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 CIRCUMFERENCEand 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
MENOPAUSEwhen 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 adi-
posity 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 over-
weight. In this circumstance health experts rec-
ommend 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;

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 prema-

ture 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 malabsorp-

tive 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 OPERATIONand 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 com-

plications are both more significant with malab-

sorptive operations. Bariatric operations include

jejunoileal bypass, biliopancreatic diversion, gas-

tric bypass, and gastric banding.

Surgical Procedure

Open bariatric surgery operations are complex,

extensive, and may take several hours for the sur-

geon to perform. Laparoscopic, or minimally inva-

sive, techniques allow the surgeon to operate

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