How to calculate the stages, degrees and type of obesity in men, women and children. How to deal with obesity of the third degree - methods of treating the disease Obesity of the 3rd degree treatment

Obesity is defined as the excess accumulation of fat resulting from the consumption of calories in excess of a person's energy expenditure. A high intake of carbohydrates and fats plays an important role in its development. The main criterion for diagnosing this condition is the body mass index, which, at rates from 25 to 40 kg / m2, is regarded as obesity of 1-2 degrees, and if it is more than 40 kg / m2, then there is obesity of extreme 4 degrees. Is it already a disease or so-called morbid obesity.

It is accompanied by neurohumoral and metabolic disorders, as well as changes in organ function. The problem is important because many diseases are associated with obesity: metabolic syndrome, diabetes, hypertension, dyslipidemia, osteoarthritis, night apnea and polycystic ovaries. Even a small excess of weight (only 10%) already leads to an increase in mortality by 20%, increasing the risk of cardiovascular disease and diabetes. Thus, it can be considered as a socially significant disease.

Treatment of this disease is a difficult task and first of all it is necessary to find out the cause. The formation of excess weight is often associated with eating disorders that are psychological in nature. For example, in patients suffering from bulimia nervosa. bulimia is a psychosomatic disorder manifested in uncontrolled consumption of food. The second name for this disorder is wolf hunger. Overeating attacks are provoked by external influences and the disease can proceed in the form of:

• paroxysmal absorption of food as a result of a strong appetite;
• constant consumption of large amounts of food;
• night food, when attacks appear at night.

Most often, the patient tries to get rid of the food eaten by vomiting or using enemas and laxatives. Bulimia with an addiction to high-carbohydrate foods can be observed with depressions. In women in the luteal phase, taste preferences change (a craving for sweets appears), appetite increases and transient bulimia.

Patients in whom reduced satiety is accompanied by anxiety-depressive disorders and bulimia are prescribed antidepressants. Appetite regulator therapy is also effective ( Sibutramine, Dietress).

A diet for obesity is always prescribed, regardless of the reason that caused it. It is based on the principles of a balanced diet - contains a sufficient amount of protein, vitamins and micronutrients. At the same time, the amount of fats (at the expense of animals), salt (up to 3-5 g), easily digestible carbohydrates and free fluid (this depends on the degree of obesity) is limited in the diet, on average 1-1.2 liters. Any foods that stimulate the appetite are also limited.

It uses low-calorie foods: low-fat fish, seafood, dietary meat, low-fat cottage cheese, milk, eggs, which contain essential amino acids and vitamins. Indigestible fiber and complex carbohydrates are represented by vegetables, fruits, cereals and cereals. The patient receives unsaturated fatty acids through the use of vegetable oils.

The correct distribution of calories throughout the day is important. This is due to the fact that in the first half of the day fat decay processes predominate, and after 18 hours liposynthesis is accelerated (especially at night). Given this, breakfast should be the most high-calorie, so it can include complex and simple carbohydrates and protein. Lunch is less high in calories. For dinner, which should be very light, you can eat lean meat / fish with a vegetable side dish. Or cottage cheese with kefir. After dinner, you can only drink water or kefir.

The composition of products, as well as proteins, fats and carbohydrates, varies depending on the degree of obesity, but the basic principles of nutrition are similar:

• Inclusion of vegetables and fruits - sources of fiber and complex carbohydrates. You need to use them daily, distributing them to all meals, since fiber slows down the absorption of carbohydrates and fats and the process of converting carbohydrates into fats. It also prevents post-meal glucose rise and peak output. insulin which promotes fat storage.
• Mandatory consumption of complex carbohydrates (whole grain bread, muesli, cereals, cereals).
• Introduction of proteins through lean meat, fish, eggs and dairy products.
• Healthy fats in the diet are vegetable oils.
• Exclusion of simple carbohydrates (sugar, honey, pastries, etc.). The need for sweets needs to be filled with berries and fruits.
• Refusal of alcohol, flavor enhancers, semi-finished products. Nuts, popcorn, seeds and chips, which are often used for snacks, are quite high in calories. These unaccounted for calories affect the weight. At a party during feasts, you need to choose less high-calorie dishes.
• Proper cooking (stewing, boiling, baking). Any fried foods are excluded.
• The last meal is no later than 2 hours before going to bed.

Diet therapy also provides for the correct diet and the implementation of certain rules:

• Five (or more) meals a day. Fractional nutrition in small portions, including snacks, prevents the development of a strong feeling of hunger, prevents breakdown and exit from the diet. Patients often have a perverted diet - they eat rarely, consume little food in the morning, and plentiful portions late in the evening. Large meals increase the volume of the stomach and increase the absorption of carbohydrates and fats.
• Proper distribution of calories: for breakfast - 30% of daily calories, for lunch - up to 40%, dinner - 10%, snacks are also allocated 10%.
• Mandatory implementation of the drinking regime, if there are no contraindications - 1.5-2 l / day.
• Avoid eating "on the go" - chips, pies, sandwiches, crackers.
• For all degrees of obesity, a subcaloric diet is prescribed (contains significantly fewer calories than the diet of a healthy person). The degree of calorie restriction depends on the degree of obesity and the condition of the patient.

With obesity 1 degree

1 degree of obesity characterized by a body mass index of 30.0 to 34. Patients at this stage do not consider themselves ill, they have no complaints from other organs, but sometimes they may experience weakness and fatigue. However, already at this stage, you need to start the fight against extra pounds, otherwise it may develop hyperinsulinemia, hypo ovarian function and menstrual irregularities.

Simple carbohydrates and sugar should be eliminated completely, replacing it with sweeteners. The norm of bread consumption is 150 g. The daily calorie content is not more than 1500 kcal. Reducing calories to this level allows you to lose 8% of your weight in six months. With moderate obesity, it is enough to even reduce it by 500 kcal compared to the usual calorie content.

Excluded:

• rich and puff products;
• fatty fish, caviar and canned food;
• fatty meats and sausages;
• salted and pickled vegetables;
• fat milk, sour cream, cream, fat cottage cheese;
• pasta.

At 2 degrees of obesity there is an excess of weight by 30-40% more than the norm and a BMI of 35-39.9.

The nutrition of patients with these two stages is similar. It is based on complex carbohydrates with a low GI: whole grains, many vegetables and fruits. All of these foods are rich in dietary fiber. Vegetables or fruits should be included in the diet five times a day. Fish should be eaten at least twice a week. It must be remembered that fasting is contraindicated, as it can lead to depression. As prescribed by the doctor, meals with a lower calorie content may be prescribed for a short time, which will be discussed below.

At obesity 3 degrees BMI exceeds 40. At grade 3, a pronounced weight gain is already noted, which causes psychophysical discomfort in the patient, leads to the appearance of concomitant diseases (musculoskeletal, cardiovascular systems) and sexual disorders. Patients feel worse, there is a constant dyspnea, worried about pain in the heart, weakness, decreased performance. The complications of impaired metabolism are diabetes, pancreatitis, hypertonic disease, nephrolithiasis.

The diet is heavily restricted in calories. Calorie reduction is achieved by cutting "fast" carbohydrates and fats. The daily diet is up to 80 g of protein, 60 g of fat and 100 g of carbohydrates. Daily calorie content is not more than 1300 kilocalories. Sometimes it is recommended to reduce it to 1000 kcal or more - 650-850 kcal. These are the so-called reduced diets. Such nutrition can be prescribed for a short time (maximum 3 months), and the patient himself must be under the supervision of a physician.

It is unacceptable to use (even occasionally):

• confectionery, sweets;
• any sweet drinks;
• ice cream;
• sweet fruits (bananas, grapes) and dried fruits;
• sugar, honey, pastries (sugar is replaced xylitol, sorbitol, sweetie);
• foods that increase appetite (spicy sauces, smoked meats and seasonings).

Starchy vegetables are best excluded from the diet altogether. These include: potatoes, rutabaga, carrots, corn, pumpkin, Jerusalem artichoke, beets, mature beans and peas, squash, zucchini, parsnip root and parsley, radish, radish. However, in everyday life, this can be difficult to do, so you need to use them as little as possible. Of course, potatoes, as the most highly starchy vegetable, are completely excluded from the diet.

The rate of fluid intake is individual, usually no more than 1-1.2 liters per day. Salt intake is also significantly limited (3 g per day). In this regard, pickles and canned food are contraindicated. The consumption of white bread, pasta, sago, white rice, semolina is significantly limited.

The food menu may contain:

• vegetables: green peas, all types of onions, cucumber, kohlrabi, eggplant, all types of cabbage, broccoli, Brussels sprouts, Beijing cabbage, cucumbers, celery, seaweed, green salads, sorrel (rarely if uric acid levels are elevated), tops vegetables, chard, dill, sweet pepper, parsley, mushrooms, chicory, spinach, garlic;
• dietary breads (with bran, grain, coarse grinding);
• buckwheat, oatmeal, added to the soup;
• unripe legumes (green beans, green peas);
• pears, apples, citrus fruits, kiwi, pineapples, plums.

When compiling a diet menu for obesity of the 3rd degree, it is necessary to take into account not only prohibited foods, but also not to exceed the volumes of single servings and the number of foods allowed per day:

• fermented milk drinks 300 ml;
• low-fat cottage cheese 100 g;
• butter 5-10 g;
• one egg;
• fruit 200 g;
• allowed vegetables 200-300 g.

The diet provides slow weight loss. Don't try to lose weight quickly. It is necessary to carry out a diet under the supervision of a specialist, and at the same time, drug correction of metabolism and an effect on increased appetite are possible. Mandatory physical activity, the level of which will also be determined by a specialist, taking into account comorbidities, but all patients, without exception, are recommended to walk daily for 45 minutes.

Obesity and diabetes very connected. The risk of developing diabetes in the third degree of obesity will increase 10 times. If a person leads a sedentary lifestyle and consumes mainly carbohydrate foods, more glucose is needed to process glucose. insulin. The pancreas works in an enhanced mode, which over time depletes it and leads to the development of diabetes.

Carrot, beet and tomato juice is considered useful, without preservatives and additives, celery juice

Nutrition for obesity and diabetes is based on a significant restriction of carbohydrates. This also applies to sweet fruits. Their allowable amount depends on the degree of violation of carbohydrate metabolism. In the presence of diabetes, choose fruits with a low glycemic index (GI less than 55 is considered low). These fruits include: grapefruits, lingonberries, cherry plums, apples, apricots, cranberries, plums, cherries, peaches, sea buckthorn, currants, gooseberries. The allowable daily allowance of these fruits is 200 g.

Patients should maintain a healthy intestinal microflora, since the quality of digestion and the absorption of substances depend on this. The quality of the microflora improves with a sufficient amount of fiber and the use of fermented foods (sauerkraut and other pickled vegetables, beet kvass, kombucha, pickled fruits).

