An alimentary obesity (exogenous constitutional) is a kind of pathology of metabolism, in which hereditary factors do not play a significant role. The leading importance in the development of this disease has external causes, but also the influence of the initial state of the body should not be excluded.

All factors contributing to the development of alimentary obesity can be divided into external and internal. There is a regular overeating, the presence in the diet of a large number is rich in fats and simple food carbohydrates (bakery products, sweets, pasta, fatty meat dishes, etc.), irregular food habits (nutrition not by regime, welcome high calorie and heavy food at night) . To date, the problem of a sedentary lifestyle as one of the key stones of the pathogenesis of obesity is particularly relevant. Internal factors include metabolic diseases (diabetes mellitus, etc.), a special group is made up of hormonal imbalances with an excessive or insufficient function of the sexual glands, occurring during pregnancy and breastfeeding, with menopausis in women. In the history of almost every obese person, relatives are present, suffering in one way or another pathology of metabolism, which indicates the constant role of genetic susceptibility to the disease.

According to UN calculations, countries with the highest percentage of obesity population include US (32.8%), Mexico (31.8%) and Syria (31.6%). Russia in this ranking takes 28 string, the level of population with excess body weight is 24.9%.

Existing classification

Classification of the degrees of obesity:

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

Types of obesity for the placement of adipose tissue:

1. Android (male) obesity is sometimes called obese in the central type. This type is characterized by the deposition of body fat in the abdomen, axillary depression, loins and backs.
2. Ginoid (female) obesity - fat deposits occur in the field of chest, buttocks and hips, lower abdomen.
3. Mixed - relatively equal distribution of body fat.

The deposition of adipose tissue in the body is a genetically deterministic process that is controlled by sex hormones. In hormonal dysfunction in men or women, there may be a redistribution of adipose tissue in the opposite sex.

Special attention should be allocated to the process of obesity of the internal organs. With a small excess of body weight, the percentage of its low, but the higher the degree of obesity, the more fat is distributed around the internal organs. It is possible to develop pathologies of fats, leading to the inclusions of bodybresses between functional cells of the organs, which leads to the development of the latter dystrophy ("Tiger" heart, liver dystrophy, etc.). Any dystrophy is accompanied by a violation or failure of the body, which leads to the emergence of concomitant diseases.

Clinical picture

In addition to fat deposits, alimentary obesity is characterized by some secondary symptoms. These include shortness of breath and respiratory failure, attacks of heartbeat with load, high sweating. They arise due to an increase in the volume of circulating blood with a fatty tissue, but the heart with such a load copes hard and with the inclusion of compensatory mechanisms. The lack of breathing can be partly due to the increased size of the internal organs and the large gland, which are pressed on the diaphragm below, squeezing the lungs. Against the background of permanent excess of lipoproteids in the blood, atherosclerotic damasses of vessels are developing, which underlies the development of coronary heart disease. Excess adequate tissue can lead to the development of a sugar diabetes of a second type. Each thick man is a potential diabetic.

Skry (white or red stripes, similar to scars, arise on the skin, arise when a person is rapidly recovered, but the elasticity of his skin does not allow to accommodate a sharply increased volume of tissue). Excessive sweating creates favorable conditions for breeding in the folds of pathogenic bacteria, which leads to mine-skinned skin diseases. Permanent overpressure on the spine can lead to its deformations and curvatures.

Diagnosis of obesity

The international standard in the diagnosis of obesity is the body mass index. It is calculated by the formula: BMI \u003d body weight (kg) / Rost² (M), (kg / m).

This indicator is very subjective, since it does not take into account the weights of the human muscle mass. Relying only on the body mass index, it is possible to erroneously calculate that the athlete with a well-developed muscles suffers from excessive weight of the body.

When inspection, the following indicators are determined:

1. The thickness of the skin fold on the stomach, at an angle of the blade, shoulder (the norm is up to 1.5-2 cm).
2. Waist girth. For a man, this indicator should be less than 101-102 cm, for a woman - less than 87-88 cm.
3. The type of constitution (hypersthenics are most inclined to obesity - people of a strong, autonomy physique).

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Necessary treatment

In order to reduce the degree or get rid of obesity, a complete reorganization of lifestyle is required. A nutritionist prescribes a strict diet with a restriction of fats and carbohydrates, gradually reducing the calorie content of the daily diet. An alimentary obesity in no way treats starvation. Food fractional, small portions, up to 5-6 times a day. Moderate physical activity is recommended for the patient: walking in the fresh air, therapeutic gymnastics and physical education. With good well-being, the load can be increased.

During pregnancy, the female organism begins to rebuild. Therefore, during this period, it is so important to keep the condition of both women and the fetus under control. According to medical statistics, a rather large number of pregnant women has a violation of blood flow. Additional in the body, requires constant control of specialists. His violation is able to lead to the death of the fetus, and this may happen at any time of pregnancy. We will try to figure out why blood flow during pregnancy is disturbed.

A bit of theory

Everyone knows that the placenta acts as a binder between the organism of a woman and the fruit. In this complex system, two types of blood circulation are distinguished - placental and fruit. Any violation of one of them can lead to sufficiently sad consequences, including the development of a variety of diseases. The severity of the problem appreciates only the doctor.

In this case, the woman in the 30th week of pregnancy should be sure to undergo a special ultrasound diagnostics, on which the vessels of the placenta in the three-dimensional image are clearly visible. If there is any violation, the doctor will definitely sees it, since the change in the spatial ratio of the uterine and fruit-placental blood circulation occurs. This is a very dangerous state of the body, since the respiratory oppression occurs, and the development of the fetus is suspended.

Degree violations

Medicine distinguishes three severity of this pathology. The very easiest is the first degree when insufficient blood circulation has not yet reached its critical values. In this case, the hemodynamics of the fetus is in satisfactory condition. Disturbance of the uterine-placental blood flow 1 A degree and insufficient fruit and placental blood circulation of 1 would be distinguished.

