Or being overweight a. Localization of fat deposits. Alternative to iodine treatment

What is obesity and why is it dangerous? This term refers to the presence of an excess amount of fat mass, which provokes excess weight in a person of any age. This disease can affect both children and adults of both sexes. Fat deposits can be placed in places where the placement of such a layer is physiologically laid down - in the thighs, abdomen, mammary glands and others. In modern medical practice, obesity is spoken of as a chronic metabolic disease that provokes many negative processes in the body. Also, overweight is one of the causes of high mortality in the developed countries of the world.

In medical classifiers, obesity (this disease implies overweight, which exceeds the average by more than 20%) has its own code. In ICD-10 - E66. This disease develops against the background of an increase in energy that enters the human body with food, with low energy consumption. The greater the imbalance between these indicators, the more rapidly obesity with overweight develops.

Why is this happening? The regulation of human weight is carried out by the inclusion of many body systems that are constantly interacting. Obese people achieve this negative phenomenon, as physical inactivity - a positive energy balance.

All excess accumulates in the body in the form of triglycerides, which make up adipose tissue. To maintain the energy balance in the body, it is necessary to regulate the level of certain hormones, correct eating habits, increase energy expenditure and the degree of absorption of nutrients. Each of these actions is controlled by certain genes that determine the features of the work of certain organs and systems.

Obesity and its consequences for the human body is a topic that has been carefully studied by many scientists. This problem is quite acute in many developed countries. According to the latest report of the Food and Agriculture Organization of the United Nations, various types of obesity are especially widespread among the population of Mexico, the United States, Syria, Venezuela, Libya and other countries. In Russia, this problem affects about 25% of the population, which is also a fairly high figure.

According to studies, obesity in women as a disease is much more common than in men. This is due to the activity of estrogen, which leads to excessive accumulation of fat in the body. The most critical age when female obesity is most often diagnosed is 30-60 years. A man, in the presence of certain negative factors, is prone to developing this disease at about the same time. The difference between the sexes lies in which types of obesity predominantly develop. In men, fat most often accumulates in the upper body. In the fairer sex, on the contrary, it is slightly lower - on the hips, buttocks. Although it is not uncommon for women to develop male-type obesity.

Causes of the disease

What is the most common cause of obesity? It has been observed that excess weight is sometimes hereditary disease. This problem is seen when, against the background of a decrease in motor activity and other negative environmental factors, the body is unable to effectively use all the energy that comes with food.

The main causes of obesity in women and men are as follows:

• consumption of food that has a high energy value at low activity. As a result, all excess is transformed into fat and accumulated in the human body;
• genetic disorders, when the problem of obesity has a clearly defined hereditary factor;
• violation of the pancreas, intestines and liver. Most often, these pathological conditions are not of an endocrine nature.

Recent studies prove that the main signs of obesity develop as a result of improper eating behavior(more than 90% of all cases). And only 5% of all registered patients acquired this problem due to metabolic disorders.

What negative factors lead to this disease?

What most often leads to the development of such a disease as obesity, the types of which are determined after taking into account all factors? Reasons for excessive weight gain include:

• slight physical activity;
• improper nutrition. In particular, the use of foods that are rich in easily digestible carbohydrates (sweet drinks, confectionery and others);
• the presence of violations leading to a decrease in enzymatic activity, which is due genetic factors. This pathological condition is accompanied by an increase in the activity of lipogenesis enzymes. There is also a decrease in the activity of substances in the human body responsible for lipolysis;

• the presence of certain diseases. Especially negatively on a person in this regard is affected by conditions when the endocrine system does not work properly. This is observed in hypothyroidism, insulinoma and other diseases;
• eating disorders associated with psychological disorders. Psychosomatics plays an important role in this process. Some people may overeat when stressed. Psychosomatics can be combined with other negative factors and give rise to excess weight;
• tendency to stress, psychological overstrain;
• sleep disturbance or lack of sleep;
• taking certain psychotropic drugs.

The mechanism of formation of fat reserves in the body

What leads to the accumulation of fat reserves in the human body? This process is carried out due to a complex neurohormonal mechanism, which includes the cerebral cortex, nervous system, subcortical formations and glands and secretions.

Most often, excess weight gain occurs against the background of a violation of the work of the central nervous mechanisms brain. There are located the main centers that regulate the presence or absence of appetite. Excessive activity these mechanisms leads to uncontrolled absorption of food. As a result, there is a significant discrepancy between the energy that enters the body with food and its consumption.

The imbalance that led to the accumulation of body fat is provoked not only by hereditary factors and the peculiarities of the work of all organs and systems, but also by eating habits. They are formed incorrectly from childhood itself, which provokes the problem of excess weight throughout life. Also, disruption of the work of the brain centers that control appetite can occur due to their damage. inflammatory process or in case of injury.

An important role in obesity, the symptoms of which are very pronounced, is played by the relationship between the pituitary gland, adrenal glands, pancreas and thyroid gland and sex glands. Any malfunction of these systems can provoke excessive accumulation of fat reserves. In particular, a decrease in the somatotropic activity of the pituitary gland leads to a decrease in the activity of fat oxidation processes in the liver. With pathologies of the thyroid gland, consumption is significantly inhibited energy reserves organism. This negative process is observed against the background of a decrease in the concentration of thyroid hormones. It also contributes to the accumulation of fat by the body, a condition in which the production of adrenaline by the adrenal glands decreases.

Weight norms

Types of obesity are determined by different factors. The list of varieties of the disease is primarily formed on the basis of body mass index. BMI is specially developed by the World Health Organization. It determines how normal a person's weight is, relative to his height. This indicator relevant for all people whose age is from 18 to 65 years. To calculate BMI, the current weight (only in kg) is taken and divided by the height squared (the indicator is taken in meters). Based on the result, a conclusion is made whether there is an excess of body fat, leading to serious negative consequences for the body.

