Obesity - degrees, causes, diet and treatment of obesity. Causes and diagnosis of obesity General principles of obesity treatment

Obesity is a disease characterized by weight gain of more than 20% of the norm due to adipose tissue. It is based on an imbalance between the synthesis, accumulation and breakdown of fat. The development of pathology is characterized by:

excess food intake;
lack of physical activity – low energy and calorie expenditure;
disturbance of metabolic processes in the body.

Doctors note the main stages of development of the pathology: stable - weight gain does not occur, progressive - body weight increases in jumps or gradually, residual - a state after persistent weight loss. Diseases are distinguished by type. Classification depends on the mechanism of development of the pathology. There are types of obesity:

primary – formed as a result of overeating and limited mobility;
secondary – the result of the development of cerebral disorders, hereditary causes;
endocrine – occurs when there are disorders in the hormonal system.

Based on a person’s appearance, one can determine the type of pathology:

Abdominal - central obesity - the body resembles an apple. Deposits in the upper part, on the waist, are typical for men, provoke diabetes, heart attack, hypertension, stroke.
Femoral-gluteal – adipose tissue predominates on the hips, buttocks, pear-shaped figure. It is observed in women, causes pathologies of the joints, spine, veins.
Mixed - even distribution of body fat throughout the body.

Overweight can be classified according to the degree of change:

the first is a slight weight gain, which can be corrected by following a diet and exercise;
the second – pronounced fat deposits, shortness of breath when moving, increased blood pressure, joint pathologies;
third – significant excess weight, breathing problems, swelling of the legs, headache;
the fourth is the difficulty of moving due to pathologies of the joints.

What causes obesity in humans

What are the risk factors for being overweight? Why does a person gain unnecessary body weight? Doctors note the causes of obesity:

hereditary predisposition;
excess caloric content of food;
binge eating;
eating disorder;
abuse of salt, sugar, alcohol, fast food, carbonated drinks, carbohydrates;
sedentary work;
insomnia;
pathology of the nervous system;
pregnancy;
menopause;
hormonal disorders;
dysfunction of the reproductive and endocrine glands;
taking medications;
lactation period;
stress.

Signs of obesity

What is overweight? This is excessive deposition of fatty tissue, which changes a person’s appearance, causes psychological and sexual problems, and destroys health. The main symptom of the disease is increased body weight. A person experiences the following symptoms:

increased abdominal size;
double chin;
fat folds on the sides;
deposits on the buttocks, shoulders, back;
thighs similar to breeches;
inguinal, umbilical hernia.

The development of the disease is accompanied by the following signs:

increased sweating;
pain in joints, spine;
disturbances in the gastrointestinal tract;
swelling;
constipation;
dyspnea;
nervousness;
decrease in working capacity;
skin stretch marks;
weakness;
drowsiness;
tachycardia;
pathologies of the cardiovascular system;
hormonal disorders;
the appearance of psychological complexes;
communication problems;
decreased self-esteem;
irritability;
thirst;
dizziness;
menstruation disorders;
decreased potency.

Complications

The disease is characterized by psychological problems that occur in an overweight person. Why is it considered dangerous to health? With the development of this pathology there are risks of complications:

cholelithiasis;
the occurrence of diabetes mellitus;
infertility;
liver damage;
metabolic disease;
hyperinsulinemia.

Excess weight causes degenerative changes in joints - arthrosis, osteochondrosis, spinal hernia. Diseases develop:

arterial hypertension;
cardiac ischemia;
ventricular hypertrophy;
oncological pathologies caused by problems with hormone secretion;
heart attack;
heart failure;
hyperuricemia;
stroke;
atherosclerosis;
sleep apnea;
pulmonary hypertension;
sexual problems - decreased libido, amenorrhea.

Obesity levels by body mass index

Doctors around the world have adopted a classification of the degree of excess body weight based on BMI.

Anyone can calculate their body mass index. To do this, you need to find out your weight, divide it by your height squared, measured in meters. Human mass index (BMI) characterizes the patient’s condition, the likelihood of developing pathologies, and the degree of obesity:

Age, years	characteristic
		weight deficiency
		normal body weight
	elevated	pre-obesity
		I degree
	very tall	II degree
	excessively high	III degree

Obesity

This degree is considered the initial form of the disease, accompanied by increased appetite, drowsiness, fatigue, and shortness of breath. This condition can be easily corrected. To do this you need:

gradually reduce body weight;
increase physical activity - do fitness, swimming, dancing;
walk more;
normalize nutrition - reduce the amount of fats, fast carbohydrates;
replace sugar with honey;
drink water;
reduce the amount of salt and flour products.

