Types of obesity. Classification of obesity according to the type of localization of adipose tissue in the body. Exceeding normal* body weight by

Obesity is a chronic pathological process that tends to recur and is characterized by metabolic disorders leading to excessive accumulation of adipose tissue in the human body. Obesity is one of the most serious medical and socio-economic problems, as it affects the reduction in life expectancy and deterioration in the quality of life of patients.

The prevalence of obesity is growing rapidly from year to year. In our country, about a third of the working-age population suffers from obesity. Statistical research data indicate that there are twice as many obese women as men.

Obesity can develop against the background of a number of diseases, and can be combined with such severe pathological processes as diabetes mellitus, cancer, dysfunction of the genital organs. In addition, obesity is one of the main risk factors for the development of diseases of the cardiovascular system.

Classification of obesity by body mass index

Diagnosis of obesity, along with determining its degree, as well as the presence of a risk of its development, is based on indicators of the body mass index, which is determined by the ratio of the body weight of the subject to his height in meters, squared. According to the classification of obesity by body mass index, the following types of body mass are distinguished:

1. underweight- while the body mass index is less than 18.5, and the risk of comorbidities is minimal.

2. normal body weight when the body mass index is in the range of 18.5 - 25.0

3. Preobesity- body mass index varies between 25.0 - 30.0. In this case, the risk of concomitant diseases increases in the examined patients.

4. Obesity 1 degree- body mass index is 30.0 - 35.0

5. Obesity 2 degrees- body mass index indicators are in the range of 35.0 - 40.0

6. Obesity 3 degrees diagnosed in cases where the body mass index is equal to or greater than 40.0. The risk of developing comorbidities is extremely high.

Etiopathogenetic classification of obesity

One of the most detailed classifications based on the causes and mechanisms of obesity is the etiopathogenetic classification of overweight, which distinguishes two main forms of obesity - primary and secondary. primary obesity is further subdivided into:

Buttock-femoral;

Abdominal;

With severe eating disorders;

stress hyperphagia;

Syndrome "night food";

with signs of metabolic syndrome.

Secondary or symptomatic obesity divided into:

1. With an established gene defect

2. Cerebral obesity, which developed against the background of neoplasms of the brain, infectious and systemic lesions. The development of this form of obesity can be facilitated by the presence of mental diseases in the patient.

3. Endocrine obesity associated with disorders in the functioning of the thyroid gland, adrenal glands, pituitary and hypothalamus, gonads

4. Medical obesity.

Clinical and pathogenetic classification of obesity

Depending on the mechanisms that contribute to the development of overweight in humans, the following are distinguished: forms of obesity:

Alimentary-constitutional, associated with the peculiarities of the diet, as well as with heredity and usually developing from childhood;

Hypothalamic, developing when the hypothalamus is damaged;

Endocrine, caused by such endocrine pathologies as hypothyroidism, hypercortisolism, hypogonadism, etc.;

Iatrogenic or drug-induced form of obesity, the development of which is facilitated by the intake of a number of drugs - corticosteroids, some antidepressants, antipsychotics, contraceptives, etc.

Classification of obesity according to the type of localization of adipose tissue in the body

When examining obese patients, a specific distribution of adipose tissue is revealed, the systematization of which makes it possible to distinguish three forms of obesity:

Top type or android obesity;

By the lower type or gynoid obesity;

- mixed or intermediate obesity.

In the upper type of obesity, fat deposits are localized mainly in the upper body, mainly in the abdomen, neck and face. This type of obesity is typical for men; in women, this type of obesity can be found during menopause. It develops after puberty. Studies by a number of authors confirm the relationship of this type of obesity with an increase in the risk of developing diabetes mellitus and a number of diseases of the cardiovascular system (arterial hypertension, heart attack, coronary heart disease, etc.). To determine the risk of developing diseases associated with metabolic disorders, computed and magnetic resonance imaging are performed to reveal the predominance of one of the types of adipose tissue - subcutaneous or visceral (enveloping the internal organs of the abdominal cavity). These studies also make it possible to quantify the mass of adipose tissue and its fluctuations during therapeutic interventions.

