Nutritional constitutional obesity of the 1st degree. Causes of exogenous constitutional obesity

Obesity and overweight. Causes of obesity, mechanisms for the development of obesity, tests for obesity, methods for correcting obesity

They say that half the population in Russia is overweight. Obesity is considered a disease of civilization. Of course, we move little, we hardly walk, but we all use transport.

Lifestyle and favorite habits give us excess weight, which our doctors call such a nasty word - “obesity”. The word is really creepy, it just hurts the ears. To part with the problem you need good motivation and willpower, a strong desire to part with the hated kilograms. Let's say you like a dress and you really want to fit into it. To do this, everyone has their own plan for parting with fat on the stomach and thighs. At the beginning of such a plan, there is always some kind of event to cleanse the intestines of toxins. Of course, you can go to the doctor and he will prescribe some medicine that reduces appetite or inhibits the absorption of fats in the intestines.

Separately, we can say food addiction leading to overweight and obesity, with whom psychologists are now successfully working, helping people not only lose excess weight, but also maintain a constant weight by changing eating behavior. Now this technique is considered the most effective in working with excess weight. However, it should be noted that the psychologist does not work with all types of overweight (obesity).

What is overweight and obesity

Not all those with extra pounds suffer obese.

Body mass index (BMI or Quettel index) is calculated using the formula: BMI = weight (kg) / height (m2)

Obesity starts with a BMI coefficient of 30, and overweight has a coefficient of 25-29

. Obesity, is a metabolic disorder of the body, characterized by the presence of excess adipose tissue. At the same time, so many kilocalories enter the body that it exceeds the required level. In obesity, cells experience excessive conversion of carbohydrates into fats. As a result, there is an accumulation of body weight approximately adequate to the energy excess.

Causes and consequences of overweight and obesity

Reasons for development overweight and obesity and the manifestations of the ensuing consequences are quite complex and diverse. A high level of lipids (fat) remains in the blood for a long time, which negatively affects the condition and functioning of the central nervous system. This leads to disruption of the centers that regulate metabolism, and, as a consequence, pathological changes in fat metabolism throughout the body.

With obesity, it is difficult for almost all organs and systems to work. First of all, the activity of the cardiovascular system is disrupted. Due to impaired cholesterol metabolism, atherosclerotic changes occur in the aorta and coronary vessels of the heart. Fatty deposits in the cardiac sac constrict the heart and interfere with its functioning. The deposition of fat between its muscle fibers reduces the force of heart contractions; the heart “grows with fat.” Circulatory failure gradually develops. The supply of oxygen to tissues decreases, which is aggravated by difficulty breathing and a gradual decrease in the vital capacity of the lungs (the lungs also become overgrown with fat). Obese people are more susceptible to hypertension, angina, myocardial infarction and cerebral hemorrhage than people with normal body weight.

Significant deposition of fat in the abdominal cavity leads to a downward displacement of the intestines and sagging of the abdomen. The activity of the gastrointestinal tract is disrupted. Bowel emptying slows down, constipation and flatulence occur, and venous hemorrhoids form. A person’s appearance also suffers. Increased sweating, diaper rash in the folds of the skin, frequent multiple pustular diseases, seborrhea (intensive formation of dandruff) on the scalp occur.

The mental state of a person is disturbed. This is manifested by drowsiness, absent-mindedness, weakening of memory, and increased fatigue. Dizziness and emotional instability with rapid mood swings are possible. On the other hand, chronic stress, which a person often experiences, can also contribute to weight gain. In conditions of a deficit of positive emotions, a person unconsciously strives to gain pleasure in order to protect himself from stress, and “eats problems.”

The following factors play a role in the development of obesity: constitutional predisposition, decreased physical activity, age, gender, professional factors, and some physiological conditions (pregnancy, lactation, menopause).
Forms of obesity

Excess weight can be attributed to psychosomatic problems. If we give a medical classification by origin, we can distinguish the following forms of obesity (since the classification is medical, the term obesity, not overweight, is applicable):

Endocrine obesity (dishormonal), (with poor compensation of diabetes mellitus), hyperinsulinism, hypothyroidism, etc.
- cerebral (central origin), - as a result of injuries, neuroinfections, etc.
- iatrogenic - caused by taking any medications or other medical procedures.
- mixed - caused by a complex of causal factors with the impossibility of identifying any one of them.
- nutritional - more calories are supplied in the diet than consumed by the body.
- constitutional - in the patient’s family there are clear indications of a burdened heredity.

