Obesity Treatment

Obesity is a chronic disease characterized by excessive accumulation of adipose tissue and has a significant impact on the functioning of the entire body. It is associated with metabolic disorders, hormonal dysregulation, and an increased risk of developing serious comorbid conditions; therefore, it cannot be considered solely an aesthetic issue.

It is important to distinguish between excess body weight and obesity. Excess body weight is an initial condition that may not yet be accompanied by significant metabolic disturbances, whereas obesity has clearly defined medical criteria and requires a comprehensive medical approach. Timely identification of the problem and appropriate management strategies help reduce health risks and prevent disease progression.

Clinical manifestations of obesity develop gradually and often intensify as body weight increases. In the early stages, symptoms of obesity may be minimal, which is why patients often attribute a decline in well-being to fatigue or age-related changes. However, as adipose tissue accumulates, the load on the body’s organs and systems increases significantly.

The most common symptoms of obesity include:

• gradual or rapid weight gain;

• shortness of breath during physical exertion;

• increased fatigue and reduced work capacity;

• excessive sweating;

• pain in the joints and spine;

• sleep disturbances, including snoring;

• elevated blood pressure;

• decreased tolerance to physical activity.

Special attention is paid to the impact of excess body weight on the cardiovascular system. Cardiac obesity is associated with increased strain on the myocardium, which over time may lead to structural and functional changes, the development of arterial hypertension, and an increased risk of cardiovascular complications.

Timely identification of obesity symptoms is an important step in assessing the severity of disorders and determining the optimal strategy for further treatment.

Determining the degree of obesity is an important stage of clinical assessment, as it allows evaluation of the severity of disorders, the risk of complications, and the need for intensive medical intervention. The classification is based on body mass index (BMI) and is used in international clinical guidelines.

The medical classification includes the following degrees of obesity:

• obesity class I (BMI 30–34.9) — the initial form of the disease, associated with an increased risk of metabolic disorders, arterial hypertension, and overload of the musculoskeletal system;

• obesity class II (BMI 35–39.9) — pronounced accumulation of adipose tissue, significantly increasing the likelihood of developing type 2 diabetes mellitus, cardiovascular, and respiratory disorders;

• obesity class III (BMI ≥ 40) — a severe form of the disease, associated with a high risk of serious complications and a substantial reduction in quality of life.

In clinical practice, the term morbid obesity is used to describe the most severe forms of obesity. It usually refers to class III obesity or obesity with a BMI ≥ 35 combined with severe comorbid conditions. This condition requires advanced diagnostic evaluation, careful medical supervision, and an individually tailored treatment program.

For the initial assessment of body weight in medical practice, the body mass index is used. Body mass index is an indicator that reflects the ratio of body weight to height and allows an approximate evaluation of excess body weight or obesity.

To calculate the body mass index, the standard formula is applied: body weight (kg) / height (m²).

This body mass index calculation is a simple and accessible method of preliminary assessment; however, in clinical practice it is used as a basic tool that requires further professional interpretation.

According to generally accepted medical criteria, the normal body mass index ranges from 18.5 to 24.9. Values above this range indicate excess body weight or varying degrees of obesity.

When interpreting the results, the physician takes individual patient characteristics into account. In particular, when assessing body mass index in women, hormonal background and age-related changes are considered, while in men a potentially higher proportion of muscle mass, which may affect the final value, is taken into account.

It is important to note that body mass index does not reflect the distribution of adipose tissue and does not allow assessment of its visceral component. Therefore, to determine the degree of obesity as accurately as possible, the physician additionally evaluates waist circumference, type of obesity, results of laboratory and instrumental examinations, as well as the patient’s overall health status.

Body mass index is the first, but not the only, step in the comprehensive assessment of body weight in modern endocrinology.

The diagnosis of obesity is aimed not only at confirming excess body weight but also at identifying its causes, type, and degree, as well as detecting associated metabolic disorders. A comprehensive examination makes it possible to develop an individualized treatment strategy and assess health risks.

