Obesity in men

It’s no secret that overweight and obesity are one of the global problems in all developed countries, including Russia. Nearly half of Russians now need to lose weight, and the number of overweight children and adults is growing at an alarming rate.

Obesity is known to be detrimental to health. Excess body fat increases LDL (“bad”) cholesterol and triglycerides, and lowers HDL (“good”) cholesterol. Obesity reduces the body’s response to insulin by raising blood sugar and insulin levels. But obesity doesn’t just lead to poor performance: it also contributes to poor health, increasing the risk of heart attack, stroke, hypertension, diabetes, gallstones, cancer, osteoarthritis, obstructive sleep apnea, fatty liver, and depression. All in all, obesity is a silent killer.

In fact, obesity and lack of exercise are responsible for about 1000 deaths in the country every day, and if current trends continue, they will soon surpass smoking as the leading preventable cause of death.

What is obesity?

Obesity affects men and women about the same. But you might be surprised to know that men suffer from it in a special way, as obesity takes a serious toll on male hormones, sexuality, and prostate health.

Obesity or overweight is determined based on BMI. It can be calculated by dividing your weight in kilograms by your height in square meters. Or use an online calculator.

BMI gives a reasonable estimate of total body fat. So, a BMI of 25 to 30 classifies a man as overweight, while a value of 30 or more means that he is already obese. But BMI doesn’t tell you how body fat is distributed. Scientists know that while excess body fat is not beneficial, abdominal (abdominal) fat is the most harmful. So, to find out if you are at risk, simply measure your waist at the level of your belly button; for men, the risk begins to increase with a waist circumference of more than 96 cm, and problems – more than 101 cm.

Causes of obesity in men

The balance between calorie intake and energy expenditure determines a man’s weight. If a person eats more calories than they burn (metabolizes), they gain weight (the body stores excess energy as fat). If a person consumes fewer calories than he absorbs, he loses weight. Therefore, the most common causes of obesity are overeating and physical inactivity. Ultimately, body weight is the result of genetics, metabolism, environment, behavior, and culture.

physical inactivity. Sedentary men burn fewer calories than active men. Health and nutrition studies have shown a strong correlation between physical inactivity and weight gain in both sexes.

Binge eating. Overeating leads to weight gain, especially if the diet is high in fat. Foods that are high in fat or sugar (such as fast food, fried foods, and sweets) have a high energy density (foods that contain a lot of calories in a small amount of food). Epidemiological studies have shown that a high-fat diet contributes to weight gain.

Genetics. A person is more likely to develop obesity if one or both parents are obese. Genetics also influence the hormones involved in fat regulation. For example, one of the genetic causes of obesity is leptin deficiency. Leptin is a hormone produced by fat cells. It controls weight by signaling the brain to eat less when body fat stores are too high. If for some reason the body cannot produce enough leptin, or if leptin fails to signal the brain to eat less, that control is lost and obesity occurs. The role of leptin replacement therapy in the treatment of obesity is being studied.

A diet high in simple carbohydrates. The role of carbohydrates in weight gain is not clear. Carbohydrates increase blood glucose levels, which in turn stimulates the production of insulin by the pancreas. And insulin promotes the growth of adipose tissue and can cause weight gain. Some scientists believe that simple carbohydrates (sugar, fructose, desserts, soft drinks, beer, wine, etc.) contribute to weight gain because they are absorbed into the bloodstream faster than complex carbohydrates (pasta, brown rice, grains, vegetables , raw foods, fruits, etc.). Thus, they cause a greater release of insulin after a meal than complex carbohydrates. This higher release of insulin is thought to contribute to weight gain.

Meal frequency. The relationship between meal frequency (how often you eat) and weight is somewhat controversial. There are many reports of overweight people eating less often than normal weight people. Scientists have observed that people who eat small meals four or five times a day have lower cholesterol levels and lower or more stable blood sugar levels than people who eat less frequently (two or three large meals a day). One possible explanation is that frequent small meals keep insulin levels stable, while large meals cause large post-meal insulin spikes.

