One of the most acute problems of modern medicine in some countries is reaching epidemic proportions.All about obesity in our article.

Obesity - a disease characterized by excessive development of adipose tissue.Most obesity occurs after 40 years, mainly in women.

Ozhirenie- disease characterized by excessive development of adipose tissue.Most obesity occurs after 40 years, mainly in women.

etiology of obesity

main factor leading to the development of obesity, is a violation of the energy balance, consisting in the discrepancy between the energy flow in the body and their cost.The most common obesity is caused by overeating, but can occur due to violations of the control of energy consumption.Undoubted role hereditary constitutional predisposition, decreased physical activity, age, sex, occupational factors, some physiological states (pregnancy, lactation, menopause).

Obesity is the hypothalamic-pituitary disease, the pathogenesis of which play a leading role expressed in varying degrees, hypot

halamic disorders that contribute to behavioral change, especially eating disorders, and hormonal disorders.Increased activity of the hypothalamic-pituitary-adrenal system: increased secretion of ACTH, cortisol production speed, accelerating its metabolism.Reduces the secretion of growth hormone, which has lipolytic action, disturbed secretion of gonadotropins and sex steroids.Characterized by hyperinsulinemia, reducing the effectiveness of its actions.Disturbed metabolism of thyroid hormones and the sensitivity of peripheral tissues to them.

Allocate alimentary-constitutional, hypothalamic and endocrine obesity.Alimentary-constitutional obesity runs in families, develops, usually in a systematic overeating, eating disorders, lack of adequate physical activity, often members of the same family or close relatives.Hypothalamic obesity is caused by disorders of hypothalamic function and therefore has a number of clinical features.Endocrine obesity is a symptom of a primary disease of the endocrine glands: Cushing, hypothyroidism, gipogonadizma.Odnako in all forms of obesity are in varying degrees, hypothalamic disorders, occurring either initially or in the process of developing obesity.

Symptoms of obesity

common feature of all forms of obesity is excess body weight.There are four degrees of obesity and two stages of the disease, a progressive and stable.When I degree the actual weight exceeds the ideal by no more than 29%, with II - an excess of 30-40%, with the III degree, 50-99%, with IV-actual weight exceeds the ideal 100% or more.

Sometimes the degree of obesity measured by body mass index (BMI) was calculated using the formula: = body weight (kg) / height (m) 2, the norm was adopted mass index, constituting 20-24,9, when I degree - Index 25-29.9, at II - 30-40, at III - more than 40.
patients I - II degree of obesity is usually no complaints at a massive obesity bother weakness, drowsiness, depressed mood, sometimes nervousness, irritability;nausea, bitter taste in the mouth, shortness of breath, swelling of the lower extremities, pain in the joints, the spine.With obesity often concerned increased appetite, especially in the afternoon, at night hunger, thirst.In women, a variety of menstrual disorders, infertility, hirsutism, decrease in male perspiration.Impurity and trophic disorders of the skin, small pink stretch marks on the thighs, abdomen, shoulders, armpits, hyperpigmentation of the neck, elbows, places of friction, increased blood pressure.When electroencephalographic study of patients with hypothalamic obesity revealed signs of lesions of diencephalic brain structures.
for the differential diagnosis of hypothalamic obesity and Cushing spend small dexamethasone suppression test, X-ray examination of the skull and spine.

If there is thirst, dry mouth determine blood sugar and fasting during the day, according to testimony carried glucose tolerance test.
in the menstrual cycle, pelvic exam, ultrasound pelvic, rectal temperature measurement, other tests of functional diagnostics.

obesity treatment

Treatment of obesity is complex, aimed at reducing body weight, including diet therapy and physical therapies.Recommended balanced low-calorie diet by lowering carbohydrate content (100-120 g) and partly fat (80-90 g) is advantageously a sufficient content of animal proteins (120 g), vitamins, minerals (in view of energy consumption).Use foods that are high in fiber, promotes rapid saturation, accelerate the passage of food through the intestines.Power fractional, 5-6 times a day.Apply fasting days: protein (eg 350 g of boiled meat or 500 grams of cottage cheese), fruit, etc. The need for the active motor mode, systematic physiotherapy, shower, massage...

