What Causes Central Obesity & How Do You Measure It?

The importance of eating healthy and maintaining a good amount of body fat can never be overemphasized. This is because when there is excess accumulation of fat, whether internally or externally, it can cause harm to the body. Excessive accumulation of fat is one of the main causes of central obesity. This type of obesity is not about how much you should weigh, but how much body fat you should have.

What Exactly Is Central Obesity?

Central obesity has to do with your visceral area. The visceral area includes the three cavities of the body – the chest, abdomen and pelvis. Central obesity, also known as abdominal obesity, can be defined as the excess accumulation of fat in the abdominal area, which is caused by excess visceral fat. 

Inside the body, the portal blood system supplies visceral fat, i.e., the fat surrounding the abdominal area. Excess fat in this area can trigger the release of fatty deposits into the portal circulation, which supplies the liver directly. This makes the visceral fat cells enlarged and trapped with excess triglycerides to pour free fatty acids into the liver.

These free fatty acids also accumulate in so many other organs that are not originally meant to store fat, like the pancreas, heart, etc. The direct consequence of this is organ dysfunction. It also causes impaired regulation of insulin, blood sugar, abnormal heart function and cholesterol. This fatty build up into the bloodstream, of course, has dire consequences, as it is the cause of many negative health conditions like:

• Glucose intolerance
• Type 2 diabetes
• High blood pressure
• Endometrial cancer
• Atherosclerosis
• Insulin resistance
• Cardiovascular diseases
• Altered metabolic profile
• Metabolic syndrome
• Obesity-related lipid disorders (e.g., hypertriglyceridemia, hypo-HDL-cholesterolaemia, etc.

Elderly people are more prone to central obesity. During the aging process, body fat is often redistributed to the abdominal region. Also, men have twice the abdominal fat of women, so elderly men are more susceptible to central obesity. This is because of body shape. Women always have a high percentage of body fat and will be generally expected to be more prone to central obesity than men, but then women largely have pear-shaped bodies, so their fat is more often located on their hips and thighs. For men, who are generally apple shaped, carry excess weight in their abdominal region.

What Causes Central Obesity?

Once a person has central obesity, it is an indication of dysfunctional adipose tissue (tissue which stores our body fat).  The issue of central obesity originates from hypercortisolemia (abnormally high levels and a deficiency of sex steroid hormones). These hormonal disorders affect the development of functional adipose tissue, thereby leading to the accumulation of visceral fat and an enlarged visceral fat depot. But then fat does not just start accumulating in the portal system; there must be an initial fat accumulation. What causes fat accumulation in the first place? 

• Lack of healthy diet – while we may be tempted to consume lots of sugary foods such as cakes, drinks, chocolates, etc. because of the instant pleasure they provide, we should keep in mind that sugar isn’t the best foods to consume regularly and can lead to excessive weight gain, slowed metabolism and the reduction in a person’s ability to burn fat. Low protein and high carb diets also affect weight negatively. We should adopt the habit of feeding on whole grains instead and generally try and include more protein onto our plates

• Excessive alcohol –  Consuming excess alcohol is known to have so many negative consequences, but pertaining to central obesity, excess alcohol consumption causes excess weight gain around their bellies (especially in males)

• Lack of exercise –  People who rarely exercise consume calories but end up not burning any of the calories off.  This makes it almost impossible to release any excess fat 

• Stress – a hormone in the body called cortisol helps people manage and deal with stress. When a person is stressed, there is a natural tendency to reach for comfort foods. During these high stress periods, the body releases cortisol which also helps help keep food in the belly for later use (biologically to avoid starvation). This continuous storage of fat in the belly can expand out the waistline and lead  to central obesity

• Genetics –  there is some research that has shown that a person’s genes can determine the likelihood of whether they will have central obesity or not

How Do You Measure Central Obesity?

The easiest way to access central obesity is by measuring your waist circumference. As opposed to waist to hip ratio measurement, it has been shown that waist circumference measurement is one of the most accurate anthropometric indicators of abdominal fat.

Steps on how to measure central obesity:

• Get a measuring tape
• This waist measurement should be taken as you breathe out
• Ensure that you relax and avoid contracting any abdominal muscle
• The tape should be set or aligned at the level of the belly button
• Circle the tape the whole way around the body and back to the starting point

Waist Circumference Risk Levels

Waist circumference for adults:

• A waist circumference equal to or greater than 94 cm in men and 80 cm in women shows a moderate risk of central obesity
• A waist circumference greater than 102 cm in men and 88 cm in women shows a high risk of central obesity.
• A waist circumference greater than 120 cm for men and 110 cm for women shows an extreme risk of central obesity

Note: different ethnic groups have different body builds.  So waist circumference measurements are unique to each ethnic group. More on this below.

Waist circumference for children:

Waist circumference measurement cannot identify risk in children and teens because there is no data to indicate appropriate cut-offs. So to measure central obesity in children, other general recommendations could suffice.

• A child above the 90th percentile for their age and with non-alcoholic fatty liver disease (NAFLD) has a high risk of developing liver fibrosis. At this point, your doctor will carry out further investigations
• A waist circumference of 12-19 years old boys between 66.8-87.2cm shows a high risk of cardiovascular disease
• A waist circumference of 12-19 years old girls  71.5-87.2cm and above have a high risk of cardiovascular disease

Limitations To Waist Circumference Measurement

The major limitation of waist circumference measurement is the variation in different ethnicities. This is mostly relevant in multicultural countries like Australia or The United Kingdom. At this point, you should already have a tape in your hand to check your status. Ensure that you are still very much below 94 cm for men and 80 cm for women as a general guideline. We all can help ourselves to live a healthy life and somehow increase our life span. Avoid the risk that comes with central obesity by ensuring that you take all the necessary precautions stated above.