Lasciate ogni speranza, voi ch'entrate (from Italian "Abandon hope, everyone who enters here").

Obesity, or more broadly overweight, is slowly becoming one of the biggest health problems of the 21st century. It causes numerous negative consequences for human health, but also in addition is regarded by many as a vital aesthetic issue.

Obesity is generally considered to be a disease in itself, but it can also be a symptom of other diseases. It follows from this that persons prone to obesity should conduct the necessary studies to identify the cause of this disease, which must be treated. Who should take on this task? Often this pathology is dealt with just by the endocrinologist. Is it correct? We'll see.

Determination of the presence of obesity

Body mass index (BMI, BMI) is used to determine what body weight is normal for each person, it is effective in adults (but does not apply to pregnant women). This index is defined as the ratio of body weight (in kg) to the square of body height (in meters).

To not count quadratic equations, using a calculator, you can divide the weight by the height (in meters, for example 1.76) and then again by the same number. A BMI is considered normal if it is 18-25. If the resulting number is lower, it is underweight, higher, overweight, and a value of more than 30 indicates obesity.

The definition of overweight and obesity based on BMI "works" only if the increase in body weight is due to excess adipose tissue. Sometimes obesity can be due to other causes, and then BMI is not effective: excessive body weight can be caused, for example, by edema in the mind various diseases, sometimes overdeveloped muscle tissue in people who exercise or use pharmacological doping.

There are various methods for objectively measuring the actual percentage of body fat, however, as a rule, this is not required. Whether the increase in BMI is due to an excess amount of adipose tissue or it happened due to other reasons - in most cases, the doctor can decide after a small examination.

Causes of excess weight and obesity (more precisely, excess body fat)

A patient who has consulted a doctor about excess adipose tissue counts on help, and, in particular, on identifying the immediate causes. The ideal outcome would be if a disorder could be found that causes the patient to experience consequences such as excess adipose tissue. Then, after recovery (elimination of the cause), the weight will decrease to required level without being forced to make any changes in habits and lifestyle. Most patients have such expectations in relation to the work of an endocrinologist, most of them consider their way of eating correct, and at least unchanged. So, why does excess weight appear, if "once" it was not?

Sometimes it is possible to detect such a violation, which leads to this. Most often it is uncompensated (untreated) (compensated is not the cause of obesity), in men (deficiency of sex hormones), less often (Itsenko-Cushing's syndrome), other disorders are extremely rare, the discussion of which is beyond the scope of the patient guide.

However, it should be emphasized that people who develop these diseases do not deal with the usual excess of body fat: in the case of (thyroid insufficiency), weight gain is at least partly due to intercellular edema, and in patients with excessive amounts of adipose tissue trunk is accompanied by atrophy of the muscle mass of the limbs.

Most often, however, no methods confirm these violations, and an excess of adipose tissue is the result of an incorrect (excessive calorie content in relation to the required numbers) diet. Such obesity is called alimentary or primary, sometimes also simple (in foreign literature).

primary obesity

As you know, the risk of developing alimentary (primary) obesity:

• characterized by genetic conditioning;
• increases with age as caloric requirements decrease.

Why it happens? Why does excessive appetite occur, the intake of excessive amounts of food in relation to needs, excessive accumulation of adipose tissue and a decrease in calorie requirements with age? These questions are still in the “not known” category. The results of obesity research can be defined by the words: "we see a tree, but we do not see a forest." Many hormones and other regulatory factors are known to influence fat accumulation, metabolism, or appetite. Unfortunately, scientists and doctors do not fully understand their significance in the case of primary obesity.

Among the few exceptions, one should include the one described in another article, and today not fully understood, although this phenomenon explains the problem only partially. In addition, diagnostic difficulties, the lack of studies on the effects of long-term growth hormone replacement, and the high cost of treatment limit the use of these advances in practice. Anticipating possible questions - diagnostics is not mentioned in contracts and directives of the Ministry of Health regarding endocrinological clinics. Even if this item is entered, the research costs exceed the money spent as a result of current contracts, which makes it impossible to fulfill them.

Thus, obesity is the result of the coexistence of genetic and environmental factors. The latter include, of course, physical inactivity and poor eating habits:

• binge eating;
• meals at any time of the day (the main meal in the evening);
• eating high-calorie foods (sweets).

Consequences of obesity

Frequent cases include situations in which overweight / obesity is not a consequence, but the cause of other disorders, for example, diabetes mellitus, arterial hypertension, hyperlipidemia (excessive levels of substances that transport fats and cholesterol in the blood), gout (joint disease caused by excessive deposition uric acid) and many others. Using lipid-lowering drugs or antihypertensive drugs will not reduce your weight. But by limiting excess weight, you can reduce lipid levels or digital blood pressure readings.

There are also other serious illness, such as polycystic ovary syndrome (), in which this relationship with obesity is not so obvious: it cannot be revealed that excess adipose tissue is the cause of this disease, but the correlation is visible - obesity and are often interconnected. Sometimes, by reducing body weight, it is possible to reduce the manifestations of other disorders.

Procedure for overweight and primary obesity

When overweight/primary obesity is already confirmed, the question arises - what's next? Further difficulties arise. As described above, with one exception, there have been no studies providing the identification of "metabolic defects" that cause alimentary obesity, in order to make a "metabolic correction" on their basis. The effectiveness and safety of any drug that disrupts metabolism and allows you to “burn” extra calories, that is, get rid of excess fat in the body without changing dietary habits and lifestyle, has not yet been confirmed.

Therefore, the only way out is to change your eating habits and lifestyle. Here the question arises, can such a tactic be called “treatment of obesity”? There is a psychological trap in this definition, because the very concept of "treatment" usually implies a passive position of the patient, whose only role is to "contemplate" the treatment, which in this case is absolutely unrealistic.

So, how to correct the lifestyle that contributes to obesity and remove the wrong eating habits? Pay attention to the fact that laziness (doing nothing), like food, is pleasant, moreover, it is a manifestation of addiction, because these actions are on the list of mortal sins. Dealing with bad habits is exactly like breaking any bad habit and requires the same methods used in dealing with drug addiction. The purpose of our event will be to:

• increasing the level of physical activity;
• reduction in caloric content (energy value) of food.

Thus, we can imagine a method of dealing with this dependence:

Replacing pleasant with pleasant

There are many ways in which the pleasure associated with eating and doing nothing can be replaced with something even more enjoyable. All kinds of trips to the SPA, active outdoor activities, subscriptions to health and beauty procedures, etc. help in this. The very acquaintance with some of these offers ( nordic walking at sunset, a disco and karaoke in a club with prizes, etc.) is already pleasant, not to mention the very participation in this part of the entertainment industry. The variety of offers, each time with new ideas, also increase the attractiveness of lifestyle changes and make it possible to break the deadlock associated with old habits. It is only important that new habits are “rooted in the blood”, and that such impulses do not end at the very start.