BMI may be as follows:

• below 18.5. Indicates a lack of weight, which is quite dangerous for the human body;
• 18,5-24,9. Normal, which indicates the best ratio of fatty tissue to total weight person;
• 25-29.9. Indicates overweight, which requires adjustment;
• 30-34.9. Indicates the initial degree of obesity;
• 35-39.9. This indicator is set to indicate the 2nd degree of development of the disease;
• more than 40. Indicates a serious pathology that is life-threatening.

Disease classification

The consequences of obesity are largely determined by its type:

• android obesity (upper type). The disease is characterized by excessive deposition of fat in the upper body. This is a type of obesity like an apple. The disease most often develops in men and is quite dangerous for health. In the presence of android type of obesity, the risk of developing hypertension, heart attack, stroke and diabetes is significantly increased;
• femoral-buttock or gynoid obesity. The figure of a person resembles a pear, since fat is mainly deposited on the buttocks and thighs. The gynoid type of obesity is most common in women. It is less dangerous because the accumulation of fat does not interfere with normal operation. internal organs. Such obesity leads to negative changes in the joints, spine, the formation of varicose veins;

• intermediate or mixed type. The disease is characterized by an even distribution of fat throughout the body;
• alimentary type. The disease develops against the background of an energy imbalance, when the body does not use up all the energy that comes from food. A hereditary factor can be seen;
• hypothalamic obesity - observed with serious illnesses CNS, when there is a violation of the hypothalamus. Characterized by rapid weight gain. Fat is mainly deposited on the lower abdomen, thighs. In the presence of a diencephalic type of disorder, accompanying symptoms are observed - dry skin, the formation of striae, hypertension, increased sweating;
• endocrine obesity - develops against the background of certain. This type of disorder is characterized by uneven deposition of fat in different parts of the body. There are also other symptoms of hormonal imbalance -,.

Why is this disease dangerous?

The consequences of obesity are quite serious. This disease is especially dangerous for children in whom all organs and systems are just being formed. This disorder is often accompanied by an abnormal functioning of the digestive system, which provokes constipation, cholecystitis and other problems.

Also, children may develop abnormally high blood pressure, dyslipidemia, insulin resistance, gonadal dysfunction, flat feet, apnea, arthrosis. Frequent cases eating disorders psychological type- anorexia, bulimia and others.

What is the risk of obesity in adults? This disease is no less dangerous in adulthood. It provokes the development of diabetes, reflux disease, increases the risk of stroke or heart attack. Any type of violation that threatens to cause arterial hypertension, arthritis, pancreatitis and other disorders, not only reduces the quality of human life, but also leads to a decrease in life expectancy.

Treatment of the disease

Everyone understands what obesity leads to, but how to deal with it? The most commonly used therapies are:

• dietary adjustments. Appointed special diet, which allows you to reduce the calorie content of food entering the human body. The products must contain all necessary complex nutrients to avoid negative consequences in the form of certain diseases;
• psychotherapy. It is aimed at changing eating behavior, developing stable habits leading to the use of a sufficient amount of food for normal life. Problems with self-esteem, stress should also be eliminated with the help of psychotherapy;
• medical treatment. It involves taking drugs that reduce appetite - Phentermine, Orlistat, Fluoxetine and others;
• vegetable compositions. The positive influence of some plants on a person who wants to lose weight has been proven. From their use, appetite decreases, the breakdown of fats in the body is accelerated;
• surgical intervention. Gastric bypass, bandaging, sleeve gastroplasty are used, which allows to reduce the capacity of the stomach.

To prevent any disease associated with obesity, you should adhere to a balanced diet and carefully monitor your weight. Parents are encouraged to teach their children healthy eating habits from an early age. Any disease with obesity will not move apart if you systematically engage in physical culture and lead active image life.

Bibliography

1. Murray R., Grenner D., Human biochemistry // Biochemistry of human intra- and intercellular communications. - 1993. - p.181-183, 219-224, 270.
2. Vloshchinsky P.E., Poznyakovsky V.M., Drozdova T.M. Physiology of nutrition: Textbook. -, 2007. -
3. Ovchinnikov Yu.A., Bioorganic chemistry // Peptide hormones. - 1987. - p.274.

⚕️ Olga Alexandrovna Melikhova - endocrinologist, 2 years of experience.

Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus etc.

Excess MT occurs when the energy value of the diet exceeds the energy expenditure of a person. There is an accumulation of fat, which over time can lead to the development of a disease - obesity.

Obesity is a metabolic and alimentary chronic disease, which is manifested by excessive development of adipose tissue and progresses in a natural course.

Epidemiology. According to WHO and domestic studies, about 50% of the population of European countries is overweight, 30% is obese. To a greater extent, this is typical for women, especially older age groups.
A significant increase in the number of people with obesity, including in developed countries, the trend towards an increase in the prevalence of obesity among young people and children make this problem socially significant.
Assessment methods. Compliance with BW (body weight) is most often assessed using body mass index (BMI) or Quetelet index.

BMI = body weight (kg) / height2 (m2)

With an increase in BMI, the risk of developing comorbidities increases. At the same time, the risk of complications, especially cardiovascular and metabolic ones, depends not only on the degree of obesity, but also on its type (localization of body fat). The most unfavorable for health and characteristic for men is abdominal obesity(AO), in which fat is deposited between the internal organs in the waist area. The deposition of fat in the thighs and buttocks, more typical for women, is called gluteofemoral.
There is a simple and fairly accurate way to assess the nature of the distribution of fat - the measurement of waist circumference (WC). OT is measured in a standing position, midway between the lower edge of the chest and the iliac crest along the midaxillary line (not at the maximum size and not at the level of the navel). The test is objectified and correlates with the degree of fat accumulation in the intra- and extra-abdominal space according to magnetic resonance imaging (MRI).

