Get rid of your belly
Before us is a fat man who drinks beer anywhere - in a bathhouse, on a date, at a meeting, in a garage - and as much as he wants. But the main attribute of a beer drinker is "his majesty's belly". It is impossible not to notice it, although in reality this belly is a fairy tale, a fiction, an invention. There is no beer belly (as well as vodka, herring, meat, etc.). There is simply a belly - of such dimensions that it obscures the life of its owner (including the beer drinker). How to clear the horizons again? How to avoid this stupid growth? This hump is the opposite. You need to know at least two things. First, what you will have to deal with, that is, what the belly is from the point of view of anatomy. Second - how to take up the task of getting rid of the belly (and whether it should be taken up)..
The concept of "belly" consists of two quantities - one variable, the other constant. With a variable quantity, everything is more or less clear. This is the skin plus subcutaneous fat, then increasing, then decreasing, depending on the circumstances. The constant value is the frame, the basis of the abdomen, what holds (and contains), sets the shape and preserves it. The frame of the anterior abdominal wall is the muscles plus dense, dense fascia (muscle cover); together they constitute the so-called muscular-aponeurotic layer.
The requirements for the strength of the muscular-aponeurotic layer (or frame) of the anterior abdominal wall are extremely high. Moreover, it carries all the dynamics (body movements: bending, twisting, squatting, etc.) and all the statics (tension without muscle movement: straining, coughing, lifting weights, constipation...). Moreover, this super-strong frame, like chain mail, provides and thereby protects the vulnerable, even sensitive to temperature changes, organs of the abdominal cavity - the intestines, liver, spleen, surrounded by a protective apron of fat, the so-called greater omentum (not to be confused with subcutaneous, superficial fat).
Since the frame is what holds, it itself, by definition, cannot change shape. All the frames of our body are like this (let's call at least the wide fascia of the thigh, which is in no way subject to stretching by muscles); all - with the exception of the muscular-aponeurotic layer of the anterior abdominal wall. Its uniqueness lies in the fact that it is able to stretch. But not in all of them - only in women, since they are carrying a child. In men, the framework of the anterior abdominal wall is not stretchable in principle - well, firstly, because in the stronger sex it is much more powerful than in women, and secondly, nature simply did not provide for such an opportunity.
However, the muscular-aponeurotic layer can "go" in men too. A huge "beer" belly is almost always a consequence of this disaster. But it does not come immediately. The process of building up the abdomen lasts quite a long time, and this is what happens during this time. When a man begins to gain weight, that is, accumulate fat, he first of all increases the amount of internal adipose tissue - the same one that serves as a shock absorber for the delicate, vulnerable organs of the abdominal cavity (in the people this internal tissue is aptly and causticly dubbed "visceral fat"). And only then do the reserves of the superficial, subcutaneous fat layer begin to grow.
What happens? From the inside, the internal organs, which have grown due to fat, are pressed, and from the outside, the heavy subcutaneous fat cushion is pulled down. As long as the muscles are able to overcome the double effect, the situation is reversed. A man can lose weight and return to his previous size, and at the right time, simply tense the abdominal muscles and pull in the stomach. But if the accumulation continues, in the end, the load becomes excessive for the abdominal muscles. They are no longer able to hold the abdominal organs and move apart. The stomach turns into a huge hernia, and the layer of subcutaneous fat, which has lost its support, begins to hang in heavy folds.
How to fix the disaster called "belly"? Diets? They affect only the subcutaneous fat layer, and not the strength of the frame. Sports? Men who are engaged in building their own body, devote half their lives to this, no less. And they completely abandon the so-called normal lifestyle (you get hungry - you start eating. Your soul is burning - you drink and relax).
Surgery can refine our silhouette from the inside by tidying up the dark pantry of our insides, that is, by throwing away the accumulations that no one needs. Isn't that what liposuction (suction of excess fat), abdominoplasty (surgery to tighten and strengthen the muscular-aponeurotic layer of the anterior abdominal wall), dermolipectomy (excision of excess skin and fat folds) are for?
On the one hand, on the other hand... Liposuction is indicated only for those who have a very strong frame and obedient skin: light and beautiful, like kid gloves, it will fit, "pour" new volumes, and will not wrinkle. Such a wonderful frame and no less wonderful skin are only found in physically fit and still quite young people, in former athletes. Will liposuction help people who are prone to being overweight (those who have been "sucking up" since childhood)? Excess fat will be removed, but then the already sagging skin folds will sag even more.
In this case, wouldn't dermolipectomy (removal of both folds and fat) help "saggy" people? At first glance - why not? At a second, more careful look, the following things will become clear. The distortion of the contours of the human body is usually caused by hormonal and metabolic disorders. The most obvious form of this is diabetes, and this is in addition to a multitude of less obvious and obvious disorders. In order to bring the patient to a state that does not interfere with the operation, all of them must be identified and, if possible, eliminated. "Saggy" people are primarily metabolically disadvantaged, that is, in terms of fat and carbohydrate metabolism, and endocrinologists should work with this first and foremost.
In addition, since "fatness" is a systemic disorder, not only the stomach sags - but also the flanks, buttocks, and neck (bull neck). With the help of dermolipectomy, can a surgeon "make" the stomach, but "make" the whole person? This is the same as creating it anew.
A huge belly, as we have already found out, is the sum of surface fat plus intra-abdominal volume, which has increased many times. What can be done with an overstretched, protruding frame? Turn to abdominoplasty - an operation to tighten and strengthen the abdominal muscles. But before fixing the muscles, you need to remember what they cover. And they cover not a vacuum, not air. The muscular-aponeurotic layer of the anterior abdominal wall will pull on the liver, intestines, the greater omentum (the largest organ of the body, which is adjacent directly to the frame) and other intra-abdominal organs. The intestines are the most troublesome. They are, of course, very stretched with their contents and gases, and they need to be cleaned.
And this is a tedious job: regular enemas and no less regular consolidation of the results with the help of a tight bandage. How long these procedures, which are not directly related to the operation, will take is difficult to say. Good things never happen quickly; in this case, this truth is also firmly grounded physiologically. Now it is clear why abdominoplasty is pointless without reducing the volume of the intra-abdominal space? If the intra-abdominal organs are not taught to be "moderate and careful", after the operation they:
a) will strive to restore their status quo, that is, to burst outward, threatening to spread the seams;
b) will put pressure on the diaphragm, pushing it upwards, into the chest cavity; reducing the lung volume and interfering with the work of the heart. Let us also recall that increased intra-abdominal pressure threatens with great troubles with the veins. Since venous blood from the lower extremities goes to the iliac and, further, to the vena cava, which lie just behind the abdominal cavity, it is clear that increased intra-abdominal pressure will complicate the venous return to the heart.
For a man over 40 and overweight (the main contingent of "beer" bellies), all this taken together is a suicidal risk in the full sense of the word. In other words, for those who need to restore the muscular-aponeurotic layer of the anterior abdominal wall, the main treatment is not surgery, but long-term preoperative compression - gradual reduction of the abdomen by gradually tightening the corset (bandage). When the contour reaches the desired one (what the surgeon can and has the right to work with) and the person finally removes the bandage - won't one strange thing turn out? Namely: is surgery necessary at all?
As we can see, a big belly is a big "black box". It is not known what lies behind this rather material concept. It is only known that one has to fight mainly not with fat, but with this unknown.
But there is one universal way to get rid of such a physical and sincere burden, a not-so-funny and inoffensive weight. It seems that Chekhov said somewhere: "He wanted to live, but he decided that he wanted to eat. And for some reason he ate." Learn not to confuse these verbs - "to live" and "to eat."