Treatment of 2nd degree obesity: diet, nutrition, medications, exercises

In the previous article, we talked about what obesity is, what its types and kinds are, how to diagnose stage 2 obesity and pathologies associated with it, i.e. those that have become the cause or consequence of obesity. Now, having recalled the main points associated with the disease itself and its diagnosis, we will try to figure out how to effectively combat the problem of excess weight and prevent this from happening in the future.

A little bit about stage 2 obesity

Let us remind you right away that obesity is not just extra pounds and a curvy figure. It is a disease that must be actively fought, otherwise its consequences will affect many organs and systems of our body. Obesity of 2 or moderate degree significantly increases the risk of developing concomitant diseases, which not only negatively affect the patient's well-being and affect his physical activity, including professional, but can also be life-threatening.

Obesity itself means an increase in the thickness and volume of subcutaneous and internal fat. When it comes to a large amount of fat that forms around internal organs and compresses them, disrupting their structure and functionality (visceral obesity), it is important to understand that this pathology is especially dangerous for the patient's life and health, as it causes the greatest number of complications.

A distinction is made between primary and secondary obesity. They differ in that in the first case, the cause of the pathology is excess food and a sedentary lifestyle, while secondary obesity is a symptom of other pathologies associated with disorders in the functioning of various parts of the brain (cortex, pituitary gland, hypothalamus), adrenal glands, and endocrine organs.

Primary obesity is also called alimentary or exogenous-constitutional. This is a fairly common type of obesity, and, according to statistics, the increase in the number of people with excess weight (and obesity in particular) is largely due to:

• unhealthy diet (food rich in fats and carbohydrates, salty and spicy dishes, alcoholic drinks and sweet sodas that stimulate the appetite),
• lack of physical activity (sedentary work, weekends in front of the TV, computer games replacing active outdoor entertainment, etc.).

Hypothalamic and endocrine obesity are already associated not so much with nutritional errors as with pathologies of the corresponding organs. Although here the quality and nutritional value of the food consumed play a far from insignificant role.

Depending on the location of fatty deposits, obesity is divided into several types:

• gynoid - hips and buttocks,
• abdominal - stomach,
• mixed - all over the body,
• Cushingoid - all over the body except the arms and legs,
• visceral – on internal organs.

You can tell if a person has stage 2 obesity by the following signs:

• noticeable ugly obesity,
• the appearance of shortness of breath not only during heavy loads, but also at rest,
• increased sweating,
• increased heart rate during physical activity,
• causeless weakness,
• the appearance of swelling in the arms and legs in the summer.

Measuring the body mass index will help clarify the diagnosis: BMI = m / h ². In this formula, m denotes weight, and h denotes a person's height. If the BMI is greater than 30 but less than 39.9, then the person's obesity has already moved from mild to moderate and will have to live with the diagnosis of "obesity stage 2" for some time.

But living does not mean resigning yourself. The second degree of obesity is not a death sentence. The main thing is to patiently follow the doctor's orders and recommendations, plus be persistent in achieving your goal, which is returning to a normal, healthy life. So let's figure out how to deal with the problem of obesity and make sure that it never comes back.

[ 1 ], [ 2 ]

Indications

A body mass index (BMI) above 30 does not necessarily mean that the patient should start taking weight loss medications. Therapy is initially carried out with diet and exercise, and based on the results of such treatment, the doctor decides whether drug therapy is appropriate.

Indications for prescribing medications are the following situations:

• non-drug therapy for 90 days resulted in a slight decrease in body weight (less than 5%),
• Several such courses of treatment were carried out, but the result was negative or insufficient,
• excess weight threatens the development of complications due to individual characteristics of the body or there is a hereditary predisposition to the development of pathologies such as diabetes, heart disease and vascular disease.

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

Contraindications

Contraindications to drug therapy are:

• children under 16 years of age,
• old age (65 years and older),
• pregnancy,
• lactation.

In addition, each of the weight loss products may have its own contraindications, which must also be taken into account when starting serious treatment of the pathology.

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

The treatment protocol

There are not so many effective and safe drugs for fighting excess weight. The bulk of what the Internet offers us in this regard either does not have the properties described in the manufacturer's instructions, or can be effective, but cause some harm to health. Both are dangerous. The use of "placebos" makes a person disappointed in treatment and give up, and dangerous drugs for health - to treat new pathologies caused by taking these miracle drugs.

Effective treatment is unlikely to be possible if the patient's emotional and mental state leaves much to be desired, which is often observed when working with people who are significantly overweight. Therefore, psychotherapy sessions are often used along with other therapeutic measures.

