Kunenepa kwambiri

Zamkati

• Kodi kunenepa kwambiri ndi chiyani?
• Kodi kunenepa kwambiri kumayikidwa bwanji?
• Kodi kunenepa kwambiri kwaubwana ndi chiyani?
• Nchiyani chimayambitsa kunenepa kwambiri?
• Ndani ali pachiwopsezo cha kunenepa kwambiri?
• Chibadwa
• Chilengedwe ndi dera
• Zamaganizidwe ndi zina
• Kodi kunenepa kumapezeka bwanji?
• Kodi mavuto a kunenepa kwambiri ndi ati?
• Kodi kunenepa kumathandizidwa bwanji?
• Ndi njira ziti zamakhalidwe ndi kusintha kwamakhalidwe zomwe zingathandize kuchepetsa thupi?
• Ndi mankhwala ati omwe amaperekedwa kuti muchepetse thupi?
• Kodi mitundu ya opaleshoni yochepetsa thupi ndi iti?
• Ofuna opaleshoni
• Kodi mungapewe bwanji kunenepa kwambiri?

Kodi kunenepa kwambiri ndi chiyani?

Mndandanda wamagulu amthupi (BMI) ndi mawerengedwe omwe amatengera kulemera ndi kutalika kwa munthu kuyeza kukula kwa thupi.

Akuluakulu, kunenepa kwambiri kumatanthauza kukhala ndi BMI ya, malinga ndi Centers for Disease Control and Prevention (CDC).

Kunenepa kwambiri kumayenderana ndi chiopsezo chachikulu cha matenda akulu, monga mtundu wa 2 shuga, matenda amtima, ndi khansa.

Kunenepa kwambiri n'kofala. CDC ikuyerekeza kuti azaka 20 aku America azaka 20 kapena kupitilira apo anali ndi kunenepa kwambiri mu 2017 mpaka 2018.

Koma BMI sizinthu zonse. Ili ndi zoperewera ngati metric.

Malinga ndi malipoti a: "Zinthu monga zaka, kugonana, fuko, ndi minofu zimatha kusokoneza ubale wapakati pa BMI ndi mafuta amthupi. Komanso, BMI siyisiyanitsa pakati pa mafuta owonjezera, minofu, kapena mafupa, ndipo siyikupereka chisonyezo chilichonse chogawa mafuta pakati pa anthu. "

Ngakhale pali zoperewera izi, BMI ikupitilizabe kugwiritsidwa ntchito ngati njira yoyezera kukula kwa thupi.

Kodi kunenepa kwambiri kumayikidwa bwanji?

Zotsatirazi zimagwiritsidwa ntchito kwa achikulire omwe ali ndi zaka zosachepera 20:

Kodi kunenepa kwambiri kwaubwana ndi chiyani?

Kuti adotolo azindikire mwana wazaka zopitilira 2 kapena wachinyamata wonenepa kwambiri, BMI yawo iyenera kukhala ya anthu amsinkhu wawo komanso kugonana kwachilengedwe:

Kuyambira 2015 mpaka 2016, (kapena pafupifupi 13.7 miliyoni) achichepere aku America azaka zapakati pa 2 ndi 19 amawonedwa kuti ali ndi kunenepa kwambiri kwamankhwala.

Nchiyani chimayambitsa kunenepa kwambiri?

Kudya ma calorie ambiri kuposa momwe mumawotchera pochita masewera olimbitsa thupi tsiku lililonse - nthawi yayitali - kumatha kubweretsa kunenepa kwambiri. Popita nthawi, ma calories owonjezerawa amawonjezera ndikupangitsa kunenepa.

Koma sikuti nthawi zonse zimangokhala ndi zopatsa mphamvu komanso zopatsa mphamvu, kapena kukhala moyo wongokhala. Ngakhale izi ndi zomwe zimayambitsa kunenepa kwambiri, zina zimayambitsa zomwe simungathe kuzilamulira.

