Obesity in women. Abdominal (upper) type of obesity

The female body is more likely than the male body to accumulate subcutaneous fat, in modern medicine there is even such a thing as abdominal obesity of one of the degrees. With such a pathology, a belly grows in a representative of the weaker sex, and this abnormal process is in no way connected with a progressive pregnancy. Studying in detail all the existing types of obesity in women, it becomes clear that being overweight causes health problems.

What is obesity in women

With abdominal obesity, internal fat, which is officially called visceral fat, predominates in a capacious concentration. When it is formed, there is a serious threat to all abdominal organs, since their usual work is noticeably complicated. Chronic diseases of the gastrointestinal tract gradually develop, and hormonal imbalance is not ruled out. So, the once healthy cells of the internal organs are reborn into adipose tissue. Therefore, female-type obesity is not only an aesthetic defect.

Causes of obesity in women

Such a health problem can occur at any age, and together with the genetic factor, it prevails even in children and adolescents. In order for the result of a therapeutic diet and other therapeutic measures to be productive, it is important to find out the etiology of the pathological process, to eliminate the main provoking factors. The reasons why fat deposition is observed in the organs of the peritoneum are presented below:

• prolonged stress;
• excess fatty foods in the diet;
• overeating of a psychogenic nature;
• hypodynamia;
• hormone therapy.

Types of obesity

Fat metabolism is more often disturbed in women, and this problem may not be related to pregnancy. There are several types of obesity, and each of them indicates the prevailing problems with women's health. The classification by female type is presented below:

1. Abdominal obesity in women. The most common type with pathological weight gain in the abdomen.
2. Leg obesity. Provoked by endocrine diseases, overweight is localized in the lower extremities.
3. Android. Male-type obesity in women, when fat accumulates in the upper abdomen, chest.
4. Mixed. The figure of a woman is covered with fat evenly, problem areas are not visually highlighted.

stages

If a woman's health problem already exists, her treatment depends entirely on the degree of the progressive pathological process. For example, at an early stage, an operation is not required, and at the fourth degree, one cannot do without it. So:

• 1 degree. Exceeding the norm by 30%;
• 2 degree. Exceeding 30 - 50%;
• 3 degree. Exceeding 50 - 100%;
• 4 degree. Exceeding the norm from 100%.

Why obesity is dangerous for women

You can increase physical activity, but the desired result is not achieved. Alimentary obesity is more often preceded by internal diseases, rather than a passive lifestyle. The health problem has a hereditary predisposition, often progresses with pathologies of the endocrine glands. If you do not take a closer look at the constantly increased appetite, the following clinical pictures are not excluded:

• disorders of the central nervous system;
• risk of diagnosed infertility;
• development of type 2 diabetes;
• general intoxication of the blood;
• heart failure;
• decrease in potency;
• hormonal imbalance with menstrual irregularities;
• salt deposits in the joints;
• arterial hypertension;
• stroke;
• pathologies associated with the liver;
• myocardial infarction.

Treatment

The abdominal type of obesity requires timely correction by medical methods. The approach to the health problem is complex, including patient motivation, adherence to a therapeutic diet, increased physical activity, and additional medication. Here are some valuable tips from experts:

1. On a diet, it is important to give up sweets, flour, fast food and smoked meats, reduce the intake of salt and spices.
2. From effective physical activity, it is recommended to choose cardio and fat-burning complexes.
3. Doctors advise people who are overweight to spend more time outdoors, to take walks.
4. With visual fullness, pay special attention to the body mass index, as you become obese, control nutrition.
5. Take pills only on the recommendation of your doctor, it is important to exclude superficial self-medication.

Medical treatment

If there is no waist, and the figure is of the "apple" type, conservative treatment with medications is not prescribed immediately. For obesity, the use of medications is appropriate if there is no positive dynamics of non-drug therapy within 3 months. It is important to note the benefits of the following pharmacological groups and their representatives:

• hormonal preparations (to restore the concentration of sex hormones): Fepranon, Mirapront, Desopimon;
• Dietary supplements (based on sibutramine): Reduxin, Goldline, Meridia, Lindax;
• Dietary supplements (based on orlistat): Orlistat, Xenical.

If the gynoid type of obesity prevails, doctors recommend taking the following medications in a full course:

1. Fepranon. The drug has a psychostimulating effect, improves metabolism and helps to reduce body weight in obesity. A single dosage is 1 tablet, the frequency of administration is up to three times a day for 1 to 6 weeks.
2. Mirapront. The drug restores sexual function, is recommended for obesity with internal hormonal imbalance. Take the tablets orally before meals in the morning. Single dose - 1 pill, multiplicity - up to 2 - 3 times a day.

Proper nutrition

It is necessary to start the treatment of women with a decrease in the concentration of sugar in the blood. In addition, it is required to reduce the doses of salt and spices, since such food ingredients prevent the outflow of fluid and form congestion. In the photo, women are frightened by their parameters and mentally I want to put them on a diet. The basis of dietary nutrition should be protein foods and vegetables, fruits as sources of vitamins and antioxidants. Here are some healthy food ingredients:

• beef, chicken, rabbit meat;
• skimmed dairy products;
• lean varieties of fish;
• vegetables, fruits, herbs.

But the following foods contribute to the growth of the abdomen in relation to the volume of the hips:

• smoked meats, sharpness, pickles;
• fast food;
• soda, alcoholic drinks;
• confectionery;
• coffee, strong tea.

Psychologist's consultation

Since food often becomes a way to “eat stress and emotional overstrain”, the psychologist must explain to the patient what threatens such a “belly holiday”. It would not be superfluous to show a photo of patients with obesity so that the problem with health and appearance is clearly visible. If the patient is properly motivated, she will voluntarily go on a diet, seriously engage in the correction of an imperfect figure.

Physical exercise

If central obesity or another type of rapid weight gain progresses, the problem cannot be solved without physical activity. In addition to regular walks in the fresh air and moderate cardio at home or in the gym, it is recommended to focus on the following exercises:

1. Every day, morning and evening, stand in the "bar", gradually increasing the time by 5 - 10 seconds and bringing it to the standard - 5 minutes.
2. Jump rope in the morning and evening, also gradually increasing the duration of each approach.

Liposuction

If a sufficient amount of fat has accumulated under the skin, which is not removed by physical activity, nutrition correction and medication, it's time to think about liposuction. This minimally invasive technique is appropriate for obesity. Its essence is as follows: small incisions are made on the abdomen, special tubes are inserted and fat is pumped out through them. The procedure is performed under local anesthesia and does not require a long rehabilitation period. Among the disadvantages is the price.

