What to eat with obesity 4 degrees. How to calculate the stages, degrees and type of obesity in men, women and children. Signs of pathological completeness

Every woman who encounters obese 4 degrees, must understand that such a diagnosis is not a sentence! Obesity 4 degrees is a serious medical problem, but it has solutions. Although it cannot be denied that this is a serious disease that is difficult to cure. On the 4 stages of obesity a person experiences serious psychological suffering: he is embarrassed to go out into the street, becomes withdrawn, believes that his life is over. Many women simply resign themselves to their problem and do not want to do anything. All this only exacerbates their condition. However, in such a critical situation, you need to get together and fight for your health!

Obesity refers to the excess accumulation of fat in the body. Body mass index at obesity 4 degrees- 40 and more. Weight problems can be triggered by the following reasons: overeating, concomitant chronic pathologies, hormonal disorders, sedentary lifestyle. Doctors distinguish several degrees of obesity. You can determine them using the body mass index calculator, which is presented on the website ves.ru. With the most severe, 4 degrees of obesity, overweight is 100 percent.

Accordingly, a person weighs more than his normal weight by 2 times or more. With 4 degrees of obesity, weight can be more than 100 and sometimes even more than 200 kilograms. With such obesity, all vital internal organs suffer: heart, lungs, liver, musculoskeletal system. The latter is forced to withstand an unbearably large load. It is possible to complicate obesity with such severe pathologies as diabetes mellitus, endocrine diseases. All this can lead to disability.

Women suffering obese 4 degrees, deserve special attention of doctors, as they experience serious suffering, starting to hate their body and life in general. Such patients may experience depression. Unsettled personal life and nervous breakdowns are possible. Therefore, it is not necessary to leave such a patient alone with her problems. In treatment obesity 4 degrees a holistic, consistent approach must be followed. In this case, the life of the patient, not just health and beauty, depends on the correct treatment. Diet and physical activity are insufficient measures for such a severity of the pathology. You need to start with a complete examination of the body and the diagnosis of all pathologies. Then surgery is likely to be required. It can be gastroplasty, liposuction, gastric bypass, gastric banding, biliopancreatic bypass.

Bariatrics in Moscow and abroad+7-925-750-25-15 - bariatric surgery consultation

Obesity 4 degrees

All patients with 100% overweight need, as a rule, constant care. They can hardly move, they cannot climb stairs, wash themselves in the bathroom and use public transport. For them, every step is difficult.

TEN BIG FACTS ABOUT OBESITY. Video

Such patients have a bunch of serious diseases, with excessive body weight associated with: hypertension, atherosclerosis, pancreatitis, diabetes mellitus, Pickwick's syndrome - respiratory failure.

OBESITY. DIET FOR OBESITY OF THE FOURTH DEGREE

FAT PEOPLE. Video

Obesity at the fourth stage of an integrated approach requires: special diets and, possibly, even surgical intervention. Treatment in a hospital is desirable, with medical supervision.

Obesity of the fourth degree quite rare, because patients rarely live to see it.
Only the hardiest organism with a large supply of vitality can bear excess weight. Twice the normal weight of a human.

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Sometimes, obesity of the fourth degree takes on a monstrous character, from the word - "monster". People look monstrous when the body turns into something monstrous and formless with mountains of fat.

SUPER RECIPE! MOM LOSE WEIGHT ON .... KG!). Video

Treatment of 4 degrees of obesity is ineffective. It is necessary to do numerous operations to the patient in order to return the human form.

Patients with the fourth degree of obesity usually really seriously ill, they cannot sometimes leave their house, and someone even their own bed.

Obesity of the fourth degree leads to heart failure and shortness of breath, even at rest. The prognosis for the future life of these patients is very dull, early death is a common occurrence.

Be healthy!

Obesity. Diet for obesity of the fourth degree. Video

EXERCISES FOR THICK. VACUUM IN THE STOMACH. PLANK. FUKUTSUJI AND DR METHOD, Video

Diet for obesity (8). Diet number 8 for obesity: sample menu

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:

First of all, weight loss.
Restoration of water-salt balance in the body.
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:

100 grams of protein.
80 grams of fat (it is worth remembering that half of the fat should be of vegetable origin).
120-150 grams of carbohydrates (important to remember: sugar is completely excluded from the diet).
The total daily energy value of all foods eaten should not exceed 1600-1800 kcal (unless otherwise prescribed).
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?

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.
All foods consumed should be low-calorie.
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.

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

Bread. Wheat or rye from wholemeal flour. No more than 150 grams per day.
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.
Fish and seafood. Low-fat varieties of fish and all seafood. No more than 200 grams per day.
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.
Eggs. You can eat one hard-boiled egg per day, as well as an omelette with the addition of vegetables.
Cereals. Barley, barley, buckwheat - in a friable form. Cereals in soups can only be in limited quantities.
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.
Fruit. Almost everything is possible and in any form. The exceptions are bananas and grapes.
Sweets. Various jellies, mousses, compotes are allowed. However, they must be prepared without sugar.
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.
Sauces. This diet involves the consumption of tomato, mushroom and vegetable sauces, as well as vinegar.
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.

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

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

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.
Breakfast 2. You can have breakfast with fruits, for example, fresh apples.
Dinner. A half portion of borscht in meat broth, but without meat, you can add sour cream. Boiled meat, stewed cabbage, dried fruit compote.
afternoon tea. You can eat fat-free cottage cheese with milk.
Dinner 1. If the patient is on diet #8, the dinner menu may consist of fish stew, vegetable stew and tea.
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:

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).
Fermented milk products, as well as stewed cabbage, are considered very useful for this diet. They need to be given special attention.
You can make various decoctions, but you need to cook them without adding sugar.
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:

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

Before eating, you need to drink a glass of water.
Before the main course, you need to eat a salad.
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.

