Obesity. Main causes, types, principles of treatment of obesity

1 Tepaeva A.I. 1

1 State Budgetary Educational Institution of Higher Professional Education “Saratov State Medical University named after V.I. Razumovsky" Ministry of Health and Social Development of the Russian Federation, Saratov

The problem of exogenous constitutional obesity is becoming one of the global ones, affecting all countries, posing a social threat to people's lives. This article discusses the causes of obesity, the prevalence of this problem and the disease that is caused by exogenous constitutional obesity. The results of a study of the quality of life of patients with exogenous-constitutional obesity are presented. It has been revealed that the prevention of obesity is one of the fundamental principles of improving the health of our society, since the main reason for the high mortality of obese people is not obesity itself, but its complications and severe concomitant diseases.

exogenous constitutional obesity

quality of life

social problem

1. Ginzburg M.M., Kryukov N.N. Obesity. Influence on the development of metabolic syndrome. Prevention and treatment. – M.: Medprofilaktika-M, 2002. – 127 p.

2. Mkrtumyan A.M. Current problems of conservative treatment of obesity. – M.: MGMSU, 2011.

3. Yashkov Yu.I. Stages of development of obesity surgery // Bulletin of surgery. – 2003 –№3.

4.Kovarenko M.A., Ruyatkina L.A. Hypothalamic pubertal syndrome or pubertal metabolic syndrome? // Obesity and metabolism. – 2006. – No. 3 (8). – pp. 21–24.

5.Kovarenko M.A., Ruyatkina L.A. Reflections on the debut of metabolic syndrome in children suffering from obesity and striae rosacea // Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. – 2006. – No. 1 (47). – pp. 22–26.

6.Kovarenko M.A., Ruyatkina L.A. Pink stretch marks in obesity: hypothalamic syndrome or connective tissue dysplasia? // Kuban Scientific Medical Bulletin. – 2009. – No. 6. – P. 54–57.

7. Ashwell M. The health of the nation target for obesity // Int. J. Obes. – 1994. – Vol.18. – P. 837–840.

8.Bray G.A. Obesity: a time bomb to be defused Lancet. – 1998. – 352 18. – R. 160–161.

9.Bray G.A., Popkin B.M. 1998.

10.Katan M.B. 1998; Doucet E., et al, 1999.

11.Lean M. E. J Clinical handbook of weight management. – Martin Dunitz, 1998. – P. 113.

12.Schutz Y. Macronutrients and energy balance in obecity // Metabolism. – 1995, Sep. – Vol. 44. – No. 9. – P. 7–11.

13.Seidell J.S. The worldwide epidemic of obesity. In Progress in obesity research. 8th International congress on obesity. B. Guy-Grand, G. Ailhaud, eds. – London: John Liddey & Company Ltd. 1999. – R. 661–8.

14.Silverstone T. Appetite suppressants // Drugs. – 1992. – Vol. 43. – No. 6. – P. 820–836.

15.Stuncard H.J., Wadden T.A.. Psychological aspects of severe obesity // Amer. J. Clin. Nutr. – 1992. – Vol. 55. – R. 524–532.

16.Shepherd J. Evolution of the lipid hypothesis // 70th EAS: Abstracts. – Geneva. – 1998. – P. 247.

17.Hodge AM; Dowse GK; Gareeboo H; Tuomilehto J; Alberti KG; Zimmet PZ Incidence, increasing prevalence, and predictors of change in obesity and fat distribution over 5 years in the rapidly developing population of Mauritius // Int J Obes Relat Metab Disord. – 1996 Feb. – No. 20(2). – R. 137–46.

Obesity is a war where there is one enemy and many victims.

Interest in the problem of obesity is increasing everywhere. In all media we often see - “Obesity is an epidemic of the 21st century”, “Obesity is a global catastrophe”... In all newspapers, websites, magazines, advertisements we see weight loss products, various diets, weight loss methods... But How often do we think about the problem itself?

The problem of obesity has existed not even for centuries, but for thousands of years (30-50 thousand years BC), as evidenced by data from archaeological excavations of Stone Age figurines.

In the distant past, the ability to store fat was an evolutionary advantage that allowed humans to survive periods of forced starvation. Fat women served as a symbol of fertility and health. They were immortalized on the canvases of many artists, for example, Kustodiev, Rubens, Rembrandt.

In the records of the period of Egyptian, Greek, Roman and Indian cultures, obesity is considered as a vice, elements of disgust for skin are noted, and tendencies to combat it are outlined. Even then, it was noted by Hippocrates that the life of excessively obese people is short, and overweight women are infertile. When treating obesity, he recommended limiting the amount of food consumed and paying more attention to physical activity.

Millions of people now suffer from the ingenious invention of nature—fat, which in the past had a protective function. Overall, this problem becomes one of global, affecting all countries. According to WHO, there are more than 1.7 billion people in the world who are overweight or obese.

In most developed European countries, between 15 and 25 % of the adult population is obese. Recently, there has been an increase in the incidence of obesity in children and adolescents all over the world: in developed countries, 25% of adolescents are overweight, and 15% are obese. Being overweight in childhood is a significant predictor of obesity in adulthood: 50% of children who were overweight at 6 years of age become obese in adulthood, and this probability increases to 80% in adolescence.

Therefore, the problem of obesity in our time is becoming more and more urgent and is beginning to pose a social threat to people’s lives. This problem is relevant regardless of social and professional affiliation, area of ​​residence, age and gender.

The significance of the problem of obesity is determined by the threat of disability in young patients and a decrease in overall life expectancy due to the frequent development of severe concomitant diseases. These include: type 2 diabetes mellitus, arterial hypertension, dyspididemia, atherosclerosis and related diseases, reproductive dysfunction, cholelithiasis, osteochondrosis. Obesity reduces resistance to colds and infectious diseases, in addition, it sharply increases the risk of complications during surgical interventions and trauma.

The problem of well-being of people suffering from overweight and obesity in modern society is quite relevant, widespread and socially significant. Modern society provokes unintentional obesity in its citizens by promoting the consumption of high-calorie, high-fat foods, and at the same time, thanks to technological progress, stimulating a sedentary lifestyle. These social and man-made factors have contributed to the rise in the prevalence of obesity in recent decades. The World Health Organization (WHO) concluded that the main cause of the obesity epidemic in the world was the lack of spontaneous and work-related physical activity of the population combined with excessive consumption of fatty, high-calorie foods.

Obesity significantly reduces life expectancy from an average of 3-5 years with slight excess weight, to 15 years with severe obesity. In almost two out of three cases, a person’s death occurs from a disease associated with impaired fat metabolism and obesity. Obesity is a huge social problem. Most of these individuals suffer not only from illness and limited mobility; they have low self-esteem, depression, emotional distress and other psychological problems due to prejudice, discrimination and exclusion that exist towards them in society. In society, the attitude towards obesity patients is often inadequate; at the everyday level it is believed that obesity is punished gluttony, punished laziness, therefore the treatment of obesity is a personal matter for everyone. Indeed, public consciousness is still far from the idea that overweight people are sick people, and the cause of their illness is often not an unbridled addiction to sneakers, but complex metabolic disorders leading to excessive accumulation of fat and adipose tissue. The social significance of this problem is that people suffering from severe obesity have difficulty finding a job. Obese people experience discriminatory restrictions in career advancement, everyday inconveniences at home, restrictions on movement, in the choice of clothing, and inconvenience in carrying out adequate hygienic measures; sexual dysfunctions are often observed. Therefore, society has not yet fully realized the need to create and implement obesity prevention programs.

