Obesity is one of the common chronic diseases caused by physical, biochemical, metabolic and behavioral changes that result in increased deposition of fat and thus weight gain. Overweight is noted from 12% to 46% of men and from 15% to 53% of women. In women older than 40 years of age living in urban areas, the incidence of obesity at 64%.
According to WHO, the United States 20% of the population aged over 30 years are obese, while one-third of them are excess body weight exceeds 20%. In England, as noted in recent decades, increasing the number of persons, body weight is considerably higher than normal. Been an increase in the number of obese people among adolescence. For example, some studies on the survey of high school graduates in several cities in Europe, the rise in obesity among boys and girls was noted more than a factor of 2. A similar pattern holds in our country.
Over the past two decades, obesity among school children has increased from 4-5% to 11.2%. It is well known that overweight brings a social evil because it promotes not only the early development of atherosclerosis, reduced labor productivity, but also leads to a significant reduction in life expectancy. The reduction in life expectancy in obesity in old age reaches an average of 10-12 years. Excess body weight by 20-35% reduces life expectancy by 3.3 years. Mortality among people older than 45 years old, obese, twice higher than those of the same age with a normal diet.
In the development of obesity is likely to play an important role constitutional and social factors that contribute to overeating. Existing psychological disorders in most cases does not give the impression of particular importance, but their presence makes it necessary to consider issues related to their influence on the course of obesity as a disease. For example, obese people often lowered self-esteem, many of them feel insecure in society, can be marked sleep disturbances in the form of hypersomnia or insomnia, severe, persistent asthenia, which manifests itself in reduced efficiency, reduced background mood, irritability, sensory, adaptive abilities to abuse various changes in living conditions.
Psychopathology in patients with obesity that may include depression and anxiety and phobic disorders are caused, in their opinion, a violation of the social and psychological adaptation. In all forms of obesity in varying degrees, there are signs of neurological damage and mental sphere. There is no doubt that these changes in obesity are not random and differ quantitatively and qualitatively from those of internal diseases.
Analysis of the few available in the literature about changes in obese psychiatric shows that they can be divided into several groups. First of all, constitutional-psychological personality traits that relate to psychogenic factors. Person-structurally, they are determined inclination to eat large quantities of food, due to what may form the disease with the presence of biochemical, endocrine, metabolic disorders. The latter in turn can strengthen due to the attraction as psychogenic factors.
Formed, thus a vicious circle that only break holding of dietary and drug treatment fails. Start to improve, the clinical short-term, so as not eliminated one of the reasons - and drive and connected it addictive. The second group of disorders is secondary. They can be called personal-reactive changes as they occur as a reaction to the actual patient medical condition, which changes their character of social functioning. Among those changes, there are several types. A common reaction is to ignore the problem. This can manifest as the formation of personal and typological characteristics of hyperactive fat people, create their own subculture, forming behaviors (creating a style of clothing, art, clubs, etc.). These changes can be described as a psychological reaction agnosia or overcompensation.
Another type of secondary person-reactive changes is the formation of neurotic depressive disorders with painful feelings of physical defect, in reaching its peak of neurotic depression. Details of the literature relating to issues of treatment of patients with alimentary obesity exchange, in our opinion are set out unsystematically and fragmentary. Most frequently raised issues of dietary treatment aimed at normalizing the caloric intake. In a number of sources of dietary treatment is analyzed in combination with medication.
Psychotherapeutic correction mainly concerns the secondary mental changes. Not addressed the need to put into practice pathogenetically based methods of psychotherapy. Not developed the application of psychotherapy as a method of choice in the psychopathological mechanisms of obesity. All methods used in the treatment of alimentary obesity exchange, recruited at random. Analysis of the data presented clearly shows that the characteristics of mental disorders encountered in obesity, as well as treatment sufficiently developed.
Thus, the current state of obesity requires further development of diagnostic methods and schemes of pathogenetic therapy of patients suffering from alimentary obesity exchange.