Zomwe zimayambitsa kunenepa kwambiri ndi izi:

• ma genetics, omwe angakhudze momwe thupi lanu limapangidwira chakudya kukhala mphamvu komanso momwe mafuta amasungidwa
• Kukula, komwe kumatha kuchepa minofu ndikuchepetsa kagayidwe kachakudya, zomwe zimapangitsa kuti zikhale zosavuta kunenepa
• kusagona mokwanira, zomwe zingayambitse kusintha kwa mahomoni komwe kumakupangitsani kumva kuti muli ndi njala komanso kulakalaka zakudya zina zamafuta ambiri
• kutenga mimba, kulemera komwe kumapezeka panthawi yapakati kumatha kukhala kovuta kutaya ndipo pamapeto pake kumapangitsa kunenepa kwambiri

Matenda ena amathanso kubweretsa kunenepa, zomwe zingayambitse kunenepa kwambiri. Izi zikuphatikiza:

• polycystic ovary syndrome (PCOS), vuto lomwe limayambitsa kusamvana kwa mahomoni oberekera achikazi
• Matenda a Prader-Willi, omwe amapezeka pobadwa omwe amachititsa njala yambiri
• Cushing syndrome, vuto lomwe limakhalapo chifukwa chokhala ndi milingo yayikulu ya cortisol (mahomoni opsinjika) m'dongosolo lanu
• hypothyroidism (chithokomiro chosagwira ntchito), vuto lomwe chithokomiro chimatulutsa mahomoni ena ofunikira
• osteoarthritis (OA) ndi zina zomwe zimayambitsa zowawa zomwe zingayambitse kuchepa kwa ntchito

Ndani ali pachiwopsezo cha kunenepa kwambiri?

Kuphatikizana kovuta kumatha kuwonjezera chiopsezo cha munthu kunenepa kwambiri.

Chibadwa

Anthu ena ali ndi majini omwe amawapangitsa kukhala kovuta kuti achepetse kunenepa.

Chilengedwe ndi dera

Malo omwe muli kunyumba, kusukulu, komanso mdera lanu zitha kutengera momwe mumadyera komanso zomwe mumadya, komanso momwe mumagwirira ntchito.

Mutha kukhala pachiwopsezo chachikulu cha kunenepa kwambiri ngati:

• khalani m'dera lomwe mumakhala zakudya zochepa kapena mungakhale ndi chakudya chambiri, monga malo odyera mwachangu
• simunaphunzirepo kuphika zakudya zabwino
• musaganize kuti mungakwanitse kugula zakudya zopatsa thanzi
• malo abwino osewerera, kuyenda, kapena kuchita masewera olimbitsa thupi m'dera lanu

Zamaganizidwe ndi zina

Matenda okhumudwa nthawi zina amatsogolera kunenepa, chifukwa anthu ena amatha kukhala chakudya kuti atonthozedwe. Mankhwala ena opatsirana pogonana amathanso kuwonjezera chiwopsezo chokunenepa.

Kusiya kusuta nthawi zonse ndi chinthu chabwino, koma kusiya kungayambitsenso kunenepa. Kwa anthu ena, zimatha kubweretsa kunenepa. Pachifukwachi, nkofunika kuganizira za zakudya ndi masewera olimbitsa thupi pamene mukusiya, makamaka mutangoyamba kumene.

Mankhwala, monga steroids kapena mapiritsi oletsa kubereka, amathanso kukulitsa chiopsezo chokunenepa.

Kodi kunenepa kumapezeka bwanji?

BMI ndiyowerengera koyipa kwa kulemera kwa munthu poyerekeza ndi kutalika kwake.

Njira zina zolondola zamafuta amthupi ndi magawidwe amafuta amthupi ndi monga:

• kuyezetsa khungu
• kuyerekezera m'chiuno ndi m'chiuno
• kuyesa zowunika, monga ma ultrasound, ma scan a CT, ndi ma MRI scan

Dokotala wanu amathanso kuyitanitsa mayeso ena kuti athandizire kuzindikira zovuta zakhudzana ndi kunenepa kwambiri. Izi zingaphatikizepo:

• kuyezetsa magazi kuti awone kuchuluka kwa cholesterol ndi shuga
• kuyesa kwa chiwindi
• kuwunika matenda ashuga
• mayesero a chithokomiro
• kuyesa mtima, monga electrocardiogram (ECG kapena EKG)

Kuyeza kwa mafuta m'chiuno mwanu kumaneneratu za chiwopsezo chanu cha matenda obwera chifukwa cha kunenepa kwambiri.

Kodi mavuto a kunenepa kwambiri ndi ati?

Kunenepa kwambiri kumatha kubweretsa zoposa kungolemera kokha.

Kukhala ndi mafuta ochulukirapo thupi ndi minofu kumapanikiza mafupa anu komanso ziwalo zanu zamkati. Zimakulitsanso kutupa m'thupi, komwe kumaganiziridwa kuti kumawopsa ndi khansa. Kunenepa kwambiri kumayambitsanso matenda a shuga amtundu wa 2.

