Obesity - a chronic disease in which there is an accumulation of excess body fat. In men, obesity is the accumulation of adipose tissue over 20% of body weight in women - more than 25%.
Now define overweight by body mass index. Body mass index by dividing weight of a person believed in kilograms by height in meters squared. Normal BMI ranges from 18 to 25 kg / m 2. A man whose body mass index above 25 kg/m2 is overweight.
Diagnosis of obesity is set at the body mass index above 30. Currently, obesity is so prevalent in the world that the World Health Organization considers obesity - an epidemic. In developed countries, except Japan and China, the obese from 20 to 30% of the population, and obesity has nearly half the population of developed countries.
Obesity arises from the discrepancy between the amount of energy coming from food and energy, and energy consumption of the body. If the body expends less energy than it receives from food, excess energy is stored in adipose tissue.
The causes of obesity are different:
disorders of appetite control
Hereditary factors
family habits
occupational factors.
The role of genetic susceptibility is large, but in any case, obesity arises as a result of the patient's eating behavior. It is believed that the contribution of hereditary factor in obesity is not more than 5%.
Reasons for growth in the number of obese patients in the present:
Availability of food. In developed countries, food is available, cheap, especially high-calorie foods digestible. In order to get food, do not have to expend much energy.
Violation of diets. Increased consumption of fats and carbohydrates in confectionery products, flour products, sweets, sweet drinks. At the same time not used protein foods, fresh fruits and vegetables.
Fast reception and lack of prozhevyvanie food. In this case the body does not have time to respond to adequate amounts of food (no time to form a feeling of fullness) and food energy absorbed excessively. In addition, processing of poorly chewed food in the gastrointestinal tract slows down, resulting in more complete extraction of food energy.
Large meal in the evening. Night increases the synthesis of cholesterol in the body and fat deposition in tissues, which contributes to reduction of energy consumption during sleep.
Obtained from food energy in modern conditions is not fully spent, aided by low physical activity, sedentary lifestyle, the mechanization of labor and other physical effort (walking, climbing stairs). This results in hypoxia (insufficient oxygen in the blood and tissues, respectively, to the human body). Insufficient supply of oxygen to body fat retards the breakdown of fats.
Obesity is classified into:
alimentary-constitutional. Usually runs in families and is developing in violation of diet.
hypothalamic obesity. It occurs in lesions of the hypothalamus in the brain. In the hypothalamus is the center of appetite regulation. With an increase in blood glucose levels, glucose acts on receptors in the hypothalamus of the center and there is a feeling of fullness. By reducing the sensitivity of the center of the regulation of appetite, satiety occurs later, or does not arise at all. endocrine obesity. Occurs when the various violations of almost all of the endocrine glands.
Morphologically obesity is:
hyperplastic
hypertrophic.
Hyperplastic obesity occurs in children. The increase in fat mass is due to increase in size of fat cells and by increasing the number of these cells. Usually in this case the patient is much harder to lose weight.
Hypertrophic obesity occurs in adults. At the same time increasing the number of fat cells does not occur, and fat mass increases due to the increase in cell size.
Often patients with increased body weight at the beginning do not make any complaints, considering his condition normal. Later, there are complaints of weakness, headaches, dizziness, insomnia, fatigue and shortness of breath on exertion, increased heart rate, heart pains, back pain, joint pain, disorders of the gastrointestinal tract (bitter taste in the mouth, nausea, constipation).
At a high degree of obesity, there are often complaints of the nervous system:
sleepiness
mood instability
hunger at night
increased appetite.
In women, often of the menstrual cycle. At full of girls menstruation begin earlier, but a long menstrual cycle is not established definitively. Obesity increases the risk of infertility in women. Adipose tissue accumulates and synthesizes estrogens from their androgen, in this connection is disturbed the normal ratio estrogens / androgens, the downside of androgens.
In women, this is manifested by increased risk of ovarian sklerokistoza and infertility in men develop gynecomastia (breast enlargement), and disturbed function of male gonads, which leads to impotence.
Violated almost all the functions of the endocrine organs. In the blood, increases the amount of insulin at normal glucose concentrations, in the end it leads to a sharp increase in the risk of diabetes.
Almost always in obese patients have disorders of the liver, gall-stone disease associated with metabolic disorders of cholesterol. High risk of atherosclerosis at a young age, coronary artery disease and myocardial infarction. Almost all obese patients have hypertension.
At high degrees of obesity increases the risk of cancer: women - cancer of the endometrium, ovary, mammary gland, in men - prostate cancer, rectal cancer.
In some patients, usually male, develops syndrome Pickwick. A large number of fat on your stomach causes high standing of the diaphragm and reduces lung capacity. This is accompanied by a decrease in oxygen delivery and tissue anoxia. These patients often sleep or nap during the day and at night they emerge periods apnea (absence of breathing), which can result in death.
The diagnosis of obesity establish the presence of excess body fat. Calculated body mass index. It turns out the distribution of body fat, which is calculated the ratio of waist to hip circumference. For men this ratio normally should not be greater than 0.95 for women - more than 0.85. If this ratio is higher obesity is abdominal.
Take into consideration the size of your waist. It is believed that when the waist circumference of 100 cm significantly increased risk of diabetes and cardiovascular disease. Provide a detailed examination of the patient to rule out other diseases that can lead to obesity.
