The relationship between overweight and obesity and the risk of premature death. Obesity as a risk factor for arterial hypertension Overweight as a risk factor

Obesity is a condition associated with serious diseases, deviations of healthy indicators from the norm. The scientific name for excessive accumulation of adipose tissue is adiposis (from the name of adipocyte fat cells that increase in size and quantity).

Causes of obesity

Main reasons:

• energy imbalance,
• genetic abnormalities
• endocrine diseases,
• taking certain medications
• Environment.

An imbalance in the distribution of energy from food causes the body to store fat. Calories consumed with foods should correlate with energy costs for breathing, thermoregulation, movement, mental activity.

The body has two options to use calories from proteins, fats, carbohydrates:

• use instantly for basic functions, active work;
• store for future needs (sugars are stored as glycogen in the liver and muscles, fats as triglycerides in adipose tissue).

The amount of incoming energy depends not only on the calorie content, but also on the method of preparation, the time interval between meals.

There are three types of adipose tissue: white, brown, beige.

White fat is stored in the subcutaneous region of the buttocks, thighs, abdomen and near the kidneys. It does:

• storage function;
• regulatory function - participates in the production of hormones responsible for appetite, satiety;
• release of inflammatory mediators (if there are a lot of them, there is a risk of complications).

Brown fat is stored in the upper chest of infants (up to 5% of weight). Serves for the rapid conversion of energy into heat (adipocytes are structurally different). Highlights active substances in inflammatory processes. There are also in adults (neck, chest area).

Beige fat - neck, shoulders, back, chest, abdomen. It resembles brown fabric in structure. "Specializes" in thermoregulatory function. Adipocytes under cold conditions can transform from "inactive" white to brown and beige, but the molecular mechanisms of this have not been studied.

Associated medical conditions and diseases

Genetic diseases with a symptom of "obesity":

• Prader-Willi syndrome;
• Bardet-Biedl syndrome;
• Alström's syndrome;
• Cohen syndrome.

Studying these syndromes helps scientists better understand the processes behind the formation of excess body fat.

Associated endocrine disorders

Hormones are involved in the process of energy metabolism. Tumors, system disorders that affect their products, can lead to obesity:

• Hypothyroidism. Condition due to low hormone levels thyroid gland. This is accompanied by a decrease in metabolic rate, weight gain even with a decrease in the number of calories consumed. The body of a person with hypothyroidism inefficiently uses fat for heat generation, the body temperature is low.
• Syndrome Itsenko - Cushing. The condition is caused by natural causes or medication. Characterized high level glucocorticoids (primarily adrenal cortisol) that provoke chronic stress. A person's appetite increases, which invariably leads to increased calorie storage.
• Tumors (malignant and benign). For example, congenital craniopharyngioma, which develops near areas responsible for the feeling of hunger, leads to severe obesity.

The organs of the gastrointestinal tract (stomach, intestines, pancreas) and adipose tissue signal hunger to the brain with hormones: inulin, leptin, glucagon-like peptide-1 (GLP-1), peptide YY, ghrelin.

The influence of medications

Drugs that affect weight include: antipsychotics, antidepressants, antiepileptics, antihyperglycemic agents.
Do not stop taking medications without your doctor's approval! But changing the form of the drug or taking an analogue can reduce the impact - this aspect should be discussed with a specialist.

Risk factors

Two groups of factors influence the weight of a person. Conditionally allocate:

• changeable: lifestyle, habits, environment;
• unchangeable: age, family history, family history, race, ethnicity, gender.

Lifestyle

Physical inactivity, improper diet, sleep, chronic stress are the main factors in the formation of obesity due to unhealthy habits.

The main terms are not proper nutrition:

• excess calorie intake
• food with an abundance of saturated and trans fats;
• eating foods with sweeteners/sugars.

People with a high BMI have a lack of sleep. The relationship between sleep and calorie distribution is confirmed by research: its lack affects the secretion of hormones that control appetite.