1st degree

Extra pounds make themselves felt by deteriorating well-being. Sweating, swelling, and breathing problems may occur. Being overweight begins to cause psychological discomfort - communication problems and complexes appear. Efforts are required to lose weight - the use of a special diet, a set of sports activities, massage. 1st degree is characterized by education:

folds on the sides;
increased abdominal size;
fat deposits on the shoulders, arms;
double chin.

2 degree

Excess body weight is more than 35%. A person's motor activity and performance decrease. Disorders of fat metabolism occur, which threaten heart disease, changes in metabolism, and endocrine pathologies. Urgent weight adjustment is required using medications, diet, and increased physical activity. The second degree is characterized by:

heavy sweating;
shortness of breath when moving and at rest;
pain in joints, spine.

3rd degree

This condition requires the intervention of specialists to combat extra pounds. The patient is more than 40% overweight. Complications are possible - heart attack, stroke, arthrosis of the joints. In the third degree, symptoms are observed:

problems in the functioning of the cardiovascular system;
headache;
swelling of the legs;
shortness of breath at rest;
Difficulties with self-care.

4th degree

The situation is characterized by excess weight, exceeding the norm by two or more times. It is rare - most patients do not live to see it. In this situation the person:

has a shapeless body consisting of fat;
cannot move independently - often lies in bed;
unable to perform basic actions;
requires self-care;
suffocates;
has problems with all organs.

Diagnosis and treatment of obesity

To select a treatment regimen for overweight, it is necessary to examine the patient. The doctor begins by collecting anamnesis, establishing heredity, concomitant chronic diseases, and the dynamics of weight gain. Diagnostics include:

measurement of weight, height, hip circumference, waist;
BMI calculation;
pressure measurement;
blood glucose determination;
tests for the level of cholesterol, triglycerides, lipoproteins - assessment of lipid metabolism;
electrocardiogram - determination of cardiac dysfunction;
Ultrasound, MRI of the adrenal glands, thyroid gland;
hormone analysis.

The treatment regimen depends on the patient’s condition, type of obesity, and degree of development. Complex therapy includes:

selection of dietary nutrition;
methods of conducting classes, the level of physical activity;
the use of medications to reduce appetite and fat absorption;
surgical treatment – gastric banding, vertical gastroplasty, bypass surgery;
psychotherapy.

Exogenous-constitutional

Primary or nutritional obesity develops when energy balance is disturbed. With an exogenous-constitutional type of pathology, the amount of food eaten in terms of caloric content does not correspond to energy consumption. Excess carbohydrates form visceral fat, deposited on internal organs. Primary obesity responds well to treatment with:

caloric restriction of food;
reducing the amount of carbohydrates, fats;
increase in physical activity;
compliance with the drinking regime.

Endocrine

This type of obesity requires seeking help from an endocrinologist. The cause of the disease lies in the dysfunction of the hormonal system, the development of pathologies of the gonads, thyroid gland, and pituitary gland. When treating the disease, in addition to normalizing nutrition and physical activity, use:

methods of psychotherapy;
medications that accelerate saturation and reduce lipid absorption;
hormone replacement therapy;
in severe cases - liposuction, surgical treatment aimed at reducing the size of the stomach.

Pituitary

Dysfunction of the pituitary gland, provoked by infections, intoxication of the body, and traumatic brain injuries, causes pituitary obesity. The disease can be caused by a hormonal imbalance that appears during pregnancy or menopause. Treatment of pathology is aimed at reducing the activity of the center responsible for appetite and includes:

taking medications – Lipocaine, Clofibrate;
fractional meals;
eating foods rich in fiber - fruits, vegetables, grains;
hormonal therapy;
active movement.

