Obesity of the third degree in women, men and children: medication, nutrition, gymnastics, exercises

At different times, there were different standards for the aesthetics of the body. I recall the naked bodies of women in the paintings of Rubens - pompous beauties with carefully traced cellulite. Subtlety later entered into fashion, extra pounds were hidden under tight corsets. In our pragmatic and rational age, weight is suitable not only from the point of view of aesthetics, but also health. Achievements and discoveries in medicine make it possible to prove that extra kilograms harm our health, worsen the quality of life, become a disease. Scientists have developed formulas for calculating the optimal weight, and all deviations from it toward increase are regarded as obesity of varying degrees. The third degree corresponds to the excess of the ideal weight by 50-99%.

[1], [2], [3], [4], [5], [6], [7], [8]

Epidemiology

In the modern world, the number of complete people is steadily growing, especially in developed European countries and America. Statistics call a depressing figure - more than 50%, and various degrees of obesity have about 30%. They say that laziness moves progress. Man is increasingly inventing mechanisms that replace various production and household processes, freeing oneself from physical exertion, and high living standards make it possible to eat well and calorically. Against this it is difficult to resist.

[9], [10], [11], [12], [13], [14],

Causes of the obesity of 3 degrees

Causes of obesity of the third degree, like any other, can be as follows:

• metabolic disorders in diseases of the endocrine system;
• Overeating, when energy is consumed less than it is produced;
• inflammation or trauma of the hypothalamus, which is involved in the processes of regulation of appetite;
• inclusion in the diet of a large amount of flour and sweet;
• low physical activity;
• hereditary predisposition.

[15]

Risk factors

Risk factors for obesity are age, hormonal disorders (excess cortisol and estrogen deficiency). Incorrect nutrition, consumption of spicy food and alcohol lead to arousal of appetite, stressful situations also aggravate the situation.

[16], [17], [18], [19]

Pathogenesis

In the regulation of fat metabolism, a complex chain is involved: the cerebral cortex, the hypothalamus, the nervous system, the endocrine glands. The pathogenesis of obesity lies in the imbalance of energy expenditure and appetite as a result of failures of one of the chain systems. The intake of energy in the body exceeds the intensity of metabolic processes, as a result, the accumulation of fat. It is assumed that these violations can be both congenital and acquired, associated with certain traditions in the family, the way of life.

[20], [21], [22], [23], [24], [25], [26], [27]

Symptoms of the obesity of 3 degrees

A mirror and a large size of clothes will prompt the existence of a problem. The fact that she went too far, will signal the symptoms of obesity, characteristic of the third degree:

• shortness of breath when walking and even moderate exercise;
• pain in the system of the musculoskeletal system;
• disturbances in cardiac activity;
• hypertension;
• discomfort of the digestive tract;
• decreased efficiency;
• Depressive states as a result of inferiority complex and low personal evaluation.

Weight for obesity 3 degrees

The weight of a person is a criterion for assessing the condition of his body and a reason to diagnose obesity. There are a number of methods based on the ratio of height and weight, with which the weight norm is determined, and all deviations from it to a greater extent give the right to treat it as obesity and, depending on their magnitude, classify. The simplest formula is the following: with a growth of up to 165 cm, the number100 is subtracted, 165-175cm - 105, and over 175cm - 110. The result of calculation is the optimal weight. With obesity of grade 3, it is 1.5-2 times higher than calculated. The first signs that the problem has acquired a serious turn is the deterioration of well-being, manifested in increased heart rate, excessive sweating, drowsiness, frequent headaches.

Obesity of the third degree in the child

Methods to determine the normal weight of adults are not suitable for the early age of children. There are special tables showing the age and weight of babies, different for boys and girls. These norms can be found on the Internet, special pediatric literature. On reception at the doctor there is a weighing and measurement of growth of the child, at deviations the pediatrist will correct a food.

In adolescence, all responsibility rests with the parents. It's no secret that often well-fed children are a matter of their pride and an indicator of care. It happens that family gastronomic traditions based on high-calorie, abundant nutrition, sedentary lifestyle lead to obesity in children. Other reasons are hormonal failures, metabolic disorders, heredity.