The gynoid type of obesity is characterized by the localization of adipose tissue in the lower part of the body (in the femoral and gluteal regions) and is more often observed in female representatives, whose figure acquires a "pear-shaped" shape. It develops most often from early childhood. Concomitant pathology in this type of obesity are diseases of the spine, joints and vessels of the lower extremities.

The mixed type of obesity is characterized by a tendency towards a relatively uniform distribution of adipose tissue throughout the body.

To differentiate this or that form of obesity, a number of authors recommend determining the ratio of the circumference of the waist and hips. If this indicator exceeds 1.0 in men and 0.85 in women, we can talk about obesity according to the upper type.

Classification of obesity based on morphological changes in adipose tissue

Depending on whether fat cells - adipocytes - undergo quantitative or qualitative changes, the following forms of obesity are distinguished:

- hypertrophic obesity, in which the size of each fat cell increases against the background of a stable indicator of their number;

- hyperplastic obesity, which is characterized by an increase in the number of adipocytes; this form of obesity usually develops from childhood and is difficult to correct due to the fact that the number of fat cells remains unchanged even with a sharp weight loss.

- mixed obesity when, along with an increase in the number of fat cells, their enlargement is noted due to an increase in the fat content in them by a factor of three.

• Obesity

  Obesity is a chronic disease characterized by an excess of adipose tissue in the body.

• Consultation with a nutritionist-endocrinologist

  The most reasonable and reasonable is the treatment of obesity in St. Petersburg under the supervision of such a doctor as a nutritionist-endocrinologist. Reviews of patients who were treated for obesity and prescribed a diet by a nutritionist-endocrinologist testify to the high effectiveness of such treatment.

Obesity has somehow imperceptibly turned from a problem of an individual into a scourge of modern society. In the developed countries of the world, such as the United States, the number of people suffering from obesity reaches a staggering 68%, and every year this statistic is only getting worse. But what is even worse, obesity has firmly taken the second place among the diseases leading to death. What can we say about others, if in Russia 50% of men and 62% of women over 30 are obese. And this is a direct path to the development of heart disease, atherosclerosis, diabetes, and hence a heart attack or stroke.

It seems that the reasons for the development of obesity are well known to everyone - a sedentary lifestyle, passion for fast food, overeating and constant stress, but only the normalization of nutrition and an active lifestyle do not always guarantee the return of a slim figure and health promotion. “Perhaps you are putting in the wrong effort!” say nutritionists. To get rid of excess weight and prevent health problems, first of all, you need to find out if you have obesity and what type it is, and only then, based on the available data, build an effective weight loss strategy. This is worth looking into in detail.

Definition of obesity by body mass index

First, let's figure out how to determine if you have obesity. To do this, it is not necessary to go to the doctors, because it is enough to calculate your body mass index to find out if you have excess weight, and if so, at what stage is obesity.

The Body Mass Index (BMI) is very easy to calculate. To do this, you need body weight (in kilograms), divided by height (in meters), squared. For example, with a height of 182 cm and a weight of 77 kg, the body mass index will be calculated as follows: BMI \u003d 77: (1.82 x 1.82) \u003d 23.3.

• For a woman, a BMI below 19 is considered underweight, 19-24 is normal weight, 25-30 is overweight, 30-41 is obese, and above 41 is severely obese.
• For men, a BMI below 20 is considered underweight, 20-25 is normal weight, 26-30 is overweight, 30-41 is obese, and above 41 is severely obese.

If you look at the appearance of a person, you can see that fat deposits are localized in different parts of the body. Based on this, doctors distinguish 3 types of obesity:

• gynoid type (female-type obesity);
• android type (male-type obesity).
• mixed type.

