The physiological role of the so-called white adipose tissue is to deposit and preserve fatty acids, including essential ones, in triglycerides, which can be used as a source of energy, as well as a protective membrane of internal organs and an insulator that prevents heat loss.
More than 90% of the energy stored in the body is energy contained in the triglycerides of adipose tissue. Fat depots allow you to have a reserve of energy necessary to ensure growth, reproductive function, and other needs arising from the influence of environmental factors or physiological conditions. Protein makes up a much smaller portion of the stored energy. Glycogen is an even smaller store of energy, but glycogen is used for quick energy gain during physical work and short-term fasting.
Brown adipose tissue is found in small amounts in the scapular and subscapularis subcutaneous tissue of newborns. The brown color is given to it by abundant vascularization. The function of brown adipose tissue is to produce heat, protect against cold and dissipate excess energy consumed with food.
The size and number of adipocytes differ in different parts of the human body. The total number of these cells increases in persons who developed obesity in childhood. Fat storage in the first months of life is carried out by increasing the size of already existing fat cells, i.e. by hypertrophy. By the end of the 1st year of life, the size of fat cells doubles, but their number changes insignificantly both in the normal development of the child and in the obese child. In children who are developing normally, the size of fat cells begins to decrease after the 1st year of life. However, with the development of obesity, the cell size in children remains the same large that the fat cells have reached by the end of the 1st year of life. As children grow, the number of fat cells increases. Fat cell hyperplasia is more pronounced in obese children than in thin children. The process of fat cell hyperplasia stops at the age of 10-12 years, and the number of fat cells remains almost constant with age. Modern data show that after puberty, rapid fat deposition (acute development of obesity) occurs mainly due to the hypertrophy of already existing fat cells. Also, with a rapid decrease in body weight, the number of fat cells does not change, but they decrease in size, losing accumulated fat. However, with a slow (over several years) formation of obesity in adults, an increase in the number of fat cells was noted, and with a slow reduction in body weight, a decrease in the number of adipocytes was observed.
The size, number and local distribution of fat cells determine the nature of obesity, its health consequences and treatment options. With a high degree of obesity, when the body weight is 75% of the desired, one should almost always expect both hyperplasia and hypertrophy, while with moderate obesity, the process may be limited mainly to adipocyte hypertrophy. The duration of weight loss that is observed with successful dietary obesity correction is shorter, but the rate of reversal of weight gain is faster in patients with fat cell hyperplasia than in hypertrophic obesity.
Adipose tissue is capable of producing and releasing biologically active substances into the bloodstream, such as adipsin (a serine protease involved in thrombosis), cytokines that alter the response to insulin, angiotensinogen.
The biological role of leptin
Leptin (from the Greek leptos - thin) was discovered in the early 1990s. It is a hormonal protein produced by adipocyte fat cells. Leptin regulates the processes of fat deposition in adipose tissue. It is assumed that leptin has specific receptors in the hypothalamus, with the participation of which a signal is transmitted to the hypothalamus about the size of adipose tissue. Thus, leptin is involved in the regulation of appetite and energy metabolism.
An analogue of leptin has been found in the blood of humans. With obesity, the concentration of leptin in human crop is increased, in contrast to mice with a genetic form of obesity, in which the level of leptin is reduced. The administration of leptin to mice with a genetic form of obesity, in which leptin is not synthesized, leads to a normalization of body weight.
In thin people, leptin in the blood plasma is mainly in bound form, and in the blood plasma of obese people, leptin is present in free form. Leptin is also present in cerebrospinal fluid.
People's blood leptin levels are predicted (in descending order of relationship) by total body fat, percentage of body fat, and BMI. During fasting and a decrease in body weight, the level of leptin in the blood decreases, and during the period of excessive food consumption, on the contrary, it is increased. Thus, leptin acts as a sensitive sensor of energy balance disorders: with a negative energy balance, the level of leptin decreases, and with a positive energy balance, it rises. Prolonged insulinemia is accompanied by an increase in blood leptin levels.
Like other hormones, the secretion of leptin is characterized by a circadian rhythm. The concentration of leptin in the blood rises at night.
It is assumed that obesity in humans may be associated with a violation of the interaction of leptin with its receptors in the hypothalamus, which leads to impaired appetite regulation and promotes the deposition of fat in adipose tissue. Obesity is presented as a state of resistance of the hypothalamus to leptin. Discovery of leptin opens new prospects in the study of the mechanism of development and treatment of obesity.
Local distribution of adipose tissue
Localization of preferential fat deposition is important for the characteristics of obesity and its health consequences.
There are two types of fat deposition:
abdominal, or android (male type, in which fat is predominantly deposited in the upper body;
gynoid, or female, type with a predominant deposition of fat on the thighs and lower abdomen.
An easy way to diagnose the two types of obesity is by analyzing the ratio of the waist circumference to the hip circumference and measuring the thickness of the fat folds. Preferential deposition of fat by male type to a greater extent increases the risk of developing diabetes and cardiovascular diseases (hypertension, myocardial infarction, stroke) and mortality from these diseases.