The second degree is characterized by a deterioration in the blood supply to the fetus. In 50% of cases, there is a decrease in the maximum blood progress rate through all heart valves, and such a violation is observed in the fetus, and in the uterine arteries.

Quite often in a short period of time the second degree passes to the third. In this case, the bloodstream practically ceases to flow to the fetus, which can cause its hypoxia. The likelihood of a decrease in diastolic blood flow in the aorta, and in some cases it can completely disappear.

The reasons

If there is a violation of blood flow 1 degree during pregnancy, the reasons leading to this may be different. Numerous adverse factors are able to influence the placenta not only during its formation, but also at later deadlines. Medical practice allocates primary and secondary due to which the functioning of the placenta, which acts as a transport, protective, immune, exchange and endocrine body is disturbed.

Thus, violation of blood flow 1 A degree during pregnancy can occur for the following reasons:

• tumor of the uterus;
• genetic defects;
• consequences of abortions;
• infectious diseases;
• hypertonic disease;
• diseases of adrenal glands and thyroid gland;
• abnormalities of the structure;
• hormonal dysfunctions;
• thrombosis, atherosclerosis;
• diabetes.

If you cannot fix this pathology in a timely manner, then 6 weeks later, a slight bleeding disorder is capable of moving to the third stage. When a problem is detected at the 30th week, a doctor still has enough time to take appropriate measures to restore normal blood circulation.

Symptoms

Any pathology is characterized by its clinical picture, so that the doctor can make the appropriate conclusion. The lack of hemodynamics leads to a change in the functioning of the placenta, which is why the fruit begins to suffer. The necessary nutrients and oxygen begin to enter it in a limited quantity, and the exchanging products are slowed down. Signs begin to appear as a result of which its intrauterine development is suspended.

Thus, if a circulation of blood flow occurred during pregnancy, the symptoms of this state are manifested as follows:

• heart palpitations;
• reducing or improving the motor activity of the fetus;
• non-compliance with the volume of belly to a specific period of pregnancy.

Such signs usually occur with a decomposed form if the uterine blood flow discrounds during pregnancy 1 A or 1 would, then these symptoms are not yet manifested, since hemodynamics are compensated. It is usually detected in diagnostic studies.

Diagnostics

To identify violation of blood flow 1 A degree during pregnancy, you need to pass a number of surveys, with which the view and the degree of changes have arisen, and also determine the state of the fetus. In this case, the doctor prescribes the following procedures:

• blood test for such hormones such as estrogens, chorionic gonadotropin, progesterone;
• cardiotocography;
• ultrasound procedure;
• dopplerometry.

In some cases, the doctor already during inspection is capable of determining the impaired disorder, focusing on the frequency of heart abbreviations of the child, which are calculated during auscultation. But the most reliable results are usually obtained after a laboratory and instrumental research.

Treatment

Violated any extent must be treated. Basically, therapeutic measures are aimed at ensuring that pathology does not progress in the future. Hemodynamics is normalized only if the violation of blood flow 1 would be revealed.

When pregnancy proceeding with deviations, various means that improve the state of the fetus are used. Conservative treatment methods are mainly used. Surgical intervention is possible only in the case of complications and in vital testimony. When normalizing blood flow disorders, a set of measures is used - pathogenetic, etiotropic and symptomatic treatment.

Medicia treatment

Most often, violation of blood flow 1 and degree during pregnancy is corrected using drugs. When identifying initial signs of violation, the treatment is carried out outpatient. A more pronounced insufficiency of blood circulation requires hospitalization in the hospital.

For treatment, the following drugs are used:

• spasmolitics - "Eufillin", "but-shp";
• vascular - "Aktovegin";
• antiagregants - "Kuraltil";
• vitamins and trace elements - "ascorbic acid", "Magna B6";
• hepatoprotectors - "Hofitol", "Esssential";
• tocolitics - "PARTASISTEN", "GINIPRAL";
• improving blood microcirculation - "Trental";
• antihipoxants - "Instenon";
• metabolic - "ATP".

Usually, two course of therapy is carried out to improve the condition - immediately after the diagnosis was made on the period of 32-34 weeks. After that, the doctor decides the question of the way of delivery. This is especially important if the circulatory disorder is wearing the blood flow of 1 degree of childbirth are carried out naturally.

Surgery

If the violation of blood flowes is pronounced, an emergency delivery is carried out. In case of intactness of conservative treatment, even in the case of a light impairment, the decision is made within two days. The cesarean section is usually carried out. If it is planned under the period of pregnancy less than 32 weeks, then the state of the fetus and its viability is assessed.

Preventive measures

To avoid such a pathological condition, as a violation of blood flow 1 A degree during pregnancy, prevention measures should be carried out. A woman who is waiting for a child should use products containing the necessary vitamins, micro and macroelements, fats, carbohydrates and proteins. Every day you should use no less than 1.5 liters of fluid, but only if the edema is not tormented.

It is also important to keep your weight under control. During pregnancy, the recommended increase in weight should not exceed 10 kg. Women from a risk group conducts prevention of drugs to interact the organism of the mother and fetus and prevent the extremely dangerous dysfunction of the uterine-placental blood circulation. An important role is played by a timely adjusted method of childbirth. But it should be remembered that even the observance of these measures does not exclude the occurrence of severe neurological complications.

Output

Thus, it is important to control blood flows during pregnancy. Causes may be different. The main thing is to follow your health, and the timely identification of pathology will help prevent severe consequences for the future child.

Obesity is an excessive deposition of fat in the human body. It can grow from the initial stage into the last - the fourth, which will cause the most serious consequences. Why obesity arises and how to be treated, you can learn more.

