In the XXI century, the problem of obesity has affected everyone-regardless of social status, age, gender and place of residence. osteoarthritis, oncological diseases (cancer of the mammary glands, uterus, ovaries, prostate), disorders of the reproductive system (up to infertility). Obesity is a chronic disease that is characterized by a pathological increase in body weight due to adipose tissue.According to data for 2017, every second adult and every sixth child are overweight or obese. The United States is the leader in the level of obesity-38.2% of the population have this diagnosis; this indicator is lower than that of everyone in Japan — 3.7 %. According to the study, women with a lower level of education are 2-3 times more likely to be obese compared to more educated representatives of the weaker sex.
overweight — if the body weight/height ratio exceeds the average value specified in the Standard Indicators of Physical Development of Children (WHO) by more than two standard deviations;
obesity — if the body weight/height ratio exceeds the median value specified in the Standard Indicators of Physical Development of Children (WHO) by more than three standard deviations.
What is overweight and obesity?
Overweight and obesity are the result of the formation of abnormal or excessive fat deposits, which can be harmful to health.
The body mass index (BMI) is a simple ratio of body weight to height, often used to diagnose obesity and overweight in adults. The index is calculated as the ratio of body weight in kilograms to the square of height in meters (kg/m2).
Adults:
According to WHO, the diagnosis of “overweight” or “obesity” in adults is made in the following cases:
- BMI greater than or equal to 25 — overweight;
- A BMI greater than or equal to 30 is obese.
BMI is the most convenient indicator for assessing the level of obesity and overweight in the population, since it is the same for both sexes and for all age categories of adults. However, BMI should be considered an approximate criterion, since it can correspond to different degrees of completeness in different people.
In children, when determining overweight and obesity, age should be taken into account.
Children under the age of 5
In children under the age of 5, overweight and obesity are defined as follows:
- overweight — if the body weight/height ratio exceeds the average value specified in the Standard Indicators of Physical Development of Children (WHO) by more than two standard deviations;
- obesity — if the body weight/height ratio exceeds the median value specified in the Standard Indicators of Physical Development of Children (WHO) by more than three standard deviations;
Children aged from 5 to 19 yea
In children aged 5 to 19 years, overweight and obesity are defined as follows:
- overweight — if the BMI/age ratio exceeds the median value specified in the Standard Indicators of Physical Development of Children( WHO) by more than one standard deviation;
- obesity — if the BMI/age ratio exceeds the median value specified in the Standard Indicators of Physical Development of Children (WHO) by more than two standard deviations;
Symptoms and signs.
The most obvious and main sign of obesity is a noticeable excess weight, which a woman or a man may notice over time due to the development of the disease. It is possible to detect overweight or a complication of obesity in any part of the body: from the abdomen to the pelvis, and if the muscular system is not too developed, it becomes noticeable. Usually an obese woman and a man notice that the shape of the body has changed noticeably, a second chin has appeared, hanging folds of fat have formed on the stomach. As mentioned earlier, there are several degrees of obesity. Thus, at the initial stage, a person may not have any complaints at all.
Causes of obesity.
The onset of obesity is a violation of the balance between the consumption of calories (and, consequently, energy) together with food, on the one hand, and energy consumption (consumption of incoming calories), on the other. those calories that do not have time to be absorbed by the body turn into fat deposits that accumulate in the subcutaneous tissue, abdominal cavity, internal organs. An increase in the amount of accumulated fat leads to an increase in body weight, which, in turn, leads to malfunctions in the functioning of many systems. Most often, overeating leads to obesity (in more than 90% of cases), less often it is a metabolic disorder (5-7% of cases).
Eating disorders occur due to disorders of the regulation of the hypothalamus and pituitary gland, which are responsible for behavioral reactions. If the activity of the hypothalamic-pituitary-adrenal system increases, this will lead to an increase in ACTH products, as well as to an increase in the rate of cortisol secretion and an acceleration of metabolism. With obesity, the level of secretion of somatotropic hormone, which usually has a lipolytic effect, decreases. Obesity contributes to the development of hyperinsulinemia. In addition, the metabolism of thyroid hormones and the sensitivity of tissues to these hormones are disrupted.