Research shows that preferential localization of fat matters more than obesity per se. The two types of obesity differ metabolically. With the android type of obesity, glucose intolerance and insulin tolerance, an increase in blood lipid fractions, an increase in blood pressure... Abdominal obesity in women increases the risk of developing breast cancer. The android type of obesity is characterized by hypertrophy and hyperplasia of intra-abdominal omental fat cells. These adipocytes are metabolically more active and release free fatty acid directly into the portal blood system, influencing the metabolism
Overweight: men and women
One married couple came to see a dietitian doctor. Each of the spouses had about 9 kilograms of excess weight, and they thought that losing weight together, supporting each other, would be much easier and more fun. They were offered the same exercise and nutrition program. A month later, it turned out that the man had lost 3.15 kilograms, and the woman gained 0.45 kilograms. Then the doctor asked if there were any differences in their lifestyle and eating habits, and received a negative answer. They ate the same foods at the same time and went to the gym together. Another month passed, and the man lost 2.7 kilograms, and the woman only 0.47 kilograms (the same weight that she gained last month). Unsurprisingly, she got very upset and was ready to give up her attempts to lose weight and started eating chocolate again.
It is this case that best confirms how different the metabolic processes of men and women are, how differently female and male fat cells are arranged and function. It was necessary for the woman to change the weight loss program and switch to a different diet, and in two months she would "catch up" with her husband, and after 6 months they both reached the weight they dreamed of. Now about everything in order A man's body from birth has the ability to burn fat faster than a woman's body. It is an irrefutable fact that women differ from men not only in the structure of internal organs. A female fat cell is larger, more active than a male, and therefore women lose weight much more slowly than men, and gain weight very quickly. However, before we can understand why a female fat cell is so stubbornly resisting our attempts to control their weight, we must first understand what this fat cell is and how it functions.
There are about 30 billion fat cells in the human body, which, under certain conditions, are capable of storing 67.5 kilograms of fat. The only job of a fat cell is to store calories when the body doesn't need them, and burn them when needed. The fat cell does not work alone, it needs help. These helpers are enzymes that transport fat into and out of the cell. Enzymes that help the body store fat are called fat-forming enzymes, and those that help burn fat are called fat-breaking enzymes. Men and women may have the same number of fat cells, but that's where the similarities end. The main difference between male and female fat cells is the different mechanism of enzyme functioning and the size of the fat cells. As you may have guessed, the female body has more fat-forming enzymes that promote fat storage and larger fat cells. In contrast, men have fewer fat-burning enzymes and smaller fat cells. Simply put, the female body is designed to store fat faster and more efficiently. The male body, on the other hand, burns fat quickly and efficiently. As a result, women lose fat very slowly, while men accumulate it slowly. Estrogen - the female sex hormone activates fat-forming enzymes. This is the reason for the accumulation of fat in the female body during puberty, pregnancy, hormone therapy and oral contraception. Mother Nature knew what she was doing by supplying the female body with such a mechanism. This is necessary to preserve reproductive function and normal bearing of the fetus. You cannot be a woman without a certain reserve of body fat. Estrogen not only stimulates fat-forming enzymes, causing them to store fat, but also indicates where exactly. This is the second major difference between men and women. Estrogen directs fat mainly to the buttocks and thighs. The average woman has an upper body size 44 and a lower body size 48. This is why women are often called pears. If a man is gaining excess weight, then fat, as a rule, is concentrated in the waist area due to the influence of the male sex hormone, testosterone. Such men are called "apples". If you are a pear-shaped figure, then the first thing you will do is gain weight in the hips and buttocks. Fat cells of a short person are larger and have more fat-forming enzymes, therefore, by dieting or actively playing sports, a tall person will lose weight faster. Of course, following a certain program, a short person will successfully get rid of excess weight, but his fat cells will show more persistence and require more effort from him. If you are an apple, your fat cells are high in fat-breaking enzymes and are small in size for faster weight loss. Of course, estrogen activates your fat cells, making them more "stubborn" than men, but compared to "pears" your body will respond much faster to changes in diet and exercise. With age, the difference between "pears" and "apples" becomes even more noticeable. Let's take a look at the functioning of female fat cells in real life. life situation... You had a tough day, you got really hungry and ate a whole pizza for lunch. Your body's calorie needs were fully met by three out of eight slices of pizza, and the remaining five slices are excess calories that enter your circulatory system in their original form. Since the fat cells in your thighs and buttocks are the most active, the five "extra" pizza slices are transported by fat-forming enzymes to these parts of the body. Now, even if you ditch the chocolate ice cream for dessert, the fat cells in your buttocks and thighs are getting bigger. But the presence of estrogen in female body is not the only reason that we easily recruit excess weight... The fact is that for most women, diet becomes an obsession. I do not know a woman who at least once in her life did not go on a diet, and most of them subject themselves to this test more than once a year. A low-calorie diet is, oddly enough, best friend female fat cells. If women knew what actually happens to their bodies when they go on a diet, they would never do it. As soon as your fat cells "understand" that the intake of calories in the body has decreased, they throw a battle cry and call on the fat-forming enzymes to begin their duties. Unfortunately, fat-splitting enzymes are not on the guest list. Diet increases the size of your fat cells, causes them to store fat more actively and burn it more slowly. And the fact that you are happy getting on the scales is not a fact that you are losing weight due to fat - most likely you are losing water and muscle, and getting rid of fat on your own without a competent specialist doctor is not so easy. Male fat cells react differently to reduced calorie intake. When a man goes on a traditional low-calorie diet, he activates his fat-breaking enzymes and successfully loses weight. A woman, if she loses weight while dieting, then quickly returns to her previous weight, and even gains more than before - we have already written about this mechanism in our previous articles. It should be said that men have another advantage: muscles. This does not mean that the male and female cells function differently. The thing is that the muscle mass of men is 40% greater than the muscle mass of women. Muscles have mitochondria, which burn calories by converting them into heat and water. Thus, the greater muscle mass you have, the more calories are sent to and burned in muscle cells and the less fat is stored in the body. So, we can argue that the male body has a mechanism that helps him, by limiting calorie intake and increasing physical activity, to successfully lose excess weight. In contrast, women are designed to gain weight successfully. have more fat-forming enzymes and less muscle mass. Therefore, female fat cells are much more "stubborn" than male ones. They concentrate mainly on the thighs and buttocks, actively storing fat and giving it away with difficulty, and are eagerly awaiting the next diets. Unfortunately, most women, trying to lose excess weight, do not take into account the characteristics of their body and resort to low-calorie diets. Before going to such extremes, please consult with a dietitian, and you will realize that when you go on a diet, your fat cells are fighting with you. And they win.
