Overweight and obesity: general principles of correction

Modern medicine views obesity as a multifactorial chronic disease that requires a serious medical approach to correct it.

In the modern world, 20-25% of the population suffers from obesity, and the more economically developed the country, the higher this figure. Along with the aesthetic problems associated with obesity and occurring primarily in women, obesity is one of the main causes of early disability and mortality in patients of working age.

The occurrence of obesity is caused by age, gender, professional factors, as well as physiological conditions of the body - pregnancy, menopause. Regardless of the etiology of obesity, there are hypothalamic disorders of varying severity. The incidence of obesity in women has doubled over the past 20 years.

According to the type of distribution of adipose tissue in the body, there are android, gynoid and mixed types of obesity.

The android type is characterized by the deposition of fatty tissue mainly in the abdominal area (male type). The gynoid type of obesity is characterized by the accumulation of fat in the gluteofemoral region, i.e. in the lower part of the body (female type). In the mixed variant, there is a relatively uniform distribution of subcutaneous fat.

Android type of obesity is combined with impaired glucose tolerance and diabetes, hypertension, hyperlipidemia in women. There are subtypes of abdominal obesity: subcutaneous-abdominal and visceral. Patients with visceral type of obesity have the highest risk of complications.

Abdominal fat deposition can be assessed by measuring waist circumference (WC). If this indicator is higher than 88 cm in women, the risk of cardiovascular diseases is very high, metabolic disorders develop and the risk of developing type 2 diabetes increases significantly. The distribution of fat tissue can be assessed by the ratio of waist circumference to hip circumference (WC/HG). If this ratio is higher than 0.85, then there is accumulation of fat tissue in the abdominal area. When diagnosing obesity, such an indicator as body mass index (BMI) is taken into account, which is equal to the ratio of body weight in kilograms to the square of height in meters.

The main mechanism of obesity is an energy imbalance between the body's energy expenditure and the amount of calories received with food. Energy imbalance is a consequence of nutritional disorders and low physical activity. Hereditary-constitutional predisposition to obesity cannot be neglected: in 1994, the obesity gene encoding the production of leptin was identified. Leptin is produced primarily by adipose tissue cells and affects food consumption and reproductive function.

Obesity affects a woman's health at any age, and with its increase, obesity usually progresses. A necessary method of treating obesity in women is weight loss and maintaining it at a constant level. The most effective is a gradual weight loss - 0.5-0.8 kg per week, it is normally tolerated by the body and gives a stable result.

Obesity treatment should be combined and include limiting calories consumed with food, increasing physical activity, using hardware methods of cosmetology, and in some cases, drug therapy (with BMI> 27). The importance of a comprehensive approach to correcting excess weight and obesity should be emphasized.

Normalizing body weight with physical exercise

Properly dosed and regularly received physical activity can not only help maintain weight, but also have a complex positive effect on the entire body as a whole. A sedentary lifestyle, on the contrary, provokes a rapid return of previously eliminated kilograms. Along with running, swimming, sports games in the last decade, fitness has gained immense popularity as a type of physical activity, including: aerobics without jumping, aqua cycling (imitation of an exercise bike in water), power fitball (aerobics using a rubber gymnastic ball), pump aerobics (strength aerobics), step aerobics (aerobics using a step platform), tai-bo (aerobics using oriental martial arts techniques), trekking (group running on exercise machines) and much more.

To seriously engage in improving your figure, a simple set of exercises is not enough. It is necessary to choose a complex that will not only make your muscles work, but will also give food for thought, i.e. will be interesting and varied. Let's dwell in more detail on two types of fitness - step aerobics and power fitball.

Step aerobics is a type of physical exercise with a health-improving focus using a step platform.

Optimal for treating excess weight are low and medium intensity but long-term loads, such as walking or toning exercises in the style of step aerobics or dance aerobics for 60 minutes a day. With high-intensity loads, the muscles mainly consume carbohydrates, and the resulting under-oxidized products (lactic acid) block the fat burning processes. Thus, it was shown that women who did aerobics for months did not change their weight by more than 0.5 kg. But as soon as they began to use a diet against the background of training, their weight began to decrease, and the rate of this decrease increased by about 20%.

