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Obesity - A chronic disease of the metabolism, which is characterized by a progressive development of excess fat tissue, which leads to complications and recurrence after treatment.
The disease is highly prevalent. Thus, for example, only 50% among Europeans have symptoms of obesity - overweight And 30% for a long time suffering from obesity. Every decade patients become 10% more. The spread of the disease contribute to several factors. Demographic factors : Increased life expectancy, race, ethnicity, female. Socio-cultural factors : Lower educational level, low income, marital status. Biological factors Influencing the occurrence of obesity, it is believed the number of births. But the main factors which have influenced this past behavioral - Poor diet, alcohol and smoking, reduced physical activity.
The weight of the body is constantly monitored nejrogumoralnoj. The expression food motivation, that is the feeling of hunger and satiety answers hypothalamus In his supraoptic nuclei are the main centers of these feelings and the center of the regulation of metabolism in the body. This center meets basic cancer - thyroid . pancreas and adrenals . This center is subordinated and autonomic system .
To date, there is no uniform system of classification of obesity. Conventionally distinguish four degrees of obesity. The most common the primary form of the disease It is 75% of cases. The cause of obesity is a primary violation of the ratio of energy produced and burned. Violation energy balance leads to increased synthesis triglycerides adipose tissue, which contributes to its accumulation. In a large percentage of cases, the primary cause of obesity is a genetic predisposition.
No less common symptomatic obesity , It is treated as complex as a form of the disease cerebral obesity and various syndromes. Cerebral form of obesity is associated with disorders of the central nervous system. The disease occurs on the basis of brain damage due to trauma, infectious diseases. Syndrome Gelineau characterized by obesity and coma. Also, obesity is a characteristic symptom of syndromes: Prader-Willi . syndrome Tsondeka . disease Babinski-Fröhlich . Endocrine obesity occurs as a symptom of disease of the endocrine system. There is this degree of disease in hypothyroidism . diabetes . secreting insuliome and other violations.
There are also local obesity , Refers to it lipophilic alimentary dystrophy . liposis and syndrome dercum . When the lipophilic dystrophy obesity manifested by edema of the subcutaneous adipose tissue, elephantiasis of the limbs. Lipomatosis is benign fatty tissue. It occurs more often in men, characterized by the appearance of painless lipomas on the limbs. Painful lipomas are a sign of the syndrome dercum. With such local obesity lipomas are located symmetrically on the trunk and extremities, characterized by generalized itching.
Symptoms of obesity
With obesity patients often complain of general malaise, shortness of breath , headache. There hyperdipsia , Increased appetite, drowsiness . Sudden bouts of hunger accompanied by weakness and dizziness . Symptoms of obesity are mainly related comorbidities. In case of violation of the digestive system are observed abdominal pain, nausea, heartburn , Intestinal disorders. Disorders of the cardiovascular system characterized by edema of the lower limbs, pain in infarction , Shortness of breath.
Obesity in women aged 30-60 occur twice as often than men. In the history of life are marked occupational factors, particularly food borne diseases and stress. In a study of obese patients there is an even distribution of fat tissue exchange-alimentary form and fat deposition at the chest, abdomen, face, with hypothalamic-pituitary form of obesity . Gipoovarialnaya form of the disease is characterized by fatty deposits in the pelvis and thighs, often in the neck fat pad is formed - withers .
With obesity normal skin. But in the case of the disease in puberty in the chest, abdomen, hips and shoulders are formed reddish neatrofichnye striae . Symptoms of obesity hypothalamic form as striae tsianichnye but also on the skin is observed pigmentation . Black acanthosis . Patients usually increased function of the sebaceous and sweat glands, the skin is often exposed to moist acne . pyoderma and other skin diseases.
Diagnosis of obesity
In the diagnosis of obesity is an important point value normal body weight Which is determined by the table with the growth, body type, gender and age. These tables are average normal rate. The excess of these indicators is the degree of obesity. To determine the severity of the disease is not enough to determine excess weight It is important to know the excess fat mass. This figure may differ from people with the same weight and height indicators. For this purpose a system methods for determining the body composition, in this case, the percentage of fat mass.
