The degree of obesity, how to treat obesity

  • Sedentary lifestyle
  • Insulin and insulin secretagogues
  • Genetic factors, in particular:
    • Increased activity of lipogenesis enzymes
    • Decreased activity of lipolysis enzymes
  • Some diseases, in particular endocrine diseases (hypogonadism, hypothyroidism, insulinoma)
  • Psychological eating disorders (for example, psychogenic overeating), leading to eating disorders.
  • Propensity to stress
  • Prader-Willi Syndrome
  • Hypothalamic dysfunction
  • Lack of sleep
  • Psychotropic drugs
  • Systemic glucocorticosteroids
  • Hormonal contraceptives

In the process of evolution, the human body has adapted to accumulate a supply of nutrients in conditions of abundance of food, in order to expend this reserve in conditions of forced absence or restriction of food - an evolutionary advantage that allowed it to survive. In ancient times, fullness was considered a sign of well-being, prosperity, fertility and health. An example is the sculpture "Venus of Willendorf" (Venus of Willendorf), dated 22nd millennium BC. er (perhaps the earliest known illustration of obesity).

Central obesity called excess fat in the abdomen. Central obesity is considered the most dangerous type of obesity and, according to statistics, is associated with an increased risk of heart disease, high blood pressure and diabetes. The common opinion that central obesity (“beer belly”) may be associated with drinking is not confirmed: neither the body mass index, nor the ratio of waist circumference and hip circumference are associated with beer consumption.

A patient is considered to be sick with central obesity, if the ratio of waist to hip volume exceeds 0.8 for women or 0.95 for men.

Pathological types of obesityAs a rule, they are associated with disorders in the human endocrine system, resulting in impaired fat metabolism.

Obesity is divided into degrees (by the amount of adipose tissue) and types (depending on the reasons that led to its development). Obesity leads to an increased risk of diabetes, hypertension and other diseases associated with being overweight. According to the WHO classification, with a waist size of more than 94 cm for men and more than 80 cm for women, the risk of developing diseases associated with obesity increases. Causes of excess weight also affect the spread of adipose tissue, the characteristics of adipose tissue (softness, elasticity, fluid percentage), as well as the presence or absence of skin changes (stretching, enlarged pores, so-called "cellulite").

In 2013, the Food and Agriculture Organization of the United Nations published a report on obesity. The UN used 2008 data to compile the report. Below is a table of the 20 countries that are most affected by obesity as a result of the UN report:

A countryPercentage of people suffering

Mexico32,8
USA31,8
Syria31,6
Venezuela, Libya30,8
Trinidad and Tobago30,0
Vanuatu29,8
Iraq, Argentina29,4
Turkey29,3
Chile29,1
Czech28,7
Lebanon28,2
New Zealand, Slovenia28,0
Salvador27,9
Malta27,6
Panama, Antigua26,8
Israel26,5
Australia, Saint Vincent and the Grenadines26,1
Dominica26,0
Great Britain24,9
Hungary24,8

Director of the Research Institute of Nutrition of the Russian Academy of Medical Sciences, Chief Scientific Secretary of the Presidium of the Russian Academy of Medical Sciences Viktor Tutelyan noted in 2005: “We have 60% of women in Russia and 50% of men - an average of 57.5% (in Russia, an average of 9 women – 8 men) suffer overweight. In our country, 57.5% of deaths are due to cardiovascular diseases. These diseases are very often due to overweight people. ”

In Mexico, in turn, about 70% of people suffered from overweight in 2008, including 32.8% from obesity (in 2009 their number dropped to 30%).

The head of Rosstat, Alexander Surinov, said that more than 40 percent of the adult working-age population, and the majority of Russian pensioners, suffer from overweight.

In 2016, The Lancet magazine published a study that suggests that by 2025 almost 20% of the world's population will be obese.

In 2016, about 39% of the adult population of the Earth was overweight with a BMI of 25 or more. Out of 1.9 billion overweight people, 650 million are obese. The first line of the WHO ranking in terms of the proportion of people suffering from obesity was occupied by the Pacific island countries. Russia in 2016 took the 55th place.

According to statistics from the Ministry of Health of the Russian Federation, the number of residents of the Russian Federation with diagnosed obesity in 2017 reached 2 million people (+1.3%). In the Jewish Autonomous Region, more than half of all obese patients are children and adolescents under 17 years of age. In another 14 regions, children and adolescents accounted for more than a third of all obese patients.

According to some sources, the Vietnamese are the “most harmonious” nation in the world, and among the Europeans there are Bosnians and Moldovans.

Clinical manifestations of obesity are characterized by the deposition of fat in various parts of the body as a result of excessive consumption of calories from food and reduced energy consumption.

For the diagnosis of obesity in practical medicine most often used body mass index (BMI). The Borngardt index is also used, in contrast to BMI, which takes into account the human physique.

