Overweight and obesity. Obesity, or overweight syndrome. Diets for obesity

Obesity is called abnormal weight gain due to excess fat accumulation.

According to the World Health Organization (WHO), more than 1.9 billion people over the age of 18 (representing 39% of the world's adult population) are overweight. Of these, over 600 million people (13% of the population) are obese.

Obesity is a common problem in Russia: about 60% of adults in our country are overweight. 20-30% of our fellow citizens are obese. At the same time, according to opinion polls, only 51% of women and 38% of men see completeness in themselves.

A simple and reliable way to determine if you are overweight or obese is to calculate your body mass index (BMI). It shows the ratio of a person's body weight to his weight. For most adults, a BMI between 18.5 and 24.9 is considered normal. A BMI between 25 and 29.9 indicates overweight, and a BMI over 30 is considered obese. However, there are exceptions when BMI is not a reliable indicator.

Firstly, BMI cannot be used to calculate the normal body weight of a child, as the child's body is still developing. See your doctor to determine if your child is overweight. Secondly, the standard BMI indicators are calculated for representatives of the Caucasian race. The thresholds for overweight and obesity may differ across ethnicities. Finally, standard BMI scores are not suitable for people with well-developed muscles (eg weightlifters). Their body weight increases due to muscles, and not due to body fat. Therefore, BMI values refuse to be elevated.

More precisely, the presence of excess fat is determined around the waist. Normally, for men, the waist circumference should not exceed 94 cm, and for women - 80 cm. Extra centimeters at the waist increase the risk of diseases associated with obesity. Another indicator that is easy to determine on your own is hip circumference... You need to measure this value at the very top of the leg. After taking your measurements, calculate the ratio of your waist to your hips. Obesity is considered to be a result of 0.85 or more for women and 1.0 or more for men.

Based on how much body weight exceeds the norm, it is customary to distinguish several degrees of obesity:

obesity 1 degree- body weight exceeds standard indicators by no more than 29%, body mass index 30-34.9;
obesity grade 2- in the body from 30 to 49% excess fat, body mass index corresponds to the value of 35-39.9;
obesity grade 3- overweight is 50-99%, body mass index is more than 40.

Sometimes obesity grade 4 is also distinguished, when a person's weight is more than twice the norm.

With 1 and 2 degrees of obesity, excess weight, as a rule, causes only a cosmetic defect and does not impair the ability to work and well-being. Therefore, people from this group try to cope with the problem of obesity on their own, without resorting to the help of a doctor, are engaged in losing weight irregularly, inconsistently and often waste time. Obesity, which has reached 3 and even more so 4 degrees, is called morbid (from the Latin "morbus" - disease). That is, it causes serious disturbances in the work of the body, which are always manifested by a deterioration in health and the appearance of a whole "bunch" of diseases.

Obese people are often worried about high blood pressure (hypertension), pain and interruptions in the heart (angina pectoris), and the risk of rapid development of atherosclerosis and heart failure increases. Excess fat triggers the development of type 2 diabetes, which often goes hand in hand with obesity. Other accompanying complaints with excessive obesity are: sweating, fatigue, shortness of breath, pain and heaviness in the legs, prolonged constipation, menstrual irregularities and infertility, poor sleep and frequent colds.

At this stage, coping with obesity and related diseases is much more difficult. Therefore, it is necessary to seriously engage in treatment already with 1 and 2 degrees of obesity, and not perceive excess weight only as an aesthetic defect.

There is another classification, where obesity is divided into types:

Primary, alimentary-constitutional type of obesity- develops due to malnutrition and hereditary predisposition. The key to treating this type of obesity is diet and a healthy lifestyle.
Secondary type of obesity, usually associated with imbalance of hormones (dyshormonal obesity), brain diseases (cerebral obesity) or mental disorders. It is very difficult to lose weight with this type of obesity without treatment of the underlying disease.

It is customary to distinguish three types of fat deposition:

gynoid ("female" type of obesity, type "pear") fat deposition, mainly in the thighs and buttocks, is the most benign;
android ("male" type of obesity, type "apple") fat deposition mainly in the abdomen and internal organs, the most dangerous obesity, is often accompanied by various diseases;
mixed type of obesity.

Causes of obesity (overweight) in children and adults

Overeating and insufficient physical activity are usually the causes of obesity. If you eat a lot of sugary and fatty foods, but do not use the energy gained in sports and physical activity, the body will store most of this excess energy in the form of fat.

The energy value of foods is measured in kilocalories (kcal). On average, a man with an active lifestyle needs about 2,500 kcal per day to maintain a normal body weight, and a woman - 2,000 kcal. And, unfortunately, it is easier to exceed this norm than it seems. For example, a large hamburger, a serving of fries and a milkshake from a fast food restaurant can add up to 1,500 calories - and that's just one meal.

Improper diet is the main cause of obesity

Obesity cannot be earned in one day, it develops gradually, under the influence of improper nutrition. The main causes of obesity are:

frequent consumption of fast food and convenience foods rich in fats and sugar;
alcohol abuse - alcoholic beverages are very high in calories, and those who abuse them are often overweight;
eating out - in a restaurant, the atmosphere is conducive to ordering an additional snack or dessert, and the dishes themselves may contain more fat or sugar;
poor eating habits - if your family or friends eat large portions, you can get used to overeating from childhood;
abuse of sugary drinks - including soda and fruit juices;
“Problem seizing” is an attempt to cope with depression or low self-esteem by eating.

Bad eating habits are usually supported by all family members, so children get used to eating improperly from an early age, and then they suffer from overeating throughout their lives.

A sedentary lifestyle (physical inactivity) as a cause of excess weight

Another important factor leading to obesity is a sedentary lifestyle. Many of us spend most of our time at work sitting at a desk in front of a computer. We prefer to get around the city by private car or public transport, rather than by bicycle or on foot. Thus, during the working day from early morning until evening, we practically do not move, using every opportunity to sit down, and instead of stairs we use elevators.

In our free time, most of us watch TV, surf the Internet or play computer games. As a result, with a sedentary lifestyle, the energy entering the body with food is not spent entirely (since mental work burns much fewer calories than physical activity) and is stored as fat.

Meanwhile, normal-weight adults are advised to devote at least 150 minutes of moderate-intensity aerobic exercise every week, such as walking or cycling. It is not necessary to do one workout lasting 150 minutes, this time can be broken down into several workouts during the week. For example, 30 minutes a day for five days.