Gynoid type of obesity

Gynoid obesity, often referred to as female-type obesity, is an accumulation of fatty deposits on the buttocks, thighs, and lower legs. Most often, this problem occurs in women whose body is pear-shaped. In this case, even having lost extra pounds, excess fat mass treacherously remains in the lower body, which seriously spoils the appearance and negatively affects self-esteem.

According to doctors, this type of obesity develops against the background of increased production of female sex hormones. That is why this problem most often haunts women, although it occasionally occurs in men who have partially or completely impaired testosterone production. Pear-shaped individuals who are prone to obesity suffer from varicose veins, hemorrhoids, diseases of the musculoskeletal system (osteochondrosis, arthritis, spondylosis and coxarthrosis), as well as venous insufficiency and cellulite.

Fighting this type of obesity is the most difficult, since fat from the hips and buttocks will go last. It is important to be patient, change your diet, and at the same time train the lower limbs, doing running, cycling and other active exercises, where most of the legs and buttocks are involved. Regular massage of local areas will also be useful.

If we talk about nutrition for female obesity, then it is important to remember that the number of meals should be at least 5 times a day, and the main emphasis should be on dinner, which should contain 40% of the daily diet. The fact is that in people with gynoid obesity, metabolic processes accelerate in the evening, which means that most of the food should be eaten at dinner, the main thing is that it should be no later than 19:00 and no later than 3 hours before bedtime. Breakfast should be left at 20%, lunch at 30% of the daily ration, and the remaining 10% should be equally divided between two snacks.

It is also important to exclude the consumption of trans fats (cooking oil, margarine), to minimize the consumption of chocolate, soft caramel, muffins and confectionery. White flour, sugar, coffee and alcoholic beverages should also be avoided. The basis of the daily diet should be raw and boiled vegetables and fruits, bran, cereals and wholemeal bread.

Let's also say that fat accumulating in the thigh area provokes the development of cellulite. To counter this scourge, you need to "lean" on foods with a large amount of antioxidants, namely fruits (lemons and apples) and berries (currants, blueberries, raspberries). The total amount of fruits or berries consumed per day should be at least 300 grams.

Android type of obesity

Android obesity is often called male-type obesity, and all because this form is more common in men (beer belly). With it, fat deposits accumulate in the upper body, mainly on the abdomen, in the chest and in the armpits. Doctors call this obesity the most dangerous for a person, since most of the fat accumulates in the internal organs, leading to high blood pressure, diabetes, infertility (in women) and impotence (in men). Moreover, from excess fat, the functioning of the liver and kidneys is disrupted, which, without treatment, can threaten the patient with kidney or liver failure.

It is not difficult to determine this type of obesity. Outwardly, in a person with such a problem, you can notice a bulging belly and the absence of a waist, which is larger in girth than the circumference of the hips. For medical reasons, a waist circumference of more than 80 cm in women and more than 94 cm in men indicates the risk of android obesity. In addition, the presence of this type of obesity can be calculated by dividing the waist circumference by the hip circumference. If the resulting index is more than 1 for a man and more than 0.85 for a woman, there is every reason to talk about male-type obesity.

However, there is also good news. The fact is that this type of obesity is the easiest to treat. To do this, first of all, it is necessary to normalize nutrition, where breakfast should be given 40% of the diet, 30% for lunch and 20% for dinner, and the remaining 10% for two snacks. Moreover, you need to start your day with food rich in heavy carbohydrates (all kinds of cereal cereals). During the day, you should eat lean meat, fish with polyunsaturated fatty acids (tuna, salmon, halibut, trout), as well as boiled or fresh vegetables and fruits, in soups and in the form of salads. You need to end your day with a light dinner with a vegetable salad and a piece of lean meat, or with kefir and bread.

Mixed type of obesity

This is the most common type of obesity, in which fat is deposited evenly throughout the body - on the arms, legs, stomach, hips and back. The danger of such obesity lies in its invisibility, because after gaining an extra 10-15 kilograms, a person practically does not notice visual changes in the figure. The hormonal background in people with such a problem is normal, and therefore the metabolism throughout the day is the same.

