Overweight what. What is obesity and how to overcome excess weight once and for all? Causes of overweight

7. Overweight and obesity

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

Epidemiology. According to the WHO and domestic studies, about 50% of the population of Russia and other European countries has excess MT, 30% is obese. To a greater extent, this is typical for women, especially older age groups. A significant increase in the number of obese people, 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 proper MT is most often assessed using the 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 concomitant diseases increases (table 7). At the same time, the risk of complications, especially cardiovascular and metabolic, depends not only on the degree of obesity, but also on its type (localization of fatty deposits). 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, which is 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 fat distribution - measuring the waist circumference (OT). OT is measured in a standing position, midway between the lower edge of the ribcage and the iliac crest in the mid-axillary 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).

If WC is ≥ 94 cm in men and ≥ 80 cm in women, AO is diagnosed, which is an independent RF of CVD. An active decrease in MT is recommended for persons with AO.

Excessive MT / obesity is an independent RF of CVD and forms a cascade of secondary RF. Adipose tissue, especially visceral tissue, is a metabolically active endocrine organ that secretes substances into the blood that are 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 RF increase the likelihood of developing a number of diseases, the likelihood of which increases with increasing BM. At the same time, if with AO the risk of CVD and DM is increased, then with the gluteofemoral type, the risk of diseases of the spine, joints and veins of the lower extremities is higher.

Excessive BW and obesity are often associated with hypertension and dyslipidemia, with BP increasing with increasing obesity. The presence of excessive MT and obesity increases the risk of developing hypertension by 3 times, coronary heart disease by 2 times. The likelihood of developing diabetes mellitus is 9 times higher in people with excessive MT, and 40 times higher in obese people. Overweight significantly reduces life expectancy: on average, from 3-5 years with a slight excess of MT and up to 15 years - with severe obesity.

The lengthening of the vascular network, 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 with excessive MT, increase the likelihood of developing hypertension. The development of atherosclerosis and coronary artery disease in people with excess MT is facilitated by closely related AH, lipid metabolism disorders (increased levels of 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 inhibitor-1 by adipocytes, which helps to reduce the fibrinolytic activity of the blood and increase the risk of thrombus formation.

7.1. Algorithm for examining persons with overweight and obesity

Collection of dietary anamnesis gives the doctor and the patient a visual representation of the patient's eating habits; allows you to develop an adequate dietary habits diet therapy plan; determines the degree 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 records all food eaten during these days, including portions, quantity, frequency, and submits in writing or sends by mail).

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

• the reasons that prompted the patient to start treatment;
• the patient's understanding of the reasons leading to the development of obesity and its negative impact on health;
• patient consent to long-term changes in eating habits and coolant;
• motivation to decrease MT;
• previous experience with MT reduction;
• 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 monitor MT.

Objective examination of the patient it is necessary to identify other RFs, comorbidities, contraindications to treatment and develop a strategy for nutritional intervention. The minimum examination of a patient with overweight / obesity, along with a general clinical examination, includes: measurement of blood pressure, ECG registration, determination of the levels of total cholesterol, triglycerides, glucose in serum on an empty stomach. If any deviations are detected, an additional examination is necessary in accordance with generally accepted diagnostic algorithms.

Determination of contraindications to treatment. WHO experts (1997) have 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. An increase in MT can be exacerbated by psychogenic disorders, including bulimia nervosa, depression, repeated episodes of binge eating, night meal syndrome, and seasonal affective disorders.

They can be difficult for the patient to overcome adherence to treatment. If the patient has signs of eating disorders (bouts 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 in combination with morning anorexia, etc.) ), consultation of a neuropsychiatrist or psychiatrist is indicated.

If you suspect secondary, endocrine obesity (Itsenko-Cushing's syndrome, hypothyroidism, etc.), an endocrinologist's consultation is necessary.

7.2. Obesity treatment

The goals of obesity treatment are:

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

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

Energy deficits in low-calorie diets can be achieved by reducing both fat and carbohydrate intake. It has been proven that the use of low-calorie diets with limited fat and carbohydrates contributes not only to a decrease in MT, 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 expenditure. A number of factors are important and, above all, the level of metabolism. Calculations show that exceeding the daily caloric intake of food over energy consumption by only 200 kcal per day increases the amount of reserve fat by about 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 an energy consumption of 2200 kcal, a person receives 1800 kcal daily, then the energy deficit is 400 kcal. Knowing that 1 g of adipose tissue gives 8 kcal, it can be calculated that in the daily energy balance of the body, 50 g of adipose tissue must be split (400: 8). Consequently, 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.

