Monday, April 9, 2012

Obesity


What is obesity?
When entered in the amount of calories the body exceeds the amount of energy consumed, the body stores excess calories in fat cells.

What causes obesity?
The main causes of obesity are cultural influences on eating habits and physical activity. Research shows that sweet drinks and fruit juices main culprits of obesity in young people. Challenges to media (TV, commercials) are particularly vulnerable children, and culture and educational system offered few healthy substitutions. Vacation time and work is increasingly carried out at rest, because people are using cars, watching TV, playing video games and working at the computer moved from one seated position to another.

Brain regulation of metabolism and behavior
Determine the weight of the nervous pathways in the brain and gastrointestinal tract. Centers for eating and satiety, which are located in the hypothalamus and pituitary gland responding to signals that indicate a high fat stores and hunger. Matter of crucial importance in this process the glucose (sugar), insulin (a hormone responsible for glucose entry into cells) and leptin (an enzyme that signals the brain that fat stores are high).Leptin performs many functions that are of great interest in studies of obesity and possibly diabetes. This is a hormone released from fat cells, its concentration increasing as much fat stored in cells. Increase the level of the hypothalamus signals the need to reduce appetite, while lowering the concentration stimulates the appetite. Leptin may act on the resistance to the effects of insulin, a hormone essential for the metabolism of blood sugar. Recent research on animals has shown that leptin is not only secreted by fat cells, but also gastric cells. Cholecystokinin, a hormone that stimulates the small intestine, the secretion of digestive juices can act together with leptin and stimulate or suppress appetite. Yet unknown mechanisms by which leptin participates in weight gain.

Genetic factors
Genetic factors influencing the metabolism of fats and regulating hormones that affect appetite and probably have a role in 70% of cases of obesity. A large number of genetic variation affecting susceptibility to obesity.Hereditary factors may include how the distribution of fat, your metabolic rate, energy reactions to over-eating, favorite food etc.. They are directly responsible for some cases of obesity is very high. Although genetic abnormalities affecting easier or harder to lose weight, the predominance of obesity in the last 20 years has dramatically increased, while the genes so they could quickly change. Human metabolism evolved so that it can conserve energy and store fat in times of starvation. Obesity is most common in the normal physiology of people living in industrialized countries with an abundance of food, it is not difficult to spend too little energy to burn excess calories. According to one theory of type 2 diabetes and obesity, which is usually a side effect of this disorder, derived from genetic actions that were once necessary for survival. Some experts argue that there is so called. "Thrifty" gene that regulates the flow of hormones to fit seasonal changes. Some nomadic peoples hormones are released during seasons in which the amount of food has always been small, resulting in resistance to insulin and efficient fat storage. This process is reversed in seasons when food is abundant. As the food with high content of carbohydrates and fats modern industrialization has become available throughout the year, the gene no longer serves its purpose but becomes harmful because it was originally used to store fat for periods of starvation, not spending. This theory could explain the high incidence of type 2 diabetes, obesity among native American tribes with nomadic history, as well as Western eating habits. Traditional foods are low in fat and high in fiber (corn, beans and acorns) which is fed nomads probably protect this vulnerable population of genetically frequent cases of obesity and type 2 diabetes, which is no longer the case. Some genetic mutations that have recently resulted in connection with specific cases of obesity include one that probably increases the number and size of fat cells and is associated with massive obesity. Another gene called melanocortin-4 receptor and plays a major role in breaking the need for eating, and which in some families with no cases of obesity.

Other causes of obesity
Overweight contributes to a range of medical conditions, although they are rarely its primary cause. Patients with under-active thyroid gland does not gain too much weight, and it is mainly accumulated body fluids. Cushing's disease is rare and is caused by high levels of steroid hormones that lead to obesity, mjesečastog face shape and loss of muscle tissue. Obesity is linked to polycystic ovarian syndrome.

Obesity in adults
Anyone who is moving a bit and have bad eating habits belong to risk group. Lack of movement and form a vicious circle of obesity. Lack of exercise contributes to weight gain and obesity is difficult to move. World Health Organization is treated as a global epidemic of obesity and health problems, as more countries accept Western habits. It is important to note that despite the fact that obesity (BMI over 30 - the body mass index) is undoubtedly dangerous, is not sure whether only overweight (BMI 25-28) is very dangerous for those who are otherwise healthy and not risk group for developing diabetes, heart disease or cancer. In men, BMI tends to increase until the 50th age, then declines. The woman's weight increases until the age of 70 years, and then equalizes. Weight gain is inevitable with aging, a gradual gain about 5 pounds at a healthy weight is not harmful.This condition is exacerbated by the fact that muscle and bone mass decrease aging, thus increasing the weight room really about 0.75 kg.