If WC is ≥ 94 cm in men and ≥ 80 cm in women, AO is diagnosed, which is an independent risk factor for CVD. Persons with AO are advised to actively reduce BW.

Overweight/obesity is an independent risk factor for CVD and forms a cascade of secondary risk factors. Adipose tissue, especially visceral tissue, is a metabolically active endocrine organ that releases into the blood substances involved in the regulation of CVS homeostasis.
An increase in adipose tissue is accompanied by an increase in the secretion of free fatty acids, hyperinsulinemia, insulin resistance, hypertension, and dyslipidemia.
Overweight/obesity and concomitant risk factors increase the likelihood of developing a number of diseases, the likelihood of which increases with increasing body weight. At the same time, if the risk of CVD and DM is increased with AO, then the risk of diseases of the spine, joints and veins of the lower extremities is higher with the gluteofemoral type.
Overweight and obesity often coexist with hypertension and dyslipidaemia, with BP rising with increasing obesity.
The presence of excess body weight and obesity increases the risk of developing hypertension by 3 times, coronary artery disease by 2 times.
The probability of developing DM in people with excess body weight is 9 times higher, in people with obesity - 40 times. Excess weight significantly reduces life expectancy: on average, from 3–5 years with a slight excess of BW and up to 15 years with severe obesity. Elongation of the vasculature, increased sodium retention in cells, an increase in the activity of the sympathetic-adrenal and renin-angiotensin-aldosterone systems, insulin resistance, and the release of biologically active substances by visceral adipose tissue observed in excess MT increase the likelihood of developing hypertension. The development of atherosclerosis and coronary artery disease in people with excess MT is facilitated by the closely related hypertension, lipid metabolism disorders (increased TG and LDL-C, decreased HDL-C), insulin resistance, impaired glucose tolerance (IGT), type II diabetes, endothelial dysfunction . In addition, there is an increase in the production of plasminogen activator inhibitor-1 by adipocytes, which helps to reduce the fibrinolytic activity of the blood and increase the risk of thrombosis.

Algorithm for Examining Persons with Overweight and Obesity

Collection of diet anamnesis gives the doctor and patient a visual representation of the patient's eating habits; allows you to develop a diet therapy plan that is adequate to your eating habits; determines the extent and nature of the intervention; develops mutual understanding between the doctor and the patient. In some cases, a 3-7-day survey is carried out (the patient writes down all the food eaten during these days, including servings, quantity, frequency, and submits it in writing or sends it by mail).
Assessment of readiness for treatment. For effective correction of overweight, it is important that patients are ready to follow the recommendations given to them. To do this, they must be motivated to reduce body weight, understand the timing and pace of treatment, for example, know that weight loss due to fat usually does not exceed 0.5-1 kg per week, and in outpatient settings this is a good result. Knowledge of the patient's motivation and previous experience is essential for follow-up emotional support patient. To assess the patient's readiness for treatment to reduce BW, it is necessary to find out:
the reasons that prompted the patient to start treatment;
understanding by the patient of the reasons leading to the development of obesity and its negative impact on health;
consent of the patient to a long-term change in eating habits and lifestyle;
motivation to reduce MT;
previous experience in reducing BW;
the possibility of emotional support in the family;
understanding the pace and timing of treatment;
the patient's willingness to keep a food diary and control BW.

Objective examination of the patient is necessary to identify other risk factors, comorbidities, contraindications to treatment and develop a strategy for nutritional intervention. The minimum examination of a patient with overweight/obesity, along with a general clinical examination, includes: measurement of blood pressure, ECG registration, determination of levels of total cholesterol, TG, glucose in blood serum on an empty stomach. If any deviations are detected, additional examination is necessary in accordance with generally accepted diagnostic algorithms.
Definition of contraindications to treatment. WHO experts (1997) determined the range of temporary, absolute and possible, relative contraindications. Temporary (absolute) contraindications for the treatment of obesity: pregnancy; lactation; uncompensated mental illness; uncompensated somatic diseases. Possible (relative) contraindications: cholelithiasis; pancreatitis; osteoporosis. Reduced diets during pregnancy and lactation are absolutely contraindicated.

Expert advice. The increase in MT can be enhanced psychogenic disorders including bulimia nervosa, depression, recurrent episodes of binge eating, night eating syndrome, seasonal affective disorder.
They can be for the patient difficult to overcome obstacles to compliance with the treatment regimen.
If the patient has signs of an eating disorder (attacks of compulsive eating in short periods of time, lack of satiety, eating large amounts of food without feeling hungry, in a state of emotional discomfort, sleep disturbance with night meals combined with morning anorexia, etc. ), consultation of a psychoneurologist or psychiatrist is indicated.
If secondary, endocrine obesity is suspected (Itsenko-Cushing's syndrome, hypothyroidism, etc.), an endocrinologist should be consulted.

obesity treatment

The goals of obesity treatment are:
− a moderate decrease in body weight with a mandatory reduction in the risk of developing associated with obesity diseases;
− MT stabilization;
- adequate control of disorders associated with obesity;
− improving the quality and life expectancy of patients.

Diet therapy for obesity. Reducing the calorie content of the diet and creating an energy deficit is the main principle of nutritional intervention. According to the severity of energy deficiency, diets with moderate calorie restriction (1200 kcal/day) and very low calorie content (500–800 kcal/day) are distinguished. The latter contribute to a more pronounced decrease in BW (1.5–2.5 kg/week) compared with a moderately reduced calorie diet (0.5–1.4 kg/week), but only by initial stage treatment. Long-term results (after 1 year) of using diets with moderate and severe calorie restriction did not show a significant difference in the decrease in BW.

