Obesity is a chronic disease, which refers to a certain degree of significant overweight and excessive fat layer, a state caused by excessive accumulation of body fat, especially triglycerides. Due to excessive food intake or body metabolism changes and lead to excessive accumulation of body fat caused by excessive weight gain and cause human pathology, physiological changes or latent.
First, the diagnosis of obesity.
International usually use the World Health Organization to develop the body mass index boundary value, that is, the body mass index in 25.0 ~ 29.9 for overweight, greater than or equal to 30 for obese. International life science society China office organized by the multidisciplinary experts composed of “China obesity working group”, China’s 21 provinces and cities, regional population body mass index, waist circumference, blood pressure, blood glucose, lipids and other related data of 240,000 people for summary analysis, and accordingly put forward the standard of Chinese people, BMI value “24” for Chinese adults overweight boundaries, BMI “28” for the boundaries of obesity; male waist circumference ≥ 85 cm, female waist circumference ≥ 80 cm for the boundaries of abdominal fat accumulation.
Second, the reasons for obesity.
1, genetic and environmental factors
2, material metabolism and endocrine function changes
3, the increase in the number of fat cells and hypertrophy
4, neuropsychiatric factors
5, life and diet habits
6.Drug obesity
Third, obesity on health effects
Endocrine disorders: obese women are prone to endocrine disorders and make more fat, so that too many fat cells inside and outside the uterus and not easy to conceive, the chances of polycystic ovary syndrome will increase significantly.
1, tumor: obese patients endometrium, gallbladder, cervical, ovarian and breast tumors have a higher chance. The risk of colon tumor also increased significantly, in short, the risk of cancer in obese patients is significantly higher than normal weight people.
2, skin disease: obese people often suffer from eczema, mostly in the head, armpits, pubic and femoral and other skin folds, resulting in red itchy eczema. In addition, due to heart hypertrophy, venous blood return slow blockage, also easy to lead to varicose veins.
3, diabetes: obesity will cause excessive secretion of insulin in the blood, serious obese people, the higher the concentration of insulin when fasting, and after eating insulin secretion can not be relatively increased, so the formation of the phenomenon of increased blood sugar. At the same time, the insulin secretion is prone to problems, so obese people will increase the risk of developing diabetes. If the weight is reduced, it will improve the situation of abnormal blood sugar.
4, hypertension: higher weight is closely related to blood pressure, therefore, obese patients with hypertension incidence is significantly higher. Research found that, with the weight loss, blood pressure will also gradually reduce.
5, cardiovascular disease: obese people mostly combined with high blood fat concentration, so easy to occur vascular embolism, accelerating the atherosclerotic changes in the blood vessels, easy to cause including coronary heart disease, myocardial infarction, ischemic heart disease … and other diseases. Research also shows that if the ideal weight can be maintained, it can reduce the incidence of cardiovascular disease, cerebral embolism.
6, joint disease: because obese people bone joints need to bear more weight, so it is easier to make the joint aging, damage and get osteoarthritis.
7, abnormal blood lipid metabolism: high blood lipid will affect the body to carry cholesterol to the liver rate, is to increase the risk factor of heart disease.
8, gallbladder and pancreas disease: obese people have excess body fat, resulting in increased cholesterol synthesis, so that cholesterol in the bile is supersaturated, resulting in the formation of cholesterol stones.
9, low respiratory function (shortness of breath): obesity causes chest wall and abdominal fat thickening, so that lung capacity decreases, lung capacity decreases and affects the function of normal lung gas exchange. Severe cases may occur pulmonary hypertension, heart enlargement and infarct heart failure.
Fourth, the nutritional treatment of obesity.
1, first of all, we must be familiar with and understand the dangers of obesity and the importance of weight loss, and be prepared to lose weight psychologically.
2, daily moderate intensity exercise at least 30-60 minutes, sweating continuous exercise, or daily 10,000 steps of jogging or 30-60 minutes of ball games. Equipped with a pedometer or energy meter is best, and consume at least 300-500 kcal per day.
3.Appropriate control of total calories: daily calorie intake of 800-1200 kcal. It is best to have a dietitian to formulate a nutrition plan according to the height and weight of obese patients and their dietary intake on weekdays, and if the food intake is large, consider gradually reducing food intake with a certain adaptation period.
4.Appropriately reduce the intake of staple foods: 200-300 grams per day, mainly including steamed buns, rice, noodles, etc.
5.Increase the intake of vegetables and fruits: 500-600 grams of vegetables and about 250 grams of fruits per day, but bananas and watermelons are appropriately limited. Consume fruits half an hour before meals.
6, reduce the intake of fats and oils, within 20 grams of oil per day, preferably using olive oil and flaxseed oil, peanut oil alternately, prohibit fried food.
7, change the habit of drinking thin rice.
8, limit salt: daily salt intake of 5-6 grams.
9.Appropriate auxiliary use of weight loss preparations.
10.Always maintain exercise and proper dieting plan to prevent weight rebound
11, if overweight or by the standard weight loss program can not work can consider surgery to lose weight: gastric banding and gastric diversion surgery, but they all have certain indications: BMI greater than 35 kg/m2, and accompanied by diabetes, hypertension and other diseases.
Our current view is that bariatric surgery is indicated for adults with BMI ≥ 35 kg/m2, aged 16 to 65 years, especially for diabetic patients with poor glycemia treated by lifestyle and medication. For diabetic patients with BMI <30 kg/m2, there is no sufficient evidence that surgery has the above-mentioned efficacy in patients with BMI <35 kg/m2, and therefore it is not recommended to promote it.
In conclusion, the nutritional treatment of obesity is a relatively complex and challenging project that requires the patient himself to face various tests of psychological, physical and willpower, as well as the formal professional guidance of a nutritional physician.