You can’t afford to think that passive activities like massage or lying in the pool are enough to fight excess weight. There are too many passive activities, which from the point of view of health have been introduced into the assortment of enterprises, sanatoriums and entertainment centers, but they are only an addition to active activities so that the proposal does not look too cruel, and the person believes that he has a choice (between Thai massage and hot stone massage, etc.).

Social support groups

This is a very important method - it is difficult to fight habits on your own, it is easier in a group. Here you can see the significant role of sports clubs, annual events or simply groups of people running, swimming, walking or riding together. Also, the previously described activities of enterprises, sanatoriums and entertainment centers contribute to the emergence of social support groups and healthy sports rivalry. Thus, if you want to fight excess weight, you should think about joining a social support group.

Traditional methods based on "strong will"

In theory volitional methods should be the most effective, although in practice our "will" is often insufficient to achieve the goal, but why not try. Therefore, you should immediately analyze your eating habits and lifestyle, and then plan changes:

• Refusal to snack between meals and the fight against "small hunger". Unfortunately, if you want to lose weight, you can't avoid not being hungry for part of the day. In general, snacking between main meals can be considered the main reason excess weight, since patients, as a rule, neglect their influence and recognize them as insignificant and unimportant, keeping in their minds a false confidence that they do not make mistakes in diet.
• Planning the amount of food (the number of slices of bread, desserts, hot, fruit) and strict adherence to these plans, despite the feeling of hunger / satiety. This is an extremely important matter. Many obese people, and especially those at risk of developing diabetes, may suffer from reactive hypoglycemia - a decrease in glucose levels within 2-3 hours after a meal due to excessive secretion of insulin. This pathology is perceived as hunger and nervousness - if you hesitate with food, instinctively your hands reach for dessert, coffee with sugar, then fruit, and so on. The only way to break the "vicious cycle" is to abstain from food. In order to endure this unpleasant sensation, it is worth spending a little time and effort on gymnastic / sports exercises.
• A change in lifestyle, finally and irrevocably - a clear establishment of the time of eating throughout the day, for gymnastic / sports training. Sometimes you need to adjust/restrict opening hours to find time for these activities. As already mentioned, it is difficult to hope for weight loss without even being hungry during the day. On the other hand, everyone is well aware that it is difficult at this time to count on efficient work, therefore, for the period of such unpleasant state you can refuse the most important work e.g. before dinner.

Metformin

In the treatment of diseases associated with obesity, such as or , this drug is used, the action of which is so complex, and the effects are so numerous, that it can be included in the group of drugs that reduce body weight. So far, this has not been shown to be beneficial in common obesity, and there is no hope that metformin will lead to weight loss without changing eating habits and increasing physical activity. Its effect on weight loss is rather to facilitate adherence to normal eating habits by increasing insulin sensitivity and thus preventing the postprandial hypoglycemia described.

Medical methods - what not to use

There are many different medicines designed to help in the fight against excess weight. But, unfortunately, most of them will not stand the test of time. Below is a concise overview of current and past ineffective and ineffective pharmacological methods:

• Swelling drugs that fill the stomach - stimuli associated with the presence food products(or substances that swell) in the stomach suppress the appetite center in the brain and stimulate the satiety center. After a promising start, it turned out that the body adapts to these stimuli. These drugs even worsened the situation - in order to induce a feeling of satiety, more food is now required than before the “treatment”. Therefore, an absolutely correct decision was made to abandon the use of this type of means.
• Drugs that inhibit the digestion of food (most often fats). The result of the action of these drugs is the removal of undigested food, thus reducing its energy value. These drugs did not bring special results in the fight against obesity, since they do not affect the appetite/satiety center, which is key in this process, they do not limit the pleasures associated with food, so their effect cannot be significant. Instead, there is a risk of reinforcing negative habits, that is, lack of control over energy value food product taken: "I'm taking a drug, so why bother with a diet." Currently, there is only one drug from this group: Orlistat (Xenical), a substance that inhibits the digestion of fats.
• Drugs that depress appetite centers. There is indeed a problem here. Avipron, Mazindol, Isolipan, Meridia (Zelixa) - how many drugs have been tested. The story is always the same ... A drug appears that inhibits the thirst center. Regardless chemical structure, the effect of such drugs should at least partially imitate the effect of psychoactive substances from the amphetamine group, since this is the essence of the effect. Appear positive reviews about the effect of the drug. After some time, it turns out that preliminary observations were too optimistic, in particular due to the fact that the drug does not provide a long-term effect. There are also descriptions of side effects - because it cannot be otherwise if the drug is a psychoactive substance, and its use is becoming wider and covers larger and larger groups of patients. Thus, a decision is made to recall the drug from the market. Is such a decision correct? The last decision about Meridia (Zelix) can be considered controversial. Many other drugs are known to have unproven or negligible therapeutic effects, and each drug, if abused or thoughtlessly used, can cause side effects.
• Preparations that "enhance the burning of fats." Once again, I would like to emphasize that there are no such funds today. In the treatment of diseases associated with obesity, such as diabetes mellitus or, a drug is used that could be attributed to this group (metformin), but the expediency of using it in the case of primary obesity has not yet been proven. Sometimes there is weight loss after application various drugs when the described action comes from the patient’s psychologically tuned behavior: the use of expensive drugs encourages change, they “treat” by the fact that the patient is interested in what he eats, distributes motor activity. The black market, of course, offers many drugs from this group, which can act as a poison rather than a cure.

Pharmacological methods that may be effective

The European Medicines Agency has registered two drugs that are used in the fight against obesity. The first is Misimba, which contains naltrexone (a partial antagonist of opioids known to be physiologically present in the central nervous system) and Bupropion (used in the treatment nicotine addiction). These drugs resemble drugs used in narcology, and such is their concept of the mechanism of action. Former effects pharmacological treatment addictions were not pleasing, so one cannot expect their amazing effectiveness. It is important to note the analogy between behavior in obesity and behavior in addiction treatment. When using complex psychological assistance, the described drug can be a valuable addition.

Surgical methods

Surgery, now referred to as bariatric procedures, is one of the few treatments (in the traditional sense of the word) for obesity with proven efficacy and acceptable risk. Surgical treatment of obesity consists of interventions that reduce the volume of the stomach or create a “bypass” shortened food path through the gastrointestinal tract. Previous observations are very encouraging. It also describes the effectiveness of these methods in the prevention of diseases associated with obesity (primarily diabetes).

Alternative to iodine treatment

If you have a sense of humor, dear reader, check out what can also be effective for obesity.

Overweight of the body arises as a result of either malnutrition, or a sedentary lifestyle, or a combination of the first and second. The diet of a person with a similar problem is dominated by carbohydrate and fatty foods. As you know, carbohydrates and fats have the highest energy value, that is, they are more caloric than proteins. The latter do not pose any threat to humans, but rather serve as a building material, perform enzymatic and many other functions in the human body. That is why many diets are based on a protein diet. So why is being overweight dangerous?