Obesity of grade 3 of the child corresponds to excess weight by 50-100%. To clarify the diagnosis, measure the circumference of the hips, waist, chest, and using the so-called caliper - a special device, the thickness of the subcutaneous fat layer.

Obesity of the third degree in men and women

Obesity in men can be determined by calculating the body mass index (BMI) by one of the existing formulas: the weight is divided by the square of the growth. Exceeding its value in 40 times testifies to obesity of 3 degrees. Male obesity is dangerous because it lowers testosterone levels. Fats turn it into estrogens, which in turn inhibit the production of testosterone and promote the accumulation of fat. It turns out a vicious circle. Another indication of low testosterone production is the waist circumference exceeding 102 cm. Reduction of sexual function is a big blow for a man. In addition to a direct threat to physical health due to excess weight, psychological problems also arise.

Obesity of grade 3 in women is much more common than in men. This is especially true for women who have crossed the 50-year mark. This is due to hormonal reorganization, a decline in business activity. Large weight at a young age can affect reproductive function, malfunctions of the menstrual cycle, tk. The level of progesterone decreases, and testosterone becomes higher. Also, besides the problems associated with excess weight inherent in both sexes, women are at increased risk of developing breast, ovarian, and uterus cancer.

Stages

Obesity of the third degree does not occur instantaneously. Weight gain occurs gradually and passes through several stages before becoming excessive. There are stable and progressive stages. Obesity is divided into 4 degrees. To determine them, you can use the formula already known to us: the weight is divided by the square of the growth. The resulting index is called Quetelet and it is different for men and women.

So, I degree for women corresponds to the index of 28-30.7, for men - 30-32.2, grade II - 30.8-35.4 and 32.3-37.2, grade III - 35.5-47 , 3 and 37.3-49.7, IV degrees - more than 47.3 and 49.7 respectively. Having made this simple calculation, we get an objective picture of the state of our body. In determining the degree of obesity in children and the elderly, some difficulty arises. Their muscles are weaker than in healthy adults. In this case, follow the dynamics of weight and make a conclusion about the stage of obesity.

[28], [29], [30], [31], [32], [33], [34], [35]

Forms

Obesity, depending on the causes of occurrence, is divided into two types: primary and secondary. Primary people suffer most (90-95%). There are several of its forms:

• alimentary-constitutional (hereditary);
• with violation of food standards;
• mixed.

Secondary happens:

• with genetic defects;
• cerebral;
• endocrine-metabolic;
• due to mental illness;
• reception of psychotropic drugs.

In other words, it is caused by head injuries, brain tumors, surgical operations, neuro-vegetative system diseases, mental disorders or diseases of the thyroid and pancreas, genetic diseases. The anatomical structure distinguishes between android, gynoid and mixed. Android - a male type or "apple", in which the fat deposits are located in the upper part of the trunk. Gynoid "pear-shaped" is characterized by a predominant accumulation of fat in the buttocks and hips. There is also a mixed type - the fat is evenly distributed throughout the torso.

[36], [37], [38], [39], [40],

Exogenously-constitutional obesity of the 3rd degree

The first part of the name - exogenously-constitutional obesity of the 3rd degree says that it is caused by exogenous factors - overeating, national peculiarities, gastronomic culture in the family. The second part indicates a hereditary predisposition, the activity of fat metabolism.

[41], [42], [43], [44], [45], [46], [47], [48]

Alimentary Obesity

Alimentary obesity is still called trunk and is primary. Violation of the balance between consumed calories and their consumption leads to the accumulation of subcutaneous "stocks" and around the internal organs. Alimentary obesity of the third degree indicates the neglect of the disease. With this diagnosis, the liver, heart, cardiovascular system suffers. Most often, the cause lies in the hereditary factor.

[49], [50], [51], [52], [53], [54]

Morbid obesity of 3 degrees

Morbid obesity means a pathological increase in weight, which makes it difficult to perform proper functions to maintain the body's normal state. It corresponds to the third degree of human obesity, in which the body mass index is equal to or exceeds 40 units. As a rule, it is predetermined by a genetic factor.

