Overweight what. What is obesity and how to defeat overweight once and for all? Causes of being overweight

7. Overweight and obesity

Excess MT occurs when the energy value of the diet exceeds the energy expenditure of a person. There is an accumulation of fat, which over time can lead to the development of a disease - obesity. Obesity is a metabolic and alimentary chronic disease, which is manifested by excessive development of adipose tissue and progresses in a natural course.

Epidemiology. According to WHO and domestic studies, about 50% of the population of Russia and other European countries have excess MT, 30% are obese. To a greater extent, this is typical for women, especially older age groups. A significant increase in the number of people with obesity, including in developed countries, the trend towards an increase in the prevalence of obesity among young people and children make this problem socially significant.

Assessment methods. Compliance with the appropriate MT is most often assessed using body mass index (BMI) or Quetelet index.
BMI \u003d Body weight (kg) / height 2 (m 2)

With an increase in BMI, the risk of developing comorbidities increases (Table 7). At the same time, the risk of complications, especially cardiovascular and metabolic ones, depends not only on the degree of obesity, but also on its type (localization of body fat). The most unfavorable for health and typical for men is AO, in which fat is deposited between the internal organs in the waist area. The deposition of fat in the thighs and buttocks, more typical for women, is called gluteofemoral.

Table 7. Classification of overweight and obesity (WHO 1998).

There is a simple and fairly accurate way to assess the nature of the distribution of fat - the measurement of waist circumference (WC). OT is measured in a standing position, midway between the lower edge of the chest and the iliac crest along the midaxillary line (not at the maximum size and not at the level of the navel). The test is objectified and correlates with the degree of fat accumulation in the intra- and extra-abdominal space according to magnetic resonance imaging (MRI) data.

If WC is ≥ 94 cm in men and ≥ 80 cm in women, AO is diagnosed, which is an independent risk factor for CVD. Persons with AO are advised to actively reduce BW.

Overweight/obesity is an independent risk factor for CVD and forms a cascade of secondary risk factors. Adipose tissue, especially visceral tissue, is a metabolically active endocrine organ that releases into the blood substances involved in the regulation of CVS homeostasis. An increase in adipose tissue is accompanied by an increase in the secretion of free fatty acids, hyperinsulinemia, insulin resistance, hypertension, and dyslipidemia. Overweight/obesity and concomitant risk factors increase the likelihood of developing a number of diseases, the likelihood of which increases with increasing body weight. At the same time, if the risk of CVD and DM is increased with AO, then the risk of diseases of the spine, joints and veins of the lower extremities is higher with the gluteofemoral type.

Overweight and obesity are often associated with hypertension and dyslipidaemia, with BP rising with increasing obesity. The presence of excess body weight and obesity increases the risk of developing hypertension by 3 times, coronary artery disease by 2 times. The probability of developing DM in people with excess body weight is 9 times higher, in people with obesity - 40 times. Excess weight significantly reduces life expectancy: on average, from 3–5 years with a slight excess of BW and up to 15 years with severe obesity.

Elongation of the vasculature, increased sodium retention in cells, an increase in the activity of the sympathoadrenal and renin-angiotensin-aldosterone systems, insulin resistance, and the release of biologically active substances by visceral adipose tissue observed in excess MT increase the likelihood of developing hypertension. The development of atherosclerosis and coronary artery disease in people with excess MT is facilitated by the closely associated AG, lipid metabolism disorders (increased TG and LDL-C, decreased HDL-C), insulin resistance, impaired glucose tolerance (IGT), type II diabetes, endothelial dysfunction. In addition, there is an increase in the production of plasminogen activator inhibitor-1 by adipocytes, which helps to reduce the fibrinolytic activity of the blood and increase the risk of thrombosis.

7.1. Algorithm for Examining Persons with Overweight and Obesity

Collection of diet anamnesis gives the doctor and patient a visual representation of the patient's eating habits; allows you to develop a diet therapy plan that is adequate to your eating habits; determines the extent and nature of the intervention; develops mutual understanding between doctor and patient (Appendix 8). In some cases, a 3-7-day survey is carried out (the patient writes down all the food eaten during these days, including servings, quantity, frequency, and submits it in writing or sends it by mail).

Assessment of readiness for treatment. For effective correction of overweight, it is important that patients are ready to follow the recommendations given to them. To do this, they must be motivated to reduce body weight, understand the timing and pace of treatment, for example, know that weight loss due to fat usually does not exceed 0.5–1 kg per week, and this is a good result on an outpatient basis. Knowing the motivation of the patient and his previous experience is necessary for the subsequent emotional support of the patient. To assess the patient's readiness for treatment to reduce BW, it is necessary to find out:

• the reasons that prompted the patient to start treatment;
• understanding by the patient of the reasons leading to the development of obesity and its negative impact on health;
• consent of the patient to a long-term change in eating habits and lifestyle;
• motivation to reduce MT;
• previous experience in reducing BW;
• the possibility of emotional support in the family;
• understanding the pace and timing of treatment;
• the patient's willingness to keep a food diary and control BW.

Objective examination of the patient is necessary to identify other risk factors, comorbidities, contraindications to treatment and develop a strategy for nutritional intervention. The minimum examination of a patient with excess body weight/obesity, along with a general clinical examination, includes: measurement of blood pressure, ECG recording, determination of levels of total cholesterol, triglycerides, glucose in fasting blood serum. If any deviations are detected, additional examination is necessary in accordance with generally accepted diagnostic algorithms.

Definition of contraindications to treatment. WHO experts (1997) identified a range of temporary, absolute and possible, relative contraindications. Temporary (absolute) contraindications for the treatment of obesity: pregnancy; lactation; uncompensated mental illness; uncompensated somatic diseases. Possible (relative) contraindications: cholelithiasis; pancreatitis; osteoporosis. Reduced diets during pregnancy and lactation are absolutely contraindicated.

Expert advice. The increase in MT can increase psychogenic disorders, including bulimia nervosa, depression, recurring episodes of severe overeating, night eating syndrome, seasonal affective disorders.

They can be for the patient difficult to overcome obstacles to compliance with the treatment regimen. If the patient has signs of an eating disorder (attacks of compulsive eating in short periods of time, lack of satiety, eating large amounts of food without feeling hungry, in a state of emotional discomfort, sleep disturbance with night meals combined with morning anorexia, etc. ), consultation of a psychoneurologist or psychiatrist is indicated.

If secondary, endocrine obesity is suspected (Itsenko-Cushing's syndrome, hypothyroidism, etc.), an endocrinologist should be consulted.

7.2. obesity treatment

The goals of obesity treatment are:

• a moderate decrease in body weight with a mandatory decrease in the risk of developing obesity-related diseases;
• MT stabilization;
• adequate control of obesity-related disorders;
• improving the quality and life expectancy of patients.

Diet therapy for obesity. Reducing the calorie content of the diet and creating an energy deficit is the main principle of nutritional intervention. According to the severity of energy deficiency, diets with moderate calorie restriction (1200 kcal/day) and very low calorie content (500–800 kcal/day) are distinguished. The latter contribute to a more pronounced decrease in BW (1.5–2.5 kg/week) compared with a moderately reduced calorie diet (0.5–1.4 kg/week), but only at the initial stage of treatment. Long-term results (after 1 year) of using diets with moderate and severe calorie restriction did not show a significant difference in the decrease in BW. The use of very low calorie diets does not lead to the formation of rational nutrition skills; there is a poor tolerance of these diets, frequent side effects from the gastrointestinal tract, cholelithiasis, disorders of protein metabolism, electrolyte balance; cases of ventricular fibrillation, etc. The use of diets with moderate caloric restriction (1200 kcal / day) causes a decrease in BW after 3-12 months to a sufficient extent (on average by 8%).

The energy deficit in the formulation of low-calorie diets can be achieved by reducing the intake of both fats and carbohydrates. It has been proven that the use of low-calorie diets with a restriction of fat and carbohydrates contributes not only to a decrease in body weight, but also to a decrease in blood pressure, and an improvement in the lipid profile.

It is necessary to establish a strict relationship between the energy value of food and energy consumption. A number of factors are important, and above all, the level of metabolism. Calculations show that the excess of daily calorie intake over energy expenditure by only 200 kcal per day increases the amount of reserve fat by approximately 20–25 g per day and by 3.6–7.2 kg per year. Thus, the term “overeating” does not mean “gluttony”, but only relative overeating, that is, the excess of the caloric value of food over the energy expenditure of the body.