Physical exercise has another important property - with the help of exercise, you can cause selective consumption of fat in the places where it accumulates in the body. It has been proven that fat is more likely to leave those areas where the muscles work intensively. When excess body weight accumulates, as a rule, fat is deposited disproportionately: in some places there is more, in others less. Thus, some women have a disproportionate amount of fat on the buttocks and thighs, while others have it on the stomach and waist. The distribution of fat in the body is controlled by hormones, and the subtle mechanisms of this process have not yet been fully studied. It is believed, for example, that fat on the buttocks and thighs in women is the so-called strategic energy reserve. It is spent only during breastfeeding and only if at this time the usual diet is insufficient. Physical exercise prevents the consumption of lean mass during weight loss. No matter how good the diet is, along with fatty tissue, muscle mass also decreases, which is undesirable. Physical activity of the same intensity, frequency and duration as regular step aerobics training allows to reduce muscle loss to a minimum. At the same time, up to 90% of fat is burned in muscles, and the more muscle tissue a person has and the more active it is, the less likely it is that a person will gain weight.

Step aerobics (like any other type of physical culture) has a general physiological effect on the body: it increases metabolism, which has a positive effect on the cardiovascular, respiratory and digestive systems; it develops strength, flexibility, speed, endurance, and coordination of movements. In turn, harmoniously developed torso muscles are of primary importance in the formation of correct posture.

The step aerobics platform, or step platform, can be made of various materials that are strong enough and do not have a negative impact on a person. On the platform, around it and through it, so-called basic steps, jumps and leaps are performed, all movements can be stylized as some kind of dance.

Musical accompaniment increases the emotionality of the exercises; positive emotions cause a desire to perform movements more energetically, which enhances their impact on the body.

When describing exercises for health programs, the number of movements per minute (frequency, which should correspond to the number of beats) is indicated. For "Low impact" it is recommended to use musical accompaniment with a frequency of 120-130 beats per minute. And for "High impact" - from 130 to 160 (very rarely - more than J60) beats per minute; Studying the biomechanical factors that occur when working on a step platform allows you to evaluate the mechanical load, the effect on the body during training. Knowledge of the physiological, biomechanical processes occurring in the body of those involved, and their results after training, helps to increase its effectiveness and safety. The forces acting on the body during training can cause an undesirable effect if they do not correspond to the physical capabilities of those involved (there is an increased risk of injury).

Energy expenditure during step training can be increased or decreased by changing the platform height. Thus, the average energy expenditure figures for step exercises at a low height (10-15 cm) are approximately equal to the figures obtained during relatively fast walking on horizontal terrain. During training on a high platform (25-30 cm), the range of energy expenditure figures is similar to the data obtained during jogging at a speed of 10-12 km/h. However, the energy expenditure figures for such platform heights do not coincide among different people. This is due to the difference in their overall fitness and coordination level. Energy expenditure during training, as an indicator of physical activity intensity, can be determined in three ways:

1. Perceived tension is a subjective assessment of muscle tension.
2. Heart rate - an estimate of energy expenditure based on the pulse cost of exercise.
3. Calculation of maximum oxygen consumption (VO2max) - allows you to accurately determine energy expenditure and is based on monitoring oxygen consumption during exercise.

To determine energy expenditure during step aerobics classes, it is enough to use one or more methods that are most convenient for the trainer, but it is necessary to take into account the conditions of the class. The following factors are considered conditions of the class:

• age and gender of those involved;
• their level of physical fitness;
• degree of fatigue at the moment;
• platform height,
• use of choreographic elements and weights on the arms or legs in the lesson.

In step aerobics classes, the intensity of the physical activity performed can be varied, as it largely depends on the rhythm of the music and the height of the platform.

The height of the platform is adjustable and is determined depending on the level of physical fitness of the exercisers, the skill of working on the step, the angle of knee flexion with its full load during the process of climbing onto the platform. The most commonly used platform height is 15-20 cm. Knee flexion during exercise should not exceed 90°, while the optimal angle is considered to be no more than 60°.