The use of very low calorie diets does not lead to the formation of rational nutrition skills; poor tolerance of these diets is noted, frequent side effects from the gastrointestinal tract, cholelithiasis, disorders of protein metabolism, electrolyte balance; cases of ventricular fibrillation, etc. The use of diets with moderate calorie restriction (1200 kcal / day) causes a decrease in body weight after 3–12 months to a sufficient extent (on average by 8%).
The energy deficit in the formulation of low-calorie diets can be achieved by reducing the intake of both fats and carbohydrates. It has been proven that the use of low-calorie diets with a restriction of fat and carbohydrates contributes not only to a decrease in body weight, but also to a decrease in blood pressure, and an improvement in the lipid profile.
It is necessary to establish a strict relationship between the energy value of food and energy consumption. A number of factors are important, and above all, the level of metabolism. Calculations show that the excess daily calories food over energy expenditure by only 200 kcal per day increases the amount of reserve fat by approximately 20–25 g per day and by 3.6–7.2 kg per year. Thus, the term “overeating” does not mean “gluttony”, but only relative overeating, that is, the excess of the caloric value of food over the energy expenditure of the body.
It is also possible to predict the loss of MT. So, if with energy expenditure of 2200 kcal a person receives 1800 kcal daily, then the energy deficit is 400 kcal.
Knowing that 1 g of adipose tissue provides 8 kcal, it can be calculated that in the daily energy balance of the body, 50 g of adipose tissue (400:8) needs to be broken down. Therefore, in 1 week the loss of MT will be 350 g (50 x 7), in 1 month - 1.5 kg, in a year - almost 18 kg. Thus, the main method of treating obesity is dietary, and the main principle of diet therapy is calorie reduction.

Principles of building a diet for overweight and obesity:
− Sharp restriction of consumption easily digestible carbohydrates, sugars up to 10–15 g (3 pieces or teaspoons) or less per day, including “pure” sugar (for sweetening tea, coffee) and sugar contained in drinks, jams, sweets, etc. Confectionery containing high-calorie fat, and sweet carbonated drinks are recommended to be completely excluded.
− Restriction of starch-containing products: bread, products and dishes from cereals, potatoes. You can eat up to 3-4 slices of black or 2-3 slices of white bread per day. You can add a serving of porridge and/or a serving of potatoes. Pasta is best avoided.
− Sufficient (up to 250–300 g) consumption of protein products: meat, fish, poultry, eggs, dairy products. They are essential for the body and are highly nutritious. But when choosing protein foods, preference is given to foods with the lowest fat content (the calorie content of such foods is much lower). If there is no choice, you can cut off visible fat, remove the skin from the chicken, remove the foam from the milk, etc.

- Consumption of large amounts of vegetables (except potatoes) and fruits (up to 1 kg in total). Products and dishes prepared from them are low-calorie and at the same time, due to the large volume of food, create a feeling of satiety. Preference should be given to acidic varieties of fruits and leafy vegetables (citrus fruits, berries, apples, cabbage, lettuce, spinach, etc.).
- Limiting the intake of fat, mainly of animal origin.

− Restriction of salt consumption in order to normalize water-salt metabolism.
It is necessary to limit salt both in its pure form (salt less when cooking, remove the salt shaker from the table), and in the form of salty foods (pickles, marinades, salted fish, etc.).
- Limiting the consumption of spicy snacks, sauces, spices that stimulate the appetite.
- Frequent meals - up to 5-6 times a day, but in small quantities.
- Alcohol is high in calories, so limiting it is important to control BW.

Popular "trendy" diets are based on the principles of strict nutritional restriction with a reduction in calories to 1000–1500 kcal. These diets do not always take into account the principles of rational nutrition. Their use is possible for a limited period of time (2-6 weeks) in apparently healthy individuals with only overweight/obesity. True enough balanced diets 1200-1500 kcal can be used longer, and in practically healthy older women - almost constantly. It should be borne in mind that dietary restrictions in children can lead to growth and developmental arrest, and in adolescence - to endocrine disorders. Relatively simple in terms of technical implementation is alternate diet (during the day, dishes from one product are used). The diet contains elements of separate nutrition, but is not balanced and suitable for people without serious diseases.
Also not balanced are the so-called fasting days . They can be practiced 1-2 times a week and only after consulting a doctor.

And the so-called “Kremlin Diet”, very similar to it, is built on a strict restriction of carbohydrates, which causes severe dehydration of the body (hence rapid weight loss), a decrease in insulin production and the conversion of carbohydrates into fats with their subsequent deposition. Diet is not balanced, can cause a shift acid-base balance, ketosis, acidosis. In addition, the “Kremlin Diet” is highly atherogenic: the fat level is twice the recommended values ​​(up to 60-64% of calories), and the dietary cholesterol content is 1000-1280 mg / day, which is 4 times higher than the recommended norm.
Separate nutrition in nature does not exist : in any product (meat, milk, etc.) there are proteins, fats, and carbohydrates. A mixed diet is more balanced. So, the lack of the amino acid lysine in buckwheat makes up for milk, where it is in excess. In this way, buckwheat with milk is a balanced dish.
Separate nutrition can be effective only if it is reduced to calorie restriction due to the uniformity of products, it cannot be practiced long time. Treatment of excess body weight and obesity by fasting is unacceptable, since fasting for more than 3 days disrupts metabolic processes in the body, has an adverse psychological effect (further increasing the importance of food for a person and stimulating appetite and hunger centers), increases the risk of complications (arrhythmias, hypovitaminosis with polyneuritis phenomena). , skin and hair lesions, etc.).