Cerebral

This type of disease is provoked by brain pathologies - neoplasms, injuries, inflammatory processes. It is characterized by an eating disorder, changes in gastronomic preferences, loss of control over the amount of food eaten, which leads to overeating. The cerebral type of the disease is observed in patients with dementia, mental retardation, consequences of stroke, and trauma. Treatment includes:

psychotherapy;
dietary food;
taking anorexic drugs, psychotropic drugs, antidepressants.

Hypothyroid

A lack of thyroid hormones causes this type of disease. Weight gain is associated with metabolic disorders and a decrease in lipotic activity of adipose tissue. Such problems are observed with trauma, radiation damage to the thyroid gland, and idiopathic hypothyroidism. Treatment of the disease involves:

hormone replacement therapy with Triiodothyronine, Thyroidin;
taking diuretics, lipotropic substances;
use of vitamins - riboflavin, calcium pangamate, ascorbic acid.

Hypothalamic

Gaining excess weight during illness is associated with increased adrenal function and an increase in cortisol in the blood. They provoke the development of a hypothalamic disease, metabolic disorders, hormonal imbalances - improper production of glucorthyroidoids, testosterone, estrogen, prolactin. Treatment is carried out in a hospital under the supervision of a doctor and includes:

dosed fasting;
taking drugs that inhibit the activity of brain centers responsible for appetite;
psychotherapy;
diet;
increased physical activity;
administration of diuretics and antihistamines.

World obesity statistics

Changes in diet and decreased physical activity have led to a sharp increase in the number of fat people in the world. Doctors note that since 1975, the number of people suffering from obesity has tripled. In 2016, there were 650 thousand people in the world with this pathology. Mortality from diseases caused by excess weight has increased. Rates have worsened significantly among children, from 4% in 1975 to 18% in 2016. Of these, 41 million are children under 5 years of age. World obesity statistics in percentage by year:

Country rating

American scientists in 2015 conducted a study of states where citizens suffer from excess weight. Social progress Imperative published statistics. The top countries by percentage of overweight people look like this:



	Saudi Arabia


	Jordan

In Russia

In our country, indicators have increased significantly over 10 years. This is due to a decrease in physical activity of the majority of the population, changes in the quality of nutrition, abuse of fatty foods, and fast food. In women, the rates increased by 3%, and in men – three times. This confirms the statistics of high mortality among the male population. The situation with excess weight in Russia in percentage looks like this:

Age, years

Obesity prevention

To avoid excess weight, you need to eat right and burn the calories you get from food through physical activity. If symptoms of obesity appear, it is advisable to consult an endocrinologist to find out the causes of the pathology. A nutritionist will help you create the right weight loss program. To prevent the disease it is necessary:

reduce the calorie content of food;
reduce the amount of carbohydrates and fats in the diet.

To forget what obesity is and to be in good shape requires effort:

increase the plant and protein component in food;
arrange a fasting day once a week;
organize fractional meals;
drink clean water;
eliminate stress;
walk daily;
swim in swiming pool;
exercise in the gym;
give up alcohol and smoking.

Video

– excess fat deposits in subcutaneous tissue, organs and tissues. It manifests itself as an increase in body weight by 20 percent or more of the average due to adipose tissue. It causes psycho-physical discomfort, causes sexual disorders, diseases of the spine and joints. Increases the risk of developing atherosclerosis, coronary artery disease, hypertension, myocardial infarction, stroke, diabetes mellitus, kidney damage, liver damage, as well as disability and mortality from these diseases. The most effective treatment for obesity is the combined use of 3 components: diet, physical activity and appropriate psychological adjustment of the patient.

ICD-10

E66

General information

The endocrine type of obesity develops with pathology of the endocrine glands: hypothyroidism, hypercortisolism, hyperinsulinism, hypogonadism. With all types of obesity, hypothalamic disorders are observed to one degree or another, which are either primary or occur during the course of the disease.

Obesity symptoms

A specific symptom of obesity is excess body weight. Excess fat deposits are found on the shoulders, abdomen, back, sides of the body, back of the head, hips, and pelvic area, while underdevelopment of the muscular system is noted. The patient’s appearance changes: a double chin appears, pseudogynecomastia develops, fat folds on the abdomen hang down in the form of an apron, and the hips take the shape of riding breeches. Umbilical and inguinal hernias are typical.

