Obesity is a problem, a serious personal problem and a serious public health problem. Severe obesity shortens life. Obesity causes or aggravates high blood pressure (high blood pressure), diabetes (excess blood sugar), bronchial and pulmonary problems, bone and joint injuries; greases the liver, heart, lungs, etc. but the most serious thing is that it makes the sufferer unhappy, because the obese person has limitations to carry out his personal activities (bathing, cleaning, dressing, etc.). Obesity profoundly affects the mind of the patient, their self-esteem is very hurt, they have a very deteriorated body image, leading them to a constant depression that gradually leads them to loneliness and great sadness.
Causes of obesity:
It develops as a result of a persistent excess of energy intake (food intake), that is, you eat too much and get little exercise, you enter more calories than you lose and this causes obesity, instead if you spend more calories than ingested, a thinning would occur. If obesity increases, a series of organic and psychological alterations occur, including high blood pressure, this is added by intensifying an increase in blood volume that sometimes reaches 8 and more liters, the normal is 5; with this the heart has to increase its work, presenting a heart failure, the obese have high blood lipids both cholesterol and triglycerides, so they are joined in two of the main risk factors of arteriosclerosis. Studies show that 70% of patients with coronary insufficiency are obese and that the other consequences of arteriosclerosis vascular accidents, brain, peripheral arterial lesions, are more frequent in obese. To make matters worse in the obese, the appearance of diabetes mellitus is also frequent, which, in turn, accelerates and intensifies arteriosclerosis, while causing serious alterations in the kidney and other organs.
Dangers of obesity:
The lungs of the obese do not expand well, due to the elevation of the diaphragm, so that the ventilatory capacity is reduced and the lung bases are poorly aerated. In large obesities there are situations of respiratory failure, which may be accompanied by accumulation of carbon dioxide with drowsiness and cyanosis (violet coloration); It is called PICKWICK syndrome . Obese people have fatty liver, and often have biliary lithrasis (cholesterol stones) that often forces surgery. Difficult venous circulation, and so varicose veins will occur up to 60% of cases. This implies an increased risk of thrombophlebitis , with its dangers of pulmonary embolism.
“The skeleton that has to support excess fat ends in a problem of knee osteoarthritis, vertebral osteoarthritis and flat skin”.
The skin of the obese easily macerates in the folds, under the large breasts loaded with fat and elsewhere. Therefore, infections by bacteria and fungi are frequent, it is prone to depressions and inferiority and frustration complexes, which sometimes lead to eating more.
What is severe obesity?
It is a disease due to excessive fat deposition, caused by various factors including hereditary, progressive, perennial, expensive, which shortens life, and with multiple harmful consequences. The weight of a normal subject consists of: water (65%), protein (12%), minerals (2.5%), especially in the bones, carbohydrates (only 0.5%) and the rest are fats and their proportion is very variable. The fat is deposited in cells called adipocytes. The severe obese may have up to 50-75% of their weight in accumulated fat. The fat cells (adipocytes) of the morbidly obese are more numerous than in the non-obese person; they are larger and much more efficient. When the obese person loses a lot of weight, the number of cells is preserved for a long time and they are waiting to be filled again with fat, once the predisposition patient returns to eat. This would explain the tendency of obese people to gain weight again.
Influence of obesity genetics:
Genetic studies have been reinforced since the obesity gene (ob) was discovered, which is specific for the adipocyte, and its product leptin (from the Greek leptos = thinness). Leptin is a hormone, of a protein nature circulating in the blood and related to the obesity gene. The concentration of leptin in blood is higher in women. The increase in this protein in obese subjects is related to the degree of severity of obesity. Leptin is a factor that acts on adipocytes and the hypothalamus, on which it induces a complex response to control the weight and energy consumed.
Types of obese:
Morbidly obese, in general, eat very fast and usually leave the plate empty. There are at least three different types of obese depending on the tastes, or the way they make their food.
- GLOTONES: Are those who eat food eagerly and excessively. This is very common in superobesos, who often only make their three meals a day and feel satisfied.
- PICADORES: They are those who are eating all day even in small quantities. They don’t stop biting something at all hours of the day.
- GOLOSOS: Smoothies, cream, sweets and sweets eaters. In general, everything is sugary.
The satiety mechanism:
The satiety mechanism is not well known or easy to modify. Satiety is a pleasant sensation of fullness of the stomach and disappearance of hunger. There is a center of satiety in a part of the brain called the hypothalamus that controls satiety and is controlled by the smell of ingested food. The mechanisms of hunger are regulated by hormones and blood sugar levels. Satiety is also regulated by hormones of the digestive system (cholecystokinin) that report directly, or indirectly, to a part of the brain so that, once activated, it sends orders to curb the appetite and so that the person does not continue eating.
What happens then so that certain patients are obese?
Probably, in addition to a genetic component, there is a poor regulation of a part of your brain (a non-thinking area of the brain called the hypothalamus) that controls appetite and energy expenditure, and that is not subject to will. That is why the popular myth must be finished that the morbidly obese person lacks will, and that his illness is imputed to the lack of character, determination, or will.
Obese patients candidates for surgery:
Repeated failure in diets and medical treatments is a good reason for surgery. What weight should be taken to be a candidate for the operation? The rule is:
- Have an obesity rate greater than 40
- Weigh twice the ideal weight.