It is also possible to predict the loss of MT. So, if with energy expenditure of 2200 kcal a person receives 1800 kcal daily, then the energy deficit is 400 kcal. Knowing that 1 g of adipose tissue provides 8 kcal, it can be calculated that in the daily energy balance of the body, 50 g of adipose tissue (400:8) needs to be broken down. Therefore, in 1 week the loss of MT will be 350 g (50 x 7), in 1 month - 1.5 kg, in a year - almost 18 kg. Thus, the main method of treating obesity is dietary, and the main principle of diet therapy is calorie reduction.

Principles of building a diet for overweight and obesity:

• Sharp restriction of the consumption of easily digestible carbohydrates, sugars to 10–15 g (3 pieces or teaspoons) or less per day, including “pure” sugar (for sweetening tea, coffee) and sugar contained in drinks, jams, sweets, etc. Confectionery products containing high-calorie fat, and sweet carbonated drinks are recommended to be completely excluded.
• Restriction of starchy products: bread, products and dishes from cereals, potatoes. You can eat up to 3-4 slices of black or 2-3 slices of white bread per day. You can add a serving of porridge and/or a serving of potatoes. Pasta is best avoided.
• Sufficient (up to 250–300 g) consumption of protein products: meat, fish, poultry, eggs, dairy products. They are essential for the body and are highly nutritious. But when choosing protein foods, preference is given to foods with the lowest fat content (the calorie content of such foods is much lower). If there is no choice, you can cut off visible fat, remove the skin from the chicken, remove the foam from the milk, etc.
• Consumption of a large number of vegetables (except potatoes) and fruits (up to 1 kg in total). Products and dishes prepared from them are low-calorie and at the same time, due to the large volume of food, create a feeling of satiety. Preference should be given to acidic varieties of fruits and leafy vegetables (citrus fruits, berries, apples, cabbage, lettuce, spinach, etc.).
• Limiting the intake of fat, mainly of animal origin.
• Restriction of salt intake in order to normalize water-salt metabolism. It is necessary to limit salt both in its pure form (salt less when cooking, remove the salt shaker from the table), and in the form of salty foods (pickles, marinades, salted fish, etc.).
• Limiting the consumption of spicy snacks, sauces, spices that stimulate the appetite.
• Frequent meals - up to 5-6 times a day, but in small quantities.
• Alcohol is high in calories, so limiting it is important for BW control.

Popular "trendy" diets are based on the principles of strict nutritional restriction with a reduction in calories to 1000–1500 kcal. These diets do not always take into account the principles of rational nutrition. Their use is possible for a limited period of time (2-6 weeks) in apparently healthy individuals with only overweight/obesity. True, fairly balanced diets of 1200-1500 kcal can be used for longer, and in practically healthy older women - almost constantly. It should be borne in mind that dietary restrictions in children can lead to a halt in growth and development, and in adolescence - to endocrine disorders. Relatively simple in terms of technical implementation is a variable diet (during the day, dishes from one product are used). The diet contains elements of separate nutrition, but is not balanced and suitable for people without serious diseases. Also, the so-called fasting days are not balanced. They can be practiced 1-2 times a week and only after consulting a doctor. The Atkins Diet and the very similar so-called “Kremlin Diet” are based on a strict restriction of carbohydrates, which causes severe dehydration of the body (hence rapid weight loss), a decrease in insulin production and the conversion of carbohydrates into fats with their subsequent deposition. The diet is not balanced, can cause a shift in acid-base balance, ketosis, acidosis. In addition, the “Kremlin Diet” is highly atherogenic: the fat level is twice the recommended values ​​(up to 60–64% of calories), and the dietary cholesterol content is 1000–1280 mg/day, which is 4 times higher than the recommended norm.

Separate food does not exist in nature: in any product (meat, milk, etc.) there are proteins, fats, and carbohydrates. A mixed diet is more balanced. So, the lack of the amino acid lysine in buckwheat makes up for milk, where it is in excess. Thus, buckwheat porridge with milk is a balanced dish. Separate nutrition can be effective only if it is reduced to calorie restriction due to the uniformity of products, it cannot be practiced for a long time. Treatment of excess body weight and obesity by fasting is unacceptable, since fasting for more than 3 days disrupts metabolic processes in the body, has an adverse psychological effect (further increasing the importance of food for a person and stimulating appetite and hunger centers), increases the risk of complications (arrhythmias, hypovitaminosis with polyneuritis phenomena). , skin and hair lesions, etc.).

Patient self-control. An important aid in dieting is the patient's Diet Diary, in which he writes down everything he eats and drinks during the week preceding the visit to the doctor. This allows both the patient and the doctor to analyze the diet (the amount of food eaten, the frequency of eating, situations that provoke extra meals), to identify eating disorders, the cause of failures, the amount and nature of the necessary correction, and also increases the constructive interaction between the doctor and the patient.

Efficiency mark. It is necessary to achieve a decrease in MT by 5–15% of the initial values ​​(depending on BMI) for 3–6 months, and further stabilization of MT. smooth slow decrease in MT. It is necessary to realize that a diet is not a one-time action, and its effect will remain only when switching to the principles of a healthy diet with a constant restriction of part of the diet.

Increasing physical activity. The use of physical training in combination with a low-calorie diet provides a greater reduction in BW and prevents weight gain after the end of a low-calorie diet. Regular FA contributes to an increase in the loss of fat mass, especially in the abdominal region, and the preservation of lean mass, a decrease in insulin resistance, an increase in the metabolic rate, and positive changes in the lipid profile.

Psychotherapy and behavioral interventions aimed at correcting the eating behavior of patients, increase the effectiveness of diet therapy and increase FA.

Medicinal effects on excess BW indicated for: ineffectiveness of non-pharmacological interventions; severe and complicated forms of obesity.

Appetite-reducing serotonergic drugs (such as the antidepressant fluoxetine) that reduce food absorption (orlistat) are used. Drug treatment can be continued up to 6 months, after a break - up to 2 years.

Surgical treatment of obesity (gastroplasty, formation of a “small” stomach, resection of the intestine, etc.) are more often used for obesity of the III degree with complications (secondary endocrine disorders, hernia of the spinal column, severe coxarthrosis, etc.). Operations of liposuction, liporesection with abdominal wall plasty, etc. are of more cosmetic importance and can be performed in the absence of well-known general surgical contraindications, at the request of the patient.

For the provision of medical care to persons with excess body weight or obesity, it seems appropriate:

• include in the list of medical services such a service as "reduction of excess body weight and treatment of obesity" and develop an appropriate standard of medical care;
• train specialists working in medical prevention rooms, medical prevention departments of polyclinics and health centers to provide medical care to reduce excess body weight and treat obesity;
• provide medical institutions with information materials about the dangers of overweight and the treatment of obesity.

Overweight, obesity and the right ways to correct them

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Dotsenko V. A. (chief nutritionist of St. Petersburg, Ph.D. of the Russian Federation, professor of the Department of Food Hygiene of the North-Western State Medical University named after I. I. Mechnikov),

Kononenko I. A. (Assistant of the Department of Food Hygiene of the North-Western State Medical University named after I. I. Mechnikov), Mosiychuk L. V. (Associate Professor of the Department of Food Hygiene of the North-Western State Medical University named after I. I. Mechnikov)

Obesity is now becoming an epidemic. According to the latest estimates from the World Health Organization, more than 1.5 billion people on the planet are overweight, and the number of obese people increases by 10% every 10 years. In the period from 2005 to 2010, the incidence of obesity in the adult population of Russia increased by 1.77 times, and in St. Petersburg - by 1.73 times. Such a high dynamics cannot but affect the indicators of health, working capacity, disability, quality and life expectancy of the population.

In order to distinguish overweight from obesity, it is customary to use the body mass index (BMI). It is calculated quite simply: the body weight in kilograms is divided by the square of the height in meters according to the formula BMI \u003d mass, kg / (height, m) 2.

Estimation of excess of normal body weight depending on BMI

The level of excess of normal body weight depending on BMI

BMI for ages 18–25

BMI for age over 25 years

normal body weight

Overweight

Obesity of the first degree

Obesity of the second degree

Obesity of the third degree

Obesity of the fourth degree

40.0 and above

41.0 and above

With obesity of the first degree, the excess of adipose tissue is from 10 to 29% of the normal weight, of the second degree - from 30 to 49%, of the third degree - from 50 to 99%. The fourth degree of obesity, the most dangerous for health, involves an excess of adipose tissue up to 100%. As a rule, the first and second degrees of obesity are characterized only by weakness and increased fatigue, with further weight gain, the state of health may deteriorate sharply and the following symptoms may occur: shortness of breath at the slightest exertion, palpitations, interruptions in the work of the cardiovascular system, frequent headaches and significant decrease in performance.