An increased amount of fats in the human diet leads to the fact that the liver does not have time to process them, and the level of low density lipoproteins in the blood rises. They tend to be deposited on the walls of blood vessels and, over time, gradually clog them. As a result, the lumen of the vessels narrows, and it is more difficult for blood to pass through the vessels, i.e., increased vascular resistance occurs, which leads to arterial hypertension. High blood pressure is the cause of rapid "wear" of blood vessels, kidneys and myocardium of the heart. Arterial hypertension triggers a cascade of responses in the body, which are closed in a "vicious circle".

For example, hypertension leads to wear and tear of the myocardium, which in turn leads to heart failure. Thus, the heart loses its ability to adequately supply blood peripheral organs due to the fact that with less force it pushes the blood along big circle circulation. A state of hypoxia occurs when the organs do not have enough oxygen, which should be brought to them by arterial blood. The brain and kidneys react most acutely to the state of hypoxia. The kidneys secrete the enzyme angiotensin 1, which is converted to angiotensin 2 in the lungs, which contributes to even greater vasoconstriction so that blood comes to the kidneys better, which further aggravates the condition of arterial hypertension. But besides the fact that the heart loses the ability to adequately supply peripheral organs with blood, it gradually loses the ability to supply blood to itself. This phenomenon is called angina pectoris, which is characterized by sharp pain behind the sternum during exercise or even at rest. For the brain, high blood pressure threatens the risk of stroke. But it's just not complete list possible consequences.

As mentioned above, the amount of low density lipoproteins in the bloodstream increases. And in addition to the above chain pathological processes, under their influence, another, no less dangerous, may arise. Being deposited on the walls of blood vessels, they can contribute to disruption of the interaction of insulin with insulin receptors in peripheral tissues, in other words, the onset of type 2 diabetes mellitus.


Elevated fat content can lead to fatty infiltration of the liver. In this case, liver cells are replaced by fat cells - adipocytes - and the liver gradually loses its ability to perform its functions. It is primarily a synthesis essential proteins our body, for example, blood clotting factors, resulting in increased bleeding. The liver performs a detoxifying function, for example, in the neutralization of alcohol or any drug, which is also gradually lost.

Everything above enumerated consequences Obesity can manifest itself not separately, but in a complex way. This phenomenon is called metabolic syndrome. Designed whole complex measures to protect the human body from such phenomena. To do this, you should eat right, exercise, control your pressure, stop smoking. If you are obese, then the main rule is to use preventive measures in combination with modern drugs that lower blood pressure and lower the level of low density lipoproteins. Be healthy!

Obesity (Latin obesitas - fullness, fattening) is a chronic disease, which is characterized by the accumulation of excessive adipose tissue in the human body, which leads to an increase body weight. The disease is progressive and is accompanied endocrine disorders . A gradual increase in body weight leads to irreversible processes in the cardiovascular and respiratory systems.

To date, in the health care of our country, and indeed the whole world as a whole, such a disease as obesity occupies almost the first place in its prevalence. According to WHO statisticians, since 1980, the number of cases of this disease has doubled, in 2008, 1.5 billion people aged 20 years and older were overweight, and it’s scary to talk about the statistics of childhood - 40 million children. Almost 3 million people die each year from being overweight or obese.

Moreover, about 44% of diabetes, 27% of coronary heart disease and 7 to 40% of oncological diseases are due to excess weight. Generally speaking, this disease from year to year quickly spreads across the globe. To combat excess weight, various methods are being developed, this is a variety of diets, and training, and surgery obesity.

Causes of obesity

The common cause of obesity is slow metabolism, as a result of which the number of calories that enter the body with food is not burned, while forming excessive accumulation of fat. However, many factors lead to a slowdown in metabolism, so the causes of obesity, ultimately, may be different.

This is primarily due to low physical activity and poor nutrition, frequent use of spicy and fatty foods, especially fatty meats, various sweets, pasta. Wrong lifestyle, prolonged sleep, chronic, smoking, are also causes of excess weight. Eating a large amount of high-calorie foods, as well as sugary carbonated drinks, also contributes to the accumulation of fat in the body.

The disease can also be associated with taking hormonal drugs, as well as with frequent stress. In some cases, excessive body weight is due to a hereditary factor - increased activity lipogenesis enzymes or decrease in activity.

Some diseases can also lead to obesity, for example, ( insulinoma , gyrothyroidism ), then such obesity is called endocrine. Diseases nervous system associated with damage to the hypothalamus, lead to hypothalamic obesity.

In addition, certain medications can also lead to obesity, for example, corticosteroids and various antidepressants . Another factor contributing to weight gain is age. Usually after 30 years there is a restructuring of special centers of the brain, among which is the center responsible for appetite. This means that in order to suppress the feeling of hunger, a person needs more food. In addition, with age, a person's metabolism slows down, which leads to gradual weight gain.

Food rich in easily digestible carbohydrates is not able to be absorbed properly if you do not balance your diet with foods that have enough protein. The wrong diet of a woman leads to the fact that the fetus in the third trimester of pregnancy is already forming a predisposition to being overweight. This is where childhood obesity comes in.

obesity symptoms

Constantly increasing body weight is the main symptom of obesity. Against the background of excess weight, symptoms such as shortness of breath, fatigue, swelling of the lower extremities, increased appetite appear, while patients prefer oily And heavy food. Patients may also be disturbed by bouts of night hunger and. In a woman, changes affect the genital area, the menstrual cycle is disturbed, signs may appear, in men it decreases. Hyperpigmentation of the skin may also appear, especially on the arms and elbows, as well as the appearance of small stretch marks ( striae ) on the neck, thighs and abdomen.

These symptoms of obesity appear long before excess weight begins to interfere with the normal rhythm of life, so many patients do not consider their weight to be overweight. In the first stages of the disease, a person's weight increases up to 20% and gradually increases. An equally important symptom of the disease is hypertension. tends to settle on the walls of blood vessels, thereby impeding blood flow.

Fat deposits can be distributed evenly, and a person does not pay attention to the appearance of excess weight for a long time. In the case when the accumulation occurs in certain places, the signs of obesity are more noticeable. In children, this localized obesity leads to growth retardation.

Obesity in children most often develops due to acquired metabolic disorders, as well as heredity. Usually obesity can be observed at 1 year, and at 10-15 years. In children 10-15 years old, the cause of obesity is usually hypothalamic syndrome, which is characterized by the appearance of stretch marks on the hips, buttocks, mammary glands. An increase in blood pressure is observed, and an increase in intracranial pressure is also possible.

Diagnosis of obesity

The World Health Organization classifies obesity according to BMI, that is body mass index. BMI is calculated by the ratio of weight to square centimeter of body area. If BMI is equal to or greater than 25, then it is simple overweight , if 30 or more - obesity . As a classification option, BMI ranks first in terms of overweight detection methods, since it is the same for both sexes and all age categories.

Accurate calculations BMI produced according to the following formulas:

• less than 0.0185 g/sq. see - underweight (dystrophy);
• 0.0185-0.0249 g/sq. see - normal body weight;
• 0.025-0.0299 g/sq. see - overweight;
• 0.030-0.0349 g/sq. see - the first degree of obesity;
• 0.035-0.039 g/sq. see - the second degree of obesity;
• more than 0.040 g/sq. see - the third degree of obesity.