In addition to the concept of a normal body weight, there is a Ideal Body Weight As a rule, the last 10% less. The ideal body weight is calculated according to Brock formula The excess of the ideal figure of 15-20% is considered the first degree of obesity, 30-49% - the second degree, 50-99% excess is the third, and more than 100% the fourth degree obesity. These indicators there are a number of amendments, depending on age and gender.
Diagnosis of obesity also includes such a thing as BMI - Value body mass index . For the calculation used Quetelet formula Where the weight divided by height, in the normal weight BMI shall be 18, 5-24, 9 kg / m2. Following this lack of body mass index, the index of 30 to 40 kg / m2 or higher is considered obese.
For successful treatment it is important not only to the degree of obesity, but where are the fat deposits. Complications of obesity is not primarily dependent on the amount of fat, and from where it is located. For quality diagnostics are used a series of measurements. Measure the circumference of the hips and waist makes it possible to determine the location of body fat and to calculate the risk of complications.
Complications of obesity
Obesity increases the risk of various diseases. Observed metabolic disorders and related diseases, such as diabetes second type giperinsulemiya , Fat degeneration of the liver . hyperuricemia . cholelithiasis . Develop and diseases of the cardiovascular system hypertension . ventricular hypertrophy . coronary artery disease . heart failure . Excess weight leads to obesity pathologies of the musculoskeletal system . Most all the complications of obesity appear arthrosis and degenerative diseases of the joints.
Obesity provokes tumors, this is due to the failure release of hormones in the body. For the same reason, and sexual dysfunction are observed - amenorrhea . decreased libido . Fertility .
The increase in BMI above 30 kg / m2 is a risk of developing heart disease bystrotekushih fatal. Severe obesity leads to the development pikvinskogo syndrome - apnea in a dream, pulmonary hypertension .
Treatment of obesity
The main principle of treatment of obesity - weight loss and the prevention of re-increase it. For this purpose appointed diet therapy and physical exercise . Used hypocaloric diet in which umenshaetsya daily amount of fats and carbohydrates, and protein foods with increased fiber content. Excluded fried, spicy, alcohol. It is important to adhere to proper diet, low-calorie diets provide short-term temporary unstable effect, and correct mode makes it possible to support the weight of the same level. Fasting should be performed only in a hospital, under the supervision of the attending physician.
Along with diet and exercise is used drug treatment of obesity . Begin treatment at a BMI over 30 kg / m2 or ineffective diets over 12 weeks. There are two directions in the treatment of obesity drugs. The first group of drugs intended to block the centers of hunger and control centers nasysheniya. Second grupa is assigned to block absorption of fat from food, increased lipolysis.
As part of medical therapy are appointed amphetamines - Fepranon . dezopimon . rehydron . These drugs act on the central nervous system and inhibit hunger. Appointment mazindol anoreticheskoe exerts an action affecting brain serotoenergicheskuyu system, wherein the need for food is reduced.
To burn excess fat in the body appointed adipozin . However, this drug has a number of side effects. Therefore, it is advisable to prescribe it in combination with diuretics and antidepressants.
Treatment of obesity also requires Psychotherapy Because it requires a fundamental change in lifestyle, getting rid of stereotypes and habits in diet. This often applies hypnosis, this technique helps not only to change habits, but umenshaetsya hunger.
When obese than 40 kg / m2 medication and diet therapy could be ineffective. In such a case applicable surgical treatment of obesity . The recommended method beauticians Liposuction It provides short-term effect and has nothing to do with the surgical treatment of obesity.
Prevention of obesity
For the prevention of obesity should follow the mode of the day. Physical activity should be maintained constantly. Properly organized diet is not only the prevention of obesity, but also a warning diseases of the digestive system and cardiovascular disorders.
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