Hypotrophy prenatal. Morbid obesity. Metabolic syndrome Mkb overweight
Chronic, lifelong, multifactorial, genetically determined, life-threatening disease caused by the accumulation of excess body fat, leading to serious medical, psychosocial, physical and economic consequences.
The role of obesity in the development of cancer of the mammary glands, uterus, prostate, and colon is known. Obesity is accompanied by a decrease in physical and mental performance up to complete disability, deprives patients of the opportunity to lead a normal life, leads to social disadaptation and the development of depressive conditions in them.
ICD-10 CODES
E66.0. Obesity due to excess intake of energy resources.
E66.1. Obesity due to medication.
E66.2. Extreme obesity accompanied by alveolar hypoventilation.
E66.8. Other forms of obesity.
E66.9. Obesity, unspecified.
obesity surgery, or bariatric surgery(from Greek baros - heavy, fat, weighty) - a relatively young field of surgical gastroenterology, the subject of which is morbid(morbid) obesity, ie. clinical manifestations of the disease.
Obesity related diseases
Obesity - the most important reason development arterial hypertension, sleep apnea syndrome, diabetes Type 2, diseases of the joints, spine, veins lower extremities, digestive tract, sexual disorders, infertility, as well as a complex metabolic disorders, united by the concept "metabolic syndrome"(syndrome-X, insulin resistance syndrome).The development of the metabolic syndrome, described in 1988 by G. Riven, is based on abdominal obesity and the state of insulin resistance developing against this background, which in turn determines the development of type 2 diabetes mellitus, arterial hypertension, atherogenic dyslipidemia, coagulopathy, metabolic disorders uric acid and others. An inevitable consequence of this complex and interrelated complex of disorders is the development of atherosclerosis and cardiovascular diseases(the main cause of death in the population).
Epidemiology
At the end of the 20th century, the WHO described obesity as a non-communicable epidemic.In industrialized countries, morbid obesity affects from 2 to 6% of the population, which is 1,700,000 people on the planet; Two-thirds of the US population is overweight, with one in five adults and one in seven teenagers being morbidly obese. The cause of death of more than 700,000 people in the US and 1,000,000 people in Europe every year is obesity. In the structure of European mortality, 13% of cases are associated with obesity.
Over the past 20 years in Europe, the incidence of obesity has tripled, and now about half of adults and one in five children are overweight. Compared with the situation in 1970, the incidence of obesity among children has increased 10 times.
obesity classification
The main criterion for determining the stage of obesity, as well as approaches to its treatment (Table 70-1), is the body mass index (BMI), determined by the formula: BMI = weight (kg) / height 2 (m 2).
Table 70-1. Classification and principles of treatment of obesity
| Body mass index, kg / m 2 | State characteristic |
Treatment |
| 18-25 | normal mass body | Not required |
| 25-30 | Overweight | Self-restriction in food, increased physical activity |
| 30-35 | Obesity I degree (initial) | Conservative treatment, including medication, in case of inefficiency - installation of an intragastric balloon |
| 35-40 | Obesity II degree (expressed) | Conservative treatment, installation of a balloon, in the presence of concomitant diseases - surgical intervention |
| 40-50 | Obesity III degree (morbid) | If conservative measures fail, surgery is performed. |
| Over 50 | Obesity IV degree (superobesity) | Surgery; a significant proportion of patients require preoperative preparation |
Principles of obesity treatment
Medical treatment of obesityOn the early stages the development of obesity (with a BMI up to 35 kg / m 2) are used conservative methods treatment(diet therapy, psychotherapy, prescribing exercise, drug treatment), but they do not always restrain the progression of the disease and provide a stable result.
Principles rational nutrition and diet therapy for obesity are well defined, but most patients are unable to radically change their lifestyle:
- lifelong introduction of strict self-restrictions in food;
- systematic control of the energy content of the diet;
- increase in physical activity.