According to the nature of the distribution of fatty tissue:
- central (abdominal)
- glutero-femoral (gynoid, female type)
- mixed

I mentioned above that psychologists are now effectively working with the problem of excess weight. I should note that psychologists alone (without an endocrinologist) can only work with nutritional-constitutional obesity. The point of the technique is to correct eating behavior. And now I will dwell in more detail on the nutritional and constitutional form of excess weight.

Nutritional and constitutional obesity

. Alimentary-constitutional obesity is the most common type.
This form of excess weight is often detected in members of the same family or close relatives. Based on the name, it is clear that this group of obesity has two main causes. The first part of the word means that the diet has an increased calorie content. This is especially dangerous if you have a sedentary lifestyle with reduced calorie consumption, systematic overeating, and eating disorders. But people who are already overweight may experience changes in their hormonal status that distinguish them from people of normal and asthenic physique. It should be noted that these changes are not the cause of obesity, but vice versa.

The second part of the term indicates that there is a certain individual predisposition that determines eating habits, the level of hunger, physical activity, and energy consumption during physical activity of a person.

With the development of obesity due to various disorders of the central nervous system, the leading role is played by pathological changes in the functioning of the hypothalamus, expressed to varying degrees, causing changes in behavioral reactions, especially eating behavior, and various hormonal disorders. At the same time, the activity of the hypothalamic-pituitary-adrenal system increases:
- the secretion of adrenal hormones increases, the secretion of a hormone with a fat-splitting effect decreases, the secretion of female and male sex hormones is disrupted. Characterized by an increase in the level of insulin in the blood and a decrease in the effectiveness of its action. The action of thyroid hormones and the sensitivity of organs and systems to them are disrupted.

Obesity levels

When a person appears I degree obesity Complaints such as weakness, fatigue, drowsiness, decreased mood, sweating, nervousness, and irritability appear. On the part of the gastrointestinal tract, nausea, the appearance of bitterness in the mouth, as well as flatulence and chronic constipation begin to bother. Shortness of breath occurs during physical labor.

At II degree obesity the lower extremities begin to swell, pain in the joints, especially in the spine, occurs due to the increased load on it. It is worth noting that if in grade I obesity the patient’s performance does not change, although signs such as shortness of breath and fatigue begin to appear during moderate-intensity physical activity, then already in grade II the performance is noticeably reduced.

For III degree of obesity Characterized by the development of an ugly disproportion of physique. The ability to work is actually lost due to constant shortness of breath even at rest. The patient has a pronounced circulatory disorder, swelling does not disappear within 24 hours. Noteworthy is the sharply increased appetite of a person against the background of general lethargy and drowsiness.

With IV degree, a person becomes completely disabled, this happens because the body weight is twice as normal. An obese patient's mental state is disturbed, he loses contact with the outside world, he does not care about anything except food.

An Indian healer once said: “In 999 cases out of 1000, you can be cured with the right diet.” The same can be said about obesity, when weight goes off scale, and with it blood pressure and everything else goes off scale. You can maintain a normal weight until retirement age and continue to maintain it at this level and beyond. An older woman with a good figure always commands respect.

Only properly organized nutrition can help. It is different for different ages. Include plenty of fresh fruits and vegetables in your menu, as they are high in fiber. Fiber is not digested in the body; it, like a broom, sweeps away all the garbage from our intestines. The most fiber is found in bran, and barley groats are quite affordable for a pensioner’s wallet. Buy barley groats, from which you cook porridge in the morning. To avoid increasing in volume, cook it in water and without sugar; at the end of cooking, add finely chopped raw apples. They give the porridge a great taste and cleanse my blood vessels of cholesterol.

In the article we discuss grade 1 obesity. We will list the causes of excess weight gain, types, and stages of the disease. You will learn how to calculate BMI and recognize pathology in the initial stages. We will also pay attention to prevention methods and a special diet.