Acute stress can cause loss of appetite at first. During the transition to the chronic phase, there is an increase in the release of cortisol, which, as described above, causes a constant feeling of hunger and weight gain.

Age

Over the past 40 years, the number of obese adolescents has increased 10 times. In some nationalities, childhood obesity is more common (according to statistics). The risk of weight gain increases with age. There is a trend towards an increase in cases where people with a healthy BMI begin to gain weight at a young and middle age. This occurs until the age of 60-65, after which weight loss begins to prevail.

Environmental influence

Environmental factors that increase risks include:

• position in society (socio-economic status, income);
• infrastructural features of the place of residence - access to places of recreation, the presence of fast food restaurants near, etc.;
• unsafe environment (ecology): exposure to reagents recognized as anesogens (have the effect of long-term effects on entire generations - cyclic compounds, tobacco smoke components, pesticides) that affect the production of hormones.

hereditary predisposition

The presence of certain (identical) sections of the DNA code in overweight families is a scientific fact confirmed by genetic studies.

Eating habits during pregnancy affect the health of the child, affect his tendency to be overweight in the future. The DNA of spermatozoa changes depending on the conditions, the state of health of the man. Acquired obesity is transmitted from fathers to children at the genetic level!

Race and ethnicity, gender

A global analysis has shown that obesity is most common among blacks, followed by Hispanics, and then by Caucasians. This series is valid for both men and women. Asians have the lowest BMI. Some nationalities carry uncharacteristic sequences in the genome that increase risks (Samoa).

Obesity occurs more often in women when compared to members of the same ethnic group. Such a high frequency is associated with complex endocrine regulation, due to the task of childbearing. The rates are higher due to the frequent occurrence of polycystic ovary syndrome (PCOS; in up to 20% of women of reproductive age), leading to their increase, ovulation disorders, and reduced fertility. However, women store less "harmful" fat, such as abdominal and visceral fat, characteristic of men.

Signs, symptoms and complications

High BMI, signs of unhealthy fat distribution (figure parameters) are the main diagnostic indicators. The location of body fat affects the risk of complications. Thus, the accumulation of visceral fat surrounding the organs inside the abdominal cavity has a greater effect on chronicity. inflammatory diseases. By releasing inflammatory factors, it leads to the body's resistance to insulin, provokes changes in the liver, and activates tumor processes. This mechanism in obese patients is still under investigation.

Complications:

• metabolic syndrome;
• type 2 diabetes;
• high levels of cholesterol, triglycerides in the blood;
• diseases of the heart, blood vessels (hypertension, atherosclerosis, stroke);
• respiratory diseases (obstructive sleep apnea, asthma, obesity-hypoventilation syndrome - Pickwick's syndrome);
• back pain;
• osteoarthritis (inflammation causes damage to the cartilage and bone of the joint);
• non-alcoholic fatty liver disease (NAFLD);
• urinary incontinence (obesity weakens the pelvic muscles, more common in women);
• gallbladder disease;
• depression,
• emotional problems (low self-esteem of children);
• cancers (esophagus, large and small intestines, ovaries, gallbladder, breast, liver).

Diagnostics

For children (percentiles): low weight -< 5, здоровый вес - 5–85, избыточный вес - 85–95, ожирение - 95.

A percentile is the percentage of children in the total sample who scored the same or less than a particular child - for children this indicator is more applicable, since age differences are large. Children's calculator is complicated. The best option is presented on the website of the CDC - Centers for Disease Control and Prevention (USA).

Please note that children's and teenage calculators must be used by ages 19 and up. The formula for adults is used only from the age of 20.

For adults (BMI): low weight -< 18.5, здоровый вес - 18.5–24.9, избыточный вес - 25–29.9, ожирение - 30 и более.

BMI calculator

No BMI calculator is a clinical guide. The value shows the relative amount of fat in the body without taking into account the constitution, health status. Standard recommendations in the conclusions after the calculation will not replace the consultation and profile examination of a doctor. Approaching the BMI to the threshold means that you need to go to the clinic, check for risk factors, change your lifestyle. The specialist should study the family history, learn habits, identify other symptoms.