Of course, such a program is very expensive, but the problem of obesity also costs a lot of money. It should be viewed as positive that society has begun to spend money on creating programs for the prevention of diseases such as hypertension, non-insulin-dependent diabetes mellitus and coronary heart disease. The pathogenesis of these diseases is very closely intertwined with the pathogenesis of obesity. It would be advisable now to build programs for the prevention of excess weight as an integral part of programs for the prevention of hypertension, coronary heart disease and type 2 diabetes. Unfortunately, to date, not a single state, despite the high social significance of the problem of obesity and the impressive amounts of economic losses associated with this problem, can boast of having a serious general state program for the prevention of obesity. Most often, the matter is limited to medical preventive work, and, in turn, is limited to the desires to lead a more active lifestyle and eat more rationally. Sometimes this kind of advice comes to us from the media. Moreover, in the treatment of obesity, along with more or less serious advice, there is advice, the scientific validity of which is very doubtful. Moreover, from time to time in the media in one form or another there are wishes that are directly opposite. Namely, that excess weight should not be treated, that an overweight person is beautiful and healthy in his own way, that the body itself knows how much it should eat and how much it should weigh, and so on. It is not difficult to imagine how overweight people, often already exhausted by numerous unsuccessful attempts to lose weight, perceive this kind of advice.

Russia ranks third in the world in terms of the prevalence of obesity and overweight: more than 30% of the working population is overweight and obese. At the same time, neither domestic science nor government policy demonstrates a proper understanding of both the scale of the problem and its social nature.

Despite this pronounced problem, the current state of obesity treatment remains unsatisfactory. It is known that the majority of those in need cannot begin it because of the fear of having to follow a monotonous, half-starved diet for a long time. Most of those who start treatment fail to achieve normal body weight, and the results achieved most often turn out to be significantly less than expected. In the majority of patients, even after successful treatment, a relapse of the disease and restoration of the original or even greater body weight are observed. It is known that 90-95% of patients restore their original body weight 6 months after completion of treatment.

The situation with obesity prevention is no better. And although recently risk factors and risk groups for the development of this disease have been practically identified, their use in prevention is still very limited.

Unfortunately, in society, and in the minds of some doctors, the idea is still strong that obesity is a personal problem of a person, a direct consequence of a lazy, idle life and excessive overeating. Perhaps, for no other disease is self-medication practiced on such a scale as for obesity. Almost any popular periodical devotes space to a dozen other tips on how to lose weight. Advice that, as a rule, is not supported by any medical reasoning. The inaction of doctors and the unsatisfactory results of traditional treatment largely determined the widespread and prosperity of healing methods, mass “coding” sessions, advertising and sale of “miraculous” remedies that promise weight loss without diets and other inconveniences. This situation is largely due to the fact that we do not fully know the etiology and pathogenesis of obesity, or, we can say that certain progress in our understanding of the causes and mechanisms of the increase in excess fat mass, achieved in the last decade, has not yet found its place in prevention diseases and treatment of patients.

Treatment of obesity, like treatment of any chronic disease, should be continuous. After achieving weight loss, the efforts of the doctor and the patient should be aimed at maintaining the effect and preventing relapses of the disease. Indeed, obesity is a disease that is most susceptible to recidivism. The probability of relapse here approaches 100%. In at least 90% of patients, the original body weight is restored within the first year after the end of diet therapy. In this regard, adherence to a diet that ensures maintenance of the achieved weight is no less important than adherence to a fasting regimen.

The main cause of obesity in both adults and children is overeating. Chronic overeating leads to disturbances in the functioning of the appetite center in the brain, and the normal amount of food eaten can no longer suppress the feeling of hunger to the required degree. Excessive, extra food is utilized by the body and stored “in reserve” in the fat depot, which leads to an increase in the amount of fat in the body, that is, the development of obesity. However, there are many reasons that force a person to overeat. Severe anxiety can reduce the sensitivity of the saturation center in the brain, and a person begins to take in more food unnoticed. A similar situation may be the result of a number of psycho-emotional factors, such as feelings of loneliness, anxiety, melancholy, as well as people suffering from neurosis such as neurasthenia. In these cases, food seems to replace positive emotions. Many people eat heavily before bed while watching TV, which also contributes to obesity.

Age plays a significant role in the development of obesity, which is why they even distinguish a special type of obesity - age-related. This type of obesity is associated with age-related disruption of the activity of a number of special centers of the brain, including the appetite center. To suppress hunger as you age, you need more food. Therefore, unbeknownst to themselves, many people over the years begin to eat more and overeat. In addition, a decrease in the activity of the thyroid gland, which produces hormones involved in metabolism, is important in the development of age-related obesity.

The most important factor leading to the development of obesity is low physical activity, when even the normal amount of food taken is excessive, since the calories that enter the body are not burned during physical activity and turn into fat. Therefore, the less we move, the less we should eat in order not to gain weight.

In a number of diseases, obesity is one of the components of the underlying disease. For example, with endocrine diseases such as Cushing's disease, hypothyroidism, hypogonadism, and insulinoma, obesity usually occurs.

In all of the above diseases, developing obesity is called secondary obesity. The principles of its treatment are similar to those used in the treatment of obesity caused by overeating and a sedentary lifestyle. In this case, the main thing is to treat the underlying disease that led to the development of obesity. An endocrinologist must find out the cause of obesity for each specific patient, who, after conducting a series of special studies, will determine whether obesity is associated only with a sedentary lifestyle and overeating or whether there is secondary obesity.

Despite the fact that patients almost never complain of increased appetite, it is necessary to find out the nature of the patient’s diet. Some doctors limit themselves to telling the patient about the food eaten and the frequency of its intake, as well as the time of the last meal during the day. Methodologically, it is more correct to ask the patient to fill out a food diary with a detailed record of the food eaten for 3-5 days, then analyze the submitted entries. This path is longer, but incomparably more effective. Correction of eating behavior with constant, competent use of a food diary gives clinically significant results.

A typical exogenous-constitutional history for a patient is as follows. Patients are convinced that they eat little and emphasize that in the morning they do not eat at all. The cup of coffee with sugar and the sandwich with cheese and butter that they drink is usually not counted as food. At work, patients begin to snack. This is usually a high-calorie, high-fat food. They often chew at work and at home automatically, without noticing it; they eat when nervous, before going to bed, and even at night.

The main strategic goal of treating overweight and obesity is not only weight loss, i.e. improvement of anthropometric indicators, but also the indispensable achievement of full control of metabolic disorders, prevention of the development of severe diseases that often appear in obese patients, and long-term retention of achieved results. Consequently, only such treatment can be considered successful if it leads to an improvement in the patient’s overall health. It has been shown that for this, in most cases, a reduction in thale weight by 5-10% of the initial value is sufficient, and is regarded as clinically significant, bringing real benefits to the health of patients. Moreover, such a reduction in body weight with a beneficial effect on health is easily achieved and requires fundamental changes in the patient’s eating habits and lifestyle.

It is necessary that all doctors understand that obesity is a serious disease and consider it an obligatory measure to include in their tasks measures aimed at the prevention and treatment of this “disease of the century.” Finally, it should be clear to everyone that the prevention of obesity is one of the fundamental principles of improving the health of our society, since the main reason for the high mortality of obese people is not obesity itself, but its severe concomitant diseases.

Reviewers:

Nelaeva A.A., Doctor of Medical Sciences, Professor, Chief Endocrinologist of Tyumen, Chief Physician of the Endocrinological Dispensary, Tyumen;

Ruyatkina L.A., Doctor of Medical Sciences, Professor of the Department of Emergency Therapy of Endocrinology and Occupational Pathology of the Faculty of Education and Training of the State Budgetary Educational Institution of Higher Professional Education "Novosibirsk State Medical University of the Ministry of Health and Social Development of the Russian Federation", Novosibirsk.

The work was received by the editor on November 13, 2012.