Diet for obesity stage 2

Since obesity is a consequence of improper eating behavior, then without its correction no treatment will be effective. In other words, many nutritionists agree that a diet for stage 2 obesity is the main method of combating the disease and is equivalent to medical procedures.

There is simply no universal diet that would help everyone lose extra pounds equally effectively. Sometimes you have to try several diets until you settle on the one that gives the greatest weight loss. The choice of diet should be based on the nutritional characteristics of stage 2 obesity.

The main provisions that need to be relied upon when choosing an effective diet are the following requirements:

• The food should be simple, but with sufficient nutritional value. The patient's body should not suffer from a lack of vitamins, microelements, essential amino acids, etc.
• A large amount of fiber in foods and dishes will help cleanse the intestines and speed up the weight loss process.
• Low calorie food, as a necessary condition for weight loss, is a common condition for all diets.
• The patient's diet should not include sweet carbonated drinks (they are replaced with mineral water and natural compotes from fruits and berries), honey and sweets, ice cream, high-calorie desserts, fatty meats and fish, sausages and smoked meats, canned goods, pickles, hot spices and sauces, alcoholic beverages.
• It is necessary to reduce to a minimum the consumption of sugar and salt, oils and fats (giving preference to vegetable oils), pastry products (especially puff pastry, yeast and shortbread), fried and hearty dishes. Dairy products should be very low in fat, ideally - fat-free. Fruits - low in sugar. It is better to take gray or black bread and preferably with bran.
• Portions should be significantly smaller than usual, while the frequency of meals should be increased to 6 times a day.
• Fresh vegetables and unsweetened fruits rich in fiber, green leafy vegetables and root vegetables rich in vitamins and microelements, low-fat dairy products, and green tea are useful.
• Fasting days. They are necessary to cleanse the body of harmful waste and toxins that prevent weight loss. On this day, the patient should eat only certain dishes. The best option is considered to be an apple and cottage cheese day (but the cottage cheese should be low-fat). You can also sit on vegetables for a day, with the exception of potatoes.

The daily diet should contain much fewer calories than before, and nevertheless the figure should not be less than 1200 kcal.

Here is an example menu for a diet for stage 2 obesity, not forgetting that the frequency of meals increases and portions are reduced by half compared to usual:

1 breakfast:

• boiled meat, sauerkraut (not pickled!),
• coffee (with milk, but without sugar, sweetener - xylitol).

2 breakfast:

• low-fat cottage cheese,
• green tea without sugar.

Dinner:

• borscht with vegetable broth without meat,
• boiled chicken, boiled or baked vegetables,
• compote of unsweetened fruits and berries.

Afternoon snack:

• large apple (fresh or baked),

1 dinner:

• boiled or baked potatoes,
• lean fish (boiled, baked or steamed)

2 dinner (light snack at night)

• A glass of kefir with zero percent fat.

Nutrition for stage 2 obesity, despite its relatively low calorie content, should still be varied. Instead of borscht, you can eat soup or vegetable stew, instead of baked potatoes, make a carrot casserole or a salad of boiled beets and low-fat sour cream, etc.

You need to eat more unsweetened fruits and raw vegetables (if possible), include in your diet a small amount of cereals (oatmeal, rice, buckwheat), rich in fiber, eggs, dairy products with low fat content.

The main thing with stage 2 obesity is the desire to lose weight. This means you will have to be patient, teaching yourself to eat little by little and only healthy food.

[ 14 ], [ 15 ], [ 16 ], [ 17 ]

Physical activity in obesity stage 2

The diet itself, no matter how effective it is, is unlikely to give a positive result if a patient with stage 2 obesity does not pay due attention to physical activity. Moreover, in this situation, not only special exercises play a big role, but also regular daily walks, swimming, tourism, cycling and even active work in the country.

As for physical exercises for stage 2 obesity, you can choose them yourself. After all, we are not talking about correcting individual body parts, but about losing weight in general, which means that any physical activity will be useful. But you can also entrust the matter to a specialist who will select a set of exercises that will help you get rid of extra pounds as quickly as possible, and not allow self-pity to overcome common sense and the desire to be healthy.

In addition, with stage 2 obesity, as with any disease, it is better to select exercise therapy taking into account the patient's age and health status, since moderate and severe obesity is often accompanied by the development of various diseases. Only a doctor can select effective exercises taking into account the characteristics of the body. In this case, you will have to exercise 3 to 5 times a week and at least half an hour a day.