Additionally, a blood test is taken. They determine the level of cortisol, hormones (sex and thyroid), do an ultrasound of the pelvis (women) to exclude PCOS.

obesity treatment

Possible therapies include weight loss programs, lifestyle changes, drugs, or surgery. The choice depends on the condition of the individual patient and the severity of obesity.

1. Nutrition. Food should be complete and at the same time not contain extra calories. Dietary prescriptions drawn up by a doctor after an examination are the best solution.
2. Sports, exercises to keep weight. The program must match the body weight. Running, heavy cardio cannot be done with severe obesity.
3. Healthy sleep every day.
4. Changes in the schedule, habits should focus on the long term and the adaptation of the body to a new energy balance.

The brain complicates the process of losing weight, because food acts like a drug on pleasure centers, stimulating them. Cognitive behavioral therapy methods allow you to "train" the brain not to associate pleasure with food. For the same purpose, drugs are used:

• Appetite suppressant/regulatory: amfepramone, phendimetrazine, lorcaserin, naltrexone, liraglutide. They all have side effects and should only be taken with a prescription. Their action is manifested only in combination with a change in lifestyle!
• Intestinal fat absorption blocker (orlistat).

In severe cases, operations are prescribed for resection of a part of the stomach or bypass surgery, installation of a laparoscopic gastric strip (narrows the lumen in the stomach, dividing it into 2 parts). Methods of bariatric surgery is an extreme measure, the operational risks of infection, bleeding, and death of the patient are high.

Helpful Hints:

1. Keep a calorie/exercise log - helps in a rigorous assessment of balance.
2. Set clear, realistic goals (“walk 30 minutes 5 days a week”).
3. Move from one small goal to another, without trying to embrace the immensity.
4. Make a plan for ignoring temptations - it will help you cope with temptations.

And remember - mistakes should not be perceived as a complete failure. Losing extra pounds is a long process.

Obesity is a risk factor

Are you overweight?

First of all, you need to decide whether your weight is normal or overweight. To do this, you need to calculate your Body mass index abbreviated as BMI.

It's very easy to do it yourself:

1. Measure and write down your weight in kilograms

2. Measure and write down your height in meters

3. Divide your body weight in kilograms by your height in meters squared.

Thus,

BMI=weight(kg) / [height(m)] 2

For example,

Your weight is 102 kg,

Height -1.68 m (168 cm),

hence,

Your BMI = 102: (1.68 x 1.68) = 36

Waist circumference If the calculation of body mass index seemed complicated to you, then you can use a simpler indicator - Waist Circumference (OT). It is measured under the lower edge of the ribs above the navel. Women with a OT of less than 88 cm and men with a OT of less than 102 cm have nothing to worry about. Higher rates are a serious reason to think about your health.

In accordance with the obtained BMI, it is possible to assess the degree of risk of developing concomitant diseases (diabetes mellitus, atherosclerosis, arterial hypertension and a number of other equally serious diseases) according to the following table:

Classification	BMI	health risk	What to do
underweight	Less than 18.5	Is absent
Norm	18.5 - 24.9	Is absent
Excess body weight	25.0 - 29.9	elevated	weight loss
Obesity	30.0 - 34.9	Tall	weight loss
	35.0 - 39.9	Very tall
pronounced obesity	Over 40	Extremely high	Necessary immediate decline body weight

Please note: A BMI > 30 is indicative of obesity, which poses a serious health risk. In this case, you should immediately consult a doctor in order to develop an individual weight loss program.

Obesity-related diseases and risk factors

Many obese individuals have impaired insulin function and carbohydrate metabolism, as well as the exchange of cholesterol and triglycerides. All of these comorbid conditions are risk factors for cardiovascular disease, and their severity increases with increasing BMI (see table).