Bibliographic link

Rodionova T.I., Tepaeva A.I. OBESITY IS A GLOBAL PROBLEM OF MODERN SOCIETY // Fundamental Research. – 2012. – No. 12-1. – pp. 132-136;
URL: http://fundamental-research.ru/ru/article/view?id=30779 (access date: 02.25.2019). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"

In general, this problem is becoming one of the global ones, affecting all countries. According to WHO, there are more than 1.7 billion people in the world who are overweight or obese.

In most developed European countries, 15 to 25% of the adult population suffers from obesity.

Recently, there has been an increase in the incidence of obesity in children and adolescents all over the world: in developed countries, 25% of adolescents are overweight, and 15% are obese.

Being overweight in childhood is a significant predictor of obesity in adulthood: 50% of children who were overweight at 6 years old become obese as adults, and this probability increases to 80% in adolescence.

Therefore, the problem of obesity in our time is becoming more and more urgent and is beginning to pose a social threat to people’s lives.

This problem is relevant regardless of social and professional affiliation, area of ​​residence, age and gender.

Russia ranks third in the world in terms of the prevalence of obesity and overweight: more than 30% of the working population is overweight and obese.

At the same time, neither in domestic science nor in public policy is there a proper understanding of both the scale of the problem and its social nature.

The significance of the problem of obesity is determined by the threat of disability in young patients and a decrease in overall life expectancy due to the frequent development of severe concomitant diseases.

These include: type 2 diabetes mellitus, arterial hypertension, dyspididemia, atherosclerosis and related diseases, reproductive dysfunction, cholelithiasis, osteochondrosis.

Obesity reduces resistance to colds and infectious diseases, and also sharply increases the risk of complications during surgery and injury.

The problem of well-being of people suffering from overweight and obesity in modern society is quite relevant, widespread and socially significant.

Modern society provokes unintentional obesity in its citizens by promoting the consumption of high-calorie, high-fat foods, while at the same time, thanks to technological progress, stimulating a sedentary lifestyle.

These social and technological factors have contributed to the rising prevalence of obesity in recent decades.

The World Health Organization (WHO) concluded that the main cause of the obesity epidemic in the world was the lack of spontaneous and labor physical activity of the population combined with excessive consumption of fatty, high-calorie foods.

Obesity significantly reduces life expectancy on average from 3-5 years with slight excess weight, to 15 years with severe obesity. In almost two out of three cases, a person’s death occurs from a disease associated with impaired fat metabolism and obesity.

Obesity is a huge social problem.

Most of these individuals suffer not only from illness and limited mobility; they have low self-esteem, depression, emotional stress and other psychological problems due to the prejudice, discrimination and exclusion that exists towards them in society.

In society, the attitude towards obese patients is often inadequate; at the everyday level it is believed that obesity is punished gluttony, punished laziness, therefore the treatment of obesity is a personal matter for everyone.

Indeed, public consciousness is still far from the idea that overweight people are sick people, and the cause of their illness is often not an unbridled addiction to kedah, but complex metabolic disorders leading to excessive accumulation of fat and adipose tissue.

The social significance of this problem is that people suffering from severe obesity have difficulty finding a job.

Obese people experience discriminatory restrictions in career advancement, everyday inconveniences at home, restrictions on movement, in the choice of clothing, and inconvenience in carrying out adequate hygienic measures; sexual dysfunctions are often observed.

Therefore, society has not yet fully realized the need to create and implement programs to prevent obesity.

Source: http://rae.ru/fs/?section=content&op=show_article&article_id=9999995

****************

In weight loss - only an integrated approach works

Obesity is a global problem of our civilization. This is the body's response to our changed way of modern life, which is changing at tremendous speed.

The body does not have time to rebuild itself, take care of it, give yourself simple joy - life is easy!

- Remember, all problems are in the head, even obesity.

Have you already made a decision and are ready to act?

It is necessary to surround yourself with professional assistants who will help you change your previous lifestyle.

Before going to a nutritionist or going to the gym, make an appointment with a psychologist.

A psychologist will help remove psychological blocks that hold weight, and all healthy... (and not so healthy) nutrition is turned into fat. Maybe you have been depressed for a long time, but you didn’t notice because you got used to it?

Pay attention to anxiety, tension, low self-esteem, lack of love or lack of dynamics in personal growth.

Maybe your body will become an ally in achieving important results.

- Your problem may be in the endocrine system, get tested.

Diets that other people advertise or share from their experiences may not be suitable for you to use. The body is yours, individual... find out its hidden features.

- A nutritionist will help you create not only an individual diet, but also a daily routine where food intake will discipline you.

To change your taste preferences, you need to have not only desire, knowledge, but also will.

Everyone knows that a person can adapt to anything; it’s only difficult at first, while a new habit is being developed.

Do not be afraid of difficulties, meet them like the wind of change bursting into your established life.

- Movement is perhaps the most important medicine against excess weight; physical activity enhances the circulation of energy in the body, affecting metabolism.

It is more difficult for heavier people to move, they lose lightness and flexibility, therefore, in order not to cause harm, be sure to exercise under the supervision of an instructor in a gym or fitness club.

Together with him, develop a set of physical activity that has a healing purpose, taking into account individual data, preventing injuries.

- If your weight reaches 100 kg or more, proportions are important taking into account your height, contact the clinic to begin complex treatment under the supervision of all specialists.

Surgical intervention is necessary for those whose weight exceeds 110 kg or more, on the recommendation of a doctor.

There are no problems that cannot be fixed, make a decision and start taking action!

I wish you joy, happiness and health, dear friends,

Svetlana Oriya, psychologist - http://wp.me/p12pVk-dKs

**********

The main rules of any diet are to hang it on the wall :)))

Drink at least two liters of liquid per day.

2. From alcohol - only a little red wine.

3. Before breakfast, drink 1 glass of water with lemon on an empty stomach. Only after 20 minutes start eating.

4. Before each meal, drink 200 ml of water. During meals, do not drink anything at all. And only after you eat, drink water or tea 40-60 minutes later.

5. You need to eat about 5-6 times a day (including snacks).

6. The last meal should be 3 hours before bedtime. Afterwards you can only have water, green tea, low-fat kefir.

7. Drink tea without sugar, or with honey. Coffee without additives (such as cream, milk, sugar) Otherwise it’s a bunch of empty calories.

8. Potatoes no more than 2 times a week. And only in boiled or baked form.

9. Grapes and bananas will wait until you lose weight. Also no more than 2 times a week.

10. A fasting day without harm to your figure can be done once a week. Or 2, but not in a row! (For example, Monday and Friday). Best unloads: Milk tea; kefir; apple days.

11. Arrange for yourself a cleansing of the intestines, liver, kidneys, if the weight has been stable for 2 months.

12. You should never forget about sports. Light morning and evening exercises. If you can't go to the gym, do it at home. There are video tutorials. Go outside and run.

13. The ideal time for sports is from 17.00 to 20.00

14. It’s better for breakfast (boiled eggs; porridge; salad; bread; fruit; cottage cheese). Never skip breakfast!

15. Soups, broths, salads, boiled lean meat, white fish, vegetables, and fruits are good for lunch.

16. Good for an afternoon snack: yogurt; salad; kefir; boiled lean meat; vegetables.

17. Good for dinner: light salad; cottage cheese; yogurt or some steamed vegetables.

18. It is better to eat fruits in the first half of the day.

19. And forget about fried foods.

20. Season salads with sour cream or natural yogurt. Well, or oil.

21. Forget about processed foods; fast food; seeds, nuts, salted chips and everything like that. Mayonnaise is completely in the trash!

You can't drink sugary water if you want to lose weight.

For sweets, a piece of dark, preferably dark chocolate in the morning. Well, give up fatty and floury foods; if you can’t, then reduce them to a minimum. Pies, cookies, buns - fu-fu-fu.

22. Eat small portions. One meal is no more than 200g.

23. Get yourself a small plate and eat with a teaspoon. It will be hard at first, but then your stomach will shrink and you will eat less in general.

The main thing is more sports and less treats!