Patient self-control. An important help in dieting is the patient's Diet Diary, in which he writes down everything he eats and drinks during the week preceding the visit to the doctor. This allows both the patient and the clinician to analyze diet(the amount of food eaten, the frequency of meals, situations that provoke extra meals), identify eating disorders, the cause of failures, the amount and nature of the necessary correction, and also increases the constructive interaction between the doctor and the patient.
Efficiency mark. It is necessary to achieve a decrease in BW by 5-15% of the initial values ​​(depending on BMI) for 3-6 months, and further stabilization of BW. Repeated courses can be carried out in six months, 1 time in 1-2 years with a gradual gradual or smooth slow decrease in MT. It is necessary to realize that a diet is not a one-time action, and its effect will remain only when switching to the principles of a healthy diet with a constant restriction of part of the diet.

Increasing physical activity. Usage physical training in combination with a low-calorie diet provides a greater reduction in BW and prevents weight gain after the end of a low-calorie diet. Regular FA contributes to an increase in the loss of fat mass, especially in the abdominal region, and the preservation of lean mass, a decrease in insulin resistance, an increase in the metabolic rate, and positive changes in the lipid profile.

Psychotherapy and behavioral interventions aimed at correcting the eating behavior of patients, increase the effectiveness of diet therapy and increase FA. The drug effect on excess body weight is indicated for: non-pharmacological interventions are ineffective; severe and complicated forms of obesity.
Appetite-reducing serotonergic drugs (such as the antidepressant fluoxetine) that reduce food absorption (orlistat) are used. Medical treatment you can continue up to 6 months, after a break - up to 2 years.

Surgical treatment of obesity (gastroplasty, formation of a “small” stomach, resection of the intestine, etc.) are more often used for obesity of the III degree with complications (secondary endocrine disorders, hernia spinal column, severe coxarthrosis, etc.). Operations of liposuction, liporesection with abdominal wall plasty, etc. are of more cosmetic importance and can be performed in the absence of well-known general surgical contraindications, at the request of the patient. To provide people with overweight or obesity with medical care, it seems appropriate:
add to the list of medical services a service such as “overweight reduction and obesity treatment” and develop an appropriate standard of care;
train professionals working in offices medical prevention, departments of medical prevention of polyclinics and in health centers providing medical care to reduce excess body weight and treat obesity;
provide medical institutions informational materials about the dangers of overweight and the treatment of obesity.

Literature: Appendix 2 to the journal "Cardiovascular Therapy and Prevention", 2011; 10 (6)

So, let's begin. And let's start, oddly enough, from childhood.

Although overweight body can be inherited - 250 genes in the human body encode body weight and if at least one of them fails, a person becomes prone to accumulating fat in the body - in many respects, the presence of obesity (or simply excess body weight) is associated with malnutrition in childhood. Overfeeding a child at an early age (in the first months) is especially dangerous. So at high calorie nutrition in the first weeks of life (especially if the child is artificially fed) the number of fat cells increases by 4-5 times, which then do not disappear anywhere, but are only filled with fat under “favorable” conditions; the volume of the stomach increases; the food center is stimulated and the child's appetite grows uncontrollably.

As puberty, under the influence of hormones, the deposition of excess fat in men and women is different. Under the influence of male sex hormones, fat is deposited in the upper body, and under the influence of female hormones, in the thighs and buttocks. To understand which hormones predominate in humans, English anthropologists have proposed a simple way: to determine the relative length of the fingers. In male women, according to anthropologists, the index finger is shorter than the ring finger (ladies, hands on the table!). Thus, scientists have identified two types of obesity, completely different in diet therapy and in the treatment of physical activity - male type (android type) and female type (gynoid type). Doctors consider the male type of obesity for women to be the most unfavorable, since at the same time there is too little estrogen to protect the body from diabetes, gout, and atherosclerosis. And in men, the female type of obesity can lead to loss of potency. By the way, with the abuse of beer in men, the synthesis of substances that suppress the production of testosterone begins, the synthesis of estrogens increases, which is accompanied by corresponding changes in the physique and distribution of fat (even false mammary glands can develop).

Before proceeding with the correction of overweight, you need to determine: firstly, whether you have an excess of body weight and secondly, fat is deposited according to the female or male type.

Express diagnostics of obesity by body mass index (BMI)

BMI \u003d body weight (kg) / body height 2 (m 2)

• Do not forget that body weight can be determined not only by fat content, but also by the development of muscles, or edema, therefore, the thickness of the fat folds (usually near the navel) and the ratio of the waist circumference to the hip circumference (to determine the type of fat deposition) are additionally measured.

How can you tell by the value obtained whether you have an excess, or, conversely, a lack of body weight? To do this, let's look at the table.

BMI classification

It should be noted that both high and low BMI values ​​are associated with health risks.

At low values BMI (less than 18.5) - increased risk of infectious diseases and diseases gastrointestinal tract.

At high values BMI (more than 30) - increases the risk of cardiovascular diseases (hypertension, myocardial infarction, stroke), type 2 diabetes mellitus (non-insulin dependent), gallstone disease, certain types of cancer.

Life expectancy in old age with obesity is reduced by an average of 10-12 years. Mortality among obese people over 45 years of age is 2 times higher than among other people with normal weight. Moreover, it was noted that in men with obesity, the biological age is 3 years more than in men with normal weight body. In women, no such differences were found. However: thin men are older (by biological age) than their peers with normal body weight by 12 years, and women by 14 years. Therefore, low body weight is also a risk factor for premature aging.

So, you have determined your BMI, and if it exceeds the norm, now you need to determine the type of obesity (male - "apple" or female - "pear").