The degree of obesity by body mass index

Depending on how excessive fat deposits in the body are larger than muscle mass, 4 degrees of obesity on body mass index are distinguished.

The body mass index (BMI) is a calculated value that helps to evaluate whether there is excess or insufficient weight. It is calculated by dividing body weight (kg) of a person per square of its growth (M).

If BMI within 20.0-25.9, then a person over 25 has a normal weight. When BMI is equal to 26-27.9, this suggests that a person has an overweight body.

Eliminate the next degrees of obesity.

BMI will be located for people over 25 years old in the boundaries of 28.0-30.9, for 18-25-year-olds - 27.5-29.9.

2 degree

Appears pain in the spine and joints, abundant sweating. Lipid exchange is disturbed, which provokes heart disease. Fat deposits are 30-50% of the muscle mass of the body, and BMI for people over 25 years old - 31.0-35.9, for younger (from 18 to 25 years) - 30.0-34.9, respectively.

In obesity of the second stage, the risk of disorders of the endocrine system and metabolism increases.

3 degree

Body mass exceeds normal performance by 50% or more. Obesity is heard hard, the person suffers from shortness of breath, poorly tolerates physical exertion. Complications arise - arthrosis of the joints, strokes, heart attacks.

BMI corresponds to 36.0-40.9 for 25-year-old people and older, and 35.0-39.9 for younger age (18-25 years).

Normal body weight is a weight that corresponds to a certain human growth, given its physique.

4 degree

Weight is greater than the norm 2 times or more. This stage is rare, since the patients simply do not live to it. They usually do not leave the beds, they cannot move, shortness of breath torments even at rest. Often, the body shape takes a monstascular character, a person resembles a monster with a shapeless body consisting of fat mountains.

BMI will show 40.0 and higher for 18-25-year-old people and 41.0 and higher for older.

Causes of obesity

There are many reasons that cause this disease - from overeating to hormonal disorders. Therefore, there are two main obesity groups:

Exogenous

Types of exogenous obesity:

• Alimentary-constitutional obesity. The main reasons are hypodymna, the cult of food (overeating, improper nutrition, passing fast food), stress, depression. It relates to family diseases. In these families, all households usually have one of the degrees of obesity. And also this species is characteristic of female, especially women who oversail a 40-year-old frontier. There is a violation of the energy balance. All the energy that enters the body is fully consumed, and is postponed in the form of adipose tissue.
• Exogenous constitutional obesity. It is progressive. People with sedentary work and Fastfud lovers are subject to him. But it differs from the previous one that is not wearing inheritance and is not a consequence of any disease.
• Visceral obesity. Fatty tissue is not postponed in the subcutaneous layer, but is localized around the internal organs. He is subject to both men and women. "Beer stomach" refers to this type. It is more difficult to treat and provoke diabetes, since it is associated with a violation of metabolic processes in the body.

Identify visceral obesity, if you measure the waist girth. The norm is considered the length of the waist circumference in women up to 80 cm, in men - no more than 95 cm. If the indicators are above these values, it means that it is time to take action.

Endogenic

Endogenous types of obesity are as follows:

• Cerebral obesity. Arises due to injury, inflammation and neoplasms (malignant and benign character) of the brain. Not hereditary disease.
• Endocrine obesity. Arises against the background of the dysfunction of the hormonal system, during diseases of the pituitary and pituitary glands, the pitpofunction of the thyroid and sex glands. Also not wearable.

These two obesity are hard to cure, because it is necessary to treat it together with the main disease that causes this ailment.

Treatment of obesity

The approach to the treatment of obesity depends on the degree of illness.

Obesity 1 degree

For the treatment of obesity 1 degree use a set of measures:

• Diet. Reduce the daily calorie content of the diet, reduce the consumption of carbohydrates and lipids. Feed fractionally, replace animal fats with vegetable oil.
• Physical exercises. Regularity is important here - it is impossible to be lazy to be lazy. Pick up the set of exercises and begin with 3-5 repetitions, gradually increasing the number of repetitions and exercises. The weight loss process will take a lot of time, it is not worth a quick result.
• Ethnoscience. Also restore the normal weight will help traditional medicine. For example, daily drink infusion from ginger. Take 50 g of a fresh ginger root, crushed it and pour 1 liter of boiling water. There is also half a lemon, sliced \u200b\u200bon slices, and a little fresh mint. Leave to stand and drink 1 cup before meal.

It is important to note that during obesity is appointed by a medical diet as a doctor - Table number 8, with which you can find from the video:

Obesity 2 degrees

With 2 degrees of obesity, they are also prescribed:

• Dietherapy, but it will be more strict. The nutritionist will pick a small-calorie diet in which vegetables and fruits will be the main products.
• Daily exercise, a specialist can be directed to therapeutic physical culture, given the age and state of the patient's health.
• Fitotherapy. Use herbs that create the effect of saturation and reduce appetite, since they will bury in the stomach. These are flax seeds or Dyagil medicinal. Effective diuretics - a lonely sheet, parsley root.

In advanced cases, drugs are prescribed, which are aimed at a decrease in appetite and output of excess fluid from the body. Preparations pick up the doctor for each patient individually.

Obesity 3 degree

With 3 degrees of obesity, the examination is first passing - they give blood to hormones and sugar and with the help of a doctor reveal the reason that provokes a set of excess weight. Apply:

• Diet and unloading days, limit in the diet of carbohydrates and sugar. Feed fractionally, reducing portions.
• Physical exercise. They are performed at a moderate pace at the initial stage. Start with morning charging, walking for short distances. More actively engage when the weight is significantly reset.
• Medical treatment. Medicinal treatment is prescribed only by a specialist.

With 3 degrees of obesity, the patient will not cope independently and only in tandem with the doctor will achieve a positive effect from treatment.