The role of white adipose tissue in storing and releasing lipids for oxidation in skeletal muscle and other tissues has been of interest to researchers for decades. And now, when the fight against obesity is recognized as one of the tasks of public health, the study of the behavior of adipocytes (fat cells), the role of neuro endocrine system in the regulation of the energetic dynamic constancy of the organism and obesity, the identification of epidemiological, pathophysiological and molecular causes of obesity is in the focus of the work of biologists and physicians.
Strictly speaking, it is customary to define obesity not as excess body weight, but as an increase in the amount of adipose tissue that threatens health. The main role of adipocytes is to store triglycerides during periods of excess calories and to mobilize this reserve when energy expenditure exceeds consumption. However, it is now widely accepted that adipose tissue underlies a complex network that regulates a wide variety of biological functions.
Adipose tissue develops extensively (that is, it increases quantitatively). There are two processes in the formation of adipose tissue.
- - Formation of primary fetal fat at 14-16 weeks of intrauterine development. These are lipoblasts or pre-adipocytes - several lipid droplets from which brown fat cells develop.
- - The formation of secondary fat occurs later in the life of the fetus (after the 23rd week of pregnancy), as well as in the early postpartum period... Differentiation of the spindle-shaped progenitor cell, in which lipids accumulate to eventually coalesce into one large droplet of cells, leads to the proliferation of fat depots formed from single-chambered white fat cells in many areas connective tissue.
The adipose tissue is broken by connective tissue septa into lobules. The number of fatty lobules always remains constant (not cells - their number can grow!), While in the process of growth and development, lobules can continuously increase in size.
Microscopic studies have shown that the second trimester can be a critical period for the development of obesity in later life... In the third trimester, adipocytes (fat cells) are present in small numbers in fetal tissues and it is important to emphasize the presence of tight coordination of angiogenesis (formation of blood vessels) with the formation of clusters of fat cells.
At birth, fat accounts for 16% of the total body weight of a child (brown fat accounts for 2-5%). During the first year of life, the amount of fat increases by 0.7-2.8 kg. The development of adipose tissue depends on gender and age. In addition, throughout life there are sensitive periods to changes in the accumulation of adipose tissue, for example, two peaks of an accelerated increase in its volume - after birth and at the age of 9 to 13 years.
Fat cells grow and differentiate most intensively in the first year of life. Then, the entire period until the beginning of puberty, this process slows down, it is even more inhibited during puberty (puberty) and remains constant throughout life in people with a stable weight. In the case of a constant intake of an excess amount of energy in the body, adipose tissue grows due to an increase in the volume of existing fat cells (adipocytes), and later also due to the formation of new cells from the depot.
Adipose tissue- a kind of connective tissue. It consists of fat cells - adipocytes. In the human body, adipose tissue has many functions. Among them: energy supply, thermal insulation, protection of organs from mechanical damage(fat pad), endocrine function.
There are two types of adipose tissue: brown and white... They differ not only in color (white is white or slightly yellowish color, and brown - brown or brown), but also by the amount of energy released. Brown produces more heat, thereby warming the body better. Newborns have a lot of it. As a person grows up, its amount decreases.
How adipose tissue develops
Fat cells develop from the mesenchyme (connective tissue) at 30 weeks of intrauterine development. During the period of embryonic development, the first period of their active reproduction occurs. As a result, the number of adipocyte cells increases. Mature fat cells are not capable of dividing, but adipocyte precursor cells retain this ability throughout a person's life.
With the onset of puberty, a second period of active reproduction of adipose tissue cells is observed. In other periods of a person's life, as a rule, there is no proliferation of progenitor cells. Fat accumulates in pre-existing fat cells by increasing their size.
When the cells' capacity to accommodate fat is exhausted, a signal is sent to the progenitor cells and they begin the process of reproduction. This is how new fat cells appear. Newly formed adipocytes are not capable of reverse development and remain for the rest of their lives. For example, a thin adult has approximately 35 billion fat cells, while a severely obese person has four times that number - 125 billion.