Relative risk of diseases often associated with obesity

Dramatically increased (relative risk > 3)	Moderately elevated (relative risk 2-3)	Slightly upgraded (relative risk 1-2)
Type 2 diabetes	Coronary artery disease	Cancer (breast in postmenopausal women, endometrium, colon)
Gallbladder diseases	Arterial hypertension	Hormonal disorders of reproductive function
Hyperlipidemia	Osteoarthritis (knee)	polycystic ovary syndrome
insulin resistance	Hyperuricemia/gout	Infertility
Dyspnea		Lower back pain caused by obesity
sleep apnea syndrome		Increased anesthetic risk
		Fetal pathology due to maternal obesity

For example, in obese individuals, the relative risk of type 2 diabetes mellitus triples compared with the risk in the general population. Similarly, obese individuals double or triple their risk of coronary heart disease.

Obesity is often accompanied by the development of:

? type 2 diabetes

? impaired glucose tolerance

? elevated levels of insulin and cholesterol

? arterial hypertension

Obesity is an independent risk factor for cardiovascular disease. Body weight is a better predictor of the development of coronary heart disease than blood pressure smoking or high blood sugar. Moreover, obesity increases the risk of other forms of pathology, including some types of cancer, diseases digestive system, respiratory organs and joints.

Obesity significantly impairs the quality of life. Many obese patients suffer from pain, limited mobility, low self-esteem, depression, emotional distress and other psychological problems due to prejudice, discrimination and exclusion in society.

OBESITY -

RISK FACTOR FOR CARDIOVASCULAR DISEASES

Cardiovascular diseases (CVD) are the main cause of death worldwide and in particular in Russia. The cardiovascular system in obesity suffers earlier and more often than others, in 80% of cases. World Organization health care considers obesity as an epidemic.

Obesity is an excessive increase in the amount of adipose tissue in the body. Damage to the heart and blood vessels is associated with the deposition of fat in the region of the heart muscles, as well as with the displacement of the heart ("transverse position") as a result of the high standing of the diaphragm.

Obesity is one of the risk factors for developing hypertension, a heart disease that can lead to myocardial infarction.

Accordingly, it is obesity that is a significant factor determining the likelihood of a person's death!

Causes of obesity:

Alimentary (due to an imbalance between the intake of calories in the body and their expenditure) - this type of obesity is the most common and is closely related to nutrition, to a greater extent with overeating; Endocrine (due to insufficient activity of the endocrine glands) - 10-13% of all cases of obesity; Cerebral (due to dysregulation of the centers of hunger and appetite) - 2-3% of all cases of obesity; Genetic disorders.

Fat can be evenly distributed throughout the body, or it can be predominantly localized on the abdomen - around the waist (“apple-shaped” obesity) or abdominal or on the hips (“pear-shaped” obesity).

Abdominal obesity is considered the most unfavorable. If the normal waist circumference is exceeded (more than 94 cm in men and more than 80 cm in women), the risk of developing diseases of the cardiovascular system is increased.

Obesity by female type associated with the deposition of fat in the lower body (thigh, lower leg). Muscle development is weak. Typical complications in this type obesity are degenerative changes in the musculoskeletal system.

The effect of excess weight on the body is obvious. If you are not overweight or obese, your blood circulates more efficiently, fluid levels in your body are easier to regulate, and you are less likely to develop diabetes, cardiovascular disease, certain cancers, and sleep apnea (stop breathing during dream).

Obesity. Effect on the cardiovascular system

The heart is an organ mainly composed of special cardiac muscle tissue (myocardium). The two atria and two ventricles of the heart are organized into two circles of blood circulation: a small (pulmonary), thanks to which the blood is enriched with oxygen, and a large one, with the help of which the blood carries oxygen throughout the body.

With obesity, the total volume of blood increases and, accordingly, cardiac output - the amount of blood pushed out by the heart per unit of time. The heart begins to work with a greater load than that of a normal person in order to provide the body that has become large with oxygen and nutrients. Over time, in order to adapt to increased loads, the heart begins to increase in size and become covered with fat, especially its left ventricle, which drives blood to all organs. This leads to the fact that the need for oxygen begins to grow in the heart itself, and at some point there is a breakdown of compensatory mechanisms and a person falls ill with a serious disease, which can most likely lead to death.