Body Mass Index Edit

The indicator for determining overweight is the Body Mass Index (BMI).

BMI = body weight / height 2 (kg / m 2).

In 2000, WHO proposed that the Mongoloid race reduce the overweight threshold from 25 to 23 kg / m 2, and the obesity threshold from 30 to 25 kg / m 2. The reason for this was epidemiological studies, which showed that the Mongoloids are beginning to suffer from problems associated with obesity, with a lower body mass index. At the same time, some researchers suggest that members of the Negroid race, as well as people of Polynesian origin, raise the overweight threshold from 25 to 26, and the obesity threshold from 30 to 32 kg / m 2.

In cases where the BMI is 40 or higher, even in the absence of obesity complications, morbid (painful) obesity is said. In the presence of such complications of obesity as type 2 diabetes mellitus, arterial hypertension, dyslipidemia, and pathology of the joints of the lower extremities, obesity is classified as morbid already with a BMI of 35 and above.

The body mass index is criticized for not taking into account the fat / muscle ratio and the type of fat distribution in the body. For example, an elderly person with a small muscle mass can be classified as a person with ideal weight, while a muscular athlete can be classified as overweight or obese. Nevertheless, the body mass index remains the only internationally recognized criterion for assessing overweight.

Magnetic Resonance Imaging Edit

The most accurate method for determining the amount of adipose tissue in the body is MRI.

In everyday life, the amount of adipose tissue in the human body is usually determined by household scales with a body composition analyzer using bio-impedancemetry method.

People who are overweight tend to exaggerate the width of their own figure, which leads to greater subjective dissatisfaction with the body image.

Basic treatments for obesity and overweight Edit

  • These include adherence to a diet with a high content of fiber, vitamins and other biologically active components (cereals and whole grains, vegetables, fruits, nuts, greens, etc.) and restriction of the use of carbohydrates that are easily absorbed by the body (sugar, sweets, pastries, bakery and pasta from flour of the highest grades), and also physical exercises.
  • A common approach in treating obesity is to test all known drugs for treating obesity. For this purpose, drugs are used to treat obesity.
  • Psychotherapeutic treatment (behavioral therapy) is also used.
  • If the result of drug treatment is insignificant or not, then it is necessary to stop such treatment. Perhaps the consideration of the feasibility of surgical treatment.

Obesity Diet Therapy Edit

The long-term results of those treatments that are based solely on a decrease in the energy value of the diet disappoint (regardless of whether such treatment is carried out under medical supervision or without medical supervision): 39. According to a study by American psychologist Tracy Mann and her colleagues, diets are generally useless as a means of combating obesity.

However, it should be noted that without adequate control of the caloric content of food and taking into account the adequacy of the amount of incoming calories to exercise, successful treatment of obesity is impossible. WHO, for successful weight loss, recommends calculating the usual caloric content of food, and then monthly caloric reduction by 500 kcal to achieve a figure of 300-500 kcal. below adequate energy requirements. For persons not engaged in active physical labor, this value is 1,500-2,000 kcal.

Scientists have found that people who regularly eat dairy products with a small percentage of fat, less likely to gain excess weight and suffer from metabolic syndrome.

Psychotherapy Edit

One of the most effective approaches in psychology for working with people suffering from obesity is cognitive-behavioral therapy, which most effectively affects the causes that induce a person to overeat. In addition, it provides an opportunity to adjust some aspects of the quality of life of patients, thereby improving their quality of life. Psychotherapeutic approach to the treatment of obesity is desirable to implement at various levels (family, school, society).

The methods of behavioral therapy used in the treatment of obesity are aimed at developing self-control, changing attitudes towards nutrition and related habits, introducing gradually increasing physical activity and creating reliable social support. In the course of controlled trials, it was found that patients to whom these methods were applied, later gained less body weight than those to whom other types of treatment were applied: 39.

Canadian scientists have found that negative relationships with parents can influence the development of obesity. And, on the contrary, a good relationship, in particular, with the father has a positive effect on the preservation of normal weight.

Drug treatment of obesity Edit

Medicines, as a rule, allow to achieve only short-term improvement, but not lasting, long-term effect: 39. If, after discontinuing the course of drug treatment, the patient has not changed his lifestyle and does not comply with dietary recommendations, the body weight will increase again. Perhaps this is due to the fact that overweight causes irreversible inflammatory processes in the hypothalamus, which disrupt the regulation of adipose tissue. Each preparation is selected by the doctor individually:

  • Phentermine (Adipex-P, fastin, ionamine - Amphetamine group) - acts as a neurotransmitter, radine, reducing appetite. May cause nervousness, headache and insomnia,
  • Orlistat (xenical) - inhibitor pancreatic lipase, reduces fat absorption by about 30%, does not suppress the feeling of hunger, but can cause stool incontinence,
  • Metformin - affects the metabolism of carbohydrates, especially indicated for obesity associated with diabetes.
  • Sibutramine (meridia) - serotonin reuptake inhibitor and norepinephrine. The drug affects the centers of saturation and thermogenesis, located in the hypothalamus. The drug is contraindicated in patients with uncontrolled arterial hypertension!
  • Fluoxetine (Prozac) - antidepressant, used by some experts to suppress appetite, but there is no information about long-term effects.
  • Lorcerin (English) (belvik) - 5-HT agonist2C-receptors suppress appetite.
  • Bupropion (wellbutrin, zyban) - a norepinephrine and dopamine reuptake inhibitor, suppresses appetite.
  • Combination Ephedrine with Caffeine - sympathomimetic, stimulates alpha and beta adrenoreceptors, stimulates the production of norepinephrine. Widespread in Denmark for the treatment of obesity.
  • Topiramate - antiepileptic drug, reduces body weight through an unidentified mechanism.
  • Naltrexone - an antagonist of opioid receptors, suppresses cravings for tasty food.
  • Liraglutide (eng.) (Victoza, saxenda) - GLP-1 receptor agonist. Presumably, enhances the action of leptin (a saturation hormone) through the suppression of its soluble receptor

Despite the large number of drugs for the treatment of obesity, almost all of them were banned by the Food and Drug Administration of the United States because of serious side effects. Currently, five of them are approved: orlistat, lorcaserine (eng.), Phentermine-topiramate, bupropion-naltrexone and liraglutide (eng.).

Surgical treatment of morbid obesity Edit

It was found out on the basis of long-term studies that surgical treatment (bariatric surgery) has the maximum effect in the treatment of obesity. Only surgical treatment makes it possible to solve this problem completely. Currently, the world's most commonly used three types of surgery for obesity. These three operations were selected by the long-term evolution of bariatric surgery, as giving the maximum effect in relation to weight loss with a simultaneous minimum level of adverse events:

  • The longest history has gastric bypass (gastric bypass). It began to be used in the 60s of the twentieth century. This operation consists in the division of the stomach into two sections - small and large, which are not in contact with each other. The small intestine is sutured to the “small stomach”, so that the food moves along a short path. This operation has two components of the action: (1) the volume of the small stomach is about 50 ml., Therefore, the patient cannot consume food in the same volume, and (2) the absorption of nutrients decreases as food moves along the shortened path.
  • Gastric banding. The operation is to impose a silicone ring (gastric band) at the border of the esophagus and stomach. The bandage creates an obstacle to the passage of food, thereby stimulating the reflexogenic saturation zone. All modern bandages are adjustable, that is, their lumen can be controlled depending on the individual situation of the patient. In its present form, the design of the bandage was proposed by an American surgeon of Ukrainian origin Lyubomir Kuzmak.
  • Sleeve gastroplasty (Sleeve gastrectomy). The operation consists in removing a part of the stomach and turning it into a thin long tube - a “sleeve”. The capacity of the stomach at the same time decreases by about 10 times (up to 150-200 ml.). Mechanisms of action of tubular gastroplasty with respect to weight reduction include the creation of a restrictive effect for the passage of food due to a narrow “sleeve”, enhanced activation of farnesoid X-receptors (English) due to an increase in bile acids and a hypothetical mechanism for removing the ghrelin-producing zone (ghrelin - hormone hunger). Sleeve gastroplasty has been used as an independent bariatric surgery since 2004.

In addition to the three standard operations described, many other operations have been proposed that are used less frequently.

Currently, all bariatric surgeries are done by laparoscopic (that is, without incision, through punctures) under the control of a miniature optical system.

It should be noted that operations related to plastic surgery, such as liposuction and abdominoplasty, are not intended to combat obesity, but are a method of surgical correction of local cosmetic defects. Although the amount of fat and body weight after liposuction may slightly decrease, but according to a recent study by British doctors, such an operation is useless for health. Apparently, the injury is caused not by subcutaneous, but visceral fat, which is located in the omentum, as well as around the internal organs located in the abdominal cavity. Previously, isolated attempts were made to do liposuction for weight loss (the so-called megaliposuction with removal of up to 10 kg of fat), but now it is left as an extremely harmful and dangerous procedure, inevitably giving a lot of serious complications and leading to gross cosmetic problems in the form of uneven body surface . Moreover, there is evidence that subcutaneous liposuction (for example, in the abdomen) leads to a compensatory increase in visceral fat that is harmful to health. Thus, bariatric surgery, rather than plastic surgery, is used to combat obesity.