Hands can perform bilateral and unilateral, simultaneous and alternating, circular and with different amplitude movements. However, motor work with hands with a large amplitude significantly contributes to an increase in heart rate, so it is recommended to alternate movements with a large amplitude and a low amplitude.

Jumps must be performed when ascending the step, and in no case when descending from it. The movement with pushing (jumping) is recommended to be performed only by sufficiently experienced practitioners.

When stepping up and down, there is a tendency to keep the center of gravity over the front leg to maintain balance. This involuntarily causes a slight forward lean of the torso, which, if performed correctly, does not have an adverse effect on the spine.

The movements of a person stepping off a platform onto the floor with his back to it always evoke a more powerful support reaction than downward steps performed facing the platform or sideways to it.

To prevent various sports-related injuries, it is important to maintain proper body position. In particular, when doing step training, it is necessary to:

1. open your shoulders, tighten your buttocks, relax your knees;
2. avoid hyperextension of the knee joint;
3. avoid excessive back bending;
4. when taking a step, bend your whole body (but do not bend forward from the hip);
5. When climbing onto or off a platform, always use a safe climbing method; facing the platform, climb using your legs, not your hands

Proper body movement mechanics improve the effectiveness of step training and reduce the risk of overuse injuries.

The basic safety rules for step training are as follows:

1. Perform steps towards the center of the platform.
2. Place your entire foot on the platform when going up, and when going down, place your foot from the toe to the heel
3. When the knee bears the load, the joint should not be bent at an angle exceeding 90°. The height of the platform is selected according to height.
4. Control the platform with your gaze.
5. When stepping off the platform, stay close enough to it (do not step further than a foot's length away from the platform).
6. Do not start moving your arms until you have mastered the movements of your legs perfectly.
7. Do not ascend or descend from the platform with your back to it.
8. Take a step lightly. Do not hit the platform with your foot.

Power fitball, or fitball gymnastics

Gymnastic balls can also be used for therapeutic and health-improving gymnastics to form a beautiful posture and normalize body weight. A bright ball, musical accompaniment and a variety of exercises create a positive psycho-emotional mood in those involved. Positive emotions increase the tone of the central nervous system and stimulate various physiological mechanisms.

Gymnastics on the ball makes passive muscles work, makes it possible to use deep muscle groups in the exercises without putting excessive strain on the spine. With the help of the ball, you can direct physical impact on individual muscle groups. For example, if you have a tendency to slouch and a round back, you can bend the thoracic spine while lying on your stomach on the ball, without affecting the lower sections; if you have a tendency to lordosis, lying on your stomach perfectly compensates for hyperlordosis and, therefore, exercises to strengthen the abdominal muscles become more effective.

Exercises on the ball involve both comprehensive and local impact on problem areas, which is especially effective in cases of excess body weight. The possibility of local impact is achieved in various positions. For example, from the initial position of sitting on the ball, exercises are performed for the upper and lower limbs, upper body and pelvis. At the same time, correct posture is maintained. Or, lying on the ball on the stomach, side or back, fixing the upper or lower body, or not fixing them. And also: lying on the back with the ball between the legs or in the hands; feet on the ball; lying on the side with the ball in the hands or between the legs.

Fitball gymnastics removes a number of restrictions and difficulties in doing health gymnastics for people with excess body weight, visceroptosis, circulatory insufficiency of the lower extremities, problems with the functions of the pelvic organs, due to the cushioning effect of the ball, active strengthening of the pelvic floor muscles, elevated position of the lower extremities, lower body. Provides an excellent opportunity to strengthen the muscles of the upper and lower extremities in the unloading position, which has a beneficial effect on the joints, increasing their mobility, elasticity and flexibility.

Thus, fitball gymnastics solves the following therapeutic and preventive problems:

1. Comprehensive development of all muscle groups, including, most importantly, massive and deep ones.
2. Balance training.
3. Developing the skill of correct posture.
4. Increased muscle elasticity and range of motion in all joints.
5. Prevention of disorders and normalization of pelvic organ functions
6. Improving coordination skills.
7. Creating a positive psycho-emotional tone of the body.
8. Improving the efficiency of the heart, lungs, and internal organs
9. Reduction of fat deposits in problem areas.

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