Obesity means excess body fat. It is believed that adult women aged 35 and older with a BMI over 30 are no longer overweight, but obese as a pathology. But overweight is not the norm, it is important to start fighting it before body fat disrupts metabolic processes.
Obesity is not only a cosmetic aspect. It is a chronic disease that can lead to diabetes, high blood pressure, obesity-related cardiovascular diseases such as heart disease, gallstones, and other chronic diseases of the digestive system, liver, and kidneys. Obesity is a risk factor for the development of several types of cancer.
Unfortunately, obesity is difficult to treat and has a high relapse rate (weight gain). Most women who lose weight gain those extra pounds again within 5 years. While medications and diets can help, treating obesity may not be a short-term “solution,” but a lifelong commitment to eating well, increasing physical activity, and doing regular exercise. The goal of treatment should be to achieve and maintain a "healthier weight", and not necessarily ideal (even a loss of 5-10 kg is already a significant relief for the body). Maintaining this weight loss for a long time can bring significant health benefits by lowering blood pressure, diabetes, and heart disease risks.
What is obesity?
Every third woman under 45 years old and every second woman older than this age is overweight or obese. But how does a woman know if she is overweight or obese? You can use your body mass index (BMI) to find out if your weight is in a healthy or unhealthy range. BMI is a tool to measure the amount of body fat. You can determine it in online calculators:women with a BMI of 25 to 29.9 are considered overweight;
women with a BMI of 30 or more are obese.
BMI gives an idea of how normal a woman's weight is. But that's not all. BMI is less accurate in some women than in others. For example, if a lady is very muscular, trained, she can be healthy and not overweight, even if her BMI is above 25. This is because muscle weighs more than fat.
Another way to find out if a woman has a healthy weight is to measure her waist circumference. Researchers and doctors agree that more than 88 - 90 cm women with a waist circumference are at a higher risk of many health problems caused by being overweight or obese.
Causes of obesity in women
A woman develops obesity when her body stores more calories than it burns during the day and night. The human body needs calories (and essential vitamins, minerals, and other nutrients) to function properly and to be active daily. But if a woman's body stores more calories than it consumes, then the lady is gaining weight.Researchers have noticed that a woman's environment throughout her life can influence the occurrence of obesity. While it is true that the food a woman eats is an important part of gaining or losing weight, other parts of her daily routine that she has no control over can increase the likelihood of obesity.
Overweight and obesity affect women of all ages, races, and nationalities. But overweight and obesity are more common among certain groups:
* women from large cities;
* housewives;
* oriental women.
Many factors play a role in overweight and obesity, including marital status, past events, and where a woman resides.
There are also some risk factors for overweight and obesity that a woman herself cannot control. However, a healthcare provider or dietitian may recommend changes in dietary habits and physical activity to help the patient achieve a healthier weight. Some medicines can cause weight gain or make it difficult to lose weight after treatment. If you suspect that the medication is affecting body weight, you should talk to your doctor. You may need to try another medicine.
Factors affecting weight gain
Obesity is a complex disease that results from a combination of many different aspects of a person's life that occur over a long period of time. A woman's weight can be influenced by:Genes and family background. Obesity is usually inherited. But there is no specific fat gene. There are many genes that can work together to make you more likely to gain weight. The situation in which a woman lives also affects her genes. When it is a small child, parents control nutrition and physical activity. This family background can affect adult weight.
Metabolism. The metabolic rate (the rate at which calories are burned in the body) can vary for many reasons, and this can affect weight gain and loss. For example, men tend to have more muscle and less fat than women, so men's bodies can burn more calories and do so much faster. A woman's metabolism can change throughout her life, for example, due to hormonal changes that occur during puberty, pregnancy, and menopause.
Age. Metabolism can slow down with age. In addition, women lose muscle as they age. By having fewer muscles to burn calories, the body needs fewer calories.
Mental trauma. Women who experience a traumatic event at any time, are under stress, or have post-traumatic stress disorder (PTSD) may be more likely to gain weight quickly after a traumatic event and develop obesity.
Medicines. Many medications women take every day, including medications for mental health problems, sleep disorders, and high blood pressure, can cause weight gain or make it difficult to lose weight.
Sleep disturbances. Lack of quality sleep can lead to weight gain. The researchers believe that low-quality sleep may be the culprit, which can affect the levels of hormones that regulate appetite and food choices. Lack of sleep that prevents you from getting enough rest can also affect your physical activity or exercise during the day.