Surgical obesity treatment has strict indications, it is not intended for those who believe that they simply have excess weight. It is believed that the indications for surgical treatment of obesity occur with a BMI higher than 40. However, if a patient has problems such as type 2 diabetes, hypertension, varicose veins and problems with the leg joints, indications arise already with BMI 35. Recently in the international literature there are works that have studied the effectiveness of gastric banding in patients with a BMI of 30 or higher. Moreover, in February 2011, the US FDA licensing authority decided to allow gastric banding, starting with BMI 30. However, this permission applies to only one bandage model - LapBand.

  • Metabolic syndrome is a complex of metabolic, hormonal and clinical disorders that are risk factors for the development of cardiovascular diseases. The basis of the metabolic syndrome is tissue insulin resistance.
  • Gastroesophageal reflux disease - refers to the most common diseases of the gastrointestinal tract and is comparable in frequency with peptic ulcer and cholelithiasis. Casting acidic gastric contents into the lower third of the esophagus.
    In about 10% of cases, acid reflux is combined with alkaline, that is, the gastric contents and the contents of the duodenum are simultaneously thrown into the esophagus. Reflux develops in obese people, in food lovers, especially at night, in alcohol abusers, coffee, and hard-core smokers.
  • Type 2 diabetes mellitus - the presence of insulin resistance (cell immunity to the effects of the hormone) and the violation of its secretion by pancreatic cells.
  • Coronary heart disease (CHD) is a disease that combines angina pectoris, myocardial infarction and atherosclerotic cardiosclerosis. IHD develops due to insufficient blood supply to the coronary arteries of the heart due to the narrowing of their lumen.
  • Myocardial infarction - the death of a portion of the heart muscle, caused by acute circulatory disorders in this area.
  • Stroke - an acute violation of cerebral circulation.
  • Arterial hypertension is the most common disease of the cardiovascular system, characterized by high blood pressure.
  • Chronic venous insufficiency is a syndrome characterized by impaired venous outflow, which leads to the disorganization of the regional microcirculation system.
  • Cholecystitis - inflammation of the gallbladder.
  • Gallstone disease is a disease in which stones form in the gallbladder or in the bile ducts.
  • Arthritis is an autoimmune disease that leads to chronic inflammation of the joints, in addition, periarticular and some other tissues, organs and systems of the body are affected, therefore rheumatoid arthritis is classified as a systemic disease.
  • Deforming osteoarthritis is a chronic non-inflammatory disease of the joints (articular cartilage).
  • Herniated intervertebral discs - a very thin cartilage plate covering the vertebral body from the disc appears to crack, causing blood to flow into the disc substance and contribute to the rapid development of hernia.
  • Polycystic ovary syndrome is an endocrine disease in which the ovaries are enlarged and contain many small vesicles filled with fluid.
  • Oncological diseases - malignant tumors arising from epithelial cells in the organs and tissues of the body. Epithelial cells have the ability to quickly divide and multiply. Cancers develop when normal cells are regenerated into tumor cells.
  • Pancreatitis - inflammation of the pancreas.
  • Fatty degeneration of the liver - the accumulation of fat in the liver cells.
  • Extreme obesity with alveolar hypoventilation is a condition in which people with extreme obesity experience alveolar hypoventilation (unable to breathe deeply and quickly enough), which leads to low oxygen levels and high levels of carbon dioxide in the blood.
  • Erectile dysfunction - in men, inability to achieve and maintain an erection. Occurs due to hormonal disorders, developing due to obesity and a decrease in testosterone levels, which leads to androgen deficiency.

It largely depends on the form, severity of obesity, the presence of complications and associated diseases.

Being overweight is not “healthy” even in cases where the sufferers do not have metabolic disorders - there are other risk factors that increase with time, overweight invariably leads to the occurrence of certain cardiovascular diseases.

Learn the degree of obesity

So, experts have developed a general classification of degrees of obesity:

  • Obesity of the 1st degree is diagnosed if the body weight of a person is above the established norm by 10-29 percent.
  • Obesity grade 2 means that the body weight of a person is 30-49 percent more than the generally accepted norm.
  • Grade 3 obesity is characterized by a 50-99 percent indent from the norm.
  • Obesity of the 4th degree is the most dangerous and is diagnosed when the body weight of a person is 100% above the normal level. That is, when the patient weighs 2 times more than expected.

The degree of obesity, depending on the norm, is a fairly objective criterion, but not the only one. How to determine the degree of obesity in another way? Specialists can also diagnose obesity by measuring the thickness of adipose tissue. For this procedure, there is a special device - caliper. After all, sometimes it happens that the patient's body weight significantly exceeds the norm, but no one can call him sick. In such cases, we are talking about athletes with a muscle mass above the norm.

Obesity 1 and 2 degrees does not give a person a lot of inconvenience. Many, looking at themselves, think that they have a couple extra pounds, but this weight is perceived as a small cosmetic defect. Not everyone even tries to fix this problem, since they do not consider that it is necessary. These degrees of obesity can disappear, becoming a normal body weight, but it will have to try. Fighting extra pounds without the help of a specialist is not advised. So a person can harm their health. Diet for obesity 1 degree, as well as the menu for obesity 1 degree can be appointed by a qualified doctor of our medical center.