Pregnancy for obesity of 3 degrees

Pregnancy for obesity of the 3rd degree is at risk due to the many different complications and threats made in excess weight. This is dangerous development:

• gestational diabetes;
• hypertension;
• infections of the genitourinary system;
• thrombosis;
• sleep disturbances and short-term respiratory arrest (apnea);
• the possibility of miscarriage or repetition of the fetus;
• violations of labor.

Obesity of the mother is a threat and health of the child. First, the child can be born with a lot of weight (macrosomia), and this is fraught with the completeness in the future. Secondly, there is a danger of congenital pathologies, for example, heart disease or diabetes. The optimal weight that a full woman can gain in a single pregnancy is 5-9 kg, with a multiple weight of 11-19 kg. After a full woman's pregnancy the doctor follows more carefully, making frequent observations and studies.

Complications and consequences

The consequences and complications of obesity of the third degree are a serious danger for the normal functioning of various human organs:

• gastrointestinal tract;
• pancreas (development of pancreatitis);
• liver;
• cardiovascular system (increased blood pressure, leg vessel disease, ischemic strokes, heart disease, atherosclerosis);
• endocrine system (type 2 diabetes);
• musculoskeletal system;
• respiratory and reproductive systems.

In addition to physical consequences, full people carry a great psychological burden, often turning into depression.

[55], [56], [57], [58]

Diagnostics of the obesity of 3 degrees

In the diagnosis of obesity, grade 3 resort to anthropometry - the definition of the basic physical data of a person: weight, height, volume in different parts of the body (chest, waist, hips). After that, existing classifications are used to determine the degree, type of obesity, the type of fat localization, which is important in determining the risks of developing various ailments and complications. Excess weight is the sphere of activity of endocrinologists and nutritionists. First of all, the doctor will determine the diet, the amount of food eaten and send for additional research to determine the source of the problem: malnutrition, hormonal failures or metabolic disorders.

With obesity of the 3rd degree, laboratory tests of the general blood and urine analysis for the determination of glucose, biochemical analysis for the state of fat, carbohydrate, protein metabolism are carried out, and deviations of other indicators indicative of concomitant diseases are revealed. It is also necessary to determine the level of thyroid hormones - triiodothyronine, thyroxine and thyroid-stimulating hormone produced by the pituitary gland.

Instrumental diagnostics makes it possible to determine the level of influence of obesity on the functions of other organs and systems. To this end, they can appoint ultrasound, MRI, fluoroscopy. To check the work of the heart sent to the electrocardiogram.

[59], [60], [61], [62], [63], [64]

Differential diagnosis

Differential diagnosis is carried out with Isenko-Cushing's disease, which has similar symptoms: obesity, urolithiasis, diabetes mellitus, menstrual cycle disorders, decreased immunity, etc. But this neuroendocrine disease caused by excessive production of adrenal cortex hormones due to excessive secretion of the pituitary gland corticotropic hormone . In women, this ailment occurs after childbirth, and may be a consequence of head injuries, bruises, brain concussions.

Treatment of the obesity of 3 degrees

The treatment of obesity of the third degree is primarily the appointment of a low-calorie diet, which is based on eating foods that are high in fiber, vitamins (nuts, grains, salads, fresh vegetables and fruits) and a small amount of carbohydrates (sugar, bakery and pasta). In parallel with the diet is recommended increased physical activity, exercise. If these methods do not result in a result, drug therapy is prescribed, which includes taking anorexigens. If the drug is ineffective, it is changed to another one. There are also surgical methods of treatment.

Medications

All drugs for weight loss are aimed at regulating weight by suppressing appetite, changing metabolism or assimilating calories. Suppression of appetite occurs with the help of catecholamines and their derivatives (amfepramone, fluoxatin). They lead to the accumulation in the central nervous system of the orphan and norepinephrine, which in turn have a depressing effect on the feeling of hunger.