At the initial stage, the physician performs a clinical examination, reviews the patient’s medical history, evaluates body mass index values, waist circumference, and the distribution of adipose tissue. This allows a preliminary determination of the form and degree of obesity.

To clarify the causes and metabolic changes, laboratory tests are prescribed:

• complete blood count;

• biochemical blood analysis with assessment of the lipid profile and glucose levels;

• hormonal profile assessment when indicated;

• evaluation of liver function and other metabolic organs.

An important component of the assessment is instrumental diagnostics, which helps identify endocrine causes of weight gain and associated conditions. In particular, thyroid ultrasound may be performed to assess its structure and functional status, as well as ultrasound examinations of other organs when indicated.

Based on the results of the comprehensive diagnostic evaluation, the physician determines the mechanism of obesity development, identifies possible complications, and develops an individualized plan for further treatment and follow-up.

The treatment of obesity requires a systematic and individualized approach, as the condition has a multifactorial nature. At the private clinic, modern obesity treatment methods are applied, aimed not only at weight reduction but also at eliminating the causes of weight gain, correcting metabolic disorders, and preventing complications. This comprehensive approach forms the basis of effective obesity management.

The treatment strategy is selected individually, taking into account the type and degree of obesity, comorbid conditions, age, and lifestyle of the patient. The main obesity treatment methods used in clinical practice include:

• nutritional correction with the development of a personalized diet plan;

• lifestyle modification with a gradual increase in physical activity;

• pharmacological therapy, when indicated, to influence appetite, metabolism, and hormonal regulation;

• treatment of associated endocrine disorders that contribute to weight gain.

A comprehensive approach involves the participation of specialists from related fields. A cardiologist helps manage cardiovascular disorders, while a gastroenterologist and a dietitian assist in normalizing dietary habits and selecting an optimal nutrition plan. When necessary, a psychotherapist addresses psychological factors affecting eating behavior, and cosmetologists help improve appearance and skin condition after weight loss.

Special attention is given to patients with different forms of the condition. In the treatment of excess body weight, the primary focus is on preventing disease progression. Treatment of abdominal obesity is aimed at reducing visceral fat and lowering cardiovascular risks. In severe cases, particularly in the management of morbid obesity, an extended range of therapeutic measures is applied under continuous medical supervision.

The treatment approach also considers sex-specific characteristics. In women with obesity, therapy often requires hormonal correction and attention to reproductive health, whereas in men with obesity, treatment is focused on reducing visceral fat and preventing cardiovascular complications.

The comprehensive use of modern treatment methods makes it possible to achieve sustainable results, improve overall well-being, and reduce the risk of recurrent weight gain.

Obesity prevention is aimed at preventing excessive accumulation of adipose tissue and the development of related metabolic and cardiovascular disorders. It is relevant both for individuals with normal body weight and for patients with excess body weight, in whom the risk of disease progression is particularly high.

The main measures for obesity prevention include:

• establishing regular and balanced nutrition with control of dietary caloric intake;

• adhering to a consistent meal schedule without long intervals or overeating;

• maintaining an adequate level of physical activity, taking into account age and health status;

• monitoring body weight and waist circumference;

• normalizing sleep patterns and reducing the impact of chronic stress;

• timely treatment of endocrine and metabolic disorders;

• avoiding harmful habits that negatively affect metabolism.

Regular preventive medical follow-up is of particular importance, as it allows early detection of metabolic changes and lifestyle adjustment before clinically significant obesity develops. A comprehensive and systematic approach to prevention helps reduce the risk of disease development and maintain stable body weight in the long term.

Obesity treatment may involve various methods, ranging from conservative weight correction programs to pharmacological therapy and, when indicated, surgical interventions. The choice of the optimal approach depends on the type and degree of obesity, the patient’s overall health status, the presence of comorbid conditions, and previous treatment experience.

An individualized treatment program is developed by the physician after an in-person consultation and the necessary examinations. During the appointment, the appropriateness of specific treatment methods and the further management plan are determined.

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