Obesity


What is obesity?
Obesity is the chronic metabolic disorder associated with the excessive development of the adipose tissue. The natural course of obesity is progressive and leads to certain complications. Obesity tends to be relapsing.

How may the proper weight of a human be estimated? Anyone has his or her own idea of the normal weight, which not always conforms with medical standards. Body mass index provides the objective estimate of one's body weight. An excessive body weight is evidenced by body mass index above 25 kg/m2, whereas obesity, by body mass index above 30 kg/m2.

At what age does obesity develop most often? Obesity may develop at any age. At present, scientists warn about an epidemic of obesity. In Russia, every third person has body mass above maximal permissible. Noteworthy is that 30-50% of patients who were obese in their childhood remain obese as adults. The number of obese children is growing and, according to statistics, double over each three decades. By now, 25% of adolescents in the developed countries have excess body weight, and 15% have obesity.

What are the causes of obesity? The most obvious cause of obesity is excess food calories. No less indisputable is reduced energy expenditure, in particular, because of insufficient physical activity. Obesity results from imbalance between energy expenditure and food intake. The balance is ensured by matching energy intake to energy expenditure. In the absence of physical activity, even one (!!!) extra sandwich or candy every day will increase body mass by 7-8 kg within one year. However, it should be minded that obesity may be not only a disease by itself but, also, may be a symptom of some other disease. Obesity is often caused by endocrine disorders (in particular, by diseases of the thyroid gland).

Is obesity hereditary? Genetically determined is not obesity by itself, but a predisposition to it, that is, an increased ability to gain weight. It would be wrong to say that, in such cases, efforts to reduce obesity are senseless. The family confinement of obesity is caused not only by heredity but, also, by habits related to eating and physical activity. The causes of obesity are difficult to categorize into hereditary and fostered. It is known that stepchildren of obese stepparents become obese as the their native children do. The probability of obesity in such cases is pretty high: 50% if the father is obese, 60% if the mother is obese, and 80% if both of them are obese.

What leads to obesity? The factors leading to obesity include peculiarities of life stile and feeding behavior, including foods with excessive calories, which are attributed mainly to fats, inappropriate eating pattern, inadequate (with regard to calory intake) physical activity, etc. Many people use eating as a tranquilizer in stressful situations or make food a sort of doping. Obesity is promoted by the habit to eat by nighttime.

Is it advisable to get rid of excess weight? Absolutely! Not only the esthetic aspect of the problem matters. Obesity leads to numerous disorders in normal human body functions and, as a result, to the development of many diseases. According to statistics, middle-aged men whose fat mass is above 20% of body mass (12-15% is the norm) are under a 20-folf higher risk of myocardial infarction in comparison with men having normal body fat.

What diseases are promoted by obesity? Obesity is one of the most important risk factors of type II diabetes mellitus, hypertensive disease, and ischemic heart disease. It leads to atherosclerotic changes promoting stroke and myocardial infarction. Associations between excess body fat and cancer, reduced fertility, dysmenorrheas, and impotence are documented. Obese people senesce early and live by 5-15 years less than normally weighting people do. According to WHO statistics, about 320000 people die annually because of diseases associated with obesity. Unfortunately, GP doctors often do not recognize the causative relationships between obesity, insulin-independent diabetes mellitus, hypertensive disease, and ischemic hart disease and, hence, do not attempt to correct their patient's weight, although it is known that such measures are potent factors of controlling and treatment of these diseases. It should be noted that the complex of measures for body weigh correction cannot be substituted for by prescribing of hypotensive, coronary-active, and sugar-reducing drugs.

What should be done if my doctor advises body weight reduction but does not suggest anything specific? Unfortunately, not all doctors recognize that obesity is a metabolic disease, which has to be treated properly without relying on self-medication prescribed by a patient to himself. Obesity is often believed to result from nothing more than laziness and the lack of self-control. The truth is that unsuccessful treatment often indicates improper treatment tactics (for example, a patient starts from drastically restricting himself and them falls into overeating). To make a treatment effective, both diet and physical activity should be carefully dosed on the individual basis. Doctors at LENMEDCENTER will select an appropriate treatment regimen for every patient.

