Apple body type: exercises for weight loss, how to dress

Types of obesity

There are 3 types of obesity: abdominal (fat deposition in the abdomen and upper torso), gynoid (fat deposition in the buttocks and thighs) and mixed.

To understand what type of obesity you have, you need to determine your waist and hip circumferences and calculate their ratio. Waist circumference (WC) is measured below the lower edge of the ribs above the navel. The circumference of the hips is in their widest area at the level of the buttocks. The OT indicator of 94 cm in men and 80 cm in women is characteristic of the abdominal type of obesity (apple type) and is synonymous with a high risk for your health.

A WC/TB ratio exceeding 1.0 in men and 0.85 in women indicates an abdominal type of obesity.

Excess body weight is not only a cosmetic defect. Obesity creates many problems: with every extra kilogram, a piece of health is lost.

It should be remembered that obesity in general and the abdominal distribution of adipose tissue in particular are independent risk factors for the development of many diseases. Moreover, the abdominal type of distribution of adipose tissue, even with a slight increase in body weight, already poses a threat to health. Visceral adipose tissue has a different sensitivity to hormonal influences that regulate changes in lipid storage and metabolism. Visceral fat deposition correlates with metabolic abnormalities in the body - insulin resistance, hyperinsulinemia, IGT, hypertriglyceridemia, increased LDL cholesterol fractions and a decrease in HDL cholesterol, while total blood cholesterol may remain relatively low.

Possible complications of obesity affect almost all human internal organs and body systems - cardiovascular, respiratory, reproductive, etc., metabolic processes are disrupted.

• Cardiovascular : arterial hypertension - high blood pressure for a long time;
• heart failure - the inability of the heart to fully perform its function;
• stroke - brain damage as a result of acute cerebrovascular accident;
• myocardial infarction - death of a section of the heart muscle; Varicose veins.

Clinical studies have confirmed that body weight is an important prognostic criterion for increased mortality in young and middle age, both among men and among women.

The most serious diseases that develop in connection with obesity are arterial hypertension, diabetes mellitus and atherosclerosis. They can significantly reduce your quality of life, leading to disability and premature death.

In obese people, high blood pressure is 5 times more common than in people of normal body weight. And the assertion that weight loss in obese people is the most effective form of treatment for hypertension is completely justified. Your body can only cope with a temporary increase in blood pressure levels. Constant high blood pressure leads to dysfunction of the heart, kidneys, and brain. Losing weight, even 5 kilograms, improves blood pressure!

Obesity is often accompanied by the development of metabolic syndrome and diabetes. Metabolic syndrome is a complex of interrelated disorders of carbohydrate and fat metabolism, as well as mechanisms of regulation of blood pressure (BP) and endothelial function, the development of which is based on a decrease in tissue sensitivity to insulin - insulin resistance. Of course, not every obese person gets diabetes. For its occurrence, hereditary predisposition, age, sedentary lifestyle, and diet are of great importance. But obesity, its duration and severity are of decisive importance in the development of diabetes mellitus. Insulin resistance is directly related to abdominal obesity and is the cause of hyperinsulinemia and type 2 diabetes mellitus. Among patients suffering from non-insulin-dependent diabetes mellitus, 80% are overweight or obese. If you are obese or overweight, you need to regularly check your blood glucose levels.

You are obese. Increasingly, you are bothered by a headache, a feeling of heaviness in the chest, your legs swell in the evening, and shortness of breath appears when climbing stairs. These symptoms indicate disturbances in the functioning of the cardiovascular system. Or it could be like this: against the background of good health, a myocardial infarction or stroke suddenly develops. The main cause of all adversity is atherosclerosis. Atherosclerosis is a systemic disease that affects the arteries, or blood vessels. The walls of blood vessels become denser due to the deposition of cholesterol in them if it is found in excess in the blood. Atherosclerotic plaques form, which gradually increase and multiply, thereby narrowing the lumen of the arteries, impeding blood flow. As blood flow slows down, there is a risk of blood clots forming. Blood clots further disrupt normal blood circulation. Thus, less and less oxygen and nutrients reach the organs and tissues, and all the cells of your body. At this stage, atherosclerosis, which until now has been secretive and asymptomatic, makes itself known. The main culprit in the development of atherosclerosis is cholesterol. The same cholesterol that is an essential component of the outer membranes of all cells in our body. The same cholesterol, without which the formation of hormones is impossible. But everything is good in moderation, and even more so cholesterol, which we consume directly from food of animal origin and especially from fats. When the measure is violated, the development of atherosclerosis accelerates.