- That the overweight is greater than 45 Kg.
When can you jump? Patients with severe obesity rates can be operated, that is, between 5 and 40 if they suffer:
- Heart failure due to obesity.
- Sleep apnea syndrome These people obese prevent them from breathing during sleep or sleep continuously
- Degenerative arthritis of the knees, hip, herniated disc.
- Reflux esophagitis.
How do you lose weight with surgery?
If the cause of obesity is in the brain, that is, in a part of the brain that should regulate energy expenditure, can surgery correct me? Surgery is not intended to treat the cause of obesity, which is in the brain. The operation is done on organs that are not sick. Surgery only tries to lose weight by manipulating the functions of the digestive system.
What will the surgeon do?
It acts on the stomach preventing the obese from eating a lot of food, or it reduces the surface of the intestine that absorbs the food, or both at the same time. If food is prevented from being absorbed, operations are called MALABSORTIVES, that is, they prevent food from passing from the intestine into the blood. Malabsortive operations are those that reduce the surface or length of the small intestine in contact with food. The operations performed on the stomach will have another purpose, such as reducing, that is, restricting the amount of food ingested. They are called RESTRICTIVES. If intake is restricted and malabsorption occurs at the same time, then the operations are called MIXED or HYBRID. The bariatric surgery is also an option used for morbid obesity.
Diet for an obese:
- Low calorie diet:
It can contain more calories than people spend so mobilize the fat in their deposits, to get the essential caloric intake. Contain sufficient amounts of hydrates, proteins, fats, vitamins and minerals, the only thing that should be scarce in the diet of an obese are the calories; If it is deprived of essential nutrients it is harmed. In addition the diet must be balanced. Any diet in which a nutrient is lacking or excessively deficient is unbalanced, not physiological and should be considered harmful. I want to clarify something very important, if you do not change eating habits, that is, the quality of eating, it will be very difficult for you to lose weight, you can do a lot of exercise routines, endure hunger as many people do, but you will always end up defeated ( a) and feeling with great remorse.
Calculate the caloric intake that an obese should take:
It can be done in two ways: using complicated calculations or simply common sense, associated with a certain experience. In both cases, the sex, age and physical activity of the obese, which determine their caloric expenditure, must be taken into account. known this, a diet with a lower energy content is projected, calculating the expected weight loss based on caloric deficit of each day, for this it must be taken into account that the caloric equivalent of 1g of body fat is 7.73 Kilocalories; therefore, a deficit of 7.73 Kilocalories will cause the loss of one gram of fat (that is, to lose 1Kg of fat there must be a deficit of 7.730 Kcal.), the same if that deficit occurs on a day that if it occurs in a week or occurs in a year.
It is possible to establish the calculation:
Deficit / Calories x days / 7.73 is = loss (in g)
We substitute “days” for 7, to make the weekly calculation; and, that fraction is always the same (7: 7.73 = 0.9, so that the formula is reduced to:
Calorie deficit x 0.9 = loss (in g)
Thus, if a man or woman whose daily caloric expenditure is calculated at 2,500 Kilocalories follows a diet of 1,500 Kcal., With a deficit of 1,000 Kilocalories, their weekly loss must be 900 grams (thus 1,000 x 0.9 = 900). if you want to lose weight more quickly, you should follow a more hypocaloric diet: for example, only 1,000 Kilocalories; Thus the caloric deficit will be 1,500 Kilocalories daily and the theoretical weekly loss will be 1,350 grams. (Of course these diets must be followed under strict medical supervision.)
Sample Slimming Menu:
Option 1: Breakfast
Skim milk: 250 ml
Coffee or tea: free
Saccharin: if you want cookies 2, 4 or 6 pieces (about 4 grams)
One fruit: 100 grams (clean)
Vegetable, preferably salads.
200 grams (raw fish)
- Meat: 100, 150 or 200 grams (clean) or fish 150, 200 or 250 grams
- Fruit: 100 grams (already peeled)
- Bread: 25 grams
Milk, skim: 100 or 200 grams
Coffee, tea, saccharin: free.
A soup (with broth, even commercial) and rice; 30 grams (heavy raw)
Pasta soup, 30 grams (raw)
- Meat or fish, in the same quantities as in food. Fish can be altered or eaten twice. Two or three days per week can be taken, instead, eggs, 1 or 2
- Fruit, 100 grams
- Bread, 25 grams
In this menu exposed here you have to take into account that you can drink all the water you want, but you cannot drink alcoholic beverages (beer, wine, spirits, etc.).
Second Option: Breakfast
Boiled eggs 1 or 2
Skim milk 250 ml
Coffee, tea, saccharins: free
Cookies: 2, 4 or 6 pieces.
One fruit: 100 grams (already clean)
Macaroni food: 50 grams (raw)
Tomato: 20 or 40 grams
Meat: 100, 150 or 200 grams or fish: 150, 200 or 250 grams
Fruit: 100 grams
Skim milk: 100 or 200 grams
Coffee, tea, saccharin: free
Vegetable dinner: 160 or 180 grams (depending on the amount of tomato used in the meal)
Meat: 50, 100 or 200 grams
Fruit: 100 grams