love for gourmet food, from which a person enjoys, becomes the main source of positive emotions.

In women, appetite increases a few days before the onset of menstruation, which is associated with the so-called premenstrual syndrome ( PMS) due to hormonal changes and the need to calm down and relax ( more of a psychological).

There is an assumption that the desire to consume food at the time of stress is associated with an incorrectly memorized program in the brain, in which the brain does not distinguish between anxiety and hunger. As a result of such a program, at the moment of stress, a feeling of hunger is included, and not anxiety. This is especially pronounced in people who survived the famine, and in new conditions ( even if it is possible to provide yourself with enough food) live according to the old program.

Along with exogenous obesity, there is also obesity associated with internal reasons- factors that regulate human eating behavior.

The hunger and satiety centers are located in the brain, in a structure called the hypothalamus. Substances that increase or inhibit appetite act on the hypothalamus. These substances are produced in nervous system, in the stomach and adipose tissue. If the balance of these substances is disturbed, then the person's eating behavior changes.

The desire to consume fatty foods occurs with increased production of the hormone ghrelin in the stomach. Appetite inhibition is due to the hormone leptin. All obese patients have a violation of the ratio of ghrelin and leptin - the amount of ghrelin is sharply reduced in the blood, and there is a lot of leptin, but the saturation center is not sensitive to it. It is important to consider that many products, especially fast food ( products fast food ) and carbonated drinks contain appetite-enhancing substances.

Low physical activity

Low physical activity or physical inactivity is a socially significant factor in abdominal obesity. Hypodynamia occurs in people living in big cities, working while sitting, in people with chronic fatigue, who do not play sports. With such a lifestyle, the energy balance or balance between the amount of energy consumed and expended is disturbed. In addition, in the absence of physical training, the regulatory systems of the body “lose their knack”. This means that the body ceases to adapt to any stress, begins to respond inappropriately to physical or emotional overstrain. That is why people gradually begin to move less and less, and the energy received from food is consumed by the body not so much during physical activity, but to maintain the level of metabolism ( biochemical processes) and for heat production. However, to maintain these processes, the amount of food that a person absorbs in the modern world is already becoming redundant.

A sedentary lifestyle and related health changes have been called the "three chairs" syndrome. The three armchairs are an office chair, a car chair and a sofa.

Genetic factors

Genetic factors are often the underlying cause of abdominal obesity, which means that in many cases fat will not be deposited in the abdominal cavity even with a large amount of food and a sedentary lifestyle. The distribution of adipose tissue in specific places in the human body is associated with the work of the genes that encode ( are responsible for the process) the formation of a special type of receptors that enhance the destruction of adipose tissue. These receptors include beta-3-adrenergic receptors. Adrenoceptors are receptors that are activated by adrenaline ( stress hormone), which is why, with physical or emotional stress, the destruction of fats occurs. The fact that during stress fats disappear from a particular area, but do not decrease in any other, is connected precisely with the number of these receptors.

Importance It also has genetic control over hunger and satiety. The Ob gene is responsible for the development of obesity ( abbreviation for the word "obesity", which in English means "obesity). The Ob gene controls the production of the hormone leptin in adipose tissue.

In addition, many people have the so-called "thrifty genotype" ( genotype - all the genes of an organism). The genotype tends to change in the course of human evolution. The economical genotype is a complex of genes that work on the principle of "putting aside fats in case of hunger." If in the process of active human life this mechanism was really saving, then in the conditions of the modern world with a sedentary lifestyle and a large amount of food consumed, the “thrifty genotype” acts to the detriment. The body accumulates too much fat, "not knowing" that, in fact, it does not need to be stored, there will always be enough food.

Symptoms of abdominal obesity

In contrast to severe general obesity, abdominal obesity itself may not cause any complaints, but cause more serious disorders and, at first glance, have nothing to do with fat accumulation. Severe shortness of breath, which is characteristic of general obesity, is not an obligatory symptom with abdominal obesity. A pronounced appetite in abdominal obesity is not only the cause of excess weight gain, but also its consequence, since in obesity the satiety center loses sensitivity to substances that inhibit appetite.