Among other reasons that affect the development of obesity, we can distinguish:
- sedentary lifestyle;
- dietary deviations (significant consumption of carbohydrates and fats, salt and sugar abuse, regular alcohol consumption, overnight dinners);
- genetic predisposition (violations of enzymatic activity, including the activity of lipogenesis enzymes, a decrease in the activity of cranial enzymes acting on the breakdown of fat);
- endocrine pathologies (insulinoma, hypothyroidism, hypogonadism, Itsenko-Cushing’s disease).
In addition, among the possible causes of obesity, overeating of a psychogenic nature, such natural conditions of the body as pregnancy, menopause or lactation are distinguished. Stress, lack of sleep and the use of hormonal drugs can also be a possible cause that serves as the beginning of obesity.
Symptoms of obesity
The main symptom of obesity is overweight. Excessive fat deposition is clearly noticeable on the abdomen, trunk, sides, back, thighs, nape, in the pelvic area. The second characteristic symptom of obesity is the underdevelopment of muscle mass.
A change in the appearance of a person: the appearance of a second and even a third chin, the development of pseudogynecomastia, the appearance of an “apron” (fat folds on the abdomen) and “breeches”on the hips — is characteristic of the diagnosis of”obesity”. In addition, with obesity, an umbilical or inguinal hernia is also often found.
People with obesity of I or II degree may not particularly complain about health problems.
As a result, the most accurate diagnostic results can be obtained, including the determination of the localization of fat deposits, their volume and ratio to the total body weight:
- Ultrasound;
- nuclear magnetic resonance;
- Computed tomography;
- X-ray densitometry.People with a diagnosis of “obesity” should regularly consult a nutritionist, a neuropsychiatrist and a physiotherapy instructor.
Complications of obesity
In addition to the psychological deviations that obesity leads to, overweight people can suffer from the following diseases:
- diabetes mellitus;
- hit;
- heart failure;
- cirrhosis of the liver;
- cholelithiasis;
- sleep apnea syndrome;
- arthritis;
- arthrosis; polycystic ovary syndrome;
- decreased libido;
- menstrual cycle disorders.
This is not the whole list of complications that obesity provokes. Obesity is the cause of oncological diseases: breast, uterine and ovarian cancer in women, prostate cancer in men. In addition, obesity increases the risk of sudden death.
Treatment of obesity
The goal of treating obesity in different people arises from the desire to look good, achieve the desired cosmetic effect, reduce the health risk, improve performance, and so on. However, the treatment of obese patients by doctors has one goal-to reduce the risk of a number of diseases and complications associated with obesity.
Treatment of any type and degree of obesity begins with the appointment of a certain diet and exercise.
The main drugs prescribed for the treatment of obesity:
drugs of the amphetamine group (regenone, dezopimone, fepranon and mirapront): their action is based on the suppression of hunger, a rapidly arising feeling of satiety and anorexic effect. Drugs of this group also have side effects: nausea, dry mouth, increased irritability, allergies and insomnia;
the combination of adiposin (a drug that immobilizes fat) with the antidepressant prozac, which can correct eating behavior;
drugs of meridia (for example, sibutramine) and xenical-do not cause serious side effects, accelerate the arrival of saturation, reducing the amount of food consumed. In addition, xenical helps to reduce the absorption of fat components.
Symptomatic therapy of existing diseases in obesity will be required. Psychotherapy in the form of conversations or hypnosis can also be prescribed in order to change the attitude to food and correct the patient’s eating behavior.
Surgical treatment will be prescribed only in the case of obesity of the III or IV degree. Most often, gastric banding surgery or vertical gastroplasty, as well as liposuction, is performed.
To always stay in good shape, have a normal weight, it is necessary to adhere to some rules for the prevention of obesity: eat right; arrange fasting days; lead an active lifestyle; give up bad habits. Following these simple recommendations will help you maintain your normal weight, be healthy and active.