I diversi tipi di obesità

L’obesità viene classificata a seconda della sua origine (essenziale o endocrina) e della distribuzione del grasso a livello corporeo (androide o ginoide).

Obesità essenziale

L’obesità essenziale, detta anche ipertrofica o iperpalstica, è la tipologia più frequente di obesità. E’ caratterizzata dall’aumento del volume delle cellule adipose a causa dello squilibrio fra il reale fabbisogno energetico della persona e l’introito calorico giornaliero. Tipicamente insorge durante l’infanzia ma può manifestarsi in età adulta a causa di stress emotivi.

Obesità endocrina

L’obesità endocrina segue all’insorgenza di patologie che alterano il funzionamento ghiandolare, ovvero le cosiddette endocrinopatie come la sindrome di Cushing, l’ipotiroidismo, il diabete, la policistosi ovarica, le lesioni ipotalamo-ipofisarie ma può essere determinata anche dall’assunzione di alcuni farmaci come i cortisonici.

Obesità androide e ginoide

A seconda della localizzazione del grasso corporeo si parlerà, come abbiamo visto, di obesità androide o ginoide. Nel primo caso il tessuto adiposo sarà concentrato soprattutto sulla regione addominale (per questo motivo vi si riferisce anche con il termine di obesità centrale o addominale), nel secondo caso il grasso corporeo sarà localizzato prevalentemente sulla zona gluteo-femorale.

Negli accumuli di grasso addominale, più frequenti negli uomini, è possibile distinguere una componente viscerale e una componente sotto-cutanea. Mentre l’uomo tende ad accumulare maggiori quantità di grasso viscerale, risultando maggiormente esposto ad infarto ed ictus, la donna presenta un maggior numero di cellule adipose sottocutanee, meno pericolose per la salute ma più difficili da smaltire. Questo, anche a parità di circonferenza della vita.

L’obesità viscerale rappresenta un grave fattore di rischio poichè comporta un maggiore afflusso verso il fegato di acidi grassi liberi (FFA) che derivano dal processo di degradazione dei trigliceridi e che, arrivando al fegato, ne riducono la capacità di metabolizzazione dell’insulina con il conseguente aumento dei suoi livelli ematici (iperinsulinemia) e, quindi, dell’ipertensione alteriosa oltre che un abbassamento dei livelli di colesterolo buono a fronte di un aumento di quelli di colesterolo cattivo.

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