So, what diseases of the cardiovascular system leads to obesity?

Arterial hypertension. This is a disease in which there is a constant or regular increase in blood pressure. Obesity is accompanied by a violation of the biological action of insulin at the level of peripheral tissues - insulin resistance. This pathological process is considered to be a key link in the development of a cascade of formidable disorders, united by the term "metabolic syndrome". Result: vasoconstriction, sodium retention by the kidneys, increased cardiac output, which is closely related to the development of arterial hypertension. Heart failure is a syndrome in which an acute or chronic disorder of the heart develops, which leads to a deterioration in the blood supply to the rest of the body. A "fat heart" cannot work effectively, sooner or later a breakdown occurs and heart failure develops. Ischemic heart disease (CHD) is a disease in which the blood supply to the heart muscle is disrupted due to damage to the coronary arteries. Most often here we have to talk about myocardial infarction and angina pectoris (the so-called "angina pectoris"). Damage to the coronary arteries occurs due to the development of atherosclerosis as a result of an increase in cholesterol in the blood. Elevated cholesterol in most cases accompanies obesity. A stroke is a violation of cerebral circulation. They talk about two types of stroke: hemorrhagic, when an artery ruptures due to excessive blood flow to the brain; and ischemic, when some parts of the brain, on the contrary, suffer from disturbances in blood flow due to interruptions in the work of the heart or atherosclerotic plaques that clog blood vessels. A unit increase in body mass index (see below) has been shown to increase the risk of ischemic stroke by 4% and hemorrhagic stroke by 6%. Sudden cardiac death - this post-mortem diagnosis is 40 times more common in apparently healthy obese patients than people with normal weight. Doctors attribute this fact to the increased sensitivity of the heart to electrical impulses in obesity, which can be the cause of frequent and extensive ventricular arrhythmias. Venous disease is another side effect of obesity that comes from a combination of increased intravascular volume and a congested lymphatic system. In addition, a decrease in physical activity has a negative effect. As a result, obesity often develops venous insufficiency and edema, which leads to venous thromboembolism and pulmonary embolism, especially in women.

How to detect obesity?

To actively detect obesity, you need to know:

2. waist circumference in centimeters, as an indicator characterizing the presence

abdominal type of obesity (the most unfavorable).

There are different formulas. For example, you can use a simple formula to determine body weight: - for men = height (cm) - 100

For women = height (cm) - 105.

Most often, the Quetelet index (body mass index - BMI) is used to calculate body weight. Quetelet index = body weight (kg) / height (m2).

Classification of body mass type by BMI

One of the important indicators of body weight is waist circumference (WC), which is measured directly above the navel.

Waist circumference and the development of complications of obesity

If you are overweight or obese, you can reduce your risk of developing cardiovascular disease by managing your weight (changing your diet) and becoming more physically active over a long period of time, and possibly your entire life.

So obesity is a disease and should be treated?

Yes, indeed, obesity is a serious disease and it can and should be treated. However, overweight people often choose the wrong weapon in the fight against this problem. This is due to the fact that in the pursuit of profit, various theories of weight loss are actively disseminated, often without any evidence base. Such methods either do not bring benefits, causing disappointment in one's own abilities, or are harmful to health. Therefore, the treatment of obesity should be carried out under the guidance of specialists.

Overweight is treated by doctors in three areas -, and. The modern approach to the problem of obesity involves the use of complex methods of treatment, such as diet therapy, psychotherapy, drug therapy, exercise therapy, massage,.

Is it possible to cope with obesity with a "hard" diet or starvation?

A rigid diet will help to quickly reduce weight, but after the diet is stopped, appetite increases, food absorption improves, and weight is gained that exceeds the original.

When an obese person tries to lose weight again with a strict diet, each time it is more difficult, and weight gain is easier. Moreover, the weight gain often increases. Therefore, diets focused on quick results (reset as much as possible more weight in a short time) are a harmful and dangerous practice. In rare cases, and only under the supervision of a specialist, such diets can be used in the early stages of the fight against excess weight.