Amfepromone - excites the center of satiation and suppresses the center of hunger. The dosage form is a dragee, a one-time dose of 25 mg per hour before meals, twice or thrice a day. Maximum can take no more than 100 grams per day. The course of treatment is 1.5-2.5 months, after a three-month break it can be repeated. The drug is contraindicated in hypertension, myocardial infarction, atherosclerosis, epilepsy and mental disorders, glaucoma, tumors, children under 12 years of age, pregnant. Adverse reactions are possible in the form of nausea, vomiting, weakness, increased blood pressure, allergic rashes.

The mechanism of action of other drugs is the blocking of cannabinoid receptors (rimonabant, acomplia).

Rimonabant - tablets are used to reduce weight along with a low-calorie diet and physical exertion. The daily dose is 20 mg. The drug can be taken for 2 years. Side effects are manifested as nausea, anxiety, diarrhea. It is not recommended for use by children, pregnant and lactating women, people with mental illnesses.

Anorexics are antidepressants that reduce appetite (sibutramine, reduxin, meridia).

Sibutramine is a crystalline powder soluble in water. It is taken in the morning, once a day for 10g, with a weak efficiency after a month, the dose is increased to 15g. Adverse reactions are possible on the part of the cardiovascular system: increased blood pressure, respiratory disorders. There may also be headaches, constipation, dry mouth. Contraindicated in children, the elderly, pregnant, during lactation, patients with epilepsy.

Accelerate the metabolism of thermogenics and lipotropics, in other words fat burners. Preparations orlistat, xenical, orsotene prevent the splitting of fats and their assimilation.

Orlistat - a powder that inhibits gastric and pancreatic lipases - enzymes that help break down fats. It is taken for 120g at the same time as every main meal, one hour after a meal. If the food is not fat, you can skip the reception. Has contraindications for use by pregnant, nursing, with increased sensitivity to the drug. Side effects - oily stool, frequent desires for defecation.

Vitamins

When losing weight, vitamins must necessarily be included in the diet, so as not to lose weight with weight loss, but to strengthen health. Knowing the influence of these or other vitamins on the processes occurring in the body, you can choose their optimal set that will help bring the expected result closer. So, vitamin D reduces the feeling of hunger, C and B8 - destroy fats, E - is necessary for the normal functioning of the immune and endocrine systems, vitamins of group B - are indispensable in the harmonious work of all human life systems: B2 - participates in metabolic processes, B3, B6 - normalizes sugar in the blood, stabilizes the hormonal background, B4 - provides fat metabolism, B5 - removes fats, sets up metabolism. Mandatory and vitamin Omega-3, which is not synthesized by the body. When taking vitamin complexes, sold in pharmacies, it is necessary to drink plenty of water (1.5-2 liters per day).

Physiotherapeutic treatment

With obesity of the third degree, physiotherapy is successfully used, but it is necessary in combination with other methods: physical exercises, dietary nutrition, and sometimes medicinal treatment. Therapeutic gymnastics should be conducted every day for at least 20 minutes in different positions with the use of different muscle groups. Well reflexotherapy: acupuncture and laser puncture. Acupuncture is a part of Chinese culture, one of the directions of traditional alternative medicine. It consists in affecting individual zones of the body, the so-called meridians - the centers of human energy, needles. A laser for this purpose uses a laser. Assign and water procedures - circular shower, underwater massage and just swimming, as a form of physical activity.

Alternative treatment

In the arsenal of alternative treatment, various herbs that reduce appetite and normalize metabolism, low-calorie diets, recipes for dishes rich in fiber, therapeutic baths. To make baths make a decoction of aire, thyme, juniper, mint, hay, birch leaves. You can individually select and other medicinal herbs, the main principle - the opening of the pores of the body. Observe the following proportion: on a tablespoon of each herb take a half liter of water, boil for several minutes, insist for at least an hour. In the bathroom with warm water poured infusion. This procedure can be repeated several times a week.

From a bran of wheat prepare such drink: 200g of bran is poured with a liter of water, boil 10min. The cooled solution is taken before meals 4 times a day for 100-150 g. Successfully used and honey: in the morning on an empty stomach a teaspoon dissolve in a glass of slightly warm water, while filling the stomach, and the body receives the necessary vitamins and trace elements. Apple cider vinegar is a known remedy for obesity: 2 teaspoons are poured onto a glass of water, they are drunk half an hour before meals three times a day.