The principles of constructing a diet for overweight and obesity:

• A sharp restriction of the consumption of easily digestible carbohydrates, sugars to 10-15 g (3 pieces or teaspoons) or less per day, including sugar "in its pure form" (for sweetening tea, coffee) and sugar contained in drinks, jams, sweets, etc. It is recommended to completely eliminate confectionery products containing high-calorie fat and sugary carbonated drinks.
• Limitation of starchy foods: 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. It is better to exclude pasta.
• 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 saturated. But when choosing protein products, preference is given to products of the lowest fat content (the calorie content of such products is much lower). If you have no choice, you can trim off visible fat, skin the chicken, skim milk, and more.
• Consumption of a large amount of vegetables (except potatoes) and fruits (up to 1 kg in total). Products and dishes prepared from them are low in calories and at the same time, due to the large volume of food, create a feeling of satiety. Preference should be given to sour fruits and leafy vegetables (citrus fruits, berries, apples, cabbage, lettuce, spinach, etc.).
• Limiting fat intake, mainly of animal origin.
• Limiting the consumption of table salt 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 hot 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 MT control.

Popular "trendy" diets are based on the principles of strict dietary restrictions with a reduction in calorie content up to 1000-1500 kcal. These diets do not always take into account the principles of good nutrition. Their use is possible for a limited period of time (2–6 weeks) by practically healthy individuals with only excess MT / obesity. True, fairly balanced diets for 1200-1500 kcal can be used longer, and in practically healthy elderly women - almost constantly. It should be borne in mind that dietary restrictions in children can lead to stunted growth and development, and in adolescence - to endocrine disorders. Relatively simple from the point of view of technical implementation is the alternating diet (meals from one product are used during the day). 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 very similar to it, the so-called "Kremlin diet" is built on strict restriction of carbohydrates, which causes severe dehydration (hence rapid weight loss), decreased insulin production and conversion of carbohydrates into fats with their subsequent deposition. The diet is not balanced, it can cause a shift in acid-base balance, ketosis, acidosis. In addition, the “Kremlin diet” is highly atherogenic: the level of fat is two times higher than the recommended values \u200b\u200b(up to 60–64% of calories), and the content of food cholesterol is 1000–1280 mg / day, which is 4 times higher than the recommended rate.

Separate food does not exist in nature: any product (meat, milk, etc.) contains proteins, fats, and carbohydrates. Mixed meals are more balanced. So, the lack of the amino acid lysine in buckwheat replenishes milk, where it is abundant. Thus, buckwheat porridge with milk is a balanced dish. Separate nutrition can only be effective if it comes down to calorie restriction due to the monotony of products; it cannot be practiced for a long time. Treatment of excess MT 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 exciting the centers of appetite and hunger), increases the risk of complications (arrhythmias, hypovitaminosis with symptoms of polyneuritis , skin and hair lesions, etc.).

Patient self-monitoring. An important aid in adherence to the diet is the patient's food diary, in which he, during the week preceding the visit to the doctor, writes down everything he eats and drinks. This allows both the patient and the doctor to analyze the food ration (the amount of food eaten, the frequency of meals, situations that provoke unnecessary meals), identify nutritional disorders, the cause of failures, the volume and nature of the necessary correction, and also increases the constructive doctor-patient interaction.

Efficiency mark. It is necessary to achieve a decrease in MT by 5-15% of the initial values \u200b\u200b(depending on BMI) for 3-6 months, and in the future stabilization of MT. Repeated courses can be carried out six months later, once every 1-2 years with a gradual phased or smooth slow decrease in MT. It is necessary to realize that the diet is not a one-step action, and its effect will be preserved only with the transition to the principles of healthy eating with constant limitation of part of the diet.

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

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

Medicinal effect on excess MT indicated for: ineffectiveness of non-drug interventions; severe and complicated forms of obesity.

Serotonergic drugs are used that reduce appetite (for example, the antidepressant fluoxetine), which reduce food absorption (orlistat). Medication can be continued for up to 6 months, after a break - up to 2 years.

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

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

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

Overweight, obesity and the right ways to correct them

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Dotsenko V.A. (Chief Nutritionist of St. Petersburg, Doctor of Science of the Russian Federation, Professor of the Department of Food Hygiene, Mechnikov North-Western State Medical University),

Kononenko I.A. (Assistant, Department of Food Hygiene, North-Western State Medical University named after I.I.Mechnikov), Mosiychuk L.V. (Associate Professor, Department of Food Hygiene, Northwestern 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, with the number of obese people increasing every 10 years by 10%. In the period from 2005 to 2010, the incidence of obesity in the adult population of Russia increased 1.77 times, and in St. Petersburg - 1.73 times. Such high dynamics cannot but affect the indicators of health, working capacity, disability, quality and life expectancy of the population.

