„Nejd\u016fle\u017eit\u011bj\u0161\u00ed je vlastn\u00ed rozhodnut\u00ed za\u010d\u00edt n\u011bco se svou v\u00e1hou d\u011blat. \u010c\u00edm d\u0159\u00edve, t\u00edm l\u00e9pe. Pokud ano, je dobr\u00e9 sv\u00e9 rozhodnut\u00ed zkonzultovat se sv\u00fdm praktick\u00fdm l\u00e9ka\u0159em, kter\u00fd n\u00e1m doporu\u010d\u00ed specializovan\u00e9 st\u0159edisko obezitologie.“<\/p>\n
Rozhovor s internistkou MUDr. V\u011brou Sta\u0148kovou<\/p>\n
– Co je to obezita a jak m\u016f\u017eeme poznat, \u017ee se n\u00e1s t\u00fdk\u00e1?<\/p>\n
Obezita pat\u0159\u00ed mezi tzv. civiliza\u010dn\u00ed nemoci a je nej\u010dast\u011bj\u0161\u00edm metabolick\u00fdm onemocn\u011bn\u00edm dne\u0161n\u00ed doby. Je charakterizov\u00e1na pozitivn\u00ed energetickou bilanc\u00ed, tedy vy\u0161\u0161\u00edm p\u0159\u00edjmem energie ne\u017e jej\u00edm v\u00fddejem. Obezita pat\u0159\u00ed spolu s kou\u0159en\u00edm a alkoholismem mezi t\u0159i hlavn\u00ed ovlivniteln\u00e9 faktory nemocnosti a \u00famrtnosti. Ke zhodnocen\u00ed v\u00e1hy a tedy i obezity se nej\u010dast\u011bji pou\u017e\u00edv\u00e1 index BMI (body mass index). Dal\u0161\u00edm vhodn\u00fdm hodnocen\u00edm nadv\u00e1hy je index WHR (waist to hip ratio \u2013 pom\u011br obvodu pasu a bok\u016f). U \u017een by toto \u010d\u00edslo nem\u011blo p\u0159es\u00e1hnout 0,8, u mu\u017e\u016f1,0.<\/p>\n
– Jak\u00e9 jsou nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010diny vzniku obezity?<\/p>\n
P\u0159\u00ed\u010diny obezity d\u011bl\u00edme na prim\u00e1rn\u00ed a sekund\u00e1rn\u00ed. Mezi prvotn\u00ed, ovlivniteln\u00e9, p\u0159\u00ed\u010diny, \u0159ad\u00edme hlavn\u011b p\u0159ej\u00edd\u00e1n\u00ed, nadm\u011brn\u00fd p\u0159\u00edsun tuk\u016f a p\u0159\u00edjem vysoce kalorick\u00e9ho j\u00eddla s malou syt\u00edc\u00ed schopnost\u00ed, zejm\u00e9na fastfoodov\u00e1 j\u00eddla, d\u00e1le jednostrann\u00e9 stravov\u00e1n\u00ed a \u0161patn\u00e9 stravovac\u00ed n\u00e1vyky, nej\u010dast\u011bji nepravideln\u00e1 strava a jedno hlavn\u00ed j\u00eddlo ve ve\u010dern\u00edch hodin\u00e1ch. V\u00fdsledkem je nadbytek tuku v t\u011ble a paradoxn\u011b nedostatek ostatn\u00edch \u017eivotn\u011b d\u016fle\u017eit\u00fdch slo\u017eek potravy. Velmi d\u016fle\u017eit\u00fdm a ovlivniteln\u00fdm faktorem obezity je nedostatek fyzick\u00e9 aktivity, dan\u00fd sedav\u00fdm zam\u011bstn\u00e1n\u00ed \u010di nedostatkem fyzick\u00e9 aktivity a sportu ve voln\u00e9m \u010dase. D\u00e1le sem m\u016f\u017eeme \u0159adit vliv psychick\u00fdch faktor\u016f, jako chronick\u00fd stres a nedostatek sp\u00e1nku. Sekund\u00e1rn\u00ed faktory vzniku obezity p\u0159\u00edli\u0161 ovlivnit nem\u016f\u017eeme, je to pod\u00edl endokrinn\u00edch chorob, onemocn\u011bn\u00ed mozku a obezita vyvolan\u00e1 jako vedlej\u0161\u00ed \u00fa\u010dinek n\u011bkter\u00fdch l\u00e9k\u016f.<\/p>\n
– Jak\u00fd vliv m\u00e1 obezita na zdrav\u00ed \u010dlov\u011bka?<\/p>\n