Excess body weight and obesity are significant risk factors for the development of gastroesophageal reflux disease, erosive esophagitis, manifested by despotic disorders (belching of eaten food and air, bitterness in the mouth, nausea, night cough, hoarseness, reflux-associated bronchial asthma). The target organ for obesity is the liver, non-alcoholic fatty liver disease (NAFLD) is formed, NAFLD is associated with obesity, and inflammation: insulin resistance leading to oxidative stress, endothelial dysfunction, chronic inflammation; obesity leads to an increase in the size of the liver, mainly its left lobe, disruption of biochemical liver parameters, changes in the structure of the organ (steatosis, fibrosis, cirrhosis).

Currently, the problem of pelvic floor dysfunction has acquired particular relevance and social significance: every third woman suffers from prolapse and prolapse of the pelvic organs, urinary and fecal incontinence, and, consequently, problems in sexual life. Predictors of the development of pelvic dysfunction include pregnancy, childbirth with a long period of expulsion and a large fetus), birth trauma, damage to the pelvic nerves and muscles, and surgical interventions on the pelvic floor. However, the main provoking factors are chronic constipation, some somatic diseases and mainly obesity. An increase in body mass index by 5 units increases the risk of developing urinary incontinence by 60-100%, and a decrease in body weight by 5-8% leads to a reduction in the frequency of episodes of urinary incontinence of various origins by 50-70%.

Compared with the general population, individuals with extreme obesity have an increased incidence of anxiety, depression, and sleep disturbances. 50% of people with a body mass index over 40 have at least one mental disorder. The prevalence of depression in the population is 17%, and the prevalence of obesity in streets is 29-56%.

The risk of carcinogenesis in postmenopausal women is 20% greater in individuals with obesity than in those without it; in addition, obesity is associated with a large tumor size; the presence of obesity worsens the prognosis of the disease.

According to modern opinion, adipose tissue is an independent active endocrine organ that secretes a number of hormones and enzymes, inflammatory cytokines. One of the important features of adipose tissue is the presence in it of the aromatase enzyme, which converts testosterone into estradiol, as well as the presence of receptors for sex steroid hormones (estrogen, testosterone, progesterone). Obesity is accompanied by suppression of ovarian steroidogenesis and decreased production of estradiol by granulosa cells. In this case, the development of follicles stops, the level of sex steroid binding globulin decreases, the secretion of gonadotropins is disrupted, and the level of sex hormones decreases. In women, the main manifestations are: irregular menstrual cycle, hypomenstrual syndrome, secondary amenorrhea, acyclic bleeding against the background of hyperplastic processes in the endometrium, high incidence of infertility. According to research data, every 3rd woman who seeks medical help with the problem of MC disorders and infertility is overweight, and every 5th is obese. Abdominal adipose tissue, neurohormonal disorders accompanying abdominal obesity, and increased activity of the sympathetic nervous system play an important role in the development and progression of insulin resistance and associated metabolic disorders, with subsequent excessive secretion of insulin into the blood, which leads to hyperinsulinemia. Insulin resistance lies in the development of many diseases of the reproductive system, such as polycystic ovary syndrome (PCOS) and infertility. Obesity and insulin resistance are closely associated with the development of systemic oxidative stress, which has a multifaceted negative impact on the reproductive system, including the development of mitochondrial dysfunction of the egg and follicular oxidative stress, regardless of whether a woman has PCOS, which increases the risk of miscarriage. There is a direct relationship between an increase in body weight and the severity of ovarian disorders, accompanied by anovulation, inferiority of the luteal phase and a decreasing frequency of pregnancies. With a BMI of more than 29 kg/cm², each kilogram gained reduces the possibility of spontaneous pregnancy by 4%.

Vitamin D

Adipose tissue plays an important role in the regulation of phosphorus-calcium metabolism (the initial stages of vitamin D formation) and the metabolism of sex steroids (aromatase in fat cells promotes the conversion of adrenal androgens into estrogens).

When assessing vitamin D deficiency in various ethnic and age groups, a relationship was identified between obesity and vitamin D deficiency. Obesity is one of the factors for vitamin D deficiency and in the development of secondary hyperparathyroidism (SHPT), a more pronounced deficiency is experienced by people suffering from morbid obesity. SHPT in obese individuals in the absence of CKD or other somatic diseases may be considered a consequence of long-term vitamin D deficiency and hypocalcemia.