Obesity of the 1st degree is the accumulation of excess body weight in the form of subcutaneous fat. This pathology is diagnosed when weight increases by 20% of the average. According to medical statistics, women are susceptible to it 50% more often than the stronger sex. The peak development of pathology occurs between 30 and 60 years of age.

Treatment should include changes in eating behavior

The main reason for the formation of the disease is an imbalance between the amount of calories entering the body and their expenditure. Excess fat and carbohydrates are converted into fat cells, which are deposited in the subcutaneous layer.

Overeating and disordered eating behavior lead to nutritional obesity. Excessive, systematic consumption of large amounts of food provokes the replenishment of fat depots. The disease is also caused by impaired metabolism (5% of cases). At the same time, metabolism decreases and hormonal disturbances occur.

Weight gain can be triggered by a genetic predisposition or disruption of the endocrine system (insulinoma, hypothyroidism, Cushing's disease).

Disturbances in the functioning of the nervous system can also give impetus to the development of the disease: stress, depression, and insomnia cause psychological discomfort to “eat up.”

Types and stages of pathology

Based on the nature of fat deposits and their location, the following types of obesity are distinguished:

1. Femorogluteal— fat cells are formed mainly in the lower part of the body. This type is more common in women. The body takes on a pear shape. Accompanied by disturbances in the functioning of the veins of the lower extremities, joints, and spine.
2. Abdominal- characterized by accumulation of fat in the upper body. The abdominal area suffers the most. The figure takes on a spherical shape. This type of obesity is more common in men. The pathology is associated with the development of diabetes, stroke, and arterial hypertension.
3. Intermediate (mixed) type- characterized by an even distribution of fat deposits throughout the body.

Based on the rate of growth of the layer, a distinction is made between progressive and gradually increasing obesity. There are stable and residual stages of the disease. In the stable phase, primary weight gain occurs; in the residual phase, this is a consequence of sudden weight loss.

There are primary, secondary, endocrine types. Primary include pathologies caused by eating disorders, secondary include those based on genetic, hereditary diseases. The endocrine type is formed due to disruption of the endocrine glands.

How to calculate BMI

Body mass index (BMI) is used to classify the degree of obesity. To calculate it, you need to divide the patient's weight (kg) by the square of his height.

First signs and symptoms

The main symptom of the disease is a change in the patient’s appearance. Typical places for storing extra pounds are the stomach, thighs, buttocks, neck, and shoulders. Excess weight begins to cause dissatisfaction with one's own appearance among patients. Against this background, depressive disorders, increased irritability, and apathy often develop.

Due to the increased load on internal organs, most body systems malfunction. The gastrointestinal tract is most often affected. Heaviness in the stomach, nausea, and constipation appear.

Strongly increased weight provokes disorders of the musculoskeletal system. The patient may feel pain in muscles and joints. Peripheral edema appears.

Women are characterized by irregularities in the menstrual cycle. In later stages it can lead to amenorrhea.

Due to endocrine disorders, the condition of the skin and hair worsens. Severe sweating appears, skin oiliness increases, and the risk of developing skin diseases (eczema, furunculosis, pyoderma) increases.

Diagnostics

If you notice something is wrong, you will need consultations from different specialists (therapist, nutritionist, endocrinologist). It also wouldn't hurt to see a psychologist.

When diagnosing, a complete medical history is collected. The doctor draws up a genetic map, determines the minimum/maximum BMI indicators, and the duration of the period of weight gain. Particular attention is paid to the patient’s lifestyle and nutrition.

For successful diagnosis and subsequent choice of treatment, important attention is paid to calculating the body weight index. Among the necessary characteristics, the coefficient of distribution of adipose tissue is used. It is calculated based on the ratio of waist circumference to hip circumference. The abdominal type of disease is indicated by indicators exceeding 0.8 units for women and 1 for men.

Additionally, ultrasound, MRI, and CT are prescribed. Research allows you to more accurately determine the location and size of fat deposits. Through a blood test, the level of triglycerides, uric acid, cholesterol, and lipoproteins is determined. Be sure to determine glucose tolerance to exclude the development of diabetes mellitus.