Treating obesity as a lifelong disease involves a dual challenge:effective and clinically significant weight loss at the first stage and maintaining the result throughout life, which is the most difficult. Previously, it was shown that with obesity with a BMI of more than 35-40 kg/m 2 conservative methods of treatment are ineffective in the long term: 90-95% of patients restore body weight to the previous level within the first year.
Surgery
Surgical interventions for digestive tract about obesity have been known since the early 1950s.In order to reduce body weight in 1953, V. Henriksson (Sweden) conducted two patients large area resection small intestine .
Due to the irreversible nature of the changes in the intestinal tract, this operation has not gained popularity. In the 1960s and 1970s it was common jejunoileoshunt surgery. Due to a sharp decrease in the absorptive surface of the small intestine after surgery, a significant steady loss of body weight was observed; effective correction hypercholesterolemia. At the same time, the study of long-term results showed that they were achieved at the cost of severe disturbances in the water and electrolyte balance, hypoproteinemia, liver failure, nephrolithiasis and polyarthralgia due to anaerobic bypass enteritis in the small intestine excluded from the passage. Currently, jejunoileoshunting is used extremely rarely.
As a historically passed stage, various modifications should be considered horizontal gastroplasty that were popular in the 1980s. Their essence was reduced to a transverse (horizontal) stitching of the stomach with the help of a stapler, leaving a narrow exit from its small part to the large one. Due to the insufficient and unstable effect, as well as due to the relatively high frequency late complications and repeated operations over time, the number of supporters of vertical gastroplasty and non-adjustable gastric banding has significantly decreased.
Information: HYPOTROPHY is a chronic eating disorder characterized by varying degrees body weight loss. As a rule, young children suffer from malnutrition. Etiology, pathogenesis. The disease is polyetiological. There are congenital (prenatal) and acquired (postnatal) malnutrition. Congenital malnutrition is most often caused by maternal diseases or associated with intrauterine hypoxia, fetal infection, genomic and chromosomal mutations. Among the causes of acquired malnutrition, exogenous and endogenous are distinguished. The first include nutritional factors (hypogalactia in the mother, an incorrectly calculated diet for artificial feeding, unilateral feeding, etc.), pyloric stenosis and pylorospasm, drug poisoning(hypervitaminosis D, etc.), infections gastrointestinal tract, lack of care, regimen, education, etc. Endogenous causes of malnutrition can be malformations of the gastrointestinal tract and other organs, CNS lesions, hereditary metabolic abnormalities and immunodeficiency states, endocrine diseases etc. The pathogenesis of malnutrition is based on a decrease in the utilization nutrients with violation of the processes of digestion, absorption and assimilation under the influence of various factors. There are I, II and III degrees of severity of malnutrition. clinical picture. Hypotrophy of the 1st degree is characterized by a loss of body weight by no more than 20% of the due age. The subcutaneous fat layer on the abdomen becomes thinner, tissue turgor decreases. The weight gain curve is flattened. Other indicators are usually within the normal range or slightly reduced. With hypotrophy of the II degree, the loss of body weight is 25-30% compared with age norm. The subcutaneous layer is preserved only on the face, it is especially thinned on the abdomen and limbs. The skin is dry, easily gathers into folds, hangs down in some places. There is a lag in growth, appetite decreases, the child becomes irritable, loses previously acquired skills, and thermoregulation is disturbed. Stool unstable: "hungry" stool (scanty, dry, discolored, with sharp and bad smell) is replaced by dyspeptic (green, undigested food particles, with mucus). With malnutrition of the III degree, the loss of body weight is more than 30% of the due to age. There is no increase in body weight, the child is significantly behind in growth. Outwardly - an extreme degree of exhaustion, skin pale gray color, the subcutaneous fat layer is completely absent. Mucous membranes are pale, dry, elements in the mouth candidal stomatitis(thrush). Breathing is shallow, heart