Vitamin D is present in a very limited amount of food, and its synthesis in the body is possible only when the skin is exposed to ultraviolet sunlight. Vitamin D promotes the absorption of calcium in the intestine and maintains adequate levels of calcium and phosphate in the blood to promote bone mineralization and prevent hypocalcemic seizures. It plays a major role in the prevention of rickets in children and osteomalacia in adults, and is necessary for bone growth and the process of bone remodeling. The function of vitamin D also affects neuromuscular conduction, immunity, and inflammation. Vitamin D is an important part of homeostasis: it reduces the risk of developing autoimmune pathologies and reduces the risk of infections. An important aspect is the interaction of the vitamin with the renin-angiotensin system - leveling molecular and clinical markers in diabetic nephropathy, reducing proteinuria, high blood pressure, inflammation and fibrosis. Vitamin D deficiency causes the development of myopathy, which is manifested by muscle weakness, difficulty walking, and many cases of falls and fractures in older people; It is also a predictor of cardiovascular accidents, dyslipidemia, and arterial hypertension. It plays an important role in reproductive health: with a deficiency, polycystic ovary syndrome is observed, the qualitative and quantitative characteristics of sperm and testosterone levels decrease. During pregnancy, vitamin D deficiency is associated with adverse outcomes: risk of preeclampia, infections, premature birth, cesarean section, gestational diabetes, and development of rickets in the child.

Obesity - increased risk of cancer

According to research, obese patients have a significantly higher risk of developing cancer. Previously, this was not given importance, but today it is reliably known that there is a relationship between excess weight and cancer. The main mechanism is a metabolic disorder in the body of obese patients. This serves as a predisposing factor in cell damage and the appearance of mutations. But this is not the only mechanism for the development of cancer tumors.

In patients with excess adipose tissue, estrogen levels increase, therefore the risk of hormone-dependent tumors of the breast and endometrium increases.

Another factor is an increase in the synthesis of insulin and the growth factor IGF-1, which contribute to the development of certain types of tumors. Adipocytes are capable of secreting other biologically active substances that stimulate the division of abnormal cells and provoke the rapid growth of tumors.

The abdominal type of obesity is accompanied by the accumulation of fat in the omentum and compression of the abdominal organs. Such patients are more likely than people without excess body weight to develop cancer of the intestines, stomach, kidneys, esophagus, and gall bladder.

Obesity also increases the risk of prostate and thyroid cancer.

The risk of endometrial cancer increases significantly in obese women during menopause. Adipose tissue serves as a source of excess estrogen in the body, which leads to hyperplastic changes in the endometrium. Due to hormonal and metabolic imbalances, the balance between division processes and natural cell death is lost.

Additional factors that increase the risk of developing uterine cancer in obese women are diabetes and hypertension. Women of normal weight who suffer from these diseases do not have an increased risk of malignancy.

The development of stomach cancer in obese patients is primarily promoted by poor nutrition. Excess fatty foods and other unhealthy foods provoke chronic inflammation, increased acidity, and reflux, which contributes to the transformation of normal cells into cancer cells.

For overweight people who have already been diagnosed with cancer, the prognosis is more guarded than for patients with similar tumors, but without extra pounds. During the treatment of cancer, excess adipose tissue can lead to various complications, and chronic diseases accompanying obesity significantly reduce the tolerability of anticancer therapy.

To prevent cancer, weight should be lost gradually. This will get rid of excess fat tissue and prevent the development of the body's stress response that occurs during rapid weight loss.

Hormones responsible for weight change

Hormones such as epinephrine, norepinephrine, glucagon, ACTH, melanocyte-stimulating hormone, growth hormone and vasopressin accelerate the release of free fatty acids from adipose tissue and increase their concentration in the blood plasma, increasing the rate of triglyceride lipolysis.

An increase in body weight may be due to a violation of the synthesis or production of biologically active substrates involved in the regulation of eating behavior. The most important monoamines and peptides that provide a balance between the feeling of hunger and satiety: orexigenic effects - norepinephrine (α2 receptors), neuropeptide-Y, β-endorphin, somatoliberin, galanin, ghrelin, somatostaitin; anorexigenic effects: norepinephrine (α1-, β-2 receptors), serotonin, cholecystokinin, melanocyte-stimulating hormone, corticoliberin, leptin, enterostatin, glucose, thyrotropin-releasing hormone, vasopressin, bombensin)

Standard laboratory and instrumental studies for obesity include a set of definitions:

• Lipid spectrum of blood,
• fasting blood glucose, OGTT if necessary,
• ALT, AST, GGTP, ALP, uric acid, creatinine,
• Blood pressure measurements,
• ECG,
• Ultrasound OBP,
• In all patients, hypercorism should be excluded by any of the following methods: excretion of 24-hour urinary cortisol, overnight suppressive test with 1 g of dexomethasone (small desamethasone test), assessment of the level of cortisol in saliva,
• Assessment of thyroid function TSH,
• Determination of the level of total, ionized calcium, 25(OH)D and PTH to diagnose vitamin D deficiency and exclude SHPT.

