Internal obesity - what does it mean? Features of visceral obesity in women and men Obesity of the abdominal organs.

Obesity of internal organs

Obesity is the most widespread epidemic that is widespread throughout the world. One part of experts considers the main cause of excess weight to be excessive consumption of fatty, sweet and fast food. Another speaks of changes in the lifestyle of modern people, who show less and less physical activity every year.

But do not forget about genetic, biochemical and hormonal factors that can lead to an imbalance in energy storage.

For example, damage to the hypothalamus (a small area in the brain that regulates the pituitary gland and energy balance) causes excessive appetite and accumulation of fatty tissue. A person with endocrine disorders will not be able to lose weight only through proper nutrition and exercise. Research has found that abnormalities in the hypothalamus lead to increased insulin levels as a result of increased activity of the vagus nerve, which connects the brain to the pancreas.

And if the hypothalamus is damaged as a result of any disease or surgery, a person will feel hungry, even with a sufficient amount of calories in the total amount of food.

Endocrine diseases contribute to weight gain; the features of its formation depend on the specific pathology:

Hypothyroidism is a disease as a result of which hyaluronic acid accumulates in tissues, fluid accumulates in the body, cardiac output decreases and thermogenesis (fat burning) decreases;

Polycystic ovary syndrome - increases the level of androgens in the female body, which contributes to an increase in adipose tissue, a deepening of the voice and the appearance of hair above the upper lip;

Cushing's syndrome - disrupts the production of growth hormone by the thyroid gland, causing the number of fat cells to increase.

Visceral fat and what is its danger

Excess adipose tissue worsens a person’s overall health and increases the likelihood of cancer, liver disease, cardiovascular disease and diabetes. It is commonly believed that obese people have a fat body composition, but this is not always the case. There are people with normal body composition whose fat tissue exceeds acceptable limits.

Probably everyone knows at least one person who, no matter how much he eats, remains in the same shape, even without exercising. In the West, such people are usually called “skinny fat” - thin fat people who have fat deposits inside. You shouldn’t envy them, since obesity of internal organs and lack of muscle mass will not bring anything good to your health.

Fatty tissue around organs can be detected using MRI or ultrasound. People whose body weight exceeds 20% have visceral or internal fat. It is this that provokes an increase in cholesterol levels, the development of inflammatory processes, an increase in blood pressure and blockage of blood vessels.

Inflammatory markers produced by internal fat cells, when released into the blood, cause the development of chronic diseases and increase the level of insulin and leptin. The amount of testosterone in the female body begins to increase, and in the male body, on the contrary, it decreases.

Signs of obesity in internal organs

A thin fat man, although he has no subcutaneous fat, he cannot boast of a slim and fit figure. His skin lacks elasticity and has an unhealthy softness with signs of cellulite, since the muscle tissue is poorly developed.

A more obvious sign is waist size and a pronounced belly, since fat reserves are deposited in this part of the body. This physique is more common in men when there are no signs of obesity on the hips, arms and chest, which cannot be said about the stomach. In women, due to estrogen receptors, fat is deposited in the hips, but after menopause they may also experience the formation of fat deposits around the waist.

What other forms of internal obesity are there?

Fatty liver disease is the formation of fatty deposits in the liver. This disease is often encountered by overweight people. The disease is characterized by pain and discomfort in the abdomen, upset and heaviness in the stomach. Such disorders can be detected using ultrasound of the liver. Fat deposits in the liver of more than 10-15% threaten the health of the body as a whole.

The disease can be triggered by excessive alcohol consumption, diabetes mellitus, poor diet and elevated levels of iron in the blood.

Fatty hepatosis is manifested by: fatigue, nausea, weakness, decreased appetite, poor concentration. Over time, a person begins to feel heaviness in the hypochondrium, and the neck becomes covered with dark spots.

Excess weight of endocrine type

Signs of thyroid type: thinning of the outer part of the eyebrows, arched palate, dry skin, hair loss, redness in the cheeks, bags under the eyes, memory loss, sensitivity to cold. The accumulation of fatty deposits predominates in the upper part of the body (arms, shoulders), and stones may also appear in the gall bladder.

Signs of pituitary type in women: fat deposition on the chest, buttocks, thighs, and lower abdomen. Headache, decreased vision, menstrual irregularities, thickening of the skin at the base of the nail plate, the appearance of a large number of moles.

General symptoms of obesity include weakness, heaviness in the legs, shortness of breath, and headache. Due to the increase in adipose tissue, muscles weaken, which subsequently develops metabolic syndrome and diabetes.

How to deal with obesity

First of all, you need to adjust your lifestyle and eliminate factors that contribute to excess weight gain.

Avoid fast food, fatty and fried foods, sweets, canned foods and soda;
Reduce your drinking;
Avoid stressful situations;
Eat in small portions;
Sleep at least 7 hours a day;
Drink more clean water (1.5-2 liters)

If the above recommendations do not have an effect, we recommend contacting an endocrinologist. Hormonal disorders require taking medications, which should be selected by the attending physician.

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Dietary supplement is not a medicine

Visceral obesity is the deposition of excess fat in the structures of internal organs. Excess weight and increased body mass index always entail serious complications in the form of diabetes, diseases of the musculoskeletal and joint system, metabolic disorders, and cardiovascular pathologies. The main reason is often typical overeating, an inactive lifestyle, lack of diet, sleep and wakefulness. Treatment of fatty deposits is long-term and requires special discipline from the patient in relation to the doctor’s recommendations. Therapeutic nutrition and a healthy lifestyle give the first tangible results within a few weeks, significantly increasing the quality of life of a patient at any age with visceral obesity.

Nature of the disease

Visceral obesity (internal) is the formation of excess mass of subcutaneous fat tissue near vital organs, reducing their resources, up to the development of functional failure. Normally, each person has certain reserves of internal fat, which performs the following functions:

shock-absorbing effect when walking, falling, bruises;
creating an internal reserve of the body for nutrition in atypical circumstances;
protection of internal organs from negative factors.

Internal obesity occurs not only in people with excess body weight. Excess visceral fat is often reported in thin patients. Determining the true volume of fat in people of any body type can only be done through diagnostic measures. Frequent localization of internal fat deposits is the iliac region of the peritoneum, thighs, and middle back. The “beer bellies” of men and women, known in clinical practice, even against the backdrop of a slender constitution, are formed precisely because of the buildup of the visceral fat layer. In women, visceral fat is more often deposited in the thighs on all sides and on the abdomen.