How one may determine the effectiveness of treatment of obesity? Many people think that the more kilograms of body weigh are lost over a certain time period, the more efficient their treatment is. This is not so. It is better to reduce body weight gradually and not to gain it back. The loss of 5-10% of excess body fat significantly reduces the risk of diseases associated with obesity. It is very important whether the treatment method is well tolerated and sufficiently safe. Effectiveness makes sense if a method provides for improvement of life quality without compromising health and if the practicing of this method does not require profound dietetic education and is not associated with significant difficulties. The objective of any treatment of obesity is not only to reduce body weight but, also, to maintain the reduced weight. Treatment of obesity, so as of any other chronic disease, must be continuing.

Is it possible to control obesity using only diet? Yes, it is. This is a conventional and, actually, the only self-sufficient method for treatment of obesity. However, many patients believe that diets are useless because even if one succeeds in reducing one's weight for a time, the lost kilograms would be regained. This belief results from the wide use of simple low-calory diets composed of a few products allowed for consumption. Because they are monotonous and poor and lack essential nutrients, they are hard to tolerate and, after their discontinuation, weight gain is inevitable. A properly devised diet must contain the physiologically normal amount of essential nutrients (proteins, vitamins, minerals, w3-polyunsaturated fatty acids, and fibers). After the diet is discontinued, feeding regimen for maintenance of the achieved body weight must be recommended.

Is it possible to control obesity by only physical exercises? Studies prove that this is possible. However, exercises must be very intense and long-lasting, e.g., as in military training. Not everyone is able to endure such regimen, especially when patients with complicated obesity are concerned. Even 60-minutes bouts of exercises two times a week cannot significantly reduce body weight without certain dietary treatment. However, if such exercises are combined with diet, they improve the ratio of muscle and fat mass in favor of muscles. Exercises are widely used by medical specialists in complex treatment of obesity.

Is it possible to control obesity with drugs? Pharmacological drugs can improve tolerance to a diet or to enhance its effect but they cannot control obesity by themselves. Therefore, one should not rely on drugs and biologically active food additives, which, as research has shown, possess low intrinsic efficacy.

Is there any sense in surgery for obesity? Patients in need of express body weight reduction may undergo liposuction (local removal of body fat). This is an efficient solution, however, the maintenance of the results achieved in this way requires diet and increased physical activity. When no changes in life stile occur, body weight is regained, as practice shows. Therefore, liposuction should not be regarded as the main therapy for obesity. Other surgery, such as vertical strip gastroplastics (the effect is achieved with a ring, which acts as if dividing the stomach into two compartments) is normally used for patients with severe obesity whose body mass index is not less that 40 kg/m2. However, it should be minded that many patient are not satisfied with the results of such treatment (according to different authors, they number may reach 13 to 40%). Surgery helps to get rid of problems associated with adherence to diet, however, possible postoperative complications should be considered (thrombotic emboly, fat emboly, pulmonary problems, postoperative hernia, etc.). It is true that their incidence is not greater than that of other abdominal operations, however, obese patients are at elevated risk in comparison with people having normal body weight. When body mass index is above 40 kg/m2, operations involving balloon insertion into the stomach, gastroplastics, and gastric shunting may be performed.

Can one control obesity by him/herself? Treatment for obesity is not less difficult than treatment for any other chronic disease. Many people having excess body fat try to control their problem by themselves using diet and exercises. However, very few of them succeed in restoring and maintaining of their normal body weight. Not everyone is able to devise a diet and adhere to it. Moreover, obese patients are often not able to perform exercises at a sufficient rate and thus to increase their energy expenditure. Patients tend to overestimate their physical load and to underestimate their calory intake.

At LENMEDCENTER, specialists will help you to find out the exact causes of obesity and to control it. They will correct feeding behavior and physical activity using careful and safe approaches basing on their patient's habitual life schedule and will do it on the strictly individual basis. Treatment regimen will include therapeutic drugs, if necessary. Individual and group psychological training sessions lead by experienced specialists are possible. You will be suggested with a complex of measures to maintain your reduced weight. To treat obesity, LENMEDCENTER uses proved traditional approaches, which provide excellent results!