Distribution of adipose tissue in the body
The bulk of body fat in human body located under the skin, most of all - in the abdomen. The thickness of the subcutaneous fat on the anterior abdominal wall in obese people it can reach 15-20 centimeters. Body fat presented in the form of lobules. The size of each of them is 0.5-1 cm.
In the abdomen, fat is not only found under the skin. There is a special formation in the abdominal cavity - the omentum, which can accumulate a lot of fat. Significant fat depots are observed in the retroperitoneal space, where the aorta, pancreas, kidneys, and other organs are located.
Types of fat deposition:
- central;
- peripheral.
In the human body, fat is unevenly distributed. There are two types of fat deposition: central ("apple-like") and peripheral ("pear-like"). They have some peculiarities. With the central type of obesity, fat deposits are found in the bulk in the abdominal cavity, and with peripheral obesity, predominantly under the skin. In case of central obesity around internal organs the deposition of metabolically active brown fat occurs. And in the peripheral, white fat is deposited under the skin, which is metabolically inactive.
The main functions of adipose tissue
1. Accumulation of energy
From 65 to 85% of the fat cell mass falls on fat, presented in the form of triglycerides. Triglycerides release a lot of energy when broken down. When you compare fats to carbohydrates and proteins for energy storage, the obvious benefits of triglycerides emerge. They are able to accumulate in large quantities in their pure form and when they are broken down, 2 times more heat is released than when carbohydrates are broken down (1 kilogram of fat contains about 8750 kcal).
2. Thermal insulation
Subcutaneous fat forms an insulating layer that protects the body from hypothermia. Thus, seals, penguins, walruses and other warm-blooded animals living in the Arctic and Antarctic have a powerful layer of triacylglycerols.
3. Mechanical protection
Adipose tissue protects the internal organs from mechanical stress and creates a so-called bed for them. This is how the fatty tissue around the kidney forms a "fat pad" and holds it in place.
4. Endocrine function
Adipose tissue is an important organ of the endocrine system. It synthesizes such important hormones like leptin and estrogens. Leptin regulates the length of the interval between meals. The higher the level of leptin, the less often a person eats.
Estrogens... Adipose tissue has aromatase activity. The aromatase enzyme P450, which is part of adipose tissue, converts the male sex hormone testosterone into female sex hormones - estrogens. The rate of this conversion increases with age and the growth of body fat.
A special aromatase activity is observed in fat accumulated in the abdominal region. So you can explain where from men with a large "beer" belly comes practically female breast why their fertility and potency decrease.
Adipose tissue is a collection of cells that perform the functions of accumulating the body's reserves, which gives it energy. Adipose tissue also performs a number of other functions that are no less important for human life: thermal insulation (protection of the body from cold), the function of a "protective cushion" from mechanical damage and ensuring the flow of certain substances into the blood. Fat cells begin to form in humans during the period of intrauterine development, starting from the 16th obstetric week. Adipose tissue reaches its peak in the first years of life, then the number of formed cells begins to gradually decrease - this happens by the end of the 10th year of life. The amount of fat reserve is finally formed by the age of 12-13 and throughout life can change under the influence of certain factors, but remains individual for each person.
The structure of fat cells
What is the structure of a human fat cell? Fat cells are 86% composed of special substances that are formed from the breakdown components of dietary fats. These substances are called triglycerides - they are the source of energy and make up 92% of all body reserves. Fat reserve is necessary for growth and development, reproductive and physiological processes in the body. The reserves of glycogen and protein account for only up to 8% - these substances serve as a source of energy during exhausting physical exertion and short-term starvation.
The structure of the fatty layer is heterogeneous - it is located under the skin and above the internal organs of a person in the form of lobules from 3 to 8 mm. In the abdominal region, fat is deposited mainly under the skin. There is a special organ in the abdomen called the "omentum" - it is able to store fat, which is then transported in the retroperitoneal space. All abdominal organs are covered with fat: pancreas, liver, intestines, aorta and kidneys.
Types of body fat
There are three types of body fat:
- Subcutaneous - fat cells are located directly under the skin, mainly in the abdomen. Its thickness in people with normal weight does not exceed 5-7 cm, if it is 10-15 cm, then this indicates excess weight, if more than 15 cm, then obesity.
- Under the muscles - located in the muscle area (strategic reserve).
- Internal - located on the surface of internal organs.
There are two types of adipose tissue: white and gray. The main functions (warming, protection, energy) are assigned to the white fabric, but the gray one plays a completely different role. In the human body, there is very little gray tissue, while white tissue can be more than enough. White adipose tissue has a yellow or yellowish tint, and gray - gray, brownish or brown (this color is due to the content of the pigment "cytochrome").
White adipose tissue tends to rapidly increase in volume (cell diameter can increase up to 20-25 mm). White tissue is formed from pre-adipocytes, which gradually develop into full-fledged fat cells. Their volume can vary depending on nutrition, exercise, or hormone synthesis.
Brown adipose tissue provides the body with heat, warming the organs - there is a lot of it in animals, this allows them to go into hibernation and not freeze. When the animal sleeps for a long time, the metabolic process and the release of heat practically stop, and the optimal temperature of the internal organs is maintained at the expense of gray adipose tissue.
An adult has a very small amount of gray tissue, but newborn children have a little more of it - this is what nature has foreseen. Then, over the years, its amount gradually decreases, and on the contrary, it becomes more white adipose tissue. Pure gray fabric is available in the area thyroid gland and kidneys.