Important! Excessive accumulation of excess fat around internal organs can cause respiratory problems. Thus, severe snoring during sleep with cessation of breathing and attacks of suffocation are often formed precisely against the background of fatty deposits.

Development mechanisms and causes

The formation of visceral fat is directly related to all parts of metabolic processes. Metabolic obesity is accompanied by increased body weight and impaired sensitivity of the cellular structures of internal organs to the insulin hormone. In addition to the risks of developing diabetes, patients’ blood pressure increases, the volume of cholesterol deposits increases, and their overall health worsens. Clinicians believe that it is disturbances in the sensitivity of cells to the hormone insulin in the absence of a high glycemic index that is the trigger for the development of diabetes mellitus, metabolic imbalance, and excess weight. Impaired insulin sensitivity depends on the following factors:

gender and age of the patient;
heredity;
features of intrauterine development of the fetus;
systematic effects of negative factors on the body;
hormonal disorders.

Visceral fat leads to impaired carbohydrate metabolism and hormonal imbalance. With a burdened endocrinological history, complications may arise from the ratio of thyroid hormones.

Features of internal fat

The rate of development of cell sensitivity to insulin and obesity depends on the following features of visceral fat tissue:

multiple nerve and vascular plexuses;
a large number of receptors responsible for excitability;
low density of nerve receptors, accelerating the breakdown of fats;
high density of receptors in relation to adrenal hormones and estrogens;
many cells that make up adipose tissue.

With an intense rate of lipid breakdown in subcutaneous fatty tissue, fatty acids are released from cellular structures, penetrating into the blood and entering the liver. Hepatocytes (liver cells) reduce their ability to bind insulin.

The volume of unclaimed pancreatic hormone increases, leading to a lack of response to insulin by cells in the muscle layers. Thus, the accumulation of underoxidized fat products occurs in the blood plasma. Under the influence of these factors, the absorption of glucose by skeletal muscles and cardiac tissues is disrupted. As visceral fat increases, insulin synthesis decreases, leading to serious endocrinological disorders.

Important! In addition to reducing the sensitivity of cells to insulin, fat metabolism is disrupted, muscle cells and collagen synthesis within organs are intensively formed. All these processes lead to dystrophic deformations of the vascular walls, provoking the formation of atherosclerotic plaques.

Norm and pathology

Nutritionists and endocrinologists can determine the presence of visceral fat only with pronounced manifestations and with a characteristic symptomatic picture. Typically, the final diagnosis is recorded on the basis of clinical data (laboratory and instrumental research methods). There is a theory that if a person’s figure increasingly resembles a circle and an apple, then this is evidence of an increase in visceral fat. To detect excess fat, simply measure a man's or woman's relaxed waist circumference.

The following are considered safe indicators:

limit up to 90 cm for women;
limit up to 102 cm for men.

In women with a pear-shaped silhouette, deposits accumulate more on the hips, rarely immediately affecting the stomach. Subcutaneous fatty tissue on the thighs secretes a specific hormone that protects myocardial and pericardial tissue. To reliably determine the volume of visceral fat, specialists resort to MRI examination. The magnetic resonance imaging method allows you to study all the tissues of the human body layer by layer, to give a reliable assessment of excess fat deposits, as well as the general condition of tissue, muscle and joint structures in general.

The volume of internal fat is considered normal up to 15% of a person’s body weight; the level of lipoprotein density should not decrease less than 1.5 mmol/l. The body mass index should not be higher than 25, especially in the absence of an active lifestyle or physical activity.

Localization of deposits

Visceral fat has “favorite” areas of excessive deposition in men and women, which is due to the anatomical features and physiological purpose of both sexes.

Deposits in women

The peculiarities of the formation of excess fat in women depend not only on anatomy, but also on the influence of certain factors (pregnancy, lactation, weight loss). Fat is usually localized in the hips, breasts and pelvic organs. The impact of internal deposits on a woman’s health is enormous:

hormonal disorders (impossibility of full-term pregnancy and lactation);
menstrual irregularities;
ovarian obesity (decreased reproductive function);
obesity of the calf muscles (due to the ability of visceral fat to be deposited evenly in women).

It develops more slowly and is gradually distributed throughout the body, including spread to internal organs. The first symptoms in women develop brighter, more intense, and are rarely latent.

Features in men

The rapid development of obesity in men is due to larger muscle structures. The soft tissue fibers are located at some distance from each other and fat molecules become clogged in these unique depots. The localization of deposits in men is as follows:

belly (protrudes in both thin and overweight men);
shoulders and forearms (the result of a decrease in the level of estrogen hormones);
obesity of the liver structures (corticosteroid dysfunction);
(hormonal imbalance).

Diagnostic measures are aimed at studying the possible causes of obesity in patients of any gender and age. Usually, effective treatment is possible only after the full picture of the disease has been revealed. For idiopathic obesity (in the absence of objective reasons), treatment is prescribed according to the symptomatic picture.

Symptoms and complications

Obesity in men and women in many clinical cases leads to the formation of persistent disorders in many organs and systems, up to and including disability of the patient. The main symptoms include:

shortness of breath even with slight exertion;
difficulty breathing during sleep (sometimes there is a feeling of insufficient filling of the lungs);
nausea, periodic vomiting (internal intoxication due to fatty liver);
arterial hypertension (high blood pressure always accompanies excess weight, heart, lung, and liver diseases);
phlebeurysm;
infertility in men and women.

The appearance of atherosclerotic plaques, the risk of thrombosis, disorders of the epigastric organs, intestines - all these mechanisms are involved in the pathological process of obesity. Complications of atherosclerosis and cardiac diseases can even provoke death.

Treatment tactics

Regardless of the reason for the formation of excess accumulations, therapeutic measures are aimed at eliminating symptomatic manifestations. With a burdened clinical history, stable remission of chronic pathologies that can accelerate excess deposits should be achieved. To achieve a therapeutic effect, it is necessary to quit smoking, streamline your lifestyle, create a diet, sleep, and wakefulness. Sports or regular physical activity is important. Against the background of existing diseases, multidirectional therapeutic exercises and long walks in the fresh air are suitable. The main methods for eliminating excess weight include:

proper nutrition;
regular physical activity;
physiotherapy (massages, warming, thermal wraps);
drug correction for severe disorders;
plastic surgery.