With obesity of the fourth degree, the actual body weight exceeds the ideal weight by more than 100%.

To measure body weight in people over 65, athletes, pregnant women and children, these formulas are being amended.

Diagnosis of obesity is also carried out according to the formula for calculating BMI Broca's index method. The basis of this method is the ratio of height and body weight. A ratio is considered normal at which body weight equals height minus 100 in centimeters. But the calculation will be correct only within 155-170 cm of growth.

If a person suffers from obesity of I and II degrees, then he has complaints of weakness, drowsiness, a sharp decline mood, increased, irritability. It can also bother chronic, as well as nausea. When exercising, it appears tachycardia And shortness of breath . At the I degree of obesity, the patient is disturbed by shortness of breath during exercise of moderate intensity, but the working capacity remains at the same level. Already with obesity of the II degree, working capacity is significantly reduced, the patient complains of swelling of the legs, as well as pain in the spine.

With obesity of the III degree, a person develops body disproportion, shortness of breath worries almost constantly, blood circulation is disturbed. Against the background of general lethargy and apathy, the patient's appetite is increased. For the IV degree of obesity, it is characteristic that a person becomes disabled, it is violated mental condition He doesn't care about anything but food.

To diagnose obesity, several factors must be considered. Firstly, the age of the patient is taken into account when the first signs of the disease appeared, recent changes in body weight, lifestyle, food preferences, presence, intensity of physical activity, use of various medicines(hormones, various food additives, laxatives).

Thus, in order to make a diagnosis of overweight or obesity, a doctor determines BMI in order to classify the disease according to severity, determines the ratio of waist circumference to hip circumference to determine the nature of the distribution of fatty tissues in the body, and then measures blood pressure. After that, the patient is sent for tests. Laboratory blood tests are carried out to determine the level cholesterol And lipoproteins high and low density in order to detect violations fat metabolism, as well as echocardiography to determine the pathologies of the heart and the entire circulatory system. In case of violations of the menstrual cycle, gynecological examinations are carried out and ultrasound procedure pelvic organs.

Complications of obesity

Obesity is characterized as a disease in which the patient has excessive fat deposits that create an additional burden on the body. musculoskeletal system , cardiovascular And respiratory system . Therefore, complications are primarily manifested by diseases of these systems and organs. Obesity is dangerous for health, for its longevity, and can lead to premature death.

Obesity very often leads to the development, circulatory disorders, diseases of the heart, joints, liver and biliary tract, as well as diabetes. In obese people, the likelihood of thrombosis in the veins of the legs is 2.5 times higher than in people with normal weight. Those at highest risk for thrombosis plump women up to 40 years old.

Fat tends to accumulate in men in abdominal cavity (abdominal obesity ), and in women - on the buttocks and thighs ( pelvic obesity ). With abdominal obesity, the likelihood of the appearance and development of coronary disease heart, which leads to an increase in blood pressure, an increase in the content of fats in the blood and the development non-insulin dependent diabetes mellitus . Weight loss leads to a decrease in blood pressure in patients suffering from hypertension, and in patients with non-insulin-dependent diabetes, this allows drug therapy to be discontinued.

On the part of the digestive organs, such complications of obesity develop as, pancreatitis , cholelithiasis .

Obese patients are often prone to the formation of malignant tumors. In men they amaze prostate And rectum , and for women uterus , ovaries And milk glands . In addition, menstrual disorders, gallbladder disease are much more common in such women than in women with normal weight. All this leads to a violation of the reproductive function.

obesity treatment

To lose weight, obese patients need to consume fewer calories than they expend. There are three methods to achieve this goal:

• self-help;
• psychological methods;
• clinical programs.

In the case of self-help, patients on their own, or in special groups, relying on the developed methods of losing weight, try to normalize your diet, do physical education. TO psychological methods weight loss include motivate yourself to lose weight, for example, the desire to surprise everyone around with your beauty and harmony, or to wear a new dress in a small size. Such motivation should be relevant, and related to the life position of a person. Such motivation should be combined with proper diet and daily physical activity.

It is very important to treat obesity in a complex way, i.e. strive to reduce body weight different ways, with the help of diet therapy, physiotherapy, exercise and medication.

The program of complex treatment of obesity usually consists of two stages - phase of weight loss (approximately 3-6 months) and mass stabilization stage (6 months).

In addition, nutritionists teach obese patients to eat right, control their health and the quality of nutrition. It is very important that the patient is aware of the need to change their eating habits and lifestyle.

Obesity treatment programs teach how to eat right, how to change lifestyle and eating habits to achieve results. To do this, doctors recommend a balanced low-calorie diet based on reducing the intake of carbohydrates and fats of animal origin, while maintaining the required amount of proteins, vitamins, and minerals in the diet. Doctors will help to individually select products, taking into account the age, degree of obesity, taste and lifestyle of the patient. You can not starve and use diets with sharp restrictions in fats and carbohydrates. Introduce foods into the diet high content fiber , which contribute to rapid saturation and accelerate the passage of products through the intestines (bran, green beans, oats, whole wheat). Meals should be fairly frequent (5-6 times a day). Also useful are fasting days(1 time per week). For those who are obese I-II degrees, doctors recommend moderately limiting fat intake.

An individual system of physical activity is developed for the patient, taking into account his lifestyle and changes in diet. Most effective daily morning exercises , as well as, i.e. brisk walking, jogging, cycling, aerobics, football. These classes should be systematic and frequent (3-5 times a week). You need to choose those physical activities that bring you pleasure. A professional fitness trainer will not only control its execution, but also correct it depending on the patient's condition. If an obese patient has diseases of the heart, blood vessels, the load should be light, focusing on the pulse.

Medical therapy helps to increase the effectiveness of other methods of treatment, and in patients with II degree obesity drug treatment begins simultaneously with a change in lifestyle and nutrition. but drug therapy not recommended for pregnant women, children, and patients over 65 years of age.

Among the drugs used in the treatment of obesity, doctors prescribe drugs that suppress appetite, promote the release of retained fluids in the body, increase energy expenditure, and reduce the absorption of nutrients in the body. For example, it prevents the absorption of fats in the intestines, but its side effect is the presence of loose stools. helps to reduce appetite and increase energy expenditure, but affects the cardiovascular system. You can also use drugs to normalize hormonal levels. Medicines for weight loss should be prescribed only by the attending physician. However, many patients supplement their treatment with special teas and fees for weight loss, as well as biologically active additives .

In diseases of obesity against the background of other diseases, for example, diabetes mellitus, diseases of the musculoskeletal system, digestive organs, treatment of the underlying disease is mandatory.

Psychocorrection sessions can also be held with the patient, in which the psychotherapist will help to understand the causes of obesity.