It is determined by waist circumference ratio (“Am I?”:) to the hips. An alarm signal may be an increase in the ratio of waist circumference to hips greater than 0.9 in men, and more than 0.8 in women, this indicates the most unfavorable type of obesity for health prognosis - male (abdominal) type obesity.

We will talk about the secrets of diet therapy and the features of physical activity for various types of obesity in the next article.

Batsukova Natalya Leonidovna

Head Department of General Hygiene of the Belarusian State Medical University

Candidate of Medical Sciences, Associate Professor.

The relationship in the historical aspect between the greatness and power of the country and the nature of nutrition is interesting. It turned out that the cult of food, gastronomic orgies, gluttony, drunkenness and obesity are signs of the degeneration of the nation that precede the collapse of the state. This has been the case throughout history, beginning with the ancient world. And vice versa, the heyday of this or that state always coincided with moderation in nutrition. Think of the classic examples: Athenian democracy, Sparta, on the one hand, and Babylon or Rome on the eve of their fall, on the other. Lucull's feasts preceded the death of Rome, Baltazar's - the death of Assyria.

Today, in the developed countries that have achieved the greatest success, with all the wealth, the cult of physical culture and moderation in food has been developed. Moderation in food is the main condition for health and longevity. And yet, in the second half of the 20th century, according to the World Health Organization (WHO), 1/4 of the world's population is obese. Over the past 20 years, the number of children in the world has increased by 60% preschool age who are obese. In developed countries, 11.7% are obese, in developing countries - 6.1%.

Obesity is reaching epidemic proportions in economically developed countries. 33% of US residents over 30 years old and 50% of residents of all regions of the former USSR are overweight, while men suffer more often. According to the Institute of Nutrition of the Academy of Medical Sciences of Russia, 20 to 30% of children are obese. In Russian cities, according to epidemiological studies, 10–20% of men and 30–40% of women of working age have some degree of obesity. Studies conducted in seven regions of Ukraine (10 thousand people aged 20 to 60 years) showed that more than 46% were overweight, and 22% were obesity of I-II degrees. This is mainly due to dietary habits and the high prevalence of sedentary image life.

Obesity is associated with several major risk factors for coronary artery disease: high blood pressure, impaired fat metabolism, diabetes. The danger is exacerbated by the fact that obese people smoke more and more.

Excess body weight, as a rule, leads to serious sexual problems. In obese men, the content of female sex hormones, estrogen, is increased in the blood, which contribute to increased excretion of the male sex hormone testosterone. It is the level of testosterone that influences sexual activity men.

Renowned nutritionist Paul Bragg states: "To be fat and sick is a crime." Let's add - in relation to oneself, to one's family, to the society in which a person lives. Excess body weight inevitably entails many diseases:

Sexual disorders (decreased potency, premature ejaculation in men);

Diseases of the liver and biliary tract (hepatitis, liver cirrhosis, cholelithiasis, cholecystitis);

Skin diseases (eczema, etc.);

High frequency of postoperative complications;

Gout;

periodontal disease;

Diseases of the cardiovascular system (atherosclerosis, hypertension, myocardial infarction, stroke, varicose veins, thrombosis, embolism);

kidney stone disease;

Increased need for antibiotics;

Multiple sclerosis;

Radiculitis, ischioradiculitis;

Diseases of the musculoskeletal system (arthritis, arthrosis, osteochondrosis, diseases intervertebral discs, flat feet, deformity of the lower extremities);

Diseases of the gastrointestinal tract (gastritis, peptic ulcer and duodenum, enteritis, chronic colitis, ulcerative colitis, ).

When overweight, there is a high risk of accidents.

This list should be above dining table in each family.

The andrologist's own long-term experience shows that about 40% of men experiencing various sexual problems, and first of all, the weakening of erection up to its complete absence, accelerated ejaculation, are overweight.

The feeling of fullness and appetite are determined mainly by the amount of carbohydrates eaten. When consuming fatty foods, it is difficult to achieve a feeling of satiety. Fatty or carbohydrate foods of the same calorie content affect the body in different ways. After a fatty meal, a man continues to feel the need for food, after a carbohydrate meal, he is saturated. Limiting fat intake alone can lead to weight loss.

When overweight, the body is able to oxidize more fat. So, with an increase in body weight by 10 kg, up to 20 g of fat is additionally oxidized daily. When using various diets for weight loss with a decrease in body weight, the amount of additionally oxidized fat also decreases. Therefore, low-calorie diets, which contain at least not a large number of fat often lead to an increase rather than a decrease in body weight. Traditionally, some peoples consume excessive amounts of fat, the same can be said about some families. This leads to obesity.

Another important factor should be taken into account. The higher physical activity, the more fat is oxidized, with physical inactivity, fat oxidation is significantly reduced.

Food should only make up for all energy costs. We emphasize: to replenish, and not to create an excess, because each unused calorie turns into body fat, and 1 kg of human adipose tissue has an energy value of 7000 kcal. Excess body weight, as a rule, is combined with physical inactivity, which exacerbates the harmful effects of obesity and greatly aggravates the course of related diseases and sexual disorders.

body weight (MT) \u003d height (cm) - 100.

However, this method does not take into account the age factor. A more complex, but more accurate method of determining:

MT \u003d 50 + 0.75 (height (cm) - 150) + (age (years) - 20): 4.

For example: a 50-year-old man with a height of 170 cm, according to the first calculation, should weigh 70 kg, according to the second - 72 kg.

To characterize the fatness of a person at the Institute of Preventive Cardiology of Russia, an indicator is used - body mass(kg): growth(m), which normally ranges from 22–24. Below 20 - underweight, 25-29.9 - overweight, more than 30 - obesity.

Note! Ideal body weight should be below normal.