Meals should be complete, balanced, divided into several small portions per day. You can’t lose weight on protein-free diets, because protein deficiency can have the opposite effect: body weight will go away, but visceral deposits will remain in the same place and become significantly stronger.

A special drug for treatment is Orlistat, which replenishes a person’s nutritional needs without affecting the patient’s mental health. In severe cases of obesity, especially in life-threatening conditions, surgical correction is carried out. Surgery is performed in two main ways:

gastric bypass (artificial conditions to reduce fat absorption);
sleeve gastrectomy (stomach volume reduction).

Metabolic disorders are the basis for the formation of visceral fat, which is why consultation with an endocrinologist, gynecologist (for women) and andrologist-urologist (for men) is so important. The treatment strategy is determined by a gastroenterologist, nutritionist and endocrinologist.

Visceral fat in the abdominal cavity forms an omentum or fat sac, which protects internal organs from damage and maintains the necessary temperature optimum. As the volume of visceral deposits grows, organs are subjected to compression and provoke the formation of persistent functional disorders. Treatment of excess weight is very important for maintaining the health of internal organs and the normal functioning of all systems.

Timely therapy allows you to quickly get rid of the pathology. The later treatment is started, the longer the process of fat removal will be. The duration of therapy depends not only on its timeliness, but also on the patient’s age, medical history and heredity. Medicine today makes it possible to achieve tangible results in a short time.

It is important to know that primary obesity is realized under the influence of external factors ( a lot 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 ( the risk increases after 40 years of age, which is associated with a 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 - adequate feeling of hunger and satiety. Fat accumulates when the body expends less energy than it consumes, that is, eating more than is necessary for the normal functioning of the body. Obesity that develops through this mechanism is called primary exogenous, that is, associated with external causes ( exogenous - coming from outside), in other words, caused by overeating. Overeating in medicine is called “hyperalimentation”. Hyperalimentation is considered a form of disorder of adaptation of the human psyche under stress, therefore overeating is often classified as a borderline psychological disorder.

Overeating is possible in the following cases:

habit- once established habit of eating in a certain way ( three meals a day, night eating syndrome);
communication- eating “for company”;
rituals- eating while watching movies ( especially in the cinema), football and other events, while a person eats without feeling hungry;
stress snacks- in case of unpleasant experiences, worries, or a desire to protect oneself, when eating a certain product, one feels calmer, which is due to psychological comfort and a feeling of safety when eating;
gourmetism- love for delicious 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) caused by hormonal changes and the need to calm down and relax ( is more psychological in nature).

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

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

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

The desire to consume fatty foods occurs with increased production of the hormone ghrelin in the stomach. Appetite inhibition occurs 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 ( instant food) and carbonated drinks contain substances that increase appetite.

Low physical activity

Low physical activity or physical inactivity is a socially significant factor in abdominal obesity. Physical inactivity occurs in people living in big cities, working while sitting, and in people with chronic fatigue who do not exercise. With this lifestyle, energy balance or the balance between the amount of energy consumed and expended is disturbed. In addition, in the absence of physical training, the body’s regulatory systems “lose their dexterity.” This means that the body stops adapting to any stress and begins to react inadequately to physical or emotional stress. 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 consumes in the modern world is already becoming excessive.

A sedentary lifestyle and associated health changes are called the “three-chair” syndrome. The three chairs are an office chair, a car seat and a sofa.

Genetic factors

Genetic factors are often the main cause of abdominal obesity, meaning in many cases fat will not be deposited in the abdominal cavity even if you eat a lot and lead a sedentary lifestyle. The distribution of adipose tissue in specific places in the human body is associated with the work of 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. Adrenergic receptors are receptors that are activated by adrenaline ( stress hormone), which is why fat is destroyed during physical or emotional stress. The fact that during stress, fats disappear from a specific area, but do not decrease in another, is due precisely to the number of these receptors.

Genetic control of hunger and satiety is also important. 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 formation of the hormone leptin in adipose tissue.

In addition, many people have the so-called “thrifty genotype” ( genotype - all the genes of a given organism). The genotype tends to change during the process of human evolution. The thrifty genotype is a complex of genes that work on the principle of “storing fat in case of hunger.” If in the process of active human life this mechanism was truly life-saving, then in the conditions of the modern world with a sedentary lifestyle and a large amount of food consumed, the “economical genotype” acts harmfully. The body accumulates too much fat, “not knowing” that, in fact, it does not need to store, 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 can cause more serious disorders and, at first glance, have nothing to do with the accumulation of fat. Severe shortness of breath, which is characteristic of general obesity, is not a mandatory symptom with abdominal obesity. A pronounced appetite in abdominal obesity is not only the cause of excess weight gain, but also its consequence, since with 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 set of symptoms). Metabolic syndrome is a disorder of hormonal balance and metabolism that increases the risk of developing cardiovascular disease. It is abdominal obesity combined with arterial hypertension ( high blood pressure), diabetes mellitus type 2 ( without insulin deficiency) and high triglyceride levels ( fatty acid) make up the so-called “deadly quartet”. This name was given to metabolic syndrome because it was found that the combination of these disorders significantly increases the likelihood of death from myocardial infarction and stroke.

Disorders associated with abdominal obesity

Name of violation	Development mechanism	How does it manifest?
*Dyslipidemia*		sexual dysfunction in men; menstrual irregularities in women; hirsutism ( Male pattern hair growth in women);
*Hypercoagulation*	Hypercoagulation is a tendency to increased blood clotting. This tendency increases the risk of vascular thrombosis ( blockage of a blood vessel by a blood clot). Hypercoagulation develops in abdominal obesity due to the production of many proteins by adipose tissue that increase blood clotting ( fibrinolysis inhibitors). Their release is associated with the effect of insulin, which necessarily increases in the blood during abdominal obesity.	an increase in the level of fibrinogen, plasminogen activator, von Willebrand factor in the analysis of the blood coagulation system.

