Obesity of the 4th degree

Obesity of the 4th degree is the most severe form of the disease. It is diagnosed when the person's weight exceeds the maximum allowable value by more than 100%. The norm can be calculated by BMI or other formulas, such as the ratio of the waist to the hips in width.

[1], [2], [3], [4]

Causes of the obesity 4 degrees

Among the main reasons for the appearance of this problem are:

• passive lifestyle;
• binge eating;
• hormonal or chronic diseases.

[5], [6], [7], [8]

Pathogenesis

The main variant of development in a person of obesity is considered to be disorders of the functions of the main central mechanisms, such as the cortex of the brain, as well as the hypothalamus - it is here that the centers regulating the appetite are located. Disorders can be not only congenital, but also acquired (in cases, caused by upbringing, family life, nutritional diet, etc.). In the presence of injuries that affect the location of these centers (with the development of the inflammatory process or not), obesity can also develop.

[9], [10], [11], [12], [13], [14], [15]

Symptoms of the obesity 4 degrees

With the development of obesity of the 4th degree, the following symptoms are observed:

• The development of systemic disorders in the functioning of the heart - IHD, heart failure, as well as increased blood pressure (and these are just some of the diseases that occur in a person at 4 of this pathology). The fat tissue begins to expand around the myocardium, causing the heart to lack oxygen. Due to poor blood supply to the tissues that arises due to atherosclerosis, their hypoxia begins;
• Since the cardiovascular system begins to function differently, there are also changes in the functioning of the respiratory system-the so-called lowering of the respiratory system. Nonspecific resistance. The process of ventilation of the lungs is greatly complicated, which causes inflammation in the airways (for example, pneumonia or bronchitis). In some cases, as a result of obesity, 4 std. Developed tuberculosis;
• Since the body weight is too high, it starts to directly affect the ODA as a result of which the patients develop various pathologies of the spine and joints, including. Osteochondrosis.

Stages

Obesity can have a progressive stage - the volume of fat stores gradually increase, resulting in a gradual increase in body weight. There is also a stable stage (this is the so-called residual stage, which is considered residual - it is noted after losing some part of the weight).

[16], [17], [18], [19], [20], [21]

Forms

There are also several separate types of obesity, they stand out, based on which areas of the body are mostly stored fat stores:

• Abdominal type (or upper, android). In this case, the fat deposits are mainly located in the upper region of the trunk, and in addition to that on the abdomen. More often this type of obesity is observed in men. With this type of disease, the risk of affecting the general state of the body is quite high, which manifests itself under the guise of developing high blood pressure, diabetes, as well as strokes and heart attacks;
• Femoral and gluteal (lower) type. In general, already by name you can understand in which areas of the body at the same time fat deposits are collected - on the hips and buttocks. This type of pathology is mainly observed in women, and concomitant complications are such diseases as venous insufficiency, and in addition various diseases of the joints and spine;
• Mixed (intermediate) type. At the same fat reserves are evenly deposited in all areas of the body.

[22], [23], [24],

4 degree of obesity in children

Today, quite a few children are obese, and in some cases even up to 4 std. This trend can be explained by the fact that children lead a sedentary lifestyle, and also eat poorly. In addition, hereditary or acquired diseases play an important role. Therefore it is very important to notice that the weight of the child began to deviate from the norm, in time. Timely treatment will avoid problems associated with the 4th stage of obesity.

[25], [26], [27], [28], [29]

Complications and consequences

In the case of development of obesity up to the 4th degree, problems begin in the whole body - changes occur both in internal organs and in veins with arteries, hair and skin, and also mucous membranes. Very serious diseases can develop, such as disorders of the endocrine system and diabetes mellitus. Later they lead to disability.

In the case of a prolonged course of the disease, it is not under the supervision of a professional specialist that complications for men become such problems as deterioration of potency, which can reach infertility. Women also have problems with reproductive function. While the possibility of conception remains, the process of gestation is associated with a high risk, with it there is a pronounced toxicosis, which in many cases creates a threat to life. Babies born often have deviations in development, and outwardly they may look like preterm, although they themselves are quite large.

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

Diagnostics of the obesity 4 degrees

Obesity can be diagnosed based on the calculation of the normal weight for a particular person, as well as BMI. To assess the extent of the fat deposited under the skin, the skin folds are examined.

Instrumental diagnostics

The most accurate indicators of the percentage, volume and location of fat deposits are determined by the procedures of such auxiliary methods of instrumental diagnostics: CT, ultrasound, NMR, and in addition x-ray densitometry, etc.

[36], [37], [38], [39], [40], [41], [42],

Treatment of the obesity 4 degrees

With obesity of the 4-th century. Treatment begins with a thorough examination of the entire body in order to determine all the accompanying pathologies. It is necessary to conduct it under the control of doctors - it's a cardiologist with a nutritionist and a psychologist and so on.

Often obesity at this stage is treated surgically. But before the operation itself, you need to go through a long period of preparation, consisting of:

• correcting the eating behavior of the patient;
• compliance with the nutritional regimen and diet conditions;
• increase of physical loads;
• treatment of obesity along with concomitant pathologies with the help of medications.

Medications

Medicines for fighting obesity of the 4th degree are used quite rarely, and they approach it very carefully, because the body condition in this case is extremely difficult.

Used in this situation, drugs: xenical, as well as orlistat and acarbose. These drugs help slow down the absorption of carbohydrates with fats. But it should be borne in mind that any drugs have side effects, and they can further worsen the patient's condition.