Abdominal obesity is one of the components of the so-called metabolic syndrome ( syndrome - a collection of symptoms). Metabolic syndrome is a hormonal and metabolic disorder that increases the risk of developing cardiovascular disease. It is abdominal obesity in combination with arterial hypertension ( high blood pressure), type 2 diabetes mellitus ( no insulin deficiency) and high triglycerides ( fatty acid) make up the so-called "death quartet". This name was given to the metabolic syndrome because it was found that the combination of these disorders significantly increases the likelihood of death from myocardial infarction and stroke.

Abdominal Obesity Disorders

Diagnosis of abdominal obesity

Diagnosis of abdominal obesity is carried out not only visually, since abdominal obesity can also be observed in, at first glance, thin people. Visceral fat is not visible from the outside, so abdominal obesity in such people, often with parameters corresponding to the model, is described as "outwardly thin, but fat inside." To assess the degree of abdominal obesity, the doctor uses various methods based on measurement and calculations, as well as instrumental diagnostic methods.

Methods for diagnosing abdominal obesity include:

• Determination of body mass index ( BMI) - allows you to assess the correspondence between height and weight of a person, that is, to determine normal, insufficient or overweight. To calculate BMI, you need to divide your weight by your height squared. BMI for assessing abdominal obesity has both advantages and disadvantages. The advantages of this method include its simplicity and lack of costs, so it is used for screening assessment among the population ( screening - a mass examination of a certain contingent to identify risk factors for the development of pathology). The disadvantages of the method are the inability to correctly assess the thickness of the adipose tissue itself, since BMI does not allow separating muscle tissue from adipose tissue, that is, obesity can be overestimated or, conversely, not detected.
• Waist circumference- allows you to determine the actual abdominal obesity. The method allows you to clearly establish the presence of adipose tissue and the risk of developing complications of abdominal obesity. This figure is clearly correlated interconnected) with metabolic diseases. It also doesn't cost anything. It is important to know that, even with a normal BMI, an increase in waist circumference is considered a risk factor for the development of metabolic disorders and some complications ( cardiovascular). To measure waist circumference, the patient is asked to stand up straight. A centimeter tape is wrapped around the abdomen at the level that is located in the middle between the lower part chest and crest ilium (a bone that can be felt in the pelvis on both sides). Thus, you need to measure not at the level of the navel, but a little higher. Obesity is diagnosed if the waist circumference in men is more than 94 cm, and in women more than 80 cm. In men, this figure is higher, since normally their waist is thicker than women's.
• Central index ( abdominal) obesity- the ratio of waist circumference to hip circumference. Abdominal obesity is considered if this indicator in women is more than 0.85, and in men it is more than 1.0. This index distinguishes abdominal obesity from other types of obesity.
• Evaluation of the thickness of the skin-fat fold- carried out using a special device called a caliper ( the measurement procedure itself - caliperometry) and is something similar to a caliper. skin fold in the abdomen, they are taken with the thumb and forefinger at the level of the navel and 5 cm to the left of it. After that, the caliper itself captures the fold. The measurement is carried out three times with an interval of 1 minute. This indicator evaluates the thickness of subcutaneous fat, however, with the accumulation of fat in the waist area, it is important to evaluate the amount of subcutaneous fat in order to identify the type of obesity.
• Instrumental methods to visualize adipose tissue- CT scan ( CT) , Magnetic resonance imaging ( MRI) , ultrasound procedure ( ultrasound). The above methods allow you to see the fat itself and assess the severity of abdominal obesity.

It is important to know that the amount of abdominal or visceral fat is reflected in the waist circumference, but obesity of the internal organs can only be detected using instrumental methods research.

If abdominal obesity is detected, the doctor will prescribe a number of laboratory tests and instrumental diagnostic methods. This is necessary in order to assess the state of organs and metabolism in the body, which could be affected due to disorders that accompany abdominal obesity.

In case of abdominal obesity, the following tests are required:

• general analysis blood;
• fasting blood glucose test;
• lipidogram ( cholesterol, lipoproteins, triglycerides);
• coagulogram ( analysis of indicators of the blood coagulation system);
• biochemical analysis blood ( liver enzymes, creatinine, urea, C-reactive protein, uric acid);
• the level of insulin in the blood;
• blood test for hormones.