Approved Products

• Low-fat fish, mussels, shrimp, squid and other low-calorie seafood that is cooked by boiling or baking.
• Lean meats (beef, rabbit, chicken and turkey) are prepared in the same way.
• Cereals - brown rice, buckwheat, basmati rice, oatmeal. Porridges are boiled in water and a portion is consumed 2 times less than usual. The frequency of consumption of cereals decreases with 2 and 3 degrees of the disease.
• Vegetable soups, cabbage soup, borscht cooked in water, vegetable broth or secondary meat broth.
• Legumes with a low glycemic index can be included in the diet several times a week: green beans, soybeans, green and red lentils. Mature legumes should be limited.
• Egg whites.
• Grain bread and yeast-free with bran.
• Cashews and peanuts, which have a GI of 15, can sometimes be enjoyed as an addition to salads.
• Vegetables and fruits in general 500 g per day. In addition to fruits, you can eat dried apricots and prunes, which have a GI of 40, bran, sesame and flax seeds, as a source of fiber.
• Preferred vegetables: green peas, all types of onions, cucumber, kohlrabi, eggplant, all types of cabbage, broccoli, Brussels sprouts, Beijing cabbage, cucumbers, celery, seaweed, zucchini, green salads, radishes, radishes, turnips, sorrel ( rare if elevated uric acid), vegetable tops, chard, dill, bell peppers, parsley, mushrooms, chicory, spinach, garlic. Carrots, potatoes, and boiled squash have a high glycemic index and should be avoided. But you can eat raw carrots and beets.
• Low-fat cottage cheese and dairy products, this also applies to hard cheeses. For dressing salads, you can use natural yogurt, using 2 tablespoons. Its calorie content is several times lower than the same amount of vegetable oil.
• For dressing salads, you need to use unrefined vegetable oils (olive, sesame or linseed, corn), but in the amount of 1 tbsp. l. Per day, given the very high calorie content.
• Weak tea with fructose, herbal teas, green tea, table water, rosehip infusion, vegetable juices with a lower calorie content and juices of unsweetened fruits (orange, pomegranate, apple).

Table of allowed products

Wholly or partially restricted products

First of all, overweight nutrition should not contain:

• Foods with a high glycemic index.
• Fast food (fried pies, french fries, chips, etc.), which is not only a high-calorie product, but also contains a dangerous dose carcinogens, since the oil for its preparation is used several dozen times.
• Fatty pork, duck, goose, trans fats, animal fats, smoked meats, canned food in oil, sausages, palm and coconut oil.
• Fried foods mean high calorie content. The calorie content of these products increases by 1.3 times.
• Fatty dairy products.
• White rice, pasta, semolina, dough products.
• Baking from any test.
• Confectionery, ice cream.
• Limit salt.

Table of prohibited products

* data are per 100 g of product

Menu (Power Mode)

Do not try to immediately sharply limit all products. During the adaptation period, you need to reduce portions by 2 times and exclude flour, sweet products and sugar, as well as reduce the amount of bread. Even such restrictions will give results. After 1-2 weeks, gradually reduce the frequency of eating cereals, replacing with vegetable side dishes.

If the food is varied, and you think over all the dishes that you can use when you feel hungry, then this will help to avoid breakdowns. It can be low-fat cottage cheese, stewed zucchini, green peas, a small portion of lentils, bran bread, bran with kefir and berries, apples or grapefruits.

For kids

Alimentary (constitutional-exogenous) obesity in children is characterized by a uniform accumulation of adipose tissue. This form occurs in 90% under the age of one year. With age, there is a slight degree of excess weight. During puberty, girls gain even more weight. The number of fat cells in a child depends on the genetic factor, and the size of the fat cells is already affected by the nutritional factor. Overnutrition during the critical puberty period leads to an increase in their size.

The difficulties in organizing the nutrition of children suffering from this pathology lie in the fact that, on the one hand, the child's body must receive vitamins, macro- and microelements, a sufficient amount of proteins. On the other hand, children who are prone to weight gain should be limited in nutrition. This should happen at the expense of carbohydrates (mainly easily digestible) and fats.

As little as possible, you need to offer buns, sweets, cookies, jam and other sweets. Potato dishes, pasta and dough dishes (dumplings, dumplings, pancakes, pancakes) should be included in the menu very rarely. Lamb, pork, beef fats and margarine should be excluded. Vegetables and unsweetened fruits should prevail in the diet.

Of course, it turns out that with such restrictions, nutrition becomes hypocaloric, and a decrease in calorie content causes the consumption of fat from the depot. In the early stages of the disease, metabolism normalizes more easily and faster and weight decreases. Usually, the caloric content of food is reduced by 200-600 kcal. You should not sharply limit and quickly reduce calories. This can cause weakness in the child and headache.

The diet for obese children includes:

• Meals 6 times a day and in small portions. Breaks between meals at 2.5-3 hours suppress hunger and reduce appetite, so the child will not eat a large amount of food at the next meal.
• Dinner is no later than 7 pm and should be light.
• High-calorie meals should be given in the morning. Breakfast and lunch may consist of meat and fish dishes, and dinner - vegetable and dairy.
• Slow eating and careful chewing. At the same time, the feeling of satiety comes faster, and the child will not overeat.

Children's dietary nutrition should include the age norm of protein obtained from cottage cheese, yogurt, meat, fish, kefir, milk. Three-year-old children should eat 80 g of meat per day, preschoolers - 100 g, from 7-12 years old up to 150 g of meat. Cottage cheese should be present in the diet daily in the amount of 50-80 g. Dairy products in the amount of 400-600 ml.

Vegetable juices are useful because they are less high in calories: tomato, beetroot, carrot, cabbage or a mix of juices. Soups should be cooked vegetarian, and once a week in a weak meat broth. To diversify the child's diet, steam meatballs, cutlets, dumplings and meatballs are prepared from fish and meat.

Dietary meals for obese children and the technology of their preparation can be found in clinical nutrition guides. Of course, not many children like vegetables, but perhaps from the list of dishes you can choose the most suitable for your child.

You can cook vegetable stew, eggplant sauté, carrots with bechamel sauce, cabbage casserole, cabbage, carrot, beetroot or squash cutlets, cabbage schnitzel, boiled fish with zucchini and low-fat sour cream, fish cutlets with vegetable garnish, cottage cheese with greens, scrambled eggs with green beans or zucchini (tomatoes). For dessert, you can offer cranberry or lemon jelly with xylitol.

Older children are assigned fasting days once a week with a caloric content of food of 600-800 kcal. These can be standard unloading diets: dairy, apple, cottage cheese, kefir. Starvation treatment is contraindicated, since catabolic processes intensify in the child's body, and this can inhibit growth and disrupt the maturation of the body.

The motor activity of the child is also an important therapeutic factor. Physical activity significantly increases the metabolic rate and accelerates weight loss.

Pros and cons

Reviews and results

This healthy diet must be constantly carried out by the sick. Small deviations from the diet are possible. However, with eating disorders, weight loss can slow down. The reviews note positive points: weight is reduced, swelling disappears and constipation. By following it, you can significantly improve your health. With a pronounced degree of obesity, nutrition should be adjusted by an endocrinologist and a nutritionist. It may take 1-1.5 months to lose weight, but it is important that losing weight does not turn into torture, and the weight achieved does not increase again.

• “... I can say that for very fat people who are used to eating a lot of high-calorie foods, it is very difficult to follow a diet. So do I. I have been doing it for the fourth month - the process is going well, but it is difficult for me. Non-caloric meals after 1.5 hours cause a feeling of hunger and you have to eat again. Any additives such as MCC, Stroynitin, Garcinia. When the endocrinologist prescribed Meridia, she felt better and was able to withstand breaks of 3-3.5 hours, she began to eat less and her weight shifted. I eat fish, vegetables, turkey, cottage cheese, 3 times a week I eat porridge, I drink kefir. The result for 4 months minus 8 kg. The doctor says that the result is good and it is impossible to reduce weight faster. With such a diet, he recommended taking vitamins, as irritability periodically rolls in and there is often a bad mood ”;
• “... The process of weight loss became more effective when I began to pay attention to the glycemic index of products. I was recommended by a doctor, as an increased level of insulin in the blood was determined. It was necessary to be examined for a long time, because I have been on diets for a long time and often, but there is little sense. Moreover, the weight returns in 1-1.5 months. The nutritionist wrote down the diet and said that you need to eat like this all the time because of carbohydrate metabolism disorders. Calorie content should be kept at 1200 kcal and eat low-calorie foods (non-starchy vegetables, eggs, meat, fish, chicken, low-fat cottage cheese and milk, cereals). For 2 months, with daily walking 3 km, I lost 5 kg. The result is good, but I think that then weight loss will slow down ”;
• “... On a diet for 2 months, I can’t stand the lack of sweets and starchy foods. For fat women, it is important not to use them. I try not to do any violations, but I do it all with anguish and through stress. Even fruits and berries do not help. The doctor recommended taking Liprina and soothing herbs. It really helped as my appetite decreased and the cravings for sweets went away. I finish the package, and then I go to the reception. I think that with a lot of weight, you can’t do without special drugs. I eat chicken breast, fish, various salads. In the summer, this can be done without problems, and in the winter you will have to buy frozen vegetable mixes and cook stews. In winter, grapefruits and oranges will help out. I use mushrooms everywhere - in omelettes, warm salads, soups and borscht."

Diet price

Food is relatively inexpensive, if you do not eat seafood every day. A large amount of vegetables and fruits in the diet in winter can slightly increase the cost of food. It can reach 1600-1700 rubles. in Week.

NOTE! Information about diets on the site is a general reference, collected from publicly available sources and cannot serve as a basis for making a decision on their use. Before using the diet, be sure to consult a dietitian.

Excess body weight is formed when there is a mismatch between the amount of energy received from food and the activity that allows this energy to be spent. The availability of a large amount of high-calorie food, if there is no need to expend energy on its extraction, quickly leads to the formation of excess body fat. A person himself does not always notice how slight fullness is replaced by obesity, and with obesity comes shortness of breath, pain in the heart and joints, and other complications. With obesity, nutrition is adjusted, and a strict diet for obesity of the 3rd degree becomes a vital necessity.

Relationship between nutrition and obesity of the 3rd degree

Snacking during stress and lack of sleep carries the risk of rapid development of obesity (photo: versiya.info)

The causes of obesity are often attributed to endocrine diseases or hormonal fluctuations. Genetic features of the synthesis of lipolytic enzymes and other external causes. They are certainly important for understanding the causes of metabolic disorders in the body. All health disorders affect body weight only together with nutrition. If, with a slow metabolism due to illness, you do not give up the habit of overeating, make up your diet from high-calorie meals and at the same time neglect any physical activity, then such a diet will provide obesity of the 3rd degree very quickly.