Heredity and obesity

There is an opinion that excess weight is inherited, but this is not entirely true. Indeed, there are genetic diseases associated with obesity, such as Prader-Willi syndrome. But they are extremely rare. Much more often the tendency to obesity is inherited, but not the disease itself. Families with a predisposition to be overweight may have some genetic characteristics - for example, increased appetite or a tendency to store fat quickly - that contribute to weight gain. It is more difficult for people with this hereditary burden to lose weight and maintain a normal body weight, but it is quite possible.

More often, familial obesity is more associated, for example, with bad eating habits learned in childhood: the tradition of watching TV, addiction to fatty and flour foods or sweets. If you abandon the established rules and start monitoring your own diet and diet, then it is quite possible to avoid the excess weight that other members of your family have.

Medical causes of obesity

In some cases, weight gain is due to a chronic condition, such as:

low thyroid activity (hypothyroidism) - when the thyroid gland does not produce enough hormones;
Itsenko-Cushing syndrome, a rare condition that causes an overproduction of steroid hormones.

Timely and effective treatment of these conditions helps to maintain a normal body weight.

Gaining extra pounds can be associated with certain medications, including hormones, drugs for epilepsy and diabetes, and certain medications prescribed for mental disorders, such as antidepressants and schizophrenia medications. Also, weight gain can be a side effect of smoking cessation.

Diets for obesity

There is no universal menu for obesity that would suit most people who want to lose weight. But if you are overweight, it is recommended to consume 600 kcal less per day than usual. To do this, it is best to replace unhealthy foods - for example, fast food, convenience foods, and sugar-containing drinks (including alcoholic ones) - with healthier ones.

Check the energy value of every food and drink that you consume so as not to exceed the daily requirement. In the menu of some restaurants and cafes, the calorie content of the dishes is sometimes indicated. Watch out for this when you are away from home, as it is easy to exceed your daily calorie requirement by eating certain foods such as hamburger, fried chicken, meat lasagne, or some Chinese food.

To meet the requirements of a healthy diet, the diet should be:

Balanced, that is, contain the amounts of proteins, fats, carbohydrates, vitamins and minerals necessary for health. The dietary rules should indicate when and how many times to eat, how to prepare it.
No strict restrictions, with a sufficient variety of permitted products.
Long-term, aimed at gradual weight loss, and not at a quick result, which is unlikely to be sustained.

Avoid diets that recommend unhealthy practices, such as fasting (abstaining from food for a long time) or cutting out entire food groups. Such methods of losing weight can lead to poor health and do not give long-term results, since they do not instill healthy eating habits. But this does not mean that any popular weight loss programs are harmful. Many of them are developed based on proven medical and scientific principles and help some people.

Diet number 8 for obesity

Diet No. 8 for obesity is a low-calorie menu in which the proportion of simple carbohydrates (glucose, fructose, sucrose), fats, especially animal origin, is reduced, and the amount of protein remains normal. Dishes are steamed, baked or boiled. Instead of sugar, substitutes are used; during cooking, food is not salted and spices are not used. It is recommended to take food in small portions, 5-6 times a day.

Wheat bread is made from wholemeal flour, and rye bread is limited. Butter baked goods, puff pastry, cookies are excluded from the diet.
Lean meat and fish, as well as aspic (jellied meat). Avoid the use of sausages, smoked meats, fish caviar, salty meats and fish.
Eggs in any form.
Low-fat dairy products.
Of oils and fats, butter and vegetable oil can be used to a limited extent. Excludes animal fats: lard, cooking oil, etc.
Buckwheat and pearl barley are recommended. The rest of the grains, as well as pasta and legumes, should be limited or excluded.
Vegetables in any form, except pickled and salted. You can eat some sauerkraut.
Potato, pasta, cereal, dairy and legume soups should be excluded from soups: pea, lentil, etc.
From fruits and sweets, diet number 8 restricts the use of: watermelons, grapes, raisins, figs, dates, honey, jam, ice cream, sweets, sugar and jelly.
All appetite-enhancing sauces, spices, and dressings, including mayonnaise, are excluded.
Prohibited drinks for obesity are sweet juices, cocoa, sweet kvass, carbonated water with natural sugar.

The main diet for diet number 8 consists of 100-110 g of protein, 80-90 g of fat and 120-150 g of carbohydrates per day. The energy value of such a diet is 1600-1850 kcal / day. For a healthy adult, this is enough to lose weight without much physical exertion.

Very low calorie diets

A low-calorie diet means consuming less than 1000 kcal per day. Such extreme nutrition allows you to quickly lose weight, but it is not safe for your health. Therefore, a very low-calorie diet is used only as a last resort, when obesity causes severe complications, and rapid weight loss is required. It is generally not recommended to follow such a diet for more than 12 consecutive weeks, and can only be followed under the supervision of a qualified professional.

To learn more about dieting and losing weight, read the following articles in the Tips section of our website:

Anorexia, bulimia, and other eating disorders

How to treat obesity with exercise

Reducing your daily calorie intake will allow you to lose weight, but in order not to regain it, you need to combine your diet with regular exercise. An exercise therapy doctor or fitness specialist can create an individual training plan that includes several hours of moderate-intensity physical activity per week. With moderate physical exertion, the pulse and breathing become more frequent, sweating is stimulated, but at the same time, a person can maintain a conversation without stumbling. Such activities include:

fast walk;
jogging;
swimming;
tennis;
walking on a stepper (or other similar simulator) in the gym.

Choose an activity you like so you don't want to quit your workout. Start exercising gradually. For example, start doing 15-20 minutes of exercise 5 times a week and then increase that time. For adults of normal body weight, it is beneficial to devote at least 150 minutes of moderate-intensity exercise each week. If you are obese, you may need to exercise harder. In most cases, it is recommended that you devote up to five hours a week to training.

Obesity treatment with surgery

The field of medicine called bariatric surgery deals with the surgical treatment of obesity. The question of radical intervention in the body is raised only with a very high body weight - morbid obesity (obesity grade 3), when the BMI is 40 and above. An indication for surgery is also a BMI of 35 or higher in conjunction with a serious illness that can be relieved by losing weight, for example, type 2 diabetes mellitus, obstructive sleep apnea syndrome or high blood pressure.

