Types of Obesity: Know and Differentiate
Obesity has been growing at an alarming rate in Brazil. For example, in the Vigilance Survey of Risk Factors and Protection for Chronic Diseases by Telephone Inquiry (Vigitel) in 2016, it was shown that obesity in adults increased by 60%, from 11.8% in 2006 to 18.9 % in 2016. Overweight also increased from 42.6% to 53.8% in the same period.
When we talk about this topic, it is important to note that there are two types of obesity: the central one (in which fat accumulation is abdominal) and peripheral (with more fat in the hips and thighs). And each of them affects health differently, although both are worrying.
Also known as android, abdominal or "apple-shaped", central obesity is more common in men and refers to the greater accumulation of fat in the trunk region.
In these cases individuals accumulate fat in the abdominal region (intra-abdominal and around and within the viscera), which increases the risk of developing cardiovascular problems, type 2 diabetes, metabolic syndrome and sleep apnea, various types of cancer and even death.
Called gynoid or "pear form", this type of obesity is more frequent in women and has a relation like the estrogen profile (female hormone). There is a greater accumulation of fat below the waist in the hips and thighs.
Although there is less fat in the visceral region, there is still a change in the hormonal production of the body, and this person's risk of developing health problems related to metabolism, such as the metabolic syndrome. Individuals with this type of obesity are more likely to have vascular diseases in the legs, such as venous or arterial insufficiency, in addition to osteoarthritis and other orthopedic problems. There is also an increased risk of the complications mentioned for central obesity, but in smaller proportions.
BMI alone does not evaluate obesity types
To reach a diagnosis of obesity, BMI (Body Mass Index) is the most commonly used parameter. Although it is a good guideline, it is not always fully correlated with the amount of body fat. Therefore, in order to make the correct diagnosis, it is important to consult a professional, who will choose the best method of evaluation according to their profile.
In clinical practice, abdominal circumference is the most used to assess visceral fat content . The location of the abdominal waist measurement may be the midpoint between the lower costal border and the iliac crest or the largest abdominal diameter between the last rib and the iliac crest. Below, check the measures of waist circumference that the International Diabetes Federation recommends using as cutoff point, according to ethnicity:
- Europídeos: greater than or equal to 94 cm in men (H)
- greater than or equal to 80 cm in women (M)
- South African, western Mediterranean and Middle East: idem to europodes
- South Asian and Chinese: greater than or equal to 90 cm (H)
- greater than or equal to 80 cm (M)
- Japanese: greater than or equal to 90 cm (H)
- greater than or equal to 85 cm (M)
- South American and Central America: same references of South Asians
There is evidence, however, of that the waist-to-height ratio is better than the waist and BMI for the detection of risk factors for cardiovascular and metabolic disease in adults of both sexes. In this case, the cutoff point is 0.5, that is, the waist should be less than half the height.
Ultrasonography is also a good method to quantify visceral fat and presents an excellent correlation with the best methods used for this purpose, ie, magnetic resonance imaging and computed tomography, which has high cost and limited use in daily clinical practice.Measurement of skinfolds is not a good method to estimate localized fat in the abdomen, but bioimpedance, especially when performed with octopolar equipment, is a good and practical alternative for estimating visceral fat, which is available in
Thus, there are several alternatives to measure visceral fat, but the combined assessment of BMI, waist waist and waist-to-height ratio are the most commonly used methods for practicality and low added cost.
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