Diet for obesity 1, 2, 3 and 4 degrees

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 the mass of a person by the square of his height in meters (weight in kg / height in m 2).

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:

No. 8a (moderate reduction)

No. 8o (maximum reduction)

Products that can be consumed without restriction:

Cabbage (all types)

Leaf lettuce, greens

Radish, radish, turnip

Green peas (young)

Tea, coffee without sugar and cream

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)

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:

Vegetable oil (1 tablespoon / day)

Cheeses over 30% fat

Curd over 5% fat

Fatty meat (pork, lamb, chicken legs)

Sausages, sausages, sausages

Canned meat, fish and vegetable in oil

From fruits: bananas, dates, grapes

Pastries, cakes and other confectionery

Cookies, pastry products

Sweet drinks (Coca-Cola, Fanta)

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).

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.

Bread and flour products

Wheat bread, black and with bran. Permissible consumption up to 150g per day.

Mostly vegetable or fruit, from unsweetened fruits. It is allowed to use vegetable soups on a weak meat broth 2-3 times a week. The norm of soup is up to 250g per day.

Of the cereals, it is advisable to use buckwheat, oatmeal and barley in the form of crumbly cereals.

Low-fat types of fish (perch, cod) up to 150-200g per day in boiled or baked form. Seafood.

Low-fat meats, chicken, turkey, rabbit up to 150g per day boiled, stewed or baked.

1-2 eggs per day, hard-boiled, protein omelettes.

Any dishes from raw, boiled, stewed and baked vegetables. Potatoes are consumed in a limited way, up to 200g per day.

Cottage cheese, milk and low-fat dairy products. Sour cream is put only in dishes.

Fruits of sweet and sour varieties in boiled and raw form. Jelly, mousses and compotes on xylitol and sorbitol.

Green tea, coffee with milk, vegetable and fruit (unsweetened) juices, rosehip broth.

Sauces and spices

Sauces on weak vegetable and meat broths with dill and parsley. From spices - vanillin, cinnamon, turmeric.

Vegetable oil in dishes, butter - in limited quantities.

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 this 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 develop atherosclerosis, diseases of the heart and joints, liver and biliary tract, diabetes mellitus, hypertension, pancreatitis, nephrolithiasis. 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 fasting days - how to lose excess

Education: Diploma in the specialty "Medicine" received at the Russian State Medical University. N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.

Diet nutrition for obesity of the 4th degree

In the world, many complain of being overweight, and about a billion people are obese. This disease develops as a result of excessive intake of calories with insufficient use of them. Various health problems or a certain physical condition can also provoke obesity. If the actual body weight exceeds the normal weight by a third or more, this is obesity. In the case of the 4th degree, this is 100% of the mass. Under such circumstances, proper nutrition and moderate physical activity are prescribed as treatment. A diet for obesity of the 4th degree, with strict adherence to it, helps to improve the condition of the body and reduce body fat.

When planning your diet in the process of treating obesity of the fourth stage, it is worth considering that fast carbohydrates contained in sweets should be excluded or replaced with low-calorie sweeteners. Distribute carbohydrate foods in equal proportions between meals. Choose foods with a low glycemic index (GI).

To prevent the feeling of hunger from coming too quickly, increase the amount of foods containing fiber. Basically, it should be fresh vegetables and unsweetened fruits, bran and cereals. These products are low-calorie and due to their volumes quickly saturate the body.

It is also strictly necessary to monitor the proportion and origin of fat in products. You need to eat fat-free or low-fat foods. It is important to maintain a balance of mono- and polyunsaturated fats, which are necessary for the body. Ensure the presence in the diet of foods rich in potassium, magnesium, iodine, antioxidants.

Adhering to a strict diet, give the body days of rest - unloading. Do them 1-2 times a week. It is preferable to eat fruits, vegetables, low-fat dairy products on such days.

In terms of dietary nutrition, be guided by the principles:

Eat no more than 1500 calories per day. In general, the diet should consist of proteins, polyunsaturated fats, amino acids, vitamins.
Minimize your intake of fast carbohydrates. Try to replace them with slow, that is, complex ones. Be sure to pay attention to the GI of products.
Use vegetable oils instead of animal fats.
To avoid eating for as long as possible, eat foods rich in fiber.
The daily diet should consist of 5-6 meals - this normalizes metabolism.
Do not eat food containing substances that stimulate the appetite (spices, sugar).
Reduce salt intake to 3 grams per day or eliminate it from the diet, as it provokes swelling in the limbs and retains fluid.

What is allowed to eat

There are specially designed diets for those who are obese or want to lose extra pounds. The most common is table number 8. According to this diet, no more than 1800 calories are allowed per day. In grams, this would correspond to 85 grams of protein, 75 vegetable fats, and 115 carbohydrates. The diet for those suffering from obesity of the 4th degree should be physiologically balanced. The optimal amount of water per day is 1-1.2 liters.

A list of products that can diversify the daily menu for obesity as much as possible:

the first hot dishes based on vegetable broths, as well as low-fat meat soups 1-2 times a week (200-250 g per day);
whole grain bread and bread with bran (150 g per day);
chicken meat, turkey, veal, rabbit meat boiled, steamed or baked (200 g per day);
seafood and low-fat fish up to 200 g per day;
buckwheat, barley and oatmeal;
dairy products with a low percentage of fat;
an egg can be per day;
vegetables and unsweetened fruits (potatoes are allowed up to 200 g per day);
vegetable oil (olive, sunflower, linseed, sesame), butter in a minimum amount;
homemade vegetable and milk sauces;
tea of any kind, coffee with milk, herbal decoctions (especially with the addition of rose hips).

What is forbidden to use

sweets and flour products;
chocolate and cocoa;
jam and honey;
grapes, melon, banana, raisins, dates, figs;
dishes with fatty meat;
sausages;
factory sauces;
carbonated drinks;
fat of animal origin;
pasta, white rice and semolina;
smoked meats, pickles and canned food;
dairy products with a high percentage of fat and sugar;
alcoholic drinks.