Surgical intervention

With male-type obesity and not only radical methods may be required to remove subcutaneous fat from the peritoneal area. The operation is performed under local anesthesia or anesthesia, provides for a two-week rehabilitation period and psycho-emotional recovery (with the participation of a psychologist). Here are some of the methods of surgical intervention in question:

• installation of an intragastric balloon;
• gastric banding;
• vertical gastroplasty;
• gastric bypass;
• biliopancreatic shunting;
• modified BPS operation.

Prevention

To prevent obesity from becoming a problem, every woman should remember about preventive measures and adhere to them almost daily. In practice, this is as easy as shelling pears, the main thing is to develop a habit, and for patients at risk, it should generally become the norm of everyday life. Here are some common preventive measures in question:

• healthy eating, correction of the usual diet;
• sports, moderate cardio loads;
• rejection of bad habits;
• walks in the open air;
• body weight control;
• emotional balance;
• control of hormonal levels, medication.

Photo of obesity in women

Video

Obesity is currently one of the most common chronic diseases. Epidemiological studies show a rapid increase in the number of obese patients in all countries. Obesity (BMI> 30) affects from 9 to 30% of the adult population of the developed world. Along with such a high prevalence, obesity is one of the main causes of early disability and mortality in patients of working age.

Obese patients have an increased risk of developing type 2 diabetes mellitus (DM 2), arterial hypertension, and cardiovascular diseases, the mortality from which is the highest in developed countries.

Obesity is a heterogeneous disease. Undoubtedly, excessive accumulation of adipose tissue in the body does not always lead to the development of severe concomitant complications. There is still a controversial question about the relationship between the development of obesity, the risk of developing cardiovascular diseases and mortality from them.

However, there are many overweight or mildly obese patients with dyslipidemia and other metabolic disorders. These are, as a rule, patients with excessive deposition of fat, mainly in the abdominal region. As epidemiological studies show, these patients have a very high risk of developing type 2 diabetes, dyslipidemia, arterial hypertension, coronary heart disease, and other manifestations of atherosclerosis.

The results of studying the relationship between the topography of adipose tissue and metabolic disorders made it possible to consider abdominal obesity as an independent risk factor for the development of DM 2 and cardiovascular diseases.

It is the nature of the distribution of adipose tissue in the body that determines the risk of developing metabolic complications associated with obesity, which must be taken into account when examining obese patients.

In clinical practice, for the diagnosis of abdominal obesity, a simple anthropometric indicator of the ratio of waist circumference to hip circumference (RT/RT) is used. The coefficient OT / OB in men > 1.0, in women > 0.85 indicates the accumulation of adipose tissue in the abdominal region.

Using CT or MRI tomography, which allowed a more detailed study of the topography of adipose tissue in the abdominal region, subtypes of abdominal obesity were identified: subcutaneous abdominal and visceral, and it was shown that patients with visceral obesity have the highest risk of developing complications. It has also been found that excessive accumulation of visceral adipose tissue, both in obesity and in normal body weight, is accompanied by insulin resistance and hyperinsulinemia, which are the main predictors of the development of type 2 diabetes. Moreover, it has been shown that excessive deposition of visceral adipose tissue is combined with an atherogenic lipoprotein profile. , which is characterized by: hypertriglyceridemia, increased levels of LDL-chl, apolipoprotein-B, an increase in small dense LDL particles and a decrease in the concentration of HDL-chl in the blood serum. It is also accompanied by disorders of the blood coagulation system, manifested by a tendency to thrombosis.

As a rule, in patients with abdominal obesity, the above disorders develop early and are asymptomatic for a long time, long before the clinical manifestation of type 2 diabetes, arterial hypertension, and atherosclerotic vascular lesions.

However, insulin resistance does not always lead to the development of IGT and DM 2, but these patients have a very high risk of developing atherosclerosis. If there is a manifestation of DM 2 in patients with abdominal obesity, then the total risk of developing cardiovascular diseases increases significantly.

Despite the fact that the detection of visceral type of obesity is most effective using CT and MRI, the high cost of these methods limits their use in wide practice. But studies have confirmed a close correlation between the degree of development of visceral adipose tissue and the size of the waist circumference (WC). It was found that WC equal to 100 cm indirectly indicates such a volume of visceral adipose tissue, in which, as a rule, metabolic disorders develop and the risk of developing DM 2 increases significantly. Therefore, the WC value can be considered a reliable marker of excessive accumulation of visceral adipose tissue. The measurement of WC in the examination of patients with obesity makes it easy to identify patients with a high risk of developing DM 2 and cardiovascular diseases.

Waist circumference > 100 cm at the age of 40 years and > 90 cm at the age of 40-60 years in both men and women is an indicator of abdomino-visceral obesity.

Metabolic and clinical disorders, which are based on insulin resistance and compensatory hyperinsulinemia, are combined into the concept of insulin resistance syndrome, also known as syndrome X or metabolic syndrome.

For the first time in 1988, G. Riven, having presented a description of the insulin resistance syndrome, which he designated as syndrome X, confirmed the importance of insulin resistance as the basis of the components of the syndrome. Initially, he did not include obesity among the mandatory features of the syndrome. However, later works, both by the author and other researchers, showed a close relationship between abdominal obesity, especially due to the excessive development of visceral adipose tissue, and insulin resistance syndrome, and confirmed the decisive role of obesity in the development of peripheral tissue resistance to insulin action. According to Riven, about 25% of non-obese people with normal glucose tolerance who lead a sedentary lifestyle also have insulin resistance. As a rule, the state of insulin resistance in them is combined with dyslipidemia, identical to that in patients with type 2 diabetes, and an increased risk of atherosclerosis.

As already mentioned, the basis of the syndrome of insulin resistance in abdominal obesity is insulin resistance and its accompanying compensatory hyperinsulinemia. Insulin resistance is defined as a decrease in the response of insulin-sensitive tissues to physiological concentrations of insulin. It has been proven that insulin resistance is the result of the interaction of genetic, internal and external factors, among the latter the most important are excessive fat intake and physical inactivity. Insulin resistance is based on a violation of both receptor and post-receptor mechanisms of insulin signal transmission. The cellular mechanisms of insulin resistance can be different in different tissues. So, for example, a decrease in the number of insulin receptors is found on adipocytes and, to a much lesser extent, in muscle cells. A decrease in the activity of insulin receptor tyrosine kinase is detected both in muscle and fat cells. Impaired translocation of intracellular glucose transporters, GLUT-4, to the plasma membrane is most pronounced in adipocytes. Moreover, studies show that insulin resistance in obesity develops gradually, primarily in the muscles and liver. And only against the background of the accumulation of a large amount of lipids in adipocytes and an increase in their size, a state of insulin resistance develops in adipose tissue, which contributes to a further increase in insulin resistance. Indeed, a number of studies have shown that insulin-stimulated glucose uptake decreases with the progression of obesity. The clamp method also revealed a direct relationship between the degree of development of abdominal-visceral adipose tissue and the severity of insulin resistance.