Mixed fat cells (white and gray) are located in the area of the shoulder blades, between the ribs and on the shoulders of a person. They differ from each other not only in color and function, but also in structure. The structure of fat cells in gray and white tissues is also different. Inside the cells of the white tissue, there are bubbles with the size of almost the entire cell, while its nucleus is slightly flattened. The nucleus of gray tissue is round in shape, and there are many bubbles in such cells. They have mitochondria containing cytochrome - it is this substance that gives the cells a brownish or grey colour... In turn, physiological processes take place in the mitochondria, due to which heat is produced.
Function of adipose tissue
Fat is necessary for a person for such processes:
- Production of hormones. A layer of fat is capable of producing hormones, primarily estrogen and leptin, which are involved in many physiological processes occurring in the human body.
- Energy and warmth. Energy is stored as fat. Its main source is carbohydrates obtained from food. Insufficient intake of them contributes to the breakdown of glycogen (fat reserves in the muscles), and excess - their deposition under the skin. When glycogen ends in the body, the direct breakdown of fats into glucose begins.
- Build the skin.
- Formation of nerve tissue.
- Biochemical reactions (assimilation of vitamins and minerals).
- Protection against mechanical stress. Adipose tissue, located around the organs and under the skin, provides a secure position (each organ is in its place), as well as protection from shock and injury. That is why organ prolapse often occurs only in thin people.
Adipose tissue is capable of accumulating toxic substances in itself, therefore, its reduction not only improves the figure, but also heals the body. With the loss of excess weight, cosmetological changes also become noticeable: the complexion improves, pains in the right hypochondrium disappear, the skin becomes elastic and taut.
Distribution of adipose tissue
Fat in the human body is distributed unevenly, and in men and women in different ways. In men, it is located more evenly, accounting for 13-18% of the total body weight. In women, fat is deposited mainly in the abdomen, thighs and mammary glands (fat percentage from 17 to 26%). Fat cells in the stronger sex are slightly denser than in women, so they do not develop cellulite. You can talk about overweight when the percentage exceeds the permissible figure. Obesity means when a person has two types of fatty layer (peripheral and central) and its volume exceeds the permissible percentage (for women up to 25%, for men 18%).
Obesity reasons
Many people wonder - where do they come from overweight? The reasons for being overweight can be different:
- Discrepancy between the consumed energy and the consumed one. With abundant nutrition and a sedentary lifestyle, the fat layer grows rapidly, therefore obesity develops. Nutrition and physical activity play an important role here.
- Genetic predisposition... In addition to a set of genes, eating habits are inherited from his parents. For example, if from childhood a person is used to eating high-calorie foods, then at an older age this habit may persist.
- Age factors. The older a person is, the easier he gains excess weight - this is due to a slowdown in metabolism, as a result of which energy is spent slowly.
- Hormonal imbalance(endocrine obesity). This type obesity occurs as a result of hormone dysfunction.
Obesity consequences
Being overweight can be the cause of many diseases. First of all, there are violations in the cardiovascular system: the load on the heart increases, the level of insulin and cholesterol rises, which often leads to the formation of blood clots. The risk of myocardial infarction and stroke also increases. Fat people are often worried about shortness of breath - they cannot climb stairs without stopping or ride while standing in transport for a long time.
One more serious illness that can be covered under overweight- This is diabetes mellitus (types 1 and 2). People with a body mass index greater than 10% are at risk of developing this endocrine disease 10 times higher than normal weight people. Body fat is primarily huge pressure on the skeleton, muscles and joints, which eventually leads to arthrosis, radiculitis and spinal deformities.
Infertility as a consequence of obesity
For women reproductive age excess weight is especially dangerous, as it can lead to infertility. Women who are obese 1 degree have a 25% less chance of conceiving a child than people of normal body weight. Even if an overweight woman managed to become pregnant, then not only the threat of miscarriage increases, but also the development of diseases such as gestational diabetes, thrombosis, hypertension, disorder heart rate and poor blood clotting. Also, increased body weight can provoke profuse bleeding during childbirth and inflammatory process in the pelvic organs. This is why it is important to get rid of extra pounds before pregnancy.
Infertility against the background of obesity develops as a result of dysfunctions of sex hormones. Body fat produces an excessive release of androgens, which blocks ovulation (the release of an egg from the follicle). At the same time, the woman has an irregular menstrual cycle, increased oily skin and increased growth body hair in unwanted areas. Insulin resistance plays an important role in the development of infertility with overweight. This phenomenon caused by a reduced sensitivity of tissue receptors to insulin, which leads to its increased production. Thus, increased insulin in the blood provokes an increase in body fat.
Obesity treatment
To cure obesity, a woman needs to consult an endocrinologist and nutritionist. The doctor will first of all carry out diagnostics in order to determine the patient's health status and identify the cause of overweight. If obesity is caused by improper diet and a sedentary lifestyle, then it is prescribed therapeutic diet and lungs physical exercises... A woman should follow these recommendations regardless of the type and causes of obesity. If extra pounds accumulate as a result hormonal disorders, then you need hormone therapy(the treatment regimen is developed strictly by the doctor).