In this case, it is necessary to fight the problem of obesity according to the "classic" scenario, that is, eat five times a day (3 main meals and 2 snacks), where the main meals should account for 25% of the daily diet, and snacks - 12 ,5%.

Tellingly, this type of obesity is associated with fluid retention in the body. You should not be afraid of this, just as you should not limit yourself to fluid intake (this will only reduce your chances of losing weight). Try to drink 1.5-2 liters of fluid per day (including liquid foods), limit salt intake, and make sure that protein foods are always present in the diet. On average, one should start from the norm of 1 g of protein per 1 kg of body weight, however, the protein norm can be increased to 2 g of protein if a person regularly exercises. In this case, it is desirable to obtain protein from lean meat and fish (rabbit, chicken breast, cod, pollock, hake), as well as from milk, eggs and plant foods (cereals, peas, beans and nuts).

So, any obese person, regardless of type, should permanently stop smoking and stop drinking alcohol. It is important to minimize the use of salt and sugar, to refuse canned foods, various purchased sauces (mayonnaise, ketchup), to reduce the consumption of confectionery and sweet muffins. White bread should also be banned, and dietary wholemeal bread should be used instead.

Physical activity in obesity

Let's not forget about physical activity, which should stimulate blood circulation, improve metabolism, and therefore accelerate fat burning and strengthen the body. A doctor should select physical activity, since some sports can be traumatic for overweight people.

For people with severe obesity, it is enough just to start moving regularly. To do this, they need a regimen of 200 minutes of cardio activity per week. You can just take daily walks and light jogs, but it is best to spend this time in the pool, swimming. Water helps to relieve stress on the spine, and besides, all the major muscles of the body are involved during swimming, which perfectly increases the effectiveness of any diet.

Obese people can ride a bike, dance or go to the gym while working on cardio equipment. But team sports, which involve jumping and any impact loads, are contraindicated for such people, as they can damage the ankles and knees. Gymnastics, namely callanetics, will also be an excellent solution. This type of gymnastics is specially designed for weight loss and healing of the body. It perfectly speeds up the metabolism and reduces the volume of the body due to the rapid burning of body fat. Being engaged in callanetics 3 times a week for an hour, in a month you can notice amazing weight loss results. Health to you and a beautiful figure! Photo: Photobank Lori

Obesity is a disease characterized by the accumulation of excess body weight due to excessive deposition of fat in certain areas of the body. Doctors around the world recognize obesity as an epidemic of the 21st century. Being overweight is a huge problem not only for obese people, but also for doctors of all specialties, because obese people are at increased risk for a variety of diseases. The first place among them is occupied by diseases of the cardiovascular system. Unfortunately, the number of children who develop this disease from a very young age is growing every day.

There are many classifications of obesity. Consider those of them that are most often used by doctors.

Classification due to the development of obesity

Depending on the genesis (cause), the following forms of obesity are distinguished:

1. Alimentary obesity in recent decades has become an epidemic among the population of developed countries. This is due solely to the way of life of many modern people. , frequent eating, the so-called fast food and overeating, combined with a sedentary lifestyle, lead to the accumulation of excess body weight. Additional predisposing factors in this case are a hereditary tendency to obesity and deviations in eating behavior (for example, the habit of eating at night or overeating when stressed).
2. The endocrine form of obesity is associated with various diseases of the endocrine system. In this case, the deposition of excess fat in the body is a sign of the underlying disease. Patients suffering from this form of the disease need complex treatment, aimed primarily at correcting the hormonal background in the body.
3. Cerebral obesity can occur as a result of infectious diseases, injuries and tumors of the brain or some of its structures (hypothalamus, pituitary gland). This form of the disease is also called cerebral.
4. Drug obesity can develop as a result of long-term use of certain drugs, such as glucocorticoids, combined oral contraceptives, antidepressants, etc.