Obesity 4 degrees

With 4 degrees, treatment is under the supervision of the attending physician. In addition to diet, exercise, treatment of related diseases, surgical intervention is used:

• Liposuction - Remove excess adhesive tissue if the patient hangs over the patient's life. As a result of the operation, the load on vital organs is reduced.
• Vertical gastroplasty - Vertically divided the stomach into two parts. After surgery, the upper part of the stomach becomes smaller in volume, and therefore fastest fill in food and the saturation occurs.
• Gastrunkingin which isolate the small part of the stomach. As a result, the patient gets less meal, but after surgery it is necessary to use vitamins and minerals throughout life.
• Biliopancreatic shunting. Remove part of the stomach. And as well as in the previous case, the reception of vitamins and minerals is needed all life.

The drug treatment method with 4 degrees is rarely prescribed, since the body is in a difficult state. A person with such a stage is considered severely ill who has all the vital organs.

Obesity liver and its treatment

Fat hepatosis is one of the common diseases of this species, in which the liver tissue is reborn into fat.

The reasons

The main reasons are:

• abuse of fatty food and alcohol;
• violation of exchange processes;
• lack of vitamins and proteins in the diet;
• chronic poisoning substances.

Development of hepatosis

In the early stages of development, the disease, especially caused by endocrine disorders, may not be exercised for a long time. Patients usually complain about disorder of digestion, nausea, vomiting. With progressive disease, jaundice is observed, which is accompanied by a skin itching. The patients have a liver.

Since the initial symptoms are characteristic of various diseases of the gastrointestinal tract, it is necessary to visit a specialist and pass the survey to establish an accurate diagnosis and appointment of the optimal treatment option.

The main task is to find a factor that provoked a fat hepatosis. Therefore, the patient should be ready to abandon the bad habits or to get away from harmful production.

During treatment, and after him, a person must adhere to a strict diet. From the diet, all fatty products are excluded - meat, fish, dairy, as well as canned food, smoke, sdobu and roasted dishes. And, of course, you should forget about any use of alcoholic beverages.

In addition to the diet, the doctor may assign a vitamin course or medication therapy. In some cases, take medicines until the end of life. And also pay special attention to lipid exchange, if necessary, adjust it with anticillary drugs.

With a non-time-started treatment, hepatosis can go into a form of chronic hepatitis or liver cirrhosis.

Treatment of obesity of the liver folk remedies

In folk medicine there are several recipes that help the liver free from adipose tissue:

• Infusion of Shipovnika. 100 g of dry rose hips fall asleep into the thermos and poured boiling water, insist 8 hours. Drink in the infusion of 200 ml 3 times a day.
• Apricot bones. A day is eaten no more than 6 nuclei borders of apricot, they prevent fat savings in the liver. However, you should not get involved in them, as they contain a small amount of cyanide.
• Lemon bones. Contribute to restoration of liver cells. To do this, they need to grind and mix with an equal number of honey. Take 1 teaspoon on an empty stomach.

Prevention of obesity

Obesity is a dangerous disease, so it is better to prevent it than to fight him for a long time. This is especially true for persons in the risk area. It:

• people who have parents suffer from overweight;
• people leading a low-effective lifestyle due to profession;
• lovers to eat well;
• people with diseases of the endocrine system and the gastrointestinal tract;
• people taking medicines are hormonal, contraceptives and psychotropic drugs.

Preventive measures:

• Restrict the consumption of food salts, and carbohydrates. Monitor the number of food consumed.
• Limit the consumption of alcoholic beverages that excite appetite and reduce saturation sensitivity.
• Lead an active lifestyle that helps burn cyocaloria.
• Improve psycho-emotional state. Since stress, depression, negative emotions, a person usually "hires" food.
• Treaty of concomitant diseases - diabetes, thyroid dysfunction.

E66 Obesity

Epidemiology

Since 1980, the number of people with obesity in some regions of North America, Great Britain, Eastern Europe, the Middle East has grown three times. Obesity indicators in the United States for the same period increased by 100%. The African continent (south of the Sahara) is the only region of the world whose residents do not suffer from obesity.

According to WHO information, as of 2014, over a global scale is obese more than 600 million adults (which is 13% of the population). More often it is celebrated in women.

But the special concern of experts of the International Association for the Study of Obesity (IASO) causes an increase in the number of children with obesity. Almost 42 million children under the age of five have either an overweight body, or diagnosed obesity 1, 2 and 3 degrees. The highest risk of obesity development in childhood in Malta and in the United States (25%), and the lowest in Sweden, Latvia and Lithuania.

Even in Africa, the number of children of this age category, which have overweight or obesity 1 degree, has almost doubled - from 5.4 million in 1990 to 10.6 million in 2014.

About half of these children live in Asia countries. For example, in China, each tenth city child has obesity. This is associated with increased consumption of carbohydrates, and not fats.

Causes of obesity 1 degree

Obesity is a complex heterogeneous disease, and more and more often doctors call it metabolic syndrome. Exogenous and endogenous risk factors of its development consist of excessive food consumption (unspent energy is maintained in the body in the form of fat), hypodynamines (lack of combusting calories of physical stress), endocrine disorders, genetic mutations and family (hereditary) predisposition.

With overeating and hypodynamics, everything is clear. Moreover, the energy spent, which gives a person, is crucial, because, as it turned out, muscle loads contribute to the release of FNDC5 membrane muscles (irisin) from the fabric of the skeletal muscles. The experimental way is proved that irisine can regulate the participation of visceral adipose tissue and subcutaneous fatty tissue in thermogenesis, that is, it behaves like a hormone adiponectin produced by white adipose cells and involved in the regulation of the level of glucose and oily acid cleavage.