What are the main reasons for the catastrophic spread of overweight and obesity? The main place in this list is occupied by an imbalance between the absorption and expenditure of energy in the body. It is known that in 75% of cases obesity develops due to improper, unbalanced nutrition. Physical inactivity and the love of Russians for fast food lead to the fact that excess calories in the form of fat are deposited not only on the figure, but also on the internal organs, which is dangerous for health.

Maintaining your weight within the given limits means drastically changing your diet, habits and even lifestyle. Not everyone has the will power to make such changes. However, the rush to lose weight and excessive dietary restrictions can lead to the so-called "seesaw effect", when weight is regained after the end of the diet. Having quickly lost 7–10 kg of weight and returned to your usual diet, you can not only get your weight back in a short time, but also gain a few extra pounds. In addition, rapid weight loss brings great harm to health - muscles, liver, immune system suffer.

The most important direction in the treatment of obesity is a properly selected diet with limited energy value. However, the use of low-calorie diets is often accompanied by insufficient intake of proteins, minerals and vitamins, which leads to disruption of metabolic processes. In this regard, diet therapy includes specialized products that are balanced in composition and adapted to the functional state of the body of people with obesity. This improves metabolic processes and leads to a positive effect. It has been established that individual diet therapy should be carried out on the basis of diagnostics (nutritional status assessment) and by compiling an individual menu with the inclusion of dietary (therapeutic and preventive) foods in the diet, including specialized foods and dietary supplements (BAA) to food.

At the Department of Nutritional Hygiene of the North-Western State Medical University. II Mechnikov, hygienic and dietary assessments of various functional foods, including protein mixtures, were carried out. Specialized products used in the diet therapy of overweight and obesity are dry protein mixtures for dissolution in water or other liquids (less often, ready-made drinks and cocktails). They are intended to be used instead of a separate meal or diet in general and have a low calorie content, which is achieved by eliminating easily digestible carbohydrates, animal fat, and also due to a sufficient content of protein, including vegetable, against the background of the required amount of dietary fiber. Such products also contain physiological doses of vitamins, macro- and microelements, the optimal ratio of PUFAs, which allows, with low-calorie diets recommended for obese people, to compensate for the lack of these nutrients in the body.

Protein shakes, which are, in fact, "food in a glass", help to reduce weight without the oppressive feeling of hunger and keep you feeling full for several hours, while fiber and a balanced complex of vitamins and minerals provide the necessary supply of nutrients to the body. The advantage of such products in diet therapy is that, in addition to a balanced composition, they are simple and easy to prepare - a cocktail is easy to mix in just 2 minutes. And besides, they can be prepared on the basis of various drinks, so due to the variety of tastes, the stickiness is reduced. Clinical studies conducted in many countries, including Germany, the USA and Russia, demonstrate the effectiveness of low-calorie diets with the inclusion of protein meal replacements in body weight correction programs. For example, recently the effect of low-calorie diets with the inclusion of protein food substitutes on anthropometric and clinical and biochemical parameters in overweight and obese individuals was studied at the Research Institute of Nutrition of the Russian Academy of Medical Sciences. The results of the study confirmed that a weight loss program based on protein shakes and mixtures is more effective than a standard low-calorie diet in reducing body fat mass, reducing waist circumference, and also provides a more comfortable weight loss process, namely satiety and lack of hunger.

In the complex therapy of obesity, it is important to limit the intake of simple sugars, which are the main energy providers and easily turn into fat. It is also necessary to increase the consumption of vegetable fats by reducing the number of animals. Feeling full is best achieved by eating low-calorie, high-volume foods, such as raw vegetables, fruits, herbs, and whole grains. In an attempt to reduce weight, in no case should you reduce the number of meals to 1-2 times a day. Multiple meals are useful, up to 6 times a day, and at the same time, the exclusion of foods that stimulate appetite (spicy snacks, spices).

A balanced diet is closely related to the lifestyle of a person as a whole. Therefore, in order to prevent overweight and obesity, in order to stay healthy and slim for as long as possible, it is necessary to create the right motivation for physical activity and try to maintain a balance between calories consumed and energy expended.

Methods for correcting excess body weight, which affects the state of health, are outlined. Methods are proposed for determining normal and ideal body weight, taking into account gender, age and constitution. Practical recommendations are given for maintaining normal body weight after achieving the effect of reducing it to normal. The first edition was published in 2009 for a wide range of readers.

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The following excerpt from the book Therapist's advice. On overweight (Ya. L. Marchotsky, 2009) provided by our book partner - the company LitRes.

Overweight is one of the main reasons for the reduction of professional and creative longevity.

Body weight is an indicator of health

Who among us does not want to have a slim figure, look younger than our years, be fit, elegant and healthy. However, one of the obstacles to this is completeness and obesity. Until recently, obesity was considered as a disease exclusively of Western civilization, now it has become a serious threat to health in developing countries. In the near future, according to researchers, obesity may become a more common cause of death than smoking. Extra pounds - the potential for acquiring all sorts of diseases and complications.

The assessment of the risk of developing diseases associated with obesity is presented in Table. one.

Table 1. Assessment of the risk of developing diseases and conditions associated with overweight

Note. BMI - body mass index, calculated by the following formula: BMI \u003d Body weight, kg: Height, m ​​2. (BMI will be discussed below.)

The main factors of the negative impact of obesity on health

Effect of adipose tissue on metabolism. Adipose tissue is actively involved in metabolic processes and is a source of free fatty acids. This contributes to the production of low and very low density lipoproteins, which increases the risk of atherosclerosis. An increase in relative body weight by 10% increases the concentration of cholesterol in the blood plasma by 0.3 mmol / l.

According to researchers, overweight people suffer from coronary heart disease in more than 50% of cases and about 60 % - arterial hypertension. Acquired diseases - atherosclerosis and arterial hypertension carry a constant threat of a tragic peak - myocardial infarction and stroke. Arterial hypertension is caused by an increase in the total blood volume and the retention of sodium salts in the tissues of the body. It has been established that with a decrease in body weight by 1 kg, blood pressure decreases by 1 mm Hg. Art. Therefore, moderately reduced actual body weight to ideal, it is possible to bring blood pressure to normal levels even without drug treatment.

Obesity leads to dysfunction of almost all endocrine glands (Fig. 1). For example, there is a decrease in glucose consumption by tissues and an increase in its concentration in the blood, i.e., hyperfunction of pancreatic beta cells develops, releasing insulin into the bloodstream. Some time after increased secretion of insulin, degenerative changes in beta cells and a functional decrease in glucose tolerance occur, which leads to the development of stable diabetes mellitus.

Rice. one. Obesity is one of the main causes of diabetes

Rice. 2. Excess body weight - the path to degenerative changes in the body

Overweight – path to degenerative changes in the body. Obesity has a significant negative impact (Fig. 2):

● on the respiratory and cardiovascular systems;

● abdominal organs and digestion;

● musculoskeletal system and sense organs;

● Decreased performance and premature aging.

Obesity impairs the function of the respiratory system, reduces the vital capacity of the lungs. This is due to the high standing of the diaphragm, as well as a mechanical obstacle to its movement. As a result, the lungs are poorly ventilated, which is manifested by shortness of breath, especially during exercise. The heart, as it were, is wrapped in a fatty shell, which prevents the contraction of the heart muscle.

With significant overweight, there is a tendency to fatty degeneration of the liver, cholecystitis, cholelithiasis, prolapse of the abdominal organs, and functional disorders of the digestive system. This is due to an increase in intra-abdominal pressure with fatty deposits, weakness of the abdominal press and due to stagnation of blood in the venous plexuses of the abdominal organs.

In obese people, there is an excessive load of body weight on the skeletal system, joints, ligaments, muscles. Degenerative changes develop, especially in the joints of the lower extremities and the spine, which is manifested by arthritis, osteoporosis, osteochondrosis of the spine, deforming arthrosis, and motor activity is disturbed.