However, without monitoring the correspondence of the calorie content of food to physical activity, successful treatment of obesity is impossible!

If you are overweight, you first need to understand the importance of proper nutrition and your own role in maintaining health. After all, excess body weight is often combined with metabolic syndrome, which, in turn, turns into diabetes.

Principles of healthy eating

1. EAT FREQUENTLY

If you are overweight, eat at least 4 times a day. This distribution of food helps to avoid feelings of hunger and overeating.

2. PRODUCTS WITHOUT LIMIT

Lean meats (beef, skinless poultry), seafood, fish. All vegetables except potatoes and corn. Cottage cheese up to 4% fat, low-fat cheese, kefir up to 1% fat, tomato juice, mineral water, tea.

3. EXCLUDING

Flour products from yeast and puff pastry, butter, sour cream, milk, kefir with a fat content of 1% or more; smoked sausages, lard, pork, yellow cheeses; bananas, seeds and nuts, juices and drinks with sugar, alcohol.

4. PHYSICAL ACTIVITY

To maintain stable weight loss, an increase in the level of physical activity is especially necessary. Regular exercise also improves insulin sensitivity, lowers insulin levels in people with hyperinsulinemia, and normalizes blood pressure. Recommended for 30 minutes a day of regular and moderate physical activity (brisk walking, swimming, riding, dancing). This reduces the risk of developing diabetes and cardiovascular disease by 35-40%.

There are many risk factors for obesity, but the main one is improper and excessive nutrition. At the same time, the following risk factors for obesity can be of great importance in the development of various degrees of obesity.

Risk Factors for Obesity - Lack of Sleep

Scientists have found that lack of sleep can be a cause of obesity. Several factors may explain this conclusion. On the one hand, the less a person sleeps, the more time he has for various activities, including eating. In addition, feelings of tiredness and fatigue interfere with regular exercise. The physiological component of this phenomenon is that sleep restriction leads to a decrease in the hormone leptin, which “tells” our brain that we are full. In addition, lack of sleep increases the release of the appetite-stimulating hormone ghrelin. Daily uninterrupted sleep for 7-8 hours is highly recommended for adults, and 10-11 hours for teenagers.

Risk Factors for Obesity - Lack of Physical Activity

Maintaining optimal weight requires a balance between the calories that enter our body and the calories that are burned. If a person is not physically active enough, then he is more likely to burn not enough calories, thereby increasing the risk of developing obesity.

Risk Factors for Obesity - Occupation

Some professions require work in different time days, such a regimen increases the risk of obesity. Persons who work the night shift are prone to overweight. Office workers, drivers, and people who are forced to sit for long periods of time are also at a higher risk of developing obesity.

Risk Factors for Obesity - Diseases and Drugs

It is well known that some medications(eg, corticosteroids) and certain diseases (eg, rare hereditary diseases, hypothyroidism, PCOS, Cushing's disease, etc.) increase the risk of obesity. A certain type of obesity can be one of the typical symptoms of a number of diseases.

Risk factors for obesity - Smoking cessation

Many smokers believe that if they stop smoking, they will increase their weight. It is important to emphasize that smoking cessation does not lead to weight gain if you reduce your calorie intake and increase your physical activity. In addition, it has been found that smoking during pregnancy can increase the risk of obesity in the baby.

Risk Factors for Obesity - Age

It is well known that the number of cases of obesity doubles between the ages of 20 and 55. With age, as a rule, there is an increase in weight, which is mainly due to a decrease in physical activity and a slowdown in metabolism. In women, a noticeable increase in weight is associated with the menopausal period, which is characterized by hormonal changes that affect the body as a whole and, in particular, weight. The condition is exacerbated by the fact that the mass of muscles and bones decreases with age.