Sample menu for the week

The diet for an obese person should be varied every day. For a complete diet, it is worth compiling a menu for several days. It is better to cook food based on dietary recipes. Proper daily nutrition will increase the chances of losing weight and improving the condition of the body. Below is a sample menu for a week in a diet for obesity of the 4th degree.

Obesity 4 (fourth) degree

Is your problem late stage obesity? This is obesity 4 (fourth) degree. Believe that your problem has a solution!

Gastric banding - a method of treating obesity of the 4th degree

Procedure

A special ring is placed in the stomach area. It is necessary in order to divide the stomach into two parts. Why is this being done? In order for part of the food eaten to enter the gastric reservoir. Thanks to this, a person quickly comes to a feeling of satiety and hunger disappears.

Liposuction - an anti-obesity procedure

Of course, everyone heard, watched and read about this method. You can immediately tell about its "minus". And it consists in the fact that it works temporarily, not permanently. This method allows you to eliminate fat deposits in certain areas of the body. But why does the weight come back? - Because the cause of excess weight has not been eliminated.

Gastric resection for obesity of the fourth degree

This is an operation that is designed to remove the stomach part. The feeling of satiety comes much faster. That is, for complete saturation, a sufficient amount of food is much less than usual.

Gastric bypass

Food immediately enters the intestines, bypassing the "main" part of the stomach. How does this happen? A shunt (corridor) is placed on the stomach. Thanks to him, the process of bypassing is “launched”.

Caloric intake allowed for obesity of the 4th degree

Calorie content, calculated on two thousand calories (daily dose set by the doctor):

Sugar (from five to ten grams).
Cottage cheese (maximum three hundred grams).
Milk (one to two glasses).
Oil (from five to ten grams).
Black bread (from fifty to one hundred grams).
Fruits (grapes and bananas - no!).
Vegetables (potatoes and legumes - no!).

Treatment of obesity of the fourth degree

Diet "Hollywood"

Breakfast is always

Tomato.
Thirty grams of almonds.
Orange.
Coffee.
Eggs are "cool" (2).
Second orange.

A decoction of various vegetables.
Cottage cheese (without high fat content).

Dinner menu (first option):

Boiled meat (one hundred grams).
Grapefruit.
Cucumber.
Tomato.

Dinner menu (second option):

Ketchup.
Cucumber.
Boiled fish fillet (one hundred and fifty grams).

Treatment of obesity of the fourth (4th) degree with apple cider vinegar

The essence of the treatment is as follows:

Two teaspoons of vinegar are dissolved in water.
Vinegar is drunk after meals - 3, 4 times a day.
Meat and fat consumption is sharply limited.
There is a need to "lean" on products of marine origin, vegetables, fruits, cereals.

The apple cider vinegar diet

Breakfast:

Cottage cheese - rice roll.

Water with apple cider vinegar (half a glass).
Two apples.

Water with apple cider vinegar (glass).
Mushroom patties.
Mashed potatoes.

Water with apple cider vinegar.
Mango pudding.

Mussels baked in sauce.
Water with apple cider vinegar (cup).
Green salad with olives.

Recipes for dishes prescribed for obesity

The vinaigrette

Vinaigrette Ingredients:

Mayonnaise (one table. Spoon).
Onion (one piece).
Vegetable oil (one tablespoon).
Medium carrot (one piece).
Apples (one hundred grams).
Medium beets (one piece).
Pickled cucumbers (two).
Potatoes (three tubers).

We wash the carrots.
We wash the potatoes.
We wash the beets.
We boil these products separately.
Cooling food.
We clean from the peel.
We cut finely.
We clean the onion.
We clean the cucumbers.
We clean the apples.
We cut.
We mix all-all the products listed above.
Fill with vegetable oil.
Pour the dish with mayonnaise.

"Envelope" meat with zucchini and stewed cabbage

Products for the preparation of the "envelope":

Milk (three tablespoons).
Greens.
Zucchini (one hundred grams).
The fourth product is butter (one tablespoon).
The fifth product is the loin of meat (one hundred and twenty grams).
The sixth product is fresh cabbage (one hundred and fifty grams).
The seventh product is a medium zucchini (one hundred grams).

We beat off the "fillet".
We make an envelope from parchment paper.
We put the broken "fillet" in the envelope.
We “place” the envelope in a frying pan (with boiling oil).
Fry the meat until it is fully cooked.
We wash the cabbage.
We chop the cabbage.
We clean the zucchini.
We cut it into slices.
Stew the zucchini with cabbage (in milk).
We take out the meat from the envelope.
Put on a plate (along with vegetables).
Drizzle with melted butter.
We cut the greens.
Sprinkle the dish with herbs.

Boiled fish + boiled potatoes

Products for the preparation of "boiled couple":

Vegetable oil (one teaspoon).
Greens.
Fish fillet (one hundred and fifty grams).
Potatoes (three things).

We wash the fish (fillet).
Cut the fish fillet into several pieces.
We salt the water.
Cook in salted water.
We clean the potatoes.
Steam peeled potatoes.
Put the fish and potatoes on a plate.
Drizzle with oil, and fish, and potatoes.
Sprinkle with herbs.

Water procedures that help get rid of the fourth degree of obesity

Circular shower.
Needle shower.
Radon baths.
Underwater shower.

How long does the course of treatment take? - Twelve tricks. Efficiency increases if you combine these procedures with a diet.

Remember that you do not need to declare a hunger strike, but refuse some drinks and foods. For example: alcoholic drinks, sweet, smoked. It will be hard. But you can do it if you want to be healthy!

Do you think being overweight is just ugly? Not! It is also very bad for your health! And if the fat is also located in the abdomen, then it is also extremely life-threatening!

