Degree 3 obesity in women, men and children: treatment with medications, nutrition, gymnastics, exercises

At different times, there were different standards of body aesthetics. One recalls the naked bodies of women in Rubens' paintings - plump beauties with carefully drawn cellulite. Later, subtlety came into fashion, and extra pounds were hidden under tightly tightened corsets. In our pragmatic and rational age, weight is approached not only from the point of view of aesthetics, but also health. Achievements and discoveries in medicine make it possible to prove that extra pounds are harmful to our health, worsen the quality of life, and become a disease. Scientists have developed formulas for calculating the optimal weight, and all deviations from it in the direction of increase are regarded as obesity of varying degrees. The third degree corresponds to an excess of ideal weight by 50-99%.

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Epidemiology

In the modern world, the number of overweight people is steadily growing, especially in developed European countries and America. Statistics call a depressing figure - more than 50%, and various degrees of obesity are about 30%. They say that laziness drives progress. People are increasingly inventing mechanisms that replace various production and household processes, freeing themselves from physical exertion, and high living standards make it possible to eat well and high-calorie. It is difficult to resist this.

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Causes grade 3 obesity

The causes of grade 3 obesity, like any other, may be as follows:

• metabolic disorders in diseases of the endocrine system;
• overeating, when less energy is expended than produced;
• inflammation or injury to the hypothalamus, which is involved in appetite regulation processes;
• inclusion of large amounts of flour and sweet foods in the diet;
• low physical activity;
• hereditary predisposition.

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Risk factors

Risk factors for obesity include age, hormonal imbalances (excess cortisol and lack of estrogen). Poor nutrition, consumption of spicy food and alcohol lead to appetite stimulation, stressful situations also aggravate the situation.

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Pathogenesis

A complex chain is involved in the regulation of fat metabolism: the cerebral cortex, hypothalamus, nervous system, endocrine glands. The pathogenesis of obesity lies in the imbalance of energy expenditure and appetite as a result of failures in one of the systems of the chain. The intake of energy materials into the body exceeds the intensity of metabolic processes, as a result, fat accumulation occurs. It is assumed that these disorders can be both congenital and acquired, associated with certain traditions in the family, way of life.

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Symptoms grade 3 obesity

A mirror and large clothing size will tell you about the existence of a problem. The fact that it has gone too far will be signaled by the symptoms of obesity, characteristic of the 3rd degree:

• shortness of breath when walking and even during moderate physical activity;
• pain in the musculoskeletal system;
• cardiac dysfunction;
• hypertension;
• gastrointestinal discomfort;
• decreased performance;
• depressive states resulting from an inferiority complex and low personal esteem.

Weight in obesity stage 3

A person's weight is a criterion for assessing the condition of his body and a reason to diagnose obesity. There are a number of methods based on the ratio of height and weight, with the help of which the norm of weight is determined, and all deviations from it in the greater direction give the right to consider it as obesity and, depending on their size, classify. The simplest formula is the following: with a height of up to 165 cm, the number 100 is subtracted, 165-175 cm - 105, and over 175 cm - 110. The result of the calculation is the optimal weight. With obesity of the 3rd degree, it is one and a half to two times higher than calculated. The first signs that the problem has become serious include deterioration in health, expressed in rapid heartbeat, increased sweating, drowsiness, frequent headaches.

Obesity stage 3 in a child

Methods for determining normal weight for adults are not suitable for young children. There are special tables that show the correspondence between the age and weight of infants, and they are different for boys and girls. These standards can be found on the Internet, in special pediatric literature. At a doctor's appointment, the child's weight and height are measured; if there are any deviations, the pediatrician will adjust the diet.

During adolescence, all responsibility falls on parents. It is no secret that well-fed children are often a source of pride and an indicator of their care. It happens that family gastronomic traditions based on high-calorie, abundant food, a sedentary lifestyle lead to obesity in children. Other reasons include hormonal imbalances, metabolic disorders, and heredity.