What pathophysiological mechanisms determine such a close relationship between insulin resistance and obesity, especially of the abdominal-visceral type? First of all, of course, these are genetic factors that affect both the development of insulin resistance and the functionality of b-cells.

In recent years, it has been found that adipose tissue itself, having endocrine and paracrine functions, secretes substances that affect tissue sensitivity to insulin. Enlarged adipocytes secrete large amounts of cytokines, especially TNF-a, and leptin. TNF-a disrupts the interaction of insulin with the receptor, and also affects intracellular glucose transporters (GLUT-4) in both adipocytes and muscle tissue. Leptin, being a product of the ob gene, is secreted exclusively by adipocytes. Most obese patients have hyperleptinemia. It is assumed that leptin in the liver can inhibit the action of insulin by affecting the activity of the PEPCK enzyme, which limits the rate of gluconeogenesis, and also has an autocrine effect in fat cells and inhibits insulin-stimulated glucose transport.

The adipose tissue of the visceral region has a high metabolic activity, both lipogenesis and lipolysis processes occur in it. Among the hormones involved in the regulation of lipolysis in adipose tissue, catecholamines and insulin play a leading role: catecholamines through interaction with a- and b-adrenergic receptors, insulin through specific receptors. Adipocytes of visceral adipose tissue have a high density of b-adrenergic receptors, especially b3-type, and a relatively low density of a-adrenergic receptors and insulin receptors.

Intense lipolysis in visceral adipocytes leads to an excess supply of free fatty acids (FFA) to the portal system and liver, where insulin binding by hepatocytes is impaired under the influence of FFA. The metabolic clearance of insulin in the liver is impaired, which contributes to the development of systemic hyperinsulinemia. Hyperinsulinemia, in turn, enhances insulin resistance through impaired autoregulation of insulin receptors in muscles. Excess FFA stimulates gluconeogenesis, increasing glucose production by the liver. FFAs are also a substrate for the synthesis of triglycerides, thereby leading to the development of hypertriglyceridemia. It is possible that FFAs, competing with the substrate in the glucose-fatty acid cycle, inhibit the absorption and utilization of glucose by muscles, contributing to the development of hyperglycemia. Hormonal disorders associated with abdominal obesity (impaired secretion of cortisol and sex steroids), in turn, also exacerbate insulin resistance.

Currently, the insulin resistance syndrome plays a leading role in the epidemic of type 2 diabetes, the metabolic variant of arterial hypertension, and cardiovascular diseases.

According to data provided by WHO, the number of patients with insulin resistance syndrome at high risk of developing type 2 diabetes is 40-60 million people in Europe. The results of the Quebec Cardiovascular Study, published in 1990, confirmed the atherogenic nature of dyslipidemia in insulin resistance syndrome. Under conditions of insulin resistance, there is a change in the activity of lipoprotein lipase and hepatic triglyceride lipase, leading to an increase in the synthesis and secretion of VLDL, a violation of their elimination. There is an increase in the level of lipoproteins rich in triglycerides, the concentration of dense small LDL particles and a decrease in HDL cholesterol, an increase in the synthesis and secretion of apolipoprotein-B. In violation of lipid metabolism in abdominal obesity, an increase in the postprandial level of FFA and triglycerides is of great importance. If normally insulin inhibits the release of FFA from fat depots after meals, then under conditions of insulin resistance this inhibition does not occur, which leads to an increase in the level of FFA in the postprandial period. The inhibitory effect of insulin on the release of VLDL in the liver is also reduced, as a result of which the balance between VLDL coming from the intestines and VLDL released from the liver is disturbed. Lipid metabolism disorders, in turn, increase the state of insulin resistance. So, for example, a high level of LDL contributes to a decrease in the number of insulin receptors.

In recent years, such a concept as an atherogenic metabolic triad in patients with abdominal obesity has been introduced into medical practice, which includes: hyperinsulinemia, hyperlipoproteinemia-B, and a high level of small dense LDL particles. It has been proven that the combination of these disorders creates a higher likelihood of developing atherosclerotic lesions in patients with insulin resistance than known traditional risk factors. Clinician-accessible markers of this triad are waist circumference and blood triglyceride levels.

Although the question of the mechanisms of development of arterial hypertension within the insulin resistance syndrome is still being discussed, there is no doubt that the complex effect of insulin resistance, hyperinsulinemia and lipid metabolism disorders play an important role in the mechanisms of increased blood pressure in patients with abdominal obesity. Such effects of insulin as stimulation of the sympathetic nervous system, proliferation of smooth muscle cells of the vascular wall, changes in transmembrane ion transport are of decisive importance in the development of arterial hypertension.

Insulin resistance and hyperinsulinemia to a large extent cause disorders in the blood coagulation system, especially a decrease in fibrinolysis factors, an increase in the level of PAI-1, which in recent years has been given great importance in the processes of atherogenesis in patients with abdominal obesity and insulin resistance.

Thus, the presented data indicate the significance of combined disorders observed in patients with abdominal obesity as part of the insulin resistance syndrome, namely insulin resistance, hyperinsulinemia, disorders of glucose and lipid metabolism in the development of arterial hypertension, DM 2 and atherosclerosis. Therefore, early diagnosis and treatment of abdominal obesity is primarily the prevention, prevention or delay of the manifestation of type 2 diabetes and atherosclerotic vascular lesions. In this regard, it is important to conduct dispensary examinations of the population in order to identify high-risk groups, patients with abdominal obesity, a comprehensive assessment of their condition using modern research methods. A carefully collected family and social history helps to assess the risk of developing complications associated with abdominal obesity, which makes it possible to identify patients with a hereditary predisposition and lifestyle characteristics that predetermine the development of abdominal obesity and insulin resistance. The scheme of examination of patients should include not only anthropometric measurements - BMI, WC, WC / OB, but also the determination of markers of the insulin resistance syndrome: the level of triglycerides, apolipoprotein-B and insulin on an empty stomach.