Treatment of obesity grade 3, as 4, is a must. If a person’s body mass exceeds the norm by 50 percent or more, then it is likely that all internal organs have shifted and have some damage. It is almost impossible to get rid of such a “lack”. In such a case, urgent treatment and a serious attitude are necessary.

Grade 3 obesity treatment should take place under the close attention of a specialist, as even improperly chosen physical exercises can cause a heart attack. Not long ago, the fattest man on the planet named Kit Martin died. Death overtook him while trying to lose weight. The man just decided to walk. In order for such cases to be rare, it is necessary to soberly assess your capabilities and not to strive to deal with the problem yourself.

Types of obesity: by female type, by male type, mixed type

Female-type obesity (pear) - fat deposits in areas of the body such as hips, buttocks, lower abdomen. This type of obesity is considered the most acceptable for women and is not associated with serious hormonal disorders. Female-type obesity is treated not only with proper nutrition and diets, but also with anti-cellulite massage and other similar procedures. It is worth noting that the types of obesity were developed by physicians.

Male obesity resembles an apple. Types of obesity, as already noted, are different and differ not only in the forms of man, but also in his state of health. So, obesity for the male type is considered the most dangerous. And all because fat accumulates not only on the outer areas of the body, but also on the internal organs.

Talking about the existing types of obesity, it is worth noting a mixed type. It is characterized by the spread of adipose tissue evenly throughout the body. Most often, this type of obesity is observed in children.

Formula for body mass index

Before you answer the question, what is the formula for body mass index, you must tell what the index is. Thus, the body mass index is the value by which the obesity is assessed.

The formula for body mass index is as follows: I = frac(m is a person's weight, h is height (meters). The value is measured in kg / m².
If you recall the history of body mass index, then you need to mention the developer of the value. They became the Belgian sociologist and statistician Adolf Ketele.

So, the question of how to determine the degree of obesity is not so difficult. After part of the work is done, the person himself decides whether to contact a specialist or not. However, the majority of people who care about their health and appearance, choose the help of physicians, nutritionists, who will tell you which diet for first degree obesity is the most appropriate, will give a few recommendations and make sure that you do everything correctly.

How to treat obesity

How to treat obesity? The main method of treatment is non-drug, with a change in diet and strict control over its menu. Fasting or diets are a thing of the past. Doctors insist on frequent fractional nutrition, from which harmful and high-calorie foods are excluded.

Drugs are prescribed to persons who have impaired glucose tolerance (prediabetes), diabetes mellitus or hormonal regulation of metabolism.

If the cause of obesity is the inability to control your appetite, the habit of “seizing up” stress, if after exhausting diets you have “food breakdowns” - periods of overeating, it is not only obesity that should be treated. Normalization of the emotional background and stabilization of the nervous system will reduce excessive craving for food as a source of pleasure.
To sign up for a consultation on obesity, treatment of alcoholism or another disease - call us, we will always help!

The degree and types of obesity, how to treat?


Obesity is a disease in which a person has excess body fat in the subcutaneous tissue, as well as in other tissues and organs. This pathology manifests itself in an increase in body weight due to the accumulation of adipose tissue by 20% or more of average values. People with obesity suffer from various sexual dysfunctions, experience psychological and physiological discomfort, over time they develop disorders in the work of the joints, the spine and internal organs. Excess fat deposits increase the risk of cardiovascular pathologies, diabetes, liver and kidney diseases. Accordingly, the risk of death increases. In this regard, obesity requires treatment, which most often consists of three components: diet, exercise, psychological assistance to the patient.

It is established that men suffer from obesity two times less than women. The age at which people usually begin to recover is between 30 and 60 years. In the Russian Federation alone, this disease affects 30% of people of working age. Another 25% of the population are overweight. The problem of obesity is concerned scientists around the world. WHO experts call this disease an epidemic of modern times, from which millions of people are already suffering. Moreover, the social status of a person and his nationality have practically no effect on the risks of obesity.

To assess the risk of obesity, the following facts should be taken into account in numbers:

People with obesity suffer from angina and coronary heart disease 3-4 times more often than people with normal body weight,

Hypertension is diagnosed in people with obesity 3 times more often,

Acute respiratory and viral infections, pneumonia and other diseases in people with obesity are more severe and prolonged. They often have various complications.

To diagnose obesity in a patient, it is necessary to determine his body mass index (BMI). Calculate this figure is quite simple. The formula proposed by WHO back in 1997 remains relevant today. So, the BMI can be determined by the following formula: the weight in kilograms divided by the height of a person in meters squared.