With excess body weight, there is a tendency to varicose veins, thrombosis, hernia formation, an increase in the risk of complications and deaths during surgical operations, complications during childbirth. Obesity is a favorable background for the development of tumors and diseases associated with metabolic disorders.

Excess body weight leads to premature aging of the body and thus to a change in vision, hearing, smell, touch, taste and temperature sensitivity, fatigue and decreased performance, impaired mobility of nervous processes, weakening the functional activity of the sex glands.

Reducing life expectancy when exceeding the norm of body weight. Science has come to the conclusion that life expectancy in people with normal weight is relatively higher than in people who are overweight and obese. In ancient Sparta, for example, young men whose body weight exceeded accepted standards were expelled from the city. According to statistics, every extra kilogram of overweight reduces life expectancy by 2 %. Obesity shortens life expectancy by 8 to 12 years.

The degree of risk for overweight for men and women is presented in Table. 2.

It is appropriate to recall the folk proverbs: “The narrower the waist, the longer the life”, “Whoever gets fat too much, he gets old.” A full man rarely lives to be 70 years old.

Table 2. Reduced life expectancy when overweight

Table 2 is based on data from the Federal Statistical Service and American insurance companies (X. Mol). Therefore, normal body weight is to a large extent not only an indicator of a person’s health and maintaining a slim figure, but also a factor characterizing the ability to work and productivity of his work, since only a person with normal body weight can work most productively. For example, obese individuals stay in bed 65 minutes longer on average than lean individuals. obese only 22 % days are on their feet, and persons with a normal weight of 36 %. Fat people do not strive for physical activity, most of them immediately find a chair for themselves.

A full person cannot feel good, if only because he constantly has to carry too much load for himself. Imagine that a person weighs 20 kg more than normal. And now let's ask a person with a normal weight to carry 20 kg all day. Of course, after a while he will become exhausted.

Maintaining normal body weight is not only a personal, medical and social problem, but also a public one. Therefore, every self-respecting person must constantly maintain a normal, or rather ideal body weight, be able to determine it taking into account gender, age, physique and, if necessary, correct it.

The main types and forms of obesity

Overweight refers to body weight above ideal. The required minimum fat for an adult male is 3% of total body weight, any amount in excess of this is considered reserve fat. In women, reserve fat can be 12-15% of body weight. This is “specific female fat”, which is related to the functional and anatomical features of the female body associated with childbirth.

According to the distribution of adipose tissue, the following types of obesity are distinguished:

● masculine or android(central, upper, abdominal, i.e., apple-shaped obesity) - fat is deposited in the abdomen, i.e., mainly around the internal organs and is a great danger, causing diseases and premature death;

● female type, or gynecoid(lower, femoral-buttock, in the form of a "pear") - localization of adipose tissue around the hips and buttocks;

● cellulite - inflammation of the subcutaneous tissues with impaired microcirculation and lymph flow, and subsequently the deposition of fats in these places. The main areas affected by cellulite are the buttocks, thighs, abdomen and less often the inner surface of the arms. The skin is inelastic, with hollows and tubercles, resembles an orange peel, in more severe cases, pain is observed in the altered areas. Cellulite occurs in 50% of women under the age of 25 and in 80% of women over 30 years of age. The causes of cellulite are:

● increased content of female sex hormones in the body;

● malnutrition;

● low physical activity;

The most accessible and simple method for assessing the type of obesity is the determination of waist circumference. If the waist circumference in men is more than 102 cm and more than 88 cm in women, then this indicates the presence of abdominal obesity, i.e. apple-type obesity, which is much more dangerous than pear-type obesity.

Obesity of the upper body can be defined by the ratio of the waist to the hips. A number above 0.95 for men and 0.80 for women indicates an increased risk of obesity.

There are two forms of obesity:

● obesity since childhood;

● obesity in adulthood.

People who become obese in adulthood find it easier to lose weight and maintain proper weight because they have fewer fat cells than those who were obese in childhood. Of particular concern is the excessive fatness of children. Since fat cells are already formed as a result of overfeeding infants, the prognosis is unfavorable.

Current knowledge on the factors contributing to obesity

Excess fat deposits in body fat cells are called obese. In humans, fat cells are formed during childhood and adolescence. Their number averages 30-40 billion.

Two processes are constantly going on in the body:

● lipogenesis - the formation of fat;

● lipolysis - the expenditure of fat.

If a person maintains a constant body weight, then lipogenesis corresponds to lipolysis. The number of fat cells remains forever unchanged. Moreover, when a person loses weight, only the total amount of fat in the cells decreases and, accordingly, the mass of these fat cells decreases.

The main reasons contributing to weight gain are outlined below.

Violation of the basic principles of rational nutrition and lack of physical activity. The main reason for most cases of obesity is excessive consumption of high-calorie foods and reduced physical activity, a decrease in energy costs compared to the energy that food supplies to the body.

In table. Figure 3 presents data from researchers showing how often violations of the principles of rational nutrition lead to obesity.

Table 3 Violation of rational nutrition

At present, almost all modern types of labor are mechanized and automated, which reduces the energy consumption for their implementation, and food rations remain the same. As a result, energy consumption will decrease among workers, and if the amount of food consumed is not reduced, then body weight will undoubtedly increase.

Consequently, the scourge of modern man, driving him into a state of obesity, are:

● positive energy balance, i.e. more energy comes from food than is consumed by the body;

● hypokinesia and physical inactivity caused by prolonged sitting in front of the TV, computer, constant use of the car, low proportion of physical labor and sports;

● significant consumption of alcoholic beverages (1 g of pure alcohol provides 7.2 kcal);

● violation of the diet (rare meals, meals at night), as well as the abuse of salty foods, spices and snacks.

genetic problems. Heredity has a strong influence on the mass of a person. Genes affect the constitution, body size and distribution of fat in it. The structure of adipose tissue can be hypertrophied and hyperplastic.

Adipose tissue hypertrophy is characterized by a small number of fat cells, but with a large amount of fat.

Hyperplasia is characterized by a large number of fat cells with a large amount of fat.

Therefore, if a person recovers in adulthood, then this is due to hypertrophy of adipose tissue. If a child is obese since childhood, then this is due to hyperplasia of adipose tissue. Obese children inherit hyperplasia from their obese parents. In such families, a cult of gluttony is often developed. The family form of nutrition, which is not differentiated for each family member by sex and age, where preference is given to meat, fats, sweets as opposed to fruits and vegetables, causes weight gain.

metabolic efficiency. Important in the development of obesity is the efficiency of metabolism, i.e. metabolism. It combines two opposite processes - the breakdown of complex organic substances (catabolism, or dissimilation) and the formation of organic substances, the constituent cells of tissues (anabolism, or assimilation).

It can be stated that an efficient metabolism, but an energetically less wasteful type of metabolism (reduced physical activity - work, sports), predisposes to obesity, while a reduced metabolism contributes to the stabilization of body weight with little physical activity. The endocrine system has a significant impact on the efficiency of metabolism. For example, insufficiency of the endocrine glands increases body weight (myxedema, eunuchism, postmenopausal period), and with thyrotoxicosis, the basal metabolism is increased, which leads to its decrease.

The activity of the enzyme lipoprotein plase. Enzyme lipoprotein plase synthesizes its own fat in the body. In obese people, this enzyme is more active due to a genetic predisposition. It is characteristic that with a low-calorie diet (hunger, unloading diet), i.e., a low intake of calories from food, this enzyme is inactive, and when an increased amount of calories is received with food, its activity increases sharply. With the transition of a person from a low-calorie diet to a normal or somewhat excessive calorie intake, the activity of lipoprotein plase increases. This is clearly manifested in people who have completed the course of a therapeutic diet, a sharp increase in body weight.

The ratio of brown to yellow adipose tissue in the body. Yellow adipose tissue is capable of storing fat, while brown adipose tissue produces heat. Brown fat cells contain many lipid droplets with the protein thermogenin, due to which the energy used to generate heat gives the cells the properties of “microheaters”. Some people who eat large amounts of food do not get better, which means that their organs contain a significant amount of brown adipose tissue.

It should be noted that large reserves of brown adipose tissue are found in newborns and in people adapted to the cold, engaged in winter swimming and winter swimming. They do not restrict themselves in food and do not get fat.

Diet. Scientists have found that with the same caloric content of the diet, a rare (one-, two-time) meal contributes to an increase in body weight: a starving person eats more than the norm, the body takes the right amount of energy for metabolism, and its excess turns into fat. More frequent meals (4 or more times) contribute to weight loss. This is especially effective when most of the daily diet is taken during the period of active physical and mental labor.