Unfortunately, in our country, surgical treatment of obesity is not included in the list of types of medical care that is free of charge under the compulsory medical insurance scheme. However, many clinics have vast experience in bariatric surgery and offer their clients several types of surgical interventions, which are selected depending on the individual characteristics and preferences of the patient.

The most common surgeries to treat obesity are:

installation of an intragastric balloon (a silicone ball that allows you to feel full when taking a small portion of food);
gastric banding (the imposition of an adjustable ring on the upper part of the stomach, dividing the organ into two parts and allowing you to feel full when the upper part of the stomach is filled with food);
Gastric bypass (creating a small reservoir in the upper stomach and bypassing the small intestine)
sleeve gastrectomy (giving the stomach the shape of a uniformly narrowed tube by cutting off most of it).

All these operations are performed laparoscopically, that is, without large incisions in the abdomen, by endoscopic manipulations through several openings in the anterior abdominal wall and navel.

In rare cases, bariatric surgery is indicated as the first treatment if your BMI is 50 or higher.

Obesity treatment in children

Very often, parents do not notice obesity in their children, so it is important to listen to the opinion of the pediatrician, who regularly examines and weighs your child. The treatment of obesity in children follows the same principles as the treatment of adults - limiting calorie intake and exercising regularly. The number of calories a child should consume per day depends on their age and height. Talk to your doctor about this.

Ideally, your child should devote at least an hour a day to moderate-intensity physical activity, such as playing football or volleyball. Passive activities such as watching TV or playing computer games should be no more than two hours a day (14 hours a week).

Orlistat is rarely prescribed for childhood obesity - for example, with a high degree of obesity or the development of diseases associated with excess weight. In world medical practice, there are cases when bariatric surgeries for weight loss were performed to treat obesity in children, but in most countries (including Russia) such interventions are prohibited until the age of 18.

6 rules to combat obesity

Set realistic goals. Loss of 3% of body weight significantly reduces the risk of complications from obesity.
Eat more slowly and keep track of what you eat and when you eat. Never satisfy your hunger while sitting in front of the TV.
Avoid situations that can trigger overeating.
Get the support of friends and family to motivate you to lose weight.
Track your progress, such as weighing yourself regularly and writing down your weight in a diary.
If necessary, seek help from a psychologist who can change your attitude towards food and build confidence in yourself.

Why is obesity dangerous?

Obesity not only spoils the appearance and creates difficulties in everyday life, but also increases the risk of developing many serious diseases.

Obese people often suffer from:

feeling short of breath (shortness of breath);
increased sweating;
snoring;
difficulties with normal physical activity;
frequent fatigue;
joint and back pain;
self-doubt and low self-esteem;
feelings of loneliness.

Certain physical problems caused by obesity can also affect relationships with family and friends, and sometimes lead to depression.

Being overweight increases the risk of disease

Obesity increases the likelihood of developing potentially serious illnesses, including the following:

type 2 diabetes mellitus;
increased cholesterol levels and atherosclerosis (narrowing of the arteries due to fatty deposits), which can cause coronary heart disease and stroke;
bronchial asthma;
pregnancy complications such as gestational diabetes and preeclampsia (a potentially dangerous increase in blood pressure during pregnancy).

On average, being overweight reduces life expectancy by 3-10 years, depending on the degree of obesity.

Which doctor should I contact for obesity?

If you are overweight or obese, be sure to talk to your doctor about safe weight loss methods and possible complications that may be caused by being overweight. Obesity is usually diagnosed by a general practitioner or family doctor. If necessary, he can refer you to narrow specialists dealing with the diagnosis of the causes and complications of obesity:

to a cardiologist (since obesity is often accompanied by hypertension and atherosclerosis);
to an endocrinologist (since people with obesity often have impaired glucose tolerance and type 2 diabetes mellitus, and overweight itself may be the cause of a violation of the production of certain hormones);
to a gynecologist (in some cases, the development of obesity may be associated with polycystic ovary syndrome);
see a dietitian (this doctor specializes in proper nutrition, he will help you choose an adequate diet for weight loss).

You can find these specialists by clicking on the links indicated.

On the Napopravku.com service, you can find weight loss medical centers that use a combination of psychological and nutritional methods to combat obesity, and also offer a system of exercise to promote weight loss. In addition, there are paid departments of hospitals and specialized centers where obesity is treated with surgery - bariatric clinics.

Localization and translation prepared by Napopravku.ru. NHS Choices provided the original content for free. It is available from www.nhs.uk. NHS Choices has not reviewed, and takes no responsibility for, the localization or translation of its original content

All materials on the site have been checked by doctors. However, even the most reliable article does not allow taking into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only supplements it. The articles have been prepared for informational purposes only and are of a recommendatory nature.

In the modern world, unlike in Ancient Greece, where stigma meant a mark or stigma on the body of a slave or criminal, the concept of stigma means a feature that is at odds with generally accepted norms or stereotypes attributed to an individual or group and, therefore, undesirable. But such a feature as the presence of objectively overweight continues to make a person, possessing it, a "slave" of their bad habits and a "criminal" in the eyes of society.

The dominant aesthetic, social and cultural values play a key role in stigmatization, since they form a system of values and reinforce the prevailing stereotypes of assessments for individuals. Theoretically, stigmatization as a social phenomenon has been well studied, starting with the classic work of E. Goffman "Stigma", within the framework of humanistic sociology, symbolic interactionism, the concept of social exchange, and the theory of social construction of reality have contributed.

Russian sociologists Lipai T.P., Mamedov A.K. define stigma as “an attribute of a social nature that indicates an insufficiently high status of an individual or a group of individuals. The very presence of stigma is regarded by others as a kind of vice, and the carrier of stigma, deserving of censure and even punishment. " Stigma strikes at the core of an individual's identity, as stigmatized people are forced to perceive messages addressed to them as derogatory, offensive and agree with such labels of public opinion or deliberately reject the process of stigmatization, challenging imposed stereotypes. Thus, expressed negative labels significantly change the individual's understanding of himself, his social identity and lead to self-stigmatization, when not only society is biased towards a person who has certain external differences, but also a person ascribes to himself certain negative qualities based on personal perception of social standards. ... Self-stigmatization with overweight is a series of prohibitions and restrictions associated with social activity that overweight people impose on their own lives, with a sense of inferiority and social failure. Stigma and self-stigmatization significantly affect the social functioning and quality of life of overweight and obese individuals. Stigmatization is primary, self-stigmatization is secondary, these are the consequences of stigmatization.