In order to distinguish obesity from obesity, it is customary to use the body mass index (BMI). It is calculated quite simply: the value of 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

Overweight by BMI

BMI for ages 18-25

BMI for ages over 25

Normal body weight

Overweight

First degree obesity

Second degree obesity

Third degree obesity

Obesity of the fourth degree

40.0 and higher

41.0 and higher

With obesity of the first degree, the excess of adipose tissue is from 10 to 29% of the normal weight, the second degree is from 30 to 49%, and the third degree is 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 sharply deteriorate and the following symptoms may occur: shortness of breath with the slightest physical exertion, heart 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 on this list is occupied by the 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 diet. The lack of exercise and the love of Russians for fast food leads 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 to health.

Keeping your weight on track means dramatically changing your diet, habits, and even lifestyle. Not everyone has enough willpower for such changes. However, the rush to weight loss and excessive dietary restriction can lead to the so-called "swing effect", when weight regains after the end of the diet. Having quickly lost 7-10 kg and returned to the 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, and 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 an insufficient intake of proteins, minerals and vitamins, which leads to metabolic disorders. 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 positive effects. It has been established that individual diet therapy should be carried out on the basis of diagnosis (assessment of nutritional status) and by drawing up an individual menu with the inclusion of dietary (therapeutic and prophylactic) food products in the diet, including specialized food products and biologically active additives (BAA) to food.

At the Department of Food Hygiene of the North-Western State Medical University named after II Mechnikov carried out hygienic and dietary assessments of various functional food products, including protein mixtures. 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 the diet as a whole 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 essentially “food in a glass,” help to reduce weight without an oppressive feeling of hunger and maintain a feeling of satiety for several hours, and fiber and a balanced complex of vitamins and minerals provide the necessary intake of nutrients in the body. The advantage of such products in diet therapy is that, in addition to a balanced composition, they are simple and convenient to prepare - a cocktail is easy to mix in just 2 minutes. And besides, they can be prepared on the basis of various drinks, therefore, due to the variety of tastes, marsiness 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 substitutes for food in body weight correction programs. For example, recently the effect of low-calorie diets with the inclusion of protein substitutes for food on anthropometric and clinical-biochemical parameters in overweight and obese people was studied at the Research Institute of Nutrition RAMS. 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 to reduce body fat mass, reduce waist coverage, and also provides a more comfortable weight loss process, namely satiety and lack of hunger.

In the complex treatment of obesity, it is important to limit the use of simple sugars, which are the main suppliers of energy and easily turn into fat. It is also necessary to increase the consumption of vegetable fats by reducing the number of animals. Feelings of satiety are best achieved through the use of low-calorie, but significant in volume of food, such as dishes from raw vegetables, fruits, herbs and whole grain products. In attempts to reduce weight, in no case should you reduce the number of meals to 1-2 times a day. Useful multiple meals, up to 6 times a day, and at the same time the exclusion of foods that stimulate appetite (savory foods, 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 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 that affect 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 an effect in reducing it to normal. The first edition was published in 2009. For a wide range of readers.

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The given introductory fragment of the book Therapist's advice. On excess body weight (Y. L. Marhotsky, 2009) provided by our book partner - LitRes company.

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

Body weight is an indicator of health

Which of us does not want to have a slim figure, look younger than our years, to be toned, elegant and healthy. However, one of the obstacles to this is fullness and obesity. Until recently, obesity was regarded as a disease exclusively of Western civilization, now it has become a serious threat to the health of developing countries. In the near future, according to researchers, obesity may become a more common cause of death than smoking. Extra pounds - a potential opportunity to acquire all kinds of diseases and complications.

An assessment of the risk of developing diseases associated with obesity is presented in Table. 1.

Table 1. Assessing 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 \u200b\u200b2. (BMI will be discussed below.)

Key Factors for the Negative Health Impact of Obesity

The 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 developing atherosclerosis. An increase in relative body weight by 10% increases the concentration of cholesterol in blood plasma by 0.3 mmol / L.

According to researchers, overweight people in more than 50% of cases suffer from coronary heart disease and about 60 % - arterial hypertension. Acquired diseases - atherosclerosis and arterial hypertension are 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 was found that with a decrease in body weight of 1 kg, blood pressure decreases by 1 mm RT. Art. Therefore, a moderately reduced actual body weight to ideal, you can bring blood pressure to a normal level even without drug treatment.