The key causes of obesity of 1 degree lies in the metabolic disorders of white adipose tissue, with an excess of which is characterized by this pathology. The adipocytes are formed by adipocytes, which are increased due to the increased level of triacylglycerin accumulated in them (Tag).

Two main processes occur in adipogenesis (lipogenesis) - cell differentiation, as a result of which predadipocytes become full fat cells, and lipolysis - splitting contained in adipocytes TAG. Products of this splitting in the form of fatty acids are highlighted in a vascular system for use as energy substrates.

Since its functions (accumulation of Tag and its remobilization) White adipose tissue can be normally carried out under the balance of both biochemical processes, the pathogenesis of obesity is associated with the disregulation of this equilibrium. As a rule, it is a decrease in lipolyase intensity, which is regulated by numerous hormones, enzymes and polypeptide mediators.

The splitting of triacylglycerol requires specific lipolytic (hydrolylase) enzymes present in adipose tissue (ATGL, HSL, MGL) and coded by certain genes. The body can miss these enzymes. The deficiency of adiponectin already mentioned the hormone of adiponectin already leads to obesity, for the sufficient synthesis of which the AdipQTL1 gene is responsible. In the accumulation of extra fat mass, malfunctions in the FTO gene can be to blame, which encodes the dioxigenase enzymes of the hydrolyzes family catalyzing Tag splitting. Any mutations and polymorphism of these genes may determine the deficit of substances providing the metabolism of fat cells. For example, in people with two copies of the allele of the FTO gene, the weight average is 3.5 kg more, and they have a higher risk of developing obesity and diabetes mellitus.

The detection of the amino acid peptide of Grethin (secreted in the stomach and the proximal part of the small intestine), which increases the appetite, glucose oxidation and lipogenesis is also played by the same role. Grethin is the only substance that stands out in response to a decrease in the contents of the tract and is suppressed when it is replenished during the food process. Already in obesity of 1 degree, as in patients with insulin resistance, levels of Great chronically low. At the same time, the visceral adipose tissue is more sensitive to the lack of Grelin than subcutaneous, and this means that the deposition of lipids will occur mainly in the visceral fatty depot. The relationship of Glimin deficiency with G274A and GHS-R genes is identified.

In addition, frequent causes of obesity of 1 degree are such endocrine disorders, such as the increased production of the pancreas enzyme lipase and hormone insulin, insufficient level of thyroid hormones (triiodothyronine). For example, when the blood glucose level increases, endogenous insulin does not just reduce it, and at the same time inhibits the secretion of the counter-regulatory hormone of the Glucagon pancreatic, one of the functions of which is to stimulate lipolysis. So insulin actually prevents glucagon to fight fat.

A no less important role in the pathogenesis of obesity is played by certain pathological changes in the work of certain brain structures, in particular the front lobes of the pituitary gland (adenogipophiz). So, prevent the splitting of TAG low level of stimulating lipolysis of the Somatotropin hormone and increased production of adrenocorticotropic hormone (ACTH). Due to excess Aktg, the bark of adrenal glands begins to produce more cortisol, which leads to an increase in blood sugar content and inhibiting triacylglycerol cleavage.

A direct ratio of sex steroids (estrogen, testosterone), somatomatin (IGF-1, insulin-like growth factor-1), catecholamines (adrenaline, receptors of which are available in adhesive tissue) are directly related to the process of accumulation and splitting of adhesive tissue cells. They are triggers of G-protein receptors, and their signals (passing through an adenylate cyclase signal transduction system) affect the activation of lipolytic adrenal tissue enzymes.

Obesity 1 degree quite often observed in schizophrenia and schizoaffective disorders, protracted depressions, as well as with bipolar and panic disorders of the psyche and agoraphobia (fear of open spaces and crowders).

Drug obesity can be provoked by atypical neuroleptics, tricyclic antidepressants, hypoglycemic drugs of the group of thiazolidine eds, sulfonylurea drugs, steroids, some anticonvulsant drugs and hormonal contraceptives.

Symptoms of obesity 1 degree

The first signs of the presence of obesity are extra kilograms. The weight of a person is considered normal under the body mass index (BMI) 18.5-25. The BMI is usually expressed in kilograms per square meter (kg / sq. M) and is calculated by dividing the human weight indicator on the indicator of its growth erected.

How to figure it out? Divide your weight in kilograms to your height in meters, and then the result obtained is once again divided into growth rate. For example: if you weigh 70 g with an increase of 1.75 m, 70 should be divided by 1.75. Answer 40. Then divide 40 by 1.75 and we obtain the body mass index - 22.9 (22.85). This is excellent, that is, healthy BMI!

Weight considers it simply excessive when BMI is 25-30, and the BMI is 30-35 indicative of obesity of 1 degree.

According to endocrinologists, subject to the lack of complications of the symptoms of obesity of 1 degree do not appear before the initial stage transition to the progressive. But then heaviness can occur in the stomach, belching, flatulence, headaches, shortness of breath with tachycardia, attacks of weakness and hyperhydrosis.

In general, the specifics of symptomatics determine the types of obesity, which endocrinologists differ depending on the cause per exogenous and endogenous. And all of the above concerns primary obesity, that is, developing due to overeating and hypodynamics. This type of excessive accumulation of adipose tissue has such names such as an alimentary obesity of 1 degree, or an alimentary-constitutional obesity of 1 degree, or exogenous-constitutional obesity of 1 degree.

All other reasons for the development of obesity are endogenous (see the previous section), and pathology can be diagnosed as obesity endocrine (hormonal, pituitary, hypothyroid, diabetic, etc.), cerebral (hypothalamic) or hereditary. In a word, the separation of obesity on species is not distinguished by strict unification.