sounds are muffled, arterial pressure reduced. The body temperature is lowered, periodic rises to subfebrile figures are noted, there is no difference between axillary and rectal temperature. infectious processes proceed asymptomatically. Often there are signs of subacute current rickets. The diagnosis of malnutrition is usually not difficult. It is much more difficult to find out the causes of malnutrition. Treatment of patients should be comprehensive and include measures aimed at "eliminating or correcting causal factors, diet therapy, prescribing restorative procedures, enzymes and symptomatic agents, eliminating foci of infection, vitamin therapy. In all cases, when prescribing a diet, it is necessary to determine food tolerance. In a period of increased nutritional load requires coprological control.In case of malnutrition of the 1st degree, the amount of proteins and carbohydrates is usually calculated per 1 kg of body weight due to age, and fats per 1 kg of existing body weight.In case of malnutrition of the II degree, the establishment of food tolerance is carried out for 3 -5 days.As a rule, breast milk or sour mixtures are prescribed (kefir, acidophilic "Baby", biolact, etc.).The calculation is first carried out on the existing body weight of the child, then on approximately due (existing +20) and only then on From the 3-4th day, the protein load is gradually increased, then the carbohydrate load, and in the last one line of fat. With hypotrophy of the III degree, it is preferable to start diet therapy with the introduction breast milk every 2 hours, 20-30 ml. Bringing the amount of food to 50 ml, reduce the number of feedings. The order of increasing the load of proteins, carbohydrates and fats is the same as with stage II malnutrition, but more gradual. Food tolerance is clarified within 2 weeks. With malnutrition II and III degree, the missing amount of fluid, nutrients and electrolytes are injected intravenously: 5-10% glucose solution, isotonic solution sodium chloride, Ringer's solution, protein hydrolysates, albumin, protein, etc. (albumin 3-5 ml / kg; hemodez up to 15 ml / kg, but not more than 200 ml; reopoliglyukin 3-8 ml / kg). Insulinglucosotherapy is shown (s / c 1 unit of insulin per 5 g of glucose administered). Treatment of malnutrition II-III degree must be carried out in a hospital. In the presence of foci of infection, antibiotics are prescribed (avoid nephro-, hepato- and ototoxic drugs), if necessary, surgical intervention is performed. Enzyme therapy, vitamin therapy are widely used. Of the stimulants, apilac, gamma globulin, albumin, plasma, and blood transfusions are prescribed. In some cases, it is advisable to use anabolic hormones (retabolil 1 mg/kg once every 2 weeks, etc.). Showing massage and exercise therapy, staying in the fresh air. The prognosis depends on the cause that led to malnutrition, and the possibilities for its elimination. With primary hypotrophy of the III degree, the prognosis is always serious; lethality is up to 30%. Prevention. If possible, ensure natural feeding, treatment of hypogalactia, rational feeding, early diagnosis diseases of newborns and infants.
Hypotrophy is a chronic eating disorder characterized by varying degrees of weight loss. As a rule, young children suffer from malnutrition.
Code by international classification ICD-10 diseases:
The reasons
Etiology, pathogenesis. The disease is polyetiological. There are congenital (prenatal) and acquired (postnatal) malnutrition. Congenital malnutrition is most often caused by maternal diseases or associated with intrauterine hypoxia, fetal infection, genomic and chromosomal mutations. Among the causes of acquired malnutrition, exogenous and endogenous are distinguished. The first include nutritional factors (hypogalactia in the mother, incorrectly calculated diet for artificial feeding, unilateral feeding, etc.), pyloric stenosis and pylorospasm, drug poisoning (hypervitaminosis D, etc.), infections of the gastrointestinal tract, deficiencies in care, regimen, education etc. Endogenous causes of malnutrition can be malformations of the gastrointestinal tract and other organs, CNS lesions, hereditary metabolic anomalies and immunodeficiency states, endocrine diseases, etc. The pathogenesis of malnutrition is based on a decrease in the utilization of nutrients with impaired processes digestion, absorption and assimilation of them under the influence of various factors. There are I, II and III degrees of severity of malnutrition.