The problem of stigma in the aspect of socio-economic inequality in relation to obese people was previously discussed by us, we also described specific discriminatory practices, such as: additional charges for air travel, increased health insurance, additional taxes, fines and layoffs for being overweight. The deepening in modern culture the consolidation of the stereotype of the identification of an individual with a certain type of personality, in relation to a slender, fit body-canon, leads to the fact that overweight people continue to remain objects for public and, even worse, medical stigmatization, the consequences of which are social marking and various forms of discrimination against obese people.

The actualization of the problem of stigmatization occurs as this deviation from generally accepted norms spreads throughout the world, against the background of the growing obesity epidemic among children and adolescents, which makes it a serious multifaceted problem of the society of the future. The main reason for the pathological weight gain is considered to be an improper lifestyle, the main components of which are inappropriate nutrition and physical inactivity, which is the basis of the most common social stigma: "All fat are lazy gluttons."

In 1968, American film director, comedian and writer Woody Allen wrote a humorous story "Notes of a Glutton", which merged the impressions of the read "Notes from the Underground" by F.M. Dostoevsky and the magazine "Weight Watchers" 7, new for those times, as well as a new, exotic problem of excess weight. The hero of this story explains his appetite by the fact that there is God in all products:

"The more I eat, the closer I will be to Him." And if V. Allen in 1968 the problem of excess weight seemed outrageously far from reality, which gave rise to a text that raises the problem of gluttony to the question of God, then during the global epidemic of obesity, this story takes on a satirical character, exposing the problem of self-search of alleged important reasons for preserving the wrong image life.

Do not forget about the existence of real causes of obesity associated with endocrine system disorders and metabolic disorders. However, the role of these factors in the development of overweight is assessed differently by society and a particular individual. In connection with the development of the aforementioned stigma, society often does not consider a possible organic pathology as a trigger mechanism in the genesis of obesity, while many overweight people turn to an endocrinologist with the conviction that they have any disorders of the hormonal function of the endocrine glands, leading to violation of the metabolic processes of the body. You can often hear: "I eat the same way as usual, but I am gaining weight" or "I do not eat anything at all and do not lose weight." Self-stigmatization of the type: "I am sick and therefore I am fat" - has a psychological defensive nature, allowing to justify the behavior leading to "excess" weight.

Pathological biochemical and hormonal changes in the body revealed during the examination are in most cases of a secondary nature, that is, they are not a cause, but a consequence of obesity, which requires medical intervention along with a prerequisite for lifestyle modification. Often, one weight correction is enough to ease the course or even eliminate all the components. 7 "Weight Watchers" is the magazine of an international company headquartered in the United States that sells products, as well as various services and programs for weight loss. The established Russian translation of "Diet", we consider inaccurate, "Weight Watchers" or "Weight Watchers" more accurately reflects the direction of activity. Founded in 1963, it has branches in many countries of the world, according to some estimates, since the inception of the organization, about 15 million people have used its services. metabolic syndrome. However, social and personal factors have a significant impact on the effectiveness of non-drug treatments.

We tried to isolate and systematize the content of the most typical statements of people with overweight and obesity - patients of an endocrinologist, characterizing the process of self-stigmatization:

1) the position of denying the problem of overweight or obesity, self-acceptance: “My weight suits me”, “I have always been like this and feel great”, “My wife loves me anyway”, “I’m just getting old,“ crawled away ”with over the years "," I have two (three) children, for a woman giving birth this is normal weight "," I do not have excess body weight, these are heavy (wide) bones "," I am all swollen, this is not fat, but fluid retention "and the like;

2) the fight against social stereotypes in relation to overweight people: “There should be a lot of good people”, “Fat people are kind and cheerful, but thin people are evil and gloomy”, “Whoever doesn’t like my appearance is their problem”, etc. ;

3) the presence of objective and subjective obstacles to losing weight: "This is my hereditary", "My excess weight is the result of an illness (metabolic disorders, hormonal disorders)", "I am too busy, I work a lot to monitor my diet (cook , eat regularly, play sports), “Healthy products are very expensive (tasteless)”, “I have a family, I have to feed my husband and children, I cannot eat separately from my family - it requires a lot of time and money”; “There is no gym or swimming pool near my house”, “The gym is an expensive pleasure”, “The equipment in the gym is designed for less weight, which means I cannot walk on the treadmill”, “They tell me that I will not be thin , “I don’t want the skin to sag,” “If I lose weight, I will have nothing to wear, and it’s expensive to change my wardrobe,” etc .;

4) lowering your own capabilities, confidence in your powerlessness in the fight against excess weight: "I have already tried everything (diets, fasting, exercise) - everything is useless", "I cannot play sports, I have shortness of breath, the joints of my legs are hard", “I need to dump too much, I can't, so I won't even start”, “I can't live without sweets”, “I can't deny myself anything, food is my only pleasure”, “This is my wife fed her, all conversations with her about healthy eating are meaningless ”, etc .;

5) social discrimination (real or imaginary): “Only beautiful and slender ones are engaged in the gym, there is no place for fat men - they will laugh at me”, “I was denied employment because I’m fat”, “I cannot dress fashionably - fashionable the industry is designed only for the thin ",

“I cannot work in a company, an organization where only thin people work, because they treat me negatively”, “I am not happy in my personal life, I can’t please anyone”, “I am only friends with fat people, they are me understand better "and the like;

6) fear of justifying social stigma: “I don’t want to be branded as a glutton, I don’t eat in the presence of my colleagues”, “I eat little in public”, “When visiting, I always leave food on my plate”, “In society, I lead an active lifestyle, because I don’t want to be considered lazy, lethargic ”and so on.

We believe that we can talk about the presence of two groups of elements that make up the phenomenon of self-stigmatization of overweight people - frustrating and protective. The first elements are called frustrating, since they reflect the mental state of the individual, which is revealed in a kind of complex of negative experiences and behavioral reactions (dissatisfaction with one's body, self-doubt, fear of negative assessments, anger, feelings of guilt, shame, hopelessness, etc.), which forms readiness to accept the category of overweight people as unworthy in many ways, weak-willed, ugly, lazy, along with self-alienation in the personal sphere and in the sphere of deep emotions. The second group of elements is called defensive because the individual is viewed from the standpoint of the ability to adapt, test by reality, these are mental and practical processes through which people overcome internal and external conflicts, namely: denial of the presence of a problem or an attempt to resist it, to fight social stereotypes, self-identification with the category of overweight and acceptance of oneself in the social sphere, agreement with socio-economic inequality and professional limitations, justification of refusal from social activity by the presence of the problem of overweight, etc. The first group of structural elements of self-stigmatization destabilizes the self-concept, reducing self-esteem, the second, on the contrary, increases self-esteem, prevents frustrating situations in which the individual's failure can manifest itself.