If a woman succeeds in losing weight successfully, this does not mean achieving the goal, since it is also important to maintain a normal weight: regularly exercise, eat right, spend time on fresh air... This will help maintain optimal fat cell structure. Often there are situations in which a woman, having lost weight, still cannot get pregnant, which means that the metabolism has not yet returned to normal. In this situation, the doctor may recommend taking a multivitamin for several months or artificial insemination.
Symptoms of obesity are similar for any type of obesity and regardless of the cause, however, there are some differences that are important in the diagnosis and in the choice of treatment tactics.
The diagnosis of obesity, or rather its part based on objective research data and symptoms, should be carried out only by a specialist, since objectification is important. Evaluation of nutrition, both excessive and insufficient, should be carried out in dynamics, and it is also necessary to compare only with the individual norm, since generally accepted standards may not always be lawful in relation to each specific person.
Public opinion about the "ideal" body weight has changed significantly over the course of human development. For example, in the Middle Ages gluttony and obesity were condemned, and even in the paintings of those times one can often find thin, even cathectic and emaciated people. Later, for example, in the 19th century, thinness was already perceived as a sign of trouble, while obesity was a sign of good social status and prosperity. It was believed that this testifies to the good skills of the mistress of the house and the high status of the family in general.
Thus, at various times, overweight people were at the peak of popularity, but became the subject of condemnation and ridicule from society. V modern world many lack tact and tolerance in relation to overweight people, especially for women, but the problem is deeper than it might seem at the beginning. Obesity may not only appear visually unattractive, but it also entails severe consequences for health. Well-being is impaired, there are malfunctions in the functioning of many body systems, which only aggravates psychological problems such patients.
Obesity manifestations can depend on the severity of obesity and on its type. Distinguish between female and male fat deposition. The classification is carried out on the basis of measuring the circumference of the hips and the circumference of the waist, with the subsequent determination of the ratio between these indicators.
Male obesity differs in that lipid deposits are predominantly localized in the upper body. The ratio of waist to hip circumference is more than 0.85 for women and more than 0.95 for men. Insulin resistance is more common with this type of obesity. At the same time, the body acquires the conditional "apple" shape.
In the female type of obesity, excess adipose tissue is deposited to a greater extent in the lower body. The waist-to-hip ratio is more than 0.85 for females and more than 0.95 for males. With this type of obesity, treatment with diet gives good results. The type of figure is called for this form of the disease "pear".
In addition to male and female, there is also mixed type obesity, in which excess adipose tissue is evenly distributed.
With regard to the degree of obesity, the generally accepted classification is considered to be 4 degrees. Determination of the severity of obesity is based on comparison with the ideal body weight calculated for a specific person strictly individually.
In the first degree of obesity, the patient's weight is less than 30% higher than his ideal body weight. For the second degree of obesity, the excess of the ideal body weight is already by 30-50%, with the third degree, the weight is 50-100% more, and with the most severe 4, the body weight exceeds the ideal by more than 100%.
The main typical signs of obesity are weight gain and visible, visually excess adipose tissue. Such patients are characterized by shortness of breath. varying degrees severity, even with little physical activity. This is due to a decrease vital capacity lungs, which is typical for overweight people. With significant obesity, this can even develop into the so-called Pickwick syndrome, which includes signs of hypoxia, which develops due to insufficient ventilation and excessive delay. carbon dioxide- drowsiness, general lethargy, decreased intellectual abilities.
Obesity is also characterized by other systemic disorders, in particular, from the endocrine system.
One of severe manifestations that accompanies obesity is insulin resistance and the resulting hyperinsulinemia. The severity of these manifestations is directly proportional to the degree of obesity, and also leads to the development of complications such as diabetes mellitus and hypertension.
With an excess of food entering the body, the level of triiodothyronine increases (with insufficient nutrition, it decreases). At the same time, the level of thyroxine and thyroid-stimulating hormone unchanged regardless of nutrition. However, despite this, the function of the thyroid gland may be impaired. Therefore, with obesity, it is imperative to consult an endocrinologist in order to assess the functioning of the thyroid gland.
For men, obesity is fraught with the development of impotence due to a decrease in concentration. total testosterone and follicle-stimulating hormone. However, this complication is typical for more significant degrees of obesity, since at the same time the level of free faction testosterone. However, erectile dysfunction often accompanies men with varying degrees of obesity.
For reproductive system the female half of the patient obesity is also dangerous. Male-type obesity is characterized by an increase, sometimes significant, in the level of androgens in the blood. In obese women, female type the excess of the level of estrone in the blood is determined (also due to the conversion of excessive free androgens into estrogens). All this leads to disruption menstrual cycle, girls have their first menstruation earlier than expected, possible uterine bleeding, ovulation disorders, infertility. Disturbances in the balance of male and female sex hormones often lead to hirsutism.
External manifestations of obesity include and skin symptoms: acanthosis of the skin, striae, frequent bacterial and fungal skin lesions and some others. Skin acanthosis is characterized by darkening of the folds on the neck, dorsum of the fingers, on the elbows, in groin areas, in the area of armpits... This condition indirectly indicates insulin resistance, and is also pathogenetically associated with the development of diabetes mellitus. Hyperpigmentation also occurs in areas of friction of the skin. Stretch marks, in other words, stretch marks, are also a clear sign of obesity. Depending on the cause of obesity, they can be either purple-red or whitish.