Symptoms (signs)
Clinical picture. Hypotrophy of the 1st degree is characterized by a loss of body weight by no more than 20% of the due age. The subcutaneous fat layer on the abdomen becomes thinner, tissue turgor decreases. The weight gain curve is flattened. Other indicators are usually within the normal range or slightly reduced. With malnutrition of the II degree, the loss of body weight is 25 - 30% compared with the age norm. The subcutaneous layer is preserved only on the face, it is especially thinned on the abdomen and limbs. The skin is dry, easily gathers into folds, hangs down in some places. There is a lag in growth, appetite decreases, the child becomes irritable, loses previously acquired skills, and thermoregulation is disturbed. The stool is unstable: "hungry" stool (scanty, dry, discolored, with a sharp and unpleasant odor) is replaced by dyspeptic (green, undigested food particles, with mucus). With malnutrition of the III degree, the loss of body weight is more than 30% of the due to age. There is no increase in body weight, the child is significantly behind in growth. Outwardly - an extreme degree of exhaustion, the skin is pale gray in color, the subcutaneous fat layer is completely absent. The mucous membranes are pale, dry, in the mouth there are elements of candidal stomatitis (thrush). Breathing is shallow, heart sounds are muffled, blood pressure is reduced. The body temperature is lowered, there are periodic rises to subfebrile numbers, there is no difference between the axillary and rectal temperatures. Infectious processes are asymptomatic. Often there are signs of subacute current rickets.
Diagnostics
Diagnosis malnutrition is usually not difficult. It is much more difficult to find out the causes of malnutrition.
Treatment
Treatment patients should be comprehensive and include measures aimed at "eliminating or correcting causally significant factors, diet therapy, prescribing restorative procedures, enzymes and symptomatic agents, eliminating foci of infection, vitamin therapy. In all cases, when prescribing a diet, it is necessary to determine food tolerance. During the period increased nutritional load requires coprological control.In case of malnutrition of the 1st degree, the amount of proteins and carbohydrates is usually calculated per 1 kg of body weight due to age, and fats - per 1 kg of existing body weight.In case of malnutrition of the II degree, the establishment of food tolerance is carried out for 3 - 5 days. As a rule, breast milk or sour mixtures are prescribed (kefir, acidophilic "Baby", biolact, etc.).The calculation is first carried out on the existing body weight of the child, then on the approximately due (existing +20) and only then on the due From the 3rd - 4th day, the protein load is gradually increased, then the carbohydrate load and then ice queue fat. With malnutrition of the III degree, it is preferable to start diet therapy with the introduction of breast milk every 2 hours, 20-30 ml. Bringing the amount of food to 50 ml, reduce the number of feedings. The order of increasing the load of proteins, carbohydrates and fats is the same as with stage II malnutrition, but more gradual. Food tolerance is clarified within 2 weeks. With malnutrition II and III degree, the missing amount of fluid, nutrients and electrolytes is injected intravenously: 5 - 10% glucose solution, isotonic sodium chloride solution, Ringer's solution, protein hydrolysates, albumin, protein, etc. (albumin 3 - 5 ml /kg; hemodez up to 15 ml/kg, but not more than 200 ml; reopoliglyukin 3 - 8 ml/kg). Insulinglucosotherapy is shown (s / c 1 unit of insulin per 5 g of glucose administered).
Treatment malnutrition II - III degree must be carried out in a hospital. In the presence of foci of infection, antibiotics are prescribed (avoid nephro-, hepato- and ototoxic drugs), if necessary, surgical intervention is performed. Enzyme therapy, vitamin therapy are widely used. Of the stimulants, apilac, gamma globulin, albumin, plasma, blood transfusions are prescribed. In some cases, it is advisable to use anabolic hormones (retabolil 1 mg/kg once every 2 weeks, etc.). Showing massage and exercise therapy, staying in the fresh air.