Every man should know that only 1% of obese people have it due to glandular diseases. internal secretion, in 99% - with overeating and physical inactivity.

Overeating is usually an important substitute various activities a person and becomes a habit in various emotional states: loneliness, boredom, fear, dissatisfaction with one's position, inferiority complex, anxiety, sexual abstinence, sexual dissatisfaction and many others. Habit depends on willpower. Neither massage, nor sauna, nor the most widely advertised electric vibrators and massagers will help with obesity, if you do not change the bad and dangerous habit of overeating or, in case of excessive eating, increase physical activity accordingly. And that takes hard work daily work. Pay attention to the average energy consumption during sports (Table 2.19).

As the results of numerous impartial studies show, fasting does indeed lead to weight loss, but this decrease is short-term, soon body weight increases again, often reaching higher figures than before fasting. In addition, during fasting, the potency in men decreases. Even Hippocrates in his "Aphorisms" wrote: "Such a strict starvation diet can have more dangerous consequences than a more plentiful one."

Table 2.19. Average Energy Expenditure and Potential Fat Loss for the Following Sports for an Hour

Note! I am categorically against fasting as a method of treating obesity and combating overweight. If you are overweight, you should exclude all refined products, and first of all white sugar, sweets, white flour, confectionery and other products from it, refractory animal fats (except butter, the amount of which should not exceed 15-20 g 2-3 times a week), table salt, cereals, pasta from soft wheat varieties. Eat about 50 g of wheat bran daily. Meals should be fractional, at least 5 times a day. Portions should be reduced.

Food must be plentiful dietary fiber, fresh fruit(exclude grapes, bananas, sweet dried fruits), vegetables. High-calorie foods should be replaced with low-calorie ones. So, replace beef, pork, lamb with chicken meat, white turkey meat (without skin) and boiled fish. Instead of whole milk and whole milk products - skimmed (milk, yogurt, low-fat cottage cheese). Animal fats must be replaced with vegetable fats, primarily olive, and sugar and sweets should be excluded. Instead of white bread, you should eat whole grain bread, pasta - only from durum wheat.

All this reduces the calorie content of food by about 700-800 kcal, and then in 9-10 days the body weight will decrease by 1 kg, in a month it will be about 3 kg, in a year - about 30-35 kg. We do not recommend reducing your daily diet more than 1000 kcal.

Note! Each overweight body weight shortens life by 6–8 months.

Own medical experience allows us to assert that there is no single system suitable for each person; that the vast majority of proposed commercial weight loss programs are ineffective or ineffective at all. Each person who is overweight should develop his own program, taking into account the recommendations of specialists.

General principles: sharp restriction of consumption high-calorie foods, fat, salt, simple sugars and increased physical activity, strict accounting of food eaten, calorie counting, regular weighing.

In recent years, we have revised the principles of the diet of overweight men. Instead of regular meals at strictly defined hours, we recommend that you be guided by the feeling of hunger, and not by habit. It is better to eat 5 times a day, little by little, when man is hungry, regardless of the time of day, than to eat at a certain time, without feeling hungry. This point of view is supported by researchers from the University of Pittsburgh and Colorado, who conducted long-term observations of 800 men and women aged 19 to 85 who lost 15 kg or more and then maintained a constant body weight for 6 years or more. At the same time, most of the subjects do what they like; harmoniously and naturally incorporate new eating habits and physical exercises into your lifestyle; they do not suffer from restrictions; They don't feel like they're missing something. These people are free and happy because they have succeeded!

So, the attentive reader got acquainted with the main components of food, nutrients and food products, their advantages and disadvantages, their influence on life processes, human needs, manifestations of excess and deficiency of certain substances. Alas, most delicacies are harmful. Smoked meats contain a lot of saturated fatty acids, and there are also carcinogenic substances. We spoke in detail about the dangers of salt and sugar, confectionery, animal fats earlier. We add that an excess of animal proteins, fats and cholesterol in the diet, in addition to atherosclerosis, contributes to the occurrence of certain types of malignant tumors, and an excess vegetable fats contributes to the reduction defense mechanisms and thus also leads to the development of atherosclerosis and malignant tumors. This does not apply to olive oil. Excess simple carbohydrates contributes to obesity, atherosclerosis, malignant tumors, violation of potency and recovery processes. For this reason, it is desirable to exclude fatty meat and sausages, confectionery, smoked meats, ice cream, sugar from the diet, and reduce salt. When cooking, do not use animal fats.

The reader may object: Are the dangers exaggerated? Delicious food is one of the greatest pleasures available to man. Do the authors call for asceticism? Not at all. From the products we recommend, you can create miracles of culinary art. It is only important to want.

One-time consumption of delicacies (on holidays!) in reasonable quantities is not only acceptable, but also desirable. But after that - work out!

Here is some information that is especially useful for those with a sweet tooth. All varieties of ordinary and chocolates high-calorie (400-500 kcal / 100 g), the fat content in the so-called chocolates is about 55%. Their systematic consumption causes diseases of the cardiovascular system, obesity, sexual disorders. The calorie content of marmalade, marshmallows and marshmallows is slightly lower (about 300 kcal / 100 g). Currently, foreign firms produce low-calorie chocolates (about 280 kcal/100 g) containing no more than 13% fat. The energy value of halva and cream cakes is close to that of chocolates (about 550 kcal/100 g). The calorie content of cookies (420-460 kcal / 100 g), gingerbread and waffles (350) is very high. One bottle (0.3 l) of Fanta, Pepsi-Cola, Coca-Cola and other sweet carbonated drinks contains 40 g of sugar (150 kcal), 100 g of Baikal drink contains 10 g of sugar (38 kcal ), 50 g of vodka - 120 kcal, 100 g of ice cream - about 250 kcal, 100 g of cookies - 400-500 kcal. All soft drinks are loaded with sugar! One mug of beer contains 150 kcal.

