Every third American suffers from obesity (36.2%), of which 18.5% are children aged 2 to 19, and 70% of the US population is overweight (including obesity). How dangerous is it to have excess body weight and what to do to get rid of it was told to us by, Chief Doctor and Founder of Smart Health Clinic, Zukhra Galimova

Obesity is a chronic disease characterized by an excessive accumulation of fatty tissue in the body. It is also a major risk factor for a few other diseases, including type 2 diabetes and cardiovascular diseases.

Result of Lifestyle

The causes of excess body weight in 90% of cases are lifestyle factors that lead to disruptions in eating habits and physical activity.

The main factors are:

● Long intervals between meals and excessive portions,

● Overeating in the evening, eating before bedtime,

● High intake of carbohydrates and fats (especially confectionery and animal origin) with a lack of fiber and dietary fiber,

● Excessive calorie intake compared to expenditure,

● Lack of physical stimulation of muscle tissue in fat processing.

Family predisposition and psychogenic overeating can also be included here.

And only 10% of obesity cases are due to disorders in the functioning of organs and systems:

● Endocrine diseases (disorders of the hypothalamic-pituitary system, thyroid gland, impaired endocrine function of the pancreas, adrenal glands),

● Influence of hormonal drugs (COCs, steroids, insulin),

● Genetically determined deficiency of lipolysis enzymes (fat breakdown),

● Brain tumors.

Regulation of eating behavior is the result of a complex interaction of reflex and hormonal mechanisms.

“Save me, I’m hungry!”: Why the brain is “misled”

The main center responsible for appetite regulation is the hypothalamus. It receives signals from the digestive organs and information about the chemical composition of the blood. When a person eats, the primary signal of satiety arises due to the stretching of the walls of the stomach and intestines. Information about these travels through sensitive fibers of the vague nerve and via the solitary tract to the hypothalamus. If a person regularly overeats, the volume of the stomach gradually increases, and the feeling of fullness can only come from large portions of food.

Another feeling of satiety after eating is formed by an increase in the level of glucose and fatty acids in the blood. Chemoreceptors of the hypothalamus react to changes in the level of these substances. Low blood glucose levels activate hunger.

One of the main hormones stimulating eating behavior is ghrelin. It is secreted by the walls of the stomach, acting on the hypothalamus, and causes hunger. When food enters the stomach, ghrelin secretion decreases. Insulin also participates in the regulation of eating behavior. Increased insulin secretion after eating suppresses appetite. These hormonal factors regulate eating behavior depending on the meal schedule. But there is a hormone that creates long-term regulation of eating behavior, coordinated with energy expenditure. This is leptin. Leptin is secreted by fat cells and suppresses appetite and increases energy expenditure.

The fatter mass, the slower the feeling of hunger should occur in a person. But if there is too much leptin, its receptors stop responding to the hormone. This phenomenon, typical of obesity, is called leptin resistance. Therefore, in patients with obesity, increased appetite occurs – the brain is “misled” that the body is starving, leading to constant overeating. Strong stress can also reduce control overeating behavior.

A Systematic Approach to Weight Correction

To determine the causes and take timely measures, an examination should be conducted, including anthropometric, clinical, laboratory, and instrumental methods. Initially, weight, height, waist circumference is measured, and body mass index is calculated.

In the second stage, the examination is primarily aimed at assessing the clinical manifestations of diseases in which obesity is one of the symptoms, i.e., the search for secondary forms of obesity (hypothyroidism, hypercriticism, etc.).

Based on the results of the examination, a joint discussion with the patient should be held to determine further treatment tactics.

The goal is to maintain the result for a year.

A good indicator for conservative treatment of obesity is a weight loss of 5–10% over 3–6 months of therapy and maintaining the result for a year. This helps reduce health risks and improve the course of diseases associated with obesity.

One method of reducing body fat mass is to create a negative energy balance, where energy expenditure exceeds the number of calories consumed.

A negative balance can be achieved by the following methods or their combination: reducing calorie intake, physical activity, self-control of behavior.

Mistakes in weight correction

Not adhering to a calorie deficit

A calorie deficit occurs when the energy our body expends throughout the day exceeds the calories from food and beverages we consume. That is, we expend more than we intake. It’s the calorie deficit that leads us to lose weight.

Low activity level

Modern sedentary lifestyles, the presence of cars in every family, the availability of transportation like taxis directly influence the fact that often, the situation unfolds as follows: we take a couple of thousand steps, engage in household chores, have sex. Daily activity usually ends there.

Lack of a plan

Most people wanting to shed extra weight don’t have a clearly defined goal, formulating a request to themselves or a trainer quite vaguely: “I want to lose weight.” However, dreams only become reality when there’s a clearly formulated plan with action points. Additionally, you need to understand how to integrate the weight loss process with your daily chores and routines so that it harmoniously fits into your lifestyle.

Lack of discipline and regularity

The weight loss process is not fast but very simple. To make it work, you need to temporarily give up your old habits, both dietary and behavioral (eating sweets, stress eating, finishing what’s been bought), formed over several years, and possibly your entire life.

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