Metabolic processes in the body slow down not only due to illness or a sedentary lifestyle, but also with chronic stress, lack of sleep. Nervous overload and poor sleep are often accompanied by an irresistible desire to eat something. It helps to calm down and fall asleep a piece of cheese, sweet curd, chocolate. The explanation for this is the high content of the amino acid tryptophan, which is responsible for sleep and calmness. But along with it, such nutrition will give a lot of extra calories, and with them rapidly growing overweight, rapidly turning into obesity.

The degree of obesity is usually calculated according to the formula adopted by the World Health Organization (WHO) for people 18-65 years old. The indicator is the body mass index. To determine it, you need to divide the weight in kilograms by the square of the height, calculated in meters. If the indicator exceeds the value of 30, we can talk about obesity of the 1st degree, more than 35 - the second. With a body mass index of more than 40, a diet for obesity of the 3rd and 4th degree is already vital, since this condition is already regarded as a direct threat to health.

Principles of nutrition in obesity

An important principle of nutrition for obesity is to eat often and in small portions (photo: haberum.com)

Diet therapy for obesity of the 3rd degree is necessarily carried out under the supervision of a physician. There are two reasons for this. The first is due to the need to drastically reduce the calorie content of the diet due to “light” carbohydrates and fats, and such a step can cause bouts of hypoglycemia even in a person who does not have diabetes. The second reason is related to the "bouquet" of diseases that inevitably accompany overweight. With obesity of the 3rd degree, symptoms of arthrosis develop due to excessive stress on the joints, respiratory failure appears due to the high rise of the dome of the diaphragm, the spine suffers, and the functioning of the kidneys, cardiovascular and digestive systems is disturbed. All these violations must be taken into account when choosing a diet for overweight correction.

The basic principles of nutrition for obesity of the 3rd degree:

• fractional meals 6-7 times a day in portions of no more than 400 g - this approach helps to avoid hunger;
• the use of a large number of foods with fiber (vegetables, pearl barley, oatmeal, bran) - they create a feeling of satiety with small amounts of food eaten;
• exclusion from the diet of "fast" carbohydrates. These are fruits, sugary drinks, chocolate and sweets, pastries (with the exception of whole grain bread). As well as juices, carbonated drinks, kissels and compotes;
• restriction of table salt - add food only in a plate. Its total allowed volume per day should not exceed half a teaspoon;
• exclusion from the diet of seasonings, spices, spicy snacks - everything that can stimulate appetite;
• control of the drinking regime - at least 1.5 liters of free liquid per day, mainly in the form of still water.

The daily energy value of the diet for obesity of the third degree is 1300 kcal. The dietary table provides for the amount of protein per day - according to the upper limit of the norm (about 90-120 g), and the amount of fats and carbohydrates is reduced to 80 and 250 g, respectively.

Food choices for obese people

As snacks for obesity, it is allowed to eat a piece of meat, a vegetable or a grain loaf (photo: fitsolutionsblog.com)

The first step in obesity is to exclude sugar from the diet. However, the body reacts very hard to a sharp rejection of sweets, so you need to replace it with stevia. It can give dishes the usual sweetness, but it does not contain calories at all. If you want a dessert unbearably, you can use sweets for diabetics, which are prepared with sweeteners.

You will have to greatly limit the list of familiar store products - such as muesli, ketchup, low-fat yogurt and cottage cheese, which are offered as products for losing weight, but actually contain a lot of hidden sugars.

The choice of products and dishes for people with obesity of the 3rd degree:

The risk of falling off the diet with obesity is the habit of snacking between main meals, especially when it is not possible to follow a clear diet. Permissible snacks can be boiled chicken or beef meat, a piece of jamon, 5-10 nuts (almonds, peanuts), cereal bread, a piece of pumpkin or cauliflower.

Recipes for obesity of the 3rd degree should include ingredients that are rich in vitamins and minerals. Against the background of restrictions in the choice of products and in the volume of servings, there is a risk of developing a deficiency of these substances. By agreement with the doctor, their deficiency is replenished with bioadditives.

Formation of the menu for obesity

The menu for obesity must be planned in advance to include all the necessary products (photo: fthmb.tqn.com)

The nutrition plan for obesity must be agreed with the doctor. He will tell you how to balance some of the diseases associated with obesity with the help of a diet. For example, obesity often causes type 2 diabetes. We'll have to focus on foods with vegetable fibers, which slow down the absorption of glucose into the blood. In case of cardiovascular complications, it is recommended to include in the daily menu products that prevent the development of atherosclerosis - celery, nuts, carrots, sweet peppers.

The menu for the week must be planned in advance in order to avoid situations when all acceptable and healthy dishes have already been eaten before lunch, you don’t want to cook something new or there is no time, and harmful snacks are used.

Sample menu plan for the week

As a second breakfast, you can gnaw carrots, a piece of pumpkin, a cabbage stump. These vegetables will dull your hunger and add no calories. Before going to bed, a glass of kefir, curdled milk or natural yogurt is recommended. These drinks will dull the feeling of hunger and improve digestion.

What is dangerous obesity, how to organize nutrition with overweight, what you can and cannot eat, see the video below.

Excess weight is not yet a problem, but with obesity the situation is somewhat different. This diagnosis can only be made by a doctor, which means that you need to somehow deal with it. In this case, the therapeutic diet number 8 will be relevant.

Briefly about the diet

If a person is diagnosed with obesity, there are various ways to deal with this problem. One of them is proper nutrition. In this case, the doctor will prescribe a diet for obesity No. 8 (this diet cannot be used without a doctor's prescription). It is necessary for people who have even the first degree of the disease. It is worth saying that this is one of the 15 diets that were once developed by the brilliant Soviet doctor M. Pevzner. The main goals of this diet:

1. First of all, weight loss.
2. Restoration of water-salt balance in the body.
3. Normalization of lipid metabolism processes.

An important point: this diet can only be prescribed to those people who do not have problems with the digestive organs and liver, as well as cardiovascular diseases. In this case, patients and so need a special diet. Therefore, once again it is necessary to clarify that this diet should be prescribed exclusively by a doctor.

Compound

So, what is the diet for obesity number 8? What should be remembered in this case? It is very important to know the composition of the diet itself in order to understand how you will have to eat to bring your weight back to normal. The daily diet will necessarily include:

1. 100 grams of protein.
2. 80 grams of fat (it is worth remembering that half of the fat should be of vegetable origin).
3. 120-150 grams of carbohydrates (important to remember: sugar is completely excluded from the diet).
4. The total daily energy value of all foods eaten should not exceed 1600-1800 kcal (unless otherwise prescribed).
5. The daily amount of fluid consumed should not be less than two liters.

Nuances

This diet has its own special nuances. What do you need to know and remember?

1. Salt is not used during cooking. However, its consumption is not completely excluded. Salt can be added to dishes directly during meals. Norm: 3 grams per meal.
2. All foods consumed should be low-calorie.
3. Products should consist of simple carbohydrates, and also have a low amount of fat in their composition.

An important point: the diet for obesity number 8 provides for fasting days. So, it can be kefir, apple, meat or vegetable periods. In this case, the daily energy value of all products should be no more than 1000 kcal.

Severe cases

Diet is very important for obesity of 2 degrees and above (3, 4 degrees). Indeed, in this case, excess weight becomes a threat not only to health, but often to the life of the patient. It must be said that in this case, patients are often placed in a hospital for complex treatment, which does not exclude this diet. However, there are certain nuances here.

1. The daily energy dose should not exceed 1200 kcal.
2. Meals should contain a minimum amount of animal fats.
3. Liquid intake per day is strictly limited: no more than two liters.
4. Dishes and foods that excite the appetite are excluded from the diet.
5. Preference is given to products that contain dietary fiber.
6. All food should be boiled, stewed or baked. Fried, chopped or pureed dishes are completely excluded.
7. When preparing sweet dishes, sugar is completely excluded. It is allowed to use its substitutes, such as fructose.
8. Food is fractional, you need to eat 5-6 times a day in small portions.

Approved Products

If the patient is prescribed diet for obesity No. 8, the following foods can be consumed without fear:

1. Bread. Wheat or rye from wholemeal flour. No more than 150 grams per day.
2. Meat. Low-fat varieties: rabbit, chicken, turkey. Low-fat varieties of beef, pork, veal and lamb are also allowed. You can also beef jelly and sausages. Norm: no more than 150 grams per day.
3. Fish and seafood. Low-fat varieties of fish and all seafood. No more than 200 grams per day.
4. Dairy. Milk and everything that is prepared from it is allowed. You can also sour cream, cheese and cottage cheese (and cottage cheese products) - all low-fat. Norm: 200 grams per day.
5. Eggs. You can eat one hard-boiled egg per day, as well as an omelette with the addition of vegetables.
6. Cereals. Barley, barley, buckwheat - in a friable form. Cereals in soups can only be in limited quantities.
7. Vegetables. All vegetables can be raw. If you want sauerkraut, you need to rinse it. Dishes from carrots, potatoes, beets and peas can be consumed in an amount of no more than 200 grams per day. Pickled vegetables can be eaten in limited quantities.
8. Fruit. Almost everything is possible and in any form. The exceptions are bananas and grapes.
9. Sweets. Various jellies, mousses, compotes are allowed. However, they must be prepared without sugar.
10. Fats. Table number 8 (diet) also involves the consumption of fat. But in small quantities. If it is butter, you can eat it in a minimal amount. Vegetable oil is limitedly allowed in dishes.
11. Sauces. This diet involves the consumption of tomato, mushroom and vegetable sauces, as well as vinegar.
12. Beverages. You can drink black and green tea, coffee (both with milk and without). Juices and compotes without added sugar are allowed.

Prohibited Products

If the patient is assigned table number 8 (diet for obesity), be sure to know about those products that should be completely excluded from the diet.

1. Bakery products from high-grade flour, as well as yeast and puff pastry.
2. Bean, potato and milk soups with pasta.
3. Fatty meats, fish. As well as smoked meats, canned food and caviar.
4. Rice and semolina, pasta.
5. It is better to refuse bananas and grapes, as well as raisins, dates, figs.
6. All kinds of confectionery, ice cream, jelly and jam are prohibited.
7. It is necessary to refuse sweet juices, compotes, as well as cocoa.
8. Completely prohibited are cooking oils, as well as mayonnaise, spicy sauces and spices.
9. And, of course, everything that belongs to products called fast food is prohibited products.