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

Fig. 1. Obesity is one of the main causes of diabetes

Fig. 2. Overweight - the path to degenerative changes in the body

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

● on the respiratory and cardiovascular systems;

● abdominal organs and digestion;

● musculoskeletal system and sensory organs;

● decreased performance and premature aging.

Obesity affects 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 the mechanical obstacle to its movement. As a result, the lungs are poorly ventilated, which is manifested by shortness of breath, especially during physical exertion. The heart, as it were, is enveloped in a fat carapace, which prevents the contraction of the heart muscle.

With significant excess body weight, there is a tendency to fatty degeneration of the liver, cholecystitis, gallstone disease, prolapse of the abdominal organs, and functional disorders of the digestive system. This is due to an increase in intra-abdominal pressure during fat 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, and 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, while impaired motor activity.

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

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

Reduced life expectancy when exceeding normal 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 8-12 years.

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

It is appropriate to recall the proverbs: "The narrower the waist, the longer the life", "He who becomes too fat, gets old." A full man rarely lives up to 70 years of age.

Table 2. Reduced life expectancy when exceeding normal body weight

Table 2 is compiled according to the Federal Statistical Service and American insurance companies (X. Mole). Therefore, normal body weight is largely not only an indicator of human health and the preservation of a slender figure, but also a factor characterizing the ability to work and productivity of labor, since only a person with a normal body weight can work most productively. For example, obese people are on average 65 minutes longer in bed than thin. Fat only 22 % days are on their feet, and individuals with normal weight 36 %. Fat people do not strive for physical activity, most of them immediately find a chair.

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

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

The main types and forms of obesity

Overweight is called body weight over ideal. The necessary minimum fat for an adult male is 3% of the 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 a “specific female fat” related to the functional and anatomical features of the female body associated with childbirth.

The following types of obesity are distinguished by the nature of the spread of adipose tissue:

● by male type, or android (central, upper, abdominal, that is, obesity in the form of "apple") - fat is deposited in the abdomen, that is, mainly around the internal organs and represents a great danger, causing disease and premature death;

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

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

● increased content of female sex hormones in the body;

● improper nutrition;

● low physical activity;

The most accessible and simplest method for assessing the type of obesity is to determine the waist circumference. If the waist size in men is more than 102 cm and more than 88 cm in women, then this indicates the presence of abdominal obesity, that is, obesity by the type of “apple”, which is much more dangerous than by the type of “pear”.

Obesity of the upper body can be determined by the ratio of waist to hip volume. A figure 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 in whom obesity begins in adulthood, it is easier to lose weight and maintain proper mass, as they have less fat cells than those who were full in childhood. Of particular concern is the excessive fatness of children. Since fat cells are laid as a result of overfeeding babies, the prognosis is unfavorable.

Current Factors on the Factors Promoting Obesity

Excess fat deposits in the body’s fat cells are called obese. In humans, fat cells are laid in childhood and adolescence. Their number averages 30–40 billion.

In the body two processes are constantly running in parallel:

● lipogenesis - the formation of fat;

● lipolysis - the expenditure of fat.

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

The main reasons that contribute to weight gain are described below.

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

In the table. Figure 3 presents the data of researchers, indicating how often violations of the principles of good nutrition lead to obesity.

Table 3. Eating Disorders

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 for workers and if the amount of food consumed is not reduced, then, undoubtedly, body weight will increase.

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

● positive energy balance, that is, more energy comes from food than the body consumes;

● 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 gives 7.2 kcal);

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

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

Adipose tissue hypertrophy is characterized by a small amount of fat cells, but with a lot 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 the child is obese since childhood, then this is due to adipose tissue hyperplasia. Obese children inherit hyperplasia from their obese parents. In such families, the cult of gluttony is often developed. A family form of nutrition, not differentiated with respect to each family member by sex and age, where meat, fats, sweets are preferred over fruits and vegetables, causes an increase in weight.

Metabolic efficiency. An important role in the development of obesity is played by the effectiveness of metabolism, i.e., metabolism. It combines two opposing processes - the decomposition of complex organic substances (catabolism, or dissimilation) and the formation of organic substances, composite tissue cells (anabolism, or assimilation).

