What diseases can obesity lead to?

The World Health Organization estimates that approximately one in three adults in the world is overweight, and one in ten is obese. Unfortunately, it is generally accepted that weight gain with age (especially in the abdominal area) is a normal process associated with aging. They say that after 30 years, metabolism slows down, and the body begins to store more fat.

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Consequences of obesity

Excess weight is not only an aesthetic problem. Obesity causes complex harm to the health of the body. Excessive body fat affects the development of cardiovascular disease, type 2 diabetes, musculoskeletal damage (such as osteoarthritis), and even some cancers (endometrial, breast, and colon cancer).

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Ultimately, obesity is almost always associated with hormonal changes - it becomes much more difficult for the body to maintain normal levels of testosterone, insulin, cortisol, leptin and other hormones. The reason is that as excess weight increases, fat cells begin to play an increasingly active role in human metabolism, disrupting metabolism.

How to determine if you are overweight?

There is a fairly simple formula that is used by doctors all over the world. This is the body mass index (BMI). The index is calculated in three stages.

Measure your height in meters and square that number.

Example: Your height is 1.68 m . m2 = 1.681.68 = 2.82.

Measure your weight in kilograms.

Example: Your weight is 62 kg .

Divide your weight (in kilograms) by the square of your height (in meters)

Example: 21.9 kg/m2

Normal BMI values are those that fall within the range from 18.5 to 24.9. A BMI from 25 to 29.9 is considered overweight, and a BMI greater than 30 is considered obese.

In addition to BMI, the most important indicator for health is waist circumference . Waist circumference is measured with a measuring tape midway between the bottom edge of the ribs and the top edge of the pelvic bone (as shown in the picture). The measuring tape should lie strictly horizontally and should not cut into the skin. Waist circumference allows you to judge the deposits of internal, abdominal fat.

Abdominal circumference in women greater than 80 cm , and in men greater than 94 cm is a risk factor for the development of diabetes mellitus, lipid metabolism disorders, and hypertension. In addition, it is a marker of insulin resistance , which may cause the development of polycystic ovary syndrome and associated infertility and cycle disorders.

Thyroid and obesity

In some cases, obesity can actually be triggered by hormonal problems that a person already has. Low levels of thyroid hormones (hypothyroidism) are characterized by serious metabolic disorders - excess weight gain, chronic fatigue, headaches, insomnia and inability to get enough sleep even with plenty of sleep.

One of the most common causes of decreased thyroid hormones and concomitant obesity is a simple lack of iodine in the daily diet, which can be corrected in the simplest ways. If you are gaining excess weight, even after following a careful diet and exercising regularly, be sure to check whether you have enough sources of iodine in your diet.

Obesity and overeating

By consuming more energy from food than the body needs for daily activity, you provoke the deposition of unclaimed calories into fat depots - this is how obesity develops. Remember that an extra couple of candies a day (200-300 kcal) will provide a weight gain of 8-10 kg of fat over the course of a year. If you want to lose weight, try to give up sweets as much as possible.

It is also necessary to take into account the fact that playing sports not only speeds up metabolism and metabolism, but also increases appetite. Trying to lose weight solely through regular workouts and fat-burning cardio, but not paying enough attention to your diet, you may even gain weight by increasing your appetite. Swimming especially increases your appetite.

Carbohydrates: the main cause of weight gain

Among other things, it is a mistake to consider fast carbohydrates solely as empty calories. Metabolism is designed in such a way that excess sugar calories are literally converted into fat and utilized by the body in fat depots as quickly as possible. If, along with an excess of carbohydrates, there is also an excess of fat in the diet, this can increase the level of cholesterol in the blood.

To combat obesity, it is important not only to carefully study the information on the glycemic index and the rate of absorption of carbohydrates, but also to limit the consumption of pure sugar as much as possible, giving up not only chocolate and sweets, but also fruit juices (including freshly squeezed) and even sweetened yoghurts. All these foods only provoke you to overeat.

How to change your lifestyle?

Unfortunately, there is no miracle method for losing excess weight. Surgeries and drug therapy are all just assistants on the path to weight loss that have a temporary effect. Obesity occurs due to consuming more calories than the body needs, and therefore the only treatment is to change this situation.

Lifestyle changes are based on two pillars: eating a sensible diet and increasing physical activity. Don’t try to start a new life “on Monday” - move towards your goal gradually, achieving new results every day.

Think and write what goals you need to achieve. Don't try to immediately lose weight to your ideal weight. At the first stage, try to reduce your weight by 5-10% of the original, remember that rapid weight loss is no less dangerous to health than obesity.