Diagnosis of abdominal obesity

Diagnosis of abdominal obesity is carried out not only visually, since abdominal obesity can also be observed in seemingly thin people. Visceral fat is not visible from the outside, so abdominal obesity in such people, often with model parameters, is described as “thin on the outside but fat on the inside.” To assess the degree of abdominal obesity, the doctor uses various methods based on measurements 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 of a person’s height and weight, that is, to determine normal, underweight 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 cost, therefore it is used for screening assessment among the population ( screening - 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 fat, that is, obesity may be overestimated or, conversely, not detected.
Waist circumference- allows you to determine abdominal obesity itself. The method allows you to clearly determine the presence of adipose tissue and the degree of risk of developing complications of abdominal obesity. This indicator clearly correlates ( interconnected) with metabolic diseases. It also does not require any costs. 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 tape measure is placed around the abdomen at the level located midway between the lower part of the chest and the iliac crest ( a bone that can be felt in the pelvic area 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 their waist is normally thicker than women's.
Central index ( abdominal) obesity- ratio of waist circumference to hip circumference. Abdominal obesity is considered if this indicator is more than 0.85 in women and more than 1.0 in men. This index allows you to distinguish abdominal obesity from other types of obesity.
Assessment of the thickness of the skin-fat fold- carried out using a special device called a caliper ( the measurement procedure itself is caliperometry) and is something similar to a caliper. The skin fold in the abdominal area is taken with the thumb and forefinger at the level of the navel and 5 cm to the left of it. After this, the fold is captured by the caliper itself. The measurement is carried out three times with an interval of 1 minute. This indicator assesses the thickness of subcutaneous fat, however, if fat accumulates in the waist area, it is important to evaluate the amount of subcutaneous fat in order to identify the type of obesity.
Instrumental methods that allow visualization of adipose tissue- CT scan ( CT) , Magnetic resonance imaging ( MRI) , ultrasonography ( 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 waist circumference, but obesity in internal organs can only be detected using instrumental research methods.

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 that could be damaged as a result of disorders accompanying abdominal obesity.

For abdominal obesity, the following tests are required:

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

For abdominal obesity, the doctor may prescribe the following instrumental studies:

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 a pronounced fat layer in the torso area and a small amount of fat on the hips. This type of obesity is figuratively called “apple-type obesity” ( The width of an 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. This figure resembles a pear, which is why it is called “pear-shaped obesity.” These two types of obesity are fundamentally different from each other. Fat deposits in the thigh area do not affect health, unlike fat in the waist area.

Pear-shaped obesity even has some advantages. In women, a large amount of estrogen is produced in adipose tissue. These female hormones tend to protect the walls of blood vessels and prevent the accumulation of cholesterol in them ( therefore, atherosclerosis does not progress in women until menopause). With abdominal obesity, the opposite occurs - the fat itself becomes a source of free fatty acids.

Apple-type obesity is usually combined with abdominal obesity, that is, there is simultaneously accumulation of fat in both the subcutaneous fat of the body and the abdominal cavity. At the same time, obesity of internal organs can occur without visible obesity. This is an important difference between the abdominal type of obesity.

There is also a mixed type of obesity, in which there is obesity throughout the body.

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

overweight- BMI 25 - 30;
obesity 1st degree- BMI 30 - 35;
obesity 2 degrees ( serious) - BMI 35 - 40;
obesity 3rd degree ( morbid or morbid obesity) - BMI 40 - 50;
superobesity- BMI 50 - 60;
super obese- BMI over 60.

The normal BMI is 18.5 - 25 kg/m2.

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 around the waist), how much to prevent the development of pathologies that develop with abdominal obesity. If obesity has a hereditary predisposition, then treatment will be long-term and even lifelong. If abdominal obesity is observed against the background of decreased physical activity and increased food consumption, then you can easily get rid of extra pounds, but you will have to constantly be careful not to gain abdominal fat again.

Treatment methods for abdominal obesity are:

diet therapy;

drug treatment;

psychotherapy;

some surgical interventions.

In any case, the treatment of abdominal obesity is always approached in a comprehensive manner.

Exercise stress

Physical activity is an important stimulus for burning fat, because fat is a source of energy, and in order for a person to perform physical exercise, 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 following a diet. If a person eats the same amount of food and exercises, the effect will be insignificant, because the body will first destroy existing fats and then create new ones from the food received. If physical activity requires more energy than the food consumed per day contains, then an energy deficit will arise. This is precisely the goal of treatment - to spend more than you 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 individually.

Moderate physical activity is preferable ( the load that a person can perform for an hour without feeling severe fatigue), for example, walking, cycling, swimming, skiing, running;
you should start with a low-intensity load ( obese people find it more difficult to do any physical work), gradually increasing its duration;
do exercises 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.

Drug treatment of abdominal obesity

Drug treatment for abdominal obesity is indicated in cases where the BMI is more than 30 and there is no effect of non-drug treatment ( diet and exercise) within 3 months. The effect of non-drug treatment is considered unsatisfactory if a person’s weight during the specified time, despite following all the doctor’s recommendations, decreased by less than 5%.

Drugs used to treat abdominal obesity

Group of drugs	Representatives	Mechanism of therapeutic action	Efficiency
*Anorexics* *(appetite suppressants)*	sibutramine ( )	These drugs act on the hunger center. Their effect is due to an increase in the duration of exposure to norepinephrine and serotonin ( appetite suppressants) to the saturation center in the brain. Quick satiety helps reduce the amount of food consumed. At the same time, the drug increases energy consumption in the form of heat. Additional positive effects include reductions in total cholesterol and triglycerides, as well as insulin.	Sibutramine is effective in patients who cannot control the amount of food they eat. This is especially true in cases where a person constantly thinks about food and constantly feels hungry. The drug is indicated for use in young people who are “seized” by depression and who do not have severe pathology of the cardiovascular system or arterial hypertension ( in these cases the drug is contraindicated). Sibutramine most effectively allows you to lose weight in the first months of its use. The drug should not be used for more than 1 year. After stopping the drug, if you do not follow a diet, fat begins to accumulate again.
*Agents that reduce fat absorption*	orlistat ( xenical)	Orlistat inhibits the activity of the lipase enzyme in the intestines, resulting in a 30% reduction in the amount of triglycerides that are absorbed from the intestines into the blood.	Orlistat is effective in people who like to eat tasty foods, especially fatty foods, if they have difficulty keeping track of their caloric intake ( often eat in restaurants), but who retain a feeling of fullness after eating. The drug can be used in old age and in the presence of cardiovascular pathology. The drug effectively prevents excessive absorption of triglycerides during the entire period of its administration. The effectiveness of the drug if the diet is not followed is minimal.
*Hypoglycemic drugs* *(lowering glucose levels)*	liraglutide ( Victoza); metformin ( siofor, glucophage).	The mechanism of action of liraglutide is due to its ability to act as a satiety hormone, that is, to reduce appetite and reduce the amount of food consumed. In addition to this effect, the drug reduces blood glucose levels, which improves metabolism and helps normalize body weight. Siofor promotes the absorption of glucose by tissues, and also inhibits the formation of glucose and fats in the liver; the formation of fats when taking this drug is also reduced.	Liraglutide is effective in patients who do not feel full and cannot control their appetite and the amount of food they eat. Moreover, unlike sibutramine, liraglutide is indicated in the presence of a high risk of cardiovascular complications and type 2 diabetes. The drug is not prescribed if there is evidence of thyroid cancer in the patient himself or his relatives. Siofor is prescribed to people with abdominal obesity, which is combined with insulin resistance.