Kunenepa kwambiri kumalumikizidwa ndi zovuta zingapo zathanzi, zina zomwe zimatha kukhala zowopsa ngati sichichiritsidwa:

• mtundu wa 2 shuga
• matenda amtima
• kuthamanga kwa magazi
• khansa (mawere, kholoni, ndi endometrium)
• sitiroko
• matenda a ndulu
• mafuta chiwindi matenda
• cholesterol yambiri
• kugona tulo ndi mavuto ena kupuma
• nyamakazi
• osabereka

Kodi kunenepa kumathandizidwa bwanji?

Ngati muli ndi kunenepa kwambiri ndipo mwalephera kuonda panokha, thandizo lachipatala lilipo. Yambani ndi dokotala wanu woyang'anira chisamaliro choyambirira, yemwe atha kukutumizirani kwa katswiri wazakudya m'dera lanu.

Dokotala wanu angafunenso kugwira ntchito ndi inu monga gawo la gulu lomwe limakuthandizani kuti muchepetse kunenepa. Gululi lingaphatikizepo wazakudya zamankhwala, wothandizira, kapena ena othandizira azaumoyo.

Dokotala wanu adzagwira nanu ntchito pakusintha njira zofunika pamoyo. Nthawi zina, amalimbikitsanso mankhwala kapena opaleshoni yochepetsa thupi. Dziwani zambiri za chithandizo cha kunenepa kwambiri.

Ndi njira ziti zamakhalidwe ndi kusintha kwamakhalidwe zomwe zingathandize kuchepetsa thupi?

Gulu lanu lazachipatala lingakuphunzitseni zosankha pazakudya ndikuthandizani kukhazikitsa dongosolo labwino la kudya lomwe limakupindulitsani.

Dongosolo lokonzekera zolimbitsa thupi ndikuwonjezera zochitika zatsiku ndi tsiku - mpaka mphindi 300 pasabata - zithandizira kukulitsa mphamvu, kupirira, ndi kagayidwe kabwino ka thupi.

Upangiri kapena magulu othandizira amathanso kuzindikira zoyambitsa zosayenera ndikuthandizani kuthana ndi nkhawa zilizonse, kukhumudwa, kapena vuto lakudya.

Kusintha kwamakhalidwe ndi machitidwe ndi njira zomwe ana amakonda kuwonda, pokhapokha atakhala onenepa kwambiri.

Ndi mankhwala ati omwe amaperekedwa kuti muchepetse thupi?

Dokotala wanu amathanso kukupatsani mankhwala ena ochepetsa thupi kuphatikiza pakudya ndi kuchita masewera olimbitsa thupi.

Mankhwala nthawi zambiri amaperekedwa pokhapokha ngati njira zina zochepetsera sizigwire ntchito komanso ngati muli ndi BMI ya 27.0 kapena kupitilira apo kuwonjezera pazokhudzana ndi kunenepa.

Mankhwala ochepetsa thanzi amalepheretsa mafuta kuyamwa kapena kupondereza njala. Otsatirawa amavomerezedwa kuti agwiritsidwe ntchito kwakanthawi (osachepera masabata 12) ndi Food and Drug Administration (FDA):

• fentamini / topiramate (Qsymia)
• naltrexone / bupropion (Letsani)
• magalasi (Saxenda)
• orlistat (Alli, Xenical), yekhayo amene akuvomerezedwa ndi FDA kuti agwiritsidwe ntchito kwa ana azaka 12 kapena kupitirira

Mankhwalawa amatha kukhala ndi zovuta zina. Mwachitsanzo, orlistat imatha kubweretsa mafuta komanso mafinya, kuthamanga mwachangu, ndi mpweya.

Dokotala wanu adzakuyang'anirani mosamala mukamamwa mankhwalawa.

Mu February 2020, a FDA adapempha kuti mankhwala osokoneza bongo a lorcaserin (Belviq) achotsedwe kumsika waku US. Izi ndichifukwa chowonjezeka cha matenda a khansa mwa anthu omwe adatenga Belviq poyerekeza ndi placebo.

Ngati mukutenga Belviq, lekani kuyitenga ndikulankhula ndi omwe amakuthandizani zaumoyo za njira zina zothandizira kuchepetsa kulemera.