Obesity of the 3rd degree in a child corresponds to excess weight by 50-100%. To clarify the diagnosis, the circumference of the hips, waist, chest is measured, and with the help of a so-called caliper - a special device, the thickness of the subcutaneous fat layer.

Obesity of the 3rd degree in men and women

Obesity in men can be determined by calculating the body mass index (BMI) using one of the existing formulas: weight divided by the square of height. Exceeding its value by 40 times indicates obesity of the 3rd degree. Male obesity is dangerous because it reduces testosterone levels. Fats convert it into estrogens, which in turn inhibit testosterone production and promote fat accumulation. It turns out to be a vicious circle. Another sign of low testosterone production is a waist size exceeding 102 cm. A decrease in sexual function is a big blow for a man. In addition to the direct threat to physical health, excess weight also causes psychological problems.

Obesity of the 3rd degree is much more common in women than in men. Women who have crossed the fifty-year mark are especially susceptible to this. This is due to hormonal changes and a decrease in business activity. Excess weight at a young age can affect reproductive function, menstrual cycle failures, since the level of progesterone decreases and testosterone increases. Also, in addition to the problems associated with excess weight, inherent in both sexes, women have an increased risk of breast, ovarian, and uterine cancer.

Stages

Obesity of the 3rd degree does not occur instantly. Weight gain occurs gradually and goes through several stages before becoming excessive. There is a stable stage and a progressive stage. Obesity is divided into 4 degrees. To determine them, you can use the formula we already know: weight divided by the square of height. The resulting index is called Quetelet and is different for men and women.

Thus, the first degree for women corresponds to the index of 28-30.7, for men - 30-32.2, the second degree - 30.8-35.4 and 32.3-37.2, the third degree - 35.5-47.3 and 37.3-49.7, the fourth degree - more than 47.3 and 49.7, respectively. Having made this simple calculation, we get an objective picture of the state of our body. When determining the degree of obesity in children and the elderly, some difficulty arises, since their muscles are weaker than those of healthy adults. In this case, the dynamics of weight are monitored and a conclusion is made about what stage the obesity belongs to.

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Forms

Obesity is divided into two types depending on the causes: primary and secondary. Most people (90-95%) suffer from primary. There are several forms:

• alimentary-constitutional (hereditary);
• with violation of dietary norms;
• mixed.

Secondary is:

• with genetic defects;
• cerebral;
• endocrine-metabolic;
• due to mental illness;
• taking psychotropic drugs.

In other words, it is caused by head injuries, brain tumors, surgeries, diseases of the neurovegetative system, mental disorders or diseases of the thyroid and pancreas, genetic diseases. According to the anatomical structure, there are android, gynoid and mixed. Android is a male type or "apple", in which fat deposits are located in the upper part of the body. Gynoid "pear-shaped" is characterized by the predominant accumulation of fat in the buttocks and thighs. There is also a mixed type - fat is evenly distributed throughout the body.

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Exogenous-constitutional obesity grade 3

The first part of the name - exogenous-constitutional obesity of the 3rd degree - says that it is caused by exogenous factors - overeating, national characteristics, gastronomic culture in the family. The second part indicates a hereditary predisposition, the activity of fat metabolism.

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Alimentary obesity

Alimentary obesity is also called trunk obesity and is primary. The imbalance between calories consumed and spent leads to the accumulation of subcutaneous "reserves" and around internal organs. Alimentary obesity of the third degree indicates an advanced stage of the disease. With this diagnosis, the liver, heart, and cardiovascular system suffer. Most often, the cause lies in the hereditary factor.

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Morbid obesity grade 3

Morbid obesity means pathological weight gain, which makes it difficult to perform the functions that are characteristic of maintaining the normal state of the body. It corresponds to the 3rd degree of human obesity, in which the body mass index is equal to or exceeds 40 units. As a rule, it is predetermined by a genetic factor.