[65], [66], [67], [68], [69]

Herbal Treatment

In addition to using herbs for water procedures, infusions, decoctions, and teas for oral administration are widely used. Such treatment entails improving the metabolism, reducing the feeling of hunger, cleaning the body of harmful toxins and toxins. To reduce the appetite will help infusion of the root of valerian: 70g per liter of cold water, drink in a day for 100-150g for 30min before eating. To combat obesity, such herbs are used: horsetail, bean pods, spores, immortelle, corn stigmas, birch buds, bark of buckthorn. You can use ready-made pharmacist diuretics.

Homeopathy

Homeopathy in the treatment of obesity is used as part of complex measures to reduce weight, its effect is not instantaneous, but a low rate of complications speaks in its favor. There are constitutional, pathogenetic and etiotropic homeopathic preparations.

The constitutional means (depending on the type of person, his personality) include sepia, sulfur, barium carbonicum, ammonium carbonium, calcium carbonium.

Calcium carbonicum - is released in granules in various dilutions, improves metabolism. Doses are assigned individually. The drug has a number of contraindications: kidney stones, stomach ulcer, high blood pressure, hypersensitivity. There are side effects in the form of arrhythmia, a special taste in the mouth, nervousness, rapid fatigue.

Etiotropic drugs are prescribed for secondary obesity and they are directed at the cause, which provoked the appearance of excess weight. This is Acidum phosphoricum, Nuks vomica, anacardium, and iznatsiya.

Ignacy is a combined preparation of plant and animal components. It is an antidepressant agent, it is prescribed for various neurological pathologies. Issued in drops, a single dose for children under 2 years - 3 drops, 2 to 6 - 5 drops, after 6 years - 10. The solution drips under the tongue, can be planted in several tablespoons of water. Take 3 times a day, without mixing with food. Side effects can occur during the first stages of treatment from the disease to which treatment is directed. It is worth continuing treatment. Pregnant is not contraindicated, with allergies to the components of the drug should be interrupted application.

Nuks vomica - the plant components of the drug cause its hepatoprotective, laxative, anti-inflammatory effect. Drops are taken a quarter of an hour before meals or an hour after. For different ages, the dosage is different: 9-15 drops for small children and 30 drops for adults three times a day. Contraindications exist for pregnant women and for individual intolerance.

Pathogenetic drugs are also directed to the treatment of concomitant diseases. So, with cardiac pathologies, appoint lachezis, arnica, spiegelia; diseases of the food tract - nuks vomiku, calcium carbonium, mercurius dulcis; urological ailments - cantharia, thuja, bryonia, etc.

Spiegelia - tincture, in heart diseases is used in low dilutions. The dose is determined by the homeopath individually. Side effect is possible in the form of a strong palpitation, nausea, vomiting. Contraindicated in pregnancy, lactating women, with an allergic reaction to the drug.

Operative treatment

Operative treatment is the most effective way to get rid of obesity. Indications for his conduct is a BMI greater than 40. In such diseases as type 2 diabetes, varicose veins, hypertension can resort to surgery and with a BMI of more than 35. In the world, two types of surgical intervention are most commonly used: gastric bypass (common in America, Canada) and gastric banding (Europe, Australia). Such operations are usually laparoscopic and give the chance to get rid of half the weight. The shunting method consists in the formation of a "small" stomach by crossing its upper part and connecting it to the small intestine. Thus, there is a decrease in the volume of the stomach from 2 liters to 20-50 ml. The method of bandaging is to impose a special bandage - a ring that divides the stomach into two parts: the upper and lower. Since the saturation receptors are in the upper smallest part, it does not take a lot of food to fill it and feel full.