Nowadays, about the medicines that suppress the appetite, nutritionists respond very negatively. The thing is that they are classified as narcotics, and they only suppress the state of the body even more.

But in any case, tablets and other medicines are allowed to be taken exclusively with the appointment of a doctor.

Vitamins

The diet supposes the additional use of vitamins of groups A, and also D (in the form of drops).

Physiotherapeutic treatment

In case of obesity IV st. It is permitted to use rain showers, and in addition, underwater shower massage (water must have a temperature of 36-37 ° C), which uses a special fan-nozzle nozzle, and the water jet should be directed at a pressure of 1-3 atm. The duration of such a procedure is 12-15 minutes, daily or after a day. The entire treatment course consists of 10/15/18 such procedures. After a similar course, patients have a lowering of cholesterol, as well as a noticeable reduction in weight.

Also effective in this pathology will be the following procedures of physiotherapeutic treatment:

• LPG or some other hardware massage that helps to increase metabolism in skin cells;
• Mesotherapy, in which injections with special substances are injected under the skin;
• hydrotherapy - so called. Shower Sharko, as well as other methods of water massage.

Operative treatment

There are several types of operations used in case of obesity of the 4th degree: it is liposuction, as well as gastroplasty, and besides this, shunting or banding of the stomach and biliopancreatic shunting.

Liposuction is the process of removing excess fatty deposits. It is considered an urgent measure to eliminate excess weight, used to ease the burden on important organs for life. But it is not considered a method of treating this pathology.

Vertical gastroplasty is an operation on the stomach, during which it is divided into 2 parts vertically. As a result, the upper part, which is smaller in volume, is filled with food, and the patient has a feeling of satiety earlier than in the usual situation. Thus, a person grows thin due to the fact that the volume of food decreases.

Gastric bypass - this operation uses a bandage (a special cuff of silicone), with which a small separate part of the stomach is created. For this, a special device is inserted under the skin, which adjusts the width of the opening of this part and thus the volume of food that is eaten by the patient.

After this procedure, you must follow a diet, limiting the consumption of all high-calorie foods. Otherwise, the process of losing weight will go much slower.

Gastroshuntirovanie - a method of surgical treatment, in which a small part of the stomach of the patient is completely isolated, so that he consumes less food. After this procedure, individual foods (such as butter, milk and sweets) to the patient are rather unpleasant. Therefore in the future he will have to additionally use special vitamins, as well as mineral supplements.

With biliopancreatic shunting, a complete removal of a certain part of the stomach is performed. In this case, the patient loses weight regardless of the amount of food consumed. The operation is also effective for type 2 diabetes. After this procedure, the patient will have to use vitamins with mineral supplements for life.

Diet for obesity 4 degrees

In the treatment of obesity 4 tbsp. Elimination of excess calories begins with the first stage. It requires strict adherence to the prescribed diet with frequent fractional meals in small portions.

Since patients with this stage of obesity have a sedentary / recumbent lifestyle, they consume a minimum of energy. A high-calorie food is eaten a lot. Therefore, in this case, the main goal is to increase the energy costs of the patient's body. For this purpose, fish from fatty meat, as well as flour products and sweets are completely excluded (or limit consumption) from the diet.

Therapeutic diet is based on the following principles:

• It is required to appoint a completely balanced diet with low-calorie foods;
• limit the intake of carbohydrates, which are quickly absorbed by the body (sugar);
• fats of animal origin are replaced by vegetable fats;
• a sense of saturation to create a consumption of low-calorie foods (vegetables, as well as individual fruits) in large quantities;
• to carry out for the patient unloading days;
• eat often, but in small portions - to reduce the feeling of hunger;
• limit the intake of liquid as well as salt;
• to remove from the diet food that provokes an appetite - smoked, salted, alcoholic drinks, spices.

Exercises for Obesity 4 degrees

Physical culture is considered one of the most important stages in the treatment of pathology. But it should be understood that exercises should be done carefully, as often these patients have problems with motor activity.

Patients develop special complexes consisting of therapeutic exercises that will help stabilize the metabolism, and also develop an overall resistance to this load in the body. They are developed individually, taking into account the physical condition of the patient, as well as the presence of concomitant pathologies.

At the initial stage the patient is mainly engaged in 5 min. Exercises include body torsions, slow walking, and raising / lowering limbs.

It should be taken into account that exercises impossible for the patient can not be prescribed. It is necessary to watch especially the condition of his spine, as well as the heart. At the 4th stage of obesity, the main rule of the physiotherapy is the daily progressive increase in the loads.

[43], [44], [45], [46], [47]

Prevention

To prevent the development of obesity, you need to eat right, limiting the consumption of foods in which there are many fats with carbohydrates. Instead, you should eat more food containing a lot of protein. It is also effective to exercise regularly, do morning exercises and take long walks. Physical exercises need to be selected, given the age, as well as the state of the cardiovascular and other systems.

In the prevention of obesity, people who are genetically predisposed to this, and also after the age of 40, are especially in need, especially if such a person leads a sedentary lifestyle.

[48], [49], [50], [51], [52], [53], [54], [55]

Forecast

Obesity of the 4th st. Has a very unfavorable prognosis. Most often in such cases, early death occurs.

[56], [57], [58], [59], [60]

Disability

In case of obesity, 4th st. Basically set the 3rd group of disability. In the presence of pronounced complications from the musculoskeletal system, as well as the cardiovascular system, a heavier group can be established.

[61], [62], [63], [64], [65], [66], [67], [68], [69]

Army

Obesity of the 4th degree makes conscripts unsuitable for enlisting in urgent military service.

[70], [71], [72], [73], [74]