I have been drinking ginger drink for several months now.

Amazing taste, I really like it: slightly bitter, tingles somewhere deep in the throat.

I drink it without sugar and never tire of admiring it.

But the most important thing is that despite all the holidays and overeating, I got on the scale yesterday (I was afraid that the weight had gone up)

But!!! HOORAY!!! Not only did he remain the same, but he also gained 3 kg!!!

Honestly, honestly!!!

I didn’t do anything else, just ginger and lemon.

And I ate on holidays (I plugged my ears, closed my eyes....and everything in a row...)

Now I will advise everyone: GINGER + LEMON + WATER, drink as much as possible)))

To prepare ginger lemonade we will need:

- 2 lemons

- a piece of ginger root (about 7 - 10 cm)

- 5 tablespoons of sugar (I drink without sugar, you can replace sugar with honey))

- 2 liters of chilled drinking water.

Wash the lemons thoroughly and peel the ginger. Cut the lemons and ginger into large pieces and grind in a blender. Place everything in a jug, pour boiling water over it and leave for about an hour.

Add sugar and strain.

Ginger lemonade is a storehouse of vitamins, an ideal remedy for boosting immunity!

An indispensable tool in a weight loss program!

*******

Super soup "Figure, AU!" - An ideal solution to weight loss.

A week later, 2 kg, as if nothing had happened!

And in another week you will lose the next 2 kg! Weight loss will continue, because the liver and intestines will be cleansed, and the metabolism will accelerate!

The soup is made from the following products:

White cabbage,

Cauliflower,

Sauerkraut,

Pumpkin,

3 onions,

2 carrots,

2 beets,

head of garlic,

bell pepper,

Tomatoes in their own juice,

Hot pepper,

Ginger,

Parsley and dill.

Cauliflower and white cabbage, bell pepper, onion and garlic must be chopped. Grate carrots, beets and pumpkin. The volume of grated pumpkin and chopped white cabbage should fit into a 700 ml bowl.

The remaining vegetables need less - 400 ml bowl. Water for soup - 1.5 liters. Yield - 4l.

Place all the vegetables (except sauerkraut) in a saucepan, add water, bring to a boil and simmer over low heat for half an hour.

After half an hour, add tomato juice, chopped and peeled tomatoes, sauerkraut, chopped hot pepper, three teaspoons of grated ginger.

And cook the soup for the remaining half an hour.

Add finely chopped greens. We do not add salt; there is enough of it in sauerkraut. Hot pepper is desirable, but not required.

Or you can beat it with a blender and get a wonderful vegetable soup - puree.

Our soup turned out sour, spicy and very tasty.

You can even eat a couple of rye breads with the soup.

Eat this soup for lunch and dinner for a week, and for the next week you can add a piece of boiled beef, chicken or fish for lunch.

Lose weight! And be healthy!

Learn to perform incredibly simple actions, bring them to automaticity and lose 5 kg in a month.

============================

It's so simple if you have a strong desire to like yourself, wear beautiful things and look attractive, seductive, 5-10 years younger in them:)))

WHAT DO WE DO?

1. For the first 3 days we reduce the volume of the stomach. We eat 5-6 times a day: a portion is a saucer, a spoon is a teaspoon.

2. Follow step 1 + add 2 - 2.5 liters of liquid per day. That's +2 more days.

3. We carry out point 1 + point 2. In addition to this, we go through our diet. We refuse junk food. We are looking for replacements for harmful products.

Reduce the amount of sweets, fatty foods, and flour. We steam, stew, boil or bake dishes in the oven.

(This is at least another + 7 days).

4. We complete all the previous points and add sports to them. In general, you should devote at least an hour to sports per day (you can half an hour in the morning, half an hour in the evening. Or distribute this hour in some other way).

It is known that obesity is the process of gradual accumulation of fat in the body, which often leads to excess body weight. In this case, fat is deposited in special “fat depots”: subcutaneous fatty tissue and around internal organs.

And excess body weight already causes numerous problems for its owner. Thus, most people who are obese usually have low self-esteem, depression, emotional stress and other psychological problems due to the prejudice that exists towards them in society.

But obesity is not only a psychological problem. Excess weight is also the cause of many serious diseases of the liver, kidneys, cardiovascular system, and also provokes the development of diabetes and some types of malignant tumors. In obese people, these diseases occur 6-9 times more often than in people of normal build.

Moreover, obesity, even to a small extent, reduces life expectancy by an average of 4-5 years; if it is pronounced, then life is shortened by 10-15 years. For example, data from the US National Center for Chronic Disease Prevention and Health suggests that about 300 thousand Americans die every year due to diseases caused by obesity.

In general, medical statistics show that on average 60-70% of deaths are associated with diseases based on fat metabolism disorders and obesity.

But in the world, according to 2014 data, more than 1.9 billion adults aged 18 years and older are overweight. Of this number, over 600 million people are obese.

As for individual regions of the world, for example, in almost all European countries, 15-25% of the adult population is obese.

Moreover, in developed countries the number of overweight people, according to various estimates, ranges from 35 to 55%, and in individual countries (Canada, USA, Australia, UK, New Zealand and Greece) - 60-70%. The share of overweight women in this statistics is approximately 52%, the share of men is 48%.

Top most obese countries according to WHO data from 2013.

It should be noted that in the list of the most obese nations, Russia occupies a far from leading position, although more than 30% of the country's working population suffers from overweight and obesity. At the same time, 24% of women and 10% of men are susceptible to obesity in Russia.

Experts are also concerned about the fact that the proportion of overweight people in the world is constantly increasing. Thus, in the UK over the past 25 years, the number of people susceptible to obesity has increased approximately 5 times.

Of particular concern is evidence that the number of overweight children and adolescents has been increasing globally in recent years. Thus, in developed countries, 25% of the younger generation are overweight, while 15% are obese. The countries most affected by childhood obesity are the United States, South Africa and Italy.

And it has long been proven that excess weight in childhood is a high probability of obesity in adulthood. At the very least, statistics show that 50% of children who are overweight at 6 years old begin to gain weight as they age, and excess weight during adolescence increases this probability to 80%.

Considering these facts, the WHO acknowledges in its documents that obesity has already become a global epidemic, or pandemic.

Since obesity is a metabolic disease, like any disease, it places a certain burden on the economy. For example, WHO experts estimate that in developed countries, the costs associated with obesity reach 7% of the overall health care budget.

Although it is assumed that this figure is much higher. For example, the United States spends about $150 billion annually on obesity treatment. To this figure should also be added losses from decreased labor productivity, loss of ability to work, etc. As a result, the cost increases to $270 billion per year.

And a 2012 UN report found that, due to the spread of obesity around the world, productivity is declining and health insurance costs are rising to $3.5 trillion a year, which is 5% of global GDP. According to statistics, back in 1995 this figure was 2 times lower.

Naturally, in order to combat obesity on a global or national scale, it is necessary to at least know the causes of this phenomenon. Of course, a person’s weight is determined to a certain extent by heredity. However, genetics alone cannot explain the increasing percentage of overweight people globally.

Therefore, doctors believe that the main reason for human obesity (95-97%) is the discrepancy between the amount of food consumed and the energy expended. At the same time, some experts focus on the increasing calorie content of food, while others focus on the decrease in physical activity of modern people.

In essence, both are right. So, on the one hand, cooking has become simpler and faster, and the products themselves have become relatively cheap; on the other hand, physical labor has been replaced by various mechanisms, and many professions have become “office-based”.

Age also plays an important role in the development of obesity. The fact is that with age, disturbances in the functioning of the appetite center occur. And to suppress the feeling of hunger, many older people begin to eat more and more food, that is, in other words, overeat.

In addition, weight gain in old age is influenced by a decrease in the activity of the thyroid gland, which synthesizes hormones involved in metabolism.