The obtained value allows you to calculate the individual BMI of a person, which is characterized by the following values:

If the BMI is less than 18.5, then the person has a deficiency of body weight,

If the value obtained is in the range from 18.5 to 24.9, then the human body weight is considered normal,

If the value obtained is in the range of 25.0 to 29.9, then the body weight is considered excessive,

The first degree of obesity is diagnosed with a BMI of 30.0 to 34.9,

The second degree of obesity is diagnosed with a BMI in the range between 35.0 and 39.9,

The third and fourth degrees of obesity are diagnosed if the BMI exceeds 40.

Moreover, a BMI in excess of 30 indicates that a person already has direct health threats and needs medical help.

Obesity symptoms

The symptoms of obesity may seem obvious to every person - this is the presence of overweight. Indeed, this is the most specific symptom indicating a problem. Fat deposits are available on the abdomen, in the back, on the sides, on the shoulders, on the hips. Moreover, the muscles of such people are most often weak and underdeveloped.

Other symptoms of obesity will be:

Changes in appearance. People get a second chin, men often suffer from gynecomastia (their mammary glands increase in size). Belly covers fat folds that resemble an apron,

Often, overweight people develop an inguinal and umbilical hernia,

Patients get tired more quickly, sleepy, sweating of such people is increased,

As the disease progresses, shortness of breath comes along, as the cardiovascular system suffers,

Due to impaired metabolic processes, disruptions in the digestive system occur. Often worried nausea, develop constipation,

The joints and the spine suffer from overload, they have pain,

Obese people have a tendency to swelling,

Women may have menstrual disorders, men suffer from potency. Libido decreases,

Folds and excessive sweating cause the development of skin pathologies, including prickly heat, furunculosis, eczema, pyoderma, acne. Stretch marks appear on the stomach and thighs. Places of increased friction are particularly affected.

Depending on where fat is deposited, there are three types of obesity. So, if fat is deposited mainly in the upper part of the body, and the figure begins to resemble an apple, the doctors speak of abdominal obesity. This condition is considered very dangerous to health, as it threatens with the development of cardiovascular pathologies.

When body fat starts to accumulate in the lower part of the body, and the body itself is shaped like a pear, then experts talk about the femoral-buttock type of obesity. Most often in this way fat is distributed among the female representatives. This type of obesity is dangerous for the development of varicose veins, venous insufficiency and articular pathologies.

As for the third type of obesity, it is called mixed. In this case, the fat is distributed evenly throughout the body.

Depending on the type of obesity, the symptoms of the disease will vary. The differences are expressed in how fast the body mass increases, and also in whether a person has problems with the endocrine and nervous system.

Based on this emit:

Symptoms of alimentary type of obesity. Gradual weight gain occurs. Fat is distributed evenly, although sometimes it accumulates more on the hips and abdomen. The endocrine system works fine,

Symptoms of hypothalamic obesity. Body weight increases very quickly. Fat is deposited to a greater extent on the buttocks and thighs, as well as on the stomach. A person experiences constant hunger, which causes him to overeat. Especially noticeable increase in appetite in the evening. Such people drink a lot of water, because they are always thirsty. Patients get up at night to eat. Patients have tremor of the extremities, they complain of dizziness. Since the weight is quickly gained, the skin does not withstand such loads. Pink stretch marks are formed on it. Women often suffer from infertility, hair can grow on the face, the menstrual cycle is broken. As for men, their sexual function is the first to suffer. The following pathologies are observed on the part of the nervous system: frequent headaches occur, insomnia appears. Blood pressure in patients is most often elevated,

Symptoms of endocrine forms of obesity. If some endocrine glands malfunction, the patient may begin to gain weight. Body fat is distributed unevenly throughout the body. Women acquire male traits; on the contrary, men begin to increase breasts, and stretch marks appear on the skin. In addition, a person suffers from symptoms associated with a particular disease of the endocrine glands,

Symptoms of lipomatosis. This form of obesity needs to be considered separately, since body weight increases due to hyperplasia of fat cells of a benign nature. On the human body there are lipomas that do not hurt, have a symmetrical shape. Men are more prone to lipomatosis. A special form of the disease is Derkum lipomatosis, in which itchy, painful lipomas appear on the arms, legs, and body.

Causes and factors contributing to obesity

Obesity often begins to develop due to the fact that there is a disruption in the normal balance between energy consumption and the supply of this energy with food. It is established that the main cause of obesity is overeating. It is precisely in 90% of cases that a person begins to gain weight. The abundance of kilocalories from food can not be consumed by the body at 100%. Therefore, the excess is converted into fat and deposited in the so-called fat "depot". As such depot serves mainly subcutaneous fatty tissue, abdominal wall and internal organs.

Over time, fat reserves increase, body weight increases, which adversely affects health. It is proved that only in 5% of cases obesity cause metabolic disorders.

