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In a young and healthy person, weight gain without a change in diet and weight gain in the abdomen is the first symptom of a possible metabolic syndrome. This is what Dr. Desimira Mironova, endocrinologist at Lozenets Hospital, said in an interview with BTA. According to her, after them appear shortness of breath, palpitations and fatigue.

In menopausal women, the accumulation of body mass in the waist area does not always indicate the presence of metabolic syndrome.

Among men suffering from obesity, reproductive problems are identified, added Dr. Mironova.

Proving metabolic syndrome begins with basic tests, and a blood count test shows nothing, the doctor said.

Metabolic center

A Metabolic Center is already working at Lozenets Hospital, which will bring together endocrinologists, gastroenterologists, psychologists, physiotherapists. Our goal is within a day or two the patient to be able to consult with several specialists and, if necessary, to do tests immediately, as we know how demotivating it affects people when they have to spend a few days to visit different doctors, she added. In the Metabolic Center, everyone who sees that there is a change in his weight, the size of clothes, the accumulation of fat tissue around the abdomen will be able to be examined. Metabolic syndrome is one of the few diseases in which patients seem to be disappointed with diagnosis because they think they are gaining weight because of a disease. It is not always necessary to include medication in therapy, as weight gain also occurs due to poor nutrition and lack of movement.

Obesity and metabolic syndrome among children

Children are in the priorities of pediatric endocrinologists, because cases of childhood obesity are already avalanche-like. In children, the criteria for the treatment of obesity are more specific, said Dr. Mironova.

In response to a question whether children gain weight because of a problem in hormonal balance or weight gain leads to an imbalance in hormones, Dr. Mironova said that both statements are true. There are monogenetic diseases associated with changes in a gene leading to genetic obesity. In these cases, the treatment is much more specific, she added and pointed out that drugs for this treatment are available in Europe. Factors of environment, nutrition, reduced motor activity and stagnant lifestyle, which in many cases parents stimulate by giving electronic devices to their children, can be factors in childhood obesity, especially if there is a family history. Studies done among mothers who were obese before their pregnancy show that the risk of a child developing metabolic syndrome and obesity by the time he enters puberty multiplied. Even if the family has a good motor culture and eats balanced when the child "encounters" junk food or other harmful food that is always sweeter, more tempting and highly marketed, he, sooner or later, reaches for it.

Taking diabetes medication for weight loss

The drug, which has recently been taken for weight loss purposes, has actually been registered and is used to treat type 2 diabetes, a disease associated with metabolic syndrome. There is another drug that is registered for the treatment of obesity, but is not reimbursed by health systems, added Dr. Mironova. According to her, a new, even more powerful drug is likely to be introduced, which shows a very good prognosis in terms of weight reduction – by 20 percent. There is a risk that people will decide that they will eat as they wish if they take such pills, she added. However, you can not drink pills for weight reduction without movement and a balanced diet. At some point, the intake of the drug will have to be stopped, and if the person has not changed his diet, a yo-yo effect will be achieved within about two years. The laziest way to lose weight is through medication, but it's not always the solution. Diet and physical activity are always included in therapy. If there is an additional disease associated with metabolic syndrome, then we treat it too, added the specialist.

Five extra pounds is not a reason to take a drug to reduce weight. Running in the park, swimming, walking and willpower will reduce the weight to the desired kilograms. Weight-reduction medications are for people suffering from obesity, not overweight, she added.

In 90 days, the brain begins to perceive food in a new way

Sugar is the drug of the 21st century, commented Dr. Mironova the desire to consume sweet foods. According to her, sugar is addictive many times more than drugs. This dependence is difficult to influence, and for this purpose psychotherapy, change of diet and lifestyle are needed. For the brain to begin to perceive food in a new way, 90 days are enough. We think we need sweets to reward ourselves, but we don't need it because we can live without taking in extra calories from sugar. Eating sweets is a problem of the brain, of the receptors on the tongue, and the effect is similar to dominoes and a closed cycle occurs. A difficult life moment and a certain psychological state can lead to an increase in food intake, receptors are affected, insulin resistance begins and becomes a vicious circle. In a stressful situation, most people resort to food.

The link between smoking cessation and weight gain has not been proven, said Dr. Mironova. It's a perception on a psychological level, it's a habit. In terms of habit, I would like to add that analyses have been done among patients undergoing bariatric surgery, after which they can lose up to 40-50 kilograms. The data show that one addiction is immediately replaced by another addiction, and very often the dependence on food is replaced by addiction to gambling, alcohol, even couples divorce.

Diagnosis for metabolic syndrome

The first symptom in a young, healthy person of the possible presence of metabolic syndrome is the most visible – weight gain and accumulation of body mass in the abdomen. Then there is shortness of breath, palpitations and fatigue. According to the doctor, it is necessary to do basic tests – lipid profile, blood sugar level testing, insulin sensitivity, liver enzymes, testing for internal inflammation, thyroid hormone testing. There is no need to immediately start by examining the level of cortisol and stress hormones.

Men and women

In men up to 45 years of age, the recommendation is to examine the level of testosterone. Obesity alters the formation of certain hormones. Very often, testosterone in men affected by obesity becomes much easier to estrogen – a female hormone than in men who do not have overweight or obesity. With such a change in hormones, a decrease in libido may occur. In fact, testosterone is a hormone that has a protective function against a man's heart, and when the testosterone level is low, the heart can suffer. If someone decides to get testosterone injectable – in adipose tissue, they will make it turn into estrogen, Dr. Mironova said. According to her, among obese men there are often reproductive problems.

Weight gain in the abdomen in postmenopausal women could be a signal of metabolic syndrome, although not necessarily. Estrogen protects a woman's bone system and heart, and when she enters menopause, her level decreases. Metabolic syndrome does not necessarily occur with the onset of menopause, but these women are more likely to develop it.

Payment of treatment

Health systems do not define obesity as a disease for which it makes sense for health funds to reimburse drugs, explained Dr. Mironova. Medicines for the treatment of obesity, however, are a serious item in the budget, and without them there is no way to prevent concomitant diseases, she added. According to her, the treatment of a patient who suffers from obesity and some other accompanying disease associated with it is very expensive. All this money can be saved long-term if obesity treatment is included, added Dr. Mironova.

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