For the treatment of patients with obesity of the IV degree is used surgical treatment of obesity. Such operations should be carried out exclusively in institutions that specialize in this type of surgical interventions and only by qualified surgeons. It is in this case that patients tolerate the operation better, and complications occur in less than 10% of patients with a high degree of risk. There are several surgical methods for the treatment of obesity: - removal of excess fatty tissue from under the skin; – removal big belly, the establishment of gastric rings, contributing to a decrease in the volume of the stomach, which contributes to the acceleration of saturation; bypass enteroanastomoses in which portions of the small intestine are removed from the digestive system. Such operations can lead to sudden weight loss, about half the patient's excess weight, and gradually slows down. Weight loss helps to improve the general condition of the patient, increase his activity and efficiency, mood also improves. In addition, the operation reduces the complications caused by obesity.

It is important to remember that weight loss is easier to achieve with a combination of diet and exercise, physical therapy and medication. Thermal procedures have a beneficial effect on obese patients - mud procedures, hot dry-air baths, salt and coniferous baths, steaming, swimming in the pool, light-thermal baths, wet wraps. Also useful sauna - a dry hot bath of the Finnish sample. It is advisable to use occupational therapy and general massage.

It is important to note that obesity in infants is purely dietary, older children are treated in the same way as adults.

Nutrition for obesity

Since the main cause of obesity is binge eating, then doctors advise to regulate nutrition, the same recommendations include the prevention of obesity. It is important that food is not big amount calories, makes you feel full. When preparing dishes for an obese patient, they try not to salt the food. Limit food intake great content carbohydrates - bread, flour, sugar, cereals, potatoes, various sweets. You can eat black bread and bread with bran in the amount of 300 g per day. Fats in the diet are limited, but not completely excluded, they can be 50-75 g per day. Cholesterol-rich foods - liver, egg yolk - are removed from the diet. Vegetable oil is better to use unrefined, about 25-30 ml. in a day. Alcohol is prohibited. Doctors are allowed to arrange a curd day, when 60 g of sour cream, 600 g of cottage cheese, 2 cups of coffee (with milk and without sugar) and 2 cups of rosehip broth are allowed. As well as fruit and vegetable days, when consumption of 1.5 kg is allowed. raw vegetables or fruit for 5-6 meals, apple day (2 kg raw apples), or meat day, when 250-350 g of boiled meat is allowed for 5-6 meals, and boiled garnish without salt, 2 cups of rosehip broth.

With obesity III-IV degrees, patients completely remove cereals from the diet and pasta, sugar, honey, sweets, while increasing the amount of vegetables consumed, and vegetable salads seasoned with vegetable oil. Also for such patients, it can also be used, which is carried out in a hospital under the supervision of a doctor.

The main diet for obesity is diet number eight. This diet is based on reducing the caloric content of the diet due to easily digestible carbohydrates with an increased protein content. It contains increased amount proteins (120 g), reduced fat (70 g), 200-250 g carbohydrate, 1 liter of liquid. Diet number eight allows only food cooked in boiled, baked and stewed form. The consumption of fried foods and foods that stimulate appetite, seasonings, and spices is limited. For drinks and sweet foods, xylitol or sorbitol is used. Subject to diet number 8, the following are allowed:

• rye and wheat bread;
• vegetable soups, beetroot, okroshka, borscht, fat-free meat broths;
• low-fat varieties of fish and meat;
• up to 1.5 eggs per day;
• kefir, milk, skim cheese, cheese, curdled milk, butter - limited;
• buckwheat, barley and pearl barley friable porridges;
• cabbage, cucumbers, zucchini;
• unsweetened berries, fruits, compotes;
• mineral water, tea, coffee with milk (without sugar), vegetable, berry and fruit juices.

Completely excluded from the diet for obesity White bread, pastry, fatty meat and fish, sausages, smoked meats, fatty cottage cheese, fatty cheeses, cream, semolina, rice, pickled vegetables, grapes, sugar, sweets, ice cream, mayonnaise, mustard, horseradish, chocolate.

Although diet number eight allows you to "lose" a few pounds in the first month, it should be followed. long time. With the right approach, monthly weight loss will be 1-2 kg, and this will not adversely affect overall health, as often happens with other diets.

In the presence of diseases associated with obesity, the use of diet No. 8 should be agreed with the attending physician.

You can start keeping a food diary where you can write down what you ate, how much, when and why. It will help in the early stages of treatment, when lifestyle and eating habits change very seriously.

Prevention of obesity

Obesity prevention is about eliminating and compliance rational nutrition. In order to prevent the development of obesity in an infant, it is necessary to systematically weigh it, especially with a hereditary predisposition to obesity. It is very important to organize proper nutrition in adolescents, as well as timely detection of diseases that are accompanied by endocrine or hypothalamic obesity .

Obesity has become one of the problems of society in the twenty-first century. The disease "recruits" new adherents around the world. It's connected with malnutrition, sedentary lifestyle, a significant number of chronic endocrine pathologies and many other factors. Literally, obesity means that body weight increases not due to muscle compaction, but due to fat deposits on different areas body. Why is obesity dangerous? Looking at overweight people, any doctor will name a dozen reasons, and in the first place there will be diseases of the heart, blood vessels, joints and bones, a violation of water-salt metabolism. In addition, this disease makes social life difficult, as modern society is dominated by trends towards sports and a healthy lifestyle.

Etiology

The disease "obesity" can develop for a variety of reasons. The most obvious is physical inactivity, that is, a discrepancy between the calories received and the energy expended. The second most common cause of excess weight is a violation of work. gastrointestinal tract. This may be a lack of pancreatic enzymes, decreased liver function, problems with digestion of food. In addition, the risk of obesity can be determined at the genetic level.

There are factors that contribute to weight gain, these include:
- consumption of sugary drinks or a diet high in sugar;
- endocrine diseases such as hypogonadism, hypothyroidism, pancreatic tumor;
- psychological disorders (violation eating behavior);
- permanent stressful situations and lack of sleep;
- taking hormonal or psychotropic drugs.

The evolution of 2 million years has provided a mechanism for the accumulation of nutrients in case there is a sudden shortage of food. And if for ancient people this was relevant, then modern man does not need such "stores". However, our body is designed in such a way that it reacts stereotypically to both positive and negative influences from the outside. Therefore, the problem of obesity this moment stood up so sharply.

Pathogenesis

The regulation of the deposition and mobilization of fat depots is carried out as a result of a complex interaction between the nervous system and the endocrine glands. main reason accumulation of large amounts of lipids is a mismatch of the cortex big brain and the hypothalamus. It is there that the centers are located, the regulation of appetite. The body requires more food than it consumes energy, so all the excess is left "in reserve", which leads to the appearance of excess adipose tissue.

Such a violation of the coordination of the center can be both an innate condition and acquired as a result of education. In addition, such problems are sometimes the result of trauma, inflammatory process, chronic endocrine pathology.

When the pituitary gland, the cortical layer of the adrenal glands and the cells of the pancreas begin to show pathological activity, and the amount of somatotropic hormone drops sharply, then almost all the fat and glucose that enter the body are deposited in tissues and organs. This leads to morphological disorders of the liver, kidneys, thyroid gland.