Menu

If the patient is prescribed diet No. 8 for obesity, the menu may be as follows:

1. Breakfast 1. Vegetable salad (you can add vegetable oil). It is also good to eat a portion of low-fat cottage cheese in the morning.
2. Breakfast 2. You can have breakfast with fruits, for example, fresh apples.
3. Dinner. A half portion of borscht in meat broth, but without meat, you can add sour cream. Boiled meat, stewed cabbage, dried fruit compote.
4. afternoon tea. You can eat fat-free cottage cheese with milk.
5. Dinner 1. If the patient is on diet #8, the dinner menu may consist of fish stew, vegetable stew and tea.
6. Dinner 2. Low-fat kefir is best consumed shortly before bedtime.

People may have a logical question: “Why are breakfast and dinner provided in two versions?” It's simple, since nutrition should be fractional, there should be several of these meals.

About dishes

If the patient is prescribed diet number 8, the recipes can be varied at your discretion. However, the following rules must be remembered:

1. Soups should be in the diet. It is best if they are vegetable. You can also cook soups in low-fat meat or fish broth. Meatballs are allowed (no more than twice a week).
2. Fermented milk products, as well as stewed cabbage, are considered very useful for this diet. They need to be given special attention.
3. You can make various decoctions, but you need to cook them without adding sugar.
4. It is good to make vegetable and fruit salads.

These tips will help diversify the menu and make eating according to special rules a pleasant experience, and not a “dry” duty.

Improving Efficiency

In order for the diet to bring maximum results, you need to know a few so-called "golden rules" of eating:

1. We must remember that food should be fractional. Meals should be at least 5.
2. The feeling of hunger is unbearable. In this case, you can eat, for example, an apple.
3. You should not eat if there is no feeling of hunger, even if the time has come.
4. In the morning you need to eat more high-calorie meals.
5. In this mode, you should try to avoid snacking as much as possible.
6. If during the meal there is a feeling of satiety, you do not need to eat everything from the plate.
7. While eating, you can not read, watch TV. You need to focus solely on food.
8. When following a diet, you should not visit establishments with pleasant smells. It can be great to whet your appetite.
9. Products must be bought according to a pre-prepared list. Also, you can’t go for food in a state of hunger.
10. If a person has a bad mood, you do not need to abuse food.

And in order for the feeling of satiety while eating to come sooner, nutritionists recommend adhering to the following rules:

1. Before eating, you need to drink a glass of water.
2. Before the main course, you need to eat a salad.
3. You need to take your food slowly. At the same time, it is worth remembering that it is important to chew food well.

expectations

What should be expected if a patient is prescribed a diet for obesity of the 1st degree? So, the main goal of a specialized meal is a positive effect on metabolism. And this, in turn, will lead to the disappearance of excess body fat. However, don't expect quick results. The weekly menu is designed so that during this time a person loses about 1 kg of weight. But at the same time, it is worth remembering that the diet is designed for a long time. And best of all, if such dietary rules become for a person not an obligation, but a life norm.

• Therapeutic diet for obesity
• Diet 8 for obesity
• Diet for obesity 1 degree
• Diet for obesity 2 degrees
• Diet for obesity 3 degrees
• Diet for obesity 4 degrees
• Diet for fatty liver
• Children's diet for obesity
• Three best fasting days

What is obesity?

Obesity is a disease characterized by excessive deposition of fat and, as a result, excessive development of adipose tissue. The main factor influencing the increase in body weight is the discrepancy between the intake of calories in the human body and their expenditure. There are also other causes of this dangerous disease, namely: endocrine disorders, hereditary-constitutional predisposition, certain physiological conditions (pregnancy, lactation, menopause), professional activity.

Today, over a billion people in the world are overweight and one of the 4 stages of obesity. In Russia, 50% of women and 30% of men suffer from this, in Germany - every second resident, in Britain and North America - every third, in the USA - every fifth. Excess weight is determined quite simply and the Quetelet index is used for this. It is calculated by dividing a person's mass by the square of their height in meters (weight in kg/height in m2).

Weight is considered normal with an index: for women - 19-24, for men - 20-25, an indicator above this indicates excess body fat. At stage I of obesity, the actual body weight exceeds the ideal by no more than 15-29%, at stage II - 30-49%, at stage III - 50-100%, at stage IV - more than 100%.

Therapeutic diet for obesity

Many special diets for obesity have been developed for the treatment of overweight patients. All of them are based on the principle of reducing the energy value of the diet due to easily digestible fats and carbohydrates with a normal protein content. Appetite-stimulating foods, table salt (up to 3 g) and liquid (up to 1.0-1.2 l) are limited. Feed fractional, 5-6 times a day. To provide the patient with a feeling of fullness, food should contain a lot of indigestible carbohydrates (fiber), it should be served boiled, stewed or baked. Animal fats are replaced with vegetable oils.

Energy value of therapeutic diet options:

Products that can be consumed without restriction:

Cabbage (all types)

Cucumbers, tomatoes

Leaf lettuce, greens

Zucchini, eggplant

• string beans

  Radish, radish, turnip

  Green peas (young)

  Spinach, sorrel

  Tea, coffee without sugar and cream

  Mineral water

  Lean meats (white chicken, turkey, veal, beef)

Vegetables can be consumed raw, boiled, baked, steamed.

The use of fats (butter, mayonnaise, sour cream) in the preparation of vegetable dishes is not allowed.

Foods to be consumed in moderation:

Milk and dairy products (low fat)

Cheeses less than 30% fat

Curd less than 5% fat

Potatoes (no more than 6 tablespoons per serving)

Corn

Mature grains of legumes (peas, beans, lentils) (no more than 6 tablespoons per serving)

Cereals (no more than 6 tablespoons per serving)

Pasta (no more than 6 tablespoons per serving)

Bread and bakery products (not rich; preferably wholemeal bread, 1 k.)

Fruits (except bananas, dates and grapes)

! “Moderate” means half of your usual portion.

Products that need to be excluded or limited as much as possible:

Butter

Vegetable oil (1 tablespoon / day)

Sour cream, cream

Cheeses over 30% fat

Curd over 5% fat

• Fatty meat (pork, lamb, chicken legs)

  Smoked meats

  Sausages, sausages, sausages

  Bird skin

  Canned meat, fish and vegetable in oil

  Nuts, seeds

  Sugar, honey

  Jam, jams

  Candies, chocolate

  From fruits: bananas, dates, grapes

  Pastries, cakes and other confectionery

  Cookies, pastry products

  Ice cream

  Sweet drinks (Coca-Cola, Fanta)

  Alcoholic drinks

It is necessary to exclude such a method of cooking as frying.

Try to use cookware that allows you to cook food without adding fat (steamer).

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Diet 8 for obesity

This diet is used for obesity of varying degrees to reduce a person's weight and restore disturbed water-salt and lipid metabolism. It uses only low-calorie foods. For example, seafood contains a large amount of organic iodine and essential amino acids. In protein foods - low-fat cottage cheese, cod and vegetable oil, amino acids, vitamins and a sufficient amount of unsaturated fatty acids are ideally combined.

Diet for obesity 1 degree

A person at this stage does not yet consider extra pounds a disease, he usually does not have any complaints. For this category of people, the norm is high physical and mental stress. Only a part of them can complain of general weakness and increased fatigue.

If you do not start getting rid of excess body fat during this period, then in the future it can lead to the development of diabetes mellitus and hyperinsulinemia, ovarian hypofunctionality (in women), and menstrual disorders. To avoid such complications, active movement during the day and a balanced diet are recommended. It should consist of 60% proteins (including animal origin), 25% vegetable fats, 5-8 g of salt and up to 1.2 liters of fluid daily.

Sugar is excluded completely, except that you can use its substitutes. All dishes are prepared without salt, they are salted separately. Eat food should be at least 6 times a day, little by little.

1st breakfast: low-fat cottage cheese (100g), stewed carrots (200g), coffee with milk without sugar (200g).

2nd breakfast: apple or fresh cabbage salad without salt with a spoonful of sour cream (170g).

Dinner: vegetable borscht (200g), stewed cabbage (150g), boiled meat (90g), dried fruit compote without sugar (200g).

afternoon tea: low-fat cottage cheese (100g), rosehip broth (200g).

Dinner: boiled fish, for example, pike perch (100g), vegetable stew (125g), green tea (200g).

For the night: low-fat kefir (150g).

The allowable norm of bread for the whole day is 150g.

Diet for obesity 2 degrees

This period is characterized by a slow but sure set of extra pounds. It is difficult to reduce body weight, but there is a guarantee that the lost kilograms will not return in the future with an active lifestyle. The treatment of this type of disease requires an integrated approach that combines moderate physical activity and thoughtful nutrition.

Diets at stages 1 and 2 of obesity are similar to each other, therefore, here in the daily diet of the patient, 60% of proteins, 25% of vegetable fats, 4-8 g of salt and up to 1.2 liters of liquid should be present. All products are consumed raw (vegetables and fruits), boiled, stewed and baked. The daily food intake is divided into 6 small portions.

Forbidden to use:

sweets and puff pastry, biscuits,

salted and pickled vegetables, legumes,

fatty meats and sausages,

fatty fish, caviar and canned food,

baked milk and sweet dairy products, fatty cottage cheese,

pasta, milk soups with pasta,

sweet juices, kvass, cocoa, lemonade,

spicy and fatty sauces, mayonnaise, hot spices.

Diet for obesity 3 degrees

This stage is characterized by the stability of body fat and for weight loss a person will need complex therapy. In some advanced cases, you can not do without surgical intervention. The state of health of patients deteriorates sharply, shortness of breath appears at the slightest physical exertion and even at rest, pain in the heart area, headaches, weakness, drowsiness, and working capacity decrease.

As complications, atherosclerosis, diseases of the heart and joints, liver and biliary tract, diabetes mellitus, hypertension, pancreatitis, nephrolithiasis develop. Treatment of patients is best done in a hospital, under the supervision of doctors and with one unloading day a week. The daily diet should include up to 80g of proteins (70% of them of animal origin), 60g of fats (30% of them of plant origin), 100g of carbohydrates. The total calorie content of products should not exceed 1300 kilocalories.

Sample meal plan for one day:

1st breakfast: boiled meat (90g), vegetable salad with vegetable oil (150g), coffee with milk without sugar (200g).

2nd breakfast: apple (about 100g).

Dinner: vegetarian borscht (200g), stewed cabbage (150g), boiled fish (100g), apple compote without sugar (200g).

afternoon tea: skim milk (180g).

Dinner: baked meatloaf stuffed with egg (90g), green tea (200g).

For the night: low-fat kefir (150g).

Diet for obesity 4 degrees

Patients with 100% overweight, as a rule, need constant care. They move with difficulty, cannot climb stairs, wash themselves in the bathroom and use public transport. Every step is difficult for them. Such patients have a whole bunch of serious diseases associated with excessive body weight: atherosclerosis, hypertension, diabetes mellitus, pancreatitis, Pickwick's syndrome - respiratory failure.