Nutrition.

Some tips to help you cope with obesity.

Try to eat more often. Yes, it sounds ambiguous, but the most favorable diet for the body is one that includes 3 main meals (breakfast, lunch, dinner) and two additional ones. Remember that your last meal should be at least 2 hours before bedtime. Nutritionists recommend consuming at least 1200 kcal per day. If you are used to eating more, reduce your daily caloric intake gradually.
Eat slowly and enjoy your food. The saturation signal takes about 15 minutes to reach the brain. The slower you eat, the less you will eat, because the signal of fullness will have time to arrive in time.
Drink enough water. The average fluid intake is eight glasses per day. Avoid sweet, carbonated drinks and soft drinks. Choose water with lemon, tea or coffee without sugar.
Your diet should contain approximately 30% fat, 55 - 60% carbohydrates and 15% protein. Be sure to eat green vegetables and fruits every day. Eating vegetables as a snack before the main course will help reduce the number of calories you eat.
Watch the calorie content of your foods. Please see the label for complete nutritional information. Try to eat as little food as possible that is high in fat and calories, that is, limit the amount of the following foods.

Products containing a lot of fat (including hidden fat).

Vegetable, ghee and butter, margarine, mayonnaise.
Sauces and gravies.
Nuts, sunflower seeds, olives.
Fatty fish and meat.
Smoked products, canned food (especially in oil).
Cream, sour cream, fatty varieties of cottage cheese and cheese (with a fat content of more than 30%, including processed cheeses, sweet cheeses, curd masses).
Sausages.

Foods containing easily digestible carbohydrates (that is, containing many calories).

Sugar and sugar-containing products: chocolates, pastries, cakes, creams, ice cream (also containing a lot of fat).
Dried fruits
Grapes, bananas

Choose foods rich in starch and fiber . These products include:

Bread and cereal products containing bran or made from whole grains
Durum wheat pasta
Grains
Fruits and vegetables

When cooking, give preference to the grill, microwave or barbecue, do not add fat or oil. Use non-stick cookware and cook in foil. Trim visible fat from meat, and do not eat the skin of poultry or fish.
Try to limit the amount of alcohol. Alcohol increases appetite, and, in addition, a lot of fatty and salty foods are eaten with alcohol.
Keep a food diary. Regardless of whether you work with a doctor or try to monitor your weight yourself, a food diary will help you assess the quantity and quality of what you eat per day. Write down everything you eat and at the time you eat it, even if it's candy you grabbed on the run. In addition, note your weight and physical activity there.
Think about it: do you always eat because you are hungry? Or do you eat away at troubles, anxiety and sadness? Or are you just having a snack for company? Try not to eat while watching TV.
What to choose if you come to a restaurant?
First, before going to a restaurant or visiting, have a light snack. Don't leave the house feeling hungry.
Order grilled, stewed, baked, boiled or barbecued dishes.
Avoid eating fried foods, crunchy foods, creamy or creamy sauces, cheese or cheese sauces. If you are not sure how a dish is prepared, ask the waiter. Please ask that the sauces be served separately. Give preference to boiled, stewed or grilled vegetables. To reduce portion size, you can order 2 types of appetizers instead of the main course. Take one dessert for two.
Ask for skim milk in your coffee. Choose low-calorie drinks: water, tomato juice, soda, drinks with sugar substitutes, low-calorie beer.
Take your time to eat the whole portion, eat slowly, enjoy your food.

Try to think through your diet in advance. When creating a menu, use the food pyramid.

Food group	Number of servings per day	Serving Size
Lean meat, poultry, fish and shellfish	170 g or less	—
products made from low-fat milk (up to 2.5% fat content)	2-3	1 cup milk 1 cup yogurt 28 g low-fat or low-fat cheese
Eggs	4 yolks per week	—
Fats and oils (including salad dressings and nuts)	6-8	1 tsp margarine or vegetable oil 1 tbsp. salad dressing 28 g nuts
Fruits	2-4	Whole fruit ½ cup chopped fruit ¾ cup fruit juice
Vegetables	3-5	1 cup leafy or raw vegetables ½ cup cooked vegetables Read also: How to preserve women's youth? Debunking myths about hormonal drugs ¾ cup vegetable juice
Bread, cereals, rice, pasta, dry peas and beans, grains, potatoes	6-11	1 slice of bread 28 g dry flakes ½ cup cooked group, dry peas or beans, potatoes, rice and other grains ½ cup tofu

Age-related hormonal changes

It is widely known that women aged 45-50 years begin menopause, characterized by changes in metabolism, sleep disturbances and even depression. However, few people know that similar age-related processes also apply to men, who, after 40-45 years, also begin andropause, leading to a gradual decrease in testosterone levels.

