OBESITY AS A RISK FACTOR FOR A VARIOUS DISEASES

OBESITY AS A RISK FACTOR FOR A VARIOUS DISEASES

Zhadyra Muslimkhanova

Student, Department of Endocrinology NCJSC Semey State Medical University,

Kazakhstan, Semey

Aida Bidakhmetova

Assistant of the Department of Endocrinology, NCJSC Semey State Medical University,

 Kazakhstan, Semey

The problem of being overweight has always bothered people, but today it has reached epidemic proportions - obesity is one of the most common modern diseases. This problem affects all segments of the population, regardless of social and professional affiliation, age, place of residence and gender. According to the World Health Organization, 25-30% of adults and 12-20% of children worldwide are obese [4].

Obesity is a biological phenomenon, and it has been known since ancient times. Obesity (lat. adirositas - literally: "obesity" and lat. obesitas - literally: fullness, obesity) is the accumulation of fat in the body, which leads to an increase in body weight and is characterized by excessive deposition of fat in the fat depots of the body. Which occurs as a result of consuming excess calories with food, the consumption of which does not exceed their consumption, that is the result of maintaining a positive energy balance for a long time [3].

The development of obesity is most often caused by an imbalance between energy intake with food and energy expenditure of the body. Excess calories that enter the body and are not consumed by the body are converted into fat, which accumulates in fat depots of the body (mainly in the subcutaneous fat, omentum, abdominal wall, internal organs, etc.). The increase in fat reserves leads to an increase in body weight and disruption of the functioning of many body systems. Overeating leads to obesity in over 90% and approximately 5% more cases of obesity are caused by a metabolic disorder [5].

Changes in eating behavior occur as a result of impaired hypothalamic-pituitary regulation responsible for controlling behavioral responses. Increased activity of hypothalamic-pituitary-adrenal system leads to an increase in ACTH production, cortisol secretion rate and acceleration of its metabolism. There is a decrease in the secretion of somatotropic hormone, which has a lipolytic effect, hyperinsulinemia develops, disruption of thyroid hormone metabolism and tissue sensitivity to them [1].

Obesity is a multifactorial disease. Both genetic and lifestyle factors influence the formation of certain constitutional parameters. Both increased energy intake and insufficient physical activity play a major role in obesity. The main cause of overweight problems around the world is improper nutrition, which is caused by more calories coming from food than are used by the body. This cause accounts for 85-90% of all obesity cases. Often the problem of poor nutrition is combined with a sedentary lifestyle, psychological, endocrine or cerebral abnormalities [2]. Women are twice as likely to become obese as men, the critical age for obesity being between 30 and 60 years [6].

Psychological reasons for being overweight are widespread. They can be different, but their essence boils down to one thing - the body tries to make up for the lack of any substance at the expense of excessive consumption of carbohydrates. Ultimately, the psychological reasons for being overweight lead to a metabolic disorder and increased body weight gain.  All psychological causes of being overweight have a dangerous tendency to progress to a chronic state of cellular deficiency. As a result, a person begins to experience a constant feeling of hunger, enormous power is engaged in the process of digestion, hunger increases even more. It is very difficult to break this mechanism [2].

The role of hereditary and constitutional predisposition, reduced physical activity, age, sex, professional factors, some physiological conditions (pregnancy, lactation, menopause) in the development of obesity is undoubted [7].

Obesity develops quite imperceptibly. At the initial stage, no symptoms are noted, then there is fatigue, weakness, apathy, increased sweating. Later, diseases associated with obesity join, which greatly aggravate the condition of the obese person. First of all affected cardiovascular system, respiratory organs, digestive system, musculoskeletal system. All this leads to the limitation of work capacity, reduction of the patient's quality of life, appearance of psychosocial restrictions [6].

Obesity causes psychological and physical discomfort, sexual disorders, and spinal and joint diseases. It is important to note that excessive body weight is not only an indicator of improper diet and low physical activity, excessive body weight increases the risk of many diseases: type II diabetes, atherosclerosis, hypertension, myocardial infarction, stroke, arthritis, kidney damage, liver, certain types of neoplasms, as well as disability and mortality from these diseases. Practically any diseases, even such as acute respiratory viral infections, influenza and pneumonia, in obese patients have a longer and more severe course, have a higher percentage of development of complications [1].

It is very important to determine the degree of obesity before starting treatment. To find out the presence and degree of obesity use the method of determining the body mass index (BMI), the ideal body weight (Mi). The nature of the distribution of body fat is determined by calculating the coefficient equal to the ratio of the waist circumference (WH) to the hip circumference (WH). The most accurate results of determining the localization, volume and percentage of fat tissue from the total body weight are obtained using auxiliary methods: ultrasound, nuclear magnetic resonance, computed tomography, X-ray densitometry, etc. [5].

In obesity, consultations of a psychoneurologist, nutritionist and physical therapy instructor are necessary. Treatment of obesity depends on the degree of obesity, the presence of comorbidities and other risk factors. Treatment methods for overweight people are divided into medicinal, physical, psychotherapeutic and necessarily include proper nutrition [4].

As clinical practice shows, medications are ineffective, and of the radical interventions only surgical liposuction in obesity, which can give complications and has its own system of postoperative recovery, can give the result. They begin treatment of obesity with the prescription of diet and exercise. A hypocaloric diet decreases basal metabolism and energy storage, which reduces the effectiveness of diet therapy. Therefore, in obesity, a hypocaloric diet should be combined with exercise that increases basal metabolism and fat metabolism [1]. Very often obesity is combined with eating disorders, psychovegetative syndrome, and pathology of the emotional sphere, which makes it necessary to use elements of psychotherapy along with the usual methods of treatment and reflexotherapy [6].

Thus, obesity is a disease that requires a deep diagnosis of its pathogenesis and complex treatment. Timely initiated systematic measures for the treatment of obesity bring good results.

References:

1. Ametov A.S. Obesity: modern look at pathogenesis and therapy: tutorial / A.S. Ametov. - Moscow: GEOTAR-Media, 2019. - Т. 1. - 382 с.
2. Demidova T.Y. Obesity and comorbid conditions. Modern principles of management and expected prospects: a textbook. - Moscow: N.I. Pirogov Federal State Budgetary Educational Institution of the Russian Ministry of Health, 2018. - 33 с.
3. Kudlay I.S. Issues of prevention of obesity and comorbid conditions // Scientific Bulletin of Kuban Health Care. - 2018. - № 5 (59). - С. 21-31.
4. Treatment of obesity and metabolic syndrome: diet therapy and pharmacotherapy: a training manual for doctors / M.L. Maksimov [et al]. - Kazan: Kazan State Medical Academy Publisher, 2020. - 56 с.
5. Nedogoda S.V. Obesity in the practice of a therapist: a guide for practical doctors. - Moscow: Eksmo, 2017. - 304 с.
6. Obesity: clinic, diagnosis and treatment: a training manual / V.V. Shkarin [et al]; ed. by V.V. Shkarin, N.A. Popova. - Nizhny Novgorod: Izd vo Nizhny Novgorod State Medical Academy, 2017. - 49 с.
7. Tarasenko N.A. Social aspects and prevention of diabetes mellitus and obesity: a monograph. - Krasnodar: Izd vo KubGTU, 2017. - 151 с.