It can be stated that an effective metabolism, but an energetically less wasteful type of metabolism (reducing physical activity - labor, sports), predisposes to obesity, while a reduced metabolism helps to stabilize body weight with low physical activity. The endocrine system has a significant effect on metabolic efficiency. For example, insufficiency of endocrine glands increases body weight (myxedema, eunuchism, postmenopausal period), and with thyrotoxicosis, the main metabolism is increased, which leads to its decrease.

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

The ratio of the amount of brown and yellow adipose tissue in the body. Yellow adipose tissue can store fat, and brown adipose tissue produces heat. Brown fat cells contain a lot of lipid droplets with thermogenin protein, due to which the energy spent on heat production gives the cells the properties of “microheaters”. Some people who consume large amounts of food do not recover, 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 present in newborns and in people adapted to the cold, engaged in winter swimming, winter swimming, and winter swimming. They do not limit themselves in food and do not get fat.

Diet. Scientists have found that with the same calorie intake, a rare (one-, two-time) meal contributes to an increase in body weight: a hungry person eats more than normal, for metabolism, the body takes the right amount of energy, 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 active physical and mental labor.

The composition of the diet. The composition of the diet is essential in the regulation of body weight. It was found that when 1 g of fat is burned in the body, 9 kcal of energy is released, and when 1 g of proteins and 1 g of carbohydrates are burned, only 4 kcal. It is characteristic that when converting excess carbohydrates into fat in the body, more than 25 % calories, and when turning dietary fats into body fats, only 3 % calories (specifically the dynamic action of food). Thus, the body is more likely to produce fats from food fats than from carbohydrates or proteins. Therefore, the use of large amounts of fats, contributes to a more enhanced formation of body fat with less energy consumption for this process.

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

● 1st group - products 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, soy, etc.).

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

The effect of stressful situations on weight gain. Stressful conditions (irritability, depression, anxiety, etc.) affect the decrease in serotonin in the brain. The low content of serotonin causes cravings for sweet, starchy, floury dishes. Consequently, a depressed mood leads to "gluttony sweets," and satiety 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. Excess carbohydrates without energy consumption leads to the formation of fat and increase body weight.

Modern society faces many challenges. But for many, it is obesity and overweight that are obstacles whose urgency to overcome is especially acute.

Obesity is a disease that must be treated, but impossible without the patient’s desire and awareness of the risks that their impaired 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 older than 50 years occurs in 50% of cases.

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

First you need to understand 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, actually very approximate, looks like a person’s height (in cm) minus 100. In reality, it is not suitable for weight analysis, so it’s better to use the body mass index - BMI (Ketle coefficient).

For its calculation, it is necessary to divide the weight of a person (in kg), by the square of growth (in m). The calculated index, falling in the range 18.5-24.9, characterizes the normal weight. Overweight is found at a BMI of 25.0 to 29.9. Everything that exceeds these values \u200b\u200bmeans 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, state 3 degree obesity.

It is even easier to diagnose excess weight by waist. 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. Female type obesity is characterized by the deposition of fat on the abdomen, legs, hips. The male type characterizes fat deposition in the upper torso and abdomen, without affecting the upper shoulder girdle and neck.

Hyperplastic (typical for obesity in children) and hypertrophic (in adults) types of obesity are different in that in the first case, the number of fat cells increases since childhood, in the second the size of the fat cell (adipocyte) increases.

Causes of Obesity

The main cause of obesity is the excess intake of nutrients over the energy expenditure of the body. The physiological needs of a person for nutrients differ depending on age and physical activity (type of employment). The main exchange of each individual can be calculated using special tables in Kcal. It is important to understand that with every decade of life, the main metabolism 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 has no diseases of the endocrine system. In addition, the physical activity of most people decreases with age. Two factors, in the absence of a critical diet, 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, the hereditary predisposition and constitutional features of a person are clearly traced, in conjunction with the 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 gland, pituitary gland, and gonads). Obesity and type 2 diabetes are the most common pathologies in endocrinology.

Treatment of obesity and normalization of overweight

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, the appointment of special drugs, and sometimes surgical treatment, is also included in the treatment.

If the patient has alimentary-constitutional obesity or is overweight, then a correctly selected reduced diet prescribed by a doctor comes to the fore. A nutritionist calculates the basal metabolism, the degree of daily calorie restriction. The greater the obesity, the stricter the caloric restriction (a decrease of 300-600 Kcal or more per day).

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

Regardless of the type and degree of overweight, a 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 nutritional nutrients included in the mandatory human diet.

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

In percentage terms, the intake of protein, both animal and plant origin, in the amount should be 15% of the daily caloric value. Saturation depends in many respects on the protein, in addition, it plays a plastic role. Protein restriction is unacceptable. Optimal for weight loss will be the use of at least 200 g of protein.