The initial stage of stigmatization can be a source of positive personality transformations, in particular, contribute to the development of motivation for losing weight. But in general, the stigmatization of people with overweight and obesity is negative, this is a problem that cannot be solved only by medical or only social means, it, as we see it, can be effectively considered in the categorical field of the sociology of medicine, but for this it must be defragmented and studied in stages, the criterion of measuring procedures in this case can be an indicator of the quality of life. One cannot do without a special study of the phenomenon of self-stigmatization - both as a reflection of social status and as a self-reflection of clinical status, also recorded in indicators of the quality of life, which may well be realized with the help of certain questionnaires in the framework of specific sociological studies. of various types, will reduce the relevance of many social and personal problems of obese patients and increase the compliance of therapeutic interventions, which ultimately helps to improve the social functioning and quality of life of obese people.

Bibliography

1. Goffman, E. Stigma: Notes on the Management of Spoiled Identity / E. Goffman. - New York: Prentice-Hall, 1963.

2. Allen V. Notes of a city neurotic, a little bespectacled Jew who stopped writing in time. St. Petersburg. Symposium Publishing House, 2002.

3. Barkovskaya A.Yu., Protashik D.V. Social inequality in the aspect of corporality. "Modern problems of medicine: theory and practice": materials of the international correspondence scientific and practical conference (05 November 2012) - Novosibirsk: Publishing house. "Siberian Association of Consultants", 2012. - 72 p. S. 52-58.

4. Barkovskaya A.Yu., Protashik D.V. Social causes of overweight and obesity in the growing generation of Russians. Sociology of Medicine - Health Care Reform. Scientific works of the IV All-Russian Scientific and Practical Conference (with international participation), October 3-4, 2013, Volgograd. - Volgograd: Volgograd State Medical University Publishing House, 2013 .-- 264 p. S. 139-145.

5. Gulina M.A. Dictionary Handbook of Social Work, 2010

6. Lipai T.P., Mamedov A.K. Stigma as a social phenomenon (research methodology). Electronic scientific publication "Actual innovative research: science and practice", 2011, No. 1.

Obesity is a chronic disease characterized by an increase in body weight due to excessive accumulation of adipose tissue. Obesity at any age. It leads to higher mortality rates as well as higher rates of common diseases.

In the civilized world, this disease becomes an epidemic. The negative consequences of obesity are no longer a problem for the individual. They wreak havoc on society, economy and demography.

Reasons for the appearance of excess weight

In the emergence and development of obesity, the main role belongs to the following factors:

heredity;
demography (age, gender, ethnic group);
socio-economic well-being of society (level of education, professional affiliation, marital status);
psychological aspect;
lifestyle and behavior (food, physical activity, alcohol, smoking, stress).

The main ones are violation of nutritional norms, the use of fatty foods and insufficient physical activity. An important role is played by a change in the lifestyle of a modern person, his reduced physical activity, which does not correspond to the number of calories consumed. The excess is stored as fat.

There are other causes of obesity:

excessive intake of carbohydrate foods;
violation of the endocrine system;
insufficient or inadequate sleep;
damage to the brain (areas responsible for eating behavior);
some medications (hormonal and psychotropic).

Very often the reasons are psychological. Many people start to eat more when they are stressed or anxious. Bad mood, sadness and family instability also require positive emotions, which a person tries to compensate with food. The habit of eating in front of the TV leads to overeating.

The risk of weight gain increases with age. This is caused by age-related disorders of the hormonal background, the brain and internal organs.

Determining the types of obesity

There are several ways to classify excess weight. can be determined:

by body mass index (BMI) - to find it, you need to divide the body weight in kilograms by the height in meters squared;
localization of body fat;
by the mechanism of occurrence and reasons.

Body mass index and its features

It is easy to determine the indicator using this formula. Depending on the result, several types of obesity are distinguished - types:

low - the index is less than 18.5. It is characterized by a deficiency in body weight and the likelihood of pathologies in the body;
average - the index falls within the range of 18.5-24.9. Ideal body weight, minimum mortality and disease rates;
increased - an index of 25.0–29.9. Pre-obesity. Exceeding the norm of body weight;
high BMI - from 30.0 to 34.9 (1 degree of obesity);
very high - index 35.0–39.9 ();
excessively high - from 40 and above (3 and 4 degrees of obesity).

If the BMI is above 30, then the consequences of obesity become threatening to health and life. Medical intervention is required: examination and treatment according to an individual program.

Localization of body fat

This classification takes into account the anatomical features of the body. On this basis, the following types of obesity are determined:

(android, upper or male) - fat accumulates in the upper half of the body, on the belly. More typical for men. The most dangerous type of obesity: the risk of hypertension, diabetes, stroke, heart attack. The figure is in the shape of an apple;
lower (gynoid, femoral-gluteal). The figure is a pear. The gynoid type of obesity is mainly found in women. Joints, spine, veins suffer;
mixed (intermediate) - fat deposits are evenly distributed throughout the body.

Mechanism of occurrence

Obesity characterizes a combination of reasons that provoked the onset of the disease:

primary (alimentary, or simple) - an excess of calories in the diet with low energy consumption. Carbohydrate and animal foods, occasional overeating meals, nighttime snacks. Genetics plays an important role. And physical inactivity reduces the ability to break down fats;
secondary (symptomatic or) - associated with serious hereditary syndromes and diseases: there may be brain tumors, systemic diseases, infectious, mental, traumatic brain injuries;
endocrine - dysfunction of the endocrine glands: hypothyroidism, hyperinsulinism, hypogonadism.

With hypothalamic obesity, appetite is increased, especially after dinner, at night, thirsty. In women, infertility, increased hair growth, and a violation of the cycle occur. In men - a violation of potency.

