Abdominal obesity
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Abdominal obesity is a type of obesity characterized by excessive accumulation of adipose tissue within the abdominal cavity and the waist area. In medicine, it is also referred to as central, visceral, or android obesity. Of particular clinical significance is visceral fat, i.e., the adipose tissue surrounding internal organs, as it exhibits high metabolic and hormonal activity. Abdominal obesity is considered one of the most important risk factors for cardiovascular diseases, type 2 diabetes, arterial hypertension, and metabolic syndrome. This problem can occur both in individuals with a high BMI and in patients with normal body weight who exhibit an unfavorable distribution of adipose tissue.
Abdominal obesity - what it is
Abdominal obesity means excessive deposition of adipose tissue mainly in the abdominal area. In contrast to gynoid obesity, in which fat accumulates primarily on the hips and thighs, the abdominal type is associated with the accumulation of fat around internal organs. Visceral adipose tissue does not solely function as energy storage. It is an active endocrine organ secreting numerous biologically active substances, including pro-inflammatory cytokines, leptin, resistin, and adipokines affecting the metabolism of the entire body.
Abdominal obesity is more common in men, however, after menopause, its prevalence also significantly increases in women. Both genetic predisposition, as well as lifestyle, physical activity level, diet, and hormonal balance, are important.
In clinical practice, abdominal obesity is one of the main components of metabolic syndrome. Even a small increase in the amount of visceral fat can lead to the development of insulin resistance, chronic inflammation, and lipid disorders.
Abdominal obesity - how to recognize it
The diagnosis of abdominal obesity is primarily based on the measurement of waist circumference and the assessment of fat tissue distribution. The BMI index itself does not always allow the problem to be detected, as it does not take into account body proportions or the location of fat tissue.
The values indicating abdominal obesity are most commonly recognized as:
- waist circumference ≥ 80 cm in women,
- waist circumference ≥ 94 cm in men according to European criteria,
- higher metabolic risk at values ≥ 88 cm in women and ≥ 102 cm in men.
The WHR (waist-to-hip ratio) index, i.e. the ratio of waist circumference to hip circumference, is also used supportively. A result:
- above 0.85 in women,
- above 0.90 in men
indicates an unfavorable type of fat tissue distribution.
Characteristic features of abdominal obesity include:
- increase in waist circumference,
- a protruding, tense abdomen,
- increased amount of fat tissue in the upper part of the body,
- relatively slim limbs with a large abdominal circumference,
- difficulty in reducing fat tissue despite dieting.
In specialized diagnostics, imaging studies are also used, such as computed tomography (CT), magnetic resonance imaging (MRI), or body composition analysis using the DXA method and electrical bioimpedance.
Abdominal obesity - causes
The development of abdominal obesity is multifactorial. A positive energy balance plays a key role, however, the distribution of adipose tissue also depends on hormonal, genetic, and metabolic factors.
The most important causes include:
Excessive calorie intake
Regular consumption of highly processed food rich in simple sugars and saturated fats promotes the deposition of visceral fat. Sweetened beverages, alcohol, and a diet with a high glycemic index are of particular negative significance.
Low physical activity
Lack of movement leads to a reduction in energy expenditure and disorders of glucose and lipid metabolism. Visceral adipose tissue shows high sensitivity to the lack of aerobic activity.
Hormonal disorders
Abdominal obesity can develop in the course of:
- insulin resistance,
- hyperinsulinemia,
- polycystic ovary syndrome (PCOS),
- hypothyroidism,
- Cushing's syndrome,
- menopause and andropause.
A significant role is also played by a chronic increase in the level of cortisol, i.e., the stress hormone, which promotes fat deposition precisely in the abdominal area.
Genetic factors
Familial predispositions affect both the rate of adipose tissue storage and its distribution. Some people have a greater tendency to accumulate visceral fat despite moderate body weight.
Sleep deficiency and chronic stress
Circadian rhythm disorders affect the secretion of leptin and ghrelin, i.e., hormones regulating appetite. Sleep deficiency increases appetite and promotes the development of insulin resistance.
Abdominal obesity and health - consequences and risks
Abdominal obesity is considered one of the most metabolically dangerous types of obesity. Visceral fat exhibits high inflammatory activity, which is why its excess affects the functioning of almost the entire body.
The most important health consequences include:
- type 2 diabetes,
- arterial hypertension,
- atherosclerosis,
- coronary artery disease,
- heart attack,
- stroke,
- fatty liver,
- sleep apnea,
- hormonal disorders,
- increased risk of certain cancers.
Chronic inflammation caused by visceral fat leads to damage to the vascular endothelium, lipid metabolism disorders, and reduced tissue sensitivity to insulin. In practice, this means accelerating the metabolic aging processes of the body.
Abdominal obesity also affects body shape and skin quality. With a significant increase in body weight, the following may appear:
- sagging abdominal skin,
- stretch marks,
- cellulite,
- swelling,
- deterioration of tissue tone.
After intensive weight loss or weight-reducing pharmacotherapy, excess skin and loss of tissue firmness are often observed. In such cases, treatments improving skin tension are used, including microneedling radiofrequency technologies, HIFU, radiofrequency waves, collagen-stimulating treatments, or body contouring procedures available in modern aesthetic medicine.
Abdominal obesity vs general obesity - the difference
General obesity means an excessive amount of body fat throughout the body and is most commonly assessed based on the BMI index. Abdominal obesity, on the other hand, refers to a specific distribution of fat, mainly within the abdominal cavity.
A person with a normal BMI can simultaneously present a significant amount of visceral fat and high metabolic risk. This phenomenon is sometimes referred to as “metabolic obesity with normal body weight”.
The most important differences between these types of obesity are presented in the table:
Feature | Abdominal obesity | General obesity |
|---|---|---|
Fat location | Mainly abdomen and internal organs | Whole body |
Metabolic risk | Very high | Dependent on fat distribution |
Main assessment parameter | Waist circumference, WHR | BMI |
Fat type | Visceral | Subcutaneous and visceral |
Hormonal influence | Very high | Variable |
Modern medicine is paying increasing attention not to body weight itself, but to the quality and location of adipose tissue. It is visceral fat that is one of the main risk markers for metabolic and cardiovascular diseases.