Forecast depends on the cause that led to malnutrition, and the possibilities of its elimination. With primary hypotrophy of the III degree, the prognosis is always serious; lethality is up to 30%.
Prevention. If possible, ensure natural feeding, treatment of hypogalactia, rational feeding, early diagnosis of diseases of newborns and infants.
Diagnosis code according to ICD-10. E46
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BMI indicators for women
- under 19- Insufficient body weight
- 19 - 24 - Normal body weight
- 24 - 30 - Overweight
- 30 - 40 - Obesity
- over 40- severe obesity
BMI indicators for men
- less than 20- Insufficient body weight
- 20 - 25 - Normal body weight
- 25 - 30 - Overweight
- 30 - 40 - Obesity
- over 40- severe obesity
Body mass index or, for short, BMI- This is an approximate value that allows you to indirectly judge whether a person is overweight or obese.
It is useful for every person to know if he is overweight. Women who are “always losing weight” are especially susceptible to this issue. Often, even slender ladies dream of losing a few kilograms, but at the same time they are guided only by fashion, and by no means by the advice of medical specialists.
Even the desired ideal figure may not be so ideal for a particular person. Because the concept of the norm depends on growth, age, physique (asthenic, hypersthenic or normosthenic), as well as on the rate of metabolic processes in the body.
To decide once and for all main question“Do I need to lose weight or can I still wait?” We recommend that you know your personal indicator - body mass index.
The formula for determining BMI was proposed in the middle of the 19th century by the sociologist and statistician Adolf Ketele, and mathematical expression body mass index as follows: body weight in kilograms divided by the square of height in meters.
Although there are several methods for assessing body weight and excess fat mass, big number methods (including Broca's formula, Lorenz's formula, formulas for determining fat content, etc.), it is the BMI value that is by far the most indicative and medically reliable. If you know your body mass index, you can visually assess the risk to your own health and susceptibility to diseases associated with obesity.
If the BMI value is in the range 16-18.49 , this means that there is a lack of body weight and a diet correction is needed to gain weight.
Normal indices body weight is 18.5-25 for women and 25-27 for men. According to statistics, people with such BMI values have the highest life expectancy and a much lower risk of developing many serious diseases.
Slight excess normal values BMI with minimal risk for good health - from 25 to 30. If your values are in this range, you should pay extra attention. physical activity and develop habits healthy nutrition. With age (after 30-40 years), the weight of all people invariably increases, so try not to gain weight anymore, or at least slow down the rate of weight gain.
If the body mass index is over 30, this is classified as one of the stages . This condition requires immediate measures to reduce body weight under the supervision of a dietitian or endocrinologist. To more accurately determine the degree of obesity, you will need additional methods and body fat tests.
It should be borne in mind that this formula for determining the normal weight is not suitable for professional athletes with developed muscles. Calculation according to this formula can show them one of the stages of obesity, since it does not take into account the actual fat content in the body.
Another reason why the body mass index may be unreasonably high is swelling or accompanying illnesses in which water accumulates in the body.
The article discusses obesity of the 2nd degree. We talk about the causes of its appearance, symptoms, diagnosis and treatment methods,. You will find out what drugs treat this disease, whether they take to the army with such a diagnosis, possible consequences and dietary habits for women, men and adolescents.
Obesity 2 (medium) degree (ICD code 10 - E66) - serious illness resulting from overweight and after the first stage of obesity. It occurs as a result of maintaining an incorrect and sedentary lifestyle, due to various diseases, taking certain medications and ignoring treatment.
This pathology is an increase in the thickness and volume of the internal and subcutaneous fat. A large amount of fat forming around internal organs and squeezing them, becomes the cause of a violation of their structure and work (visceral obesity), which entails a dangerous condition for human life and health, as it further leads to the development of various complications.
Adults and the elderly, as well as adolescents and children, are equally susceptible to this condition. Learn more about childhood obesity you can from this .
