The Effects of Weight Loss Treatments
on Upper and Lower Body Fat
Body Fat Reducing Treatments
The intra-abdominal visceral deposition of adipose tissue, which characterises
upper body obesity, is a major contributor to the development of hypertension,
glucose intolerance and hyperlipidaemia. Conversely, individuals with
lower body obesity may have comparable amounts of adipose tissue but remain
relatively free from the metabolic consequences of obesity. This raises
an obvious question are there particular weight reducing treatments which
specifically target intra-abdominal fat? In theory, surgical removal of
upper body fat should be effective. In reality, neither liposuction nor
apronectomy ('tummy tuck') have any beneficial metabolic effects, they
simply remove subcutaneous adipose tissue which is often rapidly replaced.
Vertical banded gastroplasty and gastric bypass operations may be dramatically
effective in improving blood pressure, insulin sensitivity and glucose
tolerance. However, these benefits result from a parallel reduction in
visceral and total body fat.
Body Fat Study
Studies of body fat distribution in postmenopausal women confirm that
the marked decrease in adiposity, following a program of very low calorie
diet and exercise, reflects a comparable reduction in visceral and thigh
fat. The reduction in waist circumference after a low fat/exercise program
suggests a similar situation in men. Exercise has an important role in
treatment but, once again, the fat loss is generalised. Nevertheless,
the improved metabolic parameters seen in exercising obese subjects, independent
of weight loss, suggest other beneficial actions.
Effects of Growth Hormones on Abdominal
Fat
Growth hormone (GH) has a marked lipolytic action. GH replacement treatment
for GH deficient adults with pronounced abdominal fat deposition has been
shown to reduce intra-abdominal fat by 47 percent compared to 27 percent
decrease in abdominal subcutaneous fat. Similar beneficial actions on
abdominal fat have been reported following treatment with testosterone
in obese men. The potential hazards of such treatments make them unsuitable
therapy for obesity.
Effects of Dexfenfluramine on Body Fat
Dexfenfluramine is effective in reducing total body fat but the results
from a six month randomised controlled trial indicates that it does not
specifically influence changes in waist circumference associated with
weight loss.
Conclusion on Body Fat Treatments
In conclusion, any treatment which reduces total body fat will, by its
nature, reduce intra-abdominal visceral fat. There are presently no specific
treatments which can be recommended for intra-abdominal fat but increasing
knowledge of the biochemical aberrations associated with visceral adiposity
may lead to more specific therapies for the future.
Source: International Journal of Obesity
(1997)
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