DISEASE OF THE ENDOCRINE GLANDS : OBESITY (OBESITY) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Fat deposits in the body when food is introduced in quantities in excess of need. This is exogenous obesity. Endogenous means that does not depend on food eaten and the quantity of the work produced. The main pathogenetic factors of obesity is the dysregulation of energy balance, expressed in violation of a correlation between the amount of food intake (appetite) and energy expenditure (lack of muscle activity and violation of interstitial exchange in the sense of excessive passage of carbohydrates into fats. Is reduced reactivity fat depots on the physiological impulses, leading to the mobilization of fat. These factors are associated with dysfunction of the hypothalamic nerve centers, the hyperactivity of the insular apparatus of the pancreas and pathology of currency directly adipose tissue. The impact of higher nervous activity affects the changes in the quantity of fat deposits in connection with psychical experiences. Dysfunction of the pituitary gland, especially its anterior lobe, give hypophyseal adiposity (see Pituitary-sexual dystrophy). Women often obesity occurs when disease or weakening of the sexual glands (see Hypogenitalism female). During the lowering of the thyroid gland sometimes teleohone obesity (see Myxedema and Hypothyreosis). Occasionally the so-called morbid obesity, when in the subcutaneous tissue are isolated deposits of fat, very painful, especially when pressed. Fat deposits in men on neck, chest, abdomen, and women mostly on the neck, chest, shoulders, thighs, stomach. Limb fat significantly less. Children obese relatively rare and obesity have almost always associated with dysfunction of the endocrine glands.
Symptoms. Among ozarelix sharply distinguish two types.
Some cheerful, hard-working, with good appetite, muscle, they are strong, blood pressure is normal or slightly increased. Sick they themselves do not feel, only with increased obesity, heart failure occurs. The fat in them tight.
Another type are pale sick, loose fat, complaining of weakness, inefficiency, headaches, shortness of breath, palpitations. In these patients, the accumulation of fat in serious violation of the body's functions.
Ozarelix early and often affect the cardiovascular system. The heart muscle is weakened, the heart expands. Blood pressure increased. Prematurely develops athero-arteriosclerosis and nephrosclerosis. In obese frequent Katari respiratory and pulmonary emphysema, increased susceptibility to pneumonia. Fat deposition in the abdominal cavity disrupt the proper function of the gastrointestinal tract and liver. Frequent Katari stomach and intestines, constipation, hemorrhoids, flatulence, stagnation in the gallbladder, cholecystitis, and gallbladder stones. Skin fat is always wet, often rash in areas of skin folds, seborrhea, seborroica eczema, acne and furunculosis.
The prediction of the greater, the greater the obesity.
Prevention. The caloric restriction due to carbohydrates and fat. Alcohol is prohibited. Shows a diet rich in vegetables and fruits, cheese, yogurt, brown bread. Special attention should be paid to physical exercise, avoiding overload.
The basic method of degreasing - poor calorie diet, accompanied by physical work. Other methods play a subordinate role. In mild obesity calorie limited to 1/5, i.e., up to 2000 calories, with an average obesity - 2/5, i.e., up to 1400 calories. When degreasing in the resort, sanatorium or hospital used a diet with restriction of calorie to 3/5 norms, i.e., up to 1000 - 1200 calories per day. The restriction is made only at the expense of fat and carbohydrate, the amount of protein must not fall below 100 to 120, Diets 1 and 2 can be applied within 2 to 3 months, diet 3 only 3 to 5 weeks. If severe obesity is accompanied by cardiac decompensation of the patient must be put to bed, carry, besides medication, milk diet - 5 - 6 times a day, 200 ml of milk (650 - 800 calories). Such a diet also acts diuretichesky; swelling disappear, the amount of water in adipose tissue is reduced. Weight loss comes down to 1 - 1.5 kg per day. Pevzner recommends the following diet for long-term treatment: 100 - 120 grams of protein, 100 - 150g of carbs and 60 grams of fat intermixed discharge day (1 every 9 days): milk (8 cups of milk), Apple (1 500 g apples), rice-Apple (3 times rice porridge from 25 grams of rice, 150 g of milk and 800 - 1 000 g apples), vegetable-fruit day (1, 500 g of vegetables and fruits, distributed on 4 - 5 receptions). The average dynamics of weight loss with a diet of 2 to 3 kg in a month. When weaknesses or attacks of hunger it is necessary to increase calorie better at the expense of cottage cheese or lean meat. Should be limited to the salt content in food - 8 - 10 grams per day, liquids - 1 - 1.5 l Recommended treatment at the resorts of Essentuki, Truskavets, Zheleznovodsk, Lipetsk, Darasun. Very useful hydrotherapy tubs, showers, improve metabolism and overall tone. In addition, in the absence of contraindications should be applied massage and various kinds of mechanotherapy. In some cases, to eliminate water retention in the body is recommended to enter intramuscularly Mercosul for 1.0 through the day, after the preliminary preparation of ammonium chloride 1 tablespoon 10 solution 3 times a day. Course 6 - 8 injection. With symptoms of low thyroid function used thyroidin 0.1 2 - 3 times per day in conjunction with diet therapy. It is useful to appoint and diuretic. At the first signs of thyrotoxicosis or hypersensitivity to thyroidin should the cottage of the drug be discontinued. In cases of obesity, accompanied by hypotension and a strong appetite, and sometimes recommend the use of amphetamine, which increases the excitability of the sympathetic nervous system, stimulating the mobilization of fat from the depot, and simultaneously suppresses appetite. Dose 5 to 10 mg 2 times a day. In the case of insomnia and excessive excitation treatment with amphetamine stop.