Obesity at stage 4 requires an integrated approach: a special diet and, quite possibly, surgery. It is desirable to be treated in a hospital, under the supervision of a doctor.

Diet for fatty liver

Fatty liver is also called fatty liver, steatohepatosis or fatty degeneration. All these medical terms mean the same thing, namely, the pathological degeneration of liver cells into adipose tissue. Fatty degeneration cannot be called a fatal disease and up to a certain stage it is a reversible process. But if you start the disease strongly, then a more deplorable result is inevitable - hepatitis or cirrhosis of the liver.

The diet for hepatosis of the liver involves limiting the intake of animal fats and easily digestible carbohydrates, increasing protein intake and completely abandoning flour and pasta, sugar and alcohol. In addition, traditional medicine offers a number of herbal remedies that help rid the liver of excess fat. They are represented by decoctions and infusions of immortelle, milk thistle, wild rose, etc.

Children's diet for obesity

Of particular concern to physicians, in recent years, cause excess body fat in children. In Italy, 36% of preschoolers and adolescents suffer from this, in Greece - 31%, in Spain - 27%, in the USA - 26%, in Russia - about 30%. In order not to overfeed children and save them from extra pounds, you just need to follow some recommendations:

feed babies and teenagers at the same time, 6 times a day, little by little. The first breakfast can be at 8 o'clock in the morning, and the last meal of light food no later than 20 o'clock,

breaks between meals at 3 hours help reduce appetite and get rid of hunger,

it is advisable to offer high-calorie meals to preschoolers and schoolchildren in the morning, when they are more active. For breakfast and lunch, it is advisable to cook meat and fish dishes, in the late afternoon - vegetable and dairy foods.

Diet for an obese child

A growing children's body must be provided with all useful substances, including vitamins, macro and microelements, mineral salts. However, in the menu of children prone to gaining extra pounds, carbohydrates, especially easily digestible ones, should be limited. It should be completely excluded from the use of mutton, beef and pork fat, as well as margarine. As little as possible, sweet buns, sweets, jams and cookies should be included in the diet of babies and teenagers. But vegetables in any form and unsweetened fruits and berries are very, even welcome.

Useful for kids and juices - tomato, beetroot, cabbage, carrot. It is necessary to prepare them only from fresh vegetables. In addition, each child should receive the age norm of cottage cheese, meat, fish, milk and other dairy products. Two and three-year-old kids need 80g of meat per day, for preschoolers the norm will be 100g of meat, for schoolchildren 7-12 years old - 150g of meat. The norm of cottage cheese, both for preschoolers and teenagers, is the same - at least 50g per day. It is recommended to give milk to preschool children 500-600 ml per day, to schoolchildren - 400 ml.

Soups are brewed mainly vegetarian, but no more than twice a week they can be cooked in diluted meat or fish broth. Steam meatballs, meatballs and cutlets are prepared from boiled fish and meat. But potatoes, which contain a large percentage of starch, should be included in the menu as rarely as possible. It is also important to teach your child to eat slowly, in this case, the feeling of satiety occurs faster, and the baby will not overeat.

Three best unloading days - how to lose excess

Extra pounds not only expose the body to constant stress, but also pose a threat to life. The most dangerous is obesity of the 3rd degree; how many kg are extra and how to deal with them, we will consider in more detail.

Obesity of the 3rd degree is a serious disease with excess weight of more than 50%, that is, at a rate of 60 kg in relation to height, you constantly carry more than 100 kg with you, of which 40-60 kg is fat in its natural form. This leads not only to a constant burden on the body, but also to the occurrence of serious diseases that provoke many problems and complaints, and even to a threat to life.

Extra pounds are a heavy burden for a person. They also need oxygen supply, blood circulation, which they use from the heart, exposing it to incredible stress. If obesity is divided into 4 degrees, it is not difficult to understand the condition of a person if he has a 3 degree, and extra pounds exceed almost 2 times the prescribed weight. The patient is forced to resort to outside help, since he can no longer bend over on his own, put his hands behind his back and even put on, for example, shoes.

Symptoms at grade 3 are obvious:

• persistent shortness of breath, even at rest;
• weakness, drowsiness;
• decrease in working capacity;
• headaches, pain in the heart;
• pain in the legs, back, knees;
• puffiness;
• increased sweating;
• disorders of the gastrointestinal tract;
• visible ugly folds of fat on the abdomen and thighs, and most of the fat is invisible, accumulates inside the body;
• purple inflamed stretch marks on the body.

With obesity of this degree, the hypothalamus is affected, which inevitably leads to a serious condition of the patient:

Self-calculation of body mass index

To determine the degree of obesity, you need to calculate the Broca index - an indicator of healthy weight. To compile the algorithm, subtract the number 100 from your height, then subtract another 10% from the result. For example, with a height of 160 cm, we subtract 100, we get 60. Minus 10% of 60, that is, minus 6, we get 54 kg. So, with a height of 160 cm, the normal weight should be 54 kg.

To find out how many kg are extra, you need to subtract the ideal weight from the existing weight, calculate the percentage from the resulting balance. The body mass index is your actual weight in kg divided twice by your height in meters. With an excess of body weight from 60% to 90%, the mass index is normal - 18-25%.

Can't do without a diet

There are many programs and diets for weight loss, but the main requirement is the same: to drastically reduce the intake of energy-rich foods. The higher the degree of obesity, the more rigid the diet should be. With obesity of the 3rd degree, the energy value of your diet should be reduced by at least 40%. However, it is worth considering the average energy consumption of the patient, the norm of his body weight. The percentage can be raised or increased from 30 to 50%.

To calculate the daily calorie content, you can use the same Brock formula.

One diet in the fight against obesity is not enough. We need physical exercises developed according to a special system that helps to increase muscle mass and burn fat. The diet should be chosen correctly, it is important to calculate the amount of amino acids and vitamins taken per day, limit the intake of protein foods. But a lack of protein leads to problems with the heart, liver, and other organs, so you need to gradually reduce protein intake. It is better to consult an experienced nutritionist to develop an individual diet.

The energy value of the diet should be preserved at the same time, so you should not starve yourself if you want to lose weight. It is important to understand that extra pounds will not go away overnight, the fight against obesity is a long, painstaking and daily work, primarily on oneself. Without an emotional state and a strong desire to lose weight, dieting alone is unlikely to help defeat obesity.

Regardless, food should be constant and, of course, tasty.

Amino acids, seafood include few carbohydrates, but they are tasty and quite allowed for obesity. Animal fats should be replaced with vegetable fats, which are also found in many tasty foods. To create a feeling of satiety, foods should be low-calorie, but voluminous. You need to eat more often, up to 6-7 times a day, but in small portions. It is important to remove foods that increase appetite from the diet (spices, spices, and salt that disrupts metabolism).

Make a menu for a week right away, cross out forbidden foods not only from the list, but also from your head, just don’t think about tasty, but harmful foods for you. For obesity, the use is allowed:

• rye black bread, up to 150 g per day;
• vegetable soups (fish, meat soups are acceptable, but not more than 2-3 times a week);
• cereals, pasta;
• lean fish, boiled lean beef, 2-3 times a week;
• eggs, one per day;
• vegetables, greens in any quantity;
• sour varieties of berries, fruits;
• tomato juice, tea with milk;
• dairy products that normalize metabolism;
• fats in the form of vegetable butter, but not more than 40 g per day.

At night it is useful to drink kefir at 150-200 g.

It is unacceptable for obesity to use:

• spicy, spicy food;
• sweets, chocolate;
• ice cream;
• confectionery;
• salty and smoked snacks;
• alcohol.

Medical therapy

Unfortunately, not everyone succeeds in defeating grade 3 obesity with diets and physical activity. With a large excess of weight, the load is poorly tolerated by patients, many are simply not able to perform exercises: shortness of breath, palpitations, weakness, and rapid fatigue immediately appear. Diets are ineffective in case of pathological appetite, failures and violations of the nutritionist's prescriptions are within easy reach. Not many are ready to endure bouts of hunger, they immediately break the diet without realizing it.

The treatment of grade 3 obesity with surgical methods involves an operation on the stomach to reduce its volume or the introduction of a balloon that reduces the volume. A truncated stomach fills up and saturates faster, increased appetite can be controlled.

Obesity treatment should be comprehensive, consisting of:

• drug treatment prescribed by an endocrinologist with the ineffectiveness of diets and exercise;
• hydrotherapy, water massage, which helps to remove excess salts and fluids from the body;
• physical activity in the form of gymnastics, water aerobics.

Strength exercises are excluded, and light sports with a gradual increase in load should be practiced.

Surgical intervention is an extreme measure when obesity poses a threat to the patient's life, is associated with severe diseases of the internal organs.

Together with diets and physical exercises, homeopathy gives good results in the fight against obesity. But a doctor's consultation in this case is mandatory, self-medication is unacceptable, the consequences and the degree of harm can be unpredictable in the future.

Treatment of obesity of the 3rd degree is effective with folk remedies.

Mix rowan berries, mistletoe, linden bark (100 g each), linden flowers and water pepper (70 g each), mix, prepare an infusion, taking 3 tbsp. l. collection for single use. Pour boiling water over the collection (1 tbsp.), Let it brew. Drink before meals for 1 month, 150-200 ml 4 times a day.

Obesity of the third degree can be treated with Caucasian hellebore. Take 2 tbsp. l. collection, pour boiling water (0.5 l), let it brew for 1 hour. Drink before meals 3-4 times a day for 0.5 cups. The course of treatment is 6 months.

The need for medical advice

1. Never give up.
2. Be patient. Only everyday work on yourself and willpower will eventually give positive results.
3. Create the perfect weight loss program with your doctor.
4. Follow all prescriptions and prescriptions of the doctor. Remember: the wrong step to the side can dramatically aggravate the situation.

Do not take unknown and untested drugs without the knowledge of a doctor. Obesity affects the heart, liver, stomach, kidneys, endocrine system. Medications will only increase the load on the internal organs. There is no point in panicking, only willpower, confidence in victory, psychological attitude will bear fruit, but gradually. Obesity is a disease that is treated for a long time, painfully, and you need to be prepared for this.

In the modern world, the number of overweight people is steadily growing, especially in developed European countries and America. Statistics calls a depressing figure - more than 50%, and various degrees of obesity have about 30%. They say that laziness drives progress. Man is increasingly inventing mechanisms that replace various production and household processes, freeing himself from physical exertion, and high living standards make it possible to eat well and high in calories. It's hard to resist this.

Risk factors

Risk factors for obesity are age, hormonal disorders (excess cortisol and lack of estrogen). Improper nutrition, consumption of spicy food and alcohol lead to an increase in appetite, stressful situations also exacerbate the situation.