Phunzirani zambiri za kuchotsedwa ndipo apa.

Kodi mitundu ya opaleshoni yochepetsa thupi ndi iti?

Kuchita opaleshoni yochepetsa thupi kumatchedwa opaleshoni ya bariatric.

Opaleshoni yotereyi imagwira ntchito poletsa kuchuluka kwa zakudya zomwe mungadye bwino kapena poletsa thupi lanu kuti lisamwe chakudya ndi zopatsa mphamvu. Nthawi zina zimatha kuchita zonse ziwiri.

Opaleshoni yochepetsa thupi siyokonzekera mwachangu. Ndi opaleshoni yayikulu ndipo imatha kukhala ndi zoopsa zazikulu. Pambuyo pake, anthu omwe akuchitidwa opaleshoni adzafunika kusintha momwe amadyera komanso kuchuluka kwa zomwe amadya, apo ayi atha kudwala.

Komabe, zosankha zopanda chithandizo sizothandiza nthawi zonse kuthandiza anthu onenepa kwambiri kuti achepetse kunenepa ndikuchepetsa chiopsezo cha comorbidities.

Mitundu ya opaleshoni yochepetsa thupi ndi monga:

• Opaleshoni yodutsa m'mimba. Pochita izi, dotolo wanu amapanga thumba laling'ono pamwamba pamimba lanu lomwe limalumikizana ndi matumbo anu aang'ono. Zakudya ndi zakumwa zimadutsa m'thumba ndikulowa m'matumbo, zimadutsa m'mimba. Amadziwikanso kuti opaleshoni ya Roux-en-Y gastric bypass (RYGB).
• Laparoscopic chosinthika chapamimba banding (LAGB). LAGB imagawaniza m'mimba mwanu m'matumba awiri pogwiritsa ntchito gulu.
• Opaleshoni yamanja m'mimba. Njirayi imachotsa gawo m'mimba mwanu.
• Kusintha kwa Biliopancreatic ndikusintha kwa duodenal. Njirayi imachotsa m'mimba mwanu.

Ofuna opaleshoni

Kwa zaka makumi ambiri, akatswiri amalimbikitsa kuti achikulire ofuna kuchita opaleshoni yochepetsa thupi akhale ndi BMI osachepera 35.0 (magulu 2 ndi 3).

Komabe, mu malangizo a 2018, American Society for Metabolic and Bariatric Surgery (ASMBS) idavomereza kuchitidwa opaleshoni yolemetsa kwa achikulire omwe ali ndi BMIs a 30.0 mpaka 35.0 (class 1) omwe:

• afanana ndi zovuta zina, makamaka mtundu wa 2 shuga
• sanawone zotsatira zolimba kuchokera kuchipatala, monga kudya ndi kusintha kwa moyo

Kwa anthu omwe ali ndi kunenepa kwambiri m'kalasi 1, opaleshoni imathandiza kwambiri kwa iwo a zaka zapakati pa 18 ndi 65.

Anthu nthawi zambiri amayenera kuonda asanayambe opaleshoni. Kuphatikiza apo, nthawi zambiri amapatsidwa upangiri kuti awonetsetse kuti onse ali okonzeka kutengeka ndi opareshoni ndipo ali okonzeka kusintha zina ndi zina pamoyo wawo momwe angafunikire.

Malo ochitira opaleshoni ochepa ku United States ndiwo amachita izi kwa ana ochepera zaka 18.

Kodi mungapewe bwanji kunenepa kwambiri?

Pakhala kuwonjezeka kwakukulu kwa kunenepa kwambiri ndi matenda okhudzana ndi kunenepa kwambiri m'zaka makumi angapo zapitazi. Ichi ndichifukwa chake madera, mayiko, ndi boma la fedulo akuyika chidwi pa zisankho zabwino ndi ntchito kuti zithandizire kutaya kunenepa kwambiri.

Pamunthu wanu, mutha kuthandiza kuti muchepetse kunenepa ndi kunenepa kwambiri posankha moyo wathanzi:

• Khalani ndi masewera olimbitsa thupi ngati kuyenda, kusambira, kapena kupalasa njinga kwa mphindi 20 mpaka 30 tsiku lililonse.
• Idyani bwino posankha zakudya zopatsa thanzi, monga zipatso, ndiwo zamasamba, mbewu zonse, ndi mapuloteni owonda.
• Idyani zakudya zonenepa kwambiri, zonenepetsa kwambiri.