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

Simple carbohydrates (sugars) should occupy no more than 7-8% of daily calories, given that the total amount of carbohydrates is 60-65% of all energy revenues. Simple carbohydrates include sugar, jam, honey, sweets, cakes, ice cream, confectionery, sweet carbonated drinks. Plant fibers, which are not absorbed and do not carry any energy load, are also important in nutrition and help lower cholesterol. They are found in vegetables, leafy greens, fruits, legumes, grains. The daily consumption 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 use of offal (liver, kidney, brain), which, in addition to excess fat, contains an excess of cholesterol.
• Refuse the use of processed meat (sausages, sausages, sausages).
• In order for excess weight not to accumulate in the body, it is rare to eat duck, goose, nutria meat, reduce portions of meat and poultry to 100 grams.
• Remove excess fat from the broth, visible fat from meat.
• Use cooking and baking instead of frying in oil.
• Do not use butter on bread.
• Do not season ready meals and salads with sauces, mayonnaise, to improve the taste, sprinkle with lemon, add spicy 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, prepared sauces, marinades, an excessive amount of spices, seasonings, smoked meats.
• Do not overload food; consuming no more than 5 grams of salt per day is considered optimal; in obesity, the amount of salt is reduced.
• To increase the diet 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.
• From carbohydrates, preference is given to whole grain products (cereals, bran, whole-grain bread).
• When choosing products, it is imperative to pay attention to the qualitative composition (fats, proteins, carbohydrates), the caloric content of products (indicated in Kcal / 100gr) and choose the least high-calorie ones.
• Reduce the portion of food, use less bulky dishes.
• Eat often, at least 5 times a day. Starvation is absolutely eliminated, as it leads to even greater uncontrolled weight gain.
• Choose foods sufficient in volume, occupying a large volume of the stomach, but not bearing a large energy value (vegetables, fruits, leafy greens, fish, fiber, dietary fiber).
• Dramatically reduce the use of alcohol in any form, since 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.
• The diet for obesity should be observed regularly, you can not allow rapid weight loss by fasting. Overweight should decrease gradually, about 1 kg per month. In obesity, the pace of weight loss is calculated individually by the nutritionist 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 this article, I used materials from articles posted on the Internet on various sites, in particular, from Wikipedia, from the book by Mikhail Ginzburg "How to overcome excess weight", from the article by Elena Alexandrova "Soda baths! Why are they, what is the result, recommendations. ", from the WHO Newsletter No. 311, issued in March 2013." Obesity and Overweight ", materials from the book" To Yourself a Doctor "by Professor Park Zhe Wu and my personal experience as a reflexologist.

Overweight, obesity, is a chronic disease associated with metabolic disorders 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 years and older were overweight. Overweight and obesity are the fifth most important risk factor for death in the world. 208 million adults die each year as a result of overweight and obesity. In the CIS countries, up to 55% of the population is overweight and obese.

So: overweight and obesity are defined as abnormal and excess body fat that are detrimental to health.

If BMI 18.5 - 24.5 kg / sq. m is the norm.
BMI 25 - 35kg / sq. m - obesity of 1 degree.
BMI 35 - 40kg / sq. m - obesity of 2 degrees.
BMI 40 - 50kg / sq. m - obesity 3 degrees.
BMI is more than 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 of 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 appetite and anxiety, appetite increases dramatically, more often in obese people. When a person is worried, he gains extra pounds due to increased appetite.

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

Sweet in this case plays the role of a drug. With the refusal of sweets, a painful state develops, depression, sometimes aggression can manifest itself. Increased appetite is a risk factor, but is not always the cause of excess weight.

2. Hypodynamia, lack of motor activity. In this case, the intake of energy from food exceeds its consumption. The body accumulates unspent energy for future use in the form of fat deposits, which can be used up as needed.

In old age, human energy consumption decreases. The main metabolism decreases, that is, the energy expenditure on the basic 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.

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

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

Hypothyroidism can occur 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 to keep fit. After 30 years, the synthesis of growth hormone decreases, and by the age of 50, its production stops completely.

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

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

Severe neuroendocrine disease can contribute to weight gain. itsenko - Cushing's disease, based on the violation of regulatory mechanisms that control the hypothalamus - pituitary - adrenal system. The adrenal glands produce a large number 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.