The treatment of abdominal-visceral obesity should be directed not only to the optimal compensation of existing metabolic disorders, but also, first of all, to the reduction of insulin resistance.

Due to the fact that excessive accumulation of visceral adipose tissue is one of the main pathogenetic factors in the formation of insulin resistance syndrome, the leading place in the complex treatment of patients should be occupied by measures aimed at reducing the mass of abdominal visceral fat: hypocaloric nutrition in combination with regular physical activity. The diet is compiled taking into account body weight, age, gender, level of physical activity and food habits of the patient. The consumption of fat is limited to 25% of daily calories, animal fats are not more than 10% of total fat, cholesterol is up to 300 mg per day. It is also recommended to limit the consumption of rapidly digestible carbohydrates and to introduce a large amount of dietary fiber into the diet. Daily moderate-intensity aerobic exercise is beneficial. Decrease in visceral adipose tissue mass, as a rule, leads to an improvement in insulin sensitivity, a decrease in hyperinsulinemia, an improvement in lipid and carbohydrate metabolism, and a decrease in blood pressure. However, due to the use of exclusively non-drug methods of treatment in patients with insulin resistance syndrome and abdominal obesity, even against the background of weight loss, it is not always possible to compensate for lipid and carbohydrate metabolism disorders and reduce insulin resistance and hyperinsulinemia. Therefore, a promising approach to the treatment of this group of patients is the inclusion in the arsenal of treatment drugs that can affect insulin resistance.

In this regard, it is advisable to use a drug from the biguanide class - metformin (Siofor, Berlin-Chemie). Numerous works prove that siofor improves the sensitivity of hepatic cells to insulin, contributes to the inhibition of the processes of gluconeogenesis and glycogenolysis in the liver. Improves insulin sensitivity of muscle and adipose tissue. By reducing peripheral insulin resistance, absorption of glucose in the intestine, the drug thereby helps to reduce systemic hyperinsulinemia. The ability of Siofor to have a hypolipidemic effect and increase the fibrinolytic activity of the blood was also revealed. There are reports of a beneficial effect of the drug on blood pressure levels. The absence of a hypoglycemic effect, a low risk of developing lactic acidosis and the above properties of siofor, as well as a slight anorexigenic effect, allowed us to start studying the possibilities of using the drug for the treatment of patients with abdominal obesity and insulin resistance syndrome, with normal or impaired glucose tolerance. Under our observation there are 20 patients with abdominal obesity aged 18-45 years, weighing from 91 to 144 kg, WC > 108 cm, WC / OB > 0.95, who were prescribed siofor against the background of hypocaloric nutrition. Initially, 500 mg at bedtime once a week to adapt to the drug, then 500 mg in the morning and evening after meals. The drug was not prescribed in the presence of hypoxic conditions of any etiology, alcohol abuse, as well as in violation of the liver and kidneys. All patients before treatment and during treatment (after 3 months) were tested for the levels of triglycerides, cholesterol, LDL-chl, HDL-chl, and a standard oral glucose tolerance test was performed with the determination of plasma glucose and insulin levels. No significant side effects were noted in any of the patients. During the first week of treatment, mild dyspeptic symptoms were observed in three patients, which disappeared on their own.

The follow-up examination was carried out 3 months after the start of treatment. The initial level of serum lactate averaged 1.28 ± 0.67 mmol/l, after 3 months - 1.14 ± 0.28 mmol/l. Body weight decreased by an average of 4.2%, waist circumference decreased by 7.6 cm. After 3 months of therapy with Siofor, there was a significant decrease in blood triglyceride levels from 2.59 ± 1.07 mmol/l to 1.83 ± 1.05 mmol /l, on average by 29.2%. The content of chl-LDL changed from 4.08 + 1.07 mmol/l to 3.17 ± 0.65 mmol/l, i.e. by 21.05% of the initial level; serum atherogenic index - from 5.3 to 4.2 on average, fasting insulin level - from 34.6 to 23.5 IU/ml. The initial content of HDL-chl in all patients was at the lower limit of the norm, after 3 months of treatment there was a tendency to increase it. In three patients with impaired glucose tolerance normalized parameters of carbohydrate metabolism. Our results show that the use of Siofor for a short period of time (3 months) leads to a significant improvement in lipid metabolism, a decrease in insulin secretion, and, in case of impaired glucose tolerance, to the normalization of carbohydrate metabolism. Therefore, it is quite reasonable to assume the rationality of prescribing the drug as a preventive pathogenetic agent for the treatment of patients with insulin resistance syndrome in abdominal obesity. There are also reports in the literature about the possibility of using a drug of the thiazolidinedione group - troglitazone to reduce insulin resistance in patients with metabolic syndrome with a hereditary predisposition to type 2 diabetes. However, recent publications on the toxic effect of the drug on the liver require a thorough study of the safety of troglitazone in clinical practice.

For patients with severe dyslipidemia, not amenable to diet therapy, the appointment of lipid-lowering drugs (groups of statins or fibrates) can be considered. However, before prescribing these drugs, the feasibility of lifelong treatment of patients, the possible risk of adverse reactions and the potential benefits of treatment should be carefully weighed. This applies primarily to patients with insulin resistance syndrome and dyslipidemia without clinical manifestations of atherosclerotic vascular lesions and a high risk of their development.

When prescribing symptomatic therapy - antihypertensive and diuretic drugs - for patients with abdominal obesity, it is necessary to take into account the effect of these drugs on lipid and carbohydrate metabolism.

Note!

• Patients with excessive fat deposition in the abdominal region have a high risk of developing type 2 diabetes, dyslipidemia, arterial hypertension, coronary heart disease
• Patients with visceral obesity have the highest risk of complications. The accumulation of visceral adipose tissue is accompanied by insulin resistance and hyperinsulinemia
• Waist circumference can be considered a reliable marker of excessive accumulation of visceral adipose tissue.
• Hormonal disorders associated with abdominal obesity (impaired secretion of cortisol and sex steroids), in turn, also exacerbate insulin resistance.
• Early diagnosis and treatment of abdominal obesity is the prevention, prevention or delay of the manifestation of type 2 diabetes and atherosclerotic vascular lesions.

What diet to choose? It may turn out that you are careful about food, and move a lot. However, the mirror does not reflect the figure of your desire.

There are areas of the body of women that are difficult to lose weight (abdomen, waist, buttocks, legs and hips), which are not corrected only by a suitable diet, but with the addition of appropriate physical exercises and massages of problem areas.
There are different types of obesity. General and local (zonal). According to the distribution of adipose tissue, two types of obesity are distinguished: android (abdominal) and gynoid (lower).