Pregnancy with obesity stage 3

Pregnancy with stage 3 obesity is at risk due to the many different complications and threats contained in excess weight. It is dangerous due to the development of:

• gestational diabetes;
• hypertension;
• genitourinary infections;
• thrombosis;
• sleep disturbances and short-term cessation of breathing (apnea);
• the possibility of miscarriage or post-term pregnancy;
• violations of labor activity.

Maternal obesity poses a threat to the child's health. Firstly, the child may be born with a large weight (macrosomia), which is fraught with obesity in the future. Secondly, there is a risk of congenital pathologies, such as heart disease or diabetes. The optimal weight that an overweight woman can gain during a single pregnancy is 5-9 kg, and during a multiple pregnancy - 11-19 kg. The doctor monitors the pregnancy of an overweight woman more carefully, conducting frequent observations and examinations.

Complications and consequences

The consequences and complications of stage 3 obesity are a serious danger to the normal functioning of various human organs:

• gastrointestinal tract;
• pancreas (development of pancreatitis);
• liver;
• cardiovascular system (high blood pressure, vascular disease of the legs, ischemic strokes, heart disease, atherosclerosis);
• endocrine system (type 2 diabetes);
• musculoskeletal system;
• respiratory and reproductive systems.

In addition to the physical consequences, overweight people bear a great deal of psychological burden, which often leads to depression.

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Diagnostics grade 3 obesity

When diagnosing stage 3 obesity, anthropometry is used - determining the basic physical data of a person: weight, height, volumes in different parts of the body (chest, waist, hips). After that, existing classifications are used to determine the degree, type of obesity, type of fat localization, which is important in determining the risks of developing various diseases and complications. Excess weight is the area of activity of endocrinologists and nutritionists. First of all, the doctor will find out the diet, the amount of food eaten and send you for additional tests to determine the source of the problem: poor nutrition, hormonal imbalances or metabolic disorders.

In case of obesity of the 3rd degree, laboratory tests of general blood and urine analysis are carried out to determine glucose, biochemical analysis of the state of fat, carbohydrate, protein metabolism, deviations of other indicators indicating concomitant diseases are revealed. It is also necessary to determine the level of thyroid hormones - triiodothyronine, thyroxine and thyroid-stimulating hormone produced by the pituitary gland.

Instrumental diagnostics make it possible to determine the level of influence of obesity on the functions of other organs and systems. For this purpose, ultrasound, MRI, and fluoroscopy may be prescribed. To check the heart's function, an electrocardiogram is sent.

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Differential diagnosis

Differential diagnostics are carried out with Itsenko-Cushing's disease, which has similar symptoms: obesity, urolithiasis, diabetes, menstrual irregularities, decreased immunity, etc. But this is a neuroendocrine disease caused by excessive production of hormones by the adrenal cortex due to excessive secretion of corticotropic hormone by the pituitary gland. In women, this disease occurs after childbirth, and can be a consequence of head injuries, bruises, concussions.

Treatment grade 3 obesity

Treatment of stage 3 obesity primarily involves prescribing a low-calorie diet, which is based on eating foods high in fiber, vitamins (nuts, grains, salads, fresh vegetables and fruits) and low in carbohydrates (sugar, bakery and pasta). Along with the diet, increased physical activity and sports are recommended. If these methods do not bring results, drug therapy is prescribed, which includes taking anorexigenic drugs. If the drug is ineffective, it is replaced with another. There are also surgical treatments.

Medicines

All weight loss medications are aimed at weight regulation by suppressing appetite, changing metabolism or calorie absorption. Appetite suppression occurs with the help of catecholamines and their derivatives (amphepramon, fluoxatine). They lead to the accumulation of sirotonin and norepinephrine in the central nervous system, which in turn suppress the feeling of hunger.