The main indicator characterizing this condition is BMI in the range of 35-39.9 kg/m2. The calculation of body mass index is carried out according to the formula:
I = m / h2
Where weight in kg is divided by height squared (height is measured in meters).
How to Calculate Body Mass Index In young women, stage 2 obesity results from overeating and a sedentary lifestyle. After 35 years, a slow metabolism can provoke such a condition. But usually the main reason is hormonal disbalance. The disease develops according to the gynoid type, the figure is in the form of a pear.
In men, this pathology is less often diagnosed due to the fact that the body of a man does not have such a tendency to hoarding as a woman's. The main factors in gaining excess body weight are the use of fatty foods, physical inactivity, as well as excessive passion for alcoholic products, especially beer. The disease develops according to the abdominal type, in which the figure is an apple.
In children under 1.5 years of age, obesity develops due to hereditary factors or through the fault of the parents. The main reasons are over-indulgence in milk formulas and improper introduction of complementary foods. One of the most dangerous stages is puberty, during which the body does not adequately respond to changing hormonal background. Pathology develops in a mixed type.
Types of obesity
Experts distinguish between primary and secondary forms of obesity. Primary obesity (alimentary, exogenous-constitutional) occurs as a result of a sedentary lifestyle and overeating. Secondary obesity (endocrine, hypothalamic) is due to impaired functioning various departments brain, adrenal glands and endocrine organs.
Primary obesity is the most common form of pathology. According to statistics, the appearance of excess and overweight is associated with:
- malnutrition - consumption a large number alcohol, carbonated drinks, sweet, spicy and salty products, as well as dishes with a lot of fats and carbohydrates;
- low physical activity - ignoring sports, sedentary work, spending the weekend at the TV and computer.
Secondary obesity is associated with wrong work endocrine system and the hypothalamus. But the quality of food also plays important role when excess weight appears, therefore it will not be superfluous to adhere to the principles.
The reasons
The main reason for the development of stage 2 obesity is the neglect of the first stage of the disease.
To provoking external and internal factors relate:
- hormonal disorders;
- diseases of the endocrine system;
- various viruses and infections;
- iodine deficiency;
- consequences of poisoning;
- complications after TBI;
- small physical activity;
- chronic lack of sleep;
- the use of psychotropic drugs;
- frequent stress and nervous tension;
- unbalanced diet;
- lack of thyroid hormones;
- genetic predisposition to be overweight.
Poor diet causes obesity If the cause of the disease is rare physical activity, stress and improper diet, then it will be quite simple to deal with this problem. It is much more difficult to deal with pathology if it is caused various diseases. To begin with, you will have to undergo a course of treatment, but therapy is not always effective.
signs
Signs of obesity of the second degree are:
- the occurrence of shortness of breath at rest;
- deterioration of well-being;
- visible ugly fullness;
- body mass index over 35;
- decrease in working capacity, physical activity;
- weakness for no reason;
- the formation of puffiness on the arms and legs in the summer;
- promotion heart rate during motor activity;
- increased sweating.
Each of these signs cannot indicate the presence of obesity of the second stage. But collectively they are clinical picture pathology. The final diagnosis can only be established by a specialist based on an examination.
According to the location of body fat, pathology is divided into 5 types:
- gynoid - buttocks and thighs;
- abdominal - stomach;
- mixed - the whole body;
- cushingoid - the whole body, except for the limbs;
- visceral - internal organs.
Photo obesity 2 degrees
Photo obesity 2 degrees in women 
Photo obesity stage 2 in men 
Photo of obesity of the second type in children Treatment
Therapy of the second stage of obesity involves taking certain medications and surgery. The statement that taking pills will allow you to lose up to 20 kg per month is just an opinion, since doctors themselves doubt the effectiveness of such drugs. However, without these drugs, the process of losing weight will be longer.