Obesity in children
Fatty cells proliferate during periods of growth and development: early adolescence and adolescence. Excessive eating in these times of increasing their number, which is genetically determined. Some have been born with a surplus of these cells. Be sure to play a role and influence of parents, if the parent is obese three-year child, and child (though thin) has a 30% chance tnu become one day the same. After adolescence increases the mass of fat cells, not their number and hence the weight loss in adulthood reduces the size of fat cells rather than their number, so weight loss is much more difficult for adults who have a child, when the cells multiplied, were obese.

Risk groups

A former smoker.
The trend of increasing severity followed the trend of smoking cessation. Nicotine speeds up the metabolism, and smoking cessation, even with the same amount of food eaten, can lead to weight gain which can be significant. The important fact is that weight control is not a valid excuse for smoking. Over the past century have not smoked a cigarette, and even obesity was common.

Shift workers
Workers in the late shifts (between 16 h and 8 h) eat more and have longer vacations than workers sleeping in daily shifts and are prone to gaining weight.

Diagnosing Obesity
Obesity is diagnosed by measuring body fat rather than body weight can be compared to the normal standards to be outside the limits of weight, but if it is well muscled with little physical room, not obese. Others may be too low or normal body weight, and still have too much fat. There are three basic measures for the diagnosis of obesity: body mass index (BMI from eng. Body Mass Index) as a measure of body fat, waist circumference and risk factors of diseases and conditions associated with obesity.

BMI
The best measure of body mass is a measure called body mass index (BMI). BMI is a ratio of body weight in kilograms and height in meters squared. The result is applied to scale showing the levels of body mass. Overweight is defined if BMI 25-29.9 and obese when BMI is 30 or more. These guidelines are very important for patients with increased risk of diabetes, heart disease and some cancers. Experts can not agree in the determination of "dangerous" weight at various life stages or for healthy people without these risk factors. The volume of abdominal fat is very important for the assessment of risks. Fat on the abdomen and hips could be an additional indicator of risk. Schedule fat estimated by dividing the waist measure to measure your hips. For example, women with a waist diameter of 75 cm and 100 cm hips has a ratio of 0.75, with a 16.5 waist and hips of 15.6 ratio will be 1.05. The lower the ratio, the better. The risk of heart disease rises sharply in women with a ratio above 0.8 and men with a ratio above 1.0. Anthropometry is the measurement of skinfold thickness in different areas of the body, especially the triceps, shoulders and hips. This measure is useful for determining whether the weight due to an increase in muscle mass or fat.

General guidelines for reducing overweight
Given the high percentage of failures of weight loss programs and the growing evidence that the obese are fighting against a biological mechanism that works against the conscious effort weight control, many are working on changing social conditions, arguing that the natural state of obesity. The current cultural trend that represents the extreme thinness in women caused a distorted outlook on the design of the human body and created an ideal that no one can or should follow. Obesity is the second "I" and anorexia, but the emergence of epidemic due to excess availability of food and low metabolic demands of our civilization, moving slightly. Extreme weight - too big or too small - not healthy, nor is it a normal condition. The movement, methods of solving problems and support of the environment are important prerequisites for successful weight loss program. Weight loss should not be the sole or primary purpose of health care. Some stručnjacivjeruju not weight that causes diseases associated with obesity, but junk food and lack of movement. They point to one study in which obese subjects started to exercise regularly and take plenty of fruits, vegetables, whole grains and low fat. After only three weeks, indicators of heart disease (cholesterol and triglycerides, blood pressure and insulin) have improved, although the average weight loss was less than five percent. Other studies have also confirmed the improvement of health, with a weight reduction of only five to ten percent.

Diet and lifestyle in weight control
Although many studies have been successful in the long run people who were taken off the excess weight, it is important to note that most of them carried out in a very obese subjects who applied a very strict weight loss programs. You should also know that the child is unsuccessful a very common occurrence. The stomach, which was expanded large portions continue to signal the need for large amounts of food until the time of his meals with smaller size is reduced. Even in the case of repeated failure of a child, there is no reason to surrender.

