Metabolic disorders – Obesity
Obesity is a pathological condition caused by overproduction of body fat or insufficient degradation from tissues where is physiologically stored. It occurs more frequently in women. Obesity is a significant risk factor that contributes to the emergence and development of severe somatic diseases:
- Diabetes mellitus type II.
- Gynecological cancers.
- Stomach and intestinal tumors.
- Cardiovascular disease (hypertension - high blood pressure, hypertrophy and dilatation of the left ventricle, coronary artery disease, heart rhythm disorders, myocardial infarction, stroke, varicose veins in the legs - varicose veins, thromboembolic disease).
- Respiratory System (hypoventilation and restrictions due to large "mass" on the chest, sleep apnea syndrome).
- Stomach, intestinal and liver disease.
- Orthopedic problems (degenerative joint disease, painful disorders of locomotor apparatus).
- Skin problems.
- Psychosocial - social discrimination.
- Psychological problems (low self-esteem, impaired motivation, self-blame, depression, anxiety, eating disorders).
- Surgical anesthesia risks, edema, poor wound healing, increased accidents, increased hernia.
It is often referred to as the third epidemic Millennium. Presents a problem not only in developed countries, but rising rapidly in many developing countries. The Czech Republic is in the number of obese at leading position in Europe. 21% of men and 31% of women are obese. The incidence of obesity and overweight in our country is higher than the European average. Compared to the rest of Europe is in Czech men in particular, a higher incidence of obesity in women is lower prevalence of overweight and significantly higher prevalence of obesity.
Causes of obesity
Obesity arises interaction of genetic and external factors. There are certain periods that are for the development of obesity very important - especially for women during pregnancy and the period of time thereafter, further periods of transition, at the time of teenage girls, more generally, stress factors and a period when physical activity is reduced - access to employment, the establishment families, family or work problems, end sporting activities, retirement, etc.
The main cause of obesity but is mainly discrepancy between intake and energy expenditure. Excessive intake of energy and its supply is insufficient due to lack of physical activity and sedentary lifestyle. Another role in obesity may also play a psychogenic factors and medications. Some medications can increase the appetite and contribute to the development of overweight. They are especially certain antidepressants, neuroleptics (antipsychotic medication), tranquillizers, glucocorticoids (hormone therapy - hormones of the adrenal cortex which affects metabolism), progestogens (hormone therapy for women).
Types of obesity
Management of obesity
Lifestyle changes
On the way to permanent weight reduction is a lifelong lifestyle change (especially dietary modification and modification of movement habits). This is connected with selection of the appropriate physical activities with regard to health problems, a permanent change in eating habits and drinking regime of each person. The diet should include foods that contain lots of fiber and limit foods of animal origin and highly refined foods. Optimum is a weight loss of 0.5 kg per week. It is suitable to monitor the anthropometric indicators (eg, waist circumference or the ratio of waist / hip) and regularly assign up examination specifying the proportion of lean body mass and body fat. Very important is the motivation and psychological support from family and people around. In the most extreme cases where this procedure based on a change of lifestyle is not sufficiently effective, it is possible to proceed to pharmacotherapy and surgical treatment.
Cognitive - behavioral therapy
Another tool in treating obesity is called Cognitive-behavioral therapy. It is used around the world since the 60th years and its main aim is to change the general attitude towards weight loss. During this therapy, patients are trying to change your eating and exercise habits. Cognitive-behavioral therapy is used for other eating disorders, especially in anorexia nervosa and bulimia. Therapy is recommended to use especially in lighter stages of the disease.
Physical activity
Man is largely responsible for their own health. He must therefore consult his feelings with trainer, psychologist, and dietician. Regular medical inspections are essential. During the aerobic part of the trainees heart rate should be controlled at least 2 times with using sport testers, so that patients themselves can regulate the intensity of exercise.
It is recommended that cyclical movement mainly aerobic type. The duration should be sufficient to be issued approximately 800 kJ per cycle exercise (roughly equivalent to walking speed of 5-6 km / h for at least 40 minutes). Because of risk of overloading of joint it is not recommended jumping, running.
The performance, lasting less than 40 minutes in terms of reduction of weight has no special meaning! The optimal exercise time is 40-60 minutes, 3-5x a week.
Aerobic exercise also leads to modification the parameters of metabolism and has beneficial effects on cardiovascular risk of obesity. Regular and intensive enough exercise also prevents loss of muscle mass during reduction. Another positive impact aerobic activity is increased production of endorphins. Do not forget to assign suitable and balancing exercises and strengthening exercises especially those for overall body strengthening. The goal is to increase the ratio of lean body mass to fat component and an increase in basal metabolism.
The intensity of exercise is best determined by load test. A sports physician specifies the threshold of anaerobic threshold, which should not be exceeded during exercise. As an indication we can evaluate the effect of aerobic exercises by heart rate measurement. Generally it is recommended to keep the heart rate (HR) between 60-75% of maximum HR. Beginners should exercise at the lower limit of the target HR - 60% max. Trained individuals can increase the intensity to the recommended heart rate (75% of maximum HR).
Recommended physical activity:
- walking on soft surfaces
- fitness walking
- Nordic walking
- jogging
- swimming
- cycling or exercise bike
- workout without jumps
- low aerobic
- exercise on gymnastic balls
- cross-country skiing
- dancing
- corrective exercises
- psychomotorics
Not recommended activity:
In wholly inappropriate activity for obese individuals are considered sports, where there are often jumps and falls down. The body is exposed to rapid changes in movement and various shocks. Among these sports belongs volleyball, tennis, running on hard surfaces, step-aerobics, etc. It should be borne in mind that the body of obese individuals is overloaded own weight, so we cannot overload joints and ligaments with inappropriate physical activity.