Nutrition for obesity

Fasting for obesity is contraindicated!

The minimum daily calorie intake should be at least 1500 kcal for men, 1200 kcal for women. The balance of main macronutrients is distributed as follows: fat intake 25-30% (saturated fat less than 10%), protein 15%, carbohydrates 50-60%,

The daily caloric intake should be distributed over 3 main and 2 additional meals (research has proven that with any diet, eating twice a day during the day leads to significantly greater weight gain than more frequent meals with the same caloric content of the daily diet).

Separate fluid intake from meals 30 minutes before or after meals.

The diet is compiled taking into account the patient’s body weight, age, gender, level of physical activity and food preferences. Limiting the need for fat to 25% of daily calories, animal fats to no more than 10% of the total amount of fat, cholesterol to 300 mg per day (The most cholesterol-rich food: offal (heart, tongue, liver, kidneys, offal and especially brains), salmon caviar and sturgeon fish, egg yolk, butter and ghee, crabs, shrimp, fatty meats, fish and cheeses, lard). You should also limit the consumption of quickly digestible carbohydrates and introduce large amounts of fiber into your diet. It should be noted that moderate consumption of vegetable fats in their natural form is even beneficial, as it helps the resorption of atherosclerotic plaques

Methods to combat obesity

The process of losing weight is a long-term work on your body. You need to say goodbye to extra pounds gradually, since sudden weight loss is fraught with adverse consequences. You should be patient and approach the problem comprehensively. This will keep you motivated and achieve results.

The initial stages of obesity can be successfully treated with diets, physical activity and cosmetic procedures. When a BMI is more than 30, it is often necessary to use medications that reduce appetite, as well as undergo surgical interventions aimed at reducing the volume of the stomach.

To treat obesity, the method of psychocorrection can be used. This is relevant for patients who have developed unhealthy eating habits due to changes in emotional status and mental disorders. These techniques allow you to get rid of excessive appetite and stop trying to improve your psychological state through frequent meals.

Basic principles of weight loss

• Sharp limitation of easily digestible carbohydrates
• Limit animal fat
• Limiting starchy foods
• Adequate (250-300 grams) consumption of protein foods
• Consumption of large quantities of vegetables and fruits (up to 1 kg in total)
• Limiting table salt
• Limiting spicy snacks, sauces, spices,
• Frequent eating

To achieve weight loss, try reducing your intake of the following foods by half: potatoes, bread and baked goods, pasta, sausages.

It is healthier to eat those foods that contain a lot of ballast substances: wholemeal bread, noodles and noodles made from gray flour, all tuberous (turnips, beets, carrots). But bread, noodles and noodles made from white flour, fruit and vegetable juices have little ballast substances, so they can contribute to weight gain.

Fruits, especially those rich in quickly digestible carbohydrates (grapes, bananas, dates), should, if possible, be excluded. It is healthier to give preference to low-calorie fruits and berries containing slowly digestible carbohydrates.

Diet and exercise for a slim silhouette

Women with an apple-shaped figure gain weight very quickly. In this case, not only high-calorie foods become a problem, but also dishes that cause bloating. To get flat abs, you will have to exclude yeast breads and pastries, carbonated drinks and industrial juices, sweet fruits, legumes, and white cabbage from the menu. An ideal menu should be based on fiber-rich foods: green vegetables, whole grain cereals. Low-fat fermented milk products that improve digestion are beneficial. Nutrition should be balanced, overeating is excluded.

Weighing yourself weekly will help you control your weight. If you gain 2-3 kilograms, you need to urgently take action by limiting your caloric intake.

If you have a tendency to edema, you need to give up pickles, canned food, and smoked foods. Proper drinking regimen will help avoid bloating. Instead of strong tea and coffee, it is better to drink clean water, herbal infusions, chamomile and green tea, and unsweetened homemade fruit drinks.

When choosing exercises, you need to concentrate on strengthening the muscles of the abdomen, arms, back, and back of the thighs. It is recommended to include in your daily complex:

• straight and reverse crunches on the floor, chair or fitball;
• plank pose on the elbows or outstretched arms;
• raising the legs and hips while lying down and sitting on a chair;
• alternately raising the legs up from the support on the knees.

Breathing exercises will help reduce abdominal volume and lose extra pounds. All exercises are performed after taking a deep breath and exhaling completely, while holding your breath. The complex takes no more than 15 minutes, but it must be done daily. Cardio exercises at least 3 times a week are also beneficial. Possible workouts in the gym, jogging, brisk walking.

One of the best exercises for tightening your abs is plank pose.