Foods low in fat and sugar and high fiber content
Some studies have shown that the replacement of foods rich in fat and sugar foods rich in complex carbohydrates and low in fat (fruits, vegetables, whole grains) may be more effective than counting calories, especially when it comes to maintaining weight loss. Counting fat grams can be more beneficial than keeping records of food consumed per day. One gram of fat contains nine calories while one gram of carbohydrate or protein has only 4 calories. Fat from the food faster than carbohydrates and protein transforms into body fat. In one study participants who consumed foods that are low in fat they lost three more pounds than those on standard diet with fewer calories. However, many of which reduce fat intake do not consume enough basic nutrients, including vitamins A and E, folic acid, calcium, iron and zinc, and often increase the amount of carbohydrates. Foods low in fat may not be an excuse for excessive consumption of carbohydrates, especially starchy foods and sugar. High calorie diet from any source thick. People who take food with low fat diet should be varied and, as appropriate, vitamins. Only by taking milk with low fat or skim milk can be achieved by reducing the recommended calories from fat of 30% or less and help the body get calcium. A certain amount of fat in food is necessary. You should take the form of oils of some plants and fish. Saturated fats of animal origin should be avoided.

Fat substitutes
Fat substitutes added to commercial foods or used for baking, have some desirable qualities of fat, but do not contain too many calories. Some alternative substances, such as. cellulose gel (derived from seaweed), guar gum, used for decades in many commercial foods and are considered harmless. Recently synthesized fat, olestra, is released from the body without leaving any calories in it. (Note that food containing this substance does have a caloric value as compared to carbohydrates and proteins). There are reports of cramps and mild diarrhea after eating food containing olestru. Olestra depletes the body of vitamins A, C, D and E and essential nutrients for immunity, which are found in dark fruits and vegetables.

Fiber
All health products should have high fiber content, which are important factors in weight loss. It interferes with the absorption of fat and protein, along with nutrients from foods high in fiber, may reduce the risk of heart disease, diabetes, digestive disorders and some types of cancer. Fiber is found only in plants. For the most effective weight loss insoluble fiber from wheat bran, corn, seeds and bark of fruit and vegetables. Soluble fiber from dried beans, oat bran, barley, apples, citrus fruit and potatoes, are of great importance in the daily diet.Pectin, the fiber from apples, citrus and other fruits and vegetables, increases and prolongs the feeling of fullness in people of normal weight.

Sugar substitutes
Artificial sweeteners are saccharin, aspartame and acesulfame. The first study showed that large amounts of saccharin cause cancer in rats, which are not applicable to humans. Aspartame has come under control due to reports of a rare neurological disorder that causes, such as headaches and dizziness. Unfounded concerns about the connection between aspartame numerous applications of the increasing number of people with brain cancer.

Low-calorie diet
Reduced caloric intake is a prerequisite for the treatment of obesity. The first step in maintaining a normal weight is to calculate the amount of calories needed per day, ideal weight, but varies according to sex, age and physical activity. (For example, fifty moderately active woman to sustain a weight of 67.5 kg per day to only 1650 calories, while year-old athlete needs about 2,000 calories.) Extreme diets of under 1100 calories a health risk, and often followed by binge drinking and overeating, and return to obesity. This diet usually contains enough vitamins and minerals, so they must be compensated. Drastic child causing unpleasant side effects (including fatigue, cold intolerance, hair loss, gall stones, and the creation of irregular menstrual periods) and can be dangerous. Initially mainly lose fluids and minerals, fat later, and muscles, which can constitute over 30% of the lost weight. Strict diet that lasts longer than 16 weeks or one speeding lasting longer than two or three days are very dangerous. There are rare reports of deaths caused by heart arrhythmias when liquid content child did not contain sufficient amounts of nutrients. It is important that the child containing increasing amounts of liquids and much reduced protein and sodium, can lead to hyponatremia, and this weakness, confusion, dizziness and in extreme cases, coma.

High diet
Again, the popular diet rich in protein and low in carbohydrates. Although High protein diet results in rapid weight loss, health effects are not favorable. One byproduct of this diet is the release of substances collectively known as ketones, which cause nausea, dizziness, and bad breath. But a recent study showed that the so-called. ketone diet very high in protein and very low in fat and carbohydrates, can be a harmless and effective way of losing excess weight dangerously obese adolescents under professional guidance.

