ETIOLOGY

OBESITY The cause of obesity is simple –

OBESITY IS CHARACTERIZED BY
EXCESSIVE ACCUMULATION OF
BODY FAT
consuming more calories than are
expended as energy.
Predisposing factors (Social factors,
gender, age, endocrine factors,
psychological factors, genetic factors,
physical activity, development factors,
brain damage)
CLASSIFICATIONS
(I) CLASSIFICATION BY EGOROV
1. Alimentary
2. Endocrine
3. Cerebral.

(II) CLASSIFICATION BY STAGES OF OBESITY.

A. According to Brock’s index (N: weight = height – 100).
I. Weight excess < 30 %.
II. Weight excess 30 – 50 %.
III. Weight excess 50 – 100 %.
IV. Weight excess > 100 %.
B. According to Kettle’s index (N: weight, kg – height, m2).
I. 27,5 – 29,9
II. 30,0 – 34,9
III. 35,0 – 39,9
IV. > 40,0
Classification of overweight in adults by BMI

Classification due to deposition of fat tissue.

- upper type (abdominal);
- lower type (gluteofemoralis).
CLASSIFICATION OF OBESITY
Primary obesity Secondary (symptomatic) obesity
I. Alimentary constitutive obesity I. With determined genetic defect.
1. Android (upper type, abdominal, visceral): II. Cerebral
a) with components of metabolic syndrome; 1. Tumor, trauma of brain.
b) with developed symptoms of metabolic 2. Systemic lesions of brain, infectious diseases.
syndrome. 3. Hormone-inactive tumors of hypophysis, “empty”
2. Gynoid (lower type, gluteal thigh). ephippium syndrome.
3. With marked disorder of nutritional behavior: 4. In mental diseases.
a) night eating syndrome; III. Endocrine
b) seasonal affective alternations; 1. Hypothalamic-pituitary (hypothalamic).
c) with hyperphagic reaction to stress. 2. Hypothyroid.
4. With Pickwick’s syndrome. 3. Hypoovarial.
4. Hypercorticoid.
5. With sleep apnea syndrome.
6. Combined.
OBESE PEOPLE COME TO THE DOCTOR NOT JUST COMPLAINING ABOUT THEIR
PHYSICAL CONDITION, BUT ALSO WITH COMPLICATIONS.
(CARDIOVASCULAR, PULMONARY, ORTHOPEDIC AND OTHERS).

Clinical particularities of hypothalamic obesity

1. Fast gain weight (20 – 30 kg during 1 – 2 years).
2. More frequent dysplastic localization of the fat.
3. The presence of the striae.
4. Symptoms associated with increased intracranial pressure and neurologic
picture (somnolence, raised appetite and others).
5. Signs of hypothalamic dysfunction (palpitation, hyperhydrosis,
hypertension).
1. weight reduction (to establish a caloric deficit by reducing intake below
output).- low-calorie diet, eat one portion, eating 4-5 times a day.
2. Physical activity-( regular, brings out positive emotions and in group)
3. Medications- Weight Loss Medications (Phentermine,
Topiramate/phentermine, Orlistat-prescription and over the counter,
Natrexone/bupropion, Lorcaserin, Liraglutide).
4. Physiotherapy. Massage, automassage, circulating shower-massage are very
effective in the treatment of the patients.
5. Surgery. Radical surgical treatment may offer some hope to persons with
morbid obesity (100 % overweight) in whom all others treatments have
failed.