Walking, water procedures, gymnastics elements are the best start of the day for people with excess weight. Their effect can be supported by physical activity during the day and visiting gyms and fitness clubs, where an experienced instructor will also provide all possible assistance in the fight against excess weight.

For children with obesity, parents should be an example of physical activity. Only they can interest the child in active movement, organizing walks in the fresh air, hiking, active recreation near the water, involving in active games and work.

Drug therapy for obesity

Doctors are reluctant to prescribe medications for stage 2 obesity and only in cases where diet and exercise do not produce visible positive results, and excess weight threatens the development of dangerous health pathologies.

Drug treatment of obesity is, in some ways, a trial and error method. There are simply no drugs in the world that are equally effective for all patients and help get rid of extra pounds. And here the specialist’s task is to select exactly those drugs that will give the best result.

There are 2 groups of drugs that help effectively fight excess weight:

• Anorectics are drugs that affect the human brain, in particular the saturation center located in the hypothalamus. They dull the feeling of hunger, reduce appetite, helping to more easily tolerate the restrictions in food suggested by the diet. In our country, drugs based on sibutramine are widespread: "Reduxin", "Lindaxa", "Meridia", "Slimia", "Goldline", less often prescribed drugs based on amfepramone ("Fepranone") and phenylpropanolamine ("Dietrin").
• Fat and carbohydrate blockers. These drugs prevent the absorption of fats and carbohydrates, which are responsible for weight gain, in the intestine. And although their effectiveness has been proven even with a normal diet, with grade 2 obesity they will give a decent result only in combination with diet and exercise. The most popular drugs are considered to be orlistat-based drugs: the drug of the same name "Orlistat", "Xenical", "Orsoten", "Listata", etc., as well as dietary supplements such as "Chitosan", "Reduksin-light", etc.

[ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ]

Effective drugs for obesity stage 2

One of the most popular drugs from the group of anorectics used for obesity are capsules "Reduxin". They are prescribed if the BMI exceeds 30 kg/m2 ^, which is observed in obesity of the 2nd degree.

[ 23 ], [ 24 ], [ 25 ], [ 26 ]

Reduksin

It is considered a combination drug, since its action is caused not by one, but by two main components - sibutramine and monocrystalline cellulose. The first affects the receptors responsible for satiety and appetite, and cellulose, due to its pronounced sorption and some detoxifying properties, effectively cleanses the body, and the intestines in particular, from harmful microorganisms and their waste products, slags, toxins, allergens and other unnecessary substances, promoting rapid weight loss.

" Reduksin " is a serious drug that affects the brain. Prescribing it to yourself is a big health risk, because like any similar drug, "Reduksin" has many other contraindications for use in addition to individual intolerance to the drug. These include multiple heart diseases, circulatory disorders in the brain, excess thyroid hormones, severe renal or hepatic pathologies, and closed-angle glaucoma.

Men are not prescribed this medicine for prostate adenoma. Taking the medicine is also prohibited for such a rare disease as pheochromocytoma.

The drug should not be prescribed to pregnant women or those who are breastfeeding. It is also contraindicated for patients under 18 years of age, as well as for elderly people aged 65 and over.

Reduksin is also not prescribed to people who have a pathological addiction, whether to medication, drugs or alcohol.

The drug should not be taken in combination with other centrally acting drugs used for weight management, MAO inhibitors (at least 14 days must pass after the end of therapy with them), drugs affecting the psyche and central nervous system, and tryptophan-based drugs for the correction of sleep disorders.

Reduksin therapy should be carried out under the supervision of a specialist doctor after a thorough examination of the patient. This is a necessary requirement, since the drug has several more contraindications associated with the cause of weight gain. Thus, the drug is not prescribed if there are organic causes of obesity associated with internal pathologies, and not with banal overeating (the same hypothyroidism).

Taking the drug in cases of severe eating disorders such as nervous anorexia or bulimia, mental disorders, and motor tics (Tourette's syndrome) will be inappropriate and even dangerous.

Method of administration and dosage. It is recommended to use the drug once a day (preferably in the morning) regardless of food intake. The capsules are swallowed whole with a sufficient amount of water.

In this case, treatment should be started with a drug dosage of 10 mg (the optimal daily dose with good tolerability, which can be halved if necessary). Ideally, the doctor should determine the necessary dose for the treatment of stage 2 obesity, but not the patient himself.