Pathogenesis

A complex chain is involved in the regulation of fat metabolism: the cerebral cortex, the hypothalamus, the nervous system, and the endocrine glands. The pathogenesis of obesity lies in the imbalance of energy expenditure and appetite as a result of failures of one of the chain systems. The intake of energy materials into the body exceeds the intensity of metabolic processes, as a result, fat is accumulated. It is assumed that these disorders can be both congenital and acquired, associated with certain traditions in the family, way of life.

Symptoms of obesity 3 degrees

A mirror and a large size of clothing will indicate the existence of a problem. The fact that she has gone too far will be signaled by the symptoms of obesity, characteristic of grade 3:

• shortness of breath when walking and even moderate physical exertion;
• pain in the musculoskeletal system;
• disorders in cardiac activity;
• hypertension;
• discomfort of the digestive tract;
• decrease in working capacity;
• depressive states as a result of an inferiority complex and low personal assessment.

Weight with obesity 3 degrees

A person's weight is a criterion for assessing the state of his body and a reason to diagnose obesity. There are a number of methods based on the ratio of height and weight, with the help of which the norm of weight is determined, and all deviations from it upwards give the right to consider this as obesity and, depending on their size, classify. The simplest formula is the following: with growth up to 165 cm, the number 100 is subtracted, 165-175 cm - 105, and over 175 cm - 110. The result of the calculation is the optimal weight. With obesity of the 3rd degree, it is one and a half to two times higher than the calculated one. The first signs that the problem has taken a serious turn include a deterioration in well-being, expressed in a rapid heartbeat, excessive sweating, drowsiness, and frequent headaches.

Obesity 3 degrees in a child

Methods for determining the normal weight of adults are not suitable for young children. There are special tables that show the correspondence between the age and weight of babies, and they are different for boys and girls. These norms can be found on the Internet, special pediatric literature. At the doctor’s appointment, the child’s height is weighed and measured; in case of deviations, the pediatrician will correct the nutrition.

In adolescence, the responsibility lies with the parents. It is no secret that often well-fed children are a source of their pride and an indicator of care. It happens that family gastronomic traditions based on high-calorie, abundant nutrition, a sedentary lifestyle lead to obesity in children. Other reasons are hormonal disruptions, metabolic disorders, heredity.

Obesity of the 3rd degree of a child corresponds to an excess of weight by 50-100%. To clarify the diagnosis, the circumference of the hips, waist, chest is measured, and with the help of the so-called caliper - a special device, the thickness of the subcutaneous fat layer.

Obesity 3 degrees in men and women

Obesity in men can be determined by calculating the body mass index (BMI) using one of the existing formulas: weight divided by the square of height. Exceeding its value by 40 times indicates obesity of the 3rd degree. Male obesity is dangerous because it lowers testosterone levels. Fats turn it into estrogens, which in turn inhibit testosterone production and promote fat accumulation. It turns out a vicious circle. Another indication of low testosterone production is a waist circumference exceeding 102cm. Decreased sexual function is a big blow for a man. In addition to a direct threat to physical health due to excess weight, psychological problems also arise.

Obesity grade 3 in women is much more common than in men. This is especially true for women over the age of fifty. This is due to hormonal changes, a decrease in business activity. A lot of weight at a young age can affect reproductive function, menstrual irregularities, because. progesterone levels decrease and testosterone levels rise. Also, in addition to the problems associated with excess weight, inherent in both sexes, women have an increased risk of breast, ovarian, and uterine cancer.

stages

Obesity 3 degrees does not occur instantly. Weight gain occurs gradually and goes through several stages before becoming excessive. Distinguish between a stable stage and a progressive stage. Obesity is divided into 4 degrees. To determine them, you can use the formula already known to us: weight is divided by the square of height. The resulting index is called Quetelet and it is different for men and women.

So, I degree for women corresponds to an index of 28-30.7, for men - 30-32.2, II degree - 30.8-35.4 and 32.3-37.2, III degree - 35.5-47 ,3 and 37.3 - 49.7, IV degree - more than 47.3 and 49.7, respectively. Having made this simple calculation, we get an objective picture of the state of our body. When determining the degree of obesity in children and the elderly, there is some difficulty, because. their muscles are weaker than those of healthy adults. In this case, the dynamics of weight is monitored and a conclusion is made to which stage obesity belongs.

Forms

Obesity, depending on the causes of occurrence, is divided into two types: primary and secondary. Primary affects most people (90-95%). There are several forms of it:

• alimentary-constitutional (hereditary);
• in violation of food standards;
• mixed.

The secondary is:

• with genetic defects;
• cerebral;
• endocrine-metabolic;
• due to mental illness;
• taking psychotropic drugs.

In other words, it is caused by head injuries, brain tumors, surgeries, ailments of the neurovegetative system, mental disorders or diseases of the thyroid and pancreas, genetic diseases. According to the anatomical structure, android, gynoid and mixed are distinguished. Android - male type or "apple", in which body fat is located in the upper body. Gynoid "pear-shaped" is characterized by the predominant accumulation of fat in the buttocks and thighs. There is also a mixed type - fat is evenly distributed throughout the body.

Exogenous-constitutional obesity of the 3rd degree

The first part of the name - exogenous-constitutional obesity of the 3rd degree says that it is caused by exogenous factors - overeating, national characteristics, gastronomic culture in the family. The second part indicates a hereditary predisposition, the activity of fat metabolism.

Alimentary obesity

Alimentary obesity is also called trunk obesity and is primary. The imbalance between consumed calories and their consumption leads to the accumulation of subcutaneous "reserves" and around the internal organs. Alimentary obesity of the third degree indicates the neglect of the disease. With such a diagnosis, the liver, heart, and cardiovascular system suffer. Most often, the reason lies in the hereditary factor.

Morbid obesity grade 3

Morbid obesity means a pathological increase in weight, in which it is difficult to perform the functions inherent in maintaining the normal state of the body. It corresponds to the 3rd degree of human obesity, in which the body mass index is equal to or greater than 40 units. As a rule, it is predetermined by a genetic factor.

Pregnancy with obesity grade 3

Obesity grade 3 pregnancy is at risk due to the many different complications and threats associated with being overweight. This is dangerous development:

• gestational diabetes;
• hypertension;
• infections of the genitourinary system;
• thrombosis;
• sleep disturbances and short-term respiratory arrest (apnea);
• the possibility of miscarriage or gestation of the fetus;
• birth disorders.

Maternal obesity is a threat to the health of the child. Firstly, a child can be born with a large weight (macrosomia), and this is fraught with fullness in the future. Secondly, there is a danger of congenital pathologies, such as heart disease or diabetes. The optimal weight that a full woman can gain with a singleton pregnancy is 5-9 kg, with a multiple pregnancy - 11-19 kg. The doctor monitors the pregnancy of a fat woman more carefully, conducting frequent observations and studies.

Complications and consequences

The consequences and complications of obesity of the 3rd degree are a serious danger to the normal functioning of various human organs:

• gastrointestinal tract;
• pancreas (development of pancreatitis);
• liver;
• cardiovascular system (increased blood pressure, vascular disease of the legs, ischemic strokes, heart disease, atherosclerosis);
• endocrine system (type 2 diabetes);
• musculoskeletal system;
• respiratory and reproductive systems.

In addition to the physical consequences, obese people bear a great psychological burden, often turning into depression.

Diagnosis of obesity 3 degrees

When diagnosing obesity of the 3rd degree, they resort to anthropometry - determining the basic physical data of a person: weight, height, volumes in different parts of the body (chest, waist, hips). After that, existing classifications are used to determine the degree, type of obesity, type of fat localization, which is important in determining the risks of developing various ailments and complications. Overweight is the domain of endocrinologists and nutritionists. First of all, the doctor will find out the diet, the amount of food eaten and send for additional studies to determine the source of the problem: malnutrition, hormonal disruptions, or metabolic disorders.

With obesity of the 3rd degree, laboratory studies of a general blood and urine test for the determination of glucose, a biochemical analysis for the state of fat, carbohydrate, and protein metabolism are carried out, and deviations of other indicators indicating concomitant diseases are detected. It is also necessary to determine the level of thyroid hormones - triiodothyronine, thyroxine and thyroid-stimulating hormone produced by the pituitary gland.

Instrumental diagnostics makes it possible to determine the level of influence of obesity on the functions of other organs and systems. For this purpose, ultrasound, MRI, fluoroscopy can be prescribed. To check the work of the heart is sent to the electrocardiogram.

Differential Diagnosis

Differential diagnosis is carried out with Itsenko-Cushing's disease, which has similar symptoms: obesity, urolithiasis, diabetes mellitus, menstrual irregularities, decreased immunity, etc. But this is a neuroendocrine disease caused by excessive production of adrenal hormones due to excessive secretion of corticotropic hormone by the pituitary gland . In women, this ailment occurs after childbirth, and may be the result of head injuries, bruises, concussions.

Treatment of obesity 3 degrees

The treatment of grade 3 obesity primarily consists in prescribing a low-calorie diet, which is based on eating foods high in fiber, vitamins (nuts, grains, salads, fresh vegetables and fruits) and a small amount of carbohydrates (sugar, bakery and pasta). In parallel with the diet, increased physical activity and sports are recommended. If these methods do not bring results, drug therapy is prescribed, which includes taking anorexigenic drugs. If the drug is ineffective, it is changed to another. There are also surgical treatments.

Medications

All weight loss medications aim to control weight by suppressing appetite, altering metabolism, or calorie absorption. Appetite suppression occurs with the help of catecholamines and their derivatives (amphepramone, fluoxatin). They lead to the accumulation of sirotonin and norepinephrine in the central nervous system, which in turn have a depressing effect on the feeling of hunger.

Amfepromon - excites the center of saturation and suppresses the center of hunger. The dosage form is a dragee, a single dose of 25 mg one hour before meals, twice or thrice a day. The maximum you can take no more than 100g per day. The course of treatment is 1.5-2.5 months, after a three-month break it can be repeated. The drug is contraindicated in hypertension, myocardial infarction, atherosclerosis, epilepsy and mental disorders, glaucoma, tumors, children under 12 years of age, pregnant women. Adverse reactions are possible in the form of nausea, vomiting, weakness, increased blood pressure, allergic rashes.

The mechanism of action of other drugs is the blocking of cannabinoid receptors (rimonabant, acomplia).

Rimonabant tablets are used for weight loss along with a low-calorie diet and exercise. Daily dose - 20 mg. The drug can be taken for 2 years. Side effects are manifested as nausea, anxiety, diarrhea. Not recommended for use in children, pregnant and lactating women, people with mental illness.