The composition of the diet. The composition of the diet is essential in the regulation of body weight. It has been established that when burning 1 g of fat in the body, 9 kcal of energy is released, and when burning 1 g of proteins and 1 g of carbohydrates, only 4 kcal each. Characteristically, the conversion of excess carbohydrates into fat in the body consumes more than 25 % calories, and when dietary fats are converted to body fats, only 3 % calories (specifically dynamic action of food). Thus, the body is more likely to produce fats from food fats than from carbohydrates or proteins. Therefore, the consumption of a large amount of fat, contributes to a more enhanced formation of body fat with less energy for this process.

Selection of foods in the diet. V correct selection of food products plays an important role in correcting and maintaining body weight. It is characteristic that the pancreas reacts differently (does not release insulin into the blood in the same way) to food products. Based on this, all food products are divided into 2 groups:

● 1st group - foods with a high glycemic index (glucose, bananas, confectionery, white bread, potatoes, etc.);

● 2nd group - foods with a low glycemic index (vegetables, fruits, wholemeal bread, oatmeal, soybeans, etc.).

Products of the 1st group with the same calorie content compared to the 2nd group cause a greater formation of insulin. Therefore, if all the calories are not used for work, they turn into fat. As you know, the main amount of fat is formed at night, since energy in this period is spent only on the main metabolism. Therefore, overeating before bed leads to sleep disturbance and obesity.

Effect of stressful situations on weight gain. Stressful conditions (irritability, depression, anxiety, etc.) affect the decrease in the content of serotonin in the brain. Low serotonin causes cravings for sweet, starchy, starchy foods. Therefore, a depressed mood leads to "gluttony with sweets", and saturation with them leads to satisfaction and a comfortable state. This phenomenon is due to the fact that carbohydrates provide transport to the brain of the amino acid tryptophan, from which serotonin is formed. An excess of carbohydrates without the expenditure of energy leads to the formation of fat and weight gain.

Modern society faces many problems. But for many, it is obesity and overweight that are the obstacles, the urgency of overcoming which is especially acute.

Obesity is a disease that needs to be treated, but not possible without the will of the patient and his awareness of the risks that their disturbed metabolism can lead to.

In Russia, overweight is diagnosed in 30% of the population, and obesity in more than 20% of citizens. Obesity and overweight in women over 50 years of age occurs in 50% of cases.

What can you do if you suspect that you are overweight or obese?

First you need to figure out what weight is considered ideal. For each historical period, the concept of "overweight" has changed somewhat. Currently, several formulas are used to calculate normal weight. One of them, in fact, very approximate, looks like a person's height (in cm) minus 100. In reality, it is not very suitable for weight analysis, so it is better to use the body mass index - BMI (Quetelet coefficient).

To calculate it, it is necessary to divide the person's weight (in kg) by the square of height (in m). The calculated index, falling in the range of 18.5-24.9, characterizes the normal weight. Overweight is stated with a BMI of 25.0 to 29.9. Anything that exceeds these values ​​means that this person has obesity of one degree or another.

Obesity 1 degree will occur with a BMI of 30.0-34.9.

Obesity 2 degrees diagnosed with a BMI of 35-39.9.

And finally, with a BMI exceeding 40, they state obesity 3 degrees.

It is even easier to diagnose overweight by waist measurement. A volume exceeding 88 cm in women and 103 cm in men confirms obesity.

Types of obesity

Considering obesity as such, it is important to distinguish between its types. Obesity according to the female type is characterized by the deposition of fat on the abdomen, shins, thighs. The male type characterizes the deposition of fat in the upper parts of the body and on the abdomen, without affecting the upper shoulder girdle and neck.

Hyperplastic (characteristic of obesity in children) and hypertrophic (in adults) types of obesity differ in that in the first case, the number of fat cells increases from childhood, in the second, the size of the fat cell itself (adipocyte) grows.

Causes of obesity

The main cause of obesity is the excess of nutrient intake over the energy expenditure of the body. The physiological needs of a person for nutrients differ depending on age and physical activity (occupation). The basic exchange of each individual can be calculated according to special tables in Kcal. It is important to understand that with every decade of life, the basal metabolic rate decreases by 5-8%, which means that eating food with the same qualitative and quantitative composition throughout life will inevitably lead to obesity, even if a person does not have any diseases of the endocrine system. In addition, the physical activity of most people decreases with age. Two factors, in the absence of a critical attitude to nutrition, will inevitably lead to obesity.

In the vast majority of cases, there is the so-called alimentary-constitutional obesity, when excess weight accumulates as a result of constant overeating. With this type of obesity, a hereditary predisposition and constitutional features of a person are clearly traced, in conjunction with formed family eating habits and preferences.

To a lesser extent, obesity is a consequence of diseases of the central nervous system, psychiatric pathology and disorders in the functioning of the endocrine apparatus (diabetes mellitus, diseases of the thyroid gland, adrenal glands, pituitary gland, gonads). Obesity and type 2 diabetes are the most common pathologies in endocrinology.

Treatment of obesity and normalization of overweight

The treatment of obesity is a complex task that requires an integrated approach, and sometimes the participation of a team of doctors (nutritionist, endocrinologist, therapist, surgeon, psychotherapist, gynecologist). In the presence of the above diseases, excess weight cannot be removed without treatment of the underlying pathology. In addition to mandatory diet therapy, treatment includes the appointment of special drugs, and sometimes surgical treatment.

If the patient has alimentary-constitutional obesity or overweight, then a properly selected reduced diet prescribed by a doctor comes to the fore. The nutritionist calculates the basal metabolic rate, the degree of daily calorie restriction. The greater the obesity, the stricter the caloric restrictions (reduction by 300-600 kcal or more per day).

With a severe degree of the disease (obesity of the 3rd degree), treatment can be carried out in a hospital under the control of an ECG, biochemical blood markers, include the appointment of special drugs, methods of surgical weight correction.

Regardless of the type and degree of overweight, the diet for obesity is standard.

To understand the validity of a diet designed to lose weight, it is necessary to consider the composition of the main dietary nutrients included in the mandatory human diet.

Food products consist of fats, proteins, carbohydrates, the composition of which is quite heterogeneous in terms of energy value.

As a percentage, the intake of protein, both animal and vegetable, in total should be 15% of the daily caloric intake. Saturation largely depends on protein, in addition, it plays a plastic role. Protein restriction is unacceptable. Optimal for weight loss will be the consumption of at least 200 g of protein.

Fats are divided into saturated (refractory, animal), containing cholesterol, and unsaturated. Daily intake of cholesterol in obese patients should be reduced to 150 mg/day). At the expense of fats, at least 20-30% of all human nutritional needs should be covered. Moreover, the share of animal fats (poultry, meat, offal) should account for less than 10% of daily calories. The rest of the fat should be used in the form of polyunsaturated and monounsaturated fats (vegetable oils, fish oil). It is important to get both omega-3 and omega-6 fatty acids. They do not contain cholesterol.

Simple carbohydrates (sugars) should take no more than 7-8% of daily calories, given that the total amount of carbohydrates is 60-65% of all energy intake. Simple carbohydrates include sugar, jam, honey, sweets, cakes, ice cream, confectionery, sweet carbonated drinks. Important in nutrition and vegetable fibers that are not absorbed and do not carry any energy load, help lower cholesterol. They are found in vegetables, leafy greens, fruits, legumes, grains. The daily intake of vegetables and fruits should be from 500 grams to 1 kg, dietary fiber 20 grams, it is preferable to use vegetables and fruits unchanged.

To comply with these principles, a diet for obesity should be made taking into account the following rules.