A provoking factor that has a direct effect on the human eating behavior is a violation of the regulation of the hypothalamic-pituitary-adrenal system. The more it works, the higher the rate of production of ACTH and cortisol. At the same time, the somatotropic hormone responsible for the breakdown of fats, begins to be produced in smaller quantities. In parallel, the blood insulin level increases, the absorption of thyroid hormones is disturbed. All this leads to an increase in appetite and slow down the process of assimilation of fats.

So, the main cause of obesity is overeating.

Nevertheless, it is separately possible to single out some factors contributing to the recruitment of extra kilograms, among them:

Low physical activity, sedentary lifestyle,

Genetic predisposition to enzymatic disruptions. This is expressed in the excessive activity of the lipogenesis system and in the low activity of the enzymes responsible for the breakdown of fats,

Irrational power scheme. Fat begins to actively accumulate when there are large amounts of carbohydrates, salt, fats and sugars in the diet. It is dangerous to abuse alcohol and food in the evening, especially at bedtime,

Endocrine diseases, including Cushing's disease, hypogonadism, hypothyroidism and insulinoma,

Overeating stress

Sometimes obesity is caused by the physiological state of a person. For example, women eat more than normal during pregnancy, while breastfeeding, and then it becomes a habit,

Often the reason that people overeat, becomes hormonal drugs, treatment with psychotropic drugs.

Depending on the cause of the obesity, primary and secondary obesity is isolated. Primary develops due to the impact of any external factor: overeating, low physical activity, the prevalence in the diet of fats and carbohydrates, etc. Often people have a family predisposition to fullness.

Secondary obesity is weight gain due to hereditary diseases (Gelino syndrome, adiposogenital dystrophy, etc.) or due to cerebral pathologies (mental disorders, brain tumors, etc.).

Obesity and type 2 diabetes

Obesity and type 2 diabetes are closely interrelated, since the presence of extra pounds significantly aggravates the risk of developing this dangerous disease. It is established that the third degree of obesity increases the likelihood of developing diabetes mellitus 10 times. The second type of diabetes itself is an acquired and insulin-dependent disease.

That way of life, which leads to weight gain, becomes the starting factor for increasing blood sugar levels. However, with adequate physical exertion, glucose released into the blood transforms into energy, as it is necessary for muscles to work. If a person leads a sedentary lifestyle and at the same time consumes a large amount of carbohydrates, then more insulin will be needed to process glucose. Excess sugar contributes to the formation of fat not only in the subcutaneous layer, but also around the internal organs. Naturally, for the production of insulin, the pancreas has to work in an enhanced mode, which leads to the depletion of the organ. Thus, against the background of overeating, a person gains extra pounds of fat and in parallel he develops diabetes.

In order to prevent such a situation, it is necessary to organize your diet properly, stop eating large amounts of carbohydrates, and also increase physical stress on the body. If necessary measures are taken in time, then diabetes mellitus type 2 will be eliminated and this will not require insulin therapy.

Obesity grade 1

Obesity grade 1 is referred to when a person's BMI is high and ranges from 30.0 to 34.9. If a person has a first degree of obesity, then he already needs a medical examination followed by an individualized treatment program. It has been established that a BMI above 30 is a direct health hazard. Although many patients at this stage of obesity can not make absolutely no complaints related to the state of their body.

However, obesity grade 1 is a reason for a thorough examination and weight loss.

Besides the fact that a person will increase body weight, the following symptoms may develop:

The occurrence of unexplained weakness,

Fatigue, excessive sleepiness,

General information

According to WHO international experts, obesity is a global epidemic of modern times, covering millions of people on the planet, regardless of professional, social, national, geographical, sex and age groups. In Russia, up to 30% of the working-age population suffers from obesity and another 25% are overweight. Women are susceptible to the development of obesity twice as often as men, the critical age for the appearance of excess weight is from 30 to 60 years.

Patients with obesity are 2-3 times more likely to suffer from hypertension, 3-4 times - angina and ischemic heart disease than people with normal weight. Virtually any diseases, even such as SARS, influenza and pneumonia, in patients with obesity, are longer and more severe, have a greater percentage of complications.

Causes of obesity

The development of obesity is most often caused by an imbalance between energy intake from food and energy expenditure of the body. Excess calories that have entered the body and are not consumed by it are converted into fat, which accumulates in the body's fat depots (mainly in the subcutaneous tissue, omentum, abdominal wall, internal organs, etc.). The increase in fat reserves leads to an increase in body weight and disruption of the functioning of many body systems. Overeating leads to obesity in more than 90%, and about 5% of obesity cases are caused by a metabolic disorder.