Amfepromone - stimulates the satiety center and suppresses the hunger center. Dosage form - dragee, single dose of 25 mg one hour before meals, twice or three times a day. The maximum dose can be no more than 100 g per day. The course of treatment is 1.5-2.5 months, after a three-month break it can be repeated. The drug is contraindicated in hypertension, myocardial infarction, atherosclerosis, epilepsy and mental disorders, glaucoma, tumors, children under 12 years of age, pregnant women. Side effects are possible in the form of nausea, vomiting, weakness, high blood pressure, allergic rashes.

The mechanism of action of other drugs is blocking cannabinoid receptors (rimonabant, acomplia).

Rimonabant - tablets, used for weight loss along with a low-calorie diet and exercise. Daily dose - 20 mg. The drug can be taken for 2 years. Side effects include nausea, anxiety, diarrhea. Not recommended for use by children, pregnant and lactating women, people with mental illnesses.

Anorexics are antidepressants that reduce appetite (sibutramine, reduksin, meridia).

Sibutramine is a crystalline powder soluble in water. It is taken in the morning, once a day, 10 g, if the effectiveness is weak, the dose is increased to 15 g after a month. Side effects are possible from the cardiovascular system: increased blood pressure, respiratory failure. Headaches, constipation, dry mouth may also occur. Contraindicated for children, the elderly, pregnant women, during lactation, patients with epilepsy.

Thermogenics and lipotropics, in other words fat burners, speed up metabolism. The drugs orlistat, xenical, orsothen prevent the breakdown of fats and their absorption.

Orlistat is a powder that inhibits gastric and pancreatic lipases, enzymes that help break down fats. Take 120g at a time with each main meal, or an hour after eating. If the food is not fatty, you can skip the dose. Contraindicated for use by pregnant women, nursing mothers, and those with hypersensitivity to the drug. Side effects include oily stools and frequent urge to defecate.

Vitamins

When losing weight, vitamins must be included in the diet so that with weight loss you do not lose, but rather strengthen your health. Knowing the effect of certain vitamins on the processes occurring in the body, you can choose their optimal set, which will help bring the expected result closer. Thus, vitamin D reduces the feeling of hunger, C and B8 destroy fats, E is necessary for the normal functioning of the immune and endocrine systems, B vitamins are indispensable in the coordinated work of all human life support systems: B2 - participates in metabolic processes, B3, B6 - normalizes blood sugar, stabilizes hormonal levels, B4 - ensures fat metabolism, B5 - removes fats, improves metabolism. Vitamin omega-3, which is not synthesized by the body, is also required. When taking vitamin complexes sold in pharmacies, you must drink plenty of water (1.5-2 liters per day).

Physiotherapy treatment

In case of obesity of the 3rd degree, physiotherapy treatment is successfully used, but necessarily in combination with other methods: physical exercises, dietary nutrition, sometimes medication. Therapeutic gymnastics should be performed daily for at least 20 minutes in different positions with the involvement of different muscle groups. Reflexology has proven itself well: acupuncture and laser puncture. Acupuncture is part of Chinese culture, one of the areas of traditional folk medicine. It consists of influencing individual areas of the body, the so-called meridians - human energy centers, with needles. Laser puncture uses a laser for this purpose. Water procedures are also prescribed - a circular shower, underwater massage and just swimming, as a type of physical activity.

Folk remedies

The arsenal of folk medicine includes various herbs that reduce appetite and normalize metabolism, low-calorie diets, recipes for dishes rich in fiber, and medicinal baths. To prepare baths, make a decoction of calamus, thyme, juniper, mint, hay dust, and birch leaves. Other medicinal herbs can be individually selected, the main principle is to open the pores of the body. The following proportion is observed: take half a liter of water for a tablespoon of each herb, boil for several minutes, and leave for at least an hour. Pour the infusion into a bath of warm water. This procedure can be repeated several times a week.

A drink is prepared from wheat bran: 200 g of bran is poured with a liter of water, boiled for 10 minutes. The cooled solution is taken before meals 4 times a day, 100-150 g each. Honey is also successfully used: in the morning on an empty stomach, dissolve a teaspoon in a glass of slightly warm water, thus filling the stomach, and the body receives the necessary vitamins and microelements. Apple cider vinegar is a well-known remedy for obesity: pour 2 teaspoons into a glass of water, drink half an hour before meals three times a day.