Causes of female obesity

Women usually have gynoid obesity. The female hormone estrogen causes fat to be stored in the thighs and lower legs. On the one hand, it serves as the body's defense mechanism against hunger. On the other hand, it serves to protect the fetus and provide the body with energy during childbearing and breastfeeding. Therefore, at first, the face, arms, chest, abdomen lose weight, and only after that - the lower body.

There are the following causes of obesity in women:

genetic predisposition;
hypodynamia;
excess saturated fatty acids in the diet.

Scientists have proven that there is a gene responsible for the accumulation of excess body fat. In ancient times, excess fat served to protect against hunger and weather changes. With the course of evolution, the need for this has disappeared, but the gene exists and performs its task.

Lack of the required amount of physical activity reduces the sensitivity of cells to insulin. This increases the production of triglycerides, that is, fats. There is a lot of insulin in the body, but it cannot penetrate into the cell. Type 2 diabetes mellitus develops.

Excess consumption of fatty foods suppresses the production of lipoproteins, which causes an increase in blood cholesterol levels. This leads, in addition to the accumulation of fat in the body, to problems of the heart, blood vessels, atherosclerosis.

In addition, excess weight in women is caused by hormone disorders. Especially during menopause.

Mechanisms of the appearance of gynoid obesity

Female obesity - fat accumulates in the lower body: thighs, buttocks and legs. Such obesity occurs in women with a pear-shaped figure. Appears with increased production of female hormones. Sometimes gynoid obesity occurs in men with low levels of the male hormone testosterone.

Concomitant diseases of this type of obesity:

haemorrhoids;
arthrosis;
arthritis;
disorders of the venous system;
phlebeurysm;
cellulite.

This type of obesity is more difficult to reduce. Complex methods are used: diet and exercise for the lower body, running, cycling, massage of problem areas.

With such obesity, metabolism accelerates in the evening, so dinner should be hearty. But no later than 2-3 hours before bedtime. Breakfast should be one fifth of the diet, lunch one third, dinner 40% and two snacks during the day.

In order to prevent this disease, it is necessary to monitor the quality of food:

eliminate artificial fats;
give up sweets, muffins, white bread;
do not take caffeinated drinks, alcohol.

You need to eat vegetables and fruits, coarse bread, cereals, lean meat, fish, dairy products. Add bran to food.

The gynoid type is considered not as dangerous as the others. But it is also not the norm. The consequences of this type of obesity can be the most negative.

This type has spread over the last 10 years. In his case, the fat is evenly distributed throughout the body. At first glance, overweight is not particularly noticeable. The hormonal background is normal. The main cause of mixed obesity is fluid accumulation.

But you should not limit its consumption, otherwise it will accumulate even more. You need to drink up to 2 liters per day. Eat less salt.

The metabolism is the same throughout the day. Therefore, you need to eat 4-5 times a day. Divide the entire diet into 4 parts: breakfast, lunch, dinner make up a quarter of the diet, two snacks - 1/4 of the main meal.

Obesity symptoms

First of all, a person has psychological problems: dissatisfaction with his appearance grows, self-esteem decreases, and communication difficulties appear. But being overweight is not only a cosmetic defect, it also has physical problems:

decreased performance;
dyspnea;
hypertension;
increased body weight;
diseases of the heart and blood vessels;
decreased quality of sex life;
constipation;
joint diseases.

Health problems worsen over time. An almost inevitable companion to obesity is type 2 diabetes.

There may be no special complaints about the state of health in obesity of 1 and 2 degrees. But with a higher degree, alarming symptoms appear:

weakness;
sweating;
drowsiness;
irritability;
nervousness;
swelling;
pain in the legs and spine.

At stages 3-4, pathologies appear:

heart and blood vessels: hypertension, tachycardia;
respiratory system - respiratory failure;
Gastrointestinal tract - liver dysfunctions, cholecystitis, pancreatitis;
joints and spine, knee pain;
menstrual cycle, amenorrhea;
skin diseases: boils and eczema as a result of excessive sweating; striae (stretch marks) on the abdomen, thighs, hyperpigmentation of the elbows, neck and other places of friction.

To determine your risk of diabetes and cardiovascular disease at home, you can measure your waist to hip ratio. If a woman has more than 0.85, then the risk of complications of obesity is high. This value for men is 1.

How to define obesity?

First of all, the doctor visually determines the excess body weight, and then the following points are examined:

anamnesis;
hereditary predisposition;
maximum and minimum weight after 20 years;
the occurrence and duration of obesity;
eating habits and lifestyle;
the presence of common diseases.

The indices of body mass (BMI) and ideal body mass (MI) are calculated.

The type of obesity is determined by dividing the waist circumference by the hip circumference. When in women this ratio is more than 0.8, then abdominal obesity is present. For men, this figure is more than 1.

Determine the degree of accumulation of subcutaneous fat - along the skin fold in several places of the body.

The most accurate methods for determining the degree of obesity: ultrasound, computed tomography, MRI, X-ray.

With the help of special programs, the following are carried out:

bioimpedance examination - determination of the amount of fat, muscle mass and water in the body;
densitometry - examines the ratio of bone, adipose, muscle tissue, the distribution of adipose tissue throughout the body.

The doctor prescribes studies and tests to identify disorders caused by obesity:

detection of arterial hypertension;
identification of type 2 diabetes mellitus: glucose tolerance and hypoglycemic profile;
cholesterol, lipoprotein, triglyceride levels;
identification of violations of the cardiovascular system, ECG, ECHOKG;
biochemical blood test: detecting the level of uric acid.

To independently determine obesity at the initial stage, you need to measure your waist. If for women this figure is more than 80 cm, then it's time to sound the alarm. In men, the waist should normally be no more than 95 cm.

Consequences of the disease

With an increase in body weight in a person, psychological problems caused by difficulties in personal and social life, the inability to build a career are aggravated. It has been proven that overweight women earn less than their slender counterparts for the same job.

If left untreated, the consequences of obesity can be fatal. Obesity in all cases ends with the appearance of chronic diseases:

type 2 diabetes;
Ischemic heart disease (ischemic heart disease);
hypertension, angina pectoris;
stroke.

Heart failure often leads to heart attacks. Apnea is observed during sleep.

All organs of the gastrointestinal tract are affected, heartburn is observed after eating. Osteoarthritis, arthritis, osteochondrosis and other disorders of the musculoskeletal system.

Metabolic disorders lead to decreased fertility and libido, menstrual irregularities, polycystic ovary disease.