The development of obesity contributes to a number of factors:

  • inactive lifestyle,
  • genetically determined disorders of enzyme activity (increased activity of lipogenesis enzymes and a decrease in the activity of craniocerebral injuries of enzymes that break down fats (lipolysis),
  • errors in the nature and diet (excessive consumption of carbohydrates, fats, salt, sugary and alcoholic beverages, eating at night, etc.),
  • some endocrine pathologies (hypothyroidism, hypogonadism, insulinoma, Itsenko-Cushing's disease),
  • psychogenic overeating,
  • physiological conditions (lactation, pregnancy, menopause),
  • stress, lack of sleep, psychotropic and hormonal drugs (steroids, insulin, birth control pills), etc.

Changes in eating behavior occur as a result of impaired hypothalamic-pituitary regulation, which is responsible for controlling behavioral responses. The increase in the activity of the hypothalamic-pituitary-adrenal system leads to an increase in the production of ACTH, the rate of cortisol secretion and the acceleration of its metabolism. There is a decrease in the secretion of somatotropic hormone, which has a lipolytic effect, develops hyperinsulinemia, a violation of the metabolism of thyroid hormones and tissue sensitivity to them.

Classification

In 1997, the World Health Organization proposed a classification of degrees of obesity, based on the definition of the indicator - body mass index (BMI) for persons from 18 to 65 years. BMI is calculated using the formula: weight in kg / height in meters squared. For BMI, the following options for body weight and the risk of associated complications are distinguished:

    BMI 102 cm and in women with FROM> 88 cm. To assess the degree of deposition of subcutaneous fat, determine the size of the skin fold.

The most accurate results of determining the localization, volume and percentage of adipose tissue from the total body weight are obtained using auxiliary methods: ultrasound, nuclear magnetic resonance, computed tomography, X-ray densitometry, etc. For obesity, patients need advice from a psychologist, nutritionist and physical therapy instructor.

To identify changes caused by obesity, determine:

  • blood pressure indicators (to detect hypertension),
  • hypoglycemic profile and glucose tolerance test (to detect type II diabetes),
  • triglycerides, cholesterol, low and high density lipoproteins (to assess lipid metabolism),
  • ECG and echocardiogram changes (to detect circulatory and cardiovascular disorders),
  • the level of uric acid in the biochemical analysis of blood (for the detection of hyperuremia).

Obesity treatment

Every person suffering from obesity may have his own motivation for reducing body weight: a cosmetic effect, a reduction in health risks, an improvement in working capacity, a desire to wear smaller clothes, a desire to look good. However, the goals regarding weight loss and its pace should be realistic and aimed primarily at reducing the risk of complications associated with obesity. Begin obesity treatment with diet and exercise.

Diet therapy

Patients with a BMI of 30 or an ineffective diet for 12 or more weeks. The action of amphetamine group drugs (dexafenfluramine, amphepramon, phentermine) is based on the inhibition of hunger, accelerated saturation, anorectic action. However, side effects are possible: nausea, dry mouth, insomnia, irritability, allergic reactions, addiction.

In some cases, it is effective to administer the adiposine fat-mobilizing drug, as well as fluoxetine, an antidepressant that alters dietary behavior. The most preferred to date in the treatment of obesity are considered drugs sibutramine and orlistat, not causing pronounced adverse reactions and addiction. The action of sibutramine is based on accelerating the onset of saturation and reducing the amount of food consumed. Orlistat reduces intestinal absorption of fat. In case of obesity, symptomatic therapy of the main and associated diseases is performed. In the treatment of obesity, the role of psychotherapy (conversations, hypnosis) is high, which changes the stereotypes of developed eating behavior and lifestyle.

Surgical treatment of obesity

The methods of bariatric surgery - surgical treatment of obesity are used in cases of persistent weight retention with a BMI> 40. In world practice, operations of vertical gastroplasty, gastric banding, and gastric bypass surgery are most frequently performed. As a cosmetic measure is carried out local removal of fat deposits - liposuction.

Prognosis and prevention

Timely initiated systematic measures for the treatment of obesity bring good results. Already with a decrease in body weight by 10%, the overall mortality rate decreases> than by 20%, mortality caused by diabetes,> than by 30% caused by concomitant obesity oncological diseases,> than 40%.Patients with I and II degree of obesity retain their ability to work, with III degree - they get group III disability, and in the presence of cardiovascular complications, group II disability.

For the prevention of obesity a person with a normal weight is enough to spend calories and energy as much as he gets them during the day. With a hereditary predisposition to obesity, at the age after 40 years, with hypodynamia, it is necessary to limit the intake of carbohydrates, fats, an increase in the diet of protein and plant foods. Reasonable physical activity is needed: walking, swimming, running, visiting gyms. If there is dissatisfaction with its own weight, to reduce it, it is necessary to contact an endocrinologist and a nutritionist to assess the extent of the violations and to draw up an individual weight loss program.

Watch the video: Is obesity in our genes? Study strengthens genetic link to body size (December 2019).

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