Classification according to the type of fat deposition in the body

Depending on the nature of the distribution of excess adipose tissue in the body, obesity is divided into the following types:

1. The android type of obesity is characterized by the fact that adipose tissue is mainly deposited in the upper body (axillary region, abdomen). This clinical picture is observed most often in patients with impaired glucose tolerance or diabetes mellitus, impaired lipid metabolism, hypertension, as well as hyperandrogenism and hirsutism in women.
2. Abdominal obesity is a special case of obesity that develops according to the android type. The accumulation of fat occurs mainly under the skin of the abdomen, and there is also an increase in the volume of fatty tissue surrounding the internal organs.
3. In the gynoid type of the disease, excess adipose tissue is localized mainly in the lower part of the body under the skin of the abdomen, buttocks and thighs. More common in women.
4. The mixed type of obesity is characterized by a uniform distribution of excess adipose tissue in the body.

Morphological classification of obesity

1. Hypertrophic obesity is characterized by an increase in the mass of adipocytes (fat cells), while their number remains unchanged. This type of disease often develops in adulthood.
2. With hyperplastic obesity, there is an increase in the number of fat cells in the body, this type of disease is more often observed in those who have suffered from this disease since childhood. Hyperplastic obesity rarely occurs as an independent form of the disease. Most often, there is a mixed form, in which patients also have an increase in the number of adipocytes and their volume.

Degrees of obesity by deviation from BMI (body mass index)

I st. - excess of normal body weight by 10–29%;
II Art. - excess of normal body weight by 30-49%;
III Art. - excess of normal body weight by 50-99%;
IV Art. - excess of normal body weight of 100% or more.

At the same time, it is customary to consider body weight obtained by the following calculations as normal: subtract 100 from the height value (in centimeters). Another 10% for men and 15% for women must be subtracted from the value obtained. For BMI, corresponding to the average norm, it is considered to be the value of 18.5 kg / m2 - 25 kg / m2.

Regardless of the cause and stage of obesity, this disease requires a serious one, the duration of which is almost impossible to predict.

Which doctor to contact

Obesity should first of all be examined by an endocrinologist, since this symptom often accompanies severe metabolic disorders. In addition, sometimes the help of a neurologist is needed to diagnose and treat obesity. A dietitian, as well as a specialist in bariatric surgery, a modern area of ​​plastic surgery that is effective in obesity, will help fight the increased weight itself.

Today, overweight problems are of great concern to doctors. The number of people suffering from obesity is growing inexorably day by day.

Unbalanced and excessive nutrition, low physical activity, violation of the diet leads to the fact that an increasing number of the population begins to suffer from overweight.

Due to the choice of the wrong tactics of losing weight, most people find it difficult to get rid of this problem. After all, there are 6 types of obesity, and each of them requires specific ways to fight.

What is obesity?

Obesity is a disease accompanied by excessive body fat, and developing as a result of metabolic disorders. Excess weight is one of the most serious medical and social problems, since it reduces the patient's life expectancy and significantly worsens its quality.

The World Health Organization (WHO) considers excessive deposition of adipose tissue as an epidemic that has captured millions of people.

Diagnosis of excess weight refers to body mass index. It is defined as the ratio of body weight to the square of height in meters (kg/m2). This value reflects the fat reserves in the body, and promptly signals the occurrence of excess fat, the development of obesity and the problems associated with it.

Currently, the classification of obesity by BMI developed by WHO is used. With its help, you can set the type of body weight:

• indicator less than 18.5 - underweight;
• ranging from 18.5–24.99 - normal weight;
• indicators in the range from 25 to 29.99 - preobesity;
• the weight index is 30–35 – ;
• BMI indicators are in the range of 35–39.99 -;
• body mass index exceeds 40 - the third degree of obesity.

Unfortunately, to combat extra pounds, it is not enough to determine only the weight index. Additionally, you need to set the type of obesity. Depending on the location of the deposits of adipose tissue, 6 varieties are distinguished. Below is more detailed information on each type of disease.