BMI classification

The classification of obesity is better to start with the one that is known to the general population. As a rule, the primary diagnosis of this disease is carried out based on such an indicator as This is a private value obtained after dividing body weight in kilograms by height in meters squared. There is the following gradation of obesity according to this indicator:

1. Underweight - if BMI is less than or equal to 18.5.
2. Normal body weight - mass index should be in the range from 18.5 to 25.
3. Preobesity - BMI ranges from 25 to 30 points. At this point, the risk of comorbidities, such as hypertension, bedsores and diaper rash, increases.
4. Obesity 1 degree is set if the BMI is from 30 to 35.
5. Obesity 2 degrees - the index is approaching 40 points.
6. Obesity of the 3rd degree is diagnosed when the mass index exceeds 40 points, while the person has concomitant pathologies.

Etiopathogenetic classification

The following classification of obesity is one of the most detailed in this area, as it takes into account the causes and mechanism of the development of pathology. According to it, primary and secondary obesity are distinguished. Each of them has its own subclasses.

So, primary obesity is divided into:
- gluteal-femoral;
- abdominal;
- caused by eating disorders;
- stressful;
- provoked by metabolic syndrome.

In secondary, symptomatic obesity, four subtypes can be deduced:

1. Hereditary, with a gene defect.
2. Cerebral, provoked by neoplasms, infections or autoimmune brain damage.
3. Endocrine, caused by dysregulation of the thyroid, hypothalamic-pituitary system, adrenal glands and gonads.
4. Medication associated with taking steroid drugs, hormonal contraceptives and cytostatics.

Clinical and pathogenetic classification

If we take as a basis the mechanisms that lead to the appearance of overweight, then we can make the following classification of obesity:

Alimentary-constitutional. Weight gain is associated with excess fat in the diet and inactivity. It manifests itself, as a rule, in childhood and can be associated with a hereditary predisposition.
- Hypothalamic. The increase in adipose tissue occurs due to damage to the hypothalamus and, as a result, a violation of its neuroendocrine function.
- Endocrine. At the heart of fatness is the pathology of the endocrine glands - the pituitary gland, thyroid gland, adrenal glands.
- Iatrogenic. Obesity is caused by medical intervention. This can be medication, removal of an organ or part of it, damage to the endocrine system during treatment, and much more.

Classification by localization of adipose tissue

After examining overweight patients, it was noticed that not everyone has it distributed equally. Therefore, over time, a classification of obesity was derived, based on the characteristic location of the fat layer.

The first type, also known as the upper, or android type, differs in that the upper half of the torso, face, neck, and arms increase predominantly. It occurs more often in men, but it can also be seen in women who have entered the menopause period. A number of authors claim that there is a link between this type of obesity and the risk of developing diabetes mellitus, as well as the pathology of the cardiovascular system.

The second type, the lower or gynoid, is an accumulation of adipose tissue on the thighs and buttocks, and is more common in the beautiful half of humanity. The figure of such women takes the form of a "pear". It can also develop from childhood, if aggravated by a violation of a normal diet. in this case, there will be pathologies of the spine, joints and vascular network of the lower extremities.

The third type is mixed or intermediate obesity. In this case, excess weight is more or less evenly distributed over the body, smoothing the line of the waist, neck, buttocks.

In order to determine which type of obesity the patient applied for, it is necessary to determine the ratio of waist and hip circumference. If in women this indicator is more than 0.85, and in men it is more than one, then it can be argued that a person has the first variant of the distribution of adipose tissue.

Morphological classification

In the process of obesity, changes affect all levels of life organization, not only the whole body, but also individual organs, tissues, and even just cells. Adipocytes (fat cells) may undergo qualitative or quantitative changes. Depending on this, there are:

1. hypertrophic obesity. It is characterized by a pathological increase in the size of fat cells, while their number remains the same.
2. Hyperplastic obesity, in which adipocytes are actively dividing. This form occurs in children and is treated very poorly, since the number of cells can be reduced only by aggressive methods.
3. Mixed obesity, as it is logical to assume, is a mixture of the two previous ones. That is, the cells not only increase, but there are more of them.

Classification of obesity in children

According to statistics, in Russia now about 12% of children suffer from overweight. Of these, 8.5% are urban residents, and 3.5% are rural. Obesity in adolescents and children has become such a common pathology that pediatricians have decided to introduce a special section in their educational work with young parents about diet. Obesity is considered a condition when the body weight of a child exceeds 15% of the due at his age. If correlated with BMI, then its value will approach 30 points.

There are two forms of obesity among children: primary and secondary. Primary is caused, as a rule, by malnutrition, early complementary foods or refusal breast milk in favor of the cow. But it can also be hereditary if overweight people predominate in the family. But even in this case, the child is not born fat, he just has a slow metabolism, and with proper diet and physical activity, he will keep his weight within the normal range. Critical for primary obesity are the first three years of life and puberty.

Secondary obesity is associated with the presence of acquired endocrine pathologies. The criteria by which the degree of overweight gain is determined are still debatable. The following scale has been proposed:
- 1 degree - the weight is more by 15-25% of the due;
- 2 degree - from 25 to 49% of excess weight;
- 3 degree - the mass is more by 50-99%;
- 4 degree - overweight is two or more times higher than the age norm.

Symptoms

The signs of obesity are basically similar to each other, the difference is only in the uniform distribution of excess fiber, as well as the presence of concomitant pathologies or their absence.

Most often in patients occurs that is associated with a violation of the normal diet. As a rule, such people have a hereditary predisposition to weight gain, and overuse food leads to weight gain. Symptoms occur in all members of the family, as they all eat together. In addition, older women are susceptible to this type of obesity, who, due to their poor health, lead sedentary image life.

Obesity 1 degree is observed in most people who systematically transmit, especially in the evening. This happens because there is no time and desire for breakfast and lunch. Hungry people consume their daily calorie intake at dinner and go to sleep.

It is characterized not only by weight gain, but also by the presence of symptoms of disorders of the nervous system and endocrine regulation. Obesity develops very quickly and is usually not associated with a change in diet. Fat appears mainly on the front surface of the abdomen, thighs and buttocks. Perhaps the appearance of trophic changes: dry skin, stretch marks, hair loss. Such patients complain of insomnia, headaches and dizziness. A neurologist usually manages to identify pathology in his area.

Diagnostics

Obese people have extremely reduced criticism of their condition, so to persuade or force them to go to the doctor even for a simple consultation is not an easy task. Quite another matter - patients of the endocrinologist or the neuropathologist. These themselves want to be examined and reduce weight for a speedy recovery.

The most commonly used criterion for diagnosing overweight is the body obesity index. That is, how much the actual mass is more than the due. To determine the severity, it is important not only to prove the fact of excess weight, but also the fact that it is realized at the expense of adipose tissue, and is not muscle mass. Therefore, in medical practice, they are actively trying to introduce methods for determining exactly the fat mass, and not the entire body weight.

The norm is determined taking into account statistical data collected by doctors of various specialties over the years of practice. For each gender, age, dew and physique, there are tables with already calculated pathology and norm values. Scientists have found that centenarians have a body weight of 10% less than normal. Pathological obesity is diagnosed in the opposite case, when the weight exceeded the upper limit of the permissible by 10%.