Obesity in women
The severity of obesity in women is determined by BMI. Body mass index is currently the preferred metric for many physicians and obesity researchers. BMI uses a mathematical formula that takes into account a person's weight and height.However, measuring BMI poses some of the same problems as weight-for-height charts. Not everyone agrees on the cut-off points for the healthy and unhealthy BMI ranges. It also does not provide information on the percentage of fat in the human body. However, like the weight-for-height chart, BMI is a useful general guideline and a good estimate of body fat for most adults between 19 and 70 years old. However, it can be an inaccurate measurement of body fat for professional athletes and pregnant women.
BMI is equal to a person's weight in kilograms divided by height in meters squared (BMI = kg / m2). It is important to understand what “healthy weight” means. Healthy weight is defined as a body mass index (BMI) of over 19 and under 25 for all people aged 20 and over. Obesity is generally defined as a body mass index (BMI) equal to or greater than 30, which equates to approximately 13 to 15 kg of excess weight.
The World Health Organization (WHO) uses a classification system using BMI to define overweight and obesity:
* A BMI of 25 to 29.9 is defined as “predisposition to obesity”;
* BMI from 30 to 34.99 is defined as "I degree of obesity";
* A BMI of 35 to 39.99 is defined as grade II obesity;
* A BMI of 40.00 or higher is defined as "III degree obesity."
The higher the degree, the worse the prognosis for obesity in a woman, and the longer it takes to deal with extra pounds.
Types of obesity in women
Does it matter where fat deposits are located on a woman's body? Yes. Where excess weight is stored is important for women's health. Belly fat is more dangerous to your health than fat elsewhere. In women, several body types are distinguished, depending on the distribution of excess fat - apple and pear-shaped body types.Features of body types
Some women tend to accumulate fat in the belly area (apple-shaped). In other women, fat is usually found in the thighs and butts (pear-shaped figure). Being overweight is never healthy, but an apple-shaped figure increases the risk of certain health problems, such as heart disease, type 2 diabetes, and colorectal cancer, more than a pear-shaped figure.This is because the type of fat that the female body stores in the abdomen, around the waist, is different from the type of fat stored in the back, thighs, and buttocks.
BMI shows how much fat a woman has on her body, but it does not show where this excess weight is located. To measure your waist, stand up straight and hold a measuring tape around your waist, just above your hips. Measure the waist immediately after exhalation.
Most women should aim for a waist circumference of less than 88 cm. Of course, this does not mean that if a woman's weight is concentrated mainly on the hips, she has nothing to worry about. For all women, regardless of where they store their weight, it is important to be physically active and eat well to reduce the risk of health problems.
Obesity treatment in women
To diagnose obesity, your doctor will usually do a physical exam and recommend some tests.Diagnostics
These examinations and tests usually include:A health examination. The doctor can assess the history of weight gain, efforts to reduce it, physical activity and exercise habits, diet and appetite control, other conditions, medications, stress levels, and other health problems. The doctor may also look at the health history of the entire family to see if the woman has a predisposition to certain medical conditions.
General medical examination. This includes measuring growth, checking vital signs such as heart rate, blood pressure, and temperature, listening to the heart and lungs; examine the stomach.
BMI calculation. Your doctor will check your body mass index (BMI). It should be checked at least once a year because it can help determine general health risks and what treatments might be most appropriate.
Measurement of the waist circumference. Fat around the waist sometimes referred to as visceral or abdominal fat, can further increase your risk of heart disease and diabetes. Women with a waist circumference over 89 cm may have more health risks than those with a smaller waist. As with measuring BMI, your waist circumference should be checked at least once a year.
Check for other health problems. If there are health problems, the doctor will assess them. He will also check for other possible health problems such as high blood pressure and diabetes. He may also recommend certain heart tests such as electrocardiogram, ultrasound, Holter.
Blood tests. Which tests are needed depends on the woman's health, risk factors, and any current symptoms that may arise. Blood tests may include a cholesterol test, liver function tests, fasting glucose, thyroid test, and others.
Gathering all this information will help the woman and her doctor determine how much weight to lose and what health conditions or risks are already there. This will help you decide on treatment.
Modern methods of treatment
Every woman is different, but recent research shows that women can lose weight differently than men. Most women need to eat and drink fewer calories and get the right amount of healthy food to lose weight. Increasing exercise or physical activity can help with weight loss, but healthy food choices (lean protein, whole grains, vegetables, and fruits) are what works best for many people to achieve a healthy weight. It is best to combine a healthy diet with increased physical activity. Before starting any weight loss program, you should consult your doctor.Family environment and other aspects of life can make weight loss difficult. You can take other steps, such as talking to your doctor about any medications you are taking that may lead to weight gain, more sleep, or stress management. It can also help you lose weight.
Sometimes a doctor may prescribe weight loss medications under his supervision.
Experts can recommend weight loss medications if:
* a woman has severe obesity (BMI 40 or more);
* being overweight (BMI 27 or more) and having health problems associated with being overweight, such as high blood pressure, high blood cholesterol, diabetes mellitus;
* a woman counts calories and does a lot of sports for at least 6 months, but on average she loses less than 500 g per week.
