It's time to talk about the unpleasant consequences of low mobility and excessive addiction to high-calorie foods. Over the years, the problem of obesity, as a rule, has been of greater concern to the fair half of humanity. What about men? Has “this cup” really passed them by? Unfortunately, no - obesity in men is far from uncommon these days.
What are the risk factors and signs of obesity? What stages and types of obesity in patients are known to science? In this article we will talk about this and much more.
Over the past quarter century, the number of women and men suffering from excess weight has doubled. Scientists are sounding the alarm as the consequences of obesity are slowly destroying humanity.
Currently, about 70% of men are overweight, and about 30% of the male population of the planet is obese.
Doctors and scientists carefully study the risk factors for obesity and the causes of overweight in a person, starting with the origins of the process. The following are studied: the course of the mother’s pregnancy, her diet, the child’s weight at birth, the child’s nutrition, and so on.
Scientists put physical inactivity and nutritional habits first.
What is important for a man to know?
In order for a man to produce sex hormones, and therefore to realize sexual function and the ability to bear children, his body must receive a sufficient amount of fat, since it is from fat that the main male hormone, testosterone, is synthesized.
However, with excess intake of fat into the body and/or disruption of fat metabolism, adipose tissue accumulates, which, on the contrary, disrupts the production of male sex hormones, leading to sexual dysfunction and, in some cases, infertility. Look at your reflection in the mirror. Have you exceeded the permissible reserves of adipose tissue? As the great philosopher and physician Avicenna said, “in the treatment of every disease, the fight against excess weight should be considered the first step.”
What does a man with metabolic syndrome look like?
- His “beer belly” is growing (abdominal obesity occurs when fat accumulation is concentrated in the torso and abdomen). At the same time, fatty tissue grows not only under the skin layer, but also begins to surround and compress internal organs. In addition, the fat itself turns into a separate endocrine organ and begins to secrete substances that cause inflammation and the formation of blood clots.
- A man's waist circumference exceeds 102 cm.
- Red spots periodically appear on the neck and chest due to vasospasm and increased blood pressure: “upper” pressure readings exceed 130 mmHg. Art., “lower” indicators - 85 mm Hg. Art.
There is also laboratory diagnostics for obesity in men: for this, a doctor (endocrinologist, urologist, cardiologist) can prescribe the necessary tests.
Does the coordinated functioning of the reproductive system depend on weight?
Of course, a man’s weight depends on his height, type of activity (mainly mental or physical labor), eating habits, muscle tissue development, and general (somatic) health. At the same time, it almost does not depend on nationality or territory of residence. Throughout his life, a man’s weight should be optimal, that is, within the body mass index (BMI) range of 18.5 to 24.9 kg m2.
BMI is calculated using the following formula:
BMI = weight (kg) : height2 (m)
So, for example, if your weight is 120 kg and your height is 172 cm (1.72 m),
Therefore, your BMI = 120: (1.72 x 1.72) = = 40.6 kg/m2.
Now you! Check if you are a normal weight by calculating your BMI.
Men and women differ in the distribution and deposition of adipose tissue in the body. In women, most of the adipose tissue is deposited in peripheral fat depots such as the breasts, thighs and buttocks. In men, unlike women, the deposition of adipose tissue is central; the greatest accumulation occurs in the abdominal area, which is the highest risk factor for the development of various diseases. Therefore, in men, even with a normal BMI, measuring the waist circumference (WC), which is carried out at the level of the navel, helps determine the presence of obesity. If WC exceeds 94 cm, we can talk about obesity.
If your BMI or WC is above the healthy range, it may soon lead to problems with your reproductive system. The presence of obesity leads to impaired sexual function in men, and is accompanied by a high incidence of decreased libido, erectile dysfunction (impotence), infertility, and impaired sexual development in boys. The prevalence of sexual dysfunction in obese men is quite high - more than 50%.
The described changes occur due to disruption of the production and metabolism of one of the main male sex hormones - testosterone. The more adipose tissue, the lower the amount of testosterone and its activity. It is in adipose tissue that testosterone is converted into female sex hormones - estrogens, which is why a gradual feminization of a man occurs with a parallel decrease in sexual function. In addition to disrupting the synthesis and production of testosterone, adipose tissue produces many factors that have a negative impact on the central mechanisms regulating the functions of the male genital organs. In addition, in most overweight men, carbohydrate and fat metabolism is disrupted, and hypertension, coronary artery disease and diabetes mellitus develop. These conditions also suppress sexual function.
