Obesity
– this is not an aesthetic (or cosmetological) problem, but a chronic disease, manifested primarily through the accumulation of excess fatty tissue in the body. Gaining excess weight is often a consequence of metabolic disorders, and it itself is the cause of various pathologies. Thus, excess body weight contributes to the development or aggravates the course of cardiovascular diseases, joint diseases, as well as diabetes mellitus, cholelithiasis, gout, and leads to sexual dysfunction. Therefore, the problem of excess adipose tissue is complex, and trying to cope with obesity on your own - with the help of advice from “knowledgeable” people - is sometimes downright dangerous. It is necessary to fight excess weight under the guidance of a doctor.
What is considered obesity and how does it happen?
To determine the deviation of body weight from the norm, the body mass index
– BMI. It is calculated as the ratio of body weight (in kilograms) to a person's height (in meters) squared and measured in units of kg/m².
BMI is used to characterize people aged 18 to 65 years. If the BMI is less than 18.5 kg/m², underweight is diagnosed. Normal range: from 18.5 to 24.9 kg/m². A BMI in the range of 25-29.9 kg/m² indicates the presence of overweight and obesity. This is not a disease yet, but a signal that a person should take control of his weight. With a BMI above 30 kg/m², obesity is diagnosed: from 30 to 34.9 kg/m² - I degree, from 35 to 39.9 kg/m² - II degree, over 40 kg/m² - III degree. As the degree of obesity increases, the risk of developing concomitant diseases increases - from high to extremely high, that is, concomitant diseases become simply inevitable.
There are also different types of obesity
:
Abdominal
(from the Latin word abdomen - “belly”) - when excess fatty tissue forms in the abdomen or upper torso.
This type of obesity is also called “male” obesity, since it is more common in men, or “apple” obesity. Abdominal obesity increases the risk of cardiovascular disease. Femoral-gluteal
- the lower type of obesity, more common in women. It is also called pear-shaped obesity. The lower type of obesity is often accompanied by diseases of the spine, as well as joints and veins of the lower extremities.
Mixed
when excess fat tissue is distributed evenly throughout the body.
You can determine the type of obesity by measuring your waist and hips. If a man has a ratio of waist circumference to hip circumference greater than 1.0 (WC/HR>1), then the abdominal type is diagnosed. In women, the abdominal type is established when WC/VT>0.85.
Waist circumference is also used in diagnosing obesity. If in men WC>102 cm, and in women WC>88 cm, then this is abdominal obesity. However, already with WC>94 in men and WC>80 cm in women, the risk of developing type 2 diabetes and cardiovascular diseases increases.
Obesity treatment can be carried out at the 24-hour Therapeutic Hospital on Barrikadnaya as part of the Weight Loss treatment and health program. The course of therapy can range from 1 to 10 days.
Barraquer-Simons disease
If the previous form of hypothalamic obesity affects men, then Barraquer-Simons disease affects women. The cause of the disease is a violation of the pituitary regulation of the synthesis of female sex hormones.
Barraquer-Simons disease manifests itself as obesity with the deposition of adipose tissue over the upper half of the body, as well as in the abdomen, buttocks and thighs. Patients suffer from gynecological diseases and menstrual irregularities. Many people are diagnosed with infertility. With an increase in the concentration of androgens in women, male-type hair growth is observed.
Causes of obesity
Obesity can be caused by diseases of the endocrine system or digestive organs. However, the main reason is that a person receives more energy from food than his body expends.
Factors contributing to obesity
:
- eating disorder (habit of eating a lot);
- stress (it is human nature to “eat up” stress, compensating for the negative with positive emotions that arise when eating delicious food);
- insomnia (while awake at night, a person is inclined to organize an extraordinary meal, increasing daily calorie intake);
- sedentary lifestyle;
- quitting smoking (the usual cigarette is replaced by sweets, nuts, seeds, etc.);
- family tradition;
- alcoholism;
- taking certain medications;
- pregnancy and childbirth.