The drug should be taken in combination with diet and physical activity, as well as constant monitoring of changes in body weight. If the patient's weight has decreased by less than 5% during a month of therapy with the drug, they switch to treatment with a drug with a higher dosage (15 mg).

A three-month course of Reduksin therapy is indicative, during which the patient's body weight should decrease by at least 5%. If this is not observed, it is more appropriate to look for other methods of combating excess weight.

It is recommended to stop taking the drug if, after achieving a good result, a reverse process is observed (weight gain of 3 or more kilograms).

The duration of the therapeutic course is determined by the doctor, based on the results obtained and the patient’s health condition, but in any case it should not exceed 2 years.

Taking the drug may be accompanied by multiple side effects, which are often observed during the first month of treatment with Reduksin and are not dangerous or irreversible. Dry mucous membranes, headaches, drowsiness, and itching of the skin may be felt. Some patients complain of nausea and lack of appetite, constipation, apathy or anxiety, numbness of the limbs, cramps, and swelling. Heart patients experience increased heart rate and increased heart rate and blood pressure. The risk of bleeding increases. Women complain of pain during menstruation. Some note the development of a flu-like syndrome.

All undesirable symptoms should be reported to the attending physician. At the same time, it is necessary to regularly (once every 2 weeks) measure blood pressure and heart rate. If taking the drug causes an increase in blood pressure, it should be discontinued.

Since only anorectic drugs based on sibutramine have become widespread in our country, all of the above can be applied to drugs such as Lindaxa, Goldline, Meridia, and others with a similar composition.

Another matter is drugs that block the absorption of fats and carbohydrates. Here we can already observe diversity both in composition and in mechanisms of action.

Here we can highlight drugs that prevent the absorption of fats and carbohydrate blockers. The first group includes drugs based on orlistat (Orlistat, Xenical, Orsothen, etc.), as well as most dietary supplements (the same popular Chitosan, the dietary supplement Reduksin Light). Among the drugs of the second group, it is worth highlighting the hypoglycemic drug Glucobay based on acobase, drugs based on metformin (Glucophage, Gliformin, Siofor, etc.), the lipid-lowering drug Lipobay with the active ingredient cerivastatin, an enterosorbent used to treat stage 2 obesity even in children, Polyphepan.

Xenical

It is one of the most frequently prescribed drugs that limit fat absorption. Its action is based on blocking the production of the digestive enzyme lipase, which is responsible for the absorption of dietary fats (their breakdown and absorption in the gastrointestinal tract). Thus, fats are excreted from the body in a virtually unchanged form.

Xenical is not absorbed into the blood, but acts directly in the gastrointestinal tract.

Contraindications to the use of the drug are: cholestasis (or bile stagnation, deficiency of its flow into the duodenum), chronic malabsorption syndrome, when nutrients and vitamins from food are absorbed in insufficient quantities, and, of course, individual intolerance to the drug. In epilepsy, the frequency of seizures may increase.

Method of administration and dosage. It is recommended to take the drug during meals or no later than an hour after it. A single dose of the drug is 120 mg of orlistat (1 capsule). The frequency of administration depends on the number of meals per day, since the drug should be taken with each main meal. It is recommended to limit the consumption of food containing a significant amount of fats, proteins and carbohydrates to 3 times a day. In this case, the drug intake is limited to 3 capsules per day.

If the patient for some reason did not eat at the allotted time, taking the drug at that time is considered optional. The same can be said about taking low-calorie food with a minimum content of fat and carbohydrates.

There is no point in taking more than 3 capsules per day, as this treatment does not give the best results.

The drug is used with great caution for the treatment of stage 2 obesity in children under 12 years of age and patients with liver and kidney dysfunction.

Despite the small number of contraindications, the drug nevertheless has a significant number of side effects. The most frequently observed are: bloating, changes in the appearance of feces (oily feces) and frequency of stool (more frequent urge to defecate, fecal incontinence), discomfort (pain of varying intensity, a feeling of heaviness) in the abdomen, headaches. Women complain of menstrual cycle irregularities.

Less common are non-specific symptoms such as respiratory and urinary tract infections, inflammation of the mucous membrane of the gums, damage to the integrity of the teeth, rapid fatigue and anxiety. Allergic reactions of varying severity (rash, swelling of the mucous membrane of the throat, bronchospasm, anaphylactic reactions) are not uncommon. In rare cases, the development of such pathologies as pancreatitis, hepatitis, diverticulitis, nephropathy is observed.

Reduksin Light

A dietary supplement for combating excess weight based on conjugated linoleic acid and vitamin E. It also blocks the absorption of fats, due to which, with effective diet therapy and sufficient physical activity, weight loss is achieved.