Excess corticosteroids disrupt all metabolic processes in the body. In this case, obesity develops. Fat is deposited on the shoulders, abdomen, face, mammary glands and back. The body becomes fat, and the arms and legs are thin. The face becomes moon-shaped, round, cheeks - red. Pink - purple or crimson stripes - striae appear on the skin. On the body - excessive hair growth (women grow a mustache and a beard).

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

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

Hyperinsulinism. A benign pancreatic tumor, insulinoma, secretes excess insulin, which lowers blood sugar, 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 deposits increase.

In this case, homeopathic medicines - 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 irregularities occur, facial hair growth, acne appears.

In men, low testosterone is an important factor in maintaining and progressing obesity.

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

Hyperandrogenic syndrome in women. Androgens - male sex hormones are in women. They are produced in the adrenal glands. 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. Disruption of the gastrointestinal tract.

Useful intestinal microflora contributes to the complete breakdown and assimilation of nutrients from food. In case of imbalance in the intestinal microflora with dysbiosis, candidiasis, a large number of toxins harmful to the body are formed - products of incomplete food breakdown.

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

Adipose tissue deposits toxins. Increasing the amount of slag increases the amount of adipose tissue.

Immune, hormonal, nervous, cardiovascular, digestive, urinary systems are disrupted, chronic diseases develop.

To cleanse the body of toxins and toxins, many peoples of the world use religious posts. This is the easiest way to cleanse 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 the accumulation of fluid in the body.

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

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

After a bath or physical exertion that caused severe 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 fat intake, they attract water.

G. To use only pure water, it flushes the body without stopping, products of catabolism - fat breakdown, go out with it, weight loss occurs.

D. Increase consumption of foods containing potassiumIt 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 sprouts, in carrots, pumpkins, beets, radishes, peppers, cabbage, cucumbers, avocados, greens, and especially in parsley and spinach.

E. To exclude 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 trigger the work of enzymes.

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

Magnesium - improves digestion, promotes the utilization of fats and the advancement of food through the intestines. Magnesium prevents the genes responsible for obesity from appearing. It reduces hunger, the risk of overeating, reduces stress 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, in fish (cod, carp, halibut), seafood (shrimp, seaweed).

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

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

Manganese - participates in the synthesis of B vitamins and hormones, prevents obesity of the liver and promotes the breakdown of fat in the body, normalizes lipid metabolism, and 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, an increase in blood glucose, an increase in triglycerides and cholesterol in the blood, and the development of atherosclerosis.

Chromium is found in whole grain bread, cereals made from natural grain (buckwheat, brown rice, oats, millet), heart, liver, kidneys of animals and birds, fish and seafood, in yolks of chicken eggs, 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 aronia, legumes, liver, kidneys, unrefined grains, dark green leafy vegetables, apples.

7. Hereditary factor.

Every person, one of whose parents is overweight, has a hereditary tendency to be overweight. In this case, a person gets better with the usual average diet. However, not obesity itself is inherited, but a tendency to it. A person may have a completely normal weight and not be full.

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

Food consists of proteins, fats, carbohydrates and minerals. All these components, when split in the body, give the body the necessary energy.

Carbohydrates are most easily broken down (oxidized) in the body. They give energy to the cells of organs and tissues. Many are familiar with the feeling of warmth after a hearty, hearty meal. It is broken down, carbohydrates burn.

In everyday life, a person’s appetite and food intake are linked to blood glucose and glycogen in the liver. When the blood glucose level 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 you will feel full.

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

Fat intake by the body is not regulated. Studies have found that the more fat a person eats, the more likely he will be overweight.

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

It was also established that the presence of fat in food does not reduce the consumption of other nutrients, does not reduce appetite, and 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 not a lot, but the body can not cope with its oxidation. In these cases, the accumulation of weight gain due to fat is inevitable. If a person does not want to recover, then you need to eat less fat.

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

Diseases caused by being overweight.

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

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

Myocardial infarction 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 limbs and the development of gangrene.

Cholecystitis and gallstone disease. In obese people, stones often form in the gallbladder and in the bile ducts. And after operations on the bile ducts and gall bladder, complications often arise and deaths are more common.

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 \u200b\u200btendons, joints in the form of painful nodes - tofuses and disrupt the function of the joints.

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

Exchange - dystrophic polyarthritis - develop in full more often than in people with normal weight. Joints are deformed due to the growth of cartilage. Joint function is impaired by limiting their mobility and soreness.

Malignant tumors. Fat people mainly develop cancers of the kidney, lungs, large intestine, mammary glands, and the female genital area. The development of tumors contribute to fatty foods, inactivity, impaired production of sex hormones.