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Herbal treatment

In addition to using herbs for water procedures, infusions, decoctions, and teas for internal use are widely used. Such treatment is supposed to improve metabolism, reduce hunger, and cleanse the body of harmful waste and toxins. An infusion of valerian root will help reduce appetite: 70 g per liter of cold water, drink 100-150 g every other day 30 minutes before meals. The following herbs are used to combat obesity: horsetail, bean pods, knotweed, immortelle, corn silk, birch buds, and buckthorn bark. You can use ready-made pharmaceutical diuretic mixtures.

Homeopathy

Homeopathy in the treatment of obesity is used as part of complex measures to reduce weight, its effect is not instantaneous, but the low rate of complications speaks in its favor. There are constitutional, pathogenetic and etiotropic homeopathic drugs.

Constitutional remedies (depending on the type of person, his individuality) include sepia, sulphur, barium carbonicum, ammonium carbonicum, calcium carbonicum.

Calcium carbonicum — is produced in granules in various dilutions, improves metabolism. Doses are prescribed individually. The drug has a number of contraindications: kidney stones, stomach ulcers, high blood pressure, hypersensitivity. Side effects in the form of arrhythmia, a special taste in the mouth, nervousness, rapid fatigue are possible.

Etiotropic drugs are prescribed for secondary obesity and are aimed at the cause that provoked the appearance of excess weight. These are acidum phosphoricum, nux vomica, anacardium, ignatia.

Ignatia is a combination drug made from plant and animal components. It is an antidepressant, prescribed for various neurological pathologies. It is available in drops, a single dose for children under 2 years old is 3 drops, from 2 to 6 - 5 drops, after 6 years - 10. The solution is dripped under the tongue, can be diluted in a few spoons of water. It is taken 3 times a day, without mixing with food. Side effects may occur in the early stages of treatment from the disease that the treatment is aimed at. In this case, it is worth continuing the treatment. It is not contraindicated for pregnant women, if you are allergic to the components of the drug, you should stop using it.

Nux vomica - the herbal components of the drug determine its hepatoprotective, laxative, anti-inflammatory effect. Drops are taken a quarter of an hour before meals or an hour after. The dosage is different for different ages: 9-15 drops for small children and 30 drops for adults three times a day. Contraindications exist for pregnant women and in case of individual intolerance.

Pathogenetic drugs are also aimed at treating concomitant diseases. Thus, for cardiac pathologies, lachesis, arnica, and spigelia are prescribed; for diseases of the digestive tract, nux vomica, calcium carbonicum, and mercurius dulcis; for urological ailments, cantharias, thuja, bryonia, etc.

Spigelia is a tincture used in low dilutions for heart disease. The dose is determined by the homeopath individually. Side effects may include palpitations, nausea, and vomiting. Contraindicated for pregnant and lactating women, and allergic reactions to the drug.

Surgical treatment

Surgical treatment is the most effective way to get rid of obesity. Indications for its implementation are a BMI of over 40. In diseases such as type 2 diabetes, varicose veins, hypertension, surgery can also be used with a BMI of over 35. In the world, two types of surgical intervention are most often used: gastric bypass (common in America, Canada) and gastric banding (Europe, Australia). Such operations are most often laparoscopic and make it possible to get rid of half the weight. The bypass method involves the formation of a "small" stomach by cutting its upper part and connecting the small intestine to it. Thus, the volume of the stomach decreases from 2 liters to 20-50 ml. The banding method involves applying a special bandage - a ring that divides the stomach into two parts: upper and lower. Since the satiety receptors are in the upper smaller part, it does not require much food to fill it and feel full.