Android obesity (male type), characterized by fatty deposits in the upper torso and abdomen. It happens to both men and women. Often leads to cardiovascular complications, diabetes mellitus, hyperlipidemia.
Android obesity is more risky for health; therefore, those who suffer from it must be extremely careful to prevent the occurrence of complications.

The figure with such obesity is in the shape of an apple. Fat deposits are localized mainly on the abdomen (waist) and on the trunk. They are hereditary. Many men who have a similar distribution of fat say that they are not fat, that they have a stomach, but that their arms and legs are thin. However, these features are exactly what characterize this type of obesity, which is associated with a greater risk of cardiovascular diseases (especially heart attacks), diabetes, arterial hypertension, atherosclerosis, certain types of oncology and cerebrovascular disorders. Obesity of this type can be diagnosed by the ratio of waist circumference to hip circumference. With an index greater than 1 for men and 0.85 for women.
Example:

Waist circumference 93cm, hip circumference 102cm. The index is 0.91 - abdominal (android) obesity.

Waist circumference in women is 80 cm or more, in men - 94 cm or more indicates the risk of complications

Gynoid obesity: Pear-shaped figure. Deposition of fat on the thighs, buttocks and legs. It can contribute to the appearance of hemorrhoids, varicose veins, problems with the musculoskeletal system (arthritis, osteochondrosis, spondylosis, coxarthrosis), cellulitis and venous insufficiency.
Gynoid lipodystrophy is excessive fat deposits in the lower parts of the body - thighs, lower legs. There is a lack of muscle development. The disease depends on gender, age, lifestyle, bad habits, the state of the endocrine system and genetic predisposition.

Gynoid lipodystrophy (obesity) can be defined by the ratio of the size of the waist circumference to the size of the hip circumference. If the index is less than 1, we define it as gynoid lipodystrophy (for example: waist 100, hips 120. Index less than 1.0).
Important - for the treatment of these types of obesity - a change in diet, accompanied by physical activity according to the degree of fitness and the use of massage of local areas. The changes are gradual. Know how to expect them, be patient.

Recommendations for different zones of obesity.
The diet differs depending on the localization of obesity.
If obesity affects the buttocks and thighs:
This is the area where - fat is deposited in the first place and is lost with difficulty.

Tips to keep in mind:

The diet for this type of obesity should not be lower than 1200 calories.
Drink plenty of fluids (primarily water).
Fats in the diet should be limited and controlled.
Avoid saturated and trans fats. For example: margarine, cooking oil. Many brands of the latter have removed trans fats, but still contain saturated fats. Also, chocolate, soft caramels and other sweets, snacks, pies and cakes, flan powders, biscuits, homemade cookies of all kinds, bread sticks, confectionery products, snacks, instant soups, coffee cream, fatty meat, chicken skin, entrails, cold cuts and sausages, whole dairy products Choose healthy fats, such as monounsaturated fats - olive oils, peanuts, olives (not for fat legs).
It dispenses with the consumption of white flour, first of all, if it is combined with sugar.
Include oat bran or wheat bran daily in your meals.
Use a large amount of vegetables and fruits of all colors, raw.
Drink daily milk with active fiber.
Avoid coffee and alcoholic drinks.
Choose wholemeal bread.
Daily 4 main types of food (breakfast, lunch, afternoon tea and dinner).

If obesity concerns the legs.

This may be due to cellulite, a sedentary lifestyle, wearing tight pants or clothing that hinders proper circulation.
Food based on snacks (hamburgers, cold cuts, sausages, pizzas, frozen, canned foods), due to the constant consumption of condiments like mayonnaise (even diet), ketchup, mustard, etc.

Tips to keep in mind:

Drink plenty of water. At least 2 liters daily, especially between meals.
Avoid canned foods, due to the amount of sodium (salt), additives and preservatives.
Choose fresh or dried food.
Avoid foods rich in sodium (salt).
Use fresh or dried herbs for seasoning.
Do not smoke or drink alcoholic beverages.

For all cases:

Menu for obesity for breakfast and afternoon snacks.

Change to avoid monotony.

1-1 cup skimmed milk with active fiber or low-fat yogurt is better than Greek. 2 slices wholemeal bread with feta cheese (less than 4% fat).

2 - 1 cup skimmed milk or low fat yogurt. 3 rice cookies.

3-1 cup skimmed milk or low fat yogurt. 2 vanilla or fruit biscuits (not for obesity on the thighs and buttocks).

4 - 1 skim milk drink with 1 banana (unripe) and 5 almonds.

Lunches and dinners:

Before each main course:

1 glass of plain water or with lemon juice.
At one meal 1 medium serving of (lean red) meat 1 - 2 times a week, skinless poultry 1 time a week, lean pork 2 - 3 times a week, sea fish, on the remaining days of the week, 1 bowl of vegetable soup .
In another meal (preferably for dinner), 1 plate of vegetables of all colors, accompanied by 1 small serving of boiled brown rice or vegetables (lentils, chickpeas, beans, soybeans).
The meat is cooked chopped, the fat is removed by blotting on top with a white paper towel.
For seasoning use olive oil, 1 teaspoon (lunches and dinners), lemon juice or apple cider vinegar, a moderate amount of salt.
After each meal, 1 small fruit with all the pulp or skin.

7 examples of lunches and dinners for obesity, on the buttocks, thighs and legs.

1) Grilled chicken. Salad of beets, cabbage and dill. Salad of radish, lettuce, tomato and carrot and brown rice.
2) Lean pork cutlet. Salad of onion, tomato and lettuce. Stuffed hot peppers (with onions, beans, cheese, corn, low-fat cheese. Vegetable salad.
3) Mixed salad. Salad of green beans, carrots, potatoes and boiled eggs.
4) Oven stew (with tomato and cheese), onion and hot pepper. Bean salad (with dill, soy sprouts, carrots, tomato.
5) Pork meat salad with vegetables lettuce, onion. Cabbage and tomato salad. Pasta with tomato sauce and grated cheese.
6) Fish baked with spinach and cheese sauce (chopped spinach, steamed, mixed with onions and low-fat cheese). Vegetable salad with boiled potatoes.
7) Low-fat steak. Vegetable salad. Omelette with beans (1 more egg 1 egg white, ½ beans).

With obesity on the buttocks, hips, additional snacks are added:

1 fresh fruit

1 cup active fiber milk or low-fat yogurt.