Disorders of the ovarian - menstrual cycle and infertility in very obese women. Disruptions in the cycle, inter menstrual bleeding, infertility develop. Adipose tissue interferes with the metabolism of sex hormones. Women have hair growth on their faces and torso - hirsutism. This is due to an increase in the production of male sex hormone by the adrenal glands.

In men, due to obesity, the amount of the male hormone testosterone decreases. Sex drive decreases, impotence develops, breast glands enlarge.

Basic treatments for overweight and obesity.

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

The 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 contribute to smooth weight loss., otherwise a sharp weight loss will certainly harm the body. It should be safe, should not lead to metabolic disturbances, deficiency of nutrients, trace elements, vitamins, decreased immunity, digestive system disorders, nervous system, depletion of the body’s vitality.

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

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

3. Pharmaceuticals for treating obesity are used if diet and exercise are ineffective.

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

Let's analyze some drugs.

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

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

Rimonabant (Acomilia, Zimulin) - developed recently. A receptor antagonist that has a central effect on the brain reduces appetite. It affects thermoregulation, increases energy consumption, weight loss occurs, eliminates insulin resistance and the content of lipids (fats, cholesterol) in the blood.

Metformin - It is used to treat type 2 diabetes mellitus and is able to reduce weight.

Exenamide (Baeta) - delays gastric emptying and promotes a feeling of fullness. Baeta 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, is produced by eating, delays the emptying of the stomach, causes a feeling of satiety.

Drugs for treating overweight and obesity should be prescribed by a doctor!

4. Surgical treatment of obesity. Currently, operations to combat obesity are done laparoscopically without an incision through punctures under the control of the optical system of the laparoscope. All these operations reduce the intake of food in the stomach and intestines, contribute to rapid saturation, elimination of hunger.

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

Such operations 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, then you can lose weight up to 2 kilograms in one procedure. To get 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.

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

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. While taking a bath, the lymphatic system begins to work actively and clears up. 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 in a terry towel or blanket and go to 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 the first time.
B. Cleopatra’s bath. Boil a liter of milk and add about 100 grams of honey to it. Make a scrub of 150 grams of sour cream and 150 grams of sea salt. Rub in with salt mixture, hold it on your body for 10 - 15 minutes, rinse. Add honey milk to the hot tub. Take a bath for 20 to 25 minutes. This procedure, in addition to weight loss, rejuvenates the skin and gives it elasticity.

B. Bath with mustard.
Dilute 1 cup of mustard with warm water to the consistency of batter and pour into a 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.
Beat the egg and half a glass of shower gel with a broom, add 1 teaspoon of vanillin to the mixture. Pour everything together into a warm bath. Pour slowly under running water. The bath, in addition to weight loss, improves metabolic processes in the body.
D. Bath of linden blossom.
Make a lime pick (in bags) and let it brew for 40 minutes, then add to the bath. Take a bath no more than 20 minutes.
E. Bath of bran.
Brew 1 kilogram of bran in 2 liters of milk with the addition of 1 tablespoon of honey. Pour the mixture into the bath. This bath is considered one of the best anti-aging baths. Well refreshes and tightens the skin. Take a bath no more than 30 minutes.
Y. Coniferous bath.
Dissolve in the water poured into the bath 50 - 70 grams of pine powder. Bath tones well. You can take such a bath for 15 to 20 minutes.
G. Turpentine baths.
These bathtubs 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, white turpentine baths 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 attached to the emulsion for turpentine baths.
7. Reflexology can effectively help with overweight and obesity.

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

These methods allow you to harmonize, that is, restore the patient’s energy system and reduce its weight, as well as have a therapeutic effect on concomitant obesity diseases: diabetes mellitus, arterial hypertension, joint pain, spine, lower limbs, improve cardiovascular, digestive and excretory systems of the body, boost immunity.

At home, you can work on compliance 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 before the appearance of heat 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 the pictures.)

At the points of conformity of the pituitary gland and the navel, it is necessary to put on buckwheat grain and fix the grain with a band-aid for a day.

Grains should be with an intact shell, buckwheat for cooking porridge will not work.

As soon as there is a desire to eat something - no matter how tasty, intensively press the beans several times, the desire will weaken and pass.

Place the branch of the plant in the zone of correspondence between the esophagus and the stomach so that the growth direction 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 band-aid to the points of correspondence with the mouth, esophagus, and “entrance” to the stomach. The energy flow of seeds should be directed against the movement of food. See the pictures.

Seeds located in a chain along the projection of the colon will help to reduce weight, so that their energy flow coincides with the direction of movement of the contents of the intestine.

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