Diet for obesity stage 3

The most common culprit of stage 3 obesity is still overeating, so the main task in the fight against it should be to establish proper nutrition. First of all, it should be fractional and frequent. Diet No. 8, recommended for stage 3 obesity, is based on low-calorie foods that provide satiety. It is necessary to remove fried, stewed, salty, spicy foods from the diet. Also, refuse flour, pasta, cereals, potatoes, sweets: sugar, candy, honey. Eat more raw vegetables and fruits. Fats should be limited, but not completely eliminated. A small amount of butter and unrefined vegetable oil will be needed by the body for metabolic processes. Limit foods containing a large amount of cholesterol - liver, eggs.

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Menu for a week for obesity stage 3

A weekly menu for stage 3 obesity may include "thematic" days that focus on one specific product. Food should be divided into 5-6 meals, the body should be supported with rosehip infusion - a source of many vitamins and minerals (a glass a day), and several cups of unsweetened coffee with milk are also allowed:

• meat day (300-350g boiled lean meat, preferably chicken or turkey, boiled vegetables as a side dish);
• vegetable ((boiled beets, carrots, broccoli, celery root) or cucumber (2 kg) in summer);
• apple (at least 2 kg, can be combined with a small amount of hard cheese);
• milk (every two hours a glass of low-fat yogurt, kefir or milk);
• fatty (300g sour cream in 3 doses);
• fish (200-300g boiled low-fat, possibly with a small (30g) portion of rice).

One day a week, with the doctor’s permission, can be a fasting day, while it is necessary to drink a lot of water.

Exercises for obesity stage 3

In case of obesity, physical activity is necessary to stabilize metabolic processes, strengthen muscles, and restore physical activity. It should be adaptive, take into account chronic diseases, and gradually involve in systematic exercises. It is necessary to start exercises for stage 3 obesity with a ten-minute morning warm-up and measured walking. The warm-up should include turns, tilts, and head rotations, exercises for the joints of the hands, elbows, forearms, feet, and tilts in different directions of the body. Then comes slow walking (2-3 km per hour). Gradually, physical activity increases. Walking is replaced by measured running with an increase in the length of the distance, and exercises on exercise machines are included. Three-minute running should be alternated with walking, after resting, switch to running again, and pauses should also be taken during exercise on exercise machines.

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Massage for obesity stage 3

Massage for stage 3 obesity is indicated to improve blood circulation, stimulate metabolism, increase oxidation-reduction processes, tone the body, and increase energy expenditure. The massage is directed at areas of subcutaneous fat accumulation, large muscles, and uses a "suction" technique, i.e. kneading, rubbing, stroking, shaking, and percussion techniques. The massage begins with the back, moves to the cervical spine, then to the buttocks and legs. Turn the patient over onto his back, massage the chest, sides, and arms.

Prevention

Obesity prevention is rooted in two components of the problem: nutrition and physical activity. You need to accumulate less fat and spend more. Reducing high-calorie foods, “fast” carbohydrates in your diet, and limiting portions will not allow weight to take over a person. When exercising, remember that carbohydrates provide energy in the first 20 minutes of work, and then fats begin to burn. Walking, light jogging, swimming, skiing are the sports that will bring not only benefits, but also pleasure. If obesity is a consequence of pathological phenomena, preventive measures should be directed at their source.

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Forecast

The prognosis for stage 3 obesity depends on concomitant diseases. In such people, the risk of death, for example, from cardiovascular pathologies, atherosclerosis, various infections, surgical interventions is much higher than in patients with normal weight.

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Army and obesity of the 3rd degree

Before being called up for military service, young men undergo a medical examination, which is represented by specialists of various profiles. There, their height is measured, they are weighed and their BMI is determined. The army and obesity of the 3rd degree are incompatible. If the BMI is above 40, they are exempted from service for life and sent to an endocrinologist.

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Disability due to obesity of the 3rd degree

In case of obesity of the 3rd degree, disability of the 3rd group is established. Such a conclusion is made by medical and social examination. In case of concomitant diseases, taking into account the degree of decrease in working capacity, profession, working conditions, ability to take care of oneself, the 2nd group can be determined.

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