10 peanuts (no salt).

Abdominal obesity provokes ischemic heart disease.

This type of obesity is associated with the development of metabolic processes in the body. Problems with the reproductive system are only a small fraction of the complications.

What is abdominal obesity

Under the syndrome of abdominal obesity in medicine refers to the excessive accumulation of fat deposits in the abdomen and upper torso. This type of obesity is characterized by the silhouette of an apple-shaped figure.

The pathological state of health in the development of abdominal obesity often worsens so much that it is life-threatening.

Oncological diseases affect such patients 15 times more often. The cases of cardiac ischemia increase 35 times, the number of strokes increases 56 times.

This type of obesity is accompanied by a malfunction of almost all internal organs due to the fact that they are completely surrounded by fat. More fat accumulates in the intestines.

The anterior wall of the peritoneum is often completely formed by abdominal fat. Under normal conditions, visceral fat does not exceed 3-3.5 kg. In a person suffering from a pathology, this figure increases tenfold.

If a person's weight does not exceed the optimal ones, fat simply envelops the internal organs, and they function without failure. With obesity, fat deposits are so significant that they literally squeeze the organs, paralyzing their work.


Patients with such obesity find it difficult to exercise. After all, there is a violation of blood circulation and lymphatic outflow.

The heart needs to overcome the most difficult loads, the lungs function in extreme mode. Men are the main risk group. However, despite the statistics, cases of obesity of this type are not uncommon in women.

Experts have proven that when losing weight even by 5-10 percent, metabolism improves. If the new weight is maintained for a long period, then fat and carbohydrate metabolism is accelerated.

Causes and features of pathology in women

This pathology requires immediate correction, as it is very dangerous for women's health. Deposits in the abdomen, which are characteristic of abdominal obesity, negatively affect primarily the reproductive organs and the urinary system.

Male-type obesity, as doctors call it, develops as a result of a sharp decrease in serotonin levels. This hormone in the body of a woman performs a function that regulates the mental state.

A low concentration of serotonin causes depressive states and mental disorders, which are largely able to change eating habits.

Uncontrolled weight gain causes, first of all, eating junk food in stressful situations. Disorders in the work of the hypothalamus - the food center responsible for saturation, doctors consider one of the main causes of obesity.

This pathology is characterized in that the patient experiences a constant feeling of hunger, even with periodic meals. In such a situation, overeating is simply inevitable.

Deviations in eating habits provoked by psychological prerequisites often turn into life-threatening habits.

Genetic predisposition to excess weight is one of the most complex and poorly controlled causes of abdominal obesity in the beautiful half.

Most often, the impetus for obesity in this situation is pregnancy and childbirth.

Against the background of hormonal changes and a difficult daily routine, young mothers accumulate extra centimeters at the waist, which subsequently remain for many years, or even forever.

Fat deposits accumulate gradually, squeezing the internal organs. There are problems with pressure, diabetes develops and problems in the work of the heart and reproductive organs.

Nuances and factors of development in men

Doctors diagnose abdominal obesity in men when the volume of the abdomen exceeds 102 cm.

Such obesity poses a threat not only to health, but also to the life of a man. It is important to know that due to the accumulation of fat under the skin, metabolic disorders begin in the peritoneum.

Which in turn provokes the development of complex diabetes mellitus. Hanging down of the abdomen indicates an excess of intra-abdominal fat located between the internal organs and the body itself.

Metabolic syndrome causes vascular atherosclerosis. The pressure rises. Patients complain of sexual impotence.

The work of the heart is deteriorating. The man complains of increased fatigue and drowsiness. The main cause of this type of obesity is overeating.

Uncontrolled consumption of high-calorie foods, which many men also drink beer, leads to a pathological process.

In provoking factors, heredity also plays an important role. If the boy's parents or close relatives suffer from obesity, a similar situation is possible for him.

Some doctors draw an analogy of obesity with such intractable habits as alcoholism and drug addiction. And if women are much more willing to try to get rid of extra kilos, then there are only a few men among those who want to lose weight.

Metabolic processes have a chronic course, which can be corrected only by cardinal methods to restore the most rational diet and physical activity.

Effective drug treatment

Drug therapy for the treatment of obesity is represented by drugs that reduce appetite and improve the breakdown of body fat. In addition, it is important that they contribute to the acceleration of metabolism.

Drug treatment is necessary if a set of other weight loss measures has not had the desired effect.

Weight control drugs in some cases have an exciting effect on the nervous system and cannot be taken for a long period of time.

The most popular drugs can be represented by the following list:

1. Orlistat contributes to the suppression of lipase, a pancreatic enzyme, thereby reducing the absorption of fat in the intestine.
2. Sibutramine and its analogues belong to the group of antidepressants and at the same time reduce appetite.
3. Rimonabant (Acomplia) is an innovative drug of a series of antagonists that stop appetite and promote rapid loss of excess fat.
4. Metformin is indicated in the treatment of obesity in type 2 diabetes.
5. Exenatide Byetta creates the effect of satiety, applied twice a day. Indicated for elimination of subcutaneous fat in diabetes.
6. Pramlintide (Symlin) is recommended to create a feeling of fullness by delaying gastric emptying. It is used as insulin in type 1 and type 2 diabetes.

It is important to know that if one drug is ineffective, it is important to replace it with another. Possible adverse reactions require careful study of the recommendations and admission only according to the indications of the attending physician.

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Features of the treatment of obesity in the stronger sex

In the treatment of abdominal obesity in a man, it is important, first of all, to completely change his lifestyle. Then an integrated approach and thorough diagnostics are important. At the fourth degree of obesity, surgical intervention is indicated.

It is required to significantly reduce the amount of food consumed. Products must include fiber, vitamins and minerals.

It is important to eat foods that are high in fats and carbohydrates.

According to statistics, bad habits contribute to the aggravation of the disease. Most men are unable to give up alcohol and smoking. Doctors insist that they need to be minimized.

Alcohol, for example, contains a large amount of harmful substances that inhibit weight loss and cause a deterioration in well-being.

An overdose of alcoholic beverages dehydrates the body, which is absolutely unacceptable for abdominal obesity.

Full walks in the fresh air will help to activate the metabolism. The room in which the sleeping place is located should be regularly ventilated, regardless of weather conditions.

In the treatment of male obesity requires moderate exercise. The dosage of classes should be planned by the attending physician. It is important for the patient to observe sleep patterns.