Obesity with hypercortisolism
Hypercortisolism is not an independent disease, but a syndrome that develops in various endocrinological diseases (Itsenko-Cushing's disease, Cushing's syndrome and others). What all these diseases have in common is increased production of cortisol, a hormone of the adrenal cortex.
Obesity is one of the main symptoms of hypercortisolism. The specificity of obesity due to adrenal tumors or pathology of the hypothalamic-pituitary-adrenal axis is that adipose tissue is localized mainly in the upper half of the body: on the chest, on the neck, on the face, on the abdomen.
The limbs with hypercortisolism appear disproportionately thin. This is explained by the fact that cortisol provokes muscular dystrophy; Due to the loss of muscle mass, the arms and legs become thin. For the same reason, the skin becomes thinner and stretch marks appear on it.
Hypercortisolism syndrome is characterized by increased skin pigmentation. Women often experience facial hair growth (above the upper lip); the menstrual cycle is disrupted. Men suffer from impotence. Other symptoms include: high blood pressure, depression, anxiety. A number of patients develop mental disorders.
Diagnosis is based on hormonal profile analysis. Tomography is performed to identify the tumor. Treatment is aimed at eliminating the cause of the disease (most often the cause of hypercortisolism is a tumor).
Methods for diagnosing obesity
Treatment of obesity begins with a complete health examination and identification of the cause of excess weight.
.
A set of diagnostic procedures is recommended, including methods such as:
Anthropometry
Anthropometry for obesity includes calculating BMI, measuring waist circumference and hip circumference, and assessing the thickness of subcutaneous fat using a caliper.
Bioimpedancemetry
Obesity can also be diagnosed using instrumental methods, primarily bioimpedance measurements. Using a special device, the electrical resistance of the body is measured, which makes it possible to calculate BMI, fat and lean mass, active cell mass, total body fluid, as well as separately intracellular and extracellular fluid.
Laboratory diagnostics
For obesity, a biochemical blood test is performed (indicators: blood glucose, glycated hemoglobin, cholesterol, LDL, HDL, creatinine, bilirubin, uric acid, gamma GT), as well as a hormone test (indicators: TSH, T4, leptin, insulin, vitamin D , prolactin, LH, FSH, testosterone, estradiol). Research data can be combined in a special profile “Weight Control”).
Ultrasound examinations
In case of obesity, ultrasound examinations of the abdominal organs, pelvic organs (in women, in men – prostate gland), and thyroid gland are performed.
More information about the diagnostic method
ECG
Obesity increases the risk of cardiovascular disease. An ECG will allow you to assess whether weight gain has affected your heart function. Additional research may be required if necessary.
More information about the diagnostic method
Sign up for diagnostics To accurately diagnose the disease, make an appointment with specialists from the Family Doctor network.
Benefits of weight loss for obesity
What does losing weight and maintaining weight gain through gradual changes in lifestyle and nutrition:
- reduction in the risk of developing diabetes by 58%;
- remission or reduction in the severity of type 2 diabetes in 50% of cases;
- reducing the risk of developing cardiovascular diseases;
- improvement of blood pressure, blood lipid levels;
- reducing the incidence of sleep apnea;
- reducing the risk of developing depression;
- improving mobility, physical endurance and overall quality of life.
Tangible health benefits are noted even after losing just 5% of the original weight.
Considering these data, the duration and quality of life directly depend on the normalization and stabilization of weight.
Obesity Treatment Methods
The goals of treatment may vary. This:
- weight loss
(it is safe for the body to reduce weight by no more than 0.5-1 kg per week); - maintaining the achieved level of body weight
(after losing weight) and preventing its re-increase; - treatment of concomitant diseases
or reducing the risk of their occurrence.
When and which doctor should you contact if you are obese?
Obesity treatment is carried out by an endocrinologist. It is he who conducts the initial examination of the patient, gives directions for the necessary diagnostic tests, and, if necessary, refers to other medical specialists (gastroenterologist, gynecologist, urologist, neurologist, cardiologist, ophthalmologist). To change your lifestyle, sometimes you need to consult a psychotherapist.