However, in addition to these factors leading to obesity, researchers name others. For example, many experts believe that there is a strong relationship between excess weight and education. This view is based on the assumption that with low income and low weight, a person tends to increase his weight as soon as income begins to increase. And then, starting from a certain level of weight and income, the opposite desire arises - to maintain or lose weight.

Perhaps there is a rational grain in these theories. But, most likely, obesity is due to the fact that people increasingly began to eat food that contains many additives that affect biochemical processes in the body.

After all, before, when the population ate mostly natural food, there were much fewer overweight people than in the modern era.

Over the course of human history, there have been extraordinary changes in the perception of obesity. In the Middle Ages, for example, it was considered a visual expression of high social status. A fat woman was a model of health and sexuality, and obesity in this case rarely entailed aesthetic problems. Nowadays, however, due to the health risks, obesity is identified as one of the most serious metabolic disorders. Obesity as a problem in modern society is the topic of conversation for today.

0 138569

Photo gallery: Obesity as a problem of modern society

What is obesity?

Obesity can be defined as weight gain resulting in abnormal deposits of triglycerides in fatty tissues with pronounced negative effects on the body. That is, not all obesity is obesity. Since accurately measuring the amount of fat in body tissue requires expensive and difficult-to-find tests, the health field has adopted a general method for determining the degree of obesity - the so-called "body mass index".The connection between a person’s weight in kilograms and height in meters squared, described back in 1896 by A. Quetelet, gave impetus to the creation of a general scheme for calculating the mass index:

Low body weight - less than 18.5 kg/m 2

Optimal weight - 18.5 - 24.9 kg/m 2

Overweight - 25 - 29.9 kg/m 2

Obesity 1st degree - 30 - 34.9 kg/m 2

Obesity 2nd degree - 35 - 39.9 kg/m 2

Obesity 3rd degree - more than 40 kg/m 2

In 1997, the World Health Organization (WHO) adopted a standard for weight classification according to this scheme. But then scientists noted that this indicator does not provide any information regarding the amount of fat, and more importantly, where it is located in the body. Namely, this is a fundamental factor in the development of obesity. The regional distribution of adipose tissue is an important aspect of identifying the degree of obesity and establishing the frequency and severity of concomitant diseases. The accumulation of fat in the abdominal area, known as Android (central, male type), is associated with a significant increase in health risks, much greater than with female obesity. Thus, determining body mass index is most often accompanied by measuring waist circumference. Body mass index was found to be ≥ 25 kg/m 2 in combination with a waist circumference ≥ 102 cm in men and ≥ 88 cm in women, significantly increases the likelihood of complications. Among them: arterial hypertension, dyslipidemia (impaired blood lipid metabolism), atherosclerosis, insulin resistance, type 2 diabetes mellitus, cerebral stroke and myocardial infarction.

World obesity statistics

The incidence of obesity is increasing at a rapid pace worldwide, reaching epidemiological proportions. Obesity has become a problem in modern society quite quickly - over the past couple of decades. According to official statistics, currently 250 million people on the planet are diagnosed with obesity and 1.1 billion are overweight. This trend will lead to the fact that by 2015 these figures will increase to 700 million and 2.3 billion people, respectively. The most alarming fact is that the number of obese children under 5 years of age is increasing - it exceeds 5 million worldwide. The prevalence of morbid obesity type 3 (≥ 40 kg/m 2 ) - it has increased almost 6 times over the last decade.

Across Europe, around 50% of the population is obese and around 20% overweight, with Central and Eastern Europe being the worst affected areas. In Russia, the situation is extremely serious - about 63% of men and 46% of women of economically active age are overweight, and 17 and 19% are obese, respectively. The country with the highest obesity rate in the world is Nauru (Oceania) - 85% of men and 93% of women.

What leads to the development of obesity

Obesity is a metabolic disorder of a chronic nature, resulting from a complex interaction of endogenous (genetic characteristics, hormonal balance) factors and external conditions. The main reason for its development is considered to be the maintenance of a positive energy balance by increasing energy consumption, reducing energy consumption, or a combination of both factors. Since the main source of energy for humans is nutrients, energy consumption is primarily associated with physical activity. Without sufficient activity, energy is poorly consumed, substances are not absorbed correctly, which ultimately leads to weight gain, obesity and the development of concomitant diseases.

Nutrition in the etiology of obesity

If several decades ago there were doubts about the importance of nutrition in the etiology of obesity, today, in modern society, it has been proven that diet is of paramount importance. Nutrition tracking shows that per capita energy consumption has increased over the past 30-40 years, and this problem will continue into the future. In addition to this, quantitative changes are accompanied by qualitative changes in nutrition. Fat consumption has increased sharply in recent years as healthy mono- and polyunsaturated fatty acids have given way to saturated fatty acids. At the same time, there is a jump in the consumption of simple sugars, and the consumption of complex carbohydrates and fiber has decreased. Foods high in fat and simple carbohydrates are preferred for consumption due to their good taste. However, they have a severe pronounced effect and an increase in energy density (calories per unit weight) - factors that easily lead to a positive energy balance and subsequent obesity.

The importance of physical activity

Continued economic growth and violent rates of industrialization and urbanization may minimize the need for physically demanding activities. Our ancestors did not have to pay for performing physical labor and getting stressed. Life itself forced them to do this. We, who live in cities, need to pay a considerable amount to visit a modern fitness center or swimming pool, play sports or undergo a treatment session. Meanwhile, movement is important for maintaining the normal structure and function of almost all organs and systems in our body. Its absence without good reason will sooner or later lead to pathological changes in the organs and tissues of the body, to general health problems and early aging.

Numerous epidemiological studies have shown that a sedentary lifestyle is most often associated with an increase in metabolic disorders, in particular overweight and obesity. An interesting fact is that the relationship between decreased physical activity and obesity is bidirectional, i.e. lack of physical activity leads to weight gain, and overweight people find it more difficult to initiate physical activity. Thus, the accumulation of excess weight worsens and leads to the formation of a kind of vicious circle. It is the increased energy consumption and decreased physical activity that is responsible for the observed jump in the prevalence of obesity today. Diet is considered to have a greater degree of risk because through it we can more easily generate a positive energy balance than to compensate for it later through physical activity.

Genetic obesity and heredity

Although obesity clearly has a hereditary component, the precise mechanisms underlying it are not well understood. The genetic “codes” of human obesity are difficult to isolate, because a very large number of genotypes decay under the influence of external factors. Science knows of cases where entire ethnic groups and even families have been genetically determined to be significantly more prone to obesity, but it is still difficult to say that this is 100% hereditary, since members of these groups ate the same food and had similar motor skills.

Studies conducted among large groups of people with significant differences in body mass index and body fat, as well as among twins, show that between 40% and 70% of individual differences are genetically determined. In addition, genetic factors influence mainly energy intake and nutrient absorption. Currently, despite scientific and technological progress, it is difficult to say with certainty whether this phenomenon - obesity - is genetic.

The meaning of some hormone in the development of obesity

In 1994, it was found that fat is a kind of endocrine organ. The release of the hormone leptin (from the Greek Leptos - low) gives hope for the discovery of a drug to combat obesity. Many scientists have begun searching for similar peptides in nature in order to artificially supply them to the human body.