Medicines. Medicines associated with weight gain include certain antidepressants (used to treat depression), anticonvulsants (to control seizures, such as carbamazepine and valproate), certain diabetes medicines (to lower blood sugar, such as insulin, sulfonylureas, and thiazolidinediones). ), some hormones, most corticosteroids such as prednisone. Some high blood pressure medications and antihistamines cause weight gain. The reasons for weight gain when taking medications differ for each drug.

Psychological factors. For some people, emotions affect eating habits. Many people overeat in response to emotions such as boredom, sadness, stress, or anger. Although most overweight people have no more psychological problems than normal weight people, about 30% of men who seek treatment for serious weight problems have difficulty overeating.

Disease. Diseases such as hypothyroidism, insulin resistance, Cushing’s syndrome also contribute to obesity. Some diseases, such as Prader-Willi syndrome, can lead to obesity.

Social problems. There is a link between social problems and obesity. Lack of money to buy healthy food or lack of safe places to walk or play sports can increase the risk of obesity.

What other factors are associated with obesity?

A person’s weight during childhood, adolescence, and early adulthood can also influence the development of obesity in adults. Therefore, reducing the prevalence of childhood obesity is one area that should be focused on in the fight against obesity. For example, being slightly overweight at age 20 was associated with significant obesity by age 35.

Degrees of obesity in men

Health care providers use what is called the body mass index (BMI) to calculate overweight and obesity. BMI is a tool that shows the ratio (or comparison) of height to weight and can be used to estimate body fat.

If a man is over 19, the BMI classification is based simply on the number:

• IMT < 18,5 kg/m2 – insufficient weight;
• BMI 18,6 – 24,9 kg / m2 – normal weight;
• BMI 25 – 29,9 kg / m2 – overweight;
• BMI > 30 kg/m2 – obesity.

Remember, BMI is not a perfect tool. Even if a man’s BMI classifies him as overweight or obese, you should ask your doctor if you need to make any changes to your weight to improve your overall health. A doctor will first evaluate weight gain history, activity level, diet, and body composition (such as how muscular a man is) before deciding whether any changes need to be made.

If we are talking about obesity, it is determined by the level of exceeding BMI.

The World Health Organization (WHO) uses a classification system using BMI to define overweight and obesity:

• A BMI of 25 to 29,9 is defined as “predisposition to obesity” and overweight, at which it is already necessary to lose weight;
• BMI from 30 to 34,99 is defined as “I degree of severity of obesity”;
• A BMI of 35 to 39,99 is defined as “grade II obesity”;
• A BMI of 40,00 or higher is defined as “grade III obesity” so-called morbid obesity requiring drastic treatment measures, including surgery.

Types of obesity in men

There are several classifications of obesity.

I. Depending on the area of ​​fat deposition, three forms of obesity are distinguished:

• peripheral type – accumulation of excess fat in the hips, buttocks and back, shoulders;
• central – accumulation of excess fat in the abdomen;
• combination of peripheral and central obesity.

The abdomen is considered the most dangerous area for fat accumulation, since it is located close to the vital organs and their blood supply.

II. Depending on the association with other diseases, two types are distinguished.

• type 1 obesity – it is not caused by any disease, it is associated with excessive calorie intake and insufficient physical activity;
• type 2 obesity – caused by a disease (eg, Cushing’s syndrome, hypothyroidism, insulinoma, some endocrine diseases): it accounts for less than 1% of obesity cases, and there is abnormal weight gain in type 2 obesity even with small food intake.

III. Depending on the size and number of fat cells, obesity can be divided into:

• adult type – with this type of obesity, only the size of fat cells increases, this happens mainly in middle age;
• child type – with this type of obesity, the number of fat cells increases, it is extremely difficult to reduce the number of already formed fat cells.

Treatment of obesity in men

Before determining the tactics of treatment, you need to undergo a complete examination and determine the degree of obesity and its type.

Diagnostics

Diagnosis of obesity is much more than just stepping on the scales. In fact, a thorough evaluation of a man’s weight status is a complex procedure that involves taking into account many different factors and using a variety of tools and diagnostic tests, including body mass index (BMI), waist circumference measurements, physical examinations, and laboratory tests to check for comorbidities.