How can obesity in men be treated?
This is of interest to every patient concerned about excess weight, and there may be several recommendations here. First of all, of course, it is highly advisable to follow a diet. This is the main and most stringent recommendation. But it is quite difficult to comply with it. However, it is quite possible to lose some excess weight and achieve improved mood and well-being.
But if you were temporarily on a strict diet with a lot of restrictions, the body will one way or another demand to replenish lost reserves, and, “going off” the diet, there is a risk of gaining back the lost kilograms, and sometimes, on the contrary, increasing the initial body weight. Even without overeating, you risk losing the battle with a deceived body. Therefore, all kinds of diets are extremely undesirable - it is a lot of stress for the body. The best solution would be to radically change your eating habits.
In addition to changing your diet, you must not forget about physical activity. Physical education and sports are optimal. This way, along with reducing your calorie intake, you can increase your energy expenditure for exercise. Walking is very useful; such exercises do not require any special training. Half an hour or a little more of intense walking a day, combined with a healthy diet, will help you lose weight. Additional physical activity will not be superfluous.
If you change your diet, exercise until you get tired, and the results still leave much to be desired, testosterone deficiency in the body is possible. And testosterone is an anabolic hormone that is also responsible for burning fat.
The lack of testosterone in the male body can be judged by some indirect signs: - sexual dysfunction (decreased libido, premature ejaculation, infertility and erectile dysfunction); - somatic disorders (problems with urination, such as frequent and nighttime urges, engorgement of the mammary glands (gynecomastia), pain in the joints and lumbar region, general fatigue and increase in adipose tissue); - psycho-emotional problems (depression, drowsiness, fatigue, irritability and nervousness, which can lead to problems falling asleep, insomnia, memory impairment and low reactions to stimuli).
Laboratory diagnosis of testosterone deficiency is the final stage in making a diagnosis. You can find out your total testosterone level by taking a blood test for hormones. The doctor will make a diagnosis of “hypogonadism” or testosterone deficiency if the symptoms described above are present and the level of total testosterone in the blood does not exceed 12 nmol/l.
The role of genetics in weight gain
Often, if a man suffers from a problem such as excess body weight, he begins to rely on genetics. Indeed, it has been proven that in almost 100% of obese men, someone in the family is also overweight or obese (mom, dad, brother, sister, children).
There are several gene mutations (changes) that can cause obesity. These mutations most often also contribute to the development of type 2 diabetes mellitus and other endocrine diseases. At the same time, scientists have proven that most often lifestyle influences the implementation of gene mutation. That is, even in the presence of a genetically determined factor of obesity, it is quite possible to maintain a normal weight throughout life. An example of this is an experiment in which, after the birth of a pair of identical twins from an obese mother, the children were separated. The first child was left with his biological mother and father (both obese), and the second child was placed in foster care, where healthy eating and physical activity were priorities. After 20 years, the first young man was overweight, the second was healthy and athletic. This experiment clearly shows: not everything depends on genetics.
Is metabolic syndrome common?
The seriousness of the disease is also due to the fact that over the past 20 years it has increasingly become diagnosed in children and adolescents: as a rule, metabolic syndrome in young people is associated with a passion for carbohydrate nutrition. Among the young adult population, metabolic syndrome occurs more often in men than in women: in the “weaker sex” it usually appears after menopause. The prevalence of metabolic syndrome among the population over 30 years of age in industrialized countries ranges from 10 to 20%. As for Russia, the prevalence of obesity among our compatriots is 46%. In the United States, the situation is no less dangerous: a survey conducted by the American Diabetes Association indicates that the number of adolescents and young adults suffering from metabolic syndrome is estimated at more than 2 million.
Today, different organizations around the world have different criteria for diagnosing metabolic syndrome. Moreover, they all agree that the occurrence of MS is visceral obesity. Visceral (or internal) fat is commonly called fat deposits that accumulate not under the skin, but in the abdominal cavity, around vital organs, putting pressure on them and causing dangerous changes.
How can you change your eating habits?
In Russia, 10-20% of men are obese, but the real prevalence of obesity among men is higher, which is due to low rates of treatment. Moreover, the formation of eating behavior begins from the moment of intrauterine development of the child and during the first year of life. The diet of the expectant mother already shapes the future habits of the child.