Optimal rest helps to normalize all metabolic processes and restore mental health. After all, there will be no nervous strain and stress, then you won’t have to seize them.

How to get rid of a female problem

An increased risk group is made up of women whose waist circumference exceeds 80 cm. With a waist circumference of more than 88 cm, there is a high risk of developing complex diseases.

Such indicators are a material reason to start an immediate fight against excess weight. In case of malfunction of the hypothalamus, the recommendations of a psychotherapist are important.

No diet will help restore normal weight if a person struggles with it alone. Constant monitoring of nutrition and a regimen of moderate physical activity will help to establish the functioning of vital organs in the first weeks.

You can bring your body back to normal if you replenish the missing concentration of serotonin in a short time.

The easiest way out is to introduce certain foods into the diet:

• oranges;
• strawberry;
• dates;
• figs;
• apples;
• bananas;
• dried fruits;
• hard cheeses;
• curd products;
• tomatoes;
• seaweed;
• bran.

It is important to bear in mind that with women's waist sizes exceeding 90 cm, this method is naturally indispensable. In such situations, urgent correction is necessary under the strict supervision of specialists.

To sound the alarm and just change the cravings in food habits is not enough.

It is necessary to undergo a complete examination by specialists. An ultrasound of the internal organs is required.

It is important to identify the dynamics of changes in pressure and heart rhythms. After all, too rapid weight loss can increase the load on the body and, as a rule, sudden and sometimes irreversible consequences occur.

Treatment of abdominal obesity in women should be comprehensive and gradual.

Proper therapeutic diet

The principle approaches in diet therapy are based on a fairly high level and are supported by all nutritionists in the world. The daily calorie content of food consumed should not exceed 1500-2000 kcal.

It is advisable to replace fats and carbohydrates with fiber and other useful substances. In the diet, it is recommended to consume at least 400 kcal of protein.

It is found a lot in lean meats, fish, cottage cheese, non-fish seafood and eggs. This creates a feeling of satiety, and the body expends more energy on the absorption of such products.

Useful dairy products. Sugar, confectionery, sugary drinks should be limited. With increased pressure, it is important to consume no more than 6-8 g of salt.

Alcoholic drinks provoke uncontrolled eating, so when losing weight, it is important to categorically refuse them.

Sample menu for the week

For proper and fast weight loss, you should not eat after 18.00 hours. The fundamental principle should be the observance of the principle that the densest food should be for breakfast. Dinner should be the lightest.

1. First day.
   Breakfast: vegetable juice, squash fritters, tea with milk.
   Lunch: vegetable soup, baked pink salmon, asparagus and green pea salad, blueberry compote.
   Dinner: chicken skewers, pepper, tomato and carrot salad, green tea.
2. Second day.
   Breakfast: apricot juice, rice with boiled fish, cut vegetables, cocoa.
   Lunch: broccoli soup, baked veal, boiled vegetable salad, fruit compote.
   Dinner: moussaka, green tea, kefir.
3. The third day.
   Breakfast: vegetable juice, pollock cutlets, cucumber, chamomile tea.
   Lunch: pea soup, peppers stuffed with beef and rice, pear compote.
   Dinner: scrambled eggs, salad, green tea with lemon.
4. Fourth day.
   Breakfast: juice, boiled beef tongue, vinaigrette, coffee without sugar.
   Lunch: cabbage soup, minced meat and broccoli casserole, seaweed salad, dried fruit compote.
   Dinner: cottage cheese, cucumber and tomato salad, rosehip tea, apple.
5. Fifth day.
   Breakfast: fresh fruit, krupenik, pear, coffee latte.
   Lunch: soup with cereals, stuffed eggplant, vegetable slices, compote.
   Dinner: fish fillet aspic, green peas, tea, yogurt.
6. Sixth day.
   Breakfast: juice, potato casserole, beetroot salad, cocoa.
   Lunch: kohlrabi soup, stewed herring, baked zucchini, dried apricot compote.
   Dinner: baked rabbit, Chinese cabbage salad, herbal tea, grapes.
7. Seventh day.
   Breakfast: carrot juice, scrambled eggs with mushrooms, tea with lemon, peach.
   Lunch: green cabbage soup, beef dolma, radish salad, compote.
   Dinner: cottage cheese pudding, carrot salad with garlic, orange, green tea.

For a second breakfast or afternoon snack, you can use fruits, yoghurts, sour-milk low-fat products as snacks.

Possible complications of pathology

Complications that provoke obesity can appear at any period of pathology.


Experts have combined the most common of them into one list:

• diseases of the stomach and intestines;
• gallbladder pathology;
• disorders in the work of the kidneys;
• pancreatitis;
• arterial hypertension of varying severity;
• type 2 diabetes mellitus;
• ischemic disorders, including stroke;

Obesity has somehow imperceptibly turned from a problem of an individual into a scourge of modern society. In the developed countries of the world, such as the United States, the number of people suffering from obesity reaches a staggering 68%, and every year this statistic is only getting worse. But what is even worse, obesity has firmly taken the second place among the diseases leading to death. What can we say about others, if in Russia 50% of men and 62% of women over 30 are obese. And this is a direct path to the development of heart disease, atherosclerosis, diabetes, and hence a heart attack or stroke.

It seems that the reasons for the development of obesity are well known to everyone - a sedentary lifestyle, passion for fast food, overeating and constant stress, but only the normalization of nutrition and an active lifestyle do not always guarantee the return of a slim figure and health promotion. “Perhaps you are putting in the wrong effort!” say nutritionists. To get rid of excess weight and prevent health problems, first of all, you need to find out if you have obesity and what type it is, and only then, based on the available data, build an effective weight loss strategy. This is worth looking into in detail.

Definition of obesity by body mass index

First, let's figure out how to determine if you have obesity. To do this, it is not necessary to go to the doctors, because it is enough to calculate your body mass index to find out if you have excess weight, and if so, at what stage is obesity.

The Body Mass Index (BMI) is very easy to calculate. To do this, you need body weight (in kilograms), divided by height (in meters), squared. For example, with a height of 182 cm and a weight of 77 kg, the body mass index will be calculated as follows: BMI \u003d 77: (1.82 x 1.82) \u003d 23.3.

• For a woman, a BMI below 19 is considered underweight, 19-24 is normal weight, 25-30 is overweight, 30-41 is obese, and above 41 is severely obese.
• For men, a BMI below 20 is considered underweight, 20-25 is normal weight, 26-30 is overweight, 30-41 is obese, and above 41 is severely obese.

