Obesity - a heterogeneous disease, systemic nature, with a chronic course, which is characterized by excessive accumulation of adipose tissue in the body and, consequently, deprive weight.It develops most often due to an imbalance of energy intake and expenditure of material and, as a rule, in individuals with a hereditary predisposition.There is basically a female over 40 years.
- 1 concept of the metabolic syndrome
- 2 obesity classification
- 3 Etiology
- 4 Pathogenesis overweight
- 5 Symptoms of obesity
- 6 treatment of obesity
concept of the metabolic syndrome
obesity is a major component of the metabolic syndrome .It is a complex of overweight and diseases, complications and metabolic disorders that often accompany it.This syndrome is also called syndrome X and insulinoustoychivosti syndrome.The main components of MS are : abdominal obesity , the resistance of cells to insulin, high insulin levels in the blood, violation of assimilation gluco
following types of excess body weight:
alimentary-constitutional obesity, which is characterized by family history. develops in individuals from the same family as a result of the constant overeating, poor diet and lack of adequate exercise .Among his release types:
- gynoid or gluteal-femoral obesity (pear-shaped in women);
- android or visceral (in the form of an apple, for men);
- With the presence of pronounced eating disorders;
- puberty and youth ( obesity in adolescents);
Symptomatic divided into:
- If you have established a genetic defect;
- Against the background of mental disorders;
- Brain (brain tumors and pituitary problems in the hypothalamus);
- Endocrine (in primary pathological processes in the endocrine gland - hypothyroidism, hypogonadism).
main reason that leads to the development of excess body weight is to change the balance of energy in which there is a mismatch between energy intake in the human body and its expenditure .
most often obesity is the result of nutritional factors: the consumption of excessive amounts of food, the use of high-calorie foods (fats, and alcohol), properly organized power mode (main reception the evening meal).It is important eating disorders, which is strongly associated with family and national stereotypes nutrition, and mental health problems (food cult, food as a means of comfort and performance-enhancing drugs, jam stress).
also plays an important role low consumption of energy consumption due to insufficient physical activity.And besides all of the above, there is no doubt and the role of genetic predisposition;physical states (pregnancy, menopause);age and occupational factors (drivers, cashiers and the elderly).
disease obesity is, in most cases, the hypothalamic-pituitary pathology. Its pathogenesis leading role belongs to hypothalamic disorders, the severity of which varies in one or the other side .These changes are the cause of distortions of behavioral responses, in this case, eating, and cause hormonal disturbances.Is an increase in functional activity of the single system, which includes the hypothalamus, pituitary and adrenal glands.It will be shown increased production of pituitary adrenocorticotropic hormone, increased secretion of the hormone cortisol, accelerating the metabolism of these substances.It will also experience a decrease in production of the pituitary hormone somatotropin, which has the property to stimulate the breakdown of fat tissue, the violation of the production of gonadotropin and sex hormones produced by the pituitary gland.The observed increased serum insulin and decreased sensitivity thereto tissue cells, resulting in a low effect on its release into the plasma.Also in the pathogenesis of overweight has metabolic disturbance value thyroid hormones and change the sensitivity of peripheral tissues to them cells.Furthermore
hormonal factors important genetic predisposition (its role is from 30% to 75%).It is assumed that the likelihood of inherited diabetes type and several components of metabolic syndrome.
the dominating factors of the pathogenesis of the metabolic syndrome and the concomitant abdominal obesity are such as cell resistance to insulin action and violation of lipid ratio in the blood serum.
Symptoms of obesity
One common manifestation of all types of obesity will be the excess weight body.There are two stages of current pathology: a stable and progressive.Also distinguish four degrees of severity of the disease:
- first degree of the disease, for which there is excess of the actual body weight over ideal weight is not greater than 29%;
- second degree - excess weight is from 30% to 49%;
- third degree - excess ranging from 50% to 99%;
- with fourth degree the ideal weight exceeds the actual weight of 100% and more.
also for weight estimation by clinical examination using body mass index (BMI), the calculation is carried out according to a formula:
BMI = body weight in kilograms divided by height in meters squared.
In assessing this index and the results are less than 18.5 is considered insufficient body weight (weight deficit).The data obtained in the range from 18.5 to 24.9 is taken as the norm.If the index is between 25 and 29.9, then indicate the presence of excess body weight.If the index has 30-34,9 obesity first degree 35-39,9 index indicates a second degree of obesity, and the third will be at the level of the index in the range more than 40. In an extreme degree of excess body weight will also be extremely high risk of comorbidity.
Pathology of the first and second degree of the patients do not have any complaints with more severe obesity appear related symptoms from other organs and systems.There are the following violations:
on the part of the cardiovascular system is characterized by the appearance of high blood pressure, coronary heart disease (along with its complications), heart failure, pulmonary heart disease, increased blood clotting;
- second type of diabetes and its late complications, violation of the sensitivity of tissue cells to carbohydrates;
- pauses in breathing during sleep syndrome;
- from the gastrointestinal tract: cholelithiasis, chronic constipation, fatty liver;
- on the part of the reproductive system: often polycystic ovaries in women;
- with the urinary system is characterized by the occurrence of kidney stones;
- musculoskeletal system: trophic ulcers on the legs, loss of large joints (knees, ankles, hips), lower limb swelling, pain in the spine;
- the nervous system typically develop lethargy, apathy, drowsiness, fatigue, nervousness, decrease in mood, depression, anxiety, irritability, problems communicating.Characteristically reduced self-esteem, which is not conducive to the harmonious development of personality;
- high risk of cancer (malignant lesions of the large intestine, uterus and breast).
When hypothalamic obesity characteristic nature are complaints about increased appetite (usually after dinner), night hunger pangs, very thirsty.Women are typically the occurrence of various pathologies of the menstrual cycle, occurrence of infertility and hirsutism;men can decrease potency.Also can be trophic changes of the skin, stretch marks on the skin of the thighs, abdomen, shoulders, armpits, stains on the neck, elbows, in places of excessive friction.
treatment of obesity
When treatment of the disease treatment complex, which includes diet therapy, physical and medical therapies :
- power correction mode (fractional, up to 5-6 times a day), used fasting days;
- increase physical activity, physiotherapy, massage;
- balanced diet with reduced energy value (not more than 1300 kcal per day), with a minimum consumption of animal fats, carbohydrates and restriction lung maximum increase fiber content.In the diet should be present in sufficient quantity proteins, vitamins and minerals;
- the ineffectiveness of these measures, the appearance of complications and greater risk pathology on the part of the cardiovascular system is used medication:
- orlistat, depressing the action of enzymes that break down fats in the intestinal and pancreatic juices, resulting in a breach of recyclingand absorption of fat;
- increased appetite when used anorectic drugs - sibutramine, which causes depression of appetite, rapid onset of satiety;
- statins to normalize the disturbed ratio of lipids in the blood;
- biguanides which reduce appetite digested fats and normalize elevated blood glucose;
- to mobilize fat - adipozin;
- angiotensin converting enzyme inhibitors for the correction of high blood pressure;
- concomitant treatment of diabetes of the second type;
- thyroid hormone drugs (tireoidin, triiodothyronine);
- synthetic estrogen-progestin drugs in violation of ovarian function in women;
If necessary, use a surgical therapy: reduce the amount of stomach resected portion of the small intestine.With obesity endocrine form - treating the cause of the disease.