For abdominal obesity, your doctor may prescribe the following: instrumental research:

• Ultrasound of the abdomen and pelvis;
• Ultrasound of the heart and blood vessels;
• X-ray of the chest and skull.

Classification of abdominal obesity

Abdominal obesity is also called central or android ( male). The male type of fat distribution is characterized by the severity of the fat layer in the torso and a small amount of fat on the thighs. Figuratively, this type of obesity is called "apple-type obesity" ( the width of the apple is maximum in its middle part). In contrast to abdominal or male obesity, "female" obesity is called gluteofemoral, lower, or gynoid. With such obesity, there is a normal waist, and fat is deposited in the buttocks and thighs. Such a figure resembles a pear, which is why it is called “pear-type obesity”. These two types of obesity are fundamentally different from each other. The deposition of fat in the thighs does not affect health, unlike fat in the waist.

Obesity "like a pear" even has some advantages. In women, adipose tissue produces a large amount of estrogen. These female hormones have the ability to protect the walls of blood vessels and prevent the accumulation of cholesterol in them ( Therefore, before menopause in women, atherosclerosis does not progress.). With abdominal obesity, the opposite occurs - the fat itself becomes a source of free fatty acids.

Obesity "like an apple" is usually combined with abdominal obesity, that is, at the same time there is an accumulation of fat in the subcutaneous fat of the trunk and in the abdominal cavity. At the same time, obesity of the internal organs can occur without visible obesity. This is an important difference between the abdominal type of obesity.

Also exists mixed type obesity, in which there is obesity of the whole body.

According to international classification, obesity according to BMI can be of the following types:

• overweight- BMI 25 - 30;
• obesity 1 degree- BMI 30 - 35;
• obesity of the 2nd degree ( serious) - BMI 35 - 40;
• obesity 3 degrees ( morbid or morbid obesity) - BMI 40 - 50;
• overweight- BMI 50 - 60;
• super obese- BMI over 60.

The normal BMI is 18.5 - 25 kg / m 2.

Depending on the stage, abdominal obesity is:

• progressive;
• stable.

Treatment of abdominal obesity

Treatment of abdominal obesity is necessary not only and not so much from an aesthetic point of view ( especially for women with fat deposits in the waist area), how much to prevent the development of pathologies that develop with abdominal obesity. If obesity has a hereditary predisposition, then treatment will be long and even lifelong. If abdominal obesity is observed against the background of a decrease in physical activity and an increase in food intake, then you can easily get rid of extra pounds, but you will have to constantly make sure not to gain abdominal fat again.

Methods of treatment of abdominal obesity are:

In any case, the treatment of abdominal obesity is always approached comprehensively.

Exercise stress

Physical activity is an important stimulus for fat burning, because fat is a source of energy, and in order for a person to perform physical exercises, he needs additional energy. Exercise also increases the production of the hormone testosterone, which is low in obese men. It is important to know that exercise is effective when dieting. If a person eats the same amount of food and exercises, the effect will be insignificant, because the body will first destroy the existing fats, and then create new ones from the incoming food. If physical activity requires more energy than the food taken per day contains, then an energy deficit will occur. This is precisely the goal of treatment - to spend more than receive.

It is important to know that in the presence of severe diseases of the internal organs, heavy physical activity is contraindicated. The level of physical activity is always determined on an individual basis.

• moderate physical activity is preferred ( the load that a person can perform for an hour without feeling severe fatigue), such as walking, cycling, swimming, skiing, running;
• You should start with a load of low intensity ( obese people have a harder time doing any physical work), gradually increasing its duration;
• exercise regularly;
• the ideal option is dosed non-intensive ( moderate) physical activity for 2 - 3 hours, since fats begin to be burned 30 - 40 minutes after the start of the workout.

Medical treatment of abdominal obesity

Medical treatment in abdominal obesity is indicated in cases where the BMI is greater than 30 and there is no effect of non-drug treatment ( diet and exercise) within 3 months. effect from non-drug treatment it is considered unsatisfactory if the weight of a person during the specified time, despite the implementation of all the recommendations of the doctor, has decreased by less than 5%.