Risk Factors for Obesity - Genetics and Family History

If parents are overweight, their child will usually have more high risk development of obesity. In this pattern, the most important role is played by eating habits, which are formed from childhood and are difficult to correct at an older age. A certain lifestyle and level of physical activity also plays an equally important role. At the same time, some rare hereditary diseases can increase the risk of developing obesity, due to the peculiarities of metabolism.

Risk Factors for Obesity - Environment

It is well known that in populations that have easy access to cheap tasty food, the prevalence of obesity is quite high. The development of obesity is also facilitated by the achievements of modern civilization, such as cars, washing machines etc., physical activity in such a society is usually reduced.

Risk Factors for Obesity - Lack of Calcium

A sufficient level of calcium in the body reduces the likelihood of developing obesity. Most adults need 1000 mg of calcium per day. It is important to note that the body cannot absorb calcium without sufficient vitamin D. Egg yolk, salmon, and tuna are excellent sources of vitamin D.

Risk Factors for Obesity - Gender

In women, the tendency to increase weight continues until the age of 70, then the weight curve enters a plateau. In a woman's life, there are three periods with a high risk of developing obesity - menarche (especially early), pregnancy and the postpartum period, menopause (especially early).

Risk Factors for Obesity - Economic Status

It is more common in economically disadvantaged groups. Low-income families tend to eat fewer fruits and vegetables but consume more calories per day. It is known that low-calorie foods are more expensive. This economic group also has reduced physical activity and generally lacks a culture of regular exercise.

Risk Factors for Obesity - Disability

People with physical or mental disabilities are more likely to develop obesity than the general population.

Risk Factors for Obesity - Chronic Mental Illness

People who have chronic mental illness are at high risk of developing obesity and diabetes, most likely due to their lifestyle. In addition, many of the drugs used to treat chronic mental illness can lead to weight gain and increase the risk of developing diabetes.

Risk Factors for Obesity - Lifestyle

Negative elements modern life are recognized by doctors as risk factors for obesity:

• Excessive TV viewing;
• Sugar, in particular from soda drinks, fruit juices, may be a major contributor to the development of obesity;
• Lack of physical activity plays an important role in the development of obesity.

In the 21st century, there has been an increase in the incidence of obesity. Obese people include both adults and children. The diagnosis of obesity is made if the BMI (body mass index) exceeds 30 kg/m2. Morbid obesity is considered when the weight exceeds the normal body weight by 2 or more times. In Russia, approximately 30% of the working population is obese.

The WHO (World Health Organization) recognized obesity in 1998 as a disease that progresses if left untreated.

Obesity contributes to a reduction in human life expectancy. Obesity contributes to the development of diseases such as hypertension, atherosclerosis, coronary heart disease (CHD), angina pectoris, myocardial infarction. Obesity affects the quality of life of patients, leads to early disability and a significant reduction in life expectancy of people suffering from this disease.

The mechanism of development of obesity is as follows. Human adipose tissue is made up of fat cells (adipocytes) that can produce leptin, a hormone that makes you feel full. Leptin enters the brain and leads to a decrease in appetite. With an excess of adipose tissue, the level of leptin is increased, and the body no longer correctly evaluates its amount. And in this case, the hormone ghrelin begins to be produced in a person, leading to an increase in appetite. Resistance to the hormone leptin develops. This explains the increased appetite in obese individuals.

Obesity is generally a risk factor for cardiovascular disease.

The mechanism of influence of obesity on the work of the heart is as follows. With obesity, the volume of blood passing through the heart increases, which leads to greater compression of the walls of blood vessels. The heart, in order to adapt to increased loads per unit of time, is forced to push out a larger amount of blood. Thus, there is an increase in the amount of blood that the heart is forced to eject in one systole (one contraction). At the same time, there is an increase in the number of heart contractions, and the level of peripheral vascular resistance is lowered. With an increase in the amount of adipose tissue in an obese patient, an increase in the strength of heart contractions occurs, the heart muscle stretches, and the load on the vessels increases. As a consequence, an obese patient develops hypertension and metabolic syndrome. In obese people, there is an increase in the chamber of the left ventricle of the heart and hypertrophy of the walls of the myocardium. The left atrium is also enlarged. This circumstance does not depend on the age of the patient and indicators of blood pressure (blood pressure). All these changes contribute over time to the development of heart failure, heart rhythm disturbance, and the development of atrial fibrillation.