The risk of breast cancer, female organs, prostate cancer, and colon cancer increases. The probability of sudden death increases several times. For example, in men from 16 to 68 years old, with an excess of body weight by 20%, mortality increases by 3 times.

There is a very serious complication of obesity. This is its extreme degree, when the weight is so high that the person is unable to move and maintain himself. It's called .

How is obesity treated?

Before you start fighting the disease, you need to understand what obesity is and what are the reasons for its occurrence. In the victory over excess weight, motivation remains the main one. Each patient finds his own motives: increasing visual attractiveness, reducing health risks, improving the quality of life, the ability to wear beautiful fashionable clothes.

Medical treatment includes:

weight loss;
treatment of concomitant diseases;
elimination of interacting risk factors;
maintaining the achieved body weight;
prevention of subsequent weight gain.

There are many types of therapy in the fight against obesity, but only the doctor chooses them. First of all, diet and exercise are prescribed.

Obesity treatment methods:

non-drug - teaching the patient, changing the way of life;
medication (pills and means for weight loss) - used with a BMI of more than 30, with the ineffectiveness of other methods and means;
surgical - with massive obesity (BMI more than 35-40), as well as in the absence of success in conservative treatment.

In the diet, it is necessary to limit fatty, starchy foods and sweets. Salt, sugar, alcohol are strictly prohibited. And also it is necessary to refuse ready-made sauces such as ketchup and mayonnaise. Canned foods are also banned. Meals should be fractional, with inclusions of fruits and vegetables. And also it is necessary to remember about vitamins and minerals.

What results can you achieve?

If you do not start the disease and start fighting obesity in time, you can achieve good results. Even with a 10% decrease in weight, mortality from diabetes is reduced by 3 times, from cardiovascular diseases - 5 times, oncology - by 40%.

At 1 and 2 degrees of obesity, most patients live and work fully. At grade 3, a disability of group 3 is assigned.

You can't lose weight too quickly. Weight loss of 4–5 kg per month is considered normal. But people with higher weight can lose more pounds without harming their health.

Losing weight too quickly causes:

metabolic disease;
problems in the liver, kidneys, brain;
pressure surges are observed;
the skin is saggy and unattractive.

Prevention of obesity

Physical activity is the main factor in maintaining a healthy weight. Moderate physical activity should be present. You should consume more energy than you get from food. If there is a predisposition to being overweight, it is necessary to limit carbohydrates and fats by increasing the amount of proteins and plant foods.

At normal weight, proteins should make up 15% of the total diet, fats - from 15 to 35%, the rest - carbohydrates. Most of the carbohydrates should be obtained from vegetables, fruits, and cereals. These are slow carbohydrates. And fast carbohydrates (sugar, white bread, sweets) should be minimized.

Sports, swimming, jogging should become an indispensable attribute of a healthy lifestyle and the fight against excess weight. And also it is necessary to regularly undergo examinations and professional examinations.

Eat more vitamins A, C, E, group B, chromium, manganese, molybdenum, iodine.

Good sleep is of great importance to us. Scientists have shown that chronic lack of sleep in 100% of cases leads to weight gain and type 2 diabetes.

Obesity is a chronic disease. Even a cure does not guarantee a complete and final recovery. What does obesity lead to? The disease is recurrent. Therefore, the patient must be under constant medical supervision. A visit to an endocrinologist, neurologist, nutritionist and psychologist is becoming a prerequisite for maintaining health and stable weight.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Reasons for the appearance of excess weight

Doctors are confident that the main causes of obesity are associated with genetic and endocrine disorders and heredity. Nutritionists, in response, declare that an innate predisposition to excess weight will not manifest itself if a person is taught and eaten right from childhood. Psychologists say that being overweight is a consequence of stress and dislike for your own body.

If the participant decides to ignore tradition, then he will certainly meet with condemnation and resistance from others. By changing the eating behavior, the participant unwittingly forces others to adjust their diet, which they clearly did not plan.

Lack of understanding and support in the family circle, friends complicates the achievement of the goal, and sometimes stops a person halfway to losing excess weight.

Food habits

The harm of eating habits imposed by the Western lifestyle is known to people, but it is not so easy to change habitual behavior. It seems that the crazy pace of life, the busy work schedule, the hustle and bustle and stressful situations should contribute to weight loss. As a result, another risk factor for the development of obesity arises. Pay attention to the list of habits that do nothing good for people, but harm the body and figure.

People have forgotten how to eat breakfast. Breakfast is the main boost of energy. In the morning, a person should consume at least 400 kilocalories for normal health. I didn't have breakfast in the morning - you finish eating on the go, quickly and a lot, or you eat up for the whole day with a hearty dinner.

Eat poor quality food. Delicacies, sweets, smoked meats, fast food - food rich in flavorings, carbohydrates, calories. Nutrients - zero, one harm to the body. Lack of fruits, vegetables and interfere with the synthesis of good cholesterol and the elimination of bad cholesterol.

Eat in large portions. Nutritionists recommend placing a portion on a plate that fits on two palms. People are able to eat 2-3-4 times more food, but the body will assimilate and process only the first portion into energy, and subcutaneous fat is formed from excess food.

They eat and watch TV. While eating, you need to look at the food, and listen to your own stomach in order to receive the signal from the body in time: "I am full!" The TV occupies the brain with unnecessary information, so there is no control over the saturation process. And a conditioned reflex is also developed: the TV turned on - salivation began to flow, an urgent need to make a sandwich.

Chew gum. Chewing gum contains carbohydrates, in addition, chewing gum on an empty stomach provokes gastritis and other gastrointestinal diseases. As a result, digestion and metabolism are disturbed.

They forget. Water is an indispensable solvent for digestion. You need to drink two liters of clean water at room temperature per day. No tea, no soda, no juices - plain water.

Lack of physical activity

The era of a sedentary lifestyle has come for a person. We work while sitting, driving while sitting, eating while sitting, watching TV or sitting at a computer, sitting with friends in a cafe ... Lack of physical activity is a major risk factor for overweight and obesity. Being active and athletic is good for both the appearance and the health of the whole body.

A person needs healthy physical activity, at least 60 minutes of daily exercise: running, jumping on, swimming, regular morning exercises.

