Central obesity, the "apple-shaped" obesity commonly referred to as belly fat, is the accumulation of visceral fat (fat deposited between the internal organs in the torso) resulting in an increase in waist size. There is a strong correlation between central obesity and cardiovascular disease.
While central obesity can be obvious just by looking at the naked body (see the picture), the severity of central obesity is determined by taking waist and hip measurements. The absolute waist circumference (> in men and > in women) and the waist-hip ratio (>0.9 for men and >0.85 for women)
Health risksCentral obesity is associated with a statistically higher risk of heart disease, hypertension, insulin resistance, and diabetes mellitus type 2 (see below). Belly fat is a symptom of metabolic syndrome, and is an indicator used in the diagnosis of that disorder.
Central obesity can be a feature of lipodystrophies, a group of diseases which is either inherited, or due to secondary causes (often protease inhibitors, a group of medications against AIDS). Central obesity is a symptom of Cushing's syndrome (which may cause it). Central obesity is also common in patients with polycystic ovary syndrome (PCOS).
Relationship with diabetesThere are numerous theories as to the exact cause and mechanism in type 2 diabetes. Central obesity is known to predispose individuals for insulin resistance. Abdominal fat is especially active hormonally, secreting a group of hormones called adipokines that may possibly impair glucose tolerance.
Insulin resistance is a major feature of diabetes mellitus type 2 (T2DM), and central obesity is correlated with both insulin resistance and T2DM itself. Increased adiposity (obesity) raises serum resistin levels, which in turn directly correlate to insulin resistance. Studies have also confirmed a direct correlation between resistin levels and T2DM.. And it is waistline adipose tissue (central obesity) which seems to be the foremost type of fat deposits contributing to rising levels of serum resistin. Conversely, serum resistin levels have been found to decline with decreased adiposity following medical treatment.
CausesThe main causes of central obesity are overeating and a sedentary lifestyle. Hypercortisolism, such as in Cushings syndrome also leads to central obesity.
Prevention and treatmentsPerforming adequate aerobic exercise and eating a healthy diet prevent central obesity, and losing weight via these methods is the main way to reverse the condition.
Adjunctive therapies which may be prescribed by a physician are orlistat or sibutramine. In the presence of diabetes mellitus type 2, the physician might instead prescribe metformin and thiazolidinediones (rosiglitazone or pioglitazone) as anti-diabetic drugs rather than sulfonylurea derivatives. Thiazolidinediones may cause slight weight gain but decrease "pathologic" abdominal fat, and therefore may be prescribed for diabetics with central obesity.
Sit ups mythThere is a common misconception that spot exercise (that is, exercising a specific muscle or location of the body) most effectively burns fat at the desired location. But this is not the case. Spot exercise is good for building specific muscles, but it has little effect on fat in that area of the body, or on the body's distribution of body fat. The same thing applies to sit ups and belly fat. Sit ups and other abdominal exercises are great for building the abdominal muscles, but they have little effect on the adipose tissue located there.
Slang termsThere are some slang terms used to refer to central obesity, and to people who have it. There is little scientific evidence that beer drinkers are more prone to abdominal obesity, despite it being known colloquially as "beer belly" or "beer gut". "Love handles" is a colloquial term for a layer of fat that is deposited around a person's midsection, especially visible on the sides over the abdominal external oblique muscle. "Muffin top" is a generally pejorative term used for a person whose flabby midsection spills over the waistline of his or her pants in a manner that resembles the top of a muffin spilling over its paper casing. Another slang term, "spare tire" is also used as a descriptor of the "ring" of fat surrounding one's midsection.
paunchy in Arabic: كرش
paunchy in German: Bierbauch
paunchy in Dutch: Bierbuik
paunchy in Polish: Otyłość brzuszna
paunchy in Finnish: Kaljamaha
paunchy in Swedish: Ölmage
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