Treatment methods

A nutritionist will help you create the right diet

The success of treatment directly depends on the patient’s wishes. Therefore, the competent work of a psychologist is important. A nutritionist develops an optimal nutrition system for the patient, and an exercise therapy instructor selects physical exercises to keep the body in good shape.

If the diet is ineffective within 12 days, they resort to drug intervention. Patients are prescribed drugs from the amphetamine group. They promote a quick feeling of fullness after eating.

If necessary, the doctor may prescribe fat-mobilizing drugs in combination with antidepressants (Adiposine, Fluoxetine). The drugs regulate eating behavior and help facilitate the process of weight loss.

Diet

Dietary nutrition consists of reducing the calorie content of food by 300-500 kcal. The main limitation is on carbohydrate foods and animal fats. Preference is given to boiled, steamed or stewed food. It is important to consume a sufficient amount of clean water - at least 1.5 l/day. Food is taken in small portions 5-6 times during the day.

The basis of dietary nutrition is non-starchy vegetables, lean meats and poultry, cereals, and fruits. Spicy, fried, salty foods and alcohol are strictly prohibited.

Prevention

To successfully prevent obesity, it is enough to monitor the balance of calories consumed and expended. To do this, you should adhere to proper nutrition and maintain minimal physical activity (sports).

If you are predisposed to the disease, you need to pay special attention to nutrition. Simple carbohydrates and fats should be excluded or limited. It is better to focus on fiber, protein, and plant foods.

To prevent the disease, specialist supervision is important. Once a year you need to visit an endocrinologist and nutritionist.

What to remember

1. If stage 1 obesity is suspected, the patient requires consultation with a therapist, nutritionist, endocrinologist, or psychologist.
2. Due to the increased load on internal organs, most body systems malfunction.
3. For successful prevention, it is enough to monitor the balance of calories consumed and expended.

Exogenous-constitutional obesity is a serious disease in which profound disturbances occur in the metabolic and enzymatic systems of the body.

As a result of this, there is an imbalance in the synthesis of fats and their consumption due to the low level of energy expenditure with excess energy intake.

What is nutritional-constitutional obesity?

Exogenous-constitutional obesity is otherwise called nutritional-constitutional. Alimentary means primary. It is caused by non-hormonal dysfunctions. On the contrary, obesity causes changes in the body's hormonal levels.

This disease does not affect young people; they usually have secondary obesity. Secondary is the result of diseases of the central nervous system or mental disorders.

Obesity of exogenous constitutional origin depends only on nutrition. This diagnosis is given to those who are prone to obesity and love fatty, carbohydrate foods. At the same time, it consumes an excess amount of food with very little energy expenditure. The body does not have time to spend all the energy it receives from food, and it turns into fat.

Fat is deposited on the chest, pelvic area, and thighs. For men - on the stomach. At very high levels of fat accumulation, this difference is not noticeable. Body weight is exceeded by 50 and even 70%. The danger is that some of the fat is stored in reserve around the internal organs, in the subcutaneous tissue. On the stomach, fat accumulates in the form of a huge fold.

Alimentary-constitutional obesity is caused by the following reasons:

• energy imbalance: increased calorie content and decreased calorie intake due to a sedentary lifestyle;
• systematic overeating;
• eating disorder: rare meals with large amounts of food at one time;
• often occurs among members of the same family or close relatives. In such families there is a cult of food, usually unhealthy and unbalanced.

Predisposing factors are also depression and stress. Many people, especially women, tend to eat up troubles.

Constitutional means that a person has an individual predisposition, his own eating habits, level of hunger, degree of energy expenditure, and physical activity.

This type of obesity is progressive. It is not hereditary and is not a consequence of any disease in the body. At the initial stage there may be no symptoms.

Adults after 45–50 years of age, housewives, and people with a sedentary lifestyle usually get sick.