Therefore, do not expect heart problems and type 2 diabetes to appear. Determine what degree of obesity you or a loved one has and immediately begin treatment! Moreover, it does not represent anything "unbearable".

Why is obesity dangerous?

Without exaggeration, we can say that obesity is gaining momentum, acquiring the character of a pandemic. Now more than 2 billion people (and this is a third of the world's population) are overweight!

Excessive deposition of fat under the skin, as well as in the cavities around the internal organs, is a risk factor for various diseases:

coronary heart disease, the most terrible manifestation of which is myocardial infarction;
atherosclerosis, due to which any organ can suffer, including the brain, the apogee of which becomes a stroke;
type 2 diabetes;
fatty liver (fatty hepatosis);
chronic pancreatitis - inflammation of the pancreas;
inflammation of the stomach and esophagus;
malignant diseases.

The result of obesity is metabolic syndrome X, which is also called the “deadly quartet”. It includes:

obesity itself;
diabetes;
arterial hypertension;
ischemic heart disease.

It occurs as a result of the fact that, due to an excess amount of fat (especially internal - visceral), tissues no longer perceive insulin normally. The pancreas receives "feedback", and begins to produce this hormone even more - there is an excess of it. The lack of action of insulin with its actual increase leads to:

violation of carbohydrate, fat and purine types of metabolism,
an increase in the blood of a substance called a plasminogen activator inhibitor, which increases the risk of blood clots,
increased activity of the sympathetic nervous system,
the appearance in the blood of an excess of those fatty acids that can be deposited on the walls of blood vessels, causing atherosclerosis.

It especially threatens those people in whom fat is deposited according to the male type - in the upper half of the body and, especially, on the stomach. In this case, the amount of visceral adipose tissue especially increases, and 20-30 times more free fatty acids begin to constantly pass through the liver than it should be. The liver cannot withstand such an attack for a long time, and since it is involved in almost all types of metabolism, the deterioration of its work is reflected in the state of the whole organism.

Previously, it was believed that the metabolic syndrome is the lot of people "over 50" and, mainly, women. In recent years, there has been an increase in this pathology in men, as well as in adolescents and young people. The risk of metabolic syndrome is higher in people who already have one of the "quartet" pathology, or have other hormonal or vascular problems. For example, polycystic ovaries or menopause in women, erectile dysfunction in the stronger sex.

It turns out that obesity can, if not shorten life, then significantly worsen its quality. And the more excess fat there is in the body, the higher the danger. Therefore, below we will talk about the degrees of obesity.

Causes of obesity

Although the number of overweight people is steadily increasing, scientists do not find that in this or that region, this or that nation accumulates inherited genes responsible for this event. Despite the fact that the functioning of the centers of hunger and satiety in the brain, as well as the work of hormones and are genetically determined, dietary habits and physical activity have a much greater influence on obesity. And if a person who is used to eating fast food and fried meat moves from his region to where such food is not sold or where a healthy lifestyle is cultivated, he loses weight.

Fat begins to be deposited when there are much more calories received than consumed. This does not mean that a person must eat a lot to develop obesity: in many cases, his body has a slow metabolism, so not much energy is needed for its work.

Decreased energy requirements can develop in full health when a person decides to lead a sedentary lifestyle. Physical inactivity can also be forced - when a person has some kind of chronic disease (for example, heart disease, joint pathology).

In addition, obesity can develop as a result of:

diseases of the organs that are responsible for the "processing" of food: the pancreas, liver, both parts of the intestine;
violations at the level of enzymes involved in fat metabolism: either a deterioration in the functioning of those responsible for the breakdown of fat, or an increase in the activity of those involved in the storage of fatty acids inside special cells. Such changes in enzymatic activity are mainly genetically determined;
diseases of the endocrine organs that control metabolism: the thyroid gland (with hypothyroidism, the metabolism slows down greatly), testicles or ovaries (when the production of sex hormones - both female and male - deteriorates, metabolism slows down), pancreas, adrenal glands, pituitary gland;
taking drugs that affect the brain (psychotropic);
hormonal drugs: contraceptives, glucocorticoids, insulin preparations;
lesions of the hypothalamus (there are centers of hunger and satiety): as a result of chronic or very strong acute stress, severe flu, tumors, inflammation or injury to the adjacent brain area;
mental illness: for example, psychogenic overeating;
some genetic diseases, such as Prader-Willi syndrome.

The main causes of obesity in children are genetic and congenital diseases, including those that modify (eg, hypogonadism, adrenogenital syndrome, Cushing's syndrome). In half of the cases, obesity occurs as a result of a very strong and unhealthy maternal (or grandmother's) love. Very rarely, children begin to gain weight due to a tumor that secretes hormones.
cm. .

Types of obesity

There are such types of obesity:

Central

This is such a figure that women call "apple type". It is characterized by the deposition of fat in the upper half of the body (back, breast area, shoulders), but especially in the abdomen. As a result, it becomes more than 80 cm in women or 95 cm in men.

Normally, the ratio of the circumference of the waist to the circumference of the hips should be:

in women - no more than 0.8. For example, with a 90 cm hips, the waist should not be more than 72 cm in girth;
in men - no more than 0.95. For example, with hips of 100 cm, the waist should be no more than 95 cm.

When this ratio increases, a diagnosis of central or android obesity is made. Its main cause is an excess of male sex hormones. Belly growth from beer has not been proven. Moreover, this alcoholic drink contains phytoestrogens, which resemble female sex hormones in structure, and not male ones.

Gynoid

In this case, fat is deposited in the buttocks and thighs. Hip circumference exceeds 110 cm; they look massive, often uneven skin is clearly visible on them and on the buttocks - “cellulite” (in medicine, this word is still called inflammation of the subcutaneous tissue, which is manifested by swelling and severe pain).