• Dramatically reduce the consumption of by-products (liver, kidneys, brains), which contain, in addition to an excess of saturated fats, an excess of cholesterol.
• Refuse to eat processed meat (sausages, sausages, sausages).
• In order to prevent excess weight from accumulating in the body, rarely eat duck, goose, nutria meat, reduce portions of meat and poultry to 100 grams.
• Remove excess fat from the broth, visible fat from the meat.
• Use boiling and baking instead of frying in oil.
• Do not use butter spread on bread.
• Do not fill ready-made dishes and salads with sauces, mayonnaise, sprinkle with lemon to improve the taste, add herbs.
• Prefer instead of beef and pork, fish, chicken breast. Cook fish at least three times a week.
• Increase the proportion of vegetable proteins and fats (legumes), eat high-protein foods.
• Do not use flavor enhancers, ready-made sauces, marinades, excessive amounts of spices, seasonings, smoked meats.
• Do not oversalt food, it is considered optimal to consume no more than 5 grams of salt per day, with obesity, the amount of salt is reduced.
• Increase in the diet foods rich in potassium, magnesium (jacket potatoes, dried apricots, prunes, raisins).
• When using dairy products, give preference to low-fat types of dairy products.
• Reduce the intake of simple carbohydrates to 35 grams per day (sugar no more than 5-6 pieces).
• Limit the use of potatoes (200g), bananas, pasta.
• Of carbohydrates, give preference to whole grains (cereals, bran, wholemeal bread).
• When choosing products, be sure to pay attention to the qualitative composition (fats, proteins, carbohydrates), the calorie content of the products (indicated in Kcal / 100g) and choose the least calorie ones.
• Reduce the portion of food, use less voluminous dishes.
• Eat frequently, at least 5 times a day. Starvation is absolutely excluded, as it leads to even more uncontrolled weight gain.
• Choose foods that are sufficient in volume, occupying a large volume of the stomach, but not carrying a high energy value (vegetables, fruits, leafy greens, fish, fiber, dietary fiber).
• Dramatically reduce the use of alcohol in any form, as it is very high in calories. For example, 100 grams of vodka contains 240 kcal, which is more than 10% of the daily calorie requirement.
• Do not eat fast food, chips, french fries.
• A diet for obesity should be followed regularly, rapid weight loss by fasting should not be allowed. Excess weight should be reduced gradually, about 1 kg per month. With obesity, the rate of weight loss is calculated by a nutritionist individually in each case.

This article was written at the request of my patients who are overweight and obese, so that they and other interested people better understand these issues.

When writing the article, I used materials from articles posted on the Internet on various sites, in particular, from Wikipedia, from Mikhail Ginzburg's book "How to defeat excess weight", from Elena Alexandrova's article "Soda baths! What are they, what are the results, recommendations. ", from WHO Fact Sheet No. 311, March 2013, "Obesity and Overweight", material from Prof. Park Jae-woo's book "Your Own Doctor" and my personal experience as a reflexologist.

Overweight, obesity, is a chronic disease associated with impaired metabolic processes in the body, the main manifestation of which is the accumulation of fat in the body.

According to statistics, in 2008, 1.4 billion adults aged 20 and over were overweight. Overweight and obesity are the fifth leading risk factor for death in the world. 208 million adults die each year as a result of being overweight and obese. In the CIS countries, up to 55% of the population is overweight and obese.

So: overweight and obesity are defined as abnormal and excessive fat deposits that are detrimental to health.

If BMI is 18.5 - 24.5 kg / sq. m is the norm.
BMI 25 - 35kg / sq. m - obesity 1 degree.
BMI 35 - 40kg / sq. m - obesity of the 2nd degree.
BMI 40 - 50kg / sq. m - obesity 3 degrees.
BMI over 50kg/sq. m - obesity 4 degrees.

I give an example. A person has a weight of 90 kg and a height of 1.75 m. His BMI is calculated as follows: 90kg / 1.75m x 1.75m \u003d 29.4 kg / sq.m. This corresponds to obesity 1 degree.

There are 8 main reasons for the increase in extra pounds.

One of the causes of hyperphagia is a reaction to stress. In 30% of people, with excitement and anxiety, the appetite increases sharply, more often in obese people. When a person is worried, he gains extra pounds due to increased appetite.

There is also a carbohydrate craving for stress, when you want sweets and a person consumes a large amount of sweet, starchy foods. It can also be the cause of being overweight.

Sweet in this case plays the role of a drug. With the rejection of sweets, a painful condition develops, depression, and sometimes aggression can manifest itself. Increased appetite is a risk factor, but not always the cause of being overweight.

2. Hypodynamia, insufficient physical activity. In this case, the energy intake from food exceeds its expenditure. The body stores unused energy for the future in the form of body fat, which can be used as needed.

In old age, a person's energy consumption decreases. The basal metabolism decreases, that is, the energy consumption for the main vital functions at rest - breathing, cardiac activity, the work of the liver, kidneys, intestines, muscles. Against this background, overweight and obesity appear.

3. Violation of the production of hormones - hormonal balance.

Underactive thyroid - hypothyroidism leads to a slowdown in metabolic processes in the body, including fat metabolism, the breakdown of fats is disturbed, obesity, apathy, lethargy, and drowsiness appear. Adipose tissue in hypothyroidism is distributed evenly.

Hypothyroidism is associated with insufficient intake of iodine in the body and impaired synthesis of the thyroid hormones thyroxine and triiodothyronine. You can boost the activity of the thyroid gland by including foods with a high content of iodine in the diet: sea fish, sea mollusks, sea kale.

Hypothyroidism can be in women after pregnancy and childbirth.

Growth hormone is actively produced in the body of young people growth hormone which is synthesized in the pituitary gland. This hormone utilizes fat, helps maintain good physical shape. After 30 years, the synthesis of somatotropin decreases, and by the age of 50, its production stops completely.

To restore the synthesis of somatotropin, it is necessary to get enough sleep; during the night rest, the synthesis of growth hormone increases several times, especially in the first 2 hours of sleep. You can stimulate the synthesis of growth hormone by taking the amino acids ornithine and arginine, as well as vitamins B and C in combination with potassium, magnesium and calcium. Classes in the gym with weights will contribute to the development of a double dose of the hormone at night.

Injections of growth hormone to healthy people for the purpose of losing weight are contraindicated, as they contribute to the development of diabetes and malignant tumors.

Severe neuroendocrine disease may contribute to weight gain Itsenko-Cushing's disease, which is based on a violation of the regulatory mechanisms that control the hypothalamic - pituitary - adrenal system. The adrenal glands produce a large amount of hormones - corticosteroids.

The hypothalamus activates the production of adrenocorticotropic (ACTH) hormone in the pituitary gland. ACTH causes the adrenal glands to produce excess corticosteroids.

An excess of corticosteroids disrupts all metabolic processes in the body. In this case, obesity develops. Fat is deposited on the shoulders, abdomen, face, breasts and back. The body becomes fat, and the arms and legs become thin. The face becomes moon-shaped, round, the cheeks are red. Pink-purple or purple stripes appear on the skin - striae. On the body - excessive hair growth (women grow mustaches and beards).

The disease occurs after trauma, brain infections, in women it may be after childbirth. This type of obesity can develop as a result of long-term treatment with corticosteroids, for example, in rheumatoid arthritis, bronchial asthma.

Itsenko-Cushing's syndrome does not differ in signs from the disease. It appears with tumors of the adrenal gland or tumors of various organs (bronchi, thymus, pancreas, liver).

Hyperinsulinism. A benign tumor of the pancreas - insulinoma secretes an excess amount of insulin, which lowers blood sugar levels, causes hunger and leads to overeating. Insulin also inhibits the breakdown of fat and makes diets ineffective. Progressive obesity is one of the symptoms of insulinoma.

After 40 years among women begin hormonal changes, preparing a woman for menopause. The amount of estrogen hormones produced by the ovaries decreases, and body fat increases.

In this case, homeopathic remedies - phytohormones - can help, they have fewer contraindications and side effects. You can simply add foods rich in plant hormones, such as soybeans or pollen, to your diet.

But weight gain can be associated with a serious ovarian disease - polycystic. In this case, a benign tumor - a cyst - forms in the ovary. In addition to weight gain, at polycystic menstrual cycle failures, facial hair growth, acne appear.

In men, low testosterone is an important factor in the maintenance and progression of obesity.

Produced by the pituitary gland prolactin reduces the concentration of sex hormones (estrogen in women and testosterone in men). Wherein the basal metabolism slows down and the transition of carbohydrates into fats is stimulated, obesity develops.

Hyperandrogenic syndrome in women. Androgens - male sex hormones are also found in women. They are produced in the adrenal glands. An excess of these hormones in women leads women to obesity. This can be with tumors of the ovaries, adrenal glands, due to dysregulation of the central nervous system after infections and intoxications.

4. Violation of the gastrointestinal tract.

Useful intestinal microflora contributes to the complete breakdown and absorption of nutrients from food. If the balance of the intestinal microflora is disturbed during dysbacteriosis, candidiasis, a large amount of toxins harmful to the body is formed - products of incomplete digestion of food.