Obesity levels

A common sign of obesity is being overweight. Depending on the amount of fat in the body, obesity:

• first degree - weight exceeds the norm by no more than 29%. I feel normal. There are no functional impairments. Ordinary lifestyle;
• Grade 2 – weight exceeded by 29–40%. Weakness, shortness of breath, drowsiness appear;
• third degree - weight exceeds the norm by 40% or more. Symptoms intensify, difficulties with physical activity appear;
• Grade 4 – weight exceeded by 50% or more. Poses a threat to life. Difficulty breathing, shortness of breath even at rest, inability to move. It is rare because people usually do not live to this stage.

With the first degree, no special changes are observed in a person’s life. At the second and third stages, metabolic disorders appear.

The risk of heart attack and stroke increases many times over. Problems with joints (arthrosis, arthritis), and the spine worsen.

Excessive sweating causes skin diseases. Swelling of the extremities is observed. Lipid metabolism is disrupted, which causes heart disease.

Obesity 2 degrees

When primary signs of excess weight accumulation appear, it’s time to sound the alarm, otherwise the disease develops into a condition in which functional disorders begin to appear in the body.

The body mass index at this stage is in the range of 31–36. In this case, nutritional obesity develops.

It is dangerous not only due to the manifestation of certain diseases. The danger is that the disease progresses and the weight increases.

In addition to the diseases mentioned, the following problems appear:

• renal dysfunction;
• hypertonic disease;
• angina pectoris, ischemia;
• low immunity, inability to fight infections (colds, flu);
• disorders in the sexual sphere, decreased libido;
• problems in the intestines and stomach;
• respiratory failure, cor pulmonale;
• eczema, furunculosis, acne, hyperpigmentation of friction areas;
• , breast cancer, uterine cancer.

Psychological problems arise associated with changes in appearance and the inability to lead a normal lifestyle.

The patient must make an appointment with an endocrinologist in order to immediately begin appropriate treatment. Many people miss this moment and consult a doctor only at stage 3, when health problems are so serious that there is no other way out except the clinic.

How is obesity treated?

For stage 1 obesity, the following therapy is used:

• diet – reducing total calories, limiting carbohydrate intake, excluding animal fats;
• regular physical exercise – gradual increase in loads;
• folk recipes for weight loss.

Treatment 2 degrees:

• a more strict diet - low-calorie foods, increased consumption of vegetables and fruits;
• increased physical activity – physical therapy taking into account age and health status;
• folk recipes - plants with a high fiber content, which give the effect of quick saturation: flax seed, angelica;
• Diuretic plants are used: lingonberry leaf, parsley root.

In difficult cases, medications are individually selected to reduce appetite and remove fluid.

Third degree

Requires drug treatment. First, a full examination is carried out, tests for hormones and sugar. The causes of obesity are identified. Appointed:

• diet, fasting days - strict restriction of carbohydrates, sugar. Fractional meals. Reducing portions;
• moderate physical exercise – exercise, walking. Gradual increase in loads;
• medications are used under the supervision of a physician.

Fourth degree

Diet and physical activity no longer help, they are even harmful. Treatment is mainly surgical. According to indications, the following is carried out:

• liposuction – removal of excess fat when life and health are threatened;
• vertical gastroplasty – vertical division of the stomach into 2 parts. The upper part quickly fills and saturation occurs;
• gastric bypass – removal of part of the stomach. There is less nutrition, the lack of vitamins and microelements must be replenished throughout life;
• pills are not prescribed because the body is sick. At this stage, the health condition is extremely serious. The patient is on disability.

Obesity is a very dangerous disease. It is very important to take care not to gain weight. This especially applies to those who are at risk for exogenous constitutional obesity:

• people whose parents were overweight;
• adults leading a sedentary lifestyle;
• young people with increased appetite;
• people with endocrine disorders;
• adults with gastrointestinal diseases;
• women taking hormonal drugs, contraceptives, psychotropic substances.

To avoid gaining excess weight, you must adhere to the following rules:

• reduce the consumption of salt, fast carbohydrates, sugar;
• reduce the total amount of food;
• excluding alcohol, as it stimulates the appetite and dulls the feeling of fullness;
• lead an active lifestyle with adequate physical activity;
• eliminate stress, depression, negative emotions;
• treat all concomitant diseases: diabetes, gastrointestinal disorders, thyroid.