In the people, gynoid obesity is called a pear-shaped figure. It develops with an excess of female sex hormones.

The deposition of fat according to the male or female type depends on the hormonal status. It is encoded genetically, but can change under the influence of external factors.

General

When the thickness of all fatty tissue increases, this is called general obesity. In this case, the ratio of the circumference of the waist and hips can be quite normal, without distortions towards the abdomen or buttocks. But all volumes - and waist, and arms, and legs, and hips - will be increased. With obesity of degrees 2 and 3, folds on the sides and back will be noticeable, the face will become too rounded, in the region of the 7th cervical vertebrae, fat deposition (the so-called "withers") will be visible.

Degrees of obesity

In order to correctly prescribe treatment, describe the calorie content of the diet and monitor the dynamics, the doctors decided to single out several degrees of obesity. They are evaluated by such an indicator as the difference between the ideal body weight and the actual one, expressed as a percentage.

Ideal body weight is calculated as follows:

For men: 50 kg + ((height - 150 cm)) * 0.75
For women: (50 kg + ((height - 150 cm) * 0.75)) - 3.5 kg

How many degrees of obesity? They are distinguished by 4:

Obesity 1 degree. The actual body weight exceeds the ideal by 20-29.5%. According to BMI, this is 30-34.9 kg / m 2.
Obesity 2 degrees. Actual body weight is 30-49.5% higher than ideal. Or BMI 35-39.9 kg / m 2.
Obesity 3 degrees. The real weight of a person is 50-99.5% higher than the ideal. BMI exceeds 40 kg / m 2.
Obesity 4 degrees- this is when the actual weight exceeds the calculated more than twice. In this state, the load on the internal organs is so great that it is difficult for a person to even get up and walk.

In children, the degree of obesity is calculated by exceeding the ideal body weight. The numbers are almost the same as in adults:

1 degree - 10-20%;
2 degree - 20-30%;
3 degree - 30-40%;
4 degree - over 40%.

At the same time, the ideal body weight is not calculated according to a specific formula. They are calculated according to special centile tables - in the column 50-75 centile. If your child's weight is within the 85th-95th centile, he is considered overweight, and if above the 95th centile, he is obese and requires a calculation of how much it exceeds the 75th centile indicated.

The World Health Organization has developed special tables that take into account age and height. Looking at them, you no longer need to calculate anything, but only find the desired indicator. The result should be interpreted like this:

if the result is between + 1SD and + 2SD, it is overweight;
between + 2SD and + 3SD - obesity of the 1st degree;
+ 3SD and above - obesity of the 2nd degree, medical correction is required.

Columns L, M, and S are not to be looked at when evaluating.

WHO has also developed tables where obesity is calculated using an estimate of age and BMI. Find your child's age and lead up to the intersection with the BMI (it says BMI). If the number at the intersection falls between two yellow lines - everything is fine, between yellow and red - preobesity. Above red is obesity.

Diagnostics

The first thing that will help you know if you are obese or not is your body mass index (BMI). It is calculated simply: you need to multiply your height in meters (for example, 1.72 m) by yourself (that is, 1.72 * 1.72). After that, the body weight in kilograms is divided by the resulting figure.

That is, BMI = body weight / height 2

for example, BMI \u003d 60 / 1.72 * 1.72 \u003d 20.28 kg / m 2

The norm is an indicator of 22-25 kg / m 2 - for us and Europeans. For the Negroid race and Polynesians, the norm is 23-26 kg / m 2. From 25 to 30 kg / m 2 - is considered preobese, from 30 kg / m 2 - obesity.

Of course, this definition is not entirely accurate - after all, it does not take into account muscle mass. And it may well turn out that a person has a large muscle mass, and according to BMI he has “obesity”. And, conversely, an emaciated person will have a normal BMI, although his muscles are atrophied and, therefore, his weight is made up of indicators of adipose and bone tissue.

You can more accurately conclude the presence of obesity in other ways:

bioimpedancemetry. This is a method that allows you to measure the volume of adipose and muscle tissue based on the difference in their electrical resistance. It can be carried out at home - using a device that looks like a scale, where you need to stand on metal plates, and pick up a metal tube connected to the main device with a wire;
magnetic resonance imaging. This is the most accurate method based on the different responses of the nuclei of hydrogen atoms to magnetic stimulation. Unfortunately, it is rarely used due to its high cost.

Obese people, especially abdominal ones (of the “apple” type), must be tested:

for blood glucose (blood sugar);
insulin resistance test (this is a set of tests that can detect prediabetes);
thyroid hormones - T4 and TSH;
testosterone, dihydroepiandrosterone (DHEA-S). Women take these tests from 3 to 5 days of the menstrual cycle;
LH and FSH. Women take these hormones on the 3rd-5th day of the cycle;
lipid spectrum of blood;
liver tests;
renal indicators (urea, creatinine);

A person should be examined by an endocrinologist and a nutritionist.

obesity treatment

How to start treatment for obesity? Pay attention to 5 points:

1. Diet

High-calorie foods, especially sweets and foods containing animal fats, will have to be excluded.
No fast food.
You need to calculate the number of calories (energy) that you spend per day on daily activities and exercises. For example, about 200 kcal per hour is spent on housework, 119 kcal / hour on sedentary work, and so on. By the way, sleep and rest are also considered: we spend 71 kcal/hour on sleep, 79 kcal/hour on rest. Various applications will help in counting, for example, FatSecret.
After calculating how much you spend, write down your meals so that breakfast accounts for 30% of all calories, lunch - 30%, afternoon tea - 25% and dinner - 15%. Moreover, the total number of calories should be 25% less than the amount that you spend. Applications for phones and computers can also help with this.
You need to limit the amount of fat you eat. Very significant. In this case, the body must “think” that fatty acids are coming in and you are not starving. Then he will begin to break down his own fiber. Fat should be about 4 tablespoons of 10% cream plus half an avocado. Avocados contain those substances that fight specifically with belly fat.
The food should have enough vegetable fiber, while it should not contain a lot of carbohydrates (risk of diabetes) or be "heavy" for the intestines (like white cabbage or legumes).
Add proteins to every meal. For breakfast, this is 200 g of lean meat baked or cooked in a double boiler, for lunch - beans or 1.5% thermostatic yogurt (oatmeal, raisins and nuts are put in it), for an afternoon snack - low-fat cottage cheese, for dinner - 1% kefir or buttermilk .
Get rid of the habit of eating sweets. If you want, take some raisins, prunes or dried apricots.