Patients with degrees I and II obesity may not present any special complaints; with more severe obesity, drowsiness, weakness, sweating, irritability, nervousness, shortness of breath, nausea, constipation, peripheral edema, pain in the spine and joints are noted.

Patients with grade III-IV obesity develop disorders of the cardiovascular, respiratory, and digestive systems. Objectively, hypertension, tachycardia, and muffled heart sounds are detected. The high standing of the dome of the diaphragm leads to the development of respiratory failure and chronic cor pulmonale. There is fatty infiltration of the liver parenchyma, chronic cholecystitis and pancreatitis. There are pains in the spine, symptoms of arthrosis of the ankle and knee joints. Often, obesity is accompanied by menstrual irregularities, up to the development of amenorrhea. Increased sweating causes the development of skin diseases (eczema, pyoderma, furunculosis), the appearance of acne, stretch marks on the abdomen, hips, shoulders, hyperpigmentation of the elbows, neck, and places of increased friction.

Obesity of various types has similar general symptoms, differences are observed in the nature of the distribution of fat and the presence or absence of signs of damage to the endocrine or nervous systems. With alimentary obesity, body weight increases gradually, body fat is uniform, sometimes prevailing in the thighs and abdomen. There are no symptoms of damage to the endocrine glands.

With hypothalamic obesity, obesity develops rapidly, with a predominant deposition of fat on the abdomen, thighs, buttocks. There is an increase in appetite, especially in the evening, thirst, nocturnal hunger, dizziness, tremor. Trophic skin disorders are characteristic: pink or white striae (striations), dry skin. Women may develop hirsutism, infertility, menstrual irregularities, in men - deterioration in potency. Neurological dysfunction occurs: headaches, sleep disturbance; autonomic disorders: sweating, arterial hypertension.

The endocrine form of obesity is characterized by a predominance of symptoms of underlying diseases caused by hormonal disorders. The distribution of fat is usually uneven, there are signs of feminization or masculinization, hirsutism, gynecomastia, skin stretch marks. A peculiar form of obesity is lipomatosis - benign hyperplasia of adipose tissue. Manifested by numerous symmetrical painless lipomas, more often observed in men. There are also painful lipomas (Dercum lipomatosis), which are located on the limbs and trunk, are painful on palpation and are accompanied by general weakness and local itching.

Complications of obesity

In addition to psychological problems, almost all obese patients suffer from one or a number of syndromes or diseases caused by excess weight: coronary artery disease, type 2 diabetes mellitus, arterial hypertension, stroke, angina pectoris, heart failure, cholelithiasis, liver cirrhosis, sleep apnea syndrome, chronic heartburn , arthritis, arthrosis, osteochondrosis, polycystic ovary syndrome, decreased fertility, libido, menstrual dysfunction, etc.

Obesity increases the likelihood of breast, ovarian and uterine cancer in women, prostate cancer in men, and colon cancer. There is also an increased risk of sudden death due to existing complications. The mortality rate for men aged 15 to 69 years with an actual body weight that is 20% greater than ideal body weight is one third higher than for men of normal weight.

Diagnosis of obesity

When examining patients with obesity, attention is paid to the medical history, family predisposition, the minimum and maximum weight after 20 years, the duration of the development of obesity, the activities carried out, the patient’s eating habits and lifestyle, and existing diseases are determined. To determine the presence and degree of obesity, the method of determining body mass index (BMI) and ideal body weight (IB) is used.

The nature of the distribution of adipose tissue on the body is determined by calculating a coefficient equal to the ratio of the waist circumference (WC) to the hip circumference (HC). The presence of abdominal obesity is indicated by a coefficient exceeding 0.8 for women and 1 for men. It is believed that the risk of developing concomitant diseases is high in men with WC > 102 cm and in women with WC > 88 cm. To assess the degree of subcutaneous fat deposition, the size of the skin fold is determined.

The most accurate results of determining the location, volume and percentage of adipose tissue from total body weight are obtained using auxiliary methods: ultrasound, nuclear magnetic resonance, computed tomography, x-ray densitometry, etc. If patients are obese, they need consultations with a psychologist, nutritionist and physical therapy instructor.