Overeating obesity

According to WHO, this type of obesity is the most common in the world. The localization of adipose tissue in the upper body (from the chin to the buttocks) is a consequence of overeating. Excessive food intake affects the activity of the appetite center in the brain, and disrupts its normal operation.

Therefore, the amount of food necessary to satisfy hunger will not be enough, and the body will require a new portion.

When people try to cope with this type of obesity, they try to eat less food, however, there are no visible results. The fact is that obesity caused by overeating is associated not so much with the amount of food consumed, but with an imbalance between the calories received and spent.

To cope with overeating obesity, you must follow some basic rules:

• You need to minimize your carbohydrate intake. Eliminate sugar from your daily diet.
• The working volume of the stomach should be reduced. To prevent a person from eating too much during a meal, before eating (30 minutes) you need to drink 1-2 glasses of clean water.
• People who constantly overeat should burn most of the calories that enter the body. It is worth paying attention to physical exercises at least 30 minutes a day.

Stress obesity

Obesity of nervous origin is characterized by the accumulation of superficial fat in the abdomen, the so-called lifeline. This is explained by the production of an excess amount of adrenaline during stress.

It stimulates receptors on the surface of cells, and causes them to accumulate fatty tissue. Most of these receptors are located in the abdomen and intestines, so excess weight is formed around the waist.

To solve the problem of the disease in question, first of all, it is necessary to cope with stress and anxiety. Directly normalization of the psycho-emotional background can lead to a decrease in extra pounds. The patient should learn to perceive any troubles more calmly.

Additionally, it is worth abandoning simple sugars, for example, various sweets, rich products. If a person learns to control himself in stressful situations and stops using confectionery, then soon his body weight will return to normal.

obesity caused by gluten

Gluten obesity manifests itself in the form of deposition of fat masses in the thighs. This type of disease occurs against the background of hormonal imbalance or menopause. This type of obesity is quite difficult to fight.

Statistical research data indicate that there are twice as many obese women as men. This is due to the advent of menopause. During menopause in women, the concentration of testosterone, estrogen and progesterone decreases.

The last two hormones affect the localization of adipose tissue in the gluteal-femoral region. The hormone estrogen controls the metabolism of fats and carbohydrates. A decrease in the level of this substance causes the addition of extra pounds.

To solve this problem, you need . Medications are selected that are aimed at correcting metabolism. The patient should give up addictions and increase physical activity.

Atherogenic metabolic imbalance

This type of disease is characterized by the deposition of fatty masses around the abdominal cavity. The accumulated fat puts pressure on the diaphragm, causing the obese patient provoked by an atherogenic metabolic imbalance to experience shortness of breath.

There is a deterioration in the quality of sleep, dizziness appears due to a lack of oxygen. This disease is more common in males.

Of the six types of obesity, it is this type that leads to the development of diabetes mellitus, heart attack, stroke and arterial hypertension. Therefore, a patient with such a problem must undergo a medical examination to identify the above diseases.

The disease under consideration requires an integrated approach. The patient needs to get rid of addictions, increase physical activity and eat rationally. The amount of food consumed should be moderate. Gradually, the amount of food should be reduced. From the daily diet you need to exclude:

• alcohol;
• sugar;
• products made from white flour;
• fatty foods, especially of animal origin.

The defeat of the venous channels

Obesity of the venous channels has a genetic cause. This type of disease affects mainly women, especially with hormonal changes (or climatic period). The disease is characterized by the deposition of fat masses on the legs.

To get rid of the disease, it is necessary to organize the correct physical activity. Various weight lifting machines pose a threat to a person suffering from this type of obesity. Therefore, the best options for solving the problem are walking, swimming, cycling.

That is, a variety of loads that do not allow fluid to stagnate in the lower body, keeping the muscles in good shape. Any classes must be agreed with the attending physician, and take place under the supervision of an instructor.