To date, given the abundance of food, the growing well-being of the population, the habit of eating more than necessary and storing energy reserves under one’s own covers is irrelevant. In addition, the modern trend towards accelerating the pace of life and the desire to obtain the maximum amount of material wealth has contributed to the enormous development of fast food establishments. Consequently, there are more and more overweight people on the planet. If action is not taken today, millions of people will become victims of cardiovascular, musculoskeletal and other diseases tomorrow. Therefore, the rhythm of nutrition, the family’s diet and its food preferences should be based on the following 12 principles:
Eat a variety of foods, most of which are plant-based rather than animal-based. Bread, flour products, cereals, potatoes should be consumed several times a day.
Eat a variety of vegetables and fruits several times a day, preferably fresh and grown locally (at least 400 g per day).
To maintain body weight within the recommended range (body mass index 20-25), daily moderate physical activity is necessary.
Control the intake of fat from food (no more than 30% of daily calories) and replace animal fat with vegetable fat.
Replace fatty meats and meat products with legumes, grains, fish, poultry or lean meats.
Consume low-fat milk and dairy products (kefir, sour milk, yogurt and cheese) that are low in fat and salt.
Choose low-sugar foods and consume sugar in moderation by limiting sweets and sugary drinks.
Eat less salt. The total amount of salt in food should not exceed one teaspoon - 5 g per day. You should use iodized salt.
If you drink alcoholic beverages, the total content of pure alcohol in them should not exceed 20 g per day.
Food preparation must ensure its safety. Steaming, microwaving, baking or boiling foods will help reduce the amount of fat, oil, salt and sugar used in the cooking process.
Can your andrologist help not only in the fight for men's health, but also in the process of weight loss?
For professional weight loss, men are mostly accustomed to turning to an endocrinologist, psychotherapist or cosmetic surgeon. But remember: weight optimization is a long-term process, and you need to maintain the results achieved throughout your life. You cannot prescribe a short course of treatment and achieve what you want. Therefore, it is the andrologist who is obliged to help a man throughout his life. Who, if not a specialist in men's health, knows all the secrets of the different periods of a man's life and their connection with metabolic processes in the body, especially since the relationship between dysfunction of the gonads and the development of obesity has been known for a long time.
It is known that eunuchs, as a rule, are obese, and their obesity develops immediately after castration. But obesity also occurs in men initially with a normal reproductive system, and as obesity progresses, testosterone levels in the body decrease.
Thus, testosterone deficiency in obese men is an important factor in both the development and progression of obesity, since testosterone deficiency significantly reduces physical activity, the role of which in weight loss is very large.
You can suspect testosterone deficiency by answering 10 questions:
- Do you notice a decrease in sexual desire (decreased pleasure from sex, lack of desire for sexual contact)?
- Have you become less energetic?
- Have you noticed a decrease in physical strength and/or endurance?
- Has your height decreased?
- Do you notice a decrease in “pleasure in life” (the feeling that the peak of life has been passed)?
- Have you become sad and/or irritable?
- Are you experiencing a decrease in the quality of your erections?
- Have you noticed a recent decline in your ability to participate in sports?
- Do you fall asleep after lunch?
- Has your performance decreased?
If you answer “yes” to question 1.7 or any three other questions, it is highly likely that you have testosterone deficiency and a medical examination by an andrologist is necessary. Since testosterone deficiency in obese men is a significant factor maintaining obesity, therapy aimed at normalizing testosterone levels in the blood plasma should play an important role in the complex treatment of obesity. An important issue is the choice of drug and dose selection, which must be decided individually for each patient.
Why does a man with metabolic syndrome need a urologist?
The fact is that the “components” of metabolic syndrome (obesity, high blood pressure, type 2 diabetes, insulin resistance) often “lead” to erection problems. That is why a urologist is able to assess a man’s overall health by just asking him one question: “What is the quality of your sex life?”
There are numerous studies worldwide that confirm this connection. For example, in a study by Italian urologists it was proven that the prevalence of erection problems (erectile dysfunction) among patients with metabolic syndrome was 26.7%. Turkish scientists examined 393 men in the urology department and found metabolic syndrome in 40% of them, and erectile dysfunction in 69%. The results of Finnish studies also demonstrate a high prevalence of erectile dysfunction among patients with metabolic syndrome (76.2%). Moreover, problems with erection begin to occur in men with metabolic syndrome quite early - at the age of about 40 years.