To identify changes caused by obesity, determine:

blood pressure indicators (to detect arterial hypertension);
hypoglycemic profile and glucose tolerance test (to detect type II diabetes mellitus);
level of triglycerides, cholesterol, low- and high-density lipoproteins (to assess lipid metabolism disorders);
changes in ECG and echocardiography (to identify disturbances in the circulatory system and heart);
uric acid level in a biochemical blood test (to detect hyperuremia).

Obesity treatment

Each obese person may have their own motivation for losing weight: a cosmetic effect, reducing health risks, improving performance, the desire to wear smaller clothes, the desire to look good. However, goals for weight loss and its pace should be realistic and aimed, first of all, at reducing the risk of complications associated with obesity. Treatment for obesity begins with diet and exercise.

For patients with BMI< 35 назначается гипокалорийное питание с уменьшением калорийности пищи на 300-500 ккал и усиление физической активности. Ограничение калорийности идет за счет уменьшения суточного потребления жиров (особенно, животных), углеводов (в первую очередь, рафинированных), при достаточном количестве белка и клетчатки. Предпочтительные виды термической обработки пищи – отваривание и запекание, кратность питания – 5-6 раз в сутки небольшими порциями, из рациона исключаются приправы, алкоголь.

When following a hypocaloric diet, basal metabolism decreases and energy is conserved, which reduces the effectiveness of diet therapy. Therefore, a hypocaloric diet must be combined with physical exercise, which increases the processes of basal metabolism and fat metabolism. The prescription of therapeutic fasting is indicated for patients undergoing hospital treatment with severe obesity for a short period.

Drug treatment of obesity is prescribed when a BMI is >30 or the diet is ineffective for 12 weeks or more. The action of drugs from the amphetamine group (dexafenfluramine, amfepramone, phentermine) is based on inhibition of hunger, acceleration of satiety, and anorectic effect. However, side effects are possible: nausea, dry mouth, insomnia, irritability, allergic reactions, addiction.

In some cases, the administration of the fat-mobilizing drug adiposine, as well as the antidepressant fluoxetine, which changes eating behavior, is effective. The most preferred drugs today in the treatment of obesity are sibutramine and orlistat, which do not cause significant adverse reactions or addiction. The action of sibutramine is based on accelerating the onset of satiety and reducing the amount of food consumed. Orlistat reduces the absorption of fats in the intestines. For obesity, symptomatic treatment of underlying and concomitant diseases is carried out. In the treatment of obesity, the role of psychotherapy (conversation, hypnosis) is high, changing the stereotypes of developed eating behavior and lifestyle.

Forecast and prevention of obesity

Timely, systematic interventions for the treatment of obesity bring good results. Already with a decrease in body weight by 10%, the overall mortality rate decreases by >20%; mortality caused by diabetes > than 30%; caused by cancer concomitant with obesity, > than 40%. Patients with I and II degrees of obesity remain able to work; with degree III - they receive disability group III, and in the presence of cardiovascular complications - disability group II.

To prevent obesity, a person with normal weight only needs to spend as many calories and energy as he receives during the day. With a hereditary predisposition to obesity, after the age of 40, with physical inactivity, it is necessary to limit the consumption of carbohydrates, fats, and increase protein and plant foods in the diet. Reasonable physical activity is required: walking, swimming, running, visiting gyms. If you are dissatisfied with your own weight, in order to reduce it you need to contact an endocrinologist and nutritionist to assess the degree of violations and draw up an individual weight loss program.

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

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

Treatment should include changes in eating behavior

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

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

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

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

Types and stages of pathology

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

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

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

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

How to calculate BMI

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

First signs and symptoms

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

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

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

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

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

Diagnostics

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

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

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

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

Treatment methods

A nutritionist will help you create the right diet

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

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

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

Diet

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

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

Prevention

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

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

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

What to remember

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

Obesity is a disease in which a person has excess fat deposits in the subcutaneous tissue, as well as in other tissues and organs. This pathology manifests itself in an increase in body weight due to the accumulation of adipose tissue by 20% or more of the average value. Obese people suffer from various sexual disorders, experience psychological and physiological discomfort, and over time they develop disorders in the functioning of the joints, spine and internal organs. Excessive deposits of adipose tissue increase the risk of cardiovascular pathologies, diabetes, liver and kidney diseases. Accordingly, the risk of death increases. Due to this obesity requires treatment, which most often consists of three components: dietary nutrition, physical activity, and psychological assistance to the patient.