Anorexics - antidepressants that reduce appetite (sibutramine, reduxin, meridia).

Sibutramine is a crystalline powder, soluble in water. It is taken in the morning, once a day, 10 g, with poor efficiency, after a month, the dose is increased to 15 g. Adverse reactions are possible from the side of the cardiovascular system: increased pressure, respiratory failure. Headaches, constipation, and dry mouth may also occur. Contraindicated in children, the elderly, pregnant women, during lactation, patients with epilepsy.

Accelerate the metabolism of thermogenics and lipotropics, in other words, fat burners. Preparations orlistat, xenical, orsoten prevent the breakdown of fats and their absorption.

Orlistat is a powder that inhibits gastric and pancreatic lipases - enzymes that break down fats. It is taken 120g at the same time with each main meal, one hour after a meal. If the food is not fatty, you can skip the dose. It has contraindications for use by pregnant women, lactating women, with increased sensitivity to the drug. Side effects - oily stools, frequent urge to defecate.

vitamins

When losing weight, vitamins must be included in the diet so that you do not lose weight with weight loss, but strengthen your health. Knowing about the influence of certain vitamins on the processes occurring in the body, you can choose their optimal set, which will help bring the expected result closer. So, vitamin D reduces the feeling of hunger, C and B8 - destroy fats, E - is necessary for the normal functioning of the immune and endocrine systems, B vitamins - are indispensable in the coordinated work of all human vital systems: B2 - participates in metabolic processes, B3, B6 - normalizes blood sugar, stabilizes hormonal levels, B4 - provides fat metabolism, B5 - removes fats, improves metabolism. An omega-3 vitamin is also required, which is not synthesized by the body. When taking vitamin complexes sold in pharmacies, you need to drink plenty of water (1.5-2 liters per day).

Physiotherapy treatment

With obesity of the 3rd degree, physiotherapeutic treatment is successfully used, but always in combination with other methods: physical exercises, dietary nutrition, sometimes drug treatment. Therapeutic exercises should be carried out daily for at least 20 minutes in different positions involving different muscle groups. Reflexology has proven itself well: acupuncture and laser puncture. Acupuncture is part of Chinese culture, one of the areas of traditional folk medicine. It consists in the impact on individual areas of the body, the so-called meridians - the centers of human energy, with needles. Laser puncture uses a laser for this purpose. Water procedures are also prescribed - a circular shower, underwater massage and just swimming, as a form of physical activity.

Alternative treatment

In the arsenal of folk treatment, various herbs that reduce appetite and normalize metabolism, low-calorie diets, recipes for dishes rich in fiber, therapeutic baths. To prepare baths, a decoction is made from calamus, thyme, juniper, mint, hay dust, birch leaves. You can individually select other medicinal herbs, the main principle is opening the pores of the body. The following proportion is observed: half a liter of water is taken per tablespoon of each herb, boiled for several minutes, insisted for at least an hour. Infusion is poured into a bath with warm water. This procedure can be repeated several times a week.

Such a drink is prepared from wheat bran: 200 g of bran is poured with a liter of water, boiled for 10 minutes. The cooled solution is taken before meals 4 times a day for 100-150g. Honey is also successfully used: in the morning on an empty stomach, dissolve a teaspoon in a glass of slightly warm water, while filling the stomach, and the body receives the necessary vitamins and minerals. Apple cider vinegar is a well-known remedy for obesity: pour 2 teaspoons into a glass of water, drink half an hour before meals three times a day.

Herbal treatment

In addition to the use of herbs for water procedures, infusions, decoctions, and teas for oral administration are widely used. Such treatment is supposed to improve metabolism, reduce hunger, cleanse the body of harmful toxins and toxins. An infusion of valerian root will help reduce appetite: 70 g per liter of cold water, drink 100-150 g every other day 30 minutes before meals. To combat obesity, the following herbs are used: horsetail, bean pods, knotweed, immortelle, corn stigmas, birch buds, buckthorn bark. You can use ready-made pharmaceutical diuretics.

Homeopathy

Homeopathy in the treatment of obesity is used as part of complex weight loss measures, its effect is not instantaneous, but the low rate of complications speaks in its favor. There are constitutional, pathogenetic and etiotropic homeopathic preparations.

Constitutional remedies (depending on the type of person, his personality) include sepia, sulfur, barium carbonicum, ammonium carbonicum, calcium carbonicum.

Calcium carbonicum - available in granules in various dilutions, improves metabolism. Doses are prescribed individually. The drug has a number of contraindications: kidney stones, stomach ulcers, high blood pressure, hypersensitivity. Possible side effects in the form of arrhythmias, a special taste in the mouth, nervousness, fatigue.

Etiotropic drugs are prescribed for secondary obesity and they are directed to the cause that provoked the appearance of excess weight. These are Phosphoricum acidum, Nux vomica, Anacardium, Ignatia.

Ignatia is a combined preparation of plant and animal components. It is an antidepressant, prescribed for various neurological pathologies. Available in drops, a single dose for children under 2 years old - 3 drops, from 2 to 6 - 5 drops, after 6 years - 10. The solution is dripped under the tongue, can be diluted in several tablespoons of water. Reception is carried out 3 times a day, without mixing with food. Side effects may occur in the early stages of treatment from the disease to which treatment is directed. In this case, it is worth continuing treatment. Pregnant women are not contraindicated, if you are allergic to the components of the drug, you need to stop using it.

Nux vomica - herbal components of the drug cause its hepatoprotective, laxative, anti-inflammatory effect. Drops are taken a quarter of an hour before meals or an hour after. For different ages, the dosage is different: 9-15 drops for young children and 30 drops for adults three times a day. Contraindications exist for pregnant women and with individual intolerance.

Pathogenetic drugs are also aimed at the treatment of concomitant diseases. So, for cardiac pathologies, lachesis, arnica, spiegelia are prescribed; diseases of the alimentary tract - nux vomica, calcium carbonicum, mercurius dulcis; urological ailments - cantarias, thuja, bryonia, etc.

Spigelia - tincture, for heart disease is used in low dilutions. The dose is determined by the homeopath individually. A side effect is possible in the form of a strong heartbeat, nausea, vomiting. Contraindicated in pregnant, lactating women, with an allergic reaction to the drug.

Surgical treatment

Surgery is the most effective way to get rid of obesity. Indications for its implementation is a BMI over 40. In diseases such as type 2 diabetes mellitus, varicose veins, hypertension, surgery can also be performed with a BMI over 35. In the world, two types of surgical intervention are most often resorted to: gastric bypass (common in America, Canada) and gastric banding (Europe, Australia). Such operations are most often laparoscopic and make it possible to get rid of half the weight. The bypass method consists in the formation of a "small" stomach by crossing its upper part and connecting the small intestine to it. Thus, there is a decrease in the volume of the stomach from 2 liters to 20-50 ml. The method of bandaging consists in applying a special bandage - a ring that divides the stomach into two parts: upper and lower. Since the satiety receptors are located in the upper smaller part, it does not take a lot of food to fill it up and feel full.

Diet for obesity 3 degrees

The most common culprit of grade 3 obesity is overeating, so the main task in the fight against it should be to establish proper nutrition. First of all, it should be fractional and frequent. Diet No. 8, recommended for grade 3 obesity, is based on low-calorie, satiating foods. It is necessary to remove fried, stewed, salty, spicy foods from the diet. Also give up flour, pasta, cereals, potatoes, sweets: sugar, sweets, honey. Eat more raw vegetables and fruits. Fats should be limited, but not completely eliminated. A small amount of butter and unrefined vegetable oil will be required by the body for metabolic processes. Limit foods containing a large amount of cholesterol - liver, eggs.

In the article we discuss obesity of the 3rd degree. You will find out what types of this disease exist, as a result of which it is formed and what complications it has. We will list the symptoms and tell you how to treat stage 3 obesity with medication, physical activity, psychotherapy and proper nutrition.

According to the International Classification of Diseases (ICD), grade 3 obesity is a dangerous metabolic pathology. It requires immediate treatment.

Obesity 3 degrees according to ICD 10 has the code E66. The disease has varieties depending on the cause that caused it, and the nature of the pathology.

Obesity grade 3 requires immediate treatment under medical supervision

Most often, the disease is caused by excessive consumption of high-calorie foods.. Often the cause of the formation of obesity is medication, genetic predisposition and a sedentary lifestyle.

According to external signs, this stage of obesity is not classified. In this state, fat reserves are distributed throughout the body. In this case, both the appearance and internal organs suffer.

Symptoms and BMI for grade 3 obesity

In 90% of cases, with obesity of the 3rd degree, partial or complete immobilization occurs, as a result of which isolation from society occurs. This entails disturbances in the functioning of the nervous system and mental problems.

Stage 3 obesity is characterized by increased sweating, even at rest. Any minimal physical activity is given with great difficulty and causes shortness of breath and fatigue.

The body mass index in this pathology is several times higher than the norm. At values ​​above 40 units, the 3rd degree of obesity is diagnosed.

Diagnosis of obesity 3 degrees

If the 1st stage of the disease can be easily confused with a small set of excess weight, then the 3rd degree of obesity can be diagnosed without special training. Despite this, it is important not to delay the visit to the doctor. The specialist will determine the severity of the course of the disease and select the appropriate treatment method.

Treatment of obesity 3 degrees

In 90% of cases, the patient is determined for inpatient treatment. Also often resort to surgical intervention to alleviate the patient's condition.

For the successful treatment of obesity of the 3rd degree, an integrated approach and a positive attitude of the patient are important. The main rules are to increase physical activity, reduce the calorie content and size of meals, maintain healthy sleep for at least 7-8 hours a day and avoid stressful situations.

Medical therapy

For the treatment of stage 3 obesity, drugs are prescribed that block the feeling of hunger, affecting the brain centers. Some of them additionally interfere with the absorption of fat. The following drugs are most often prescribed: Naltrexone, Fastin, Adiposin, Xenical, Fluoxetine, Liraglutide, Bupropion, Reduxin.

At 3 stages of obesity, surgical intervention is often resorted to. Gastric banding and bypass showed high efficiency. The purpose of these operations is a significant reduction in the size of the stomach. This contributes to a faster feeling of satiety.

Physical activity

With obesity of the 3rd degree, it is important to increase the patient's motor activity and restore muscle tone. For this, exercises, muscle stretching exercises, and aerobic sports are introduced into the daily routine of the day. The main rule is a gradual increase in load.

For the treatment of obesity of the 3rd degree, swimming is useful. At the same time, it is important that there is a trainer nearby who will control the process and measure the pulse and pressure.

Psychotherapy

One of the fundamental components of successful treatment of stage 3 obesity is psychotherapy. As a rule, with this diagnosis, the patient has already come to terms with this state of affairs and does not want to change anything in his life. The main task of the doctor and relatives is to support the patient and instill in him faith and motivation to fight the disease. Without the desire of the person himself to lose weight, medicine is powerless.