Surgical methods for treating abdominal obesity

An important difference between abdominal or visceral obesity and regular obesity is that it cannot be cured with surgery. With ordinary, “external” obesity, fat accumulates in the subcutaneous fat, so it can be removed surgically or destroyed by injection ( by introducing substances) methods is not difficult. It is impossible to remove the fat that surrounds the internal organs, because technically it is not possible to isolate and remove the fatty tissue in which the vessels and nerves pass without damaging anything.

Surgical options for abdominal obesity include:

Gastric banding- the application of a ring in the upper part of the stomach, which divides the stomach into two parts. The small top can hold a small amount of food at a time, causing the stomach to send signals to the brain that it is full. This will create a feeling of satiety.
Reducing stomach volume- in some people who eat a lot, the volume of the stomach is increased, so satiety 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” helps to quickly create a feeling of fullness.

These operations do not guarantee a cure for visceral obesity, but they can stop the process of fat accumulation and reduce the amount of fat deposits, since the person after the operation will not be able to eat much food. The effectiveness of such an operation varies from person to person.

Stomach operations for abdominal obesity are performed in the following cases:

Abdominal obesity is combined with general obesity:
there is severe abdominal obesity;
BMI is more than 35 and there is a pathology concomitant with abdominal obesity;
BMI is more 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 treatment for abdominal obesity depends on the psychological state of the patient and his motivation. Since a person is required to change his lifestyle, the participation of a psychologist or psychiatrist may be required. In addition, abdominal obesity itself, especially in women, causes self-doubt. Lack of self-confidence often causes overeating. That is why eliminating psychological discomfort makes it possible to increase the effectiveness of physical training and other treatment methods.

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 his habits and lifestyle over a long period?
What are the reasons that motivate you to lose excess weight?
Does the patient understand the dangers and risks associated with abdominal obesity?
Is there emotional support from family members regarding weight loss?
Does the patient realize that the effect will not be immediate, but after a certain period of time?
Is the patient ready to constantly monitor himself, keep a diary and monitor his body weight?

Traditional methods of treating abdominal obesity

Traditional methods of treating abdominal obesity promote fat burning, but without diet and physical activity, such treatment is ineffective.

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

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

The following folk recipes help reduce appetite:

Decoction of corn silk. To prepare the tincture, you need to take 10 grams of stigmas, add water to them and boil for 30 minutes. After the resulting decoction has cooled, you can take 1 tablespoon 4 to 5 times a day before meals. The decoction is taken for a month, after which a break is taken for 5 - 10 days. Corn silk should not be used if there is increased blood clotting.
Licorice root decoction. You can consume 1 - 2 roots per day, a decoction of which is prepared in the same way as a decoction of corn silk.
Dandelion infusion. You need to take a tablespoon of dandelion grass ( crushed), pour a glass of boiled water and leave to steep for 6 hours. After this, the tincture must be strained. You should drink in small portions throughout the day.
Young bran. Pour boiling water over the bran for 30 minutes, and then drain the water. The resulting slurry can be added to any dish. For 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.
Burdock root decoction. Take 2 teaspoons of plant roots ( ground), pour a glass of boiling water over them, then put on low heat for 30 minutes. The resulting decoction is taken in small portions throughout the day.
Kelp ( 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 case of kidney pathology.
Beet cakes ( push-ups). The beets should be peeled and grated, the juice should be squeezed out, and the resulting juice should be rolled into small balls the size of beans. The balls should be left to dry, after which take 3 tablespoons of the cake at a time. It is allowed to use low-fat sour cream to make the cakes easier to swallow. It is important to know that you cannot eat anything with the cakes ( the digestion process will be disrupted).

For abdominal obesity, the following herbal preparations are used:

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

For abdominal obesity, acupuncture may be effective ( 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 correct eating behavior. Before starting the diet, the attending physician will ask several questions to obtain information about the patient's eating habits. This information is called diet-namnes ( anamnesis - data about something). The doctor may ask the patient to write down everything he eats for 3 to 7 days, as well as portion sizes, amount of food, frequency of meals, and caloric content of foods. It is advisable to create a diet for any type of obesity on an individual basis.

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

The deficit is calculated taking into account energy ( calories), which a person needs per day to perform his work and lead 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 job 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 doctor will reduce the resulting amount of daily calorie intake so that a calorie deficit occurs.

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

with BMI 27 - 35 a deficit of 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 your 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 from fats will slow down.

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

The general principles of diet therapy for abdominal obesity include:

frequent meals ( 4 - 5 times a day), which allows you to maintain metabolism at the desired level;
small portions;
giving up alcohol ( it has a lot of calories);
reducing the amount of fat consumed by 25% of the daily norm ( You can eat no more than 250 grams of cholesterol per day);
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 quickly digestible 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 eliminating 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, it is advisable not to eat the visible fatty parts of such products ( chicken skin, milk froth);
be sure to consume proteins of plant origin ( soybeans, beans, mushrooms, cereals, peas), given that the body's total need for protein per day is 1.5 g/kg body weight.

Proteins are the main product in the diet. The fact is that, firstly, part of the muscle tissue is always lost along with fat ( and these are squirrels), and you need to restore muscle mass. Secondly, the body spends a lot of energy to digest and absorb proteins, that is, protein foods help increase metabolism and burn fat. Provided that the diet does not consist of carbohydrates, adipose tissue becomes the main source of energy for the body's needs.