It has been established that men suffer from obesity two times less often than women. The age at which people usually begin to gain weight is between 30 and 60 years old. In the Russian Federation alone, this disease affects 30% of people of working age. Another 25% of the country's population is overweight. Scientists all over the world are concerned about the problem of obesity. WHO experts call this disease a modern epidemic, which already affects millions of people. Moreover, the risk of developing obesity is practically not affected by a person’s social status and nationality.

To assess the dangers of obesity, you should take into account the following facts in numbers:

For angina pectoris and IHD obese people suffer 3-4 times more often than people with normal body weight;
Hypertension is diagnosed in obese people 3 times more often;
Acute respiratory and viral infections, pneumonia and other diseases in obese people are more severe and protracted. They are more likely to experience various complications.

To diagnose a patient obesity, it is necessary to determine his body mass index (BMI). Calculating this indicator is quite simple. The formula proposed by WHO back in 1997 remains relevant today. So, you can determine BMI using the following formula: weight in kilograms divided by a person’s height in meters squared.

If the BMI is less than 18.5, then the person is underweight;
If the obtained value is in the range from 18.5 to 24.9, then the person’s body weight is considered normal;
If the resulting value is in the range from 25.0 to 29.9, then body weight is considered overweight;
The first degree of obesity is diagnosed with a BMI from 30.0 to 34.9;
Second degree obesity is diagnosed with a BMI in the range between 35.0 and 39.9;
The third and fourth degrees of obesity are diagnosed if the BMI exceeds 40.

Moreover, a BMI exceeding 30 indicates that a person already has direct health threats and needs medical attention.

Obesity symptoms

The symptoms of obesity may seem obvious to everyone: being overweight. Indeed, this is the most specific sign indicating a problem. Fat deposits are found on the abdomen, back, sides, shoulders, and thighs. Moreover, the muscles of such people are most often weak and underdeveloped.

Other symptoms of obesity include:

Changes in appearance. People get a second chin, men often suffer from gynecomastia (their mammary glands increase in size). The abdomen is covered with fat folds that resemble an apron;
Often, people with excess body weight experience inguinal and umbilical hernias;
Patients get tired faster, drowsy, and sweating in such people is increased;
As the disease progresses, shortness of breath joins, as the cardiovascular system suffers;
Due to violations of metabolic processes, failures occur in the digestive system. Nausea is common and constipation develops;
The joints and spine suffer from excessive stress and pain occurs;
Obese people are prone to edema;
In women, menstrual cycle disturbances are possible; in men, potency suffers. Sexual desire decreases;
Wrinkles and increased sweating cause the development of skin pathologies, including prickly heat, furunculosis, eczema, pyoderma, acne. Stretch marks appear on the stomach and thighs. High friction areas are particularly affected.

Depending on where fat is deposited, there are three types of obesity. So, if fat is deposited mainly in the upper part of the body, and the figure begins to resemble an apple in shape, then doctors talk about the abdominal type of obesity. This condition is considered very dangerous for health, as it threatens the development of cardiovascular pathologies.

When fat deposits begin to accumulate in the lower body, and the torso itself is shaped like a pear, then experts talk about the femoral-buttock type of obesity. Most often, fat is distributed in this way in females. This type of obesity is dangerous for the development of varicose veins, venous insufficiency and articular pathologies.

As for the third type of obesity, it is called mixed. In this case, the fat is distributed evenly throughout the body.

Depending on the type of obesity, the symptoms of the disease will vary. Differences are expressed in the rate at which body weight increases, and also in whether a person has problems with the endocrine and nervous systems.