Obezita je spojena s \u0159adou komplikac\u00ed a p\u0159idru\u017een\u00fdch onemocn\u011bn\u00ed. D\u011bl\u00edme je na mechanick\u00e9 a metabolick\u00e9. Mechanick\u00e9 jsou d\u00e1ny vy\u0161\u0161\u00ed t\u011blesnou hmotnost\u00ed, zad\u00fdch\u00e1v\u00e1n\u00ed, vy\u0161\u0161\u00ed z\u00e1t\u011b\u017e\u00ed kloub\u016f, kter\u00e9 tak d\u0159\u00edve podl\u00e9haj\u00ed degenerativn\u00edm zm\u011bn\u00e1m ve smyslu artr\u00f3zy, bolesti zad, ploch\u00e9 nohy, \u010dast\u011bj\u0161\u00ed v\u00fdskyt k\u00fdl a \u00faraz\u016f. Pot\u00ed\u017ee d\u00fdchac\u00edho syst\u00e9mu \u2013 \u010dast\u00e9 chr\u00e1p\u00e1n\u00ed a apnoick\u00e9 pauzy vedouc\u00ed k chronick\u00e9mu nevysp\u00e1n\u00ed a \u00fanav\u011b. V\u00fdskyt ekz\u00e9m\u016f a stri\u00ed d\u00edky ko\u017en\u00edm z\u00e1hyb\u016fm a vy\u0161\u0161\u00ed potivosti. Metabolick\u00e9 komplikace obezity jsou d\u00e1ny hlavn\u011b vy\u0161\u0161\u00ed koncentrac\u00ed tuk\u016f koluj\u00edc\u00edch v krvi a jejich ukl\u00e1d\u00e1n\u00edm do c\u00e9v a org\u00e1n\u016f, kter\u00e9 naz\u00fdv\u00e1me aterosklerosou. Ateroskler\u00f3za je komplexn\u00ed onemocn\u011bn\u00ed vedouc\u00ed k takov\u00fdm komplikac\u00edm jako infarkt myokardu, vysok\u00fd krevn\u00ed tlaku, porucha metabolismu glukosy, a tedy vzniku cukrovky, ztukovat\u011bn\u00ed jater, posti\u017een\u00ed slinivky a onemocn\u011bn\u00ed \u017elu\u010dn\u00edku a \u017elu\u010dov\u00fdch cest. Obezita se \u0159ad\u00ed i mezi rizikov\u00e9 faktory vzniku n\u00e1dor\u016f. Krom\u011b zdravotn\u00edch rizik m\u00e1 obezita tak\u00e9 v\u00fdznamn\u00fd vliv psychosoci\u00e1ln\u00ed. Ob\u00e9zn\u00ed lid\u00e9 jsou \u010dasto spole\u010densky diskriminov\u00e1ni, co\u017e vede k \u00fazkosti, depresi a dal\u0161\u00edm poruch\u00e1m p\u0159\u00edjmu potravy.<\/p>\n
– Pokud se rozhodneme, \u017ee s na\u0161\u00ed nep\u0159im\u011b\u0159enou v\u00e1hou chceme n\u011bco ud\u011blat, na koho se obr\u00e1tit?<\/p>\n
Nejd\u016fle\u017eit\u011bj\u0161\u00ed je vlastn\u00ed rozhodnut\u00ed za\u010d\u00edt n\u011bco se svou v\u00e1hou d\u011blat. \u010c\u00edm d\u0159\u00edve, t\u00edm l\u00e9pe. Pokud se rozhodneme zredukovat svou v\u00e1hu, je dobr\u00e9 sv\u00e9 rozhodnut\u00ed zkonzultovat se sv\u00fdm praktick\u00fdm l\u00e9ka\u0159em, kter\u00fd n\u00e1m doporu\u010d\u00ed specializovan\u00e9 st\u0159edisko obezitologie.<\/p>\n
– Jak prob\u00edh\u00e1 n\u00e1sledn\u011b sni\u017eov\u00e1n\u00ed hmotnosti?<\/p>\n
D\u016fle\u017eit\u00e9 je tak\u00e9 stanoven\u00ed si splniteln\u00e9ho c\u00edle a vyvarovat se st\u0159\u00eddav\u00e9ho \u00fabytku a n\u00e1r\u016fstu hmotnosti. Nemocn\u00ed s kol\u00edsavou t\u011blesnou hmotnost\u00ed jsou z hlediska onemocn\u011bn\u00ed srdce a c\u00e9v rizikov\u011bj\u0161\u00ed ne\u017e osoby s konstantn\u00ed v\u00e1hou. Z\u00e1kladem je zm\u011bna stravovac\u00edch n\u00e1vyk\u016f a spojen\u00ed diety se sportem. Vyb\u00edrat hlavn\u011b potraviny bohat\u00e9 na vl\u00e1kninu, ovoce a zeleninu, celozrnn\u00e9 pe\u010divo, denn\u011b j\u00edst t\u0159i