Patients with alimentary-constitutional obesity make up more than 70% of all those who are overweight. This means that in most cases, the culprits for the accumulation of excess weight are the people themselves who lead an unhealthy lifestyle, eat incorrectly, and exercise little. Added to this are constant nervous overloads.

All these negative factors are quite easy to eliminate. This means that a person’s health is in his own hands.

Alimentary obesity (exogenous-constitutional) is a type of metabolic pathology in which hereditary factors do not play a significant role. External causes play a leading role in the development of this disease, but the influence of the initial state of the body on the process should not be excluded.

All factors contributing to the development of nutritional obesity can be divided into external and internal. External symptoms include regular overeating, the presence in the diet of large amounts of food rich in fats and simple carbohydrates (baked goods, sweets, pasta, fatty meat dishes, etc.), incorrect eating habits (not eating according to the schedule, eating high-calorie and heavy foods at night) . Today, the problem of a sedentary lifestyle as one of the key links in the pathogenesis of obesity is particularly relevant. Internal factors include metabolic diseases (diabetes mellitus, etc.). A special group consists of hormonal imbalances with excessive or insufficient function of the gonads that occur during pregnancy and lactation, and during menopause in women. In the anamnesis of almost every obese person there are relatives suffering to one degree or another from metabolic pathology, which indicates the invariable role of genetic predisposition to the disease.

According to UN estimates, the countries with the highest percentage of obese populations include the United States (32.8%), Mexico (31.8%) and Syria (31.6%). Russia occupies 28th place in this ranking, the level of the population with excess body weight is 24.9%.

Existing classification

Classification of degrees of obesity:

1. Excess body weight is 10-29%.
2. Excess weight – 30-49%.
3. Excess weight – 50-99%.
4. The actual body weight of a person exceeds the norm by 100%.

Types of obesity based on the location of adipose tissue:

1. Android (male) obesity is sometimes called central obesity. This type is characterized by the deposition of fat masses in the abdomen, armpits, lower back and back.
2. Gynoid (female) obesity - fat deposits occur in the chest, buttocks and thighs, and lower abdomen.
3. Mixed – relatively equal distribution of fat throughout the body.

The deposition of adipose tissue in the body is a genetically determined process that is controlled by sex hormones. With hormonal dysfunction in men or women, redistribution of adipose tissue may occur according to the type of the opposite sex.

Particular attention should be paid to the process of obesity of internal organs. With a slight excess body weight, its percentage is low, but the higher the degree of obesity, the more fat is distributed around the internal organs. It is possible to develop pathologies of fat metabolism, leading to inclusions of fat drops between the functional cells of organs, which leads to the development of dystrophies of the latter (“tiger” heart, fatty liver, etc.). Any dystrophy is accompanied by disruption or insufficiency of the organ, which leads to the appearance of concomitant diseases.

Clinical picture

In addition to fat deposits, nutritional obesity is characterized by some secondary symptoms. These include shortness of breath and respiratory failure, palpitations during exercise, and increased sweating. They arise due to an increase in the volume of circulating blood along with adipose tissue, but the heart has difficulty coping with such a load and requires the activation of compensatory mechanisms. Shortness of breath may be partly due to the increased size of the internal organs and the greater omentum, which press on the diaphragm from below, thus compressing the lungs. Against the background of a constant excess of lipoproteins in the blood, atherosclerotic vascular lesions develop, which underlies the development of coronary heart disease. Excess fat tissue can lead to the development of type 2 diabetes. Every fat person is a potential diabetic.

Striae may appear on the skin (white or red stripes, similar to scars, appear when a person recovers quickly, but the elasticity of his skin does not allow him to accommodate the sharply increased volume of tissue). Excessive sweating creates favorable conditions for the proliferation of pathogenic bacteria in the folds, which leads to pustular skin diseases. Constant excess pressure on the spine can lead to deformations and curvatures.

Diagnosis of obesity

The international standard for diagnosing obesity is body mass index. It is calculated using the formula: BMI = body weight (kg)/height² (m), (kg/m).

This indicator is very subjective, since it does not take into account the weight of a person’s muscle mass. Based only on body mass index, one can mistakenly assume that an athlete with well-developed muscles is overweight.