Here's what's important: keeping a food diary. It not only needs to write down what you ate, but also when you ate it. This way you can see exactly what time of the day you overeat. Practice shows that this happens after lunch, when most of the work has already been redone, and there is no energy left for cooking. In this case, prepare yourself healthy (for example, raw food) snacks, nuts, dried apricots, sour-milk products (see).

2. Mood

This is a very important component for therapeutic weight loss. No esoteric or unconfirmed information.

A person must remember when excess weight began to appear. Most likely, there was some kind of stress or resentment. Maybe it all began to grow after childbirth, when the woman did not see the support she expected from her husband, when no one explained to her that men also have a lot of stress after the birth of a child. Maybe this is an insult to parents who once said something in childhood.

In any case, you need to find this moment, forgive all the offenders - and move on.

The second point is to tune in to love for your body. You don't even have to think the word "hateful" in relation to any part of your body. Better learn to visualize how leukocytes come from the circulatory system to adipose tissue - and destroy the membranes of fat cells, removing the fat itself through the lymph.

You can choose any suitable affirmation or suggestion method - there are quite a few of them on the Internet. You can also find various neuro-linguistic programming that will help you instill in your subconscious that you are losing weight. But we believe that the main thing is to still love yourself, stop being ashamed of your body, but at the same time work on it.

And one more important point: no need to suffer to deny yourself something. You need to give up junk food and start moving more - in the name of self-love. All psychologists write about this: when a person feels like a martyr who refuses fried potatoes, for example, or forces himself to go to fitness, he will lose weight. But this weight is able to return very quickly. Therefore, all actions are performed purely out of love for yourself and for your health!

3. Massage, self-massage

This is also a very important aspect of the treatment of obesity, which does not require much moral effort from a person.

You need to start self-massage only 3-4 hours after eating. It is done like this:

Gently massage problem areas. If this is the stomach, then in a circle - clockwise. For one zone - 2 minutes;
press harder on the skin (if the stomach is clockwise). For one zone - 2 minutes;
start pinching the skin first with larger pinches, then with smaller areas. Tingling should be carried out in a circle and make the skin redden. The middle line of the abdomen - do not touch. This takes 5-7 minutes for one zone;
take a shower and repeat the massage of the problem area with jets of water. We work the stomach in a circle;
finish the massage by applying a warming cream to the problem areas.

4. Movements, exercises

A set of exercises should be selected by a kinesiologist or a rehabilitation specialist. After all, we need exactly those who will work out the problem area, but will not immediately increase the already overloaded heart and blood vessels. Good results will be if you start with a slow walk, and be sure to do this for at least 30 minutes a day. Subsequently, the duration of hiking will need to be increased.

If you find it difficult to walk on your own, instead of walking, apply:

sitting classes;
exercises on the upper limbs;
exercises with weights;
swimming;
water aerobics.

Dancing gives a good effect. They don't have to be exhausting either. Just turn on pleasant music and dance for 3 minutes a day, actively moving your hips and turning your torso to the sides (twisting). This will help the waist to “appear” again.

Spinning the hula hoop, doing the plank, and pumping the press are the next steps that you can move on to when you reduce the weight by 1/10 of the original. All this is done not to exhaustion, but slowly and in a good mood.

5. Cosmetic procedures

Cosmetologists offer many of their methods of treating obesity. But here we will not advise liposuction or the introduction of lipolytics - drugs that dissolve subcutaneous fat. Because this is a very serious risk of fat embolism. But LPG-massage (or roller-vacuum), lymphatic drainage or anti-cellulite massage is an opportunity to start the process of fat breakdown.

The main thing is that you first consult with a therapist - is it possible to use any of these methods. Because your swelling and shortness of breath are not at all such harmless symptoms. They talk about the fact that - from excess weight or for other reasons - the heart suffers.

Medical treatments for obesity

They are appointed by a council of a nutritionist, therapist, psychiatrist (or psychotherapist). In severe cases, they resort to the help of surgeons who perform various operations on fatty tissue and abdominal organs.

So, medical treatments include:

drug treatment of obesity;
surgery.

Medical therapy

drugs that regulate hormone levels. Such medications by themselves will promote some weight loss;
drugs specifically targeted at obesity. They are used if other methods fail to reduce weight.

For medical treatment of obesity in the Russian Federation are allowed:

"Orlistat": blocks the breakdown of fatty acids in the digestive tract;
"Sibutramine": inhibits the reuptake of serotonin and norepinephrine in the brain;
cellulose - being a sorbent, removes unsplit fats. It is usually used together with other drugs;
Liraglutide is a human glucagon-like peptide that activates specific receptors. It reduces appetite and the amount of food consumed.
cm. .

Surgery

It is carried out with the ineffectiveness of conservative measures, if:

BMI over 40 kg/m2 or
BMI more than 35 kg / m 2 in the presence of severe diseases, the course of which can be affected by weight loss (these are obstructive sleep apnea, diabetes mellitus, heart failure, arterial hypertension, respiratory failure, bronchial asthma, osteoarthritis, urinary incontinence).

The need for surgery is decided by a council consisting of an endocrinologist, internist, anesthetist, cardiologist, nutritionist, psychiatrist, and, if necessary, other specialists.