As methods of therapy, not only individual consultations are used, but also the method of group and family treatment. It is important for the patient to recognize the problem and want to deal with it.

Diet

For successful treatment of stage 3 obesity, it is important to monitor compliance with proper nutrition. The patient's diet should contain products of different categories in order to saturate the body with the components necessary for life.

It is important to reduce the amount of food consumed and reduce its calorie content. The maximum daily allowance is 1500 kcal. Patients with stage 3 obesity are shown a therapeutic diet table No. 8 according to Pevzner.

According to this method, the patient should eat at least 5-6 times a day. At the same time, it is important to monitor the amount of fluid you drink. Its volume should be at least 1.5 liters per day. Useful green tea without sugar, vegetable and fruit juices.

The patient's diet should include fresh vegetables and fruits, lean meat, dairy products, and cereals. The amount of fat and carbohydrates consumed must be reduced.

Fatty and fried foods, fast food, canned food, marinades, pickles, spices, sauces, soda, confectionery should be completely excluded from the diet of a patient with grade 3 obesity. Fasting days should be arranged once a week.

Possible Complications

With obesity of the 3rd degree, serious violations occur in the work of all body systems. In this condition, without proper treatment, the risk of death is high.

Complications of obesity stage 3:

• hypertension;
• atherosclerosis;
• diabetes;
• apnea;
• kidney failure;
• disorders of the gastrointestinal tract;
• oncology;
• impotence and infertility;
• mental disorders.

For more information about obesity, see the video:

What to remember

1. Obesity grade 3 according to the ICD is a dangerous metabolic pathology. She was assigned the code E66.
2. With this pathology, it is important to increase motor activity, follow the principles of a healthy diet and work with a psychotherapist to increase the patient's socialization.
3. With obesity of the 3rd degree, disturbances occur in the work of all body systems.

In society, the concept of being overweight is rather relative. Someone likes donuts, and now plus size models are conquering the catwalks. Someone is gaining 60 kg - and immediately begins to actively lose weight, considering himself fat.

In medicine, everything is much more precise and definite. There are quantitative parameters that indicate the presence of such a disease as obesity. Moreover, it is delimited from just excess weight. According to WHO, there are 3 degrees of this pathology, and the last one is the most dangerous.

The essence of the disease

According to medical data, grade 3 obesity is a metabolic pathology when the BMI (body mass index) exceeds 40 points.

The disease is difficult to classify according to other criteria. For example, it cannot be attributed either to or to the genoid (gluteal-femoral) type. Adipose tissue in the body accumulates so much that it is distributed throughout the body, and not in any separate part of it.

The main feature of this stage is the high risk of not only dangerous concomitant diseases, but also death. It is characterized in 90% of cases by limited movement, social isolation and serious psychological and physiological problems. And the treatment is very, very difficult.

The reasons

The main reason for grade 3 obesity is a neglected state and stages when it is much easier to reverse everything. The lack of willpower and the necessary treatment leads to such a deplorable result.

Other factors help a person in this - external (lifestyle) and internal (state of the body):

• uncontrolled use of easily digestible carbohydrates - sweets, pastries, soda, fast foods;
• heredity;
• unhealthy eating habits: eat not on schedule, but when you want, “jamming” not only problems, but often just a bad mood;
• lack of motor activity;
• calorie intake is many times greater than consumption;
• serious diseases of the gastrointestinal tract, liver, heart;
• a state of constant stress and chronic fatigue;
• severe congenital diseases.

As a rule, all these reasons do not arise out of nowhere. They have been present in a person's life for a long period of time - if it came to 3 degrees of obesity. This is when excess weight is just beginning to appear, you can be in search of a provoking factor, make mistakes, undergo examinations. And by this stage, a person usually already knows what exactly in his life served as the starting point of the pathological condition.

Clinical picture

If obesity of the 1st degree can be easily confused with ordinary overweight (especially if it is), then the pathology of the last stage is visible to the naked eye. Here are just a few of its signs:

• impossibility of motor activity (it is difficult to bend down, turn around, walk an extra distance;
• dyspnea;
• pathological weight gain;
• increased sweating even at rest;
• the BMI indicator exceeds the norm several times;
• psychological problems: the formation of internal complexes due to appearance, which in most cases leads to isolation from society;
• the work of most internal organs is disrupted - certain diseases are constantly manifested;
• blurred contours of the body, which begins to resemble a jelly-like ball.

To calculate BMI and determine the degree of obesity, the formula is used:

I \u003d m (weight) / h 2 (height)

Weight is in kilograms, height is in meters. If it turned out more than 40, a diagnosis is made - obesity of the 3rd degree.

If this disappointing diagnosis was made, you need to immediately begin to act. The first step is seeking medical help. In 90% of cases, a person is determined for inpatient treatment. If you have to deal with pathology at home, doctors describe in detail behavioral therapy for such patients. Here are their recommendations:

• go swimming, and under the supervision of a coach or doctor, with the obligatory fixation of pressure and pulse;
• move as much as possible;
• giving up alcohol and smoking;
• in the morning, perform feasible exercises for charging: start with the simplest, and then gradually complicate them, the first classes can be 5 minutes, but each time they need to be extended in time;
• the rooms in which such patients are located should be well ventilated;
• undergo a course of treatment for stressful conditions, if possible, visit a psychologist and various trainings on motivation and self-improvement;
• sleep 7-8 hours.

Only a doctor can answer all questions about obesity of the 3rd degree. Self-medication is not only impossible, but also life-threatening.

Obesity 3 degrees - how many kg?

Any doctor will tell you that this question is incorrect. This disease is not determined by the number of kilograms. 120 kg with high growth can produce a BMI of less than 40. And in bodybuilders, the bulk can be muscle, not fat, despite their large weight category.

Where to start treatment?

Definitely - with a visit to the doctor and the consistent implementation of all his recommendations.

Is it possible to conceive a child?

The chances of this happening are very small because the visceral fat at this stage is tightly wrapped around the reproductive organs. Even if conception occurs, the pregnancy will be very difficult, and it will be almost impossible to complete it. This pathology causes cardiac arrest, hypertensive crisis, respiratory spasms and other conditions that are life-threatening for women and children.

Is this obesity different for women and men?

According to statistics, women are diagnosed with this disease more often than men. They constantly experience hormonal surges (during puberty, pregnancy, lactation, menopause, menopause), which become the causes of pathology. In addition, the fair sex is more emotional, prone to feelings and stress. This forces them to increase portions, eating each new problem.

What to do if a child has been diagnosed?

Rely on the competence of doctors and do everything they say: conduct a course of treatment, and you need to start with psychological help. Obesity of the 3rd degree in children is, first of all, problems with peers who do not accept such people in their circles. Against the background of internal complexes, a feeling of constant anxiety, self-doubt, phobias and low self-esteem develops. The result - problems with learning, conscious isolation from society, immersion in oneself up to autism.

Food

A necessary part of any treatment for this disease is low-calorie. Most often, such patients are recommended the Pevzner table No. 8.

Features of clinical nutrition must be strictly observed:

• 5-6 meals a day at the same time;
• drink 1.5 liters of water per day;
• exclusion from the diet of harmful foods, the list of which is probably known to everyone: fatty, sweet, flour, smoked, salty, mayonnaise, chips, soda, fast food, etc .;
• the menu is balanced: you cannot completely refuse carbohydrates and fats, but their amount should be reduced, but there should be enough fiber and protein;
• for breakfast - carbohydrates (cereals, pasta), for lunch and dinner - protein (meat, fish, eggs, cottage cheese);
• once a week - ;
• recommended drinks: green tea without sugar, freshly squeezed fruit and vegetable juices;
• the daily calorie intake is no more than 1,500, but this is the maximum upper bar, which, if possible, should be lowered to a minimum;
• fruits and vegetables are a must.

As with other degrees of obesity, with the third, you just need to organize proper nutrition.

Sample menu for 1 day for a strict diet

Sample menu for 1 day for a sparing diet

Treatment

Comprehensive treatment of pathology includes not only diet and behavioral therapy. We have to resort to drastic measures.

Medications

First, the doctor prescribes medication. As a rule, these are drugs such as:

• Adiposine;
• Bupropion, Zyban, Wellbutrin;
• Hormonal agents;
• Liraglutide, Victoza, Saxenda;
• Lorcaserin, Belwick;
• Naltrexone;
• , Orlistat;
• Pramlintid, Simlin;
• Rimonabant, Acomplia;
• Sibutramine-containing drugs:,;
• Topiramate; Fastin;
• Fepranon, Regenon, Desopimon, Mirapont;
• , Prozac;
• Exenatide Byeta.

These drugs for obesity of the 3rd degree effectively block the feeling of hunger, give a false feeling of satiety, affecting the centers of the brain. Some reduce the absorption of fats in the intestines. But most of them are ineffective at this stage of obesity. In addition, they are fraught with various side effects.

Secondly, the doctor may allow treatment with folk remedies, but no one will say whether they will be of any use in such a neglected condition.

Usually assigned:

• decoctions and infusions of birch buds, chamomile, immortelle, St. John's wort, cleansing the intestines;
• laxatives - dried apricots, tansy, fennel, prunes;
• reducing appetite - kelp, wormwood, motherwort, nettle;
• fat-burning - mess, rosehip, green tea, ginger, guarana.

The effectiveness of alternative methods of treatment for obesity of the 3rd degree is subjected to great doubts by physicians.

Surgical intervention

Another way to fight obesity is to agree to stomach surgery. It can be:

• bandaging;
• reduction of the volume of the stomach with the help of a special balloon;
• shunting (including biliopancreatic).

How exactly to treat this pathology in such a neglected state, only doctors can tell after examinations and studies. Therapy is complicated by numerous concomitant diseases, which also require separate treatment.

Complications

This disease contributes to the development of very serious pathological conditions, which often end in death.

The most common complications include:

• apnea;
• atherosclerosis;
• infertility;
• hypertension;
• hormonal imbalance;
• impotence;
• oncology;
• kidney failure;
• problems with the gastrointestinal tract;
• risk of sudden death;
• self-isolation, prolonged depression up to a suicidal state;
• diabetes.

Grade 3 obese people should not perceive their body and lifestyle as something normal. But often this is what happens, they resign themselves to the state of affairs to which they are accustomed. They find it hard to tear themselves away from their favorite couch and pizza burgers that are delivered directly to their homes. The result is complete immobilization, social isolation and death, and long before old age.

Therefore, the first point of treatment for this pathology should be psychological assistance to the patient. He must realize the depth of the problem, find motivation for himself and begin to act. Without the patient himself, medicine is powerless in this case.