• Leptin -a hormone of adipose tissue, which at the vascular level is proportional to its quantity. Leptin acts on specific receptors located in the hypothalamus that send satiety signals to the brain. It lets you know when the body has received enough substances from food. Sometimes mutations occur in this gene, which is responsible for the production of leptin. Individuals suffering from this mutation have low vascular levels of leptin and they constantly feel the need to absorb food. People constantly feel hungry and, trying to get enough, they themselves provoke the development of morbid obesity. External supply of leptin is extremely important for these people. However, obese patients often have higher serum leptin levels, but at the same time their appetite is greatly increased. In such cases, resistance and leptin replacement therapy have no effect.
• Grelinate -This is a hormone of the gastrointestinal tract, the action of which is similar to that of leptin. It is defined as a hunger hormone. Its level increases before eating and decreases immediately after eating. Ghrelinate is being used to develop an anti-obesity vaccine that will prevent it from reaching receptors in the central nervous system and causing hunger. Often, with obesity, this feeling turns out to be false, so it would be better to stop the access of the hunger hormone to the brain altogether. This is a chance for an obese patient to start leading a normal life.
• Peptide YY -another hormone that is involved in the formation of appetite. Produced in various parts of the small and large intestines after meals, this hormone slows stomach emptying, thereby improving digestion and absorption of nutrients and increasing the feeling of fullness. People who are obese have lower levels of peptide YY. Consumption of protein-rich foods and drinks has been found to increase the secretion of peptide YY and prolong the feeling of fullness.
• Adiponectin -another hormone produced in adipose tissue with potential influence on the development of obesity. Although its role in the body is not fully understood, it has been clearly demonstrated that patients suffer from obesity with low levels of adiponectin and vice versa - after weight loss, its concentration increases. Experiments conducted on laboratory mice have proven rapid weight loss after external use of adiponectin. Before human trials begin, however, many questions must be answered.

Why is obesity such a significant disease?

The social significance of obesity is determined not only by the alarming proportions it has reached among the world's population, but also by the health risks it poses. Of course, there has been a proven link between overweight, obesity and premature mortality. Moreover, obesity is one of the main etiological factors in the pathogenesis of a large number of diseases that affect the economically active population of the planet and lead to disability and loss of ability to work. According to official data, about 7% of total health care spending in some developed countries is devoted to treating the consequences of obesity. In reality, this figure may be many times higher, since most of the diseases indirectly associated with obesity are most likely not included in the calculation. Here are some of the most common diseases caused by obesity, and the risk it poses to their development:

The most common diseases caused by obesity are:

Significantly increased risk (Risk > 3 times)	Moderate risk (Risk > 2 times)	Slightly increased risk (Risk > 1 time)
Hypertension	Cardiovascular diseases	Cancer
Dyslipidemia	Osteoarthritis	Back pain
Insulin resistance	Gout	Developmental defects
Diabetes mellitus type 2 Sleep apnea Gallstone disease	Asthma

Obesity is a chronic metabolic disorder with very serious health consequences. And although to some extent its development is genetically predetermined, behavioral factors, in particular nutrition and physical activity, play a decisive role in the etiology. So the appearance of overweight or even obesity - all this will depend primarily on ourselves, and everything else is just excuses.

A peculiar paradox of our days is the spread of diseases of excess nutrition in economically developed countries, the consequences of which are very diverse and are characterized by pronounced specificity, depending on the excess consumption of individual nutrients. Scientists have found that excess purines in food leads to metabolic arthritis and gout; vitamin D - to intensify calcification processes; glucose and sucrose - to a significant worsening of diabetes; proteins - to renal failure syndrome.

According to world statistics, obesity firmly occupies first place among patients with food excess. In modern conditions, the struggle (note: the struggle) for normal body weight has become not only a medical, but also a social problem. And here's why. According to experts, approximately half of the adult population of our country is overweight, and 25 percent are obese. This disease is very insidious.

Firstly, because there is no clear distinction between overweight and obesity. It is generally accepted that if excess weight exceeds normal weight by 20 percent, this is already obesity. However, even a small, within 5-7 percent, excess of the norm is already an alarming signal for health.

Secondly, because a person who is even significantly overweight, but feels well, does not consider himself sick and consults a doctor only when obesity has already led him to some kind of disease. Such a person becomes a victim of his own illiteracy in matters of nutrition.

Scientists note that about 90 percent of cases of excess weight are associated with poor nutrition, mainly overeating. Therefore, it is within the capabilities of every person to prevent the increase in body weight (with the exception of rare cases when medical intervention is necessary). But it can be very difficult for most people to reduce excess weight and bring it to normal. And even if there is no pronounced obesity yet, in order to get rid of extra pounds, the help of a doctor is often required. If it comes to obesity, then it is imperative to see a doctor, and the sooner the better.

Overeating, especially in conditions of a sedentary lifestyle (hypokinesia), leads to the accumulation of adipose tissue. Fat is not ballast, inert, neutral, but a very active, rather aggressive tissue. Its aggressiveness in the body is manifested primarily in the uncontrollable desire to form similar tissue in ever-increasing quantities. It greedily absorbs fat from the blood and, in addition, forms new fat from carbohydrates. Needing constant nutrition and oxygen, adipose tissue constantly requires additional nutritional resources. A vicious circle is created: as a person’s weight increases, his appetite increases.

Excess body weight and obesity have a significant negative impact on all vital processes of the body, reduce life expectancy and become one of the main risk factors for the occurrence of many serious diseases, in particular cardiovascular diseases. Excess weight leads to a number of dangerous phenomena such as metabolic disorders (especially fat metabolism), which is accompanied by an increase in the synthesis of cholesterol and beta-lipoproteins. In this regard, the likelihood of developing atherosclerosis increases, the load on the heart increases due to increased body weight and limited respiratory excursions of the diaphragm, and a predisposition to increased blood pressure arises. According to statistics, hypertension occurs in obese people 10 times (!) more often than in people with normal weight. Obesity sharply reduces performance and creative potential. Obesity contributes to the development of diseases of the cardiovascular system (atherosclerosis, hypertension, angina pectoris, myocardial infarction), diseases of the liver and gallbladder (cholecystitis, cholelithiasis), pancreas (diabetes mellitus, pancreatitis) and complicates their course. It contributes to the development of diseases of the musculoskeletal system (arthrosis), pathological processes in the lungs. Obese patients do not tolerate surgical interventions well, especially operations in the abdominal cavity.

According to the World Health Organization (WHO), the cause of every second death in developed countries is damage to the heart and blood vessels. Over the past 20-25 years, the number of these diseases in our country has also increased. Doctors are especially alarmed by the “rejuvenation” of some cardiovascular diseases, in particular such severe ones as myocardial infarction. The reasons for this situation are known to science: the saturation of modern life various kinds stress, consumption of high-calorie, cholesterol-rich foods; smoking and alcohol abuse, sedentary lifestyle.

Scientists have established a direct connection between physical activity and lipid (fat) metabolism. People with fairly intense physical activity experience a decrease in cholesterol and beta-lipoprotein levels in the blood. Constant physical activity can be one of the factors that prevents or inhibits the development of coronary atherosclerosis, the accelerated development of which contributes to hypertension, diabetes mellitus, obesity and other diseases. By the way, the risk of cardiovascular diseases in people engaged in physical labor is 2 times less than in people leading a sedentary lifestyle.

Obesity is the cause of premature decline of some important physiological functions, in particular sexual function, and premature aging. The average life expectancy of obese people is reduced by 6-7 (and according to other sources, by 10-15) years. But that's not all. As the famous hygienist K.S. writes. Petrovsky: “A dramatic manifestation of the aggressiveness of adipose tissue is its ability to cumulate (accumulate) various harmful substances, including pesticides. Toxic substances accumulated in adipose tissue are difficult to remove and remain in it for a long time.” Everyone knows that at one time they began to widely use the chemical DDT, which, as it turned out, is dangerous for all living things. And despite the fact that this drug has not been used for more than two decades, it is found in the adipose tissue of people living both in cities and in rural areas. It is found in people who have never been in contact with this drug. In fat samples taken during surgical interventions, as well as during autopsies of people who died from various diseases, DDT and other organochlorine pesticides are usually found, sometimes in quite high concentrations.

Harmful substances enter the body with plant foods that have been treated with pesticides, as well as with products of animal origin if the animals have eaten food containing pesticides.