Physical Activity
It is important to note that the risk of obesity are not only the excess pounds, they result from the excessive amount of fat. Physical activity that fat replaces muscle, the most important factor in any weight reduction program, but as a diet, just as difficult to maintain. Since obesity is often associated with heart disease and other diseases, before applying the child physical activity program should be developed in consultation with the doctor.Most experts recommend a daily 45 to 60 minutes of exercise, mostly aerobic, walking in nature, brisk walking or dancing temperamental. Ergometry burns most of the excess calories. Resistance or strength training 2-3 times a week should be an integral part of the regime, which is an excellent fat replaces muscle. All these exercises should not be implemented all at once rather than spread them throughout the day. A new study has shown that maintenance of physical activity with total loss of excess weight and frequent exercise than at least 10 minutes, may be the most effective program to eliminate obesity. It should be noted that useful any regular physical activity. Even moderate regular exercise improves insulin sensitivity (which, in turn, helps prevent heart disease and diabetes). Although intense physical activity does not help the current burn excess calories, your metabolism stays elevated after exercise, and what activities are difficult to metabolism before his return to the level of idle longer continues to burn calories. An elevated metabolism may take a few minutes after the last activity of up to several hours after prolonged or strenuous physical activity. Although the loss of calories lost in the period after the activity is not large, over time they can be of great importance in maintaining a healthy weight. Physical activity also improves psychological well-being and replaces nekretanja habits that usually lead to excessive consumption of "snacks". It is a slight damper appetite. It is important to realize that weight loss makes initial level of physical activity to burn fewer calories per kilometer they walk or pretrčanom. Speed ​​weight loss slows down, sometimes daunting pace, so that after the initial dramatic need to combine diet with exercise. People should be aware of this fact and follow the daily workout. Aging its amount should be increased to maintain a constant body weight.

Cognitive-behavioral therapy
The goal of this therapy has changed the daily habits of eating, which is useful in preventing relapse after initial weight loss. The patient initially keeps a diary of all activities related to nutrition, including time of day, length of meal, emotional states, society and, of course, the type and amount of food eaten. The therapist and patient together examine this log to determine realistic goals and patterns that the patient can change. For example, if you normally eat watching TV, then the patient may be advised to eat in another room. Good eating habits are encouraged award - other pleasures, which replaces the excessive consumption of calories and habits nekretanja.Behavioral therapy has proven useful especially in those with excessive reaction to the taste, odor and appearance of food.

Drugs and methods for treatment of obesity
Drugs used for weight loss called anoreksici. The effect disappears over time, most of which require increasing doses, and this dependence and danger. Neither one of them does not remove the basic problems that probably cause obesity. Unless prescribed by a physician, to remove excess pounds should use other methods that do not involve medication. Except in very rare cases only, pregnant and nursing women should not take any means medicinal preparations, including herbal and those not prescribed.

Herbal preparations and preparations that are dispensed without a prescription
Each product is intended for removing excess weight, including diet pills that are dispensed without a prescription, herbal tablets and preparations should be considered with caution. Many dietary herbal teas contain laxatives, which can cause gastrointestinal disturbances, and their excessive use of chronic pain, constipation and addiction. In rare cases leads to dehydration and death. The substances contained in tea as senna, aloe, cascara sagrada, rhubarb root, cascara, and castor oil. And some fiber supplements containing rubber Guare cause obstruction of the gastrointestinal tract.

Medications

Anoreksanti that release serotonin
The effect of some tablets can be achieved by increasing levels of serotonin, a brain substance that prevents depression and reduces the need for calories. Unfortunately, the most widely used of these drugs cause very serious side effects, including heart valve abnormalities and, rarely, a potentially fatal condition called.pulmonary hypertension.

Sibutramine
Sibutramine maintains the balance of serotonin and norepinephrine, another neurotransmitter, and increases metabolism. The tests showed that significantly reduces body weight and factors that cause diabetes. Sibutramine in obese patients during a given six months removed an average of 11% by weight. Sibutramine causes a feeling of fullness and increases energy levels. Side effects are dry mouth and insomnia.

Orlistat
Orlistat slows the production of lipase, the gastric enzyme that breaks down fat. No increases serotonin, but enhances its effect and acts as a stimulant. A recent study showed that during the first year of application, the average weight loss was 10%. In addition, in the second year of taking orlistat patients were given back half the weight of those patients who were switched to placebo pills. The medicine can cause gastrointestinal problems and disrupt the absorption of vitamins A, D and E. Not confirmed fears that the increased risk of breast cancer.

Amphetamines
To remove the excess weight once they are mostly used amphetamines, which is no longer the case. They improve mood in the short term provide a moderate weight loss. But a serious threat to create a habit, excitement, and insomnia.

Surgical treatment of

Liposuction can remove fat cells from specific areas, eg. thighs, buttocks, or knees, while the weight gain after surgery agree more on other sites. Liposuction fat is sucked in a special apparatus. Pain after surgery can be strong, and the skin is often not contraction, which gives it the look flabby.