Against the background of weight loss reduced the basal metabolic rate, which contributes to the conservation of energy received from food and reduce the effectiveness of dietary treatment.This requires allocation in the treatment of daily caloric intake and increase physical activity.

are of great interest, of course, drugs for the treatment of obesity, which, however, need to take a very long time, and if the non-pharmacological treatment of obesity does not bear fruit.Drug treatment of obesity should be under the supervision of a physician.Some sredstvasposobstvuyut quite certain weight loss, the rate of which is generally aligned to the six months of treatment, but after a year of treatment, the effectiveness of them, according to recent studies, begins to fall.What can we offer modern pharmacology for the treatment of obesity?These known drugs are sibutramine and phentermine have the ability to reduce appetite.At their reception quickly a feeling of saturation that makes you quietly give up the absorption of extra portions of food.Also patients with an increased appetite anoreksigeinye prescribed drugs: Fepranon, teronak.The course of treatment no more than 1-1.5 months because of the possible occurrence of addiction to them.In connection with the stimulating effect of drugs it is recommended to use them in the morning.medicinal plant Garcinia Kambozhdiyskaya Because of its property to reduce hunger has been widely rasprosstranenie among anti-obesity agents.Xenical (orlistat) - one of today's most popular products to help reduce body weight.Xenical blocks the enzymes that promote the absorption of fat - pancreatic lipase and intestinal lipase.Like other medications, Xenical without a diet ineffective.Lots of what he can do - is to reduce the absorption of fat by one-third, ie,two-thirds of consumed dietary fat is metabolized by the body anyway.The main advantage is the absence of Xenical its absorption in the systemic circulation, and hence it does not cause systemic side effects.The tablet, to be exact, the blue capsule, works only in the intestine, does not affect other organs prinimaetsyavo mealtimes.The mood at the reception it is getting worse, so kakzheludok though feels satiated, but the brain receives fewer calories and feels that it "cheated".Against the background of the drug may experience unpleasant side effects from the gastrointestinal tract caused by the pharmacological action of the drug that prevents absorption of fat food, marked as headaches ,null, reduced absorption of fat-soluble vitamins, and other allergic reactions.

Sometimes as fat-mobilizing fundsadipozin administered at 50 U 1-2 times a day for 20-30 days rates in combination with diuretics.

When endocrine forms of obesity are treated with the underlying disease.The women in the absence of recovery of ovarian function due to lower body weight and normalizing conducted drug correction estrogengestagennymi synthetic drugs.In the case of weight gain in the background progestinoestrogennyh drugs they cancel and prescribe progesterone and synthetic progestins.In case of violation of carbohydrate tolerance - biguanides have also lipolytic and partly anorectic properties.

Obesity IV degree of obesity, if the weight is 45 kilograms or more, the treatment of choice is surgical therapies.bariatric hirurgiya.V arsenal of bariatric surgery available today several operations audited, the general sense of which - significantly reduce the amount of food into the stomach, since you can not do it at will!For example, gastric banding.This is when you impose on the stomach silicone ring, which is why it becomes similar in shape to an hourglass.And the upper section of the stomach is able to fill and stretch even a small amount of food, and it is stretching the upper part of the stomach tells the brain that you are satisfied and do not want to eat more.You understand that if it happens all the time, the food you eat is not an example less than before the surgery - all genius is simple!And so slowly, a year and a half, losing 50-70% of excess weight.

stomach is still possible to shunt - also creates a "small ventricle" in the upper part of the usual volume of somewhere 50 ml, which is also stitched loop of the small intestine.As a result, half of the food does not pass the usual manner, and directly into the intestine, i.e. the nutrients are not absorbed from it.The result is very impressive - 70-100% of excess body weight for a year and a half.

more sparing surgery for the treatment of obesity - the introduction of intragastric balloon as an interim measure.Silicone is a ball which is already filled with fluid in the stomach.Keep pretending that he has food, balloon simulates the feeling of satiety, affecting the body wall.Unfortunately, after only 6 months of the balloon must be removed to avoid complications, but at this time you can lose 10 - 15 kgs.But also to get the long-awaited result, you should not forget that the disease will not go anywhere if you take up the mind and does not build up, finally, the right diet and sufficient physical activity, which are essential parts of a healthy lifestyle.

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