In turn, a decrease in testosterone levels leads not only to loss of muscle mass, but also provokes “female type” obesity, characterized by increased deposition of fat reserves on the hips and lower abdomen. It is also important that bad habits (primarily smoking and excessive alcohol consumption) bring the onset of this andropause closer.

Treatment

At every stage of a woman’s life, we are faced with such a complex pathological process as obesity. Currently, there are great opportunities for therapy, but in gynecological practice we often do not take into account the fact that in the treatment of almost all diseases accompanied by obesity, the main or first stage in the management of women should be weight reduction.

Treatment of obesity should be comprehensive. The main methods of therapy are:

patient education;
balanced hypo- and eucaloric nutrition;
exercise stress;
drug therapy;
surgery.

Only switching to a rational, balanced diet allows you to achieve stable loss of excess body weight. The use of drug therapy makes it easier to follow nutritional recommendations and promotes faster and more intense weight loss, and also helps maintain the results achieved and prevent relapse.

Drug therapy for obesity is needed in the same way as for any other chronic disease. It has now been established that it is impossible to cure obesity with medications, and therefore their prescription is of an auxiliary nature and is a complement to dietary and physiotherapeutic treatment methods. The main indications for drug treatment are formulated:

to make it easier to follow a diet;
as a temporary measure after the start of treatment in some patients with depression and patients with peptic ulcers who find it difficult to adhere to a diet;
in short courses with 6-month and one-year intervals, to maintain body weight after a relapse;
patients whose body weight has not decreased when using the diet.

According to the mechanism of action, drugs for the treatment of obesity can be divided into three groups:

reducing food intake (anorectics).
increasing energy expenditure (thermogenic sympathomimetics)
reducing the absorption of nutrients: Xenical (peripheral action)

Among the peripherally acting drugs for the treatment of obesity, orlistat 120 mg (Xenical) is currently used. The action of the drug Xenical is aimed at the key factor in obesity - dietary fats. Fats are broken down in the intestine into monoglycerides and fatty acids with the participation of pancreatic lipase, phospholipase and small intestinal juice lipase. An indispensable condition for ensuring normal absorption of fat is its emulsification in the small intestine - i.e. the formation of particles whose sizes do not exceed 0.5 microns, which corresponds to the distance between neighboring microvilli of enterocytes. The action of the drug Xenical is aimed at suppressing the activity of pancreatic and gastrointestinal lipases, as a result of which food fats remain undigested and cannot be absorbed through the intestinal wall, thus reducing their entry into the blood by 30%, which creates an energy deficit and promotes weight loss.

Despite the ease of diagnosing obesity, progress in prevention and treatment cannot yet be considered satisfactory. The usual recommendation “eat less and move more” is not able to radically help an obese patient.

Not every patient who consults a gynecologist about problems associated with menstrual and reproductive disorders complains of excess body weight. And not every gynecologist knows the methods of examining and treating such patients, despite the fact that treatment of any pathology must begin with reducing excess body weight, if any.

Healthcare in economically developed countries is just beginning to develop approaches to the treatment of obesity that meet modern ideas about the nature of this disease. The first steps taken in this direction are encouraging. However, we are at the very beginning of the journey. Apparently, the future lies in programs aimed at preventing obesity in society, in serious algorithms for diagnosing and treating this disease, and in new, pathogenetically based treatment methods.

The economic costs of treating obesity and its associated diseases are very high. This includes both direct costs to the health care system and indirect costs associated with reduced work capacity and disability caused by the disease. An analysis of data from more than 17,000 health care organization members in the United States found that direct health care costs increased in parallel with increases in body mass index. In developed countries, the direct cost of treating obesity accounts for 3 to 5% of all healthcare costs, and the cost of treating comorbidities in obese patients also depends on body mass index.

Thus, obesity is a global problem that requires not only attention from healthcare, but also consideration at the governmental level of every economically developed state and, first of all, from the standpoint of women’s reproductive health.

Despite the absence of an “ideal” anti-obesity drug on the modern pharmaceutical market, it is worth noting that the use of both drugs with a central mechanism of action and drugs with peripheral action is justified. Even G. Bray (1979) said that the “ideal” drug for the treatment of obesity should be safe and suitable for long-term use.

Since obesity is now generally recognized as a condition that threatens human health, and long-term non-surgical and non-drug treatments are lacking, there is a high need for effective pharmacological means of weight loss that would be sufficiently safe and could be used for a sufficiently long time.