Obese patients are often concerned about excessive sweating. This is especially uncomfortable in the hot season. In this case, the condition is aggravated unpleasant odor, since such patients are characterized by an increase in the looseness of the skin, which increases the risk of developing fungal and bacterial skin infections. For such patients, acne and furunculosis are a common problem.
Obesity is characterized by a higher mortality rate than among other population groups, which is also associated with damage to almost all body systems. This includes diseases of the cardiovascular system, pathology of the endocrine system, digestive tract, osteoarticular system. Obesity increases the risk of even some cancers.
An increase in blood pressure, which almost always accompanies obesity, leads to an increase in the load on the heart muscle, and myocardial hypertrophy develops. In addition, fatty degeneration of the heart occurs, the so-called obesity of the heart develops. Because of this, rhythm disturbances often occur, up to a high risk sudden death as a result of an attack of arrhythmia. For patients with obesity, complaints of pain in the heart, sensations increased heart rate, shortness of breath, increased blood pressure.
In addition, on cardiovascular system extremely negatively affected by atherosclerosis, which is also a constant companion of obesity. This is due to an imbalance between lipoproteins of different densities, which leads to the deposition of fatty (atherosclerotic plaques) on the inner walls of blood vessels. These plaques can cause embolism, including can lead to the development of myocardial infarction, which also contributes to an increase in the percentage of deaths from obesity.
Functioning is often impaired when overweight lymphatic system, lymph stagnation occurs, edema is characteristic, especially of the lower extremities.
Vascular lesion in obesity is secondary and is characterized by the development venous insufficiency, varicose veins, especially the veins of the lower extremities, phlebitis. In addition, the risk of stroke increases. The frequency of thrombosis and embolism in such patients is also quite high.
Excess weight even affects the organ of vision - the risk of developing cataracts, according to recent studies, increases by 12 percent in obese people. In addition to cataracts, the risk of developing glaucoma, macular degeneration, that is, damage to the retina of the eye, increases. When lipid metabolism is disturbed, which is characteristic of obesity, even the composition of the lacrimal fluid is disturbed, which leads to both lacrimation and dry eye syndrome, chronic fatigue eye.
Diabetes mellitus is the most common complication of the endocrine system in obesity. As a rule, we are talking about type 2 diabetes mellitus, that is, about non-insulin dependent diabetes mellitus associated with insulin resistance. However on this moment there is no consensus as to which of these diseases is the most important: diabetes or obesity. Many experts believe that with non-insulin dependent diabetes mellitus only forms of obesity are combined, which are hereditary, while acquired forms of obesity do not cause diabetes mellitus. This opinion arose due to the fact that according to studies, 80% of patients with non-insulin-dependent diabetes mellitus develop obesity, but a large number of obese people do not develop diabetes. In addition, it is very rare that non-insulin dependent diabetes develops in people whose body mass index is less than 22.
The defeat of the respiratory system in obesity is usually observed with a pronounced degree of the latter. Obesity of 1-2 degrees rarely leads to impaired lung function. Aside from shortness of breath, there are usually no complications. With severe obesity, there may be more dangerous complications, for example, obstructive sleep apnea, this pathology occurs due to the deposition of lipid tissue in the pharynx and trachea. In this case, the first symptom of such a complication is snoring during sleep.
A typical symptom is also patient complaints that they often wake up at night for no reason or with a feeling of lack of air. Because of bad sleep there is drowsiness during the day, up to the acute need for short-term sleep in the middle of the day, in the morning people are worried about headaches. All this leads to impaired concentration and attention, memory, decreased ability to work, increased irritability. A complex of such violations leads to depression, decreased sex drive, both in men and women.
Often such attacks can be triggered by alcohol intake, sedatives, antihistamines. These drugs can aggravate the health of patients and should be warned about the need to abandon such provoking factors.
The digestive tract is affected secondarily in obesity. Often, obese patients go to the doctor with complaints of pain in the right hypochondrium, a feeling of heaviness in this area, and colic attacks. The excretory part of the pancreas suffers most of all, since overeating and predominance fatty foods, especially fast foods, has Negative influence on the processes of food digestion and enzymatic breakdown of food. Pancreatitis often develops, which can significantly worsen the quality of life of patients and requires adherence to a strict diet, the violation of which leads to an exacerbation of attacks.
In addition to the pancreas, the gallbladder also suffers. The incidence of cholecystitis (inflammation of the gallbladder) is in direct proportion to the degree of obesity. It is believed that damage to the gallbladder occurs due to increased excretion of cholesterol through the biliary tract, changes in the level of bile acids, phospholipids. Possible development of cholelithiasis - education gallstones which often requires surgical treatment in a planned or urgent manner.
With obesity, the liver is also affected - hepatitis develops, it is possible diffuse changes liver on initial stages, fatty liver hepatosis develops. Liver dysfunction does not occur immediately, but develops over a long time, therefore, complaints may not appear in patients immediately, while the liver tissue is already suffering.
Due to the disruption of the functioning of the enzymes of the digestive tract, intestinal disorders, stool disorders often occur, such patients have a tendency to constipation. It is also characteristic increased gassing in the intestines.
Excess weight increases the load on the musculoskeletal system, especially on the joints. Arthritis and osteoarthritis are more common in obese patients than in people with normal body weight. The articular tissue of the lower extremities is especially affected, in particular, arthrosis of the ankle and knee joints... The lack of exercise, characteristic of obese individuals, also aggravates the condition.