Despite the fact that this drug is not a full-fledged medicine, it has its own contraindications for use. These are chronic heart pathologies, periods of pregnancy and lactation, age under 18, hypersensitivity to the components of the dietary supplement.

Like Xenical, Reduksin Light is recommended to be taken with each main meal in the amount of 1 or 2 capsules. The maximum daily dose is 6 capsules.

The therapeutic course lasts from 1 to 2 months. Moreover, such courses must be taken at least 3 times a year with an interval of at least 1 month between courses.

The drug's side effects are not described in the instructions. However, there is confirmed information indicating a connection between the dietary supplement and the development of such pathologies as diabetes mellitus, gallstone and urolithiasis, hypervitaminosis.

Glucobay

A drug that blocks the absorption of carbohydrates. Acarbose in the drug blocks the production of alpha-glucosidase in the pancreas, which is responsible for breaking down sugar into glucose and fructose. This leads to complex sugars losing their ability to be absorbed in the intestines and enter the blood. This action is effective both for diabetes and for the treatment of excess weight, in particular, stage 2 obesity.

Glucobay is taken in a daily dosage of 300 mg. The frequency of administration is 3 times a day. It is better to take the tablet immediately before meals whole or chewed with food.

If the effect is insufficient after 1-2 months of therapy, the dosage can be increased to 600 mg per day.

Contraindications to the use of the drug are chronic gastrointestinal pathologies with impaired absorption of nutrients, pathologies leading to flatulence, renal failure, periods of pregnancy and lactation, age under 18 years, hypersensitivity to the drug.

Side effects include: bloating and abdominal pain, decreased stool frequency, nausea, intestinal obstruction, occasionally swelling, allergic reactions in the form of skin rashes.

Drugs called enterosorbents, which bind and remove harmful substances and toxins from the intestines, helping to quickly reduce weight, also help in the treatment of many pathologies, including stage 2 obesity.

Polyphepan

A preparation from the family of intestinal sorbents, effective in lipid metabolism disorders, including obesity. It is produced in the form of powder, tablets or granules for internal use.

The main contraindication to the use of the sorbent is hypersensitivity to the drug. However, it is undesirable to use it in case of exacerbation of gastric and duodenal ulcers, intestinal atony and gastritis occurring against the background of low acidity of gastric juice.

It is recommended to take the drug an hour and a half before meals. The powder is diluted in ½ glass of water, the tablets are simply washed down with water. The daily dose is 12-16 tablets (for adults) or 8-10 tablets (for children).

The daily dose for the preparation in powder and granules is calculated based on the ratio: 0.5-1 gram per kilogram of weight per day. The daily dose is divided into 3-4 doses.

The duration of treatment can vary from 3 to 14 days at the discretion of the doctor.

In rare cases, taking the drug may be accompanied by constipation and allergic reactions.

Other methods of treating stage 2 obesity

Drug therapy for obesity will not be successful unless it is supported by a special low-calorie diet and maintaining physical fitness. But even in this case, the fight against excess weight will continue for more than one day.

Treatment of stage 2 obesity is a long process that requires willpower and a positive attitude from the patient. Often, patients, not seeing results in the next couple of months, give up and become depressed. To avoid such situations, it is advisable to supplement obesity therapy with sessions of psychological help and the prescription of antidepressants.

During psychotherapy sessions and hypnosis sessions, patients are taught not only to be critical of their problem, but also to develop correct eating habits, self-control during meals, the ability to resist their desires and surroundings during feasts, the ability to deal with stress without resorting to food, etc.

Physiotherapeutic treatment of obesity also shows good results, which, according to experts, is in 2nd place of honor among other methods of treating obesity of 1, 2 and 3 degrees. The goal of physiotherapy is to correct the endocrine system, normalize metabolism, and stimulate the body's internal forces to fight pathology.

We have already mentioned the benefits of exercise therapy as one of the methods of physiotherapy. It is also worth noting such a point as bicycle ergometry tests, which are necessary due to the fact that the body's reserve forces are declining with increasing obesity.

Massage is a wonderful addition to therapeutic exercise, helping to increase tone and relieve fatigue. Sweating procedures also have a good effect (in the absence of cardiovascular pathologies). Examples of such procedures are light, steam and mud baths, wet wraps, paraffin applications, hot procedures (for example, a bath, a sauna).