Treatment for obesity is necessary if your BMI (body mass index) is more than 30 kg/m². But sometimes treatment should be started with a BMI>27 kg/m² if:
- You are planning a pregnancy;
- there is abdominal obesity (the ratio of waist circumference to hip circumference in men is more than 1, in women - more than 0.85);
- you suffer from type 2 diabetes mellitus or arterial hypertension;
- there is a hereditary predisposition to type 2 diabetes or arterial hypertension;
- increased blood cholesterol levels (threat of atherosclerosis);
- are concerned about diseases of the musculoskeletal system (joints, spine).
The obesity treatment complex includes:
Lifestyle change
Treatment of obesity will be ineffective without lifestyle changes. First of all, it is necessary to overcome eating habits that contribute to overeating, as well as increased physical activity agreed with the doctor.
Diet correction
It is necessary to limit daily energy intake to 1200-1500 calories. The transition to a diet must be carried out under the supervision of a doctor.
Drug treatment
If necessary, drug treatment can be carried out as prescribed by an endocrinologist.
Treatment of concomitant diseases
Treatment of concomitant diseases can be carried out both on an outpatient basis and, if necessary, in a day hospital.
Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.
Obesity 3 degrees
- Obesity
- Diagnostics
- Degrees of the disease
- Causes
- Treatment
- Obesity in children
- Complications
Obesity is a complex of disorders caused by improper metabolic processes in the body.
Among the reasons that have a direct impact on the development of pathological processes are usually poor nutrition, insufficient physical activity, hereditary predisposition (the presence of the so-called obesity gene) and other diseases of the endocrine system. Clinical picture
A distinctive sign of the disease is an increase in the volume of adipose tissue. Depending on how much the actual weight exceeds the norm established by calculating the body mass index, the degree of obesity is diagnosed, which corresponds to the stage of development of the disease. Obesity of the 3rd degree is diagnosed if body weight indicators differ from the norm by 50-99%, and is considered a dangerous form of the disease, as it involves systemic complications relating not only to the endocrine (type 2 diabetes mellitus, metabolic syndrome), but also to other systems :
- From the cardiovascular system,
the patient develops signs of coronary heart disease. The speed of blood flow undergoes significant changes, causing venous insufficiency in the lower extremities. Tissue nutrition becomes difficult against the background of systemic atherosclerosis. The patient's condition is also characterized by chronically high blood pressure. A serious danger is posed by myocardial dystrophy, in which there is a significant increase in fat cells around the pericardium and between the myocardial fibers. Their proliferation leads to hypertrophy of the heart muscle. As a result, the heart requires more oxygen. The heart rate increases, leading to shortness of breath. As the disease progresses, this symptom makes itself felt both during exercise and at rest. - On the part of the central nervous system,
increased fatigue and other symptoms of impaired nervous activity are observed. The patient's ability to perform heavy physical labor is inhibited; mental activity is also difficult due to decreased attention, deterioration of memory and other thought processes. - On the part of the respiratory system
, the mobility of the diaphragm changes, as a result of which the ventilation function of the lungs is performed in an incomplete volume, and pathologies in gas exchange arise. The result of all these processes is hypoxia. Breathing becomes shallow, the skin often becomes bluish in color. - From the excretory system,
pathological changes are reversible. The main manifestations will be polyuria and hyperuricemia. Often patients with grade 3 obesity are susceptible to infectious pathologies that arise secondary to nephrolithiasis. The group of diseases includes primarily cystitis and urethritis. - From the reproductive system,
reproductive function may be impaired. In men it manifests itself in the form of decreased potency, in women in the form of pathologies during pregnancy. Toxicosis during gestation also has more pronounced symptoms. After birth, children are often large, but with obvious signs of prematurity and abnormalities. At first, the mother may have no or insufficient lactation.
In addition to those listed, other symptoms are possible with grade 3 obesity. The clinical picture is described taking into account the patient’s physiology and is often individual. Considering the seriousness and danger of the disease for human life, obesity should not be perceived only as an aesthetic problem. To treat pathology, you need to seek help from a qualified specialist.
