Obesity
Physician-therapist, somnologist
Novikov Maxim
Experience 13 year
Doctor of the highest category. Member of the European Respiratory Society and the Russian Respiratory Society
Modern medical centres apply different strategies to treating obesity. The choice of strategy depends on the symptoms and the presence of chronic diseases in the patient’s body. A therapist, gastroenterologist, cardiologist, and endocrinologist are the key medical professionals who are involved in treating obesity.
How to Diagnose Obesity
To diagnose obesity, the body mass index (BMI) indicator is used.
To determine the normal weight of a person, we need to start by determining their body mass index (BMI). The following formula is used to calculate it: the person’s current weight (kg)/height (m) squared. The normal BMI value falls within the range of 18 to 25.
Here are the four degrees of obesity:
- BMI 25-30 — borderline value, the presence of excess weight;
- BMI 30-35 — 1st-degree obesity;
- BMI 35-40 — 2nd-degree obesity;
- BMI of 40 and over — 3rd-degree obesity.
In addition to weight, we also take into account the thickness of the skin fold under the shoulder blade, which can be taken with a pinch (up to 2 cm is the norm), and the size of the circumference of the abdomen (at the waist and in the most prominent place).
Excess Weight Symptoms
The primary sign of obesity is an increase in body weight and volume. Besides, overweight patients have the following symptoms:
- shortness of breath after minor physical exertion (such as walking or doing the housework), people with grade 3 obesity struggle to breathe even at rest;
- high blood pressure and headaches that are related to the “flies” that the patient sees in front of their eyes when changing the position of their body as well as pain behind the sternum;
- pain in the joints and back, constrain in movement due to the high load on the musculoskeletal system;
- digestive disorders, such as constipation, the feeling of heaviness after meals, bitter taste in the mouth;
- decreased libido;
- menstrual cycle disorders, typically irregular menstruation or complete absence of it;
- fatigue, weakness, and emotional instability.
Such manifestations often tend to be ignored. People do not consider them a serious reason to consult a doctor. This is another common problem of obesity. Patients often begin to take measures to bring their weight back to normal when they already have health problems that threaten the normal functioning of their organism.
Causes of the Disease
The main factors that lead to the accumulation of excess fat in the human body are overeating and lack of physical activity. Approximately 90% of cases of obesity are associated with these two reasons. The conditions that lead to the development of obesity are large amounts of high-calorie food rich in simple carbohydrates and animal fats (such as sweets, carbonated drinks, bakery products, fast food, sausages, and smoked or fried products).
Weight gain can take place as the result of the malfunction of the following organs: 
- hypothalamus-pituitary gland suffers from a deficiency of tropic hormones (such as somatotropin, thyrotropin, and adrenocorticotropin). These substances produce a stimulating effect on the thyroid gland and adrenal glands as well as accelerate energy metabolism;
- thyroid gland. The thyroid hormones thyroxine and triiodothyronine directly regulate the exchange of essential nutrients as well as stimulate the breakdown of fat tissue and protein synthesis. A deficiency of these hormones leads to an increase in body weight;
- pancreas — excess insulin contributes to obesity;
- adrenal glands — hypercorticism and Itsenko-Cushing syndrome. The excess of corticosteroids (adrenal hormones) in the blood facilitates the breakdown of fats in the liver but at the same time stimulates their deposition in the abdomen, shoulders, and face;
- genitals — testosterone deficiency in men and oestrogen deficiency in women contribute to obesity.
There are genetic disorders that consist in the abnormality of leptin production and a decrease in tissue sensitivity to it. This leads to systematic overeating, which is difficult to control. In addition to leptin, other substances are involved in the regulation of hunger and satiation centres. They are predominantly synthesised by cells of the stomach and small intestine.
One of the possible types of obesity is the iatrogenic one. It is provoked by irrational intake of hormonal drugs due to improper prescription or self-medication.
What Does Obesity Lead to
Obesity affects the condition of all organs and systems. Many of its consequences pose a threat to human life.
Obesity leads to the development of these pathologies:
- diseases of the cardiovascular system, such as hypertension and atherosclerosis, which in turn lead to myocardial infarctions, strokes, retinopathy (retinal detachment and blindness) and nephropathy (chronic renal failure);
- endocrine disorders, such as type 2 diabetes mellitus, steroid diabetes, and Itsenko-Cushing syndrome;
- diseases of the bone and joint system, such as osteoarthrosis, osteoarthritis, and herniated discs;
- oncological diseases, such as cancer of the colon, liver, and gallbladder as well as hormone-dependent types of tumours (those of the breast, endometrium, and prostate).
The consequences of trivial obesity can lead to significant restrictions on one's quality of life, disability, and even death. It is much easier to prevent them than to cure them. After all, the anti-obesity pill has not been invented yet.
Prevention of Obesity
Obesity is a chronic disease. Proper eating habits can serve as a guarantee not only of your health but also of the health of your future children, grandchildren, and even great-grandchildren.
To prevent obesity that develops due to endocrine diseases, it is necessary to consult with an endocrinologist once per year and have regular medical checks to determine the level of hormones inside your body.
Here are the key nutrition recommendations:
- optimise your caloric intake according to your individual parameters and physical activity;
- drink a sufficient amount of clean water: 30 ml per 1 kg of your body weight per day;
- give preference to low-fat varieties of meat;
- include fish and seafood in your diet at least once per week;
- eat fresh seasonal vegetables and fruits every day;
- limit salt intake to 4 grams per day;
- limit alcohol consumption.
These doctors will help you calculate the optimal calorie content and compose a healthy diet: a therapist, a gastroenterologist, and an endocrinologist. If you are obese, you should avoid experimenting with diets and fasting. These methods are ineffective and can even be dangerous.
Every day, it is important to find time for minimal physical activity, such as walking, going up the stairs, doing morning exercises, taking a break from long sedentary work to move around a bit, etc.
2-3 times per week, it is worth allocating one hour for fitness classes. When choosing the ideal type of activity, consider consulting a therapist. They will recommend the optimal sports discipline for you, taking into account your current state of health.
If alarming symptoms appear, such as unreasonable weight gain or menstrual disorders, you need to consult an endocrinologist.