Sleep problems

Chronic sleep problems lead to depletion of the body. A person who does not get enough sleep feels sluggish, not ready for vigorous activity. Instinctively, the body looks for a source of additional energy and finds it in food. In addition, fatigue reduces the level of protein, which is responsible for the regulation of appetite, slows down the metabolism. No matter how much a person eats, the body's energy reserves will not be replenished. Calories burn slowly, hunger continues to torment.

Psychological

People who are in a state of chronic emotional stress seek to drown out internal discomfort in any way. Not finding support among loved ones, many find solace in food.

Stress

Stressful situations increase the level of hormones in the human body. In order to protect against an aggressive external environment, hormones are produced: cortisol (responsible for conserving energy resources) and cortisone (causes the accumulation of fat reserves). The fight against stress begins.

To get rid of a stressful state, a person needs to apply an active strategy: find and eliminate the cause of the situation. But more often the struggle takes place in a passive form, the body tries to eliminate the consequences, and not the cause of the situation.

People who tend to be overweight choose passive strategies to deal with stress - instead of looking for solutions, they "seize problems."

Psychotherapists have noticed that symptoms of central obesity in women (when excess abdominal fat accumulates on the abdomen) indicate dissatisfaction with life. A thick fat pad is formed in the solar plexus, the energy center, to protect against the outside world. The more a woman is dissatisfied with herself, with life, the more fat is formed on the belly.

Alexithymia

With alexithymia, a person does not know how to distinguish emotions, does not recognize the difference between fear and anxiety, sadness and anger. Feeling nervous tension, boredom, frustration, people experience emotional hunger, but take it for physical hunger. As a result, every emotional outburst is accompanied by a hearty snack.

Sexual problems

Lack of regular sex life leads to a lack of the good hormone oxytocin. Oxytocin, the "calm hormone", is also released when consumed. Therefore, single people compensate for the lack of sex by eating fatty foods.

Being overweight can be associated with negative sexual experiences in the past.

People who have experienced sexual abuse, anxiety and fear at the thought of intimate relationships, unconsciously strive. Excess weight helps them get rid of attractive forms, hide their natural sexuality, and avoid repeating unpleasant experiences.

Many women gain weight after marriage. Psychologists say that slender beauties who have found family happiness turn into crumpets due to the loss of the need to seduce and attract men. A married woman has no one to demonstrate the dignity of a figure, except her own husband. And the husband allegedly loves his wife "in any form" ...

Homework: After familiarizing yourself with the mechanisms of excess weight, make a list of risk factors that lead to the accumulation of fat in your body or prevent you from losing weight. Using the list, find solutions to help you address the causes and develop a weight loss strategy.

Fighting excess weight

Fighting overweight is primarily an internal opposition to willpower, excessive appetite and laziness. The latter factors win more often, so few people manage to get closer to the cherished ideal weight.

If your decision to lose weight is harder than a stone, you are ready to believe in the power of a healthy diet and adjust your diet, stop sitting on the couch and start performing a daily set of exercises for losing weight - you can defeat excess weight !!!

Nutritionist assistance

Consulting a dietitian is a necessary step towards losing weight. Each organism is unique, so there is no single prophylaxis that can help everyone. By contacting a nutritionist, you will receive comprehensive information about your body, you will find out which weight loss strategy is right for your body. The specialist will explain in detail the basic rules of losing weight, which will have to be followed throughout your life.

Not to starve! The diet only needs to be slightly adjusted: reduce a single serving, replace harmful products with useful analogues. Rigid diets instead of weight loss provide the opposite effect. Feeling prolonged hunger, the body decides that extreme times have come and an urgent need to stock up on fat.

There is often and little by little! Nutritionists recommend eating the daily diet for 5 meals: breakfast, lunch, lunch, afternoon tea, dinner. Feeling the urge to have a snack, choose fruits, vegetables,. You cannot eat before bedtime.

Observe the balance of nutrients! Balance your diet to eat 30% protein, 20% fat, and 50% carbohydrates per day.

Expend more calories than you ate! Therefore, the more you eat at lunch, the more physical activity you need to burn the calories you receive. Conclusion: either eat in moderation, or sweat in the gym sparing no effort.

Drink water! A glass of water, drunk half an hour before meals, will dull hunger and the desire to gobble up all the dishes on the table. In addition, water is a universal solvent, essential for digestion.

Psychologist's help

Normal eating behavior is the best therapy for overweight. Track what you think, what you do and feel while eating, write down the observations in your diary. Recordings will help you understand what behaviors need to be changed.

Eat meaningfully! Listen to your inner feelings, try to eat to satisfy your hunger, do not "seize" stress and emotional stress.

Turn off your TV! You need to take food at the table, looking at the plate, thinking about the benefits that the food eaten will bring. Break the associative connection of eating with watching TV, reading, talking.

Distinguish between hunger and emotion! Track what emotion makes you feel hungry? Fear, boredom, sadness, weariness? If your emotions are pulling you into the refrigerator, not hunger, find other ways to satisfy your emotional needs.

Learn to think sensibly! A negative attitude towards healthy eating makes diet a punishment for losing weight. Learn to overcome negative attitudes, encourage healthy eating habits, otherwise therapy will not work.

Choose an active rhythm! Use to track your activity level and calories burned during the day. This way you will quickly learn self-control and make sure that you have chosen the right path.

THESE ARTICLES WILL HELP YOU Lose Weight
Your feedback on the article:

Causes of obesity (overweight) in children and adults

Improper diet is the main cause of obesity

A sedentary lifestyle (physical inactivity) as a cause of excess weight

Heredity and obesity

Medical causes of obesity

Diets for obesity

Diet number 8 for obesity

Very low calorie diets

How to treat obesity with exercise

Obesity treatment with surgery

Obesity treatment in children

6 rules to combat obesity

Why is obesity dangerous?

Being overweight increases the risk of disease

Which doctor should I contact for obesity?

Reasons for the appearance of excess weight

Determining the types of obesity

Body mass index and its features

Localization of body fat

Mechanism of occurrence

Causes of female obesity

Mechanisms of the appearance of gynoid obesity

Obesity symptoms

How to define obesity?

Consequences of the disease

How is obesity treated?

What results can you achieve?

Prevention of obesity

Send your good work in the knowledge base is simple. Use the form below

Similar documents

Reasons for the appearance of excess weight

Food habits

Lack of physical activity

Sleep problems

Psychological

Stress

Alexithymia

Sexual problems

Fighting excess weight

Nutritionist assistance

Psychologist's help