Hydro- and balneotherapy are also essential in this regard. For example, contrast baths with a course of 15-18 procedures performed daily, sulphide, carbon dioxide, radon, sea, iodine-bromine baths. Various showers are also widely used for stage 2 obesity: Charcot's shower (from 10 to 16 procedures with a water temperature of 30-35 degrees and a jet pressure of 1.5 to 3 atmospheres, the duration of the procedure is 3-7 minutes), underwater shower massage, fan shower, etc.

A wide variety of physiotherapeutic procedures contribute to effective weight loss in obesity. Unfortunately, not all of them are available in medical institutions, so in case of obesity of the 2nd degree, patients are often sent to specialized sanatoriums equipped with various equipment for various physiotherapeutic procedures. For example, for climatotherapy (aero-, helio-, thalassotherapy), hyperbaric oxygenation, oxygen foam intake. In parallel with this, mineral water is taken, which reduces the resorption of dietary fats (Essentuki 4 or 20, Narzan, Borjomi, etc.).

Folk treatment of obesity stage 2

Drug treatment of any disease is fraught with the development of various side effects, which are often more dangerous than the disease itself. Therefore, many patients are looking for an alternative to such treatment in traditional medicine recipes. And there is something in this, especially when it comes to the treatment of stage 2 obesity, which in itself is not as dangerous to health as anorectic drugs used to reduce appetite.

But you can also reduce your appetite with folk remedies. A decoction of corn silk is excellent for reducing appetite. To prepare the medicinal composition, take 10 g of raw material and pour a glass of boiling water over it, then boil for half an hour and leave to cool. The strained decoction is taken 4 times a day before meals, 3 tablespoons.

Oat decoction (whole grain, not flakes) also helps fight excess weight. To prepare it, 2 tablespoons of grain are boiled in a liter of water in the evening until ready. Leave to infuse until morning, then strain and drink half a glass three times a day.

Ginger tea with honey is also effective in combating excess weight. It is best to prepare it using natural green tea, adding ginger root infusion to it.

Another tasty and healthy drink is chamomile tea with lemon (for 1 glass of tea take half a lemon).

Fasting days on fruit and vegetable juices will also help you fight weight; lemon juice is also effective for weight loss.

Herbal treatment in many cases can perfectly replace drug treatment of obesity stage 2. Chamomile, lemon balm, mallow, senna, nettle and other herbs will be effective.

[ 27 ], [ 28 ], [ 29 ], [ 30 ], [ 31 ]

Homeopathy for obesity

One of the relatively safe methods of treating stage 2 obesity is homeopathy. And here we already find a wide range of drugs that help fight both the underlying disease and its consequences.

In case of alimentary obesity due to overeating and consumption of high-calorie foods, the following drugs will be effective: Nux vomica, Ignatia, Acidum phosphoricum and Anacardium.

If there are disorders of fat metabolism, a homeopathic doctor can prescribe remedies such as Thuja, Pulsatilla, Fucus or Graphitis.

In addition to the main homeopathic preparations, drainage agents are prescribed to help enhance the effect of the first and speed up the result. Such preparations include Lycopodium, Taraxacum, Solidago, Carduus marianus.

Treatment with homeopathic remedies also takes into account concomitant diseases. Thus, for cardiac pathologies, Arnica or Lachesis may be prescribed, for gastrointestinal diseases - Calcium carbonicum, for respiratory diseases - Ipecacuanha or Kalium iodatum, etc.

Doctors and patients also have good reviews about specific preparations, such as "Grace" (5 granules 3 times a day half an hour before meals) and "Dietol compositum" (8 granules 5 times a day half an hour before meals or an hour after). But these preparations should also be prescribed by a homeopathic doctor, who takes into account not only the existing diseases, but also the characteristics of the patient's body.

Conclusion

Surgical treatment of stage 2 obesity is indicated only when other methods of therapy have proven ineffective, and excess weight threatens complications, such as type 2 diabetes, hypertension, varicose veins. In this case, the BMI is within 33-35 kg/m ².

Bariatric surgery in this case resorts to such operations as gastric bypass and adjustable gastric banding, performed laparoscopically, without incisions. Doctors resort to the once popular liposuction less and less often, since it gives a temporary effect and is not always safe for health.

But in any case, it is easier to prevent a disease than to treat it later, which in the case of obesity is a long and difficult process. And the measures to prevent obesity are quite simple: proper nutrition plus physical activity to compensate for the energy coming into the body along with calories, which subsequently settles in the form of fat deposits if it is not spent.

[ 32 ], [ 33 ], [ 34 ], [ 35 ], [ 36 ]