Toxins enter the body with food (food, drinks), respiration (exhaust gases, etc.), through the skin (contact with household chemicals, paints). All this accumulates in the body, including in adipose tissue. .

Adipose tissue stores toxins. Increasing the amount of toxins increases the amount of adipose tissue.

The activity of the immune, hormonal, nervous, cardiovascular, digestive, urinary systems is disrupted, chronic diseases develop.

To cleanse the body of toxins and toxins, many peoples of the world use religious fasts. This is the easiest way to achieve cleansing of the body. Fasting stimulates cleansing processes in the body, metabolic processes improve, extra pounds go away, people lose weight.

5. Violation of water-salt (mineral metabolism) and fluid accumulation in the body.

The reason is a violation of the excretory systems of the body: kidneys, skin. The human body is 70-80% water. Eating large amounts of salt, sugar, smoked meats, spicy foods leads to dehydration of body cells. To maintain the constancy of the internal environment - homeostasis, the body includes protective mechanisms for the accumulation of water, while its release is reduced.

The place of accumulation of water in the body is the adipose tissue of the subcutaneous tissue and the omentum in the abdominal cavity, and this increases the weight of the human body. This is how the hydrophilic properties of adipose tissue are manifested.

After a bath or physical exertion that caused heavy sweating, one to three kilograms of weight is lost.

To avoid the accumulation of excess water in the body, you must:

A. Limit salt intake, it causes fluid retention.

B. Limit sugar intake, it causes increased thirst.

B. Reduce the consumption of fats, they attract water.

D. Use only clean water, it flushes the body without lingering, catabolism products come out with it - the breakdown of fats, weight loss occurs.

D. Increase consumption of foods containing potassium It helps to remove fluid from the body.

There is a lot of potassium in such products: meat products, many cereals, jacket potatoes, wheat bran, green peas and beans, wheat germ, carrots, pumpkin, beets, radishes, peppers, cabbage, cucumbers, avocados, greens, and especially in parsley and spinach.

E. Eliminate or significantly limit the use of alcohol, it retains fluid in the body.

6. Lack of important trace elements and minerals in the body.

Biochemical processes in the body proceed only in the presence of enzymes - catalysts for chemical reactions. But enzymes act in the presence of activators - coenzymes. Activators are molecules of certain trace elements and minerals. They are the "keys" that start the work of enzymes.

Consider the trace elements involved in fat metabolism and preventing weight gain and obesity.

Magnesium- improves digestion, promotes the utilization of fats and the promotion of food through the intestines. Magnesium prevents the genes responsible for obesity from manifesting. It reduces the feeling of hunger, the danger of overeating, reduces tension from stress, relieves the body of the need to store substances for future use.

It is found in green vegetables (spinach, cucumbers), legumes, nuts, whole grains, sprouted wheat grains, fish (cod, carp, halibut), seafood (shrimp, seaweed).

Zinc- participates in the activity of more than 20 enzymes, is a structural component of the pancreatic hormone - insulin. It normalizes fat metabolism, increases the intensity of fat breakdown and prevents fatty liver. The greatest need for zinc during the period of intensive growth and puberty in childhood and adolescence.

It is found in meat products, unpolished rice, mushrooms, oysters, seafood, eggs, yeast, sunflower seeds, apples, baked goods, and vegetables.

Manganese- participates in the synthesis of B vitamins and hormones, prevents fatty liver and promotes the breakdown of fat in the body, normalizes lipid metabolism, prevents the development of obesity.

It is found in meat, fish, seafood, legumes, cereals.

Chromium- participates in carbohydrate metabolism, reduces the body's need for insulin. A lack of chromium leads to obesity, fluid retention in tissues and increased blood pressure, increased blood glucose levels, increased triglycerides and cholesterol in the blood, and the development of atherosclerosis.

Chromium is found in whole grain bread, natural grain cereals (buckwheat, brown rice, oats, millet), heart, liver, animal and bird kidneys, fish and seafood, egg yolks, honey, pine nuts, mushrooms, brown sugar , in beets, radishes, peaches, beer and brewer's yeast, dry red wine.

Molybdenum- promotes the metabolism of carbohydrates and fats, prevents obesity.

It is found in chokeberries, legumes, liver, kidneys, whole grains, dark green leafy vegetables, and apples.

7. Hereditary factor.

Every person has a hereditary tendency to be overweight, one of whose parents is overweight. At the same time, a person recovers with the usual average nutrition. However, obesity itself is not inherited, but a tendency to it. At the same time, a person can have a completely normal weight and not be full.

8. The qualitative composition of food is important in the development of overweight and obesity.

Food consists of proteins, fats, carbohydrates and minerals. All these components, when broken down in the body, give the body the energy it needs.

Carbohydrates are the easiest to break down (oxidize) in the body. They provide energy to the cells of organs and tissues. Many people know the feeling of warmth after a hearty meal. It breaks down, burns carbohydrates.

In everyday life, a person's appetite and food intake are related to the content of glucose in the blood and glycogen in the liver. When the level of glucose in the blood decreases, hunger appears, when it rises, a feeling of satiety appears. If you eat sweets 20 minutes before a meal, your appetite will decrease, and a feeling of satiety will appear.

It has been experimentally established that the human body under normal conditions does not use carbohydrates to build and accumulate fat. Carbohydrate intake is tightly controlled by the body. This reduces the likelihood of them overeating.

Fat intake by the body is not regulated. Research has found that the more fat a person eats, the more likely they are to be overweight.

The relationship between fat abuse and extra pounds is much stronger than the relationship between being overweight and the abuse of flour and sweets.

It has also been established that the presence of fat in food does not reduce the intake of other nutrients, does not reduce appetite, does not increase the feeling of satiety.

Excess fat in food contributes to its deposition in adipose tissue. The human body is an ideal trap for fat if there is a lot of it in food or if there is not much, but the body cannot cope with its oxidation. In these cases, the accumulation of weight gain due to fat is inevitable. If a person does not want to get better, then you need to eat less fat.

The ability to burn fat decreases with age. The main tissue where fat is burned is muscle. With limited mobility and physical activity, the ability of muscles to oxidize fat drops sharply. This is the reason for weight gain in athletes who have quit sports and training and in older people who have reduced physical activity.

Diseases caused by being overweight.

Atherosclerosis- violation of cholesterol metabolism, hypercholesterolemia, deposition of fats and cholesterol on the walls of arteries. In obese people it occurs in 65% of cases.

Cardiac ischemia. In 50% of cases, the narrowing of the heart arteries leads to angina pectoris - attacks accompanied by pressing, squeezing pains in the region of the heart, heart rhythm disturbances, which can lead to myocardial infarction.

Myocardial infarctions develop in obese people 4 to 5 times more often than in people with normal weight.

Hypertonic disease- in obese people in 3rd place.

Diabetes- leads to damage to the kidneys and the development of their insufficiency, to blindness, to damage to the vessels of the extremities and the development of gangrene.

Cholecystitis and cholelithiasis. Obese people often develop gallstones and bile duct stones. And after operations on the biliary tract and gallbladder, complications often occur and more often there are deaths.

Gout- this is a violation of the excretion of uric acid salts from the body - a product of nitrogen metabolism. These salts are deposited in the tissues of the body in the area of ​​tendons, joints in the form of painful knots - tophi and disrupt the function of the joints.

Osteochondrosis- destruction and thinning of the intercostal and intervertebral cartilages with infringement of the intervertebral nerves. In obese people, due to the increased load on the spine, it occurs much more often than in people with normal weight.

Exchange - dystrophic polyarthritis- develop in overweight people more often than in people with normal weight. Joints are deformed due to the growth of cartilage tissue. The function of the joints is impaired due to the limitation of their mobility and soreness.

Malignant tumors. Obese people mainly develop cancers of the kidney, lungs, large intestine, mammary glands, and the female genital area. The development of tumors is facilitated by fatty foods, inactivity, and a violation of the production of sex hormones.

Violations of the ovarian-menstrual cycle and infertility in very obese women. Cycle disorders, intermenstrual bleeding, infertility develop. Adipose tissue interferes with the metabolic processes of sex hormones. In women, hair grows on the face and trunk - hirsutism. This is due to an increase in the production of the male sex hormone by the adrenal glands.

In men, due to obesity, the amount of the male hormone testosterone decreases. Sexual desire decreases, impotence develops, mammary glands increase.

