The 31-year-old pony has been suffering from type 2 diabetes for more than a year. His blood sugar control is very good and there are no complications. He came to see a doctor that day and gave me a very beautiful blood sugar monitoring table.
He asked me: [Is that all right? ]
I shook my head and said, “No, you have to lose weight.”
Do you think I am fat? ] He paused and looked puzzled: [I’m not overweight, why should I lose weight? ]
[Weight is good, but waist circumference exceeds the standard, which is also obesity! ] I laughed, [Fat or not, it’s not just weight that has the final say! ]
If you still think that weight is the only criterion and weight loss is weight loss, then you and the pony have misunderstood obesity.
There is a kind of obesity, not only weight has the final say.
In the impression of many people, the person who is full of fat is obese. In medical terms, this is called systemic obesity, and more vividly, it is called uniform obesity, that is, fat accumulates symmetrically in limbs and chest and abdomen.
Usually we use body mass index (BMI, abbreviated as BMI) to determine the degree of systemic obesity. Body mass index = weight (kg)/height m2. When the height is certain, the heavier the weight, the greater the body mass index.
For example, an adult has a height of 1.60 m, a weight of 70 kg, a body mass index = 70/1.62 = 27.34, and a unit of kg/m2.
In our country, the body mass index is normal in 18.5 ~ 23.9, emaciation is less than 18.5, overweight is in 24 ~ 27.9, and obesity is equal to or greater than 28.
The pony mentioned earlier has a normal body mass index. Why do I still think he is obese? Because there is also a kind of obesity called abdominal obesity, ponies belong to this.
The fat of abdominal obesity is mainly deposited under the skin of the abdomen, as well as around and inside the liver, pancreas, gastrointestinal tract and other organs in the stomach. Therefore, abdominal obesity is also vividly called central obesity and visceral obesity.
The typical feature is a large belly, also commonly known as beer belly and general belly. Abdominal obesity is mostly manifested as apple-shaped figure, waist circumference is larger than hip circumference, and limbs are thinner. Usually, when body mass index ≥ 25 kg/m2, abdominal obesity may occur.
However, 14% of the people with normal body mass index will show abdominal obesity. Therefore, doctors do not always have the final say in the diagnosis of obesity.
How to determine whether it is abdominal obesity?
Mainly by measuring waist circumference to determine whether it is abdominal obesity. So, how to accurately measure waist circumference?
There are many methods, and a better one is recommended:
1. The measured person’s body is upright, his arms are naturally drooping, he breathes smoothly, he does not tuck in his abdomen or hold his breath, his feet are separated by about 30 ~ 40 cm, he is as wide as his shoulders, his abdomen is relaxed, and his abdominal skin is exposed.
2. The measuring person can use an inelastic tape measure with the lower edge of the scale about 1 cm above the navel and horizontally encircle it for 1 week.
3. When measuring, the tape measure should be close to the skin, but it should also avoid being pressed too tightly to cause the tape measure to fall into the skin. The surveyor’s eyes are on the same horizontal plane as the tape measure scale, and record the reading.
The latest standard for defining abdominal obesity in China is: waist circumference ≥ 90 cm for men and ≥ 85 cm for women.
Abdominal obesity is more lethal.
Compared with systemic obesity, abdominal obesity is more destructive to health. Abdominal obesity is the brother of many diseases. A considerable number of patients with hypertension, hyperlipidemia, hyperuricemia and fatty liver will also be complicated with abdominal obesity.
1. Fatty liver
Excessive visceral fat can easily cause fatty liver, aggravate insulin insensitivity and lead to further blood sugar abnormalities. It is not easy to control blood sugar.
2. Insulin resistance and diabetes
Obesity itself will confront the insulin secreted in the body, making the body insensitive to insulin and unable to play a normal hypoglycemic role, thus causing type 2 diabetes. The risk of diabetes in systemic obesity is 3.7 times that of normal population, while the risk of diabetes in abdominal obesity is 10.3 times that of normal population.
3. Causing hyperlipidemia
Abdominal obesity is extremely easy to cause endocrine hormone secretion abnormalities, leading to visceral fat is easier to decompose, into the blood fat content is also increased, forming hyperlipidemia. Visceral fat is continuously generated and decomposed, which has become a nightmare for hyperlipidemia patients. These metabolic disorders affect each other, cause and effect each other, and eventually form a vicious circle.
4. Atherosclerosis
Glucose and lipid metabolism disorders will accelerate the formation of atherosclerosis. Arterial blood vessels are no longer elastic and unimpeded. Cardiovascular and cerebrovascular diseases such as hypertension, coronary heart disease and cerebral infarction are also quietly coming.
5. Affect heart function
Not only that, abdominal obesity also has an impact on the structure and function of the heart. The cardiac cavity of abdominal obesity is enlarged and the diastolic function of the heart is reduced more obviously than that of overweight.
6. Raise blood uric acid
In addition, the increase of blood uric acid is also closely related to the increase of visceral fat, which is easy to induce gout.
Shut up and keep your legs open is a truth that will never change.
Some people may not have the disease yet, but they have also seen abdominal obesity, which cannot be taken lightly at this time. It is necessary to actively prevent and treat the occurrence of abdominal obesity. Even if the body mass index is normal, but the waist circumference exceeds the standard, it is also necessary to actively intervene. Quickly shut up, take your legs and lose weight and waist!
Of course, weight loss and waist thinning should not be too fast. It is generally recommended to lose 7% ~ 10% of weight within one year, and waist circumference should reach the normal range, i.e. Male < 90 cm and female < 85 cm.
Under the guidance of a doctor, according to the height, weight to determine the diet intake plan, and then aerobic exercise, such as walking fast for more than 30 minutes a day, at least 5 days a week. If it really can’t be reduced, you can also seek help from a doctor, use some drugs and even carry out surgical treatment.