And on where the fat accumulates, the types of obesity accumulate: abdominal (other terms - top, central, android or male) with a characteristic increase in fat tissue in the abdominal region (on the abdomen) - both under the skin and due to visceral (intra-abdominal ) fat; femoral-berical (female or hyneoid); Mixed (most frequent with endocrinopathy).

Clinical practice has shown that obesity 1 degree in abdominal type has more serious complications.

Obesity 1 degree in women

Describing obesity of 1 degree in women, it should be noted the most important role of sex hormones in the regulation of the energy balance. First of all, this is the ratio of androgens and estrogen.

Even with a relatively normal mode of food, women may have problems with the regulation of gomeostasis of adipose tissue. Thus, when the testosterone is insets, hyperagrances are developing, often associated with increased accumulation of visceral fat; It also occurs in cases of the presence of polycystic ovary syndrome in women, and during menopause.

Why is the normal estrogen level so important? Because the sex hormone of female ovaries can activate the synthesis of a pituitary neuropeptide alpha-melanocystimulating hormone, which induces a number of catabolic effects, including splitting fat savings. In addition, the effect of estrogen in the hypothalamus increases the local activity of leptin, inhibiting food intake and an increase in energy consumption.

Obesity 1 degree during pregnancy can occur as excessive gestational weight gain. Pregnant women recover by 10-18 kg, and this is due to hormonal changes in the body and the biological and physiological needs of this state. However, the obesity of the future mother significantly increases the risk of intrauterine pathologies of the fetus and various obstetric complications.

Obesity 1 degree in men

Over the past 25 years, obesity 1 degree in men is 20 years old and older have become a problem for 15-18% of the male population of developed and developing countries.

This obesity 1 degree in abdominal type - with a thick stomach and a swimming waist, also significantly thickens the fatty layer in the armpit zone and the spawn belt.

The thicker of the waist in men after 30 years, the lower the level of testosterone in the body: according to foreign researchers, an increase in the volume of the waist by 10-12 cm reduces the generation of male sex hormone by 75%, which leads to the development of erectile dysfunction. While the natural process of aging reduces the testosterone level by an average of 36%. The reason for this is explained by the fact that the adipose tissue produces estrogens (as mentioned above). At the same time, the reproductive function of a man due to a low amount of spermatozoa and a decrease in their mobility suffers.

Many specialists allocate hypoptioning obesity syndrome in men, combining obesity 1 degree, hypoxemia (reduction in blood oxygen) during sleep, hyperkapinia (increased content of carbon dioxide in the blood) during the daytime - as a result of too slow or surface breathing ( hypoventilation).

Frused obesity satellite in men - kidney stones, benign prostate gland hyperplasia, urinary incontinence, as well as changes in the metabolism of sex hormones, which can provoke the development of prostate cancer.

By the way, how do obesity 1 degree and the army combine? In the list of diseases attached to the order of MO "On the military-medical examination in the Armed Forces", obesity is absent, so the suitability or limited suitability of a fat guy to military service is determined individually.

Obesity 1 degree in children

Depending on the age, gender and constitutional features, the mass of the body of healthy children varies. An annual child can weigh 9-12 kg with 70-80 cm growth.

Obesity 1 degree in children is diagnosed when their weight exceeds the average age rate by 20-25%. And chronic overeating can already be observed at a two-year-old child.

So, obesity can be a one-year-old baby with a body weight of more than 12-13 kg; at a three-year-old age - more than 18 kg; five-year plans - more than 24-25 kg; in seven years - over 30-32 kg; At 10 years old - more than 45-47 kg, and in 16 - 85 kg.

Domestic pediatricians are confident that the main causes of child obesity are associated with excessive and improper nutrition (especially habit to sweets, sweetened drinks and snacks), which violates the metabolism, and a low-tech lifestyle, and the problems of an endocrine or cerebral nature determine the rather low percentage of obesity. 1 degree in children.

Indeed, according to medical statistics, in 93% of cases, obesity in the child is recognized as idiopathic, that is, arising from an unknown reason. Only 7% of cases are associated with hormonal or genetic factors. And more often than other hindreed states are observed hypothyroidism and lack of growth hormone. And the so-called syndromic obesity, diagnosed with congenital syndromes of Cushing, Prader-Willie, Barda-Bidla or Pekhrantza Babinsky, is very rare.

A significant role in the development of child obesity is played by genetics: according to some data, 80% of children whose parents suffer from obesity, also have a significant excess body weight.

But completely eliminating the influence of hypothalamic and pituitary violations on the mechanism of development of obesity in children is impossible. In adolescence, for the most part, girls, the initial degree of endogenous obesity may be a sign of the hypothalamic syndrome of puberty period (puberty dispituitarism) - one of the types of violations of the hormonal balance of the hypothalamic-pituitary-adrenal axis and the overall metabolism. Fat stocks are localized by mixed type - on the buttocks, hips, chest, shoulders, and there is also a strip-like atropodermy (Strya).

Complications and consequences

To have a general idea of \u200b\u200bwhich consequences and complications entails an excess fat in the body, even when obesity 1 degree, it is sufficient to note the increase in the level of low-density cholesterol (LDL) and development on this soil atherosclerosis, hypertension, heart failure, ischemic heart disease and etc.

Obesity worsens the reaction of the body into insulin and contributes to an increase in blood glucose content: excess fat is based on 64% of diabetes cases in men and 77% of cases in women.

In addition, as a result of obesity, it may occur: obstructive sleep apnea, choletiasis and urolithiasis, gastroesophageal reflux disease, liver and fatty pancreatic disease, chronic renal failure, degenerative-dystrophic pathology of the joints, lymphangectatic swelling of the lower extremities, menstrual disorders and infertility in women , Erectile dysfunction in men.

And this is not a complete list of health problems to which obesity 1 degrees. British Heart Foundation experts associate at least ten species of cancer developing during overweight.

