Obesity

Overweight and abesity are not only estetical but also an emotional problem for patient, but a very huge medical problem. Overall disturbances an accompany the obesity, such as: diabetics, arterial hypertention, lipidic managemetn disturbances, degenerative joint disease and others.

People with obesity have a lot worse quality of life. They feel phisycally worse. Their love life is poorer. Some par of them has been discriminated since their childhood, they have been treated as lees attractive less intelligent. Childersn not often want to play with "fatsos", which are languorous and less phisycally capable. People with overweight and obesity have al very low self esteem, they feel not good enough, they are not keen on meeting new people, they avoid meetings, e.g.: on trips (beach, swimming) where one should uncover his body.They are predisposed for depression, fears, not always eagerly take part in social life. Every try to get rid of few kilos and impossibility to loose weight leeds discontinue to try taking actions connected with reduction of body weight. Obese explain that their failures are connected with their weight, not being able to match clothes, shoes, being unattractive, e.g.: lose in a competiotion for some work position not with professional incapibilities. Even though it should be admitted, that the appearance is essential when choosing a candidate in most of proffesions. Obesity originates whet the nuber of calories is bigger than the needs of the organism along with low phisical activity.

It seems, that the role of genetic predispositions is smaller then it is said. In particular obese people say: my parents were obese, I am fat and my children also will be. They do not think that this is linked to their eating habbits:a lot, greasy,sweet, few times a day, not to be hungry.What about phisical activities - it is a great effort, why bother. The biggest obesity the hargest activities are. For adults it has a hypertrophic character - fat cells get bigger, and after they gain their maximum size, they start to grow new fat cells - adipocytes. For children obesity has a hyperplastic character - the more a child gets calories the more adipocytes. Large cells dispence more substances pathologically arousing apetite. Neuropetid Y should be mentioned here, it intesifies the apetite for carbohydrates, galanine, which intesifies the wish for high fat meals.The is also to much insuline emision, especially after meals W nadmiarze wydzielana jest także insulina, szczególnie po posiłkach. The level of glucose suddenly lowers and the person who ate just a moment ago has to eat something right away once again. The level of glucose in blood decreases very fas and the person who just eate has to eat again urgently. The leptine is emited through adipocytes and resistines, which control our apetite and stimulate phisical activity. It should be point out that the obesity is hardly ever connected with metabolic disturbance. Należy zaznaczyć, że rzadko otyłość jest związana z zaniżoną przemianą materii. Just the oposite, the metabolism is faster for obese than for slim people. It is connected with incerased need for calories with the high body mase. Is should be undelined that endcrynologic diseases, such as hypothyroidism or Cushing syndrom can be the the reason of obesity.

During the last few years, the number of obese people increased, it is connected with eccessed consumption of fat, meal availibility, processed meals, which contain "hidden" fat. Greasy dishes gives many calories but do not give the feeling of fullness, and they are being easily stored as fatty tissue. In Poland, in comparison with other countries, the percentage of obese people is quite high, About 1,5 milion men and 2 milion women are obese. Total of 1/5 population of people suffer from ilnesses connected with inproper nutrition. To evaluate the extent of obesity we use the BMI (body mass index) indicator - body weight (in kilos)/ hight (in m2). If it indicates more than 25, it is overweight, if it is over 30, it is obesity.
The risk of occurance of obesity related illnesses depends not only on our body weight, obesity level, but also on how the fatty tissue is spread all over our body. The most dangerous is stomack obesity; it is connected with overpresure, diabetic, coronary heart disease. That is why WHO introduced so called waist meassuring. For women the upper norm limit is 80 cm, more than 88 cm is obesity, for men 94 cm is still normal, and over 102 cm it is obesity. Obesity can cause systemic diseases; some of them can cause different skin changes. The most common illnes caused by obesity is type II diabetic, arterial overpresure, lipidic managent disturbane, coronary heart disease, encephalopathy, breathing problems, cholecystolithiasis, degenerative joint disease and some of the cancers.

Skin changes, which accompany obesity, are in general vascural disturbances. Swelling, heavy legs feeling, difficulties with the circulation of he lymph to lower limbs and varicose veins. The last ones are vessel distentions of mainly lower limbs, connected with dissaperiance springy fibers in their divisions and ineficiency of venous valves. The other important problem is cellulit but more about it some other time.

Dr n. med. MAGDALENA CIUPIŃSKA
specjalista dermatolog


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