The main methods of treatment of overweight and obesity.

1. Diet with a high content of fiber, vitamins and other biologically active components (cereals, whole grains, vegetables, fruits, nuts, herbs) and limiting the use of easily digestible carbohydrates (sugar, sweets, pastries, bakery and pasta from premium flour).

Diet for obesity should be prescribed strictly individually, based on the characteristics of metabolic processes in the body and the reasons that led to the diagnosis of obesity.

Diet should promote gradual weight loss, otherwise, a sharp weight loss will certainly harm the body. It should be safe, should not lead to metabolic disorders, deficiency of nutrients, microelements, vitamins, reduced immunity, disorders of the digestive system, nervous system, depletion of the body's vitality.

The diet should be prescribed by the attending physician, preferably a nutritionist, based on diagnostic data, be an important part of the treatment of obesity and contribute to the overall improvement of the body.

2. Regular exercise, manifestation of physical activity(60 minutes per day for children, 150 minutes per week for adults). Daily walks or jogs up to 5 km are effective. A set of exercises for the treatment of overweight and obesity is best agreed with a sports medicine specialist. A set of exercises should be individual for each person and take into account his age and state of health.

3. Pharmaceutical drugs for the treatment of obesity are used when diet and exercise fail.

Drugs for the treatment of obesity should have the following mechanism of action:
- suppress appetite;
- increase the metabolism in the body;
- affect the body's ability to absorb certain nutrients from food;
- Suppress digestion and reduce the absorption of calories.

Let's take a look at some drugs.

Orlistat- reduces the absorption of fat in the intestines due to the suppression of the action of the pancreatic enzyme - lipase. It can cause frequent fat stools (steatorrhea), but if the fat content of the diet is reduced, these symptoms will go away.

Sibutramine (Meridia, Lindax, Thalia, Reduxin)- antidepressant, anorexic, regulates appetite, reduces the desire to eat. May cause high blood pressure, dry mouth, constipation, headache, irritability, insomnia.

Rimonabant (Acomilia, Zimulin)- Recently developed. Antagonist of receptors that have a central effect on the brain, reduce appetite. Affects thermoregulation, increases energy consumption, weight loss occurs, eliminates insulin resistance and lipids (fats, cholesterol) in the blood.

Metformin- used to treat type 2 diabetes and is able to reduce weight at the same time.

Exenamide (Byetta)- delays gastric emptying and promotes a feeling of satiety. Byetta is used to treat type 2 diabetes and can significantly reduce weight. Causes nausea in some patients.

Pramlintid (Simlin)- an analogue of the intestinal hormone amylin, produced for meals, delays gastric emptying, causes a feeling of satiety.

Drugs for the treatment of overweight and obesity should be prescribed by a doctor!

4. Surgical treatment of obesity. Currently, operations to combat obesity are performed laparoscopically without incision through punctures under the control of the optical system of the laparoscope. All these operations reduce the flow of food into the stomach and intestines, promote rapid satiety, eliminate hunger.

Indications for surgical treatment of obesity occur with a BMI above 40 kg/sq.m. However, if the patient has problems such as type 2 diabetes mellitus, hypertension, varicose veins and diseases of the leg joints, indications occur with a BMI of 35 kg / sq.m.

Operations such as liposuction and abdominoplasty are not designed to combat obesity, but correct local cosmetic defects. After liposuction, the amount of fat and body weight are slightly reduced, but such an operation is useless for health. It is not subcutaneous fat that causes harm to health, but visceral fat, located in the omentum and around the internal organs in the abdominal cavity.

5. Therapeutic baths for weight loss.

A. Soda baths.

If you take a bath with baking soda dissolved in it, you can lose up to 2 kilograms in one procedure. To obtain the best effect, soda baths should be taken in courses of 10 procedures every other day. The duration of the procedure is 20-25 minutes.

150 - 200 liters of hot water with a temperature of 37 - 39 degrees should be taken into the bath and 200 - 300 grams of sodium bicarbonate should be added. And in the bath, you can add up to 300 grams of sea salt (sold in pharmacies) for a greater effect.

A soda bath not only reduces weight, but also relaxes the body well, allows you to dump the negative energy that has accumulated during the day. During the bath, the lymphatic system begins to work actively and is cleansed. Soda baths are indicated for dermatitis, seborrhea, dry eczema, fungal infections of the skin.

If a person wants to get rid of the effects of radioactive radiation, then sea salt should not be added to the bath.

After taking a soda bath, you do not need to wash yourself with water. Wrap yourself up in a towel or blanket and get into bed. It is better to take these baths in the evening before going to bed.

There are other therapeutic baths, the recipes of which are simple, but the result will be obvious from the first time.
B. Cleopatra's bath. Boil a liter of milk and add about 100 grams of honey to it. Make a scrub with 150 grams of sour cream and 150 grams of sea salt. Rub with salt mixture, hold it on the body for 10-15 minutes, rinse. Add honey milk to a hot bath. Take a bath for 20-25 minutes. This procedure, in addition to weight loss, rejuvenates the skin and gives it elasticity.

B. Mustard bath.
Dilute 1 glass of mustard with warm water to the consistency of batter and pour into the bath. Take a warm bath for no more than 10 minutes, then take a warm shower and wrap yourself in a blanket for half an hour.
G. Hollywood bath.
Whisk an egg and half a glass of shower gel with a whisk, add 1 teaspoon of vanilla to the mixture. Pour everything together into a warm bath. Pour slowly under running water. Bath, in addition to weight loss, improves metabolic processes in the body.
E. Bathtub of lime blossom.
Brew lime collection (can be in bags) and let it brew for 40 minutes, then add to the bath. Take a bath for no more than 20 minutes.
E. Bran bath.
Brew 1 kilogram of bran in 2 liters of milk with the addition of 1 tablespoon of honey. Pour the resulting mixture into the bath. This bath is considered one of the best rejuvenating baths. Well refreshes and tightens the skin. Take a bath for no more than 30 minutes.
Y. Coniferous bath.
Dissolve in water poured into the bath 50 - 70 grams of coniferous powder. The bath is good for toning. You can take such a bath for 15 - 20 minutes.
G. Turpentine baths.
These baths are prepared on the basis of emulsions for turpentine baths, which are sold in pharmacies. Yellow turpentine baths are recommended for people with high blood pressure. If the pressure is normal or low, baths based on white turpentine are recommended. Such baths, in addition to weight loss, increase skin elasticity, increase immunity. The procedure for preparing the bath can be seen on the instructions supplied with the emulsion for turpentine baths.
7. Reflexology can effectively help with overweight and obesity.

Doctors - reflexologists use for this: acupuncture, magnetoreflexotherapy, thermoreflexotherapy, laser reflexotherapy, pharmacoreflexotherapy, seed reflexotherapy.

These techniques make it possible to harmonize, that is, restore the energy system of the patient's body and reduce its weight, as well as have a therapeutic effect on the diseases associated with obesity: diabetes mellitus, arterial hypertension, pain in the joints, spine, lower limbs, improve the functioning of the cardiovascular, digestive and excretory systems of the body, improve immunity.

At home, you can influence the correspondence points pituitary gland, navel, esophagus, stomach, small intestine. You should find these points, mark them with a green felt-tip pen.

These points should be well massaged until heat appears in them.

Stimulation of these points can be carried out in the standard correspondence system on the hand and in the “insect” system on any finger. (See pictures.)

On the points of correspondence to the pituitary gland and the navel, it is necessary to put buckwheat grains each and fix the grains with a band-aid for a day.

The grains must be with an intact shell; buckwheat is not suitable for cooking porridge.

As soon as there is a desire to eat something tasty, press the grains intensively several times, the desire will weaken and pass.

Place the sprig of the plant on the zone corresponding to the esophagus and stomach so that the direction of growth of the plant is opposite to the natural movement of food through the esophagus.
You can also put seeds, for example, apple seeds, attaching them with a plaster to the correspondence points of the mouth, esophagus, "entrance" to the stomach. The energy flow of seeds must be directed against the movement of food. See pictures.

Weight loss will be helped by seeds located in a chain along the projection of the large intestine, so that their energy flow coincides with the direction of movement of the intestinal contents.

In conclusion, I want to say that the treatment of overweight and obesity requires perseverance, perseverance, self-restraint in taking certain foods, sufficient physical activity, giving up bad habits and drinking alcohol. Treatment must be agreed with the doctor!