Russian and foreign experts defend “responsible self-treatment of obesity”
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Pandemics in the modern world are more than enough. As soon as the coronavirus left the main place on the agenda, experts were quick to remind that humanity is not suffering from covid alone. Other global epidemics gaining momentum in the 21st century include allergic diseases, depression, and diabetes. And according to many experts, the obesity pandemic is now at the top of the ranking of planetary dangers.
– You can often hear: what is there to discuss, you need to eat less, and that’s it. In fact, obesity is a very serious disease that has become a global problem. In 2000, 325 million inhabitants of the Earth suffered from it, in 2020 – already 650 million, and by 2030, according to forecasts, 1.1 billion people will have obesity, – said Yuri Zhulev, co-chairman of the Russian Union of Patients (VSP ), inaugurating the forum “Responsible self-treatment of patients with overweight and obesity”.
In Russia, according to experts, body weight goes off scale (it is with an excessive excess of kilograms that the diagnosis of “obesity” is made, see “Be informed”) in a third of the adult population. Among children and adolescents, 16-17% are overweight. “The number is terrifying, because this is our future,” Zhulev said. Forum participants cited research data: almost one in two (about 50%) of those who were overweight at age 6 face the same problem as in adulthood (usually after age 30). So, the hopes of parents that “children’s fat” will disappear forever, the child will “outgrow” – alas, they are often not justified. As they say, take care of a slim waist from an early age.
Obesity literally steals years from a person’s life: it is reduced by an average of 15 years with a pronounced stage of the disease, doctors warn. Today it is known that excess weight actively participates in the development of cardiovascular diseases, diabetes and many types of cancer. “Therefore, we propose to recognize obesity as a socially significant disease. This will allow us to form a support system for patients,” explained Yury Zhulev.
At the same time, the so-called responsible self-treatment plays a very important role in the fight against being overweight, the experts noted. What it is?
FIVE PRINCIPLES OF RESPONSIBLE SELF-TREATMENT
In fact, the attitude of most doctors to the word “self-medication” is traditionally skeptical, if not condemning.
“However, today the whole world is beginning to understand self-treatment as responsibility for one’s own health, self-help, self-care,” Yan Vlasov, VSP Co-Chairman, Doctor of Medical Sciences, said at the forum.
In the treatment of obesity, more than anywhere else, a lot depends on the patient himself, his behavior, discipline, adds Yuri Zhulev. These are the five main components of responsible self-treatment of overweight patients identified by the forum experts.
1. Correct diagnosis.
Often people underestimate the scale of their fullness, said Antonina Starodubova, chief nutritionist at the Moscow Department of Health, deputy director of the Federal Research Center for Nutrition, Biotechnology and Food Safety. For example, according to an FRC study, only 1.5% of parents of school-age children reported that their son or daughter was obese. 6.6% admitted that the child is overweight. While medical diagnoses showed: in fact, 18.6% of schoolchildren are overweight and 8.9% are obese. Feel the difference!
Therefore, experts advise to undergo professional diagnostics, during which, among other things, specialists can determine how much fat, muscle, etc. have.
! Where can you find all this? You can check for free during the medical examination (remember, it takes place at the district clinic you are attached to for service as per MHI policy). There are even more opportunities to diagnose overweight and obesity in health centers operating in all regions of the country, Oksana Drapkina, chief therapist of the Russian Ministry of Health, Academician of the Russian Academy of Sciences, told the forum. Such centers are initially “sharpened” for a healthy lifestyle and the fight against excess weight. You can find their addresses on the portal of the Ministry of Health.
2. Healthy eating and exercise.
Everyone knows the “golden” rule of losing weight: the number of calories consumed should be less than the amount used. Competent calorie reduction without compromising health (healthy eating) and reasonable physical activity help to achieve this, recalled Antonina Starodubova.
However, it is equally important to observe another principle, the nutritionist emphasized. You need to normalize nutrition and lose weight slowly, gradually, without stress, which in the end will only exacerbate the problem. “If you have been increasing your current body weight for several years, then reduce it slowly, in a calm mode, and not in a few months,” the expert urged.
3. Compliance with the doctor’s prescriptions.
Yes, yes, this can also be considered self-medication. The doctor gives the main recommendations, and then the patient himself must build a course of action for him to comply with them. Including, in some cases, making a decision independently, say, about the use of certain drugs as part of a doctor’s general prescriptions, forum participants explained.
By the way, which doctors to contact for the treatment of obesity? The question is not that simple, the experts pointed out. It is recommended to start with a therapist, and then you may need to see an endocrinologist, nutritionist, and even a geneticist. In some cases, a surgeon, when bariatric surgery is necessary for medical reasons (in some cases it can be performed free of charge, according to compulsory medical insurance).
4. Competent choice of drugs in pharmacies.
“The low adequacy of the selection of drugs in pharmacy chains is the scourge of responsible self-treatment,” said Yan Vlasov, co-chairman of the All-Russian Union of Patients. And he cited impressive data from one of the VSP studies. It turned out that in almost half of the cases (47%), pharmacists on their own initiative recommend a replacement if the patient has the drug he needs in the pharmacy. Moreover, in 61% of cases, this replacement is not a drug, but a dietary supplement – a dietary supplement!
With such a misfortune, of course, we have to fight. But this is a question for the regulatory authorities, the authorities, the experts concluded. What about non-medical patients? At the very least, read the instructions to understand: you are offered a medication or a dietary supplement.
5. Treatment control.
Everything is simple here. To understand whether you are on the right track, comrades who are losing weight, you need to periodically undergo control checks. Free – at the same place of the initial diagnosis: as part of a medical examination in your district or in a health center (see above).
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What is the diagnosis of obesity?
Endocrinologists use the following gradation (according to the clinical recommendations of the Ministry of Health of the Russian Federation):
– Body mass index (BMI, how to calculate – see below) from 30 to 34.9 – Obesity of the first degree,
– BMI from 35 to 39.9 – second degree obesity,
– BMI of 40 and above – 3rd degree obesity.
! How to calculate your body mass index:
– Take your height in meters, square it. Then divide your body weight in kg by the resulting figure. This is how you find out your body mass index (BMI).
– If the BMI is in the range of 18.5 – 24.9, then you have a normal weight;
– BMI from 25 to 29.9 – you may be overweight, you need to reduce it, but so far this is not a medical diagnosis;
! With a BMI over 30, you should definitely see a doctor.