Diet for obesity of 3 degrees

The most frequent culprit of obesity of the 3rd degree is still overeating, so the main task in dealing with it should be to establish proper nutrition. First of all, it must be fractional and frequent. Diet No. 8, recommended for obesity of grade 3, is based on low-calorie foods that provide saturation. It is necessary to remove fried, stewed, salty, spicy food from the diet. Also refuse from flour, pasta, cereals, potatoes, sweets: sugar, sweets, honey. There are more raw vegetables and fruits. Fats need to be limited, but not completely eliminated. A small amount of butter and unrefined vegetable will be needed by the body for metabolic processes. Limit foods containing large amounts of cholesterol - liver, eggs.

[70], [71], [72],

Menu for the week for obesity of 3 degrees

The menu for the week with obesity of grade 3 may include "thematic" days, focusing on one particular product. Food should be divided into 5-6 receptions, support the body with a decoction of wild rose - the source of many vitamins and minerals (a glass a day), and several cups of unsweetened coffee with milk are allowed:

• meat day (300-350 g of boiled lean meat, preferably chicken or turkey, boiled vegetables for garnish);
• vegetable ((beets, carrots, broccoli, celery root boiled) or cucumber (2 kg) in summer);
• apple (at least 2 kg, can be combined with a small amount of hard cheese);
• Milk (every two hours a glass of fat-free yogurt, kefir or milk);
• fat (300 g sour cream for 3 meals);
• fish (200-300 g boiled lean, you can with a small (30 g) portion of rice).

One day a week, with the permission of the doctor, can be made unloading, while drinking plenty of water.

Exercises for obesity of 3 degrees

Obesity requires physical exertion to stabilize metabolic processes, strengthen muscles, restore physical activity. It should be adaptive in nature, take into account chronic diseases, gradually involve in systemic studies. Begin the exercises for obesity of grade 3 is necessary with the morning ten-minute warm-up and dosed walking. The warm-up should include turning, tilting and rotating the head, exercises for the joints of the hands, elbows, forearms, feet, tilts to the different sides of the trunk. Then follows slow walking (2-3 km per hour). Gradually increases the physical load. Walking is replaced by a dosed run with an increase in the length of the distance, lessons are connected on the simulators. A three-minute run should be alternated with walking, resting, again go to jogging, during training on the simulators also need to pause.

[73], [74], [75], [76]

Massage for obesity of 3 degrees

Massage for obesity of the third degree is indicated for improving blood circulation, stimulating metabolism, increasing oxidation-reduction processes, body tone, increasing energy costs. Massage is directed to the areas of accumulation of subcutaneous fat, to large muscles and uses a "suction" technique, i.e. Kneading, grinding, stroking, shaking, percussive techniques. Massage begins from the back, pass to the cervical spine, then to the buttocks and legs. Turn over on a back, massage a thorax, sides and arms or hand.

Prevention

Prevention of obesity lies in two components of the problem: nutrition and motor activity. Accumulate fat need less, spend more. Reduction in the diet of high-calorie foods, "fast" carbohydrates, restriction of the portion will not allow the weight to take power over the person. With exercise, remember that in the first 20 minutes of work, energy is given by carbohydrates, and then fats are burned. Walking, easy running, swimming, skiing - these are the kinds of sports that will bring not only good, but also enjoyment. If completeness is a consequence of pathological phenomena, preventive measures need to be directed to their source.

[77], [78]

Forecast

The prognosis of obesity of the third degree depends on the concomitant diseases. At such people the risk of a lethal outcome, for example, from cardiovascular pathologies, atherosclerosis, various infections, surgical interventions is much higher than in patients with normal weight.

[79], [80], [81],

Army and obesity grade 3

Before the call for urgent service, the young men undergo a medical commission, which is represented by specialists of various profiles. They measure growth, weigh and determine BMI. The army and obesity of the third degree are incompatible. With BMI rates above 40, life is released from the service and sent to the endocrinologist.

[82], [83], [84], [85], [86]

Disability for obesity of grade 3

With obesity of the third degree, disability of the third group is established. Such a conclusion is made by medical and social expertise. With concomitant diseases, considering the degree of decrease in working capacity, the profession, the working conditions, the ability to service oneself, the second group can be determined.

[87], [88], [89], [90]