For the treatment of obesity, the following operations are used:

Installation of an intragastric balloon. This reduces the capacity of the stomach.
Installation of an adjustable stomach ring. This narrows the lumen of the stomach.
Vertical gastroplasty. The essence is the same as in the previous case.
Gastric bypass. In this case, there is a narrowing of the lumen of the stomach and a decrease in the absorption of fats and nutrients.
Small bowel and biliopancreatic shunting. They are rarely used due to complications. Their essence is to reduce the absorption of nutrients.

The type of operation is selected depending on the degree of obesity, concomitant diseases, eating behavior. Each of them has contraindications.

Is your problem late stage obesity? This is obesity 4 (fourth) degree. Believe that your problem has a solution!

Look at the photo

Procedure

Liposuction - an anti-obesity procedure

Gastric resection for obesity of the fourth degree

This is an operation that is designed to remove the stomach part. The feeling of satiety comes much faster. That is, for complete saturation, a sufficient amount of food is much less than usual.

Gastric bypass

Caloric intake allowed for obesity of the 4th degree

Calorie content, calculated on two thousand calories (daily dose set by the doctor):

Sugar (from five to ten grams).
Cottage cheese (maximum three hundred grams).
Milk (one to two glasses).
Oil (from five to ten grams).
Black bread (from fifty to one hundred grams).
Fruits (grapes and bananas - no!).
Vegetables (potatoes and legumes - no!).

Treatment of obesity of the fourth degree

Diet "Hollywood"

Breakfast is always

Orange.
Coffee.
Second orange.

Lunch Choice:

1 option:

Tomato.
Thirty grams of almonds.
Orange.
Coffee.
Eggs are "cool" (2).
Second orange.

Option 2:

A decoction of various vegetables.
Cottage cheese (without high fat content).

Dinner menu (first option):

Boiled meat (one hundred grams).
Grapefruit.
Cucumber.
Tomato.

Dinner menu (second option):

Ketchup.
Cucumber.
Boiled fish fillet (one hundred and fifty grams).

Treatment of obesity of the fourth (4th) degree with apple cider vinegar

The essence of the treatment is as follows:

Two teaspoons of vinegar are dissolved in water.
Vinegar is drunk after meals - 3, 4 times a day.
Meat and fat consumption is sharply limited.
There is a need to "lean" on products of marine origin, vegetables, fruits, cereals.

The apple cider vinegar diet

Breakfast:

Cottage cheese - rice roll.

Lunch:

Water with apple cider vinegar (half a glass).
Two apples.

Water with apple cider vinegar (glass).
Mushroom patties.
Mashed potatoes.

Water with apple cider vinegar.
Mango pudding.

Mussels baked in sauce.
Water with apple cider vinegar (cup).
Green salad with olives.

Recipes for dishes prescribed for obesity

The vinaigrette

Vinaigrette Ingredients:

Mayonnaise (one table. Spoon).
Onion (one piece).
Vegetable oil (one tablespoon).
Medium carrot (one piece).
Apples (one hundred grams).
Medium beets (one piece).
Pickled cucumbers (two).
Potatoes (three tubers).

Cooking like this:

We wash the carrots.
We wash the potatoes.
We wash the beets.
We boil these products separately.
Cooling food.
We clean from the peel.
We cut finely.
We clean the onion.
We clean the cucumbers.
We clean the apples.
We cut.
We mix all-all the products listed above.
Fill with vegetable oil.
Pour the dish with mayonnaise.

"Envelope" meat with zucchini and stewed cabbage

Products for the preparation of the "envelope":

Milk (three tablespoons).
Greens.
Zucchini (one hundred grams).
The fourth product is butter (one tablespoon).
The fifth product is the loin of meat (one hundred and twenty grams).
The sixth product is fresh cabbage (one hundred and fifty grams).
The seventh product is a medium zucchini (one hundred grams).

Cooking like this:

We beat off the "fillet".
We make an envelope from parchment paper.
We put the broken "fillet" in the envelope.
We “place” the envelope in a frying pan (with boiling oil).
Fry the meat until it is fully cooked.
We wash the cabbage.
We chop the cabbage.
We clean the zucchini.
We cut it into slices.
Stew the zucchini with cabbage (in milk).
We take out the meat from the envelope.
Put on a plate (along with vegetables).
Drizzle with melted butter.
We cut the greens.
Sprinkle the dish with herbs.

Boiled fish + boiled potatoes

Products for the preparation of "boiled couple":

Vegetable oil (one teaspoon).
Greens.
Fish fillet (one hundred and fifty grams).
Potatoes (three things).

Cooking like this:

We wash the fish (fillet).
Cut the fish fillet into several pieces.
We salt the water.
Cook in salted water.
We clean the potatoes.
Steam peeled potatoes.
Put the fish and potatoes on a plate.
Drizzle with oil, and fish, and potatoes.
Sprinkle with herbs.

Water procedures that help get rid of the fourth degree of obesity

The most dangerous pathology in overweight is the fourth degree of obesity. It is quite rare - unfortunately, for the simple reason that even at the previous stages, the functioning of the most important organs undergoes serious negative changes, often leading to death.

What threatens fourth degree obesity, how to cope with the disease, lose weight and restore the quality of life - in our short review.

What it is

One of the main indicators of the degree of fatness of a person is the body mass index - BMI, which is the ratio of weight to the square of his height in meters.

Example: height - 1.75 m, weight - 70 kg. BMI in this case is 70 / 1.75 * 1.75 = 22.8

With a maximum rate of 26 units, in people suffering from the fourth degree of obesity, this figure goes off scale beyond the mark of 40! In terms of absolute values, the body weight of such people is more than twice the normal one, and the reason for this is the excess fat content.