And obesity in children's and adolescence is associated with an increased risk of obesity in adulthood (up to 41-63%), with concomitant long-term health risks.

Diagnosis of obesity 1 degree

The diagnosis of obesity of 1 degree from weighing, growth measurements (for calculating BMI), as well as determining the ratio of the waist circle and the thighs (which allows you to clarify the localization of body sediments).

To determine the volume of adipose tissue and its distribution, instrumental diagnosis is carried out using X-ray absorption (DEXA), ultrasonic densitometry, as well as MRI to identify the amount of visceral fat.

Differential diagnosis

Differential diagnosis is necessary to identify possible pathologies: hypothyroidism, ovarian polycystic diseases (or Stein-leventul syndrome in women), tumor of insulin production of pancreatic cells (insulin), congenital hypophized tumor in children (cranefaring), etc.

Treatment of obesity 1 degree

To date, changes in nutrition - a diet in obesity of 1 degree with a decrease in calorie and exercises are generally accepted methods for the treatment of obesity 1 degree.

The quality of nutrition can be improved by increasing the consumption of food fibers and reduce the consumption of high-calorie products such as fats and carbohydrates. But at the same time, the diet should be products containing all the necessary vitamins, micro and macroelements. The ultimate goal is to lose up to 5-10% of the weight.

How to lose weight in obesity 1 degree, more see - diet 8 in obesity. In the same publication, there is a list of products that should be avoided, and an approximate diet menu by obesity 1 degree.

Dietary changes are effective and in limiting excessive weight gain during pregnancy.

Along with the diet and physical education in the treatment of obesity, drugs can be used, in particular, the overwhelming lipase and decreasing fat absorption drug xenical (other trade names Orlystat, Orlyimax, Orstoden). This pharmacological agent is accepted three times a day - before each food in one capsule. But it is contraindicated in the presence of stones in the kidneys and the increased content of oxalates in the urine, with pancreatitis, fibrosis and celiac disease. Among the possible side effects are nausea, diarrhea, flatulence, headaches, sleep disorders.

Operational treatment

If diet, exercises, behavioral psychotherapy and pharmacology do not give effect, resort to at least surgical treatment through bariatric surgery. This treatment has strict testimony and is not intended for those who believe that they simply have overweight. As a rule, the testimony for surgical treatment of obesity occurs at the BMI above 40. However, if the patient has problems such as type 2 diabetes, hypertensive disease, varicose veins and problems with foot joints, readings occur already at BMI 35.

Surgical intervention happens in the form:

1. introduction of an intragastric cylinder to reduce the volume of the stomach;
2. the shunting of the stomach at which it is separated into two separate "compartments" of different sizes, leaving only a smaller part in the functioning state;
3. imposing on the stomach bandage, which slows down moving food;
4. solve gastroplasty (vertical excision gastrectomy).

In obesity of 1 degree, gastroplars are mainly used, during which part of the stomach is removed, and from the remaining form a long and rather thin "sleeve". The capacity of the stomach decreases approximately 10 times (up to 150-200 ml).

Popular treatment

Among the means of folk treatment of obesity, green tea and celery root are most effective. Tea is able to increase the level of metabolism and accelerate the oxidation of fats, and through the stimulation of the nervous system - to make you move more and, accordingly, to spend more calories. And digesting celery root dishes requires a lot of energy

Treatment of herbs having a diuretic and relaxing effects, doctors are categorically not recommended. But in order to form a little appetite, the phytotherapists advise the leaves of the plantain. The plantain contains fibers that fully fill the volume of the stomach, which contributes to the feeling of satiety, and also normalizes blood glucose levels. In addition to the leaves of the plantain, you can use seaweed laminarium, which enhances the work of the thyroid gland, dulling the feeling of hunger.

Obesity and overweight. Causes of obesity, obesity development mechanisms, obesity tests, obesity correction methods

It is said that half of the population in Russia has an excess weight. Obesity is considered to be a disease of civilization. Of course, we are moving little, we almost do not walk on foot, and everything in transport we move.

Lifestyle and favorite habits give us an overweight, which our doctors call such a nasty word - "obesity". The word is really terrible, just the ears cut. For parting with the problem, good motivation and willpower are needed, a solid desire to part with hateful kilograms. Suppose you liked some kind of dress and you really want to get into it. For this, each has its own planning plan with fat on the stomach and hips. At the beginning of such a plan, there is always any event for cleaning the intestine from slags. Of course, you can go to the doctor, and he will appoint some kind of medicine that lowers appetite or inhibits suction of fats in the intestine.

Separately, it is possible to say nutritional dependence leading to Excess weight and obesityWith which psychologists are now successfully working, helping people do not just lose weight, but also maintain permanent weight by changing food behavior. Now this technique is considered the most effective in 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 owners of unnecessary kilograms suffer obesity.

The body mass index (BMI or KETLE index) is calculated by the formula: BMI \u003d weight (kg) / height (M2)

Obesity begins with the NAME 30 coefficient, and the excess mass of the body has a coefficient of 25-29

. Obesity, This is a violation of the metabolic behavior of the body, characterized by the presence of an excessive amount of adipose tissue. At the same time, so much kilocalorium comes into the body, which exceeds the required level. In obesity in cells, excessive conversion of carbohydrates into fats is observed. As a result, an approximately adequate energy excess accumulation of body mass is noted.

Causes and consequences of overweight and obesity

Causes of development overweight and obesity And the manifestations of arising from this consequences are quite complex and diverse. In the blood, a long time remains a high level of lipids (fat), which adversely affects the state and functioning of the central nervous system. This leads to a violation of the work of centers regulating metabolism, and, as a result, a pathological change in fat metment throughout the body.

