Obesity: when the size is more important than the weight

Published: 04/13/2010 - Updated: 08/14/2019

In recent years, new theories and new parameters that help to combat obesity have developed. Thus, we observe important changes in diagnostic criteria. Dr. Ricardo Chiosso, Medical Director of Diquecito Sanatorium, clarifies certain aspects of this new movement he called "normal weight obese."

New parameter: location of body fat

Compared with the historical diagnostic criteria of obesity sustained on the basis of determining the Body Mass Index (BMI), an approach to the existing body fat in the body gained momentum in recent years, regardless of BMI. This position, which is considered as cases of risks to those in which the incidence of body fat is more than 25% and 32% in men and women respectively, was taken and applied by health professionals worldwide, which were highly positive.

However, research recently introduced a new criterion for the detection and measurement of obesity, despite making reference to the above parameters, presents a different reading, and for many, more accurate than its predecessors.

This new vision determines obesity from a viewpoint of "location" of body fat, regardless of their percentage occurrence in the body and the historical body mass index. This brings to light situations of risk not previously diagnosed, and extends the dangers of overweight persons who are below 30 BMI points but whose fat is hosted on high-risk sectors, more specifically in the abdominal area, determined by waist circumference.
Then appeared a new class of previously unknown people, which seem serious risks from the medical point of view: the "normal weight obese."

Associated Diseases

This new approach to obesity based on the location of body fat has allowed specialists in the area understand the reasons for the conditions that a lot of people face, who, despite being within the historical parameters of healthy weight, usually suffer from diseases linked to overweight.

In this regard, Dr Chiosso explains: "Speaking about location of fat rather than weight that shows the scale-but nevertheless to take this into account, is the more useful diagnostic criteria of obesity (and better value prognosis) we know, as it was found that the weight of the patient could be altered, for example, edema, for muscle mass and even tumors exist in these cases with no real risks associated with obesity. Neither the percentage of body fat by itself is a criterion of all right, since that fat can be housed in areas that are not the most dangerous to health, such as the hips and thighs. "

"High-mobility" fat

"There is a type of obesity that has greater risks than the other one, and this has a direct relationship to this location of the fat that is necessary to determine," adding: "We may find, even with the so-called 'normal weight obese `, which are those whose BMI is normal but whose location of fat is risky." 

Continuing the topic, the teacher recognizes that "professionals in the field, in fact, say that these people have even more urgency to address treatment of lower weight than those with a BMI greater than 30 but mainly hosted fat in hips and legs, "and explains:" This is because fat in the abdomen behaves more aggressively than the fat of the hip and leg, as it has high mobility. There is a fat deposit, static but is dynamic, restless metabolically, and circulates throughout the blood system causing narrowing and blockages in the same, and depletion on insulin from the pancreas. "

Waist

The most appropriate method to determine abdominal fat is CT scanning. However, simply measuring the circumference of the waist is sufficient to determine whether it is excessive or not.

Although originally considered "high risk" to any waist measurement exceeding 88 inches in the case of women and 102 centimeters in the case of men, these parameters were reduced to 80 inches in women and 94 in men (figures from which we can speak of some degree of risk).

Risks

People with excess abdominal fat mainly face three major risks: the chance of developing diabetes, a marked predisposition to heart attacks (or its predecessor: atherosclerosis) and high probability of hypertension.

Research has shown that a hypertensive patient who have central obesity showed a greater improvement by reducing body weight at a rate of 3 to 4 inches from the waist (about a point of BMI), which restricted intake of salt, for example.

The role of food

Upon detection of excessive abdominal fat diet is recommended soluble fat type, and adding plenty of fiber for the purpose of drag and evacuate the body fat. In this context, the fruit and vegetables should always be present.

In a second step, with a higher caloric value, "recommends the incorporation of whole grains to your daily diet with bran and gluten. They, you know, have a higher fat pulling power than refined flours. But beware that any excess in these good foods also turn into body fat!

The diet should be given generally low in fat and high in fiber. It must contain carbohydrates but normal proportion of complex traits, and slightly elevated protein to help prevent muscle loss and help weight loss.

Changing habits

It is highly recommended for those with excess body fat to do an hour of daily aerobic exercise, with a minimum time of half an hour. This practice becomes a "must" when the person approaches the age of menopause, precisely the stage of life in which abdominal obesity is widespread prevalence.

In this instance, the loss of abdominal fat is more difficult because of a sum of negative factors such as simultaneous decline in hormone levels, an increase in the amount of calories and reduced physical expenditure.

Physical activity is recommended to the patient, something that represents a smaller risk of abandonment. In this regard, they will have great impact affinity groups and personal preferences, and success will be determined precisely because of the continuity over time rather than the intensity of the selected activity.

How and where to measure abdominal fat?

At the time of abdominal fat measurement readings can fall into completely different depending on who is the operator responsible for it. It is therefore important to follow these guidelines:

  • Being the person standing, loosened the belt, there must be a midpoint between the crest of the hip and the last rib.
  • On the side of the body is the reference point and then mark a midpoint between the two extremes of reference.
  • On this point is running half a centimeter, preferably metal or inextensible material. Breathe in and out so that it has the abdomen in shape.
  • After the final exhalation, the measurement is made on the middle and always parallel to the floor.

Source: Prof. Dr. Ricardo Chiosso (MP 13766), Medical Director of Diquecito Sanatorium
Route E-55, Km-13 ½ – The Diquecito, La Calera (Cordoba, Argentina)

More details at: www.diquecito.com.ar

About the author
  • Miriam Reyes

    Miriam Reyes is a professional expert in nutrition and dietetics. She has more than 12 years of experience in caring for patients with overweight and eating problems. She studied at the Universidad del Valle de Atemajac (UNIVA), where she obtained a degree in nutrition. Linkedin profile.