Self-monitoring and testing at home

The most successful obesity management strategy involves early diagnosis and intervention. Studies have shown that receiving an official obesity diagnosis is more likely to result in weight loss (compared to those who have never been diagnosed).

IMT. The most commonly used scale that medical professionals use to diagnose obesity is called body mass index, or BMI. It takes into account the total body fat content, expressed by dividing a person’s weight (in kilograms) by the square of their height (in meters). A normal BMI ranges from 18,5 to 24,9 (kilograms of weight per square meter of height).

BMI can be used as part of a self-test for obesity using online calculators.

Waist measurement. Fat stored in the abdomen is called visceral fat, which can further increase the risk of serious illness. In people with a BMI in the range of 25 to 34,9, a waist size greater than 98 cm in men is associated with an increased risk of the disease. It may be helpful to monitor this measurement as changes in waist circumference are an independent predictor of risk, regardless of total weight, within normal or overweight ranges on the BMI scale.

Waist measurements should be taken at least once a year. A person can measure the waist by themselves. However, other measurements (e.g., BMI) must also be considered because waist circumference thresholds are unreliable for patients with a BMI greater than 35, and waist circumference may not be a reliable measure of abdominal fat for all sex and age groups.

Other diagnostic methods used to detect or evaluate obesity, which include:

• a physical examination to evaluate height, weight, vital signs, and a head-to-toe general assessment;
• health history;
• a history of weight loss efforts, exercise, and eating habits;
• review of family history (to assess the possibility of hereditary factors);
• laboratory analyzes and tests.

It is important to understand the importance of seeking professional help when it comes to diagnosing obesity in men. Diagnostic testing for obesity and overweight may include some laboratory tests to evaluate the extent to which the condition is affecting a person’s overall health and to check for signs of an underlying disease. The laboratory tests your doctor orders depend on many conditions, such as individual risk factors for obesity, comorbidities, and current symptoms.

Lab tests may include:

• cholesterol levels – low levels of good cholesterol (HDL) and high levels of bad cholesterol (LDL) are commonly associated with obesity;
• fasting blood sugar and hemoglobin A1c (HbA1c) to check for signs of prediabetes or diabetes;
• a thyroid activity test to look for signs of thyroid disease commonly associated with obesity
• liver function tests to detect fatty liver, which often accompanies obesity.

Your doctor may order other tests to evaluate the overall impact of obesity on the body. One such test is an electrocardiogram, which is used to look for signs of heart disease.

Modern treatments

The overall goal of successful obesity treatment is to achieve a healthy weight and maintain it for a long time. It seems simple, but the treatment of obesity is complex and varied, it is extremely difficult to achieve an effect in a couple of weeks, it may take years of therapy and lifestyle changes.

Before an effective obesity treatment plan can be formulated, several issues need to be addressed, including:

• what changes in the diet need to be made, assessing what exactly and how much is consumed daily;
• exercise plan (including class schedules and training regimens);
• behavior modification (for example, working on willpower and dealing with emotional overeating);

In some cases, obesity treatment also includes prescription drugs to reduce appetite, or bariatric surgery such as gastric bypass.

Currently, there are several prescription drugs approved in different countries for short-term and long-term use in the treatment of obesity.

No single treatment for obesity is right for everyone, but losing weight and keeping it off basically comes down to two key components:

• low calorie diet;
• physical training regimen.

Prevention of obesity in men at home

Like many chronic diseases such as diabetes and cardiovascular disease, obesity can be prevented in most cases through a healthy lifestyle. Eating a balanced, portioned diet, getting as much exercise as possible, finding healthy outlets to deal with stress, and getting enough sleep can go a long way in weight management.

While this is especially important for people with a family history of obesity, diseases that contribute to weight gain, and other risk factors, adherence to these strategies is important for all men from a young age.

Popular questions and answers

We will talk about the problem of losing weight with obesity with endocrinologist Oksana Mikhaleva.