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 indicators. It is important that the diet helps reduce the amount of abdominal fat, that is, you need to focus, first of all, on reducing your waist circumference.

The effectiveness of the diet is assessed after 3 to 6 months. The diet is considered effective if body weight has decreased by 5 - 15%, and the waist circumference has also decreased. It must be borne in mind that a decrease in the thickness of visceral fat in people who are not apparently fat may not cause a sharp decrease in the number of kilograms. Laboratory diagnostics allows us to evaluate the effectiveness in this case ( normalization of test parameters) and magnetic resonance imaging.central obesity index). The fact is that the way fat is distributed throughout the body can determine its health hazard. If the waist-to-hip ratio 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 whether there is 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 abdominal area ( abdomen - belly), that is, at the waist and inside the abdomen, around the internal organs ( visceral - pertaining to the insides). Fat inside the belly is called visceral fat. It is present and normal, enveloping the internal organs, being part of their anatomy ( 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 in the belly and around the waist) is diagnosed during examination and waist measurement. Abdominal obesity is registered 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 at the middle of the distance between the lower part of the chest ( conventionally this is the lower edge of the costal arch) and ilium ( the pelvic bone, which 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 indicator, you need to divide your waist circumference by your 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, the result is more than 1.0, and in women more than 0.85, then this is abdominal obesity.

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

Severe 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. Fat accumulation in thin people is diagnosed using magnetic resonance imaging ( MRI), which allows you to see the thickening of the fatty layer of internal organs ( visceral or internal 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 the cause of the development of metabolic syndrome. It is for this reason that doctors, when talking about abdominal obesity, mean metabolic syndrome.

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

Metabolic syndrome includes the following components:

abdominal obesity- waist circumference for men is more than 94 cm, and for women more than 80 cm;
dyslipidemia ( lipid or fat metabolism disorder) - increased levels of cholesterol and triglycerides in the blood;
insulin resistance- cell insensitivity to insulin, which is necessary for the use of glucose;
diabetes mellitus type 2- 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 around 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 extremities makes it difficult for the child to move, but does not pose a serious health risk, however, if general obesity causes an increase in waist circumference, then this is a serious reason to consult 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- independent disease;
secondary- develops against the background of other diseases.

In children, primary abdominal obesity is more often observed, 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 always under the influence of external factors (a lot of food, little physical activity). This type of obesity is called exogenous-constitutional (exogenous - caused by external factors, constitution - a feature of a given organism).

In contrast to exogenous constitutional obesity, there are forms of primary obesity that lead to increased accumulation of fat in the waist area and around internal organs, regardless of the influence of external factors. Such forms are called monogenic diseases ( mono - one). Monogenic diseases are caused by a single mutation in genes that are associated with obesity. This type of obesity develops during the first year of a child's life. Most often, monogenic obesity develops with leptin deficiency. Leptin is the “satiety” hormone and acts in the brain to reduce appetite and promote a feeling of fullness. 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 WC/TB is more than 0.8 in girls and more than 0.9 in boys.

Less commonly, abdominal obesity in children has secondary causes. This is usually a pathology of the endocrine organs ( thyroid gland, adrenal glands, pituitary gland).

The consequences of abdominal obesity in children are:

diabetes mellitus type 2 ( increased blood sugar levels that are not due to insulin deficiency);
high levels of cholesterol and triglycerides in the blood ( increases the risk of early development of vascular and cardiac pathology);
increased blood pressure;
hormonal disorders (adolescents may experience delayed puberty, menstrual irregularities in girls).

Is abdominal obesity the same in women and men?

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

Abdominal obesity has common symptoms 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 manifest itself as a violation of sexual function, since the conversion of male sex hormones into female ones occurs in adipose tissue. In women, hormonal balance is also disrupted, 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 explained by the presence of the hormone estrogen in the female body, which protects the walls of blood vessels and slows down the process of fat accumulation. In men, estrogen levels are several times lower, so the risk of developing atherosclerosis ( fatty plaques in blood vessels, narrowing the lumen) much higher.

Another difference between abdominal obesity in men and women is the method of treatment. It is easier for women to lose excess weight through diet and exercise. In men, the most effective treatment is the administration 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 of abdominal obesity begins with diet modification and exercise. If a patient has a serious disease of internal organs in a state of exacerbation, then the doctor first seeks to stabilize the condition, and then begins 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 medications.

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

age;
features of eating behavior ( foodie, increased appetite, uncontrollable feeling of hunger, inability to get enough);
presence of concomitant diseases.

Abdominal obesity is the cause of the development of pathologies such as arterial hypertension, type 2 diabetes mellitus ( loss of cell sensitivity to glucose), atherosclerosis of the arteries ( narrowing of arteries by cholesterol plaque). The main organ that suffers from all of the above reasons 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, therefore the combination of abdominal obesity and the above pathologies is called metabolic syndrome.

For abdominal obesity, your doctor may prescribe the following medications:

Sibutramine ( Reduxin, Meridia, Goldline, Lindaxa) - reduces appetite, affecting the satiety center in the brain, and also enhances heat production ( To produce heat, the body also burns fat and expends energy). The drug is not prescribed to patients with heart and vascular diseases, as well as high 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 older people.
Liraglutide ( Victoza) - inhibits appetite and improves the process of glucose consumption by tissues. For this reason, it is used if abdominal obesity is accompanied by type 2 diabetes mellitus, including the development of complications ( damage to the kidneys, heart, brain), as well as at a high risk of developing severe heart pathology. Liraglutide is contraindicated if a person has a malignant tumor of the thyroid gland, as well as if this tumor has been observed in any of the family members.
Metformin ( siofor, glucophage) - this drug is used to treat diabetes, it helps normalize carbohydrate and fat metabolism.

If the cause of abdominal obesity is a specific pathology ( most often these are hormonal disorders), then obesity is called secondary. In this case, treatment is carried out not only by a nutritionist, but also by a specialist ( endocrinologist, gynecologist and others).

Is glucophage used for abdominal obesity?

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

Obesity of internal organs, especially the pancreas, leads to a serious disruption of its normal functioning. Fatty infiltration of the pancreas or steatosis, as this pathology is otherwise called, develops as a result of the accumulation of fats in the cells of the organs.