Scientists have found that the greater the volume of fat in the human body, the more harmful substances are accumulated in the body. Therefore, people who are severely overweight have large amounts of toxic substances in their fat depot. The harm of their presence for the development of astheno-vegetative syndrome, manifested by some functional disorders of the nervous and cardiovascular systems, has been proven. Further research is being conducted on the impact of these toxic substance depots on human health.

Harmful substances are absorbed especially intensively and with the greatest completeness by adipose tissue from products of animal origin and to the least extent from plant origin. Particularly high concentrations of toxic substances are observed in the adipose tissue of people who consume a lot of meat and fatty foods. As a result of studies conducted in our country and a number of other countries, it was found that in the adipose tissue of vegetarians, that is, people who do not consume animal products, the concentration of pesticides is insignificant, and in some cases completely absent, while in people who eat a mixed diet, A large amount of toxic substances is always found in adipose tissue.

It is known that increased appetite arose in the process of evolution, became entrenched and passed on to us by inheritance. The feeling of pleasure experienced by a person when eating is associated, as already mentioned, with the work of a certain center in the cerebral cortex (appetite center), which tends to become more active when eating. Therefore, the more we eat, the more we want to eat. This center, which previously signaled to a person that the body needs to replenish energy, now makes it known that a person can give himself another portion of pleasure. In some people, they are sent so often that their food intake turns into almost continuous greedy chewing, swallowing, and smacking. Unfortunately, a harmful habit, which primarily indicates a complete lack of food consumption culture, is sometimes so strong that a person needs to show significant volitional effort to give it up. But it is (and only) the volitional factor that allows you to do this. All other means, for example, taking various kinds of drugs that are designed to suppress the activity of this center, at best do not give the desired results, and at worst, they are harmful to health.

The physical and biological essence of the feeling of hunger, also called appetite, has not yet been fully elucidated. Scientists believe that the appetite center is stimulated by various impulses: a decrease in the concentration of glucose (sugar) in the blood, emptying of the stomach. The excitation of this center creates a feeling of hunger, the degree of which depends on the degree of excitation of the center.

Overeating is as old as humanity itself. The feeling of hunger is characteristic not only of humans, but also of all developed animals, and therefore there is no doubt that we inherited it from our distant ancestors. Since the latter could not always count on luck in finding food, certain advantages in the struggle for existence were given to those creatures that, having found food, consumed it in large quantities, that is, those that had an increased appetite. Thus, increased appetite apparently arose during the evolution of the animal world, became established in the offspring and was passed on to humans. The savage mostly suffered from hunger, and overeated only when he managed to get a lot of food. This apparently happened rarely, so our ancestor did not have any negative consequences from overeating. The abundant food was followed by a period of active hunting, which often lasted a very long time, and all reserves from short-term overeating were burned up in the process of vigorous physical activity. Overeating became a negative factor in the nutrition problem when it became systematic.

Currently, in developed countries, the problem of obtaining food for humans has lost its former severity, and in connection with this, increased appetite has also lost its biological meaning. Moreover, it has become a kind of enemy of man, since it is precisely because of increased appetite that systematic cases of overeating occur, which often turn into the most ordinary, vulgar gluttony.

Experimentally, scientists were able to establish that a thin, normally eating person eats a significantly larger amount of food on an empty stomach, that is, when he is really hungry, than on a full one. Obese people eat the same amount of food on an empty and full stomach. Scientists' conclusion from this experiment: fat people do not know when they are hungry and when they are full.

Further experiments showed that obese people also react inappropriately to other signals from their body. Thus, the body of thin people, under the influence of factors that cause fear, reacts to this with a sharp reduction in the need for food. Overweight people in a state of stress eat the same or slightly larger amounts of food as in completely normal situations.

Among those suffering from obesity, a fairly large proportion are those who were overfed in childhood. Currently, 10 percent of children in economically developed countries are obese. Physiologists warn that overfeeding children is especially dangerous, as this leads to an increase in their number of fatty tissue cells. If in an adult, when overeating, the size of the cells simply increases, then in childhood the number of fat cells in the youngest increases, which then work “like time bombs.” Corresponding Member of the Academy of Medical Sciences V.A. Shaternikov writes: “Their own hardships suffered in the past, the hungry years of war - all this leads to the fact that children are stuffed with all sorts of sweets and cookies, especially grandmothers. Guests carry candy, chocolate, and cakes, forgetting that now is a completely different time, that the fats and sugar that they pour out, as if from a cornucopia, will bring a child momentary joy, and subsequently many years of harm.”

Often such thoughtless, even criminal behavior towards a child by adults indicates a lack of basic culture in matters of feeding children. And sometimes adults do this in order to satisfy the whims of children (raised by them) in the simplest way, instead of taking on the burdensome chores of educating a child’s food culture.

Many researchers, as a result of extensive experiments, convincingly prove that the root of the problem of obesity is in habits established in childhood. The total number of fat cells that we take with us as we enter adulthood depends entirely on how we ate (or rather, how our closest people fed us) in childhood and early adolescence. Once these cells appear, they will remain with the person until the end of his life. Losing weight does not mean reducing the total number of fat cells in the body. It only shows a decrease in the amount of fat in each of the existing cells.

A child is taught everything, but rarely does anyone teach him to eat correctly. Academician A.A. Pokrovsky writes: “Cultivate in yourself and especially in children a penchant for simple food. Try to instill in them a love of natural, fresh and simply boiled foods: milk, potatoes, boiled meat, fresh fruits and berries. Children’s taste can and should be educated so that it corresponds to the usefulness of products.” And to develop in children a love for sweets and, even worse, for fatty-sweet, spicy, salty, and gourmet dishes, means cultivating in them a bad taste, which, as a rule, always leads to poor nutrition with all the ensuing consequences.

Obesity is a disease of improper metabolism that threatens with serious consequences. But even before painful phenomena in various organs develop, a person’s appearance changes: the figure is deformed, posture worsens, gait changes, and ease of movement is lost. Often, an overweight person becomes the object of jokes from others and feels this deeply, but does not take measures to change his lifestyle. And this is no coincidence. Some psychiatrists believe that in obese patients, qualities such as initiative, perseverance, and will are reduced.

Since we touched on the appearance of an obese person, we cannot help but say one more thing. In the past, some peoples believed that fullness, which did not reach ugly forms, was a sign of health, and sometimes beauty. So, at the end of the last century, in order to make themselves “beautiful,” thin people went to all sorts of tricks just to look more respectable: the outlines of figures changed by adding cotton wool to certain parts of the body. As academician A.A. writes Pokrovsky: “There was a time when a peculiar type of leggy obesity was considered a sign of beauty.” But to be honest, even today the so-called moderate obesity still causes envy among many.

But is it worth continuing to be so naive? Our naivety turns into downright tragic consequences. Shouldn't we consider, for example, that obese people die from cardiovascular disease between the ages of 40 and 50 at twice the rate of normal-weight people? To the above, it should be added that with obesity, the central nervous system suffers, memory weakens, interest in the environment decreases, drowsiness and dizziness appear.

The great ancient physician Galen called the stomach a divine organ, which very often suffers from an ugly attitude towards it, but has served man faithfully for a very long time. However, even this organ, with a large margin of safety, sometimes fails. This happens when the owner of the stomach tortures him daily: he eats a lot, chews poorly, fills the stomach with various harmful and often poisonous substances: alcoholic drinks, a lot of hot seasonings. The stomach suffers special abuse when its owner is a drunkard. As a rule, in this category of people the stomach and other digestive organs undergo monstrous changes and become unable to perform the physiological functions that nature intended for them.

