Visceral obesity

Fat cells accumulate energy storage and fat-soluble vitamins( A, E, K, D), excrete hormones, protect internal organs from shocks and injuries, maintain temperaturebody. If the energy is more than consumed, the cells increase in volume, which leads to an increase in the thickness of the adipose tissue.

In the body, fat is distributed differently: in some cases it is deposited in the thighs and legs, in others in the abdominal area( on the stomach).The most visceral obesity is most dangerous, as it leads to the development of somatic diseases.

The essence of the problem

The primary alimentary-exogenous obesity is allocated, which is formed as a result of the intake of excess fat and carbohydrates in the body, and secondary, due to diseases of the central nervous system or the endocrine system.

Primary obesity occurs in 75% of people with excess weight. It develops due to the fact that the body receives more energy than is consumed, the diet is violated( most calories are consumed at night) or meals are rare, but abundant.

Not always obesity occurs in people due to excessive consumption of food, sometimes the reason for lack of physical activity. The genetic factor in the development of obesity has not been proven, the fact that the whole family suffers from the disease is explained by common habits and way of life.

Exogenous-constitutional obesity is divided into gynoid( gluteal and femoral) and abdominal, when fatty tissue accumulates in the abdominal cavity. When fat is around the organs, and not under the skin, it is said about visceral obesity.

The risk of the appearance of pathologies of the cardiovascular system is related to the volume of fat in the body, and the nature of its distribution. Thus, a person with upper obesity( abdominal, central, android) is more likely to get heart disease than a person with a lower type of obesity( gluteal, femoral, gynoid, peripheral).

There are three layers of adipose tissue: subcutaneous, visceral, and located under the muscle tissue. Visceral fat differs from subcutaneous fat - type of adipocytes, lipolytic activity, sensitivity to insulin and other hormones. All adipose tissue is 80% composed of subcutaneous fat.

Obesity in men and women varies in different ways. So, in men visceral fat is first accumulated, and after that, the subcutaneous deposit is deposited. In case of weight loss, fat is first consumed filling the space between the internal organs, and only then does the waist volume decrease.

Obesity in women begins with an increase in the subcutaneous layer of adipose tissue, as estrogen prevents the deposition of visceral fat. But still, with an increase in body weight, the volume of visceral adipose tissue increases.

Fat accumulates in the subcutaneous tissue, the retroperitoneal space, the epicardium, the mesentery of the small intestine, rarely liver hepatosis occurs.

Visceral adipose tissue surrounds the abdominal cavity( most of it accumulates around the intestine), stomach, liver, kidneys and other organs. Epicardial fat is a special form of visceral fat around the heart. It produces substances that affect the functioning of the cardiovascular system.

A person without problems with excess weight of visceral fat is about 3 kg. If there is obesity, then this figure can increase by 10 times. Fat cells surround the internal organs and, if necessary, provide them with energy. But if a lot of fat accumulates in the lipocytes, they squeeze the organs, affect the blood supply and movement of the lymph.

In a patient with visceral obesity, complications from the pancreas and cardiovascular system are much more common than in people with gluteal-adiposity obesity.

Reasons for

Factors provoking the development of obesity:

• hormonal disorders that occur during childbearing, lactation, menopause;
• Central Nervous System Disease( stress, psychosis, panic attacks);
• excessive consumption of beer( testosterone is converted into female sex hormones and ceases to participate in the cleavage of fats);
• reduced physical activity( sedentary work, inactive rest);
• malfunctioning hypothalamus;
• improper nutrition( the menu is dominated by fats or carbohydrates, a thick dinner before bed);
• overeating;
• on the background of drug therapy( taking hormonal drugs, tranquilizers, antidepressants);
• disruption of the endocrine system( Itenko-Cushing syndrome, hypothyroidism);
• a lack of serotonin( a hormone responsible for a good mood and a feeling of satiety).

Waist circumference can also be considered a marker of redness of visceral fat

Diagnosis

Increasing the amount of visceral fat can not only in people with obesity. British scientists found that 45% of the fair sex and 60% of men with a body mass index of 20-25 units increased the amount of visceral tissue. They explained this by the fact that people supported weight "sitting down" on a diet, as a result of the cells accumulate fat "for a rainy day."

Those examined who had a normal content of visceral fat, led an active lifestyle and did not starve.

To diagnose abdominal obesity, it is enough to measure the circumference of the waist and hips. If the coefficient of OT / OB is more than one in men and above 0.85 in women, this indicates the deposition of adipose tissue between internal organs.

If a person under the age of 40 years has a waistline of more than a meter( and at the age of 60 years, the figure is more than 90 cm), then it is believed that there is abdominal obesity, which increases the risk of cardiovascular disease.

Consequences of

In a person suffering from obesity, the regulation of energy balance has been changed, there is an intermittent exchange disorder with increased formation of adipose tissue from fats and carbohydrates coming from food, there are difficulties with mobilizing fat from the cells.

With excessive food intake, lipogenesis is higher than lipolysis, so triglycerides are deposited in fat cells( lipocytes).The number of these cells in an adult does not change( progenitor cells divide only during embryonic development and puberty), triglycerides increase the size of the lipocytes threefold.

But if the body continues to receive fat, then the precursor cells begin to divide. With an extreme degree of obesity, the number of lipocytes can increase 10 times. If new cells are formed, then when losing weight they no longer disappear, but only decrease in size.

Any type of obesity leads to atherosclerosis, chronic cholecystitis, osteochondrosis, osteoarthrosis, atherosclerosis, hypertension, varicose veins and many other diseases.

Visceral adipose tissue disrupts the heart, which makes a person practically incapable of physical activity. Changes in the worse side and the lungs, so there are difficulties with breathing. The walls of the intestine are squeezed, which leads to disruption of the body and slagging the body.