There are several formulas for calculating ideal mass body. All fashionistas know one of them - one hundred must be taken away from height in centimeters. The resulting number will be the desired value. But this is a very conditional and unreliable study. More accurate is the BMI or Quetelet index, which was given above. Measurement of the ratio of the circumference of the waist and hips also has great importance in the characteristics of obesity, since the location of fatty tissue depends on the cause that caused weight gain.

Treatment

The fight against obesity is carried out viciously and everywhere. Now the media is actively promoting a healthy lifestyle and the cult of a beautiful, athletic body. Of course, it is not worth bringing the situation to the point of absurdity, but the general direction of the youth movement is more preferable than decadent hedonism.

The main principles of obesity treatment include:
- a diet rich in complex carbohydrates and fiber, vitamins, nuts and greens. Be sure to limit baking, sweet and carbonated drinks.
- physical exercises that should strengthen the body and speed up the metabolism.
- drugs for weight loss and appetite;
- psychotherapy;
- surgery.

To achieve long-term results of any of the types of treatment, it is necessary to change your diet and the frequency of meals. There is an opinion that diets are useless in the fight against obesity, but they help to consolidate the achieved weight and prevent the disease from returning. The World Health Organization recommends calculating the calorie content of the food that the patient consumes as usual and gradually reducing the number of calories. It is necessary to reach the mark of 1500 - 1200 kilocalories, provided that the person does not overload himself physically.

Psychotherapy is aimed at strengthening willpower and self-control in relation to food intake and dependence on restaurants. fast food and sweet sparkling water. Medicines in the process of weight loss help to achieve only a short-term effect. After stopping the pills, the patient returns to the previous lifestyle and does not follow the recommendations received at discharge. Despite the fact that now the pharmacological industry can offer a large selection of overweight drugs, almost all of them are prohibited due to the side effects caused.

Surgical methods include suturing the stomach, popular in the sixties of the last century. The essence of the operation is that the organ is divided into two unequal parts and the small intestine is sutured to the smaller one. Thus, the volume of the stomach decreases, and the rate of passage of food becomes higher. The second option is gastric banding. A ring is installed in the cardial part, which narrows the lumen of the esophagus and food, touching this artificial obstacle, irritates the satiety center, allowing the patient to eat less.

What type of obesity is the most dangerous? Perhaps everything. No one can say that typing is good for a person. The level of danger depends on how much the actual weight exceeds the norm, and what concomitant diseases he has.

What is overweight? It is a field of study in endocrinology and nutrition and is of interest to many areas of medicine as one of the suggested factors for various diseases. According to statistics, children and adults are equally susceptible to obesity. Obesity is often accompanied by sleep disturbance, posture, diseases of the musculoskeletal system, cardiovascular and respiratory systems.

Against the background of increased body weight, it is recommended to conduct examinations more often, follow medical recommendations to reduce excess body weight. To eliminate obesity, patients undergo a course of treatment from medication and physiotherapy correction. Many people have to follow a long-term regimen of therapeutic nutrition. Complications of being overweight are always serious, which is why it is so important to take care of your own health on early stages development of pathology.

The nature of the pathology

Obesity (from the Latin "obesitas" - nourishment, fullness) is characterized by excessive accumulation of fatty tissue in human body. It is characteristic of pathology chronic course, since the processes of accumulation and preservation of fat in the subcutaneous structures last for years. IN rare cases patients gain weight within a few weeks. Violation of the mass, that is, the primary process, occurs due to overeating, inactivity, lack of proper diet. The development of complications against this background is secondary. All of them bring colossal harm to health, often irreversible.

Obesity is determined not only by measuring weight, but also by measuring the volume of subcutaneous fat. In clinical practice, the following indicators are of particular importance for determining body weight:

• body mass index (fat index or BMI);
• waist circumference;
• parameters of the ratio of waist and hips;
• anthropometric indicators (measurements of skin folds).

Important! Body mass index is a determining factor clinical diagnostics obesity. Patients can independently determine the possible risks of the appearance of pathology using conventional weighing.

Stages of obesity and calculations

Overweight in patients is classified according to the severity of the course according to the change in body mass index (BMI). Clinicians distinguish 4 main stages in the development of pathological fat accumulation:

• Stage 1 - BMI varies from 25 to 30 kg / m 2;
• Stage 2 - BMI ranges from 40 kg / m 2;
• Stage 3 - BMI varies from 40 to 50 kg / m 2;
• Stage 4 - BMI exceeds 50 kg / m 2.

Already at the first stage of the development of pathology, patients feel the first signs: nausea, shortness of breath even with slight physical exertion, fatigue, sweating. Early obesity provokes exacerbation of existing chronic diseases, leads to the formation of new pathological abnormalities. Excess weight is directly related to a change in the function of many internal organs or systems.

Calculation rules

Body weight is considered superfluous, at which BMI strongly deviates from the norm in relation to the height and body weight of the patient. Today, there are many methods for people of any age, but the simplest one is calculated by the formula: height in cm - 100. The resulting value should vary within an error of 10%. A strong excess indicates the presence of excess body weight. There is an example for calculation rules. So, height 180 cm, weight 90 kg. According to the formula, 180-100=80 kg. 10% of 80 = 8, which means the optimum for this patient is from 72 to 88 kg. Calculations indicate an excess of the recommended weight by 2 kg.

These calculations are quite approximate, which is unacceptable in the diagnosis of obesity with serious complications, as well as in childhood. To eliminate an error of 10%, doctors resort to calculating BMI using the formula: weight (kg) divided by height in meters squared. In the calculations, you can focus on the following example. Height 180 cm, weight 90 kg. BMI = 90 / 3.24 = 27.7. This indicator means overweight.

Weight control can be done at home. You need to weigh yourself every morning, on an empty stomach, after going to the toilet. For the accuracy of the data, it is better to weigh yourself without clothes or in the same clothes. In addition to weighing, you can measure waist circumference once a week to determine by doctors the redistribution of fat over a certain period of time.

Physiology

Physiological or metabolic processes in overweight are changes in the composition and volume of fats, proteins, carbohydrates. The mechanism of fat formation is due precisely to violations in the digestion and assimilation of these main components. Entering the digestive tract, fats break down into fatty acids, fats and glycerol compounds. One part is absorbed through the intestinal walls and distributed throughout the body for the implementation of biochemical processes, the other is deposited in the subcutaneous adipose tissue, provoking the accumulation of fat volume.

Carbohydrates in the complex processes of food digestion are transformed into monosaccharides (breaking down into fructose and glucose) and enter the bloodstream. In muscle and liver structures, monosaccharides are converted into glycogen, and in excess they are deposited in subcutaneous fat. In the exchange of carbohydrate-containing compounds key value has insulin. It is he who converts glucose into glycogen, deposits it in adipose tissue.

In fat metabolites, leptin plays a huge role, which prevents excessive fat accumulation. Metabolic disorders lead to gynecological diseases and endocrine disorders in women, provoke in men impotence, other serious pathologies from the vital organs.