To excess nutrition, in contrast to undernutrition, a physiological adaptation usually occurs, the essence of which is that, regardless of the person’s consciousness, there is a decrease in the digestibility and utilization of nutrients. In this case, a significant part of the nutrients is removed from the body. Here, adaptation to excess nutrition plays a positive role and regulates our flaws in nutrition, that is, overeating. But the trouble is that the degree of adaptation to excess nutrition varies widely among different people, depending on individual characteristics. There are people, and relatively young ones, in whom these adaptive capabilities are so poorly developed or completely absent that any overeating leads to an increase in their body weight. In addition, adaptation tends to decline with age. Sometimes this process of decline can last a relatively long time, but most often it happens quickly, and the person, without noticing, “gets better” in a short period of time. This usually happens when the behavioral pattern changes dramatically: on vacation, etc. Rapidly gained weight often becomes the beginning of the process of obesity.

Thus, if in young years a person could consume excessive amounts of food and at the same time remain slim, then in the future this ability is usually impaired, and sooner or later (this must always be remembered!) excess nutrition leads to an increase in body weight due to fat deposition and subsequently to obesity.

How to avoid obesity?

There is only one way to achieve this: moderation in food.

Why has obesity become the problem of the century in economically developed countries? This question was also answered by G. Fletcher. He wrote: “The almost universal habit of eating at every opportunity, guided by all sorts of whims of appetite, to gorge on food to satisfy the sensation of taste, without paying attention to the actual needs of our body - this habit has created completely unnatural ideas about life, and we have moved far away from the true laws nutrition."

Many modern scientists believe that a human life is 100-120 years, and he lives at best 1/2 of this period. There is almost a unanimous opinion among scientists that intemperance is to blame. “We ourselves, through our intemperance, our disorderliness, our disgraceful treatment of our own body, reduce this normal period to a much smaller figure,” argued I.P. Pavlov.

Gluttons, gluttons and just food lovers have created their own philosophy. They explain their addiction to food by the inability to resist food, with references to the hungry past. And everything looks much simpler: food is one of the most powerful and multifaceted sources of pleasure that is available to a person of any age. Few people can resist the temptation to eat abundantly and deliciously. Food addiction is especially dangerous in old age. As academician N.M. writes Amosov, over the years, “it becomes more and more difficult to maintain the level.” The fitness of the body decreases, there is a process of decrease and then extinction of individual functions, the disappearance of pleasures that were associated with them. “The function of reproduction disappears, production work ceases, prestige melts, communication decreases. The losses are partially compensated by the pleasures of food, peace and information.” The psyche is involved in the aging process. Lifestyle changes. Restriction of movement, increased nutrition, plus a decrease in unpleasant emotions associated with stopping work lead to deterioration in health, and an aging person becomes a victim of disease.

It is difficult to give up tasty and high-calorie food and force yourself to leave the table with a feeling of hunger, as the great ancient physician Galen advised to do. The practice of posting such reminders in some food establishments should be revived: “Those who care about their health should moderate their appetite.” There is an English proverb that a third of diseases come from bad cooks, and two thirds from good ones. It is difficult to argue with Luigi Cornaro, who stated: “Moderation in food purifies the senses, gives lightness to the body, agility in movements and correctness of actions. Protecting yourself from the excesses of the table is the best way not to suffer from other excesses.”

Outstanding representatives of culture, including our country, preached moderation in food and adhered to it themselves. Considering abstinence to be the basis of all the virtues of a thinking person, they directly connected it not only with a person’s health, but also with his morality, his worldview.

The great Russian writer L.N. Tolstoy, who strictly adhered to moderation in general and in nutrition in particular, believed that “a person who overeats is unable to fight laziness... Apart from abstinence, no good life is conceivable. Every achievement of a good life must begin through him... Abstinence is the liberation of a person from lusts, is the subjugation of them by prudence... Satisfaction of needs has a limit, but pleasure does not have it.”

What should be done to prevent and treat obesity?

The scientific prerequisite for modern principles of prevention and treatment of obesity is the theory of balanced nutrition, the main rules of which are: achieving energy balance; establishing the correct ratio of basic nutrients: proteins, fats, carbohydrates; establishing a certain ratio of vegetable and animal fats; correct ratio between sugars and starch; balancing of minerals. In other words, for obesity, a low-calorie diet is prescribed, but balanced in all essential factors and containing a sufficient amount of protein.

When determining the calorie content of the diet, one must proceed from individual energy needs, which should be reduced, depending on the amount of excess body weight, by 20-40 percent. It is also necessary to change the diet: it should become five or six meals a day in order to achieve adaptation of enzyme systems and a decrease in appetite. This is achieved by introducing low-calorie foods between main meals, mainly natural vegetables and fruits: cabbage, carrots, turnips, rutabaga, apples. The feeling of satiety is achieved not due to calorie content, but due to a significant amount of food. Dishes that stimulate the appetite are limited or completely excluded from the menu: various types of savory snacks, spices. It goes without saying that complete abstinence from any alcoholic beverages - beer, wine - is necessary. Failure to comply with this requirement negates all treatment, since any, even minor, drinking sharply weakens the patient’s self-control over food consumption.

Since obesity is the result of an energy imbalance, and the body's sources of energy are carbohydrates and fats, special control is necessary over the consumption of these particular nutrients. Restriction of carbohydrates is required, especially sugar, which, unfortunately, is the main supplier of energy for many and easily turns into fat in the body. Yes, sugar is very dangerous. It not only represents the so-called “empty calories”, since it does not contain any nutrients necessary for the body, but also contributes to the development of dental caries and diabetes.

In our country, sugar consumption is continuously increasing and currently amounts to more than 120 grams per day per person, whereas, in accordance with the recommendations of the Institute of Nutrition of the Academy of Medical Sciences, one should strive to ensure that it does not exceed 50 grams per day. Too much sugar consumption can cause significant harm to your health. In the human digestive tract, sugar molecules, or sucrose, are very quickly broken down into two simpler molecules - glucose and fructose, which are very easily absorbed into the blood. In response to an increase in the concentration of glucose in the blood, a hormone is released from the pancreas - insulin, which promotes better absorption of glucose by tissues, which leads to the normalization of sugar (more correctly - glucose) in the blood. When consuming sugar in significant quantities and many times a day, the load on the pancreas increases and there may come a time when the gland cannot cope with this load, which will lead to the occurrence and development of diabetes mellitus. This is the price you sometimes have to pay for your sweet tooth.

Another source of energy for the body is fats. They also need to be limited, especially animal fats. In the diet of an obese person, up to 50 percent of the body's fat needs should be covered by vegetable fats.

The quantity and quality of fats in the daily diet can affect the development of atherosclerosis, in patients with whom there are significant disturbances in the processes of fat metabolism and, as a consequence, an increased content of total lipids, cholesterol and some other lipid components in the blood serum. It has been established that an increase in the amount of animal fats in the diet contributes to the occurrence of these disorders or their intensification. If fats in the daily diet make up 30-35 percent (calorie content), and at least 30 percent of them are vegetable oils, then the threat of lipid metabolism disorders cannot be expected. If the fat content, mainly from animals, increases, then a so-called risk factor for the development of atherosclerosis arises. Therefore, it is necessary to constantly monitor the quantity and quality of fats in the daily diet.

An indispensable condition of a therapeutic diet for obesity is limiting salt intake to 5-6 grams per day. Excess of it is a risk factor for hypertension. This conclusion can also be considered proven. Food should be salted moderately so that it appears under-salted. You can get used to this relatively quickly and even better appreciate the taste of the food served on the table.

When treating obesity, control over fluid intake is also established. It is advisable that its total volume does not exceed 1-1.5 liters per day.

All of the above advice on therapeutic nutrition for obesity, we especially emphasize this, is of a general nature and cannot be considered as medical advice, for which you should contact your doctor.

Classmates

Joke:

My girlfriend has been on a diet for 2 weeks, and at night I found her in the kitchen with a bun in her teeth.
Noticing me, she throws the bun and yells:
“I’m not me, and the bun is not mine.”, and then burst into tears! Girls.... 😆