In obesity, it is difficult to work with almost all organs and systems. First of all, the activity of the cardiovascular system is violated. Due to the impairment of cholesterol, atherosclerotic changes of the aorta and coronary heart vessels are formed. Fat sediments in the heart bag are constrained by the heart, interfere with its work. The deposition of fat between its muscle fibers reduces the power of heart abbreviations the heart "is becoming fat". There is gradually insufficient blood circulation. The provision of oxygen tissues decreases, which is exacerbated by the difficulty of breathing, gradually decreasing the lungs of the lungs (lungs also bore fat). People suffering from obesity are to a greater extent than people with a normal mass of the body are subject to hypertension, angina, myocardial infarction and brain hemorrhages.

A significant deposition of fat in the abdominal cavity leads to the intestinal displacement down, the abdomen. The activity of the gastrointestinal tract is broken. Emptying of the intestine slows down, constipation arise, flatulence, venous hemorrhoids are formed. The appearance of a person suffers. Increased sweating, diameters in the folds of the skin, are parts of multiple minerals, seborrhea (intensive dandruff formation) of the scalp.

The mental state of man is disturbed. This is manifested by drowsiness, dispellation, weakening of memory, increased fatigue. Dizziness and emotional instability with rapid mood changes are possible. On the other hand, chronic stress, which often experiences a person, can also contribute to weight gain. In the conditions of a deficit of positive emotions, a person unconsciously seeks to enjoy to protect against stress, and "hire problems."

The following factors play a role in the development of obesity: a constitutional predisposition, a decrease in physical activity, age-related, sex, professional factors, some physiological conditions (pregnancy, lactation, climax).
Obesity forms

Overweight can be attributed to psychosomatic issues. If you bring a medical classification by origin, then the following obesity forms can be distinguished (since the Classification is medical, we will apply the term obesity, and not overweight):

Endocrine obesity (discharmal), (with poor compensation for diabetes mellitus), hyperinsulinism, hypothyroidism, etc.
- cerebral (central origin), - as a result of injuries, neuroinfections, etc.
- Yatrogenic - caused by the reception of any drugs or other medical manipulations.
- Mixed - caused by a complex of causal factors with the inability to allocate any one of them.
- Alimentary - there are more calories in the food diet, which is consumed by the body.
- Constitutional - in the patient's family there are clear instructions on burdened heredity.

By the nature of the distribution of fatty fiber:
- Central (Abdominal)
- Glütero - Femoral (Guinoid, Female Type)
- Mixed

Above I mentioned that psychologists work with the problem of overweight now. It should be noted that psychologists independently (without an endocrinologist) can only work with an alimentary - constitutional obesity. The meaning of the methodology is the correction of food behavior. And now I will stop more on an alimentary constitutional form of overweight.

Alimentary - constitutional obesity

. Alimentary-constitutional obesity It is the most common view.
This form of overweight is often detected from a member of one family or close relatives. Based on the name it is clear that this obesity group has two main reasons. The first part of the word denotes that the food diet has an increased calorie content. This is especially dangerous with a sedentary lifestyle, in which reduced calorie consumption, systematic overeating, violation of the food regime. But people who already suffer over weight may appear in hormonal status, distinguish them from people of normal and asthenic buildings. It should be noted that not these changes are the cause of obesity, but on the contrary.

The second part of the term suggests that there is a certain individual predisposition, which determines the food habits, the level of feeling of hunger, motor activity, as well as energy consumption during human physical activity.

When developing obesity due to various violations of the central nervous system, the leading role is played by expressed pathological changes in the work of hypothalamus, causing a change in behavioral reactions, especially food behavior, and various hormonal disorders. This increases the activity of the hypothalamic-pituitary-adrenal system:
- the secretion of adrenal hormones increases, the secretion of the hormone with a fat-making effect is reduced, the secretion of female and men's sex hormones is disturbed. It is characterized by improving the level of insulin in the blood, reducing the effectiveness of its action. The effect of thyroid hormones and sensitivity to them organs and systems are disturbed.

Degrees of obesity

When a person appears I degree of obesity There are such complaints as weakness, fast fatigue, drowsiness, reduction, sweating, nervousness, irritability. The gastrointestinal tract is beginning to disturb the nausea, the appearance of bitterness in the mouth, as well as flatulence, chronic constipation. With physical work, shortness of breath appears.

For II degree of obesity The lower limbs begin to eat, bolted pain in the joints, especially in the spine due to an increase in the load on it. It is worth noting that if at the I degree of obesity, the patient's performance does not change, although such signs are beginning to appear as shortness of breath, fast fatigue in the physical exertion of the average intensity, then at the II degree performance is noticeably declining.

For III degree of obesity Characterized by the development of ugly disproportionality of the physique. Disability is actually lost due to constant shortness of breath even alone. The patient has a pronounced circulatory disorder, swelling does not disappear during the day. Attention is drawn to a sharply increased appetite of a person against the background of general lethargy and drowsiness.

With IV degree, a person becomes a complete disabled person, this is because the body weight exceeds normal twice. A mental state is disturbed by obese, he loses its connection with the world around, it does not care except food.

Once, one Indian healer said: "In 999 cases from 1000, you can cure with the help of the correct diet." The same can be said about obesity when the weight is rapidly, and the pressure is dried with it, and everything else. Normal weight can be saved to retirement age and continue to maintain it at this level. An elderly woman with a good figure always causes respect.

It can only help properly organized food. It is different for different ages. Include in your menu a lot of fresh fruits and vegetables, because they have a lot of fiber. The fiber is not digested in the body, it, as a tip, sweep the whole garbage from our intestines. Most of the fiber is contained in bran, and the barley cereals are quite suitable for the pensioner wallet. Buy a bier, from which you cook my porridge in the morning. In order not to increase in volumes, boil it on water and without sugar, at the end of the cooking, add finely chopped raw apples. They give a good taste and clean my vessels from cholesterol.