Central obesity
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Central obesity (or 'apple-shaped' or 'masculine' obesity) occurs when the main deposits of body fat are localised around the abdomen and the upper body.
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Associations
Central obesity is common in polycystic ovary syndrome (PCOS) and Syndrome X, and it is associated with a statistically higher risk of heart disease, hypertension, insulin resistance and diabetes mellitus type 2.
Central obesity can also be a feature of lipodystrophies, a group of diseases which is either inherited, or due to secondary causes (often protease inhibitors, a group of medications against AIDS).
Diagnosis
Central obesity is diagnosed by measuring the waist-hip ratio. When this exceeds 1.0 in men or 0.9 in women, one can speak of central obesity.
Therapy
Weight loss is the main intervention against central obesity when this is considered disfiguring or when it puts one at a risk for the abovementioned diseases. Adjunctive therapies are the use of orlistat or sibutramine. In the presence of diabetes mellitus type 2, the physician might prefer to prescribe metformin and thiazolidinediones (rosiglitazone or pioglitazone) as anti-diabetic drugs rather than sulfonylurea derivatives.