Abdominal Obesity - Prevention and Treatments

Prevention and Treatments

A permanent routine of exercise, eating more healthily‚ and consuming the same number or fewer calories than used will prevent and help fight obesity. A single pound of fat is believed to yield approximately 3500 calories of energy, and weight loss is achieved by reducing energy intake. Adjunctive therapies which may be prescribed by a physician are orlistat or sibutramine, although the latter has been associated with increased cardiovascular events and strokes and has been withdrawn from the market in the United States, the UK, the EU, Australia, Canada, Hong Kong, Thailand, Egypt and Mexico.

In the presence of diabetes mellitus type 2, the physician might instead prescribe metformin and thiazolidinediones (rosiglitazone or pioglitazone) as antidiabetic drugs rather than sulfonylurea derivatives. Thiazolidinediones may cause slight weight gain but decrease "pathologic" abdominal fat (visceral fat), and therefore may be prescribed for diabetics with central obesity. Thiazolidinedione has been associated with heart failure and increased cardiovascular risk; so it has been withdrawn from the market in Europe by EMA in 2010.

Low-fat diets may not be an effective long-term intervention for obesity: as Bacon and Aphramor wrote, "The majority of individuals regain virtually all of the weight that was lost during treatment." The Women's Health Initiative ("the largest and longest randomized, controlled dietary intervention clinical trial") found that long-term dietary intervention increased the waist circumference of both the intervention group and the control group, though the increase was smaller for the intervention group. The conclusion was that mean weight decreased significantly in the intervention group from baseline to year 1 by 2.2 kg (P<.001) and was 2.2 kg less than the control group change from baseline at year 1. This difference from baseline between control and intervention groups diminished over time, but a significant difference in weight was maintained through year 9, the end of the study.

Abdominal obesity is associated with GH secretion and a cluster of cardiovascular risk factors that characterize the metabolic syndrome. Franco and colleagues, Sahlgrensk University Hospital, Gothenburg, Sweden, had an experiment of GH treatment to forty postmenopausal women with abdominal obesity for 12-month trial. GH treatment reduced visceral fat mass,increase thigh muscle area, and reduced total and low-density lipoprotein cholesterol compared with placebo. Furthermore, a positive correlation was found between changes in GDR and other organs. The researcher Franco said that "In postmenopausal women with abdominal obesity, 1 year of GH treatment improved insulin sensitivity was associated with reduced hepatic fat content."