What pills help to lose weight correctly with obesity of the second stage? These are anorectics and blockers of fats and carbohydrates, let's look at each of them in more detail.
Anorectics
This group of drugs has a direct effect on the human brain, namely, on the saturation center in the hypothalamus. Contribute to dulling hunger and make it easier to endure food restrictions.
In the Russian Federation, it is allowed to take sibutramine tablets, which are prohibited in some countries:
- Reduxin;
- Lindax;
- Meridia;
- Goldline;
- Slimia.
Drugs containing amfepramone (Fepranone) or phenylpropanolamine (Dietrin) may also be prescribed.
Fat and carbohydrate blockers
Such drugs prevent the absorption of fats and carbohydrates in the intestines, provoking weight gain. In combination with diet and sports activities for obesity of the second stage, such drugs show a decent result.
Most often prescribed drugs containing orlistat as the main active ingredient:
- Listat;
- Orsoten;
- Glucobay.
At the same time, various dietary supplements, for example, Chitosan, show the worst result.
If obesity is in an advanced stage, therapy is not limited to taking pills, but surgery is also necessary. In the case when other methods of weight loss have not yielded any result, and obesity threatens with serious complications, including fatal outcome, experts prescribe bariatrics (gastric bypass, it's bandaging). Liposuction is not advisable, as the procedure gives only a temporary effect.
Allowed to use funds traditional medicine(diuretic and fat-burning herbs). But only after the permission of the attending physician.
Contraindications
Drug therapy for type 2 obesity is prohibited in the following situations:
- age up to 16 and over 65 years;
- breast-feeding;
- pregnancy.
In addition, each drug has its own list of contraindications, which must first be studied.
Nutrition (diet) for type 2 obesity Diet
Because common cause development of obesity is an unbalanced diet, then without correction of the diet, therapy will be ineffective. Many experts are inclined to believe that diet therapy is the main method of dealing with type 2 obesity, therefore it is referred to as therapeutic measures.
There is no universal diet that would help all overweight people cope with their problem. In some cases, you have to sit on several diets to find one that would be effective in a particular case. It can be noted that it is definitely not suitable for obesity, as it belongs to the category of hard and involves the use of alcohol.
When selecting suitable diet certain requirements must be followed:
- Meals should be simple, while having sufficient nutritional value. In the body of a person who is losing weight, without fail receive vitamins, trace elements and important amino acids.
- Eating a lot of fiber helps cleanse the intestines, so that excess weight will quickly go away.
- An important condition for all dishes is their low calorie content. In this case, we recommend that you try .
- For the duration of the diet, carbonated drinks should be completely excluded from the diet, replacing them with mineral water, natural berry-fruit compotes. Also banned are honey, smoked meats, sausages, sweets, pickles, flour products, alcohol, spicy spices and sauces, ice cream. It is necessary to minimize the consumption of granulated sugar and salt, oils and fats. Bread can only be eaten black and gray, mostly bran.
- Allowed the use of dairy products, but with a minimum fat content, best of all - fat-free. Fruits can also be eaten, but they must contain a minimum amount of sugar, no grapes and bananas!
- During weight loss, you should reduce the volume of servings, eat fractionally (6 times a day).
- It is useful to include unsweetened fruits, fresh vegetables and herbs in the diet. You can eat apples, but only green ones.
- Be sure to arrange at least once a week a fasting day. It helps cleanse the body of harmful substances that prevent you from leaving overweight. At this time, you can only eat certain foods, such as apples or cottage cheese (preferably low fat). It is permissible to eat only vegetables on a fasting day, except for potatoes.
- The importance of drinking regimen has long been proven in weight loss. Drink at least 2 liters per day clean water if there are no problems with edema. The principle is based on the drinking regime. Also useful to know.
Caloric content of products daily ration should be lower than before weight loss. But at the same time, the figure should not be less than 1200 kcal.
Below is sample menu in stage II obesity. Remember, portions should be reduced, and the multiplicity of their intake increased.
