Abdominal obesity - any successful treatment?

My mother is 53. Her weightis 95kg and she is 165cm tall. Her body is normal except for her abdomen. It’s like a bag full of 20kg fat. I dont trust the health system here in Saudi Arabia, and the term “calorie” is alien to most of the people here. I know this is not the right place for medical advice. But I need to know the options that I have to help my mother. Can this be treated? What kind of physician should I look for? What kind of knowledge does my mother need? She doesnt eat much, yougurt and bread mostly. I bought a treadmill yesterday, but I’m not sure this will work. any help is appreciated.

You need to discriminate between visceral fat and subcutaneous fat. Normally the term abdominal obesity refers to the former. It is located inside the abdominal cavity and so is sometimes called “organ fat.” This is a major risk factor/marker for Type II diabetes.

The second kind of fat is just below the skin. It is also unhealthy but for different reasons and is not nearly as bad as visceral fat. This is the kind commonly seen in women whereas I believe (not certain) visceral fat is more common in men.

There’s one thing I want to mention but I won’t give any detail since it’s technically off topic. Testosterone augmentation in men with low levels can help to reduce the amount of visceral fat.

In English units your mother is 5’ 5" and weighs 205 lbs. She’s quite obese in pure weight terms. She needs to lose around 50 -60 lbs depending on her frame.

Are you saying she’s proportioned normally in the legs, arms, chest, buttocks etc. , everywhere except for her stomach? It’'s rare but some women do gain weight that way. The best thing to do is is simply to walk a mile a day and cut your intake consumption. Sometimes a distended belly can be the sign of various diseases but if she is otherwise healthy she’s probably just overweight.
Liposuction is an operation used to scoop out stubborn belly fat but it is major surgery.

Bread can be quite fattening.

Walking outside is not an option in Saudi. It’s in the mid 40s over there at the moment, never mind the religious police. And it’s Ramadan.

He got her a walking treadmill per the OP.

A person cannot spot reduce. He or she must loose weight all over the body.

That’s what’s unclear in the OP. A 205 lb 5’5’ woman is seriously overweight and needs to diet and exercise. If the weight is ALL in her stomach then that’s a bigger health concern than if it was distributed around the body, and she also has a fat stomach which is far more typical.

Getting someone ramped up to diet and exercise all by themsleves in a culture with very limited accessto exercise facilties for women is a substantial challenge.

So, a lot of carbs and fat, and little else. It doesn’t sound like the best diet.

Possibly way off here, but are you sure it’s fat? Liver disease and other issues can cause ascites, an accumulation of fluid in the abdomen. What does her doctor think about her weight and health?

Eating yogurt and bread is probably really unhealthy. She should be eating more HEALTHY foods and frequently. And since she is older it’s going to be really hard for her to lose weight but she really needs to start exercising. Fat is hard for anyone to lose and it gets extremely hard as you get older. Surgery is a big step to take if you haven’t even considered a good diet and exercise.


Really? I have a loaf of whole wheat (white bread isn’t much different) bread right now that says there are 60 calories per slice; the entire loaf has 22 servings/slices, so that is 1,320 calories for the entire loaf, which is fairly large (certainly large enough that the thought of eating the entire thing in one day would put me off, especially if I had to eat it by itself). Similarly, yogurt doesn’t necessarily have a lot of calories and fat (and they do both have protein, so it isn’t just fat and carbs, although vitamins would be lacking, depending on if they enrich bread and yogurt over there).

Of course, if she never exercises, that could certainly cause problems that lead to obesity.

Unless one is eating plain Greek yogurt, a diet that is mostly bread and yogurt is mostly carbs. Regular yogurt is just sugar in a cup with a nominal amount of protein and no fats. Greek yogurt at least has more protein but if it’s pre-mixed it’s still loaded with sugar.

Your body takes carbs and uses them for fuel, and what it doesn’t need for fuel it stores as fat. If you’re not moving around much, the stored fat doesn’t get burned off and new fat from un-used insulin keeps piling on.

As for why it’s concentrated in the abdomen, I don’t know. But a diet that is mostly bread and yogurt sounds awfully similar to a diet that is mostly beer (grain and sugar). Could be she has a beer belly.

That is my worry as well. She could even have a big tumor. Or an hormonal imbalance that causes her to have such a " male" pattern of fat distrbution.

Your mom has an BMI of 35, adjusted for her age and gender. That might help in researching.

Here’s the wiki page on abdominal obesity. http://en.wikipedia.org/wiki/Abdominal_obesity

One relevant quote:

Did your mom always have this fat distribution, of has she been this way only since menopause? If so, she might want to get her hormones checked.

Why wouldn’t you trust an Saudi doctor? And if you don’t, aren’t there foreign docs in expat villages?

“Beer belly” is a misnomer:

Whether you subscribe to the (calories in - calories out)/3600 theory of weight loss or the processed carbs => high levels of insulin => weight gain theory, her diet is bad by either measure. There is a lot of disagreement between the two camps so if BOTH say to change the diet, that’s gotta be saying something important.
She needs lean protein and something with fiber and medium to low sugar (lots of sugar = lots of calories).

It is subcutaneous fat (the fat that collects under the skin) or is it visceral fat (the fat inside the abdomen that surrounds the internal organs?

My understanding of liposuction is that it really doesn’t work long term, the body maintains its weight vi a complex, redundant system of chemicals and hormones. If you lipo out some fat it usually just comes back eventually.

There is a new lipo-esqe treatment called zeltiq that uses freezing to kill off subcutaneous fat. But again, who knows if it’ll just come back after you spend thousands of dollars on the treatment.

If all she is eating is bread and yogurt she is mostly ingesting carbohydrates. Carbohydrates are good if you are very active but if you don’t lose it, it gets stored in fat. So if bread is all your eating and you are not balancing any of the other foods you would get fat.