There are only a few weight loss drugs approved for the treatment of obesity today. Most of these are not recommended for women who may become pregnant because medications can cause serious birth defects in the baby.
Weight loss surgeries, also called bariatric surgeries, can help treat obesity.
A doctor may suggest surgery for weight loss if:
* body mass index (BMI) 40 or higher;
* A BMI of 35 or higher and have health problems related to weight, such as heart disease or diabetes.
Bariatric surgery is not a “quick fix”. This is a serious operation, after which a long recovery is needed.
Prevention of obesity in women at home
Women generally require fewer calories than men, especially as they age. This is because women naturally have less muscle, more fat, and usually less height than men.On average, adult women require between 1,600 and 2,400 calories per day. As women get older, they need to consume fewer calories in order to maintain the same weight. She can also keep her weight healthy by increasing physical activity.
Is it possible to lose weight on diets alone?
It is known that body weight is determined by two main factors - calorie intake and calorie expenditure. Consequently, either excessive incoming energy resources or their insufficient consumption can lead to overweight and obesity.Physically, subject to a balanced diet with a reduced-calorie content, bodyweight will decrease. But on the condition that the consumption of calories exceeds their consumption. The required maximum number of calories in the daily diet, in which a person will lose body weight, is calculated individually by a general practitioner, endocrinologist, or nutritionist.
Often the problem in reducing body weight with this approach, when we only reduce calorie intake, becomes a synchronous decrease in physical activity. Patients say: "they began to eat less, but they also have no strength - I don't even walk at all." In this case, both the consumption of calories and their consumption are reduced. And in total, it all comes down to the fact that the weight does not change, and when the patient runs out of strength to maintain the diet for a long time, there is a return to the usual diet and hence a rollback in body weight. To prevent such consequences, I approach the problem of obesity in a comprehensive manner: I change my diet and physical activity.
And still, very often we find certain secondary factors, including hormonal ones, that interfere with maintaining a normal weight. This can be insufficient thyroid function (hypothyroidism), insulin resistance, hyperleptinemia, lack of vitamins and minerals, testosterone deficiency in men and excess androgens in women, anemia, and more. All this requires a comprehensive medical (I repeat, professional) approach to solving the problem of obesity.
We must not forget about the psychological problems of the cause of obesity. If they are, the help of a psychologist is needed. In mild cases, I make do with personal conversations with patients. Often the kind word of the doctor is enough (of course, in conjunction with the above approaches), which allows you to achieve very good results.
It is also advisable to keep a food diary - it allows you to improve control of food intake. This alone will reduce body weight to 5 kg or more.
What should be the physical activity?
Physical activity is necessary to one degree or another for all patients - it is an integral component in losing weight and maintaining a healthy lifestyle.The volume, intensity, duration, and frequency of physical activity can vary widely.
Young people can train intensively and often if there are no contraindications.
With age, various pathologies appear - cardiovascular pathologies, diseases of the musculoskeletal system, nervous system, digestive system, so there may be contraindications to certain loads. But this does not mean that you need to give uploads completely! You just need to talk to your doctor about the appropriate exercise. For example, a cardiologist will tell you the maximum heart rate (pulse), a neurologist and orthopedist can prohibit certain rotational and tilting movements, a gastroenterologist - to limit exercises that increase intra-abdominal pressure and more.
The general recommendation for physical activity to reduce body weight is to engage in aerobic activity most of the days a week (4 times a week or more) for at least 40 minutes.
What to do with saggy skin after losing weight?
The problem of sagging skin is always relevant for patients in whom we have reduced their body weight by 15 kg or more.First, from the first days of a weight loss program, we recommend that you include dietary supplements in your treatment plan. Collagen helps to maintain the required amount of the extracellular matrix of connective tissue, vitamin C is also a factor in the synthesis of collagen itself, omega fatty acids improve the condition of the skin, coenzyme Q and l-carnitine help in maintaining muscle tone, which indirectly has a positive effect on the condition of the skin, etc.
Secondly, it is necessary to reduce body weight smoothly and gradually. The principle "the quieter you go - the further you will be" is especially relevant here. With a smoother decrease in body weight, the skin and subcutaneous connective tissue have time to adapt and compensate for their structure and function.
We strongly recommend physical activity, it allows you to maintain muscle tone, which will prevent skin sagging.
It is necessary to exclude both hormonal (excess cortisol, hypothyroidism) and metabolic (anemia) disorders as causes that aggravate sagging skin.
In case of pronounced changes in the skin, the patient is referred for a consultation with a dermatologist to prescribe local preparations and carry out hardware and other methods for correcting defects.