Menu:
- first breakfast - unsweetened coffee with milk, boiled meat, sauerkraut;
- second breakfast - unsweetened green tea, fat-free cottage cheese;
- lunch - unsweetened fruit and berry compote, borscht cooked in vegetable broth without meat, boiled chicken meat, baked vegetables;
- afternoon snack - green apple;
- first dinner - baked potatoes, boiled low-fat fish;
- the second dinner (before going to bed) - a glass of fat-free yogurt.
Nutrition for type 2 obesity should be varied and low-calorie. If desired, borsch can be replaced with vegetable stew or soup, baked potatoes - with boiled beet salad and low-fat sour cream or baked carrots.
The most important thing in stage 2 obesity is the desire to lose weight and become healthier. So, you will need to be patient in order to achieve your goal.
Exercise for type 2 obesity Physical activity
Excess weight will not go away on its own if you only follow a diet, and the rest of the time you sit on the couch or at the computer. Movement is life, so behavioral therapy plays a huge role in losing weight.
If you want to get rid of excess weight, you will have to change your lifestyle. For this:
- Try to move more. If you're at home, put on some upbeat music and start cleaning. Walk up the stairs, forget what an elevator is, take hiking outdoors.
- Practice all techniques complex therapy with obesity.
- Be less nervous and worry. Rejoice in life!
- Find the motivation to lose weight and do everything to achieve what you want.
- Give up bad habits Forget about alcohol and high-calorie foods.
- If you are experiencing problems with mental state take a course of antidepressants.
- Exercise regularly. Exercise in the morning, go to the pool in the afternoon, go for a bike ride in the evenings. All these activities underlie exercise therapy (physiotherapy exercises), which can be prescribed by a specialist.
- Get enough sleep. Sleep at least 8 hours a day.
- Strictly follow all the recommendations of your doctor.
Adhere to these rules, as well as follow the recommended diet therapy, and after short term you can achieve amazing results.
Obesity and the army
Many parents and guys are interested in the question of whether they take into the army with a second degree of obesity. We have already described above how to calculate the body mass index, now we will consider by what criteria a specialist identifies whether an overweight guy is fit for service.
- Category "A" - full suitability for military service.
- Category "B" - suitability for military service with some restrictions. When passing medical examination the presence of minor pathologies is confirmed, for example, slightly impaired vision.
- Category "B" - assignment of the status of limited fit. This category exempts from military service in peacetime, but in martial law, the conscript is enlisted in the 2nd queue.
- Category "G" - assignment of the status of "temporarily unusable". It means that the conscript has some pathologies that can be treated, for example, fractures or obesity. In such a case, a delay of six months is granted, which can be extended in the future if necessary.
- Category "D" - complete exemption from military service due to unsuitability.
Based on this, it should be noted that a conscript with stage 2 obesity can be drafted into the army only after weight correction and the necessary therapy.
Complications
Due to the fact that visceral fat puts pressure on most internal organs, their functioning is disrupted and slowed down.
In the absence of therapy and control by specialists, obesity of the second stage becomes the cause of such diseases:
- diseases of the gastrointestinal tract - pancreatitis with complications;
- gallbladder disease (more common in women);
- haemorrhoids;
- hypertension;
- type 2 diabetes;
- fatty hepatosis;
- cardiac ischemia;
- myocardial infarction;
- ailments of the musculoskeletal system;
- labored breathing;
- impotence, infertility.
If you ignore the treatment, then pregnancy may not occur. Such a diagnosis during pregnancy is dangerous, since in this case the risk of developing various complications on early dates pregnancy, anemia and respiratory ailments - in the later stages.
Obesity of the 2nd degree is not a death sentence and is not as dangerous as the last stage of the disease. But at the same time it carries more serious consequences, how initial stage obesity. Therefore, it is important to seek help from specialists, and not wait for the problem to go away on its own.
Video: Three tests for obesity