Due to impaired excretion of urate with excess body weight more than high frequency incidence of gout. Urinary system suffers from excessive development of perirenal tissue and concomitant changes in renal tissue. This provokes stagnant urine, which increases the risk of infections. urinary tract, leads to nephropathy of varying severity. Impaired renal function further exacerbates arterial hypertension, formed vicious circle.
The muscular system in obesity is underdeveloped, this leads to both a general decrease in muscle tone and muscle strength, and to complications such as hernias, especially inguinal and umbilical hernias.
Obesity can provoke more high risk the development of certain types of cancer. An example would be colon cancer (usually direct and colon). In addition, women are at increased risk of developing breast and endometrial cancer, even during the menopausal period, because obese women have increased estrogen levels due to increased production of the precursors of this hormone - androstenedione - in adipose tissue. Men are characterized by an increase in the percentage of cancer development. prostate... The reason for this kind of complications lies in a general metabolic failure, a violation of the patient's hormonal profile, and severe metabolic disorders.
Immunity in obese patients is usually reduced. Even ordinary respiratory infections are usually harder for them, they last longer, and complications often develop. More and the frequency of development of autoimmune diseases.
Many people may think that obesity is only an aesthetic problem, but this is far from the case. Obesity is serious pathology, which is characterized by multiple organ damage and big number complications, as evidenced multiple symptoms obesity.
Excess weight for modern man became one of the worst nightmares, because the main fashion trend today is harmony and beauty. To maintain a graceful figure and maintain a normal weight, we resort to a variety of methods - from standard diets to a cardinal solution to the problem with the help of a surgeon's scalpel. Fighting fat is spent great amount manpower and resources, but what do we actually know about him? What is the mechanism of its formation? What methods will help to defeat him? Is it possible to get rid of fat cells permanently?
The widespread belief that fat cells develop in the body only with improper lifestyle and overeating is fundamentally wrong. In fact, a person is born with a certain number of adipocytes and cells that, if necessary, can turn into them - pre-adipocytes. Fat cells are necessary for the body to perform a number of functions: they participate in the production of hormones, detain certain types of toxins, accumulate energy reserves organism in case of hunger and serve as a kind of protection against cold and mechanical shock.
But to perform these functions, a minimum number of small adipocytes is sufficient. If a person regularly overeats, he leads sedentary image life and does not waste the energy received from food, the body begins to store the excess in fat.
The mechanism of this process is as follows: already existing adipocytes begin to increase in size, thereby causing an increase in body volume. On average, a fat cell can become 30-40 times larger than it was in the beginning. Sooner or later, if the process of fat accumulation does not stop, the body sends a signal to pre-adipocytes, and they are reborn, forming new "stores" for fat stores.
In an obese person, the number of adipocytes can reach 100-130 billion cells, while their normal amount should not exceed 30-35 billion.
Since fat cells in a certain amount are needed by the body, they are equipped with a special mechanism for interacting with organs and tissues. If you look at an adipocyte under a microscope, you can see that it consists of a fat globule surrounded by the finest blood vessels and collagen fibers. With the help of capillaries, the fat cell "communicates" with the body, receiving nutrients from it and, in turn, giving it fat as an energy source. But if the size of adipocytes is too large, and the number of fat cells concentrated in one place exceeds the norm, they lose their connection with the circulatory system. There is a local accumulation of adipocytes, which, gathering in a kind of lumps, squeeze the lymphatic and blood vessels, thus disrupting the full supply of nutrients to tissues.
As a result, the structure of subcutaneous fat changes, it turns into a lumpy, shapeless mass (this is what is called cellulite). In order to consume fat from storage cells, communication with other body systems is necessary, and such adipocyte colonies are completely devoid of it. It turns out a vicious circle - no matter how many people are on diets, no matter how many hours they spend in sports hall, he fails to get rid of the largest accumulations of fat cells, and sooner or later the weight stops falling.
This is due to the fact that the initial weight loss in such cases occurs due to the destruction of relatively young and small fat cells, which have not yet lost their full connection with the circulatory system. As soon as they all give up their reserves, the process of weight loss will stop.
For this, it is necessary to restore their connection with the rest of the body again, that is, destroy the membranes of a part of adipocytes, thereby changing the structure of the subcutaneous fat. This can only be done with external influence aimed at the areas of local accumulation of fat cells. The most effective ways to damage the membranes of adipocytes and force the fat to come out, as well as force the cell colonies to change their structure, ultrasonic cavitation and mesotherapy for weight loss are considered today.
The destruction of adipocyte membranes by ultrasonic waves occurs due to a mini-explosion inside the cell. The air bubble created by cavitation explodes, completely destroying the fat cell.
Mesotherapy is the introduction of substances into the folds of fat that damage even the densest membrane of adipocytes and stimulate metabolic processes in tissues.
As a result of both procedures, the work of the lymphatic and circulatory system in the area of adipocyte accumulation, and the mechanism for introducing fat from the body is triggered.
Even the densest fat-containing cells can be destroyed with modern technologies that allow you to achieve amazing results in a short period of time. It is enough to turn to the help of professionals, and the problem of local fatty deposits will be solved.
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