Pancreas is very bad for obesity, which is why insulin production is disrupted and diabetes mellitus is developing. The liver accumulates fat in the cells, it ceases to cope with the protective function and toxins enter the bloodstream.

Visceral adipose tissue belongs to the endocrine organs, as it produces cortisol, interleukin-6( an inflammation hormone), leptin. Fat cells testosterone is converted into female sex hormones( estrogens), so in obese men, obesity goes by the female type and there are problems with potency.

Elevated cortisol levels result in chronic stress. Because of the inflammation hormone, even with small disturbances in the cells, a strong inflammatory reaction can develop. Because of the action of hormones synthesized visceral fat tissue, the activity of all cells worsens, which contributes to the deposition of harmful substances( slags, cholesterol, fats) in them.

Venous blood flowing from visceral adipose tissue through the portal system penetrates the liver. Because of this, many free fatty acids and adipokines penetrate into the gland. Free fatty acids lead to the formation of hepatic insulin resistance, and adipokines promote the activation of anti-inflammatory mediators.

Thus, obesity provokes:

• type II diabetes mellitus;
• hypertension;
• swelling;
• shortness of breath;
• violation of reproductive and sexual function;
• change of the cardiovascular system;
• impaired hepatic function;
• lethargy, fast fatigue;
• stress, depression;
• increased appetite.

The physician should take into account not only the severity of obesity but also the concomitant diseases

Treatment of

The treatment of visceral obesity is to compensate for the development of metabolic disorders and suggests a decrease in insulin resistance. The therapy is complex and includes measures designed to reduce the mass of abdominal-visceral fat. Patients are assigned hypocaloric diet and regular exercise.

If there are signs of obesity, then you need to seek advice from an endocrinologist. The therapy is carried out in two stages: weight loss( takes from 3 to 6 months) and its stabilization( lasts up to a year).In most cases, patients need psychological help to understand which problems are "stuck" and learn to avoid it.

Principles of nutrition for obesity

The diet is made individually, taking into account the patient's body weight, age, sex, eating habits, physical activity. You can eat fat only 25% of daily calories, with animal fat should not be more than 10% of the total amount of fat, and cholesterol to 300 mg per day.

Consumption of fast-digestible carbohydrates is limited. It is recommended to eat a lot of vegetables and fruits, because they contain dietary fiber. When compiling a menu, a person suffering from obesity should be guided by the lists of permitted and forbidden foods( DU No. 8 on Pevzner is recommended).

It is necessary to completely abandon fast food and trans fats. It is impossible to completely exclude fats, as this can cause lipolysis disorder. Weight reduction and blood counts should be monitored by a physician.

Physical activity

Physical activity is necessary in all forms and stages of obesity. The regime of aerobic loads is selected individually, because it depends on many factors( from clinical manifestations of obesity, concomitant pathologies, age, sex, physical fitness).

The primary task is not to harm the cardiovascular system. Exercises increase energy consumption, normalize metabolism, accelerate the breakdown of fats, improve the functions of all body systems, increase efficiency.

Daily aerobic loads of low or medium intensity are required.

For exercises in young and middle-aged patients without heart or vascular disease, endurance exercises are especially useful. It is recommended walking, running, rowing, swimming, sports games. Exercises for speed are difficult to implement and do not give the necessary energy costs.

The fractional load method is used, that is, several approaches must be taken during the day. The course of treatment is divided into two periods. During the first patient adapts to increasing physical exertion, and in the second, when shortness of breath and a strong heartbeat, you can increase the number of approaches( one session lasts from 45 minutes).

As studies show, with a loss of 10-15% of the total body weight, 30% of visceral fat is burned and the risk of cardiovascular pathology is significantly reduced.

Taking medication

Reducing fat, in most cases, leads to a decrease in hyperinsulinemia, restoration of metabolism, normalization of blood pressure, return of sensitivity to insulin. Unfortunately, not all insulin resistance and abdominal obesity go with weight loss, so medications are prescribed.

If for 2 months there is no result from therapy, the doctor can prescribe the following drugs:

• Orlistat .The active substance inhibits lipase, which leads to disruption in the cleavage and absorption of fats. Contraindicated in the syndrome of malabsorption, cholestasis. As a side effect, flatulence, steatorrhea, frequent defecation, stool incontinence, imperative urge to empty the bowels. The likelihood of unwanted effects increases with non-compliance with the diet. Treatment lasts from 3 months. Analogues Alli, Xenalten, Xelikan, Orlimax, etc.
• Metromormin ( Glucophage).It is indicated for type II diabetes mellitus. Reduces the absorption of glucose from the intestine, speeds up its utilization, increases sensitivity to insulin, and in addition reduces the level of triglycerides and lipoproteins in the blood.
• Analogues of the gluconoid-like peptide .The peptide is produced by the cells of the ileum and large intestine in response to food intake. Stimulate its secretion of triglycerides and carbohydrates contained in the chyme. In the stomach, it suppresses the secretion of hydrochloric acid and weakens the motor, and in the pancreas stimulates the production of insulin and inhibits the synthesis of glucagon and somatostatin. Thus, the drug suppresses the feeling of hunger.

Therapy is considered ineffective if 10% of the weight of

has not been consumed. If weight reduction is necessary in a short period of time for medical reasons, and if complex therapy does not lead to results, surgical intervention may be prescribed. Obesity is not only a cosmetic defect, it is also an inability to lead an active lifestyle, difficulties with establishing social contacts, health problems.

To get rid of extra pounds it takes a lot of time, will power and work on yourself. Do not expect quick results and set a goal to instantly lose weight, so the risk of causing irreparable harm to health increases and it is likely that the motivation will decrease. We need to start small and get used to a new way of life.