hlavn\u00ed j\u00eddla, dostate\u010dn\u011b p\u00edt (okolo 1,5 litru denn\u011b), omezit slazen\u00e9 a sycen\u00e9 n\u00e1poje. Nedoporu\u010duje se p\u0159\u00edsn\u00fd z\u00e1kaz n\u011bkter\u00fdch j\u00eddel a hladov\u011bn\u00ed, kter\u00e9 \u010dasto vedou k poru\u0161e diety ve smyslu n\u00e1razov\u00e9ho p\u0159ej\u00edd\u00e1n\u00ed a nekontrolovan\u00e9ho mls\u00e1n\u00ed. Doporu\u010dila bych vyhnout se nejr\u016fzn\u011bj\u0161\u00edm inzer\u00e1t\u016fm a rychl\u00fdm diet\u00e1m, kter\u00fdch je pln\u00fd internet. Velmi \u010dasto jsou jednostrann\u00e9 a nevyv\u00e1\u017een\u00e9, vedou sice k poklesu hmotnosti, ale po jejich skon\u010den\u00ed se kila naberou zp\u011bt, mnohdy i s n\u011bkolika nav\u00edc oproti p\u016fvodn\u00ed v\u00e1ze. Nejlep\u0161\u00edch \u00fasp\u011bch\u016f je mo\u017eno dos\u00e1hnout kombinac\u00ed \u00fapravy stravovac\u00edch n\u00e1vyk\u016f, psychoterapie a t\u011blesn\u00e9ho tr\u00e9ninku.<\/p>\n
– Jak je to s chirurgick\u00fdm \u0159e\u0161en\u00edm obezity a kdy se k n\u011bmu p\u0159istupuje?<\/p>\n
Chirurgick\u00e9 \u0159e\u0161en\u00ed obezity spo\u010d\u00edv\u00e1 v band\u00e1\u017ei \u017ealudku, kdy se p\u0159i\u0161krt\u00ed gumov\u00fdm krou\u017ekem horn\u00ed \u010d\u00e1st \u017ealudku. Vznikne tak vak, kter\u00fd se p\u0159i j\u00eddle napln\u00ed a vede k pocitu sytosti ji\u017e po mal\u00e9m mno\u017estv\u00ed j\u00eddla. K tomuto z\u00e1kroku se ov\u0161em p\u0159istupuje a\u017e po vy\u010derp\u00e1n\u00ed a selh\u00e1n\u00ed v\u0161ech konzervativn\u00edch postup\u016f, u BMI? 40 a u v\u00fdznamn\u00fdch poruch metabolismu.<\/p>\n
– M\u016f\u017ee si ka\u017ed\u00fd z n\u00e1s s\u00e1m zjistit jak na tom s obezitou je?<\/p>\n
Ano. Nejpou\u017e\u00edvan\u011bj\u0161\u00ed metodou zji\u0161t\u011bn\u00ed a klasifikace obezity je index BMI. Vypo\u010d\u00edt\u00e1 se jako hmotnost (kg)\/ v\u00fd\u0161ka (m2). Norm\u00e1ln\u00ed v\u00e1ha m\u00e1 BMI 18,9 \u2013 24,9. BMI? 18,9 je podv\u00e1ha, BMI 25 \u2013 29,9 ozna\u010dujeme nadv\u00e1ha, BMI 30 a v\u00edce je obezita.<\/p>\n","protected":false},"excerpt":{"rendered":"
„Nejd\u016fle\u017eit\u011bj\u0161\u00ed je vlastn\u00ed rozhodnut\u00ed za\u010d\u00edt n\u011bco se svou v\u00e1hou d\u011blat. \u010c\u00edm d\u0159\u00edve, t\u00edm l\u00e9pe. Pokud ano, je dobr\u00e9 sv\u00e9 rozhodnut\u00ed zkonzultovat se sv\u00fdm praktick\u00fdm l\u00e9ka\u0159em, […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14556,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-14733","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14733","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14733"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14733\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14556"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14733"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14733"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14733"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}