Etiology

The main causes of obesity, which can progress to grade 4, are:

excessive addiction to food;
sedentary lifestyle;
certain types of infectious and chronic diseases;
congenital or acquired disorders of the central nervous system;
diseases and injuries of the endocrine system;
hormonal disruptions;
hereditary predisposition.

Symptoms

Visually, such people look excessively obese, move with difficulty, and often are not even able to leave the house. All this is a consequence of the pathological state of the internal organs, which undergo, in particular, the following changes:

The growth of adipose tissue around the heart muscle reduces the access of oxygen to it, leading to hypoxia of myocardial tissues and makes the heart work hard;
Sharp jumps in blood pressure become commonplace;
Problems in the cardiovascular system negatively affect the respiratory system: due to difficulty in pulmonary ventilation, inflammatory processes occur, leading to pneumonia, bronchitis and even tuberculosis;
An incredible load on the musculoskeletal system affects the spine and joints. Almost everyone who has grade 4 obesity has osteochondrosis, many are plagued by periodic fractures;
A frequent companion of the disease is a decrease in libido and sexual dysfunction, up to impotence and infertility;
Disruptions in the work of hormones, which are both a cause and a consequence of the last degree of obesity, lead to severe endocrine diseases - diabetes mellitus, tumors of the adrenal glands, and others;
A terrible blow is also dealt by the disease to the psychological state of the patient: the impossibility of maintaining a normal lifestyle, difficulties in starting a full-fledged family lead to nervous breakdowns and depression, which in turn provoke a set of regular kilograms.

Is there a disability

With the diagnosis of "obesity of the fourth degree", at least the third group of disability is established. But, since excessive weight in the vast majority of cases is accompanied by serious disturbances in the activity of vital organs, its owners, as a rule, have a higher group.

Treatment

It should be understood that the treatment of 4 degrees of obesity is a daunting task. It can be solved only in stationary conditions, with the use of complex measures and surgical intervention.

Which doctor to contact

The initial consultation should be with an endocrinologist, a nutritionist and a nutritionist (specialist in clinical nutrition). In the future, after a comprehensive examination by specialists of other profiles and in the absence of absolute contraindications, the patient will be prescribed a surgical intervention, which is usually preceded by conservative treatment in a hospital.

In the preparatory period before the operation, it is required to adjust the eating behavior (and regimen) and physical activity (in the direction of a gradual increase) of the patient. This happens under constant medical supervision.

Methodology

The main goal of treatment is to suppress the patient's appetite with a simultaneous increase in his energy consumption. The optimal solution is one of the following surgical interventions:

Liposuction is a surgical method for removing excess fat. Not being a proper treatment, it contributes to a rapid decrease in body weight and eases the load on the most important functional organs;
With vertical gastroplasty, such a separation of the stomach is performed, in which food penetrates only into the upper, smaller part of it, leading to early satiety and a decrease in the amount of food consumed;
Banding involves the formation of a small part of the stomach using a special bandage, which is a silicone cuff. The effect is the same as in the previous case;
As a result of gastric shunting, there is already an absolute isolation of a small, intended for eating, area of \u200b\u200bthis digestive organ;
The biliopancreatic bypass method is recognized as an extreme measure, in which part of the stomach is completely removed.

The use of medications in complex treatment is not a common indication and is done with caution, since there is a risk of numerous side effects. For the most part, drugs are used that promote the absorption of fats.

Restrictions

The whole life of a patient with grade 4 obesity must be carried out under the strictest conditions: without this, even the most drastic measures will be in vain. First of all, it concerns the diet.

Diet

The most important restriction involves adherence to a diet (therapeutic nutrition) according to the following principle:

Frequent, but metered meals with an emphasis on low-calorie;
Complete exclusion from the menu of fatty meat and fish, flour products, sweets, carbonated drinks;
A strict taboo is also on products - appetite provocateurs. This applies to spices, pickles, smoked meats, alcoholic beverages;
Replacement of animal fats with vegetable ones;
Inclusion in the diet of a large number of low-calorie vegetables and fruits;
Limiting fluid intake;
Permanent holding.

Physiotherapy

Every day, gradually and consistently - this is the main motto of physiotherapy exercises! This is what the load should be. You should start with a trivial raising and lowering of the arms, unsharp turns of the torso, slow. At the beginning of the cycle, only 5-7 minutes are enough, with a further increase in duration. During classes, you should be especially attentive to the condition of the heart and spine.

Psychological correction

Another important factor on the path to recovery. Here, a large role is assigned to the relatives of the patient, who are required to constantly maintain his faith in his own abilities and in the ultimate success. It would be nice if he himself starts planning how many kg to lose weight, say, in a month.

It should be borne in mind that after even a slight weight loss, the skin on the hips, abdomen, buttocks and in the décolleté area sags, taking on a completely unaesthetic appearance. The patient, especially if it is a woman, needs to be helped to realize that this is an inevitable factor that can later be corrected with the help of plastic surgery. Otherwise, he may simply give up and lose the desire to continue treatment.

Features of the course in childhood

As hard as it is to realize, there is a steady trend towards a rejuvenation of the disease, especially in countries that are prosperous in terms of living standards. Moreover, all these symptoms are fully manifested in the child. In combination with a fragile psyche, such a physical ailment can lead to irreversible consequences if you do not take drastic measures for treatment, and even better - to prevent the growth of obesity to such a level.

In the treatment of grade 4 obesity in children, the use of medications is prohibited until the age of 15. Instead, gentle physiotherapy is recommended for small patients (forbidden for heart disease!).

Let's be honest: the prognosis for this disease is generally unfavorable. Without long-term serious treatment, the patient has little chance of living even up to 40-45 years. That is why prevention is of great importance, which should be carried out even in childhood: do not overfeed children, encourage them to play sports and outdoor activities. If, nevertheless, the baby has signs of excessive fatness, you should immediately go for a consultation with a specialist.