Based on this, they distinguish:

Symptoms of nutritional type obesity. There is a gradual gain in body weight. Fat is distributed evenly, although sometimes it accumulates more on the hips and abdomen. The endocrine system works normally;
Symptoms of hypothalamic obesity. Body weight increases very quickly. Fat is deposited mostly on the buttocks and thighs, as well as on the abdomen. A person experiences constant hunger, which makes him overeat. The increase in appetite is especially noticeable in the evening. Such people drink a lot of water because they are thirsty all the time. Patients get up at night to eat. Patients have a tremor of the limbs, they complain of dizziness. Since weight is gained quickly, the skin cannot withstand such stress. Pink stretch marks form on it. Women often suffer from infertility, and growths may appear on their face. hair, the menstrual cycle is disrupted. As for men, their sexual function primarily suffers. On the part of the nervous system, the following pathologies are observed: frequent headaches occur, insomnia. Blood pressure in patients is most often elevated;
Symptoms of endocrine obesity. If the functioning of some endocrine glands is disrupted, the patient may begin to gain weight. Fat deposits are distributed unevenly throughout the body. Women acquire masculine features; in men, on the contrary, their breasts begin to enlarge and stretch marks appear on the skin. In addition, the person suffers from symptoms associated with one or another disease of the endocrine glands;
Symptoms of lipomatosis. This form of obesity needs to be considered separately, since body weight increases due to hyperplasia of benign fat cells. Lipomas appear on the human body, which do not hurt and have a symmetrical shape. Men are more susceptible to lipomatosis. A special form of the disease is Dercum lipomatosis, which causes itchy, painful lipomas to appear on the arms, legs, and body.

Causes and factors contributing to obesity

Obesity most often begins to develop due to the fact that there is a disruption in the normal balance between energy expenditure and the supply of this energy along with food. It has been established that the main cause of obesity is overeating. It is this that in 90% of cases contributes to the fact that a person begins to gain weight. The abundance of kilocalories received from food cannot be 100% consumed by the body. Therefore, the excess turns into fat and is deposited in the so-called fat “depots”. Such depots are mainly subcutaneous fat, the abdominal wall and internal organs.

Over time, fat reserves increase and body weight increases, which negatively affects health. It has been proven that only in 5% of cases obesity cause metabolic disorders.

A provoking factor that has a direct impact on a person’s eating behavior is a dysregulation of the hypothalamic-pituitary-adrenal system. The more actively it works, the higher the rate of production of ACTH and cortisol. At the same time, the somatotropic hormone responsible for the breakdown of fats begins to be produced in smaller quantities. At the same time, the level of insulin in the blood increases, and the absorption of thyroid hormones is disrupted. All this leads to an increase in appetite and a slowdown in the process of fat absorption.

So, the main cause of obesity is overeating.

However, we can separately highlight some factors that contribute to the gain of extra pounds, among them:

Low physical activity, sedentary lifestyle;
Genetic predisposition to enzymatic failures. This is expressed in excessive activity of the lipogenesis system and low activity of enzymes responsible for the breakdown of fats;
Irrational diet plan. Fat begins to actively accumulate when carbohydrates, salt, fats, and sugars are present in large quantities in the diet. Alcohol abuse and eating in the evening, especially before bedtime, are dangerous;
Diseases of the endocrine system, including Cushing's disease, hypogonadism, hypothyroidism and insulinoma;
Overeating due to stress;
Sometimes obesity may be determined by the physiological state of the person. For example, women eat more than normal during pregnancy, while breastfeeding, and then it becomes a habit;
Often the reason that a person overeats is taking hormonal drugs or treatment with psychotropic drugs.

Depending on the cause that led to obesity, primary and secondary are distinguished. obesity. Primary develops due to the influence of some external factor: overeating, low physical activity, predominance of fats and carbohydrates in food, etc. Often people have a family predisposition to obesity.

Is it possible to get pregnant with obesity? You can get pregnant if you are obese, but with grades 3 and 4, the chances of conception are extremely low. If pregnancy does occur, the risk of developing various pregnancy pathologies remains high.

Does it affect obesity for potency? Yes, obesity negatively affects potency. Especially in this regard, the hypothalamic obesity with fat deposition in the lower body. Problems with potency are observed in almost all men at stages 3 and 4 of obesity.

Is it possible to eat watermelons if you are obese?? Watermelon contains a large amount of sucrose - fast carbohydrates that contribute to weight gain, so if you are obese, it can be consumed in very limited quantities.

Do they take obese people into the army?? People with grade 3 obesity are not accepted into the army when their BMI is between 35.0 and 39.9. In this case, the man is considered temporarily unfit (for up to 6 months). During this time, he must undergo an inpatient examination. A similar decision can be made again for another 6 months. If treatment for obesity does not give a positive result after a year, then the person is recognized as having limited fitness and is exempt from conscription.