Misnikova Inna Vladimirovna, doctor-an endocrinologist, a sleep, consultant Open clinic on Mira Avenue: “the Problem of excess weight, alas, now familiar to many. Often people eat irregularly, eat a lot of junk food, a little move. And the doctors, unfortunately, often believe that obesity is exclusively a problem of the patient, its payback for wrong way of life.
a Year and a half ago I was approached by a man 37 years of age, who came to the reception with my mother. His main complaint was the fact that he was rapidly gaining weight, and the weight is large enough – by the time he weighed 145 kg at growth of 168 cm, he had a severe obesity.
the question is concerned about his something else, he said that much of anything is no longer an issue. The main problem is whatever he did, the weight was constantly increasing. He sat on different diets; set earring for weight loss in the ear. And sometimes the weight really started to decline. However, after losing 10-15 pounds then the weight came back with a vengeance.
it was clear to Me that not only extra pounds it bother you – must be a lot of health problems that accompany such a weight. And when I started actively questioning, it appeared that his legs, as long as he can’t walk. Because of this, the choice of exercise is very limited, as from pain in the spine, the joints, so doctors ‘ recommendations to increase physical activity is simply not working.
the Fat he distributed on the so-called humanoid type. In which the hands and feet is not very full, but it greatly increases the belly and neck.
the more we talked, the more it became clear. The man opened the heart and told me that during the day, feels awful, feels a constant weakness, constantly falls asleep on the go. Even when he was sitting on reception started to camaret and mom picked up the conversation. She said that the son was married twice, both marriages failed, he has children, but problems with excess weight severely limit his life: he wants but can not have children.
it Turned out that the nights he cannot sleep and constantly goes to the toilet 6 or 7 times gets up in the night. And gradually sleep disturbances progressing. Sleep the patient surface, every rustle he wakes up. And he snores badly, sometimes even wakes up from his own snoring. In the morning, feels sleepy.
Another serious problem – he fell asleep at the wheel. Before quietly drove long distances, and now afraid of trying to be with someone or even not to drive because falling asleep while driving can all of a sudden. All this SIM��Toms, resulting in the violation of breathing during sleep.
it would Seem to me a patient who came in with the same complaint on excess weight. And when they started to understand, found a bunch of problems, which often remains residual, out-of-focus the attention of the doctor. Like in humans, obesity – so, are to blame. You need to eat less, move more – and all will be well. But experience and practice show that such patients are difficult to treat. They need a comprehensive approach; must take into account changes in many organs, the cardiovascular system and the liver (very often, these patients are steatosis, which threatens to cirrhosis in the future). Patients with metabolic syndrome, metabolic disorders due to weight gain.
Sometimes the weight exceeds the standard indicators are very few, and the metabolic disorders already there, all individually. So even a small weight gain, especially the deposition of fat in the abdomen, and most importantly – an increase in the waist (in women — more than 80 cm, in men more than 94 cm) should alert! Need to be tested and examined: are there any metabolic disorders?
But back to our patient: he was diagnosed severe stage of sleep apnea, which often occurs in people with excessive weight and large volume of the neck. If the male neck circumference over 43 cm (man usually knows the size of the shirt), it greatly increases the risk of apnea; these patients it is necessary to examine and prescribe treatment.
This patient, despite the fact that his mother had too much faith in the success of his treatment, did not believe that it will help, I thought that everything is tested that some extra costs; so, the patient, despite his half-asleep state, was determined to change my life. He knew that he was a young man, but cannot work, cannot create a family, and need something to do
We examined him and began to heal. I gave him medication to reduce weight, corrected diet. And now, after months, I can say that the result is pleasing – it doesn’t just have a different feel. He decreased the risk of heart attack and stroke. He almost completely changed his life.
When we began to treat sleep apnea, it improved memory, reaction, he ceased to sleep during the day, became easy to drive – and that’s even with the original weight. Then gradually on the background of treatment decreased weight and improved objective health indicators (glucose levels, cholesterol, blood). And then develop and personal life – he has established a relationship with the children.
To the last consultation, he already weighed about 100 lbs. still have a bit to lose weight and keep the weight off. In addition, normalized blood sugar, although it was pre-diabetes (this is a reversible state, gr��samee the development of diabetes type 2 if nothing is done).
of Course, in such patients, the physician should rule out hormonal disturbances (e.g., thyroid dysfunction or disease of the adrenal glands can lead to weight gain and sleep disturbance). But our patient’s hormones were normal.
Here we were dealing with a very common today alimentary-constitutional obesity when due to the possible genetic predisposition people begin to overeat, eat unhealthy food, convenience food, drinks with sweeteners, and it leads to a permanent progressive weight gain.
we must remember that many of the metabolic disorders associated with sleep disorders. The quality and quantity of sleep is a mandatory component of a healthy lifestyle: a person should sleep 7-8 hours and without disorders of sleep structure that he recovers fully. However, in patients with violation of breathing during sleep deep sleep is often virtually absent, they are not restored and experience daytime sleepiness that are harmful for the metabolism.
Any problems with excess weight require treatment to the doctor. If you reduce weight cannot on the background of dietary recommendations or physical activity, if a person has weakness during the day, drowsiness, snoring and sleep disorders requires consultation with a specialist, not just an endocrinologist, but also a specialist in sleep medicine. Such patients today are many, but not all of them know that their problems can be associated with sleep disorders. So be sure about your health and in time seek the advice of a doctor!