Features in children

The definition of excess weight, as well as diagnostic measures for significantly different from adults. The difference is due constant change height and weight of the child at a certain age. BMI is especially difficult to calculate during puberty, during the period of rapid growth of the skeleton.

Girls during puberty and later have physiologically more body fat than boys. BMI indicators at one age can signal the occurrence of obesity, and at another state absolute norm. In clinical practice, a special chart is used to determine the health of a child at different ages.

So, if the BMI of a child exceeds the BMI of other children by 10%, then it can be attributed to the risk group. If the child's BMI exceeds more than 90% of the BMI of other children in the measurement group, then there is clearly obesity. Parents need to be attentive to the development and physique of their own child. High performance BMI against the background of active physical life, playing sports is a signal of the development of pathological conditions in the child's body.

Predisposing factors

The main causes of overweight are considered to be violations of biochemical processes inside the body caused by various internal or external factors. The triggers for the development of pathology can be considered:

1. Metabolic disorders. The mechanism for the development of metabolic disorders is simple - a person consumes more energy than he spends in a day. Abundance, excessive eating, nighttime snacking - all this leads to body fat.
2. genetic factors. With a hereditary predisposition, the likelihood of overweight (including diseases that led to obesity) in children with overweight parents is significantly increased.
3. Sedentary lifestyle. Sport and daily training consume fats, provoke strengthening muscle tissue prevent deposition in subcutaneous fat.
4. Lack of diet, bad habits. Alcohol (especially beer) contributes to the violation metabolic processes in the body, leads to the deposition of fat in the thighs and abdomen in men, women, adolescents. food consumption in different time, fast food snacks and the use of aggressive foods (salty, spicy, sour, fried) contribute to the development of obesity.

The lack of a normal balanced diet in children of different ages quickly leads to an increase in body mass index. In developed countries, it is customary to monitor the weight of the child, and with predisposing factors, engage in regular prevention of dangerous obesity. Of particular importance are active games and physical education at school, in kindergarten.

Symptoms and signs

In some patients, even a 5-10% deviation from the normal weight can cause some discomfort in the form of heaviness, a feeling of fullness in the stomach, and shortness of breath. With a significant deviation of BMI from the norm characteristics experience all categories of obese patients:

• severe shortness of breath with little physical exertion;
• bouts of hunger;
• menstrual irregularities in women;
• swelling of limbs, face in the morning;
• stretch marks (small striae) in the neck, décolleté, thigh and abdomen;
• arterial hypertension.

As the pathological condition the way of life of the patient also changes: physical activity decreases, the psychological state is disturbed. Adolescents tend to be left alone because of the ridicule of their peers, self-esteem and personality assessment breaks down. For many obese people, being overweight means being alone, eating too much food. An important part of the treatment of this disease is psychological assistance.

Consequences

Excess fat is always serious complications, as it is the determining link in many diseases. For the prevention and treatment of almost any somatic pathology, weight loss or stabilization is important. normal weight, active lifestyle and diet food. Not to be underestimated negative impact fat on the musculoskeletal system. So, even 3-4 kg of excess weight exert a daily load on the spine, lower limbs, leading to the development of destructive-degenerative processes. Particularly important are:

1. Cardiological diseases. When overweight, the heart needs to work several times faster, which leads to the development of hypertension and hypertension. Cholesterol accumulates in blood vessels, forming plaques - common cause atherosclerotic changes, heart attacks and strokes. With hereditary or autoimmune-induced obesity, the patient's clinical history often has left ventricular heart failure.
2. Liver diseases. The liver suffers from the use of poor quality or aggressive food, alcohol. The structures of the liver are oversaturated with fats, causing fatty liver or steatosis. Complications of the disease can be cirrhosis and other destructive processes leading to liver failure and death of the patient.
3. Pathologies of the digestive tract. The stomach and intestines are subject to serious stress when overweight. A distended stomach requires more and more food, the mucous membranes of the internal organs are constantly irritated. Obese patients often suffer from heartburn, flatulence, constipation and unstable stools.
4. The pituitary gland and the thyroid gland. The human endocrine system reacts strongly to weight fluctuations, responding to weight gain with hormonal disruptions and a decrease in immunity. The main danger from endocrinology is the formation of diabetes mellitus.

Important! Excess weight can cause kidney disease, the formation of oncogenic tumors of various localization and genesis. Joint diseases with an increase in obesity, they begin to progress, patients experience severe pain in the limbs, limitation of mobility, up to its complete limitation.

Complications during pregnancy

During pregnancy, women undergo a mandatory monthly examination by a gynecologist to identify possible deviations in fetal development. In addition to screening studies and ultrasound of the fetus, the woman herself is also examined, revealing edema, parameters of the growing abdomen, and the woman's weight. Tracking the dynamics of weight allows you to respond in time to strong jumps in BMI. The danger of being overweight during pregnancy is obvious. It can cause:

• the formation of varicose veins of the lower extremities;
• edema;
• arterial hypertension;
• hemorrhoids;
• difficult and long labor due to a large child.

Weight during pregnancy is gaining imperceptibly, a woman allows herself more sweets, starchy foods. Almost all family members are condescending to the preferences of a woman during this period, which is fraught with unpleasant consequences for the body of the child and the woman in labor.

Treatment tactics

Before treating overweight in children and adults, complex diagnostics for possible diseases that could provoke an increase in fatty tissue. Additionally, they take blood tests, urine tests of various directions, prescribe instrumental research if necessary. The treatment of obesity is always complex and involves the following steps:

• medical nutrition;
• sports or exercise therapy;
• massage and apparatus treatment;
• homeopathy and medicines;
• surgical operation (vacuum liposuction is used).

It should be noted that surgical correction is a temporary panacea for excess weight and is ineffective if all other rules are not followed. healthy lifestyle life. When excess fat is removed using a vacuum, it will return again after some time after the patient's transition to the usual way of life. The method has many contraindications, a long recovery period, and complications.

Diet

To provide the body of an adult with all useful and nutritious substances, it is enough to use a single serving of 250 gr. Preference should be given to fresh quality products. The basic rules of clinical nutrition and any diet include:

• food in small portions, but often;
• adherence to the schedule of eating;
• "slow" food with a long chewing of each piece.

Drink between meals clean water without gas, brush your teeth. This way you can prevent hunger. The diet will be effective if the patient leads a socially active lifestyle, participates in many activities, is busy at work. It is only important to remember to eat at certain hours (breakfast, lunch, afternoon tea, dinner). The last meal should be 4 hours before bedtime.

If you are slightly overweight, you can drink a course of vitamins and metabolism-improving drugs. All medicines are prescribed by a doctor in a certain dosage, in agreement (if necessary) with other specialists in the medical profile. In severe cases, patients may need the help of a psychologist or psychiatrist. With a burdened clinical history, it is recommended to prevent the development of exacerbations of various chronic diseases in time.

Obesity is a chronic deposition of fat in the subcutaneous adipose tissue. Pathology is dangerous with complications for the health of children and adults, which is why it is so important to respond in time to any changes in weight. Sports, active lifestyle, attending massage sessions and Attentive attitude to your own body will allow you to maintain normal weight and make the figure slim.