During inspection, the following indicators are determined:

1. The thickness of the skin fold on the abdomen, at the angle of the shoulder blade, and shoulder (the norm is up to 1.5-2 cm).
2. Waist circumference. For a man this figure should be less than 101-102 cm, for a woman - less than 87-88 cm.
3. Type of constitution (hypersthenics – people with a strong, stocky build) are most prone to obesity.

Necessary treatment

In order to reduce or get rid of obesity, a complete reorganization of lifestyle is required. The nutritionist prescribes such a patient a strict diet with limited fats and carbohydrates, gradually reducing the calorie content of the daily diet. Nutritional obesity is by no means cured by fasting. Meals are fractional, in small portions, up to 5-6 times a day. The patient is recommended to have moderate physical activity: walks in the fresh air, therapeutic exercises and physical education. If you feel well, the load can be increased.

Obesity is the excessive formation and deposition of adipose tissue in the human body. Usually occurs due to excessive intake of high-calorie foods and low physical activity. Over time, excess food is stored as fat. In our body, fat can be formed not only from fatty foods, but also from protein (meat, fish, eggs) and carbohydrate (sweets, baked goods) foods. Obesity is a disease characterized by excessive development of adipose tissue (excess weight more than 20% of normal).

With obesity, patients complain of increased appetite, especially in the afternoon, hunger at night, drowsiness, mood instability, irritability, sweating, weakness, shortness of breath. With significant obesity, Pickwick syndrome develops (hypoxia and drowsiness as a result of poor ventilation of the lungs).

Due to increased stress on the musculoskeletal system, osteoarthritis occurs. Changes in the cardiovascular system are manifested by arterial hypertension. Skin lesions can manifest as trophic disorders, furunculosis, seborrhea, small pink stretch marks on the thighs, abdomen, shoulders, armpits, hyperpigmentation of the neck, elbows and friction points. Women develop various menstrual cycle disorders, infertility; in men, decreased potency. There is a high risk of developing type 2 diabetes.

Types of obesity

Experts distinguish nutritional-constitutional, cerebral and endocrine forms of obesity. Reasons nutritional-constitutional Obesity is a genetic predisposition, constitutional characteristics, systematic overeating, poor diet (heavy night meals for example), a diet high in lipids of animal origin and easily digestible carbohydrates, physical inactivity. Cerebral obesity occurs as a result of traumatic brain injury, intoxication, brain tumors, and stress. Endocrine obesity is a manifestation of the pathology of the peripheral endocrine glands.

In the nutritional-constitutional form, fatty tissue is distributed evenly throughout the body; with hypothalamic-pituitary - fat deposits are located more in the face, shoulder girdle, mammary glands, abdomen and limbs; with hypoovarian - in the pelvis and hips.

There are 2 types of general obesity: male (abdominal) and female (gluteal). Based on the severity of the development of adipose tissue, 4 degrees are diagnosed: 1 - characterized by exceeding the ideal weight by 20 - 30%; 2 - by 30 - 50%; 3 - by 50 - 90%; 4 - more than 90%.

Obesity occurs in 12% of the population (women are 2-3 times more likely than men). Age over 40 increases the risk of developing this condition.

Degrees of obesity. Self-diagnosis of obesity

You can determine whether you are overweight by calculating your body mass index. It is quite simple to calculate - take your weight in kilograms and divide by your height squared in meters. With normal body weight, the body mass index is 18.5 - 24.5. With grade 1 obesity, the body mass index is 30 - 35. With grade 2 obesity, the body mass index is 35 - 40. With grade 3 obesity, the body mass index is more than 40.

A simple approximate way to diagnose obesity is to determine the thickness of the fat fold in the epigastric region (normally 1 - 1.5 centimeters, with obesity - more than 2 centimeters).