According to statistics, with obesity, the incidence of hypertension is 75%, type 2 diabetes mellitus - 60%, coronary heart disease -20%.

Obesity contributes to the development of dyslipidemia, about 30% of obese people have elevated levels of cholesterol and its fractions in the blood, which in turn leads to the formation of atherosclerotic plaques, including on the walls of the heart vessels.

A high percentage of mortality and the incidence of cardiovascular diseases is due to vascular damage, since obesity is a factor leading to atherosclerosis, arterial hypertension, and the risk of myocardial infarction.

The link between obesity and the development of cardiovascular diseases and complications was established during the Framingham study, which over the course of 26 years conducted studies on 5209 men and women who did not suffer from cardiovascular diseases. As a result of this study, it was found that obesity is a risk factor for cardiovascular complications, especially in women. The study showed that with an increase in BMI to 25.0-29 kg/m2, the risk of coronary artery disease increased by 2 times, and with a BMI above 29 kg/m2, the risk of coronary artery disease increased by 3 times.

Attention should be paid to the fact that an increased risk of cardiovascular diseases is present not only with obesity, but also with an increase in body weight. This circumstance was also established during the Framingham study, which revealed the dependence of the influence of body weight after 25 years on the risk of cardiovascular disease and a decrease in the risk of cardiovascular disease with a decrease in body weight.

In the United States, a 14-year adult study (4,576,785 men and 588,369 women) showed that high BMI was a predictor of cardiovascular mortality, mostly in men. An increased risk of mortality has also been found in overweight men and women. Based on the results of the study, it was concluded that the risk of mortality increased from cardiovascular diseases in all overweight individuals in all age groups. The results of the study confirm the established relationship between the risk of mortality and the presence of obesity, as well as an increased risk of mortality, even with a moderate increase in body weight.

The main task in the treatment of obesity is to reduce the risk of developing cardiovascular diseases (hypertension, coronary heart disease, angina pectoris, myocardial infarction) and other diseases such as diabetes, atherosclerosis, etc. In the case of successful treatment of obesity, the health of patients not only improves, but also their life expectancy increases, the level of quality of life of obese patients increases.

For the treatment of obesity, it is most advisable to reduce body weight from 0.5 - 1.0 kg per week for six months and maintain the achieved result for a long time.

A sharp decrease in body weight, especially if the patient suffers from a cardiovascular disease, can contribute to the occurrence of serious complications, the development of arrhythmia, sudden death(with a lack of protein intake from food, atrophy of the heart muscle, especially in the elderly). Therefore, in the process of reducing body weight, it is necessary to regularly conduct electrocardiography and measurement of blood pressure. An increase in exercise in obese patients with cardiovascular pathology should be recommended with caution - only if the patient's condition is stable and a thorough cardiac examination is performed, after exercise tests, blood pressure measurements, Holter monitoring). It is necessary to avoid rapid weight loss with frequent attacks of angina pectoris, the patient's unstable condition, with unstable angina pectoris, within six months after myocardial infarction. Rapid weight loss is contraindicated if the patient is diabetic or has signs of heart failure.

It has been established that lifestyle changes, increased physical activity and a gradual decrease in body weight due to a decrease in calorie content lead to a decrease in the risk of developing cardiovascular diseases. With a weight loss of 1 kg. blood pressure is reduced by 1 mm Hg. In hypertension, weight loss by 8-10 kg reduces the wall thickness of the left ventricle.

It is advisable to treat patients with obesity with the participation of a nutritionist, a nutritionist. Currently, diet therapy, increased physical activity, pharmacotherapy and surgical treatment are used to treat obesity.

Thus, it has been proven that weight loss is effective for the prevention and treatment of cardiovascular diseases, improves the quality and increases life expectancy.

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