If you look at the appearance of a person, you can see that fat deposits are localized in different parts of the body. Based on this, doctors distinguish 3 types of obesity:

• gynoid type (female-type obesity);
• android type (male-type obesity).
• mixed type.

Gynoid type of obesity

Gynoid obesity, often referred to as female-type obesity, is an accumulation of fatty deposits on the buttocks, thighs, and lower legs. Most often, this problem occurs in women whose body is pear-shaped. In this case, even having lost extra pounds, excess fat mass treacherously remains in the lower body, which seriously spoils the appearance and negatively affects self-esteem.

According to doctors, this type of obesity develops against the background of increased production of female sex hormones. That is why this problem most often haunts women, although occasionally it also occurs in men who have partially or completely impaired testosterone production. Pear-shaped individuals who are prone to obesity suffer from varicose veins, hemorrhoids, diseases of the musculoskeletal system (osteochondrosis, arthritis, spondylosis and coxarthrosis), as well as venous insufficiency and cellulite.

Fighting this type of obesity is the most difficult, since fat from the hips and buttocks will go last. It is important to be patient, change your diet, and at the same time train the lower limbs, doing running, cycling and other active exercises, where most of the legs and buttocks are involved. Regular massage of local areas will also be useful.

If we talk about nutrition for female obesity, then it is important to remember that the number of meals should be at least 5 times a day, and the main emphasis should be on dinner, which should contain 40% of the daily diet. The fact is that in people with gynoid obesity, metabolic processes accelerate in the evening, which means that most of the food should be eaten at dinner, the main thing is that it should be no later than 19:00 and no later than 3 hours before bedtime. Breakfast should be left at 20%, lunch at 30% of the daily ration, and the remaining 10% should be equally divided between two snacks.

It is also important to exclude the consumption of trans fats (cooking oil, margarine), to minimize the consumption of chocolate, soft caramel, muffins and confectionery. White flour, sugar, coffee and alcoholic beverages should also be avoided. The basis of the daily diet should be raw and boiled vegetables and fruits, bran, cereals and wholemeal bread.

Let's also say that fat accumulating in the thigh area provokes the development of cellulite. To counter this scourge, you need to "lean" on foods with a large amount of antioxidants, namely fruits (lemons and apples) and berries (currants, blueberries, raspberries). The total amount of fruits or berries consumed per day should be at least 300 grams.

Android type of obesity

Android obesity is often called male-type obesity, and all because this form is more common in men (beer belly). With it, fat deposits accumulate in the upper body, mainly on the abdomen, in the chest and in the armpits. Doctors call this obesity the most dangerous for a person, since most of the fat accumulates in the internal organs, leading to high blood pressure, diabetes, infertility (in women) and impotence (in men). Moreover, from excess fat, the functioning of the liver and kidneys is disrupted, which, without treatment, can threaten the patient with kidney or liver failure.

It is not difficult to determine this type of obesity. Outwardly, in a person with such a problem, you can notice a bulging belly and the absence of a waist, which is larger in girth than the circumference of the hips. For medical reasons, a waist circumference of more than 80 cm in women and more than 94 cm in men indicates the risk of android obesity. In addition, the presence of this type of obesity can be calculated by dividing the waist circumference by the hip circumference. If the resulting index is more than 1 for a man and more than 0.85 for a woman, there is every reason to talk about male-type obesity.

However, there is also good news. The fact is that this type of obesity is the easiest to treat. To do this, first of all, it is necessary to normalize nutrition, where breakfast should be given 40% of the diet, 30% for lunch and 20% for dinner, and the remaining 10% for two snacks. Moreover, you need to start your day with food rich in heavy carbohydrates (all kinds of cereal cereals). During the day, you should eat lean meat, fish with polyunsaturated fatty acids (tuna, salmon, halibut, trout), as well as boiled or fresh vegetables and fruits, in soups and in the form of salads. You need to end your day with a light dinner with a vegetable salad and a piece of lean meat, or with kefir and bread.

Mixed type of obesity

This is the most common type of obesity, in which fat is deposited evenly throughout the body - on the arms, legs, stomach, hips and back. The danger of such obesity lies in its invisibility, because after gaining an extra 10-15 kilograms, a person practically does not notice visual changes in the figure. The hormonal background in people with such a problem is normal, and therefore the metabolism throughout the day is the same.

In this case, it is necessary to fight the problem of obesity according to the "classic" scenario, that is, eat five times a day (3 main meals and 2 snacks), where the main meals should account for 25% of the daily diet, and snacks - 12 ,5%.

Tellingly, this type of obesity is associated with fluid retention in the body. You should not be afraid of this, just as you should not limit yourself to fluid intake (this will only reduce your chances of losing weight). Try to consume 1.5-2 liters of fluid per day (including liquid foods), limit salt intake, and make sure that protein foods are always present in the diet. On average, one should start from the norm of 1 g of protein per 1 kg of body weight, however, the norm of protein can be increased to 2 g of protein if a person regularly exercises. At the same time, it is desirable to obtain protein from lean meat and fish (rabbit, chicken breast, cod, pollock, hake), as well as from milk, eggs and plant foods (cereals, peas, beans and nuts).

So, any obese person, regardless of type, should permanently stop smoking and stop drinking alcohol. It is important to minimize the use of salt and sugar, give up canned foods, various purchased sauces (mayonnaise, ketchup), reduce the consumption of confectionery and sweet muffins. White bread should also be banned, and dietary wholemeal bread should be used instead.

Physical activity in obesity

Let's not forget about physical activity, which should stimulate blood circulation, improve metabolism, and therefore accelerate fat burning and strengthen the body. A doctor should select physical activity, since some sports can be traumatic for overweight people.

For people with severe obesity, it is enough just to start moving regularly. To do this, they need a regimen of 200 minutes of cardio activity per week. You can just take daily walks and light jogs, but it is best to spend this time in the pool, swimming. Water helps to relieve stress on the spine, and besides, all the major muscles of the body are involved during swimming, which perfectly increases the effectiveness of any diet.

Obese people can ride a bike, dance or go to the gym while working on cardio equipment. But team sports, which involve jumping and any impact loads, are contraindicated for such people, as they can damage the ankles and knees. Gymnastics, namely callanetics, will also be an excellent solution. This type of gymnastics is specially designed for weight loss and healing of the body. It perfectly speeds up the metabolism and reduces the volume of the body due to the rapid burning of body fat. Being engaged in callanetics 3 times a week for an hour, in a month you can notice amazing weight loss results. Health to you and a beautiful figure! Photo: Photobank Lori