For example, with a height of 1 meter and 75 centimeters and a weight of 80 kilograms, the body mass index is equal to 80 divided by 1.75 squared. This will be equal to 26.12. It turns out that there is either a little excess weight or the person has an optimal physique, but is still far from obesity. True, this method of determining ideal weight does not pay attention to the difference between male and female figures, as well as to the percentage of fat and muscle tissue in the body. People who exercise and have a muscular physique will have the same body mass index as people who already have little body fat. However, body mass index remains the only internationally recognized criterion for assessing excess weight. For objectivity, when determining optimal proportions, it is necessary to pay attention to various data.

Obesity is a chronic problem; over time, “thanks to” it, the following diseases develop: diabetes mellitus, hypertension, myocardial infarction, cholelithiasis, varicose veins, arthrosis of the joints.

Causes of obesity

Obesity develops as a result of an imbalance between the amount of energy entering the body and expended during the day. People prone to weight gain usually gain much more energy than they expend. Excess energy accumulates and is deposited in the form of subcutaneous and internal fat. There are a number of reasons that contribute to the development of obesity: a sedentary lifestyle, genetic factors (heredity), disruption of the endocrine glands, a tendency to stress, constant lack of sleep, and frequent use of various diets.

Obesity treatment

Obesity must be treated in a comprehensive manner. It is imperative to include a certain diet and increase physical activity. A balanced low-calorie diet is recommended. .Limit energy consumption to 1200 - 1500 kilocalories per day. The diet is limited to easily digestible carbohydrates, fats of animal origin (at least 50% of lipids must be of plant origin), table salt to 5 grams per day, liquid to 1 - 1.5 liters per day. The diet should include 90 - 120 grams of protein, 40 - 80 grams of fat, 100 - 120 grams of carbohydrates and a sufficient amount of vitamins and minerals. High fiber foods are recommended to treat obesity. promoting rapid saturation. Meals are fractional, 5 - 6 times per day. 1 - 2 a week there are fasting days: protein (curd - 5-- grams of cottage cheese per day; meat - 250 - 350 grams of boiled meat or fish), carbohydrate (apple - 1.5 kilograms of apples and rice porridge from 75 grams of rice and 450 grams of milk; curd-kefir - 400 grams of cottage cheese and 700 milliliters of kefir). Complete fasting is possible only in a hospital setting or after preliminary self-preparation.

For increased appetite, anorexigenic drugs are prescribed: fepranon, teronnac, desopimon, fenfluramine. The course of treatment is about 1 - 1.5 months. Since this group of drugs has a stimulating effect, it is recommended to use them in the first half of the day. To stimulate lipolysis, adiposine and metformin are prescribed. In the initial period of treatment, it is possible to use diuretics: hypothiazide, furosemide or herbal preparations (birch buds and leaves, horsetail and others) - for 1 - 2 weeks. 3 - 4 degree obesity, initial manifestations of Pickwick's syndrome are indications for surgical treatment.

To enhance metabolic processes in alimentary obesity, cold procedures are prescribed - wet body rubdowns, douches, cool showers, contrast baths.

In case of nutritional obesity without disorders of the cardiovascular system, thermal procedures are indicated.

1. Light-thermal baths (55 - 60 C), for 10 - 15 minutes, every other day.

2. General wet wraps lasting from 45 to 60 minutes, followed by a rain shower at 36 - 37 C.

3. Thermal baths - hot fresh baths, baths with a temperature increasing from 35 to 41 C and hot dry air baths.

4. Finnish sauna or Russian steam room.

To improve the function of the endocrine, nervous, cardiovascular and digestive systems, mineral waters are used in the form of baths, swimming in a pool with mineral water, ingestion and intestinal lavages. Sulfide, carbon dioxide, radon, and chloride baths are used.

Treatment of obesity should be carried out over a long period of time, over 1-2 years. Body weight should decrease gradually. A rapid, significant decrease in it if the patient returns to his previous lifestyle has the opposite effect.

Among the physical methods of rehabilitation, physical therapy is of great importance in the treatment of obesity, morning hygienic exercises, dosed walking, sports exercises (running, rowing, swimming, cycling), outdoor and sports games are used. It is advisable to use occupational therapy and general massage.

An obesity treatment program must be developed individually for each person based on the state of health and the reasons that caused this problem. Some people need to pay more attention to nutrition, while others need to intensify their own physical activity.

You can learn more about various methods of losing weight here Weight correction

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