Fat cells interfere with the normal functioning of healthy cells. The reasons, first of all, should be sought in metabolic disorders. Despite the seriousness of the disease, with timely initiation of treatment, its progression can be stopped and organ function restored.

Reasons for the development of pathology

The essence of the disease is that healthy pancreatic tissue is replaced by fat cells. The process of obesity is characterized by slow development and can last for years. In most cases, pancreatic obesity is not an independent disease, it is the result of the development of other disorders in the body, i.e. it is a secondary pathology.

Pancreatic obesity occurs for various reasons, but in most cases it is associated with metabolic disorders. Against this background, normal organ cells die and are replaced by fat cells. The occurrence of the disease can be triggered by the following factors:

alcohol abuse;
acute or chronic pancreatitis;
hereditary predisposition;
diabetes;
chronic hepatitis;
excess body weight;
thyroid diseases.

Symptoms

There are no symptoms of the disease in the initial stages due to the fact that fat cells, located in separate areas of the pancreas, are not yet able to compress nearby organs and therefore their functionality is not temporarily affected.

As the disease progresses and fat cells accumulate in the gland, the following signs appear:

nausea and vomiting;
abdominal cramps;
increased gas formation;
feeling of heaviness;
frequent stools with fatty admixtures;
diarrhea;
pain in the right hypochondrium.

Symptoms of the disease appear when a third of the organ is replaced by fatty tissue. As a result, the functioning of the pancreas itself is disrupted and other surrounding organs are compressed. Since the complete digestion process is ensured by enzymes secreted by the gland, if its functioning is impaired due to obesity, fatty and protein foods are especially difficult to digest.

Depending on the extent of damage to the gland by fat cells, there are 3 degrees of such obesity. The first degree is characterized by damage to 1/3 of healthy gland cells, the second degree 2/3 and the third more than 60%. The crowding of fat cells and the location of their accumulation also affect the severity of the disease.

Why is excess weight dangerous?

Diagnostic and treatment methods

Any disruption of the pancreas affects the functioning of other nearby organs, in particular the stomach and, as well as the spleen and kidneys. In addition, the endocrine and cardiovascular systems are affected. All this necessitates the need to take therapeutic measures to restore normal functioning of the pancreas.

Treatment methods for pancreatic obesity are determined after diagnostic procedures. To identify this disease, ultrasound is used, which makes it possible to identify foci of increased echogenicity in the tissues of the pancreas. In addition, magnetic resonance imaging of the abdominal cavity is used, which can be used to accurately determine where in the organ fatty areas are located. The patient is also prescribed urine and blood tests.

For pancreatic obesity, treatment is carried out mainly using conservative medicine methods and following the principles of proper nutrition. Surgical treatment is used only in advanced and complex cases of the disease. But surgical methods are rarely used. In general, pancreatic obesity can be successfully treated, provided that adequate measures are taken in a timely manner and a special diet is followed.

Obesity of the pancreas is characterized by a slow course and therefore the patient has time to normalize the problems that have arisen in the functioning of the organ. For treatment to be successful, the patient must completely stop taking any types of alcohol and adhere to a diet. If a patient with pancreatic obesity takes any medications that affect the diseased organ, they should be discontinued or replaced with others.

The goals of treatment are to reduce the load on the pancreas and stop the process of cell death. Therapy is long-term and complex. It is selected individually in each specific case. For the treatment of pancreatic pathologies, the following groups of drugs are prescribed:

eliminating pancreatic insufficiency and stimulating digestion - Pancreatin, Festal, Mezim;
antispasmodics that relieve pain - Platyfillin or No-shpa;
drugs that normalize hormonal levels and metabolism.

Nutritional Features

Since the pancreas plays a key role in the digestion process, to get rid of obesity it is necessary to reduce the load on it. A special diet is provided for this. It will help improve metabolic processes and prevent further fat deposition in the pancreas tissue.

Strict control over nutrition will help correct any disturbances in the functioning of the pancreas. Diet is necessary not only after the acute phase of the disease has been eliminated, but also during the period of remission, to prevent relapses.

The main point in such a diet is the exclusion or minimal consumption of foods that slow down digestion and increase inflammatory processes in the gland. This applies primarily to spicy, fried, salty and sweet foods and alcohol. Meals should be frequent and small.

The therapeutic diet involves drinking large amounts of fluid, at least 3 liters per day. You can drink any water. It is useful to include dried fruit compote in your drinking regimen, but without adding sugar. You should not drink carbonated drinks, coffee or cocoa, or grape juice. Weak tea with lemon is allowed. Allowed drinks include decoctions of herbs and berries diluted with water.

It is recommended to include more fermented milk products in your diet - yogurt, yogurt, kefir. Food should be chopped or pureed. Preference should be given to boiled, baked or steamed foods. Avoid eating too hot or cold foods. The last meal should be 2 hours before bedtime.

According to the diet for pancreatic obesity, the following products are allowed for consumption:

dried bread made from wheat flour of not the highest grade, crackers, unleavened dry biscuits;
curd products and milk;
soups and dishes made from boiled and stewed vegetables with the addition of a small amount of butter or sour cream;

porridge from rice, oatmeal, buckwheat and semolina;
boiled pasta;
lean meats and fish, chicken eggs;
soft and sweet berries and fruits, baked apples.

In case of obesity of internal organs, high-fat dairy products and broth-based soups, fatty meats, canned foods and offal should be excluded from the diet. Wheat, barley, pearl barley and corn porridge are prohibited. You should not eat fruits and vegetables with a high content of coarse fiber.

Video: Abdominal obesity

From medicine, the etiology of obesity is the deposition of excess fat in the subcutaneous tissue, tissues, and organs. The disease is manifested by a weight gain of 20% or more from the normal body mass index (BMI). Obesity causes psychophysical discomfort, sexual disorders, diseases of the joints and spine. The risk of developing coronary heart disease, hypertension, atherosclerosis, and diabetes mellitus increases. Neglected cases can result in disability and death. Women aged 30-60 years are twice as likely to develop the disease.

Types of obesity

Weight is controlled using the BMI ratio, which is the ratio of a person's weight to their height squared. The normal value of the coefficient ranges from 18.5-24.9 kg/m2. There is also Broca's index, which is calculated as body height in cm minus 100. The values of the indicator cannot be considered completely reliable. Using arithmetic, the degree of obesity is also calculated as the ratio of the proper weight to the measured weight and multiplied by 100%. The disease has several classifications: according to the mechanism of development, places of localization of deposits, cause of occurrence.