Obesity inactivity

Obesity due to sedentary activity is observed in people who have drastically reduced their usual physical activity. This category includes former professional athletes. Fat deposits are localized in the back, waist and middle abdomen.

You can cope with the pathology by changing the diet. With a weight index of more than 30, overeating and starvation are contraindicated, as they exacerbate the problem. You should eat at certain hours, portions should be small.

It is worth giving preference to products of plant origin, and reduce the amount of refined carbohydrates. Refuse sweets.

Gradually begin to be active. First, learn to do daily exercises in the morning. Then introduce regular workouts with an emphasis on cardio, designed to effectively burn adipose tissue.

Obesity has become one of the most common diseases in recent years. The WHO has recognized it as an epidemic of the 21st century. Of course, in such a situation, effective tactics of treatment and prevention are simply necessary. By following simple rules, the formation of visible fat deposits and the disease in general can be prevented.

Having a certain supply of fat, a person is “confident in the future”, because he knows that in case of unforeseen circumstances, it is due to the breakdown of fat that he will be provided with energy and water. Thanks to adipose tissue, a comfortable body temperature is maintained, internal organs are protected from external influences, and in some cases from the spread of the inflammatory process (for example, with appendicitis and ulcers). In addition, subcutaneous adipose tissue is a generator of biologically active substances, such as vitamins and hormones, as well as a participant in metabolic processes, in particular, those occurring in the musculoskeletal system. The conclusion suggests itself about the exceptional benefits of fat for humans, but then why is obesity dangerous, because, based on the foregoing, fat performs important functions in the body? Indeed, it does. But only until it becomes too much and it starts to slow down metabolic processes, slowly killing a person. reduces the quality of a person’s life, changes his behavior and psyche, and in addition, causes a number of diseases, which can be as difficult to get rid of as it is to get rid of excess weight itself. Produced on time calculating the degree of obesity will help keep the situation under control and will avoid the development of at least alimentary or primary obesity.

Forms of obesity depending on the cause of the pathology

Primary (exogenous) or alimentary obesity caused by lifestyle. A modern person eats a lot and moves little, and a violation of the normal ratio between incoming and outgoing calories inevitably leads to fat accumulation. How a person eats is also important, because the development of alimentary constitutional obesity can be caused not so much by a plentiful as by an unbalanced diet, for example, with an excess of fats and carbohydrates, as well as disordered meals. Irregular nutrition in alimentary constitutional obesity (when fat is deposited under the skin, changing the contours of the body) is very common, and usually a person cannot understand why his weight is increasing, although he “does not eat anything” all day, well, except for dinner ... In addition, the primary form of the disease is caused by improper eating behavior, for example, the abuse of fast food and the habit of "seizing" stress, eating to relieve psychological stress.

Secondary (organic, endogenous) obesity, develops due to diseases of the internal organs of a person or having a hereditary character. With this form, people gain weight despite a reasonable amount of good quality food consumed, and they usually fail to get rid of extra pounds without the intervention of doctors. And we are talking not only about the help of nutritionists, but also about the participation in the process of narrow specialists - an endocrinologist and a gastroenterologist.

There are the following types of secondary obesity:

• endocrine obesity, which leads to diseases of organs that produce hormones, that is, the thyroid gland (thyroid obesity), the pituitary gland, adrenal glands, as well as the pancreas and gonads; treatment of this type of obesity is carried out in a complex manner, and first of all, the hormonal background is normalized for the patient;
• cerebral (brain) obesity, which is a complication after infectious diseases, injuries and neoplasms of the brain; a serious pathology requiring equally serious treatment;
• drug obesity, arising from the use, as a rule, of hormonal drugs, for example, glucocorticoids and oral contraceptives, as well as antidepressants, especially if they are used uncontrollably by a person who is not actually suffering from depression.

