Encyclopedia of Health and Medicine

A–B
abdominal adiposity The accumulation of body
fat around the middle of the trunk, forming the
“apple” body shape or the “spare tire” appearance.
Abdominal adiposity has emerged as a pattern of
fat storage that correlates to an increased risk for
CARDIOVASCULAR DISEASE (CVD) and particularly
HEART ATTACK. Doctors assess abdominal adiposity
using WAIST CIRCUMFERENCE and WAIST TO HIP RATIO
measurements. Reducing abdominal adiposity
through weight loss correspondingly lowers
related health risks. Abdominal adiposity may
become a particular concern for women after
MENOPAUSE when hormonal influences can shift fat
storage patterns within a woman’s body.
A person can be of healthy weight and still
have abdominal adiposity because abdominal adiposity
is a mechanism of fat distribution in the
inner tissues of the abdomen such as around the
vital organs. A person who is of healthy weight
but who has abdominal adiposity often appears to
have a somewhat thickened trunk and thin arms
and legs, carrying the traditional “apple” body
shape even though he or she does not look overweight.
In this circumstance health experts recommend
more physical activity to lower the BODY
FAT PERCENTAGE. With overall reduction in body fat
the trunk stores less fat, lowering the health risks
associated with abdominal adiposity.
HEALTH CONDITIONS ASSOCIATED
WITH ABDOMINAL ADIPOSITY
ATHEROSCLEROSIS
CORONARY ARTERY DISEASE (CAD)
HEART ATTACK
HYPERLIPIDEMIA
HYPERTENSION
ISCHEMIC HEART DISEASE (IHD)
PERIPHERAL VASCULAR DISEASE (PVD) type 2 DIABETES
See also ASCITES; BODY MASS INDEX (BMI); BODY
SHAPE AND CARDIOVASCULAR DISEASE; DIET AND HEALTH;
284
EXERCISE AND HEALTH; HEALTH RISK FACTORS; LEAN MUS-
CLE MASS; OBESITY; WEIGHT LOSS AND WEIGHT MANAGE-
MENT.
bariatric surgery Any of several types of surgical
operations to achieve rapid and significant weight
loss in people who have morbid OBESITY (obesity
severe enough to pose an imminent risk to life).
People who weigh 100 pounds or more above
healthy weight or who have a BODY MASS INDEX
(BMI) of 40 or greater are at severe risk for premature
death as well as for health conditions due to
obesity. At this level, body fat accounts for one
third or more of total body weight. People whose
BMIs are between 35 and 40 and who also have
CARDIOVASCULAR DISEASE (CVD) or OBSTRUCTIVE SLEEP
APNEA
are also candidates for bariatric surgery
because their obesity is a key contributory factor
in these conditions. US surgeons perform about
140,000 bariatric operations a year.
Types of bariatric surgery are either malabsorptive
or restrictive, according to the mechanism by
which they impede the digestive process. The
long-term success rate for maintaining weight loss
varies with the kind of OPERATION and the person’s
commitment to lifestyle changes in EATING HABITS
and physical exercise after the surgery. In general
the amount of weight loss and the extent of complications
are both more significant with malabsorptive
operations. Bariatric operations include
jejunoileal bypass, biliopancreatic diversion, gastric
bypass, and gastric banding.
Surgical Procedure
Open bariatric surgery operations are complex,
extensive, and may take several hours for the surgeon
to perform. Laparoscopic, or minimally invasive,
techniques allow the surgeon to operate