Classification by development mechanism:

hyperplastic (increase in the number of adipocytes, i.e. fat cells);
hypertrophic (increase in the size of adipocytes and their fat content).

Classification by fat localization:

Android (apple type). Fat deposits accumulate in the torso area (armpits, abdomen). It is more common in men, which is why it is also called the male type.
Gynoid (pear-type). Fat accumulates mainly in the thighs, buttocks, and lower abdomen. The second name is based on the female type.
Mixed type. The deposits are evenly distributed throughout the body.

Classification by reason of occurrence:

Primary or alimentary-constitutional.
Secondary.

In addition, secondary obesity is divided into:

cerebral;
endocrine;
against the background of taking antipsychotics, mental illness.

Symptoms

Characteristic symptoms will help determine the presence and extent of the disease. There are 4 main stages with the following BMI indicators, depending on age:

First stage

This type is more common in children. Characterized by slight weight gain, approximately 20% of ideal weight. It does not cause any discomfort. Women, when minor visible manifestations appear, begin to exhaust themselves with diets. Frequent breakdowns result in even greater weight gain and psychological trauma. Symptoms of first degree obesity:

increased appetite;
chronic overeating.

Second stage

In the second degree, the risk of dysfunction increases, and metabolism slows down even more. The percentage of fat from lean body mass is 30-50%. Obesity in the second stage is characterized by the following symptoms:

dyspnea;
pain in the spine;
dysfunction of the endocrine system
discomfort in the joints;
profuse sweating.

Third degree

Obesity is difficult to tolerate. A person’s weight in the third stage exceeds normal body weight (NBW) by 50% or more. BDC is the weight that corresponds to the height of a particular person, taking into account his body type. In the third degree, a person has difficulty withstanding even minimal physical activity. The following symptoms are noted:

drowsiness;
decreased mood;
nervousness;
swelling of the lower extremities;
liver enlargement.

In addition to the listed symptoms of the third stage, complications of obesity arise:

arthrosis of the joints;
myocardial infarction;
strokes.

Fourth degree

A person's body weight is doubled compared to normal. This stage is rarely achieved, since advanced third degree often turns fatal, the person simply does not live to see it. Rare people with the fourth stage of the disease lead a bed lifestyle. Symptoms of obesity of the fourth degree:

the usual contours of the body are no longer visible;
inability to perform basic actions independently;
respiratory failure;
decreased appetite.

Signs of obesity

The development of nutritional-constitutional or primary obesity is caused by an exogenous (nutritional) factor. Weight gain is associated with a high energy diet and low energy expenditure. Secondary obesity is often accompanied by hereditary syndromes:

Lawrence-Moon-Bardet;
Gelineau;
Babinski-Froelich disease.

This type of illness can develop against the background of cerebral lesions:

dissemination of systemic lesions;
brain tumors;
traumatic brain injuries;
infectious diseases;
consequences of surgical operations;
mental disorders.

Alimentary-constitutional

In women, the main fat trap is often the thigh area, in men it is the abdominal area. In contrast to the secondary type of obesity, with alimentary-constitutional obesity there are no symptoms of damage to the endocrine glands, however, the disease manifests itself as follows:

excess weight increases gradually;
fat deposits are evenly distributed throughout the body.

Hypothalamic

Signs of hypothalamic obesity:

obesity develops very quickly;
fat is deposited in the buttocks, thighs, and abdomen;
Trophic skin disorders are characteristic (white and pink stretch marks on the skin of the thighs, buttocks, dryness);
increased appetite, especially in the evening.

Endocrine

Endocrine type obesity is divided into the following subgroups:

pituitary;
hypothyroid;
menopausal;
adrenal;
mixed.

The endocrine form of obesity is characterized by the presence of symptoms associated with underlying and concomitant diseases caused by hormonal imbalance. Manifested by the following symptoms:

feminization (masculinization);
hirsutism;
gynecomastia;
lipomatosis

Signs of obesity in internal organs

Subcutaneous or visceral fat settles on internal organs and impedes their functioning. It is localized in the torso area, enveloping the liver, heart and kidneys. The presence of this type of fat can be determined by measuring your waist circumference (WC). There is a high risk of developing diseases associated with visceral fat in women with WC > 88 cm, in men with WC > 102 cm. This type of fat:

increases blood cholesterol levels;
increases blood pressure;
provokes inflammatory processes;
increases the amount of testosterone in women, decreases it in men.

Why is obesity dangerous?

The disease can completely destabilize the functioning of the body. Excess weight affects the psycho-emotional state, causes depression, and complete rejection of oneself. The disease can provoke diseases of the spine, joints, cardiovascular system, destabilization of liver function, development of endocrine diseases, decreased function of the genital organs, menstrual irregularities in women and premature menopause. Obesity stages III and IV can be fatal.

Treatment

An important stage of treatment is the diagnosis of obesity. Depending on the degree of development of the disease, appropriate treatment is selected. In the first stages, a low-calorie, hypocarbohydrate diet and moderate physical activity are prescribed. With a sufficient amount of protein and fiber in the diet, it is necessary to reduce the consumption of fats and carbohydrates. Mainly small meals (5-6 times a day) and aerobic exercise.

Starting from the advanced second stage of the disease and higher, drug treatment is prescribed. Drugs of the amphetamine group (phentermine, amfepramone, dexafenfluramine) are used. They dull the feeling of hunger and promote faster satiety. Some side effects are possible, for example, mild nausea, dry mouth, irritability, insomnia, allergies, addiction. In this case, fat-mobilizing drugs such as sibutramine and orlistat are prescribed.

At stages III and IV, in order to save a person’s life and lose excess weight, surgical intervention is necessary. Popular methods of bariatric surgery today: gastric banding, vertical gastroplasty, gastric bypass. For cosmetic purposes, a procedure called liposuction is used to remove local fat deposits on the body.

Most people are already in the pre-obesity stage. In order not to start the development of the disease, you need to reconsider your eating habits, adhere to the balance of calories, proteins, fats, carbohydrates, based on your norm. You need to periodically measure OT and track your weight loss results using photos. Photos not only reflect progress, but also serve as a kind of motivator. To regulate lipid metabolism, you need to maintain water balance and sleep patterns, and increase physical activity.