Very important diet. Back in the 17th century, the great French philosopher, mathematician and physiologist Rene Descartes recommended eating little, but often and regularly. We consider the following diet to be the most appropriate (in terms of calories): 1st breakfast - 15%, 2nd breakfast - 15%, lunch - 40%, afternoon tea - 5%, dinner - 25%. The body cannot quickly use a large number of calories, so with one or two meals a day some of them turn into reserve fat. These figures are approximate - this is by no means a law. Other things being equal, in order to lose weight, you need to eat often in small portions. A simple trick will help you. Use children's plates (small), immediately put a small portion on them and quickly remove the rest from the table. Food on the table "calls": "put more."

We have long understood that there are no obligatory meals, a person should eat when he is hungry. It's important not to overeat. The rule "Give dinner to the enemy" does not comply modern principles nutrition! One should not eat when one is not hungry. Do not arrange "load" days. Especially dangerous is overeating on holidays, accompanied by a large amount of alcohol.

Food should not be very hot or very cold. And this is the rule in many nations. Yes, they don't eat in China. hot food which unfortunately is the rule in Europe and America. In a very interesting novel by Mr. Rutherford, Letters to Ancient China, the mandarin Gao-Dai, transported by a time machine from the 10th century to Munich of our time, writes to his friend: “Usually big-nosed (as the ancient Chinese call Europeans) eat their food piping hot. From such heat, all organs of taste are immediately closed. No one is able to distinguish subtle nuances in this state. The highly respected mandarin did not know about the great harm that such food does to the mucous membrane.

You should eat slowly, slowly, chewing food thoroughly. And for this you need to have healthy teeth. A person's health largely depends on the condition of their teeth. Alas, in the second half of the 20th century, due to the ever-increasing consumption of sugar, pollution environment Caries and periodontal disease are very common. One of the most important factors in prevention is oral hygiene. It is necessary to brush your teeth 2 times a day for 2-3 minutes, cleaning all surfaces of the tooth and interdental spaces.

The most convenient and appropriate toothbrushes of medium hardness with a serrated, horizontal or slightly concave cone. Preference should be given to toothpastes containing fluorine, biologically active substances, vitamins. Wooden toothpicks additionally clean the interdental spaces. Brushing your teeth should begin and end by rinsing the mouth with a tooth elixir and thoroughly rinsing the toothbrush, which should be kept open in a glass with the working part up.

Very common chewing gums. After eating, it is advisable to chew gum that does not contain sugar (!) For several minutes.

Each meal should take at least 20 minutes. In between meals, try not to think about food, and hide food (especially delicacies), avoid temptation. Food should be a celebration! Serving, mood are important. In all world religions, it is customary to bless food and the Creator who gives food. “You open your hand and generously saturate all living things,” says Psalm 145.

In conclusion, we will cite the words from the Egyptian papyrus of the 2nd millennium BC. e.: “Man eats too much. He lives on only one quarter of what he eats; the remaining three-quarters live on.”

Here are some foods that will help you lose weight:

Natural fat-free yogurt (no more than 1–1.5% fat);

1/4 teaspoon of cinnamon helps lower blood sugar levels;

Soy products contain lecithin, which lowers cholesterol and fat levels in the blood, increases the level of "good" cholesterol;

Foods rich in vitamin C. Vitamin C is involved in the production of carnitine, which promotes weight loss;

Coffee and green tea - caffeine helps to "burn" fat;

Hot peppers, ginger, mustard, garlic contain capsacin;

Water helps to remove toxins;

Grapefruits are rich in antioxidants that slow down cell aging.

Common misconception! There are miracle cures that allow you to quickly reduce weight. This is not true. Today there are no effective harmless drugs for fast weight loss. All such drugs have a large number of harmful side effects. Be careful with advertising!

What is overweight? It is a field of study in endocrinology and nutrition and is of interest to many medical fields 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 have to comply long mode medical nutrition. Complications of being overweight are always serious, which is why it is so important to take care of your own health in the early stages of the development of pathology.

The nature of the pathology

Obesity (from the Latin “obesitas” - nourishment, fullness) is characterized by excessive accumulation of fatty tissue in the human body. The pathology is characterized by a 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. AT 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 self-determine possible risks 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 small physical activity, fatigue, sweating. Early obesity provokes exacerbation of existing chronic diseases, entails 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- this is a change 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 into digestive tract, fats break down into fatty acid, fats and glycerol compounds. One part is absorbed through the intestinal wall 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, insulin is of key importance. It is he who converts glucose into glycogen, deposits it in adipose tissue.

In fat metabolites, leptin plays a huge role, which prevents excessive accumulation fats. Metabolic disorders lead to gynecological diseases and endocrine disorders in women, provoke sexual impotence in men, and 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 to the constant change in the height and body 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 the 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.

Lack of 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. Special meaning have active games and physical education classes 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;
• violations menstrual cycle among 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.

Effects

Excess fat always has 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 of normal weight, an active lifestyle and diet food. The negative impact of fat on 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. pituitary and thyroid. Endocrine system a person reacts strongly to weight fluctuations, responding to weight gain with hormonal disruptions, 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 different 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 backfire for the body of the child and the woman in labor.

Treatment tactics

Before treating overweight in children and adults, a comprehensive diagnosis is carried out for possible diseases, which 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 of a healthy lifestyle are not observed. 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.

Between meals, you should drink 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, upon agreement (if necessary) with other specialists in the medical profile. AT 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, an active lifestyle, attending massage sessions and attentive attitude to own body It will keep your weight in check and make you look slim.