Forms of obesity according to the dynamics of the development of pathology

Few people gain weight instantly, as a rule, fat gradually accumulates over several years and in the early stages of the development of the disease does not burden the person too much. Having reached a certain value, body weight stabilizes: it may slightly decrease or increase, but in general it is maintained at a certain level. Thus, we can distinguish:

• progressive (dynamic) obesity, in which body weight is steadily growing;
• stable obesity, in which overweight is fixed at certain indicators and has no tendency to increase.

Forms of obesity by gender

1. Obesity by female type, which is also called gynoid obesity, experts do not consider it too dangerous, since it is typical for women with normal hormonal levels and a properly functioning endocrine system. If obesity develops according to the female type, then an excess of adipose tissue is noted in the lower body, that is, in the thighs, lower third of the abdomen and on the buttocks, which makes the figure look like a pear. If for ladies such a comparison is natural, because a thin waist, coupled with lush hips, looks very attractive, then the female type of obesity does not paint men and does not add sexuality.
2. male obesity, also called android obesity, manifests itself in the deposition of fat on the abdomen, shoulders and chest, making the body look like an apple. Although visually, men with this type of obesity do not look as deplorable as their pear-shaped comrades (at least they do not cause unnecessary associations), but serious problems lie in wait for them. If fat is mainly deposited on the abdomen, then the so-called abdominal type of obesity develops, which over time is supplemented by visceral obesity, that is, the deposition of fat in the abdominal cavity and directly on the internal organs. The male type of obesity is quite common in women, which sometimes indicates an excess of male sex hormones in them.
3. Mixed type of obesity is considered the most common and manifests itself in a uniform distribution of fat in all areas of the body. Experts note that this type of obesity is typical for children.

Types of obesity by zones of deposition

Fat (triglycerides) accumulates in special cells - adipocytes, which conditionally represent a ball with a bubble of fat inside. Receiving more and more portions of fat, adipocytes increase in size, but since they cannot grow indefinitely, the body uses other, originally non-fat cells, endowing them with the ability to accumulate triglycerides. How many fat cells a person will have, and in what areas of the body they will be located - this is inherent in the human genome.

The type of obesity is determined by the type of tissue that "sheltered" fat and can be:

• peripheral- triglycerides are deposited mainly in the subcutaneous adipose tissue and in the subfascial (deep) layer, expressed mainly on the thighs and abdomen;
• central() - griglycerides are deposited on the internal organs.

Degrees of obesity

* The easiest way to determine the normal body weight is to subtract 100 from the height in centimeters. For example: If you are 165 cm tall, your normal weight will be 65 kg.

**Body mass index (Quetelet index) can be obtained by dividing the weight in kilograms by the height in meters. A person is of normal weight if their BMI is between 18.5 and 24.5. For example: a person who weighs 90 kg with a height of 1.7 m suffers from the first degree of obesity (index 31).

Obesity of the first degree, as a rule, does not cause any special problems, however, in some cases shortness of breath, sweating and fatigue are noted. Weight is adjusted by diet and exercise.

Obesity of the second degree affects the physical and psycho-emotional state of a person who is faced with the fact that it becomes difficult for him to climb stairs, bend over and maintain balance. Shortness of breath appears even when walking calmly, pressure jumps are observed, sometimes pains in the heart appear.

Significantly worsens the quality of life of a person who begins to be ashamed of his appearance and physical weakness - even slight physical stress causes pain in the muscles and joints. Efficiency decreases sharply, you constantly want to sleep, there are violations of the heart rhythm and the sugar content in the blood rises.

Obesity of the fourth degree in most cases, it deprives a person of freedom of movement - in order to overcome even a short distance, he needs to mobilize all his will; to the difficulties of moving in space due to problems with joints that are under enormous stress, diseases of the heart, liver and diabetes are added.

Obesity: video

Attention! Obesity of any degree threatens the development of serious pathologies of the musculoskeletal system, because every kilogram of excess weight greatly increases the load on the spine and joints. In addition, adipose tissue has the ability to produce estrogens (female sex hormones) and thus affect the human hormonal background.