Surgical removal of adipose tissue is suitable in cases of dangerous obesity. Experts advise you to those who have a BMI above 40 and the percentage of ideal body weight greater than 180%, and in case of failure of other methods. In most obese weight loss one year after surgery was 50% with improvement in all other accompanying diseases (diabetes, high blood pressure, apnea during sleep, joint pain, and incontinence). Vomiting is the most common side effects. After surgery, patients need to adopt a healthy lifestyle, and consistency should be preserved for a lifetime.

How dangerous are obesity and overweight?
In general, studies have shown that the lowest risk of heart disease, diabetes and some cancers in people with a body mass index (BMI) of 21-25. The risk is slightly higher in the value of 25-27, indicative of 27-30, a dramatically through the 30 Everyone from high-risk groups should take care of removing the excess pounds.Not harmful themselves overweight, but unhealthy diet and poor mobility. Age may help define the risk of obesity. Excess body fat in older people may be nutritional reserves and protection of bones in the event of a fall.Obese children are often lifelong battle with his overweight and are very risk group for the disease of high blood pressure, arterial and heart disease and liver damage when they grow up. Parents should be advised that programs to control body weight in their children as a healthy diet and movement.

Heart disease, vascular disease and diabetes
Obesity is a risk factor for heart disease, high blood pressure, diabetes and stroke. Weight is concentrated in the abdominal area and upper parts of the body is a greater health risk than fat accumulated on the thighs and buttocks.

High blood pressure
Obesity is a major risk factor for hypertension. What is worse, overweight with high blood pressure are at increased risk of left ventricular enlargement, which is a major risk factor for heart attack. Obesity can over time cause high blood pressure, altering the physical properties of kidney function and leading to sodium and water retention. Blood pressure increases the body's attempts to establish a flow of fluid. Even moderate weight loss benefits of blood pressure and reduce the risk of heart attack.

Cholesterol levels
The effect of obesity on cholesterol levels is complex. Total cholesterol and triglycerides are usually high while HDL ("good" cholesterol) is low.

Insulin resistance and type 2 diabetes
Obesity is closely associated with type 2 diabetes Almost 90% of type 2 diabetes and obesity appears weak mobility for the dramatic rise in type 2 diabetes that occurred in the last few years. People with this type of diabetes usually have normal or increased levels of insulin, a hormone crucial for the metabolism of sugar. But they can not use insulin, so are the so-called. state of insulin resistance, which many experts now believe that the independent factor for heart disease.

Carcinoma
Excess weight can be a major risk factor for esophageal cancer, especially among young smokers. Obese women compared to lean in the 2-3 times greater risk of contracting cancer of the uterus and gall bladder (adipose tissue secretes additional amounts of estrogen, a hormone that is considered one of the causes of these cancers). Obese men are more likely to suffer from cancer before the colon and prostate.

Muscles and bones
Obesity is stressful to the muscles and bones, a fatter people are more susceptible to getting a hernia, pain in the lumbar and worsening arthritis.

Gall stones
The incidence of gallstones is higher in obese women than men. The risk of scale is especially great for rapid weight loss.

Reproductive and hormonal problems
Women after 18 The gain in weight in the higher risk of getting cancer of the uterus. Abnormal amounts of body fat, 10-15% too high or too low, can contribute to infertility in women. In men, obesity may help to reduce testosterone levels. Multiple are the dangerous effects of obesity in pregnancy: hypertension, diabetes during pregnancy, urinary tract infection, thrombosis, prolonged labor, increased fetal death rate in the later stages of pregnancy and cesarean section. Infants of obese mothers also showed a higher risk of developing defects affecting the brain or spine. Supplements of folic acid, usually effective in preventing these conditions may not be as effective in overweight women.

Hypoxia
Obese people are at risk of hypoxia, a condition in which there is not enough oxygen to meet bodily needs. Obese should invest more effort to breathe, their muscles are weak and deteriorating lung capacity. Pickwickian syndrome, named for the obese character in the Dickens novel, occurs in severe obesity when lack of oxygen causes a profound and chronic insomnia and final cessation of cardiac function.

Sleep and sleep disorders
Obese people and those who tend pridrijemati, falling asleep faster and sleep longer during the day. But at night they need more time to sleep, and sleep less than people of normal weight. Obesity is particularly associated with apnea, which occurs when the upper palate in sleep relaxes and falls, temporarily blocking the air passage. Some people are not aware of this condition, but only faint symptoms such as morning headache, fatigue and nervousness. Sleep apnea is daytime sleepiness is associated with an increased risk of heart arrhythmias, stroke, heart failure, left, and with the traffic and other accidents.

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