Drugs used to treat abdominal obesity

Surgical methods for the treatment of abdominal obesity

An important difference between abdominal or visceral obesity and ordinary obesity is that it cannot be cured with surgical treatment. With normal, "external" obesity, fat accumulates in the subcutaneous fat, so its removal by surgery or destruction by injection ( through the administration of substances) methods is not difficult. It is impossible to remove the fat that surrounds the internal organs, because it is technically not possible to isolate and remove adipose tissue, in which the vessels and nerves pass so as not to damage anything.

Options surgical care with abdominal obesity are:

• Banding of the stomach- the imposition of a ring in the upper part of the stomach, which divides the stomach into two parts. The small upper part can hold a small amount of food at one time, while the stomach will send signals to the brain that it is full. This will create a feeling of fullness.
• Reducing the volume of the stomach- in some people who eat a lot, the volume of the stomach is enlarged, so saturation occurs only if the stomach is full ( and this is possible when eating a large amount of food). Removing part of the stomach and creating a "small stomach" contributes to the rapid onset of satiety.

These operations do not guarantee a cure for visceral obesity, but they allow you to stop the process of fat accumulation and reduce the amount of fat deposits, since a person after the operation will not be able to eat a lot. The effectiveness of such an operation is individual.

Stomach surgery for abdominal obesity is performed in the following cases:

• abdominal obesity is combined with general obesity:
• there is a pronounced abdominal obesity;
• BMI is more than 35 and there is a pathology associated with abdominal obesity;
• BMI greater than 40 even in the absence of other diseases.

Surgical treatment is not performed if the patient has not followed a diet and exercise regimen for at least 6 months or does not agree to follow the doctor's recommendations.

Psychotherapy

The effectiveness of the treatment of abdominal obesity depends on psychological state patient and his motivation. Since a change in lifestyle is required of a person, the participation of a psychologist or psychiatrist may be required. In addition, abdominal obesity itself, especially in women, causes self-doubt. Self-doubt often causes overeating. That is why the elimination of psychological discomfort allows you to increase the effectiveness of physical training and other methods of treatment.

It is important that the patient is psychologically prepared before starting diet therapy.

To determine readiness for treatment of abdominal obesity, the patient must answer the following questions:

• Is the patient willing to change their habits and lifestyle over an extended period?
• What are the reasons that motivate you to lose weight?
• Is the patient aware of the dangers and risks associated with abdominal obesity?
• Is there emotional support for family members in the issue of weight loss?
• Does the patient realize that the effect will not be immediately, but after a certain period of time?
• Is the patient ready to constantly monitor himself, keep a diary and monitor body weight?

Alternative methods of treatment of abdominal obesity

Folk methods treatment of abdominal obesity promotes fat burning, however, without diet and exercise, such treatment is ineffective.

Folk remedies for the treatment of abdominal obesity can act as follows:

• reduce appetite and increase satiety- infusions and decoctions of oats, barley, algae ( spirulina, kelp), flax seeds, marshmallow root;
• remove excess fluid from the body- anise seeds, green watermelon peel ( powder or pulp), birch buds, lingonberries, St. John's wort, corn stigmas, celery root, pumpkin seeds, rose hips;
• have a laxative effect- calendula, flax seeds, cucumber fruit, linden blossom, dandelion roots, plantain leaf, beetroot, dill seeds, anise and cumin.

The following can help reduce your appetite folk recipes:

• A decoction of corn stigmas. To prepare the tincture, you need to take 10 grams of stigmas, pour them with water and boil for 30 minutes. After the resulting decoction has cooled, it can be taken 1 tablespoon 4 to 5 times a day before meals. The decoction is taken for a month, after which they take a break for 5-10 days. Corn silk should not be used with increased blood clotting.
• A decoction of licorice root. 1-2 roots can be consumed per day, a decoction of which is prepared in the same way as a decoction of corn stigmas.
• Dandelion infusion. You need to take a tablespoon of dandelion herb ( crushed), pour a glass of boiled water and leave to infuse for 6 hours. After that, the tincture must be filtered. Drink in small portions throughout the day.
• young bran. Pour bran with boiling water for 30 minutes, and then drain the water. The resulting slurry can be added to any dish. The first 7 - 10 days it is recommended to add 1 teaspoon, after which 1 - 2 tablespoons of the mixture 2 - 3 times a day.
• Decoction of burdock root. Take 2 teaspoons of plant roots ( ground), pour them with a glass of boiling water, and then put on a slow fire for 30 minutes. The resulting decoction is taken in small portions throughout the day.
• Laminaria ( seaweed, seaweed). Take kelp and fill it with water, leave for a day. Drink in small sips when you feel hungry. Laminaria is contraindicated in kidney pathology.
• Beet cake ( squeezes). The beets should be peeled and grated, the juice squeezed out, and small balls the size of beans should be rolled from the resulting squeeze. The balls should be left to dry, and then take 3 tablespoons of cake at a time. It is allowed to use low-fat sour cream to make it easier to swallow cakes. It is important to know that you can’t eat anything with cake ( the digestion process is disturbed).

For abdominal obesity, the following herbal preparations are used:

• Gathering 1- consists of buckthorn bark, sea grass, rose hips, raspberry leaves, blackberries, nettles, St. John's wort and yarrow. 1 tablespoon of the collection should be poured into a glass ( 200 ml) boiling water.
• Gathering 2- consists of rowan berries, mistletoe, linden flowers, water pepper, linden bark. Prepare as well as collection 1.
• Gathering 3- consists of dill seeds, chamomile, flowers. It is prepared in the same way as collection 1.

With abdominal obesity, there may be effective application acupuncture ( acupuncture), especially if obesity occurs in women after menopause.

Diet for abdominal obesity

An important aspect of the treatment of abdominal obesity is the formation of proper eating behavior. Before starting a diet, the attending physician will ask a few questions to obtain information about the patient's eating habits. This information is called diet history ( anamnesis - information about something). The doctor may ask the patient to write down everything he eats for 3 to 7 days, as well as portion sizes, the amount of food, the frequency of meals, the calorie content of foods. Diet for any type of obesity is desirable to be individually.

The basic principle of the diet for abdominal obesity is to reduce calories or energy value food. This creates a nutrient deficiency that will force the body to begin the process of breaking down fat.

The deficit is calculated taking into account the energy ( calories), which is necessary for a person per day to perform his work and maintain his usual lifestyle. Gender, age, climatic conditions and characteristics of the character and personality of a particular person are also taken into account. There are no absolute values. A person who leads a sedentary lifestyle will need fewer calories than someone whose work involves intense physical activity. To calculate calories, there are special formulas that take into account weight, height and other indicators listed above. In any case, the amount received daily allowance The doctor will reduce calories so that there is a calorie deficit.

Reducing the energy value of food in abdominal obesity is carried out as follows:

• with BMI 27 - 35 a deficit equal to 300 - 500 kcal / day should be created, while a person will lose approximately 40 - 70 grams per day;
• with a BMI over 35- the deficit should be 500 - 1000 kcal / day, and weight loss - 70 - 140 grams per day.

It is important to know that absolute fasting is not effective as it slows down the metabolism. A slow metabolism is characterized by the fact that the same fats that a person wants to get rid of will be destroyed more slowly. In addition, the processes of formation of various biologically active substances will slow down. active substances from fats.

It is undesirable to use diets with a sharp energy deficit. Such diets are worse tolerated, and the results of "slow" and "fast" diets are not very different from each other.

To general principles diet therapy for abdominal obesity include:

• frequent meals ( 4 - 5 times a day), which allows you to maintain metabolism on right level;
• small portions;
• abstaining from alcohol it has a lot of calories);
• reduction in the amount of fat consumed by 25% of the daily requirement ( you can eat no more than 250 grams of cholesterol per day);
• the exclusion of such products as butter, mayonnaise, margarine, fatty meats and sausages, sour cream and cream, fatty cheeses, canned meat and fish, lard;
• specially produced sweets for people with diabetes ( "diabetic" chocolates, sweets, jam, cakes), should also be excluded;
• exclusion of fast-digesting carbohydrates ( sugar, honey, grapes, bananas, melon, jam, confectionery, sweet juices);
• reducing the amount of slowly digestible carbohydrates ( potatoes, bakery products, pasta, corn, cereals);
• limiting the amount of table salt, as well as the exclusion of all salty foods ( smoked meats, marinades);
• exclusion of spices, sauces and snacks that increase appetite;
• adding dietary fiber to the diet vegetables and fruits up to 1 kg per day);
• the diet should contain a sufficient amount of animal proteins, that is, boiled meat ( lean beef, lamb, lean pork, chicken, turkey), dairy products ( kefir, curdled milk, yogurt, unleavened milk, low-fat cottage cheese) and eggs, while it is desirable not to eat the visible fatty parts of such products ( chicken skin, milk foam);
• be sure to use plant-based proteins ( soybeans, beans, mushrooms, cereals, peas), given that the body's total protein requirement per day is 1.5 g/kg of body weight.

Proteins are the staple in the diet. The fact is that, firstly, along with fat, part of the muscle tissue is always lost ( and these are squirrels), and it is required to restore muscle mass. Secondly, the body spends a lot of energy to digest and assimilate proteins, that is, protein food helps to increase metabolism and burn fat. Provided that the diet does not consist of carbohydrates, adipose tissue becomes the main source of energy for the needs of the body.

• grapefruit;
• green tea;
• hot spices ( pepper, mustard, horseradish);
• cinnamon;
• ginger.

The goal of dietary therapy for abdominal obesity is not to achieve any fixed or ideal BMI. It is important that the diet helps to reduce the amount of abdominal fat, that is, you need to focus, first of all, on reducing the waist circumference.

The effectiveness of the diet is evaluated after 3 - 6 months. The diet is considered effective if the body weight has decreased by 5 - 15%, while the waist circumference has also decreased. It should be borne in mind that a decrease in the thickness of visceral fat in apparently not fat people may not cause a sharp decrease in the number of kilograms. In this case, the efficiency can be estimated laboratory diagnostics (normalization of analysis indicators) and magnetic resonance imaging. index of central obesity ). The fact is that by the way fat is distributed throughout the body, one can determine its danger to health. If the ratio of the circumference of the waist and hips in women is more than 0.8, and in men more than 0.9, then this indicates abdominal obesity.

A narrow waist is not always a sign of the absence of abdominal obesity. The most reliable way to find out if there is an excessive accumulation of fat inside the abdomen is magnetic resonance imaging.

Are abdominal and visceral obesity the same thing?

Abdominal and visceral obesity are names for the same pathology, which is characterized by the accumulation of fat in the abdomen ( abdomen - belly), that is, at the waist and inside the abdomen, around the internal organs ( visceral - pertaining to the viscera). The fat inside the abdomen is called visceral fat. It is present and normal, envelops the internal organs, being part of their anatomy ( blood vessels and nerves pass through this fat). With abdominal obesity, the amount of this fat increases, so organ function begins to suffer.

What are the criteria for abdominal obesity?

Abdominal obesity ( accumulation of fat inside the abdomen and around the waist) is diagnosed during the examination and measurement of the waist. Abdominal obesity is recorded if the waist circumference in men exceeds 94 cm, and in women more than 80 cm. The waist circumference is measured not at the level of the navel, but in the middle of the distance between the lower part of the chest ( conventionally, this is the lower edge of the costal arch) and ilium (pelvic bone that can be felt under the skin).

The second important criterion for abdominal obesity is the ratio of waist circumference to pelvic circumference ( hips). To calculate this figure, you need to divide the waist circumference by the hip circumference. If this index is less than 0.8, then obesity is considered not abdominal, but gluteal-femoral ( fat is more pronounced below the waist). If, when measured in men, an indicator of more than 1.0 is obtained, and in women more than 0.85, then this is abdominal obesity.

Normally, the waist circumference and hip circumference for women should be less than 0.8, and for men less than 0.9.

Expressed obesity is visible to the eye, but there are cases when a person has abdominal obesity, which is not visible. People with invisible obesity began to be called "thin on the outside, fat on the inside." This can be observed in both models and athletes. The accumulation of fat in thin people is diagnosed by magnetic resonance imaging ( MRI), which allows you to see the thickening of the fat layer of internal organs ( visceral or visceral fat).

Are abdominal obesity and metabolic syndrome the same thing?

Abdominal obesity and metabolic syndrome are two pathologies that are often combined, or rather, abdominal obesity is one of the components and cause of the metabolic syndrome. It is for this reason that doctors, when talking about abdominal obesity, have in mind the metabolic syndrome.

Metabolic syndrome is a complex of metabolic disorders ( metabolism), which is observed in abdominal obesity. An important point and metabolic syndrome, and abdominal obesity is the presence of a high risk of developing myocardial infarction and stroke.

The metabolic syndrome includes the following components:

• abdominal obesity- waist circumference in men more than 94 cm, and in women more than 80 cm;
• dyslipidemia ( lipid or fat metabolism disorders) - increased levels of cholesterol and triglycerides in the blood;
• insulin resistance- insensitivity of cells to insulin, which is necessary for the use of glucose;
• type 2 diabetes- high blood glucose levels with normal or even elevated insulin levels;
• arterial hypertension- increase in blood pressure more than 130/80 mm Hg.

Does abdominal obesity occur in children?

Abdominal obesity ( obesity in the waist) also develops in children, leading to the development of the same disorders as in adults ( metabolic disorder or metabolic syndrome). Most often, abdominal obesity in children and adolescents develops against the background of general obesity, less often fat accumulates in the waist area separately. The accumulation of fat in the limbs makes it difficult for the child to move, but does not pose a serious health hazard, however, if general obesity causes an increase in waist circumference, then this is a serious reason to visit a doctor.

The causes of abdominal obesity in children are external factors in the presence of a genetic predisposition of the body.

Depending on the cause, abdominal obesity in children can be:

• primary- an independent disease;
• secondary- develops against the background of other diseases.

Children are more likely to experience primary abdominal obesity, which is caused either by overeating and a sedentary lifestyle, or by hereditary metabolic disorders. In any case, obesity develops in the presence of a genetic predisposition, but necessarily under the influence of external factors (a lot of food, little physical activity). This type of obesity is called exogenous-constitutional (exogenous - due to external factors, the constitution is a feature of this organism).

Unlike exogenous-constitutional obesity, there are forms of primary obesity that lead to increased fat accumulation in the waist and around internal organs, regardless of external factors. These forms are called monogenic diseases ( mono - one). Monogenic diseases are caused by a single mutation in genes that are associated with obesity. Such obesity develops during the first year of a child's life. Most often, monogenic obesity develops with a deficiency of leptin. Leptin is a “satiety” hormone that acts on the brain to reduce appetite and make you feel full. With its deficiency, the child constantly wants to eat. Unlike monogenic obesity, with exogenous constitutional obesity, leptin is elevated, but the brain does not respond to it.

Abdominal obesity in children and adolescents is diagnosed in the same way as in adults - by measuring waist circumference ( FROM) and hip circumference ( ABOUT). The first value is divided by the second and the OT/OB index is obtained. The presence of abdominal obesity is established if OT / OB in girls is more than 0.8, and in boys it is more than 0.9.

Rarely, abdominal obesity in children has secondary causes. Usually it is a pathology of the endocrine organs ( thyroid, adrenal glands, pituitary gland).

The consequences of abdominal obesity in children are:

• type 2 diabetes ( an increase in blood sugar that is not associated with insulin deficiency);
• high levels of cholesterol and triglycerides in the blood ( increases the risk early development pathology of blood vessels and heart);
• increased blood pressure;
• hormonal disorders (adolescents may have delayed puberty, menstrual irregularities in girls).

Is abdominal obesity the same for women and men?

Abdominal obesity in women and men has some features. Common to both sexes is an increase in waist circumference, but in women, abdominal obesity is considered an increase this indicator more than 80 cm, and for men more than 94 cm. This is due, of course, to the fact that the female figure is distinguished by a narrow waist and pronounced hips. In men, on the contrary, fat is initially distributed more in the torso than in the limbs.

Abdominal obesity has common manifestations in both men and women, such as high blood pressure, increased blood sugar and cholesterol. In addition to these disorders, in men, abdominal obesity can be manifested by a violation of sexual function, since male sex hormones are converted into female sex hormones in adipose tissue. In women, hormonal balance is also disturbed, which is associated with the production of stress hormones during obesity, and this leads to menstrual irregularities and infertility.

In women before menopause ( hormonal changes, which are accompanied by a decrease in the level of female sex hormones in the blood) the risk of developing adverse complications of abdominal obesity ( heart attacks and strokes) much lower. This is due to the presence in female body the hormone estrogen, which protects the walls of blood vessels, slows down the accumulation of fat. In men, the level of estrogen is several times lower, so the risk of developing atherosclerosis ( fatty plaques in the vessels narrowing the lumen) much higher.

Another difference between abdominal obesity in men and women is the method of treatment. Women find it easier to lose weight through diet and exercise. In men, the most effective help is the introduction of testosterone, the male sex hormone. This therapy is called hormone replacement therapy. By restoring the level of testosterone in the blood of men, doctors achieve fat burning and the disappearance of the "beer belly".

How is abdominal obesity treated if there is another disease?

Treatment for abdominal obesity begins with diet and exercise modifications. If the patient has serious illness internal organs in a state of exacerbation, then first the doctor seeks stabilization of the condition, and then proceeds to the treatment of abdominal obesity. If within 3 months, while following a diet and performing physical activity, the patient loses less than 5% of the initial body weight, then the doctor prescribes medication.

The choice of drug for the treatment of abdominal obesity depends on the following factors:

• age;
• eating habits ( gourmet, increased appetite, uncontrollable feeling of hunger, inability to get enough);
• the presence of comorbidities.

Abdominal obesity is the cause of the development of such pathologies as arterial hypertension, type 2 diabetes mellitus ( loss of cell sensitivity to glucose), arterial atherosclerosis ( narrowing of the arteries by plaque). The main organ that suffers from all of the above causes is the heart. In addition to the heart, abdominal obesity also affects the kidneys, brain and liver, although all organs experience stress in their own way. The fact is that abdominal obesity disrupts almost all types of metabolism, so the combination of abdominal obesity and the above pathologies is called the metabolic syndrome.

For abdominal obesity, the doctor may prescribe the following drugs:

• Sibutramine ( reduxin, meridia, goldline, lindax) - reduces appetite by affecting the satiety center in the brain, and also enhances heat production ( to generate heat, the body also burns fats and expends energy). The drug is not prescribed to patients with diseases of the heart and blood vessels, as well as with increased blood pressure.
• Orlistat ( xenical) - reduces the amount of fatty acids ( triglycerides), which, together with food, enter the intestines and from there are absorbed into the blood. This drug can be used in the presence of heart disease, as well as in the elderly.
• Liraglutide ( victoza) - inhibits appetite and improves the process of glucose uptake by tissues. For this reason, it is used if abdominal obesity is accompanied by type 2 diabetes, including the development of complications ( damage to the kidneys, heart, brain), as well as at a high risk of developing severe heart disease. Liraglutide is contraindicated if a person has malignant tumor thyroid gland, and also if this tumor was observed in any of the family members.
• Metformin ( siofor, glyukofazh) - this drug is used to treat diabetes mellitus, it helps to normalize carbohydrate and fat metabolism.

If the cause of abdominal obesity is a specific pathology ( most often it is hormonal disorders), then obesity is called secondary. In this case, not only a nutritionist is involved in treatment, but also a narrow specialist ( endocrinologist, gynecologist and others).

Is Glucophage Used for Abdominal Obesity?

Glucophage is a drug that is used to treat diabetes. With abdominal obesity, it can also be prescribed. There are two indications for this. Firstly, with abdominal obesity, there is almost always a violation of carbohydrate metabolism - initial form diabetes mellitus, which is called insulin resistance. Secondly, glucophage tends to enhance the oxidation of fatty acids, that is, to stimulate the process of using fat as an energy source. In addition, glucophage inhibits the formation of new fatty acids. All this contributes to lowering the level of glucose and total cholesterol, causing an energy deficit in the body, to compensate for which the body begins to burn fat. An important